Neural Correlates of Affective Influence on Choice

ERIC Educational Resources Information Center

Piech, Richard M.; Lewis, Jade; Parkinson, Caroline H.; Owen, Adrian M.; Roberts, Angela C.; Downing, Paul E.; Parkinson, John A.

2010-01-01

Making the right choice depends crucially on the accurate valuation of the available options in the light of current needs and goals of an individual. Thus, the valuation of identical options can vary considerably with motivational context. The present study investigated the neural structures underlying context dependent evaluation. We instructed…

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.

Attitudes of cannabis growers to regulation of cannabis cultivation under a non-prohibition cannabis model.

PubMed

Lenton, Simon; Frank, Vibeke A; Barratt, Monica J; Dahl, Helle Vibeke; Potter, Gary R

2015-03-01

How cannabis cultivation is dealt with under various examples of cannabis legalization or regulation is an important consideration in design of such schemes. This study aimed to (i) investigate support among current or recent cannabis growers, for various potential policy options for cannabis cultivation if prohibition were repealed, and (ii) explore the support for these options across countries, scale of growing operations, demographics, drug use and cannabis supply involvement variables. This study utilized data from the online web survey of largely 'small-scale' cannabis cultivators, aged 18yrs and over, in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Data from 1722 current and recent cannabis growers in Australia, Denmark and the UK, who were all asked about policy, were included in the analysis. It investigated support for various frameworks for cultivation: (no regulation (free market); adult only; growing licenses; restrictions on plant numbers; licensed business-only sale; approved commercial growing; etc.). Among current growers, support for these options were compared across countries, across scale of growing operations, and by demographics, drug use and crime variables. Although there were some between country differences in support for the various policy options, what was striking was the similarity of the proportions for each of the eight most popular policy options. Among current growers, many of these positions were predicted by demographic, drug use and cannabis growing variables which were conceptually congruent with these positions. The results have relevance for the provisions regarding cannabis cultivation in the design of new non-prohibitionist models of cannabis which are increasingly under consideration. It should be of interest to policy makers, drug policy researchers, law enforcement and cannabis cultivators. Copyright © 2014 Elsevier B.V. All rights reserved.

A Review of Pharmacological Treatment Options for Lung Cancer: Emphasis on Novel Nanotherapeutics and Associated Toxicity.

PubMed

England, Christopher G; Ng, Chin F; van Berkel, Victor; Frieboes, Hermann B

2015-01-01

Lung cancer remains a leading cause of death. Current treatment options are generally ineffective, highlighting the dire need for novel approaches. While numerous biologically-active chemotherapeutics have been discovered in the last two decades, biological barriers including minimal water solubility, stability, and cellular resistance hinder in vivo effectiveness. To overcome these limitations, nanoparticles have been designed to deliver chemotherapeutics selectively to cancerous tissue while minimizing pharmacokinetics hindrance. Numerous studies are underway analyzing the efficacy of nanoparticles in drug delivery, theranostic applications, and photothermal therapy. However, while nanoparticles have shown efficacy in treating some cancers, their potential toxicity and lack of targeting may hinder clinical potential. With the aim to help sort through these issues, we conduct a review to describe recent applications of nanotherapeutics for the treatment and diagnosis of lung cancer. We first provide a detailed background of statistics, etiology, histological classification, staging, diagnosis, and current treatment options. This is followed by a description of current applications of nanotherapeutics, focusing primarily on results published during the past five years. The potential toxicity associated with nanoparticles is evaluated, revealing inconclusive information which highlights the need for further studies. Lastly, recent advances in mathematical modeling and computational simulation have shown potential in predicting tumor response to nanotherapeutics. Thus, although nanoparticles have shown promise in treating lung cancer, further multi-disciplinary studies to quantify optimal dosages and assess possible toxicity are still needed. To this end, nanotherapeutic options currently in clinical trials offer hope to help address some of these critical issues.

Multirole cargo aircraft options and configurations

NASA Technical Reports Server (NTRS)

Conner, D. W.; Vaughan, J. C., III

1979-01-01

The paper discusses multirole cargo aircraft options and configurations. It was shown that derivatives of current wide-body aircraft would be economically attractive through 2008, but new dedicated airfreighters incorporating 1990 technology would offer little or no economic incentive. Option studies indicate that Mach 0.7 propfans would be economically attractive in trip cost, aircraft price, and airline ROI; spanloaders would be lower priced with higher ROI, but would have a relatively higher trip cost because of aerodynamic inefficiencies. Finally, air cushion landing gear configurations are identified as an option for avoiding runway constraints on airport accommodation of very large airfreighters.

Sound therapy for tinnitus management: practicable options.

PubMed

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

2014-01-01

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

Callings in Career: A Typological Approach to Essential and Optional Components

ERIC Educational Resources Information Center

Hirschi, Andreas

2011-01-01

A sense of calling in career is supposed to have positive implications for individuals and organizations but current theoretical development is plagued with incongruent conceptualizations of what does or does not constitute a calling. The present study used cluster analysis to identify essential and optional components of a presence of calling…

Early Phase Contingency Trajectory Design for the Failure of the First Lunar Orbit Insertion Maneuver: Direct Recovery Options

NASA Astrophysics Data System (ADS)

Song, Young-Joo; Bae, Jonghee; Kim, Young-Rok; Kim, Bang-Yeop

2017-12-01

To ensure the successful launch of the Korea pathfinder lunar orbiter (KPLO) mission, the Korea Aerospace Research Institute (KARI) is now performing extensive trajectory design and analysis studies. From the trajectory design perspective, it is crucial to prepare contingency trajectory options for the failure of the first lunar brake or the failure of the first lunar orbit insertion (LOI) maneuver. As part of the early phase trajectory design and analysis activities, the required time of flight (TOF) and associated delta-V magnitudes for each recovery maneuver (RM) to recover the KPLO mission trajectory are analyzed. There are two typical trajectory recovery options, direct recovery and low energy recovery. The current work is focused on the direct recovery option. Results indicate that a quicker execution of the first RM after the failure of the first LOI plays a significant role in saving the magnitudes of the RMs. Under the conditions of the extremely tight delta-V budget that is currently allocated for the KPLO mission, it is found that the recovery of the KPLO without altering the originally planned mission orbit (a 100 km circular orbit) cannot be achieved via direct recovery options. However, feasible recovery options are suggested within the boundaries of the currently planned delta-V budget. By changing the shape and orientation of the recovered final mission orbit, it is expected that the KPLO mission may partially pursue its scientific mission after successful recovery, though it will be limited.

48 CFR 570.401 - Renewal options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Renewal options. 570.401... Requirements 570.401 Renewal options. (a) Exercise of options. Before exercising an option to renew, follow the... survey. Before exercising an option to renew a lease, review current market information to ensure the...

Effect of different signal-processing options on speech-in-noise recognition for cochlear implant recipients with the cochlear CP810 speech processor.

PubMed

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.

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2014 CFR

2014-04-01

... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to... determining the current availability of an optional form of benefit or social security supplement if the...

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2013 CFR

2013-04-01

... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to... determining the current availability of an optional form of benefit or social security supplement if the...

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2012 CFR

2012-04-01

... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to... determining the current availability of an optional form of benefit or social security supplement if the...

Study of the feasibility of utilizing solar, wind, and geothermal energy in Hobbs, New Mexico. Final report. Volume 2

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

Taylor, B.J.; Huettner, D.A.; Murry, D.

The objective of this study was to provide an economic analysis of the various solar options for Hobbs, New Mexico. In so doing, an assessment of the current state of the art in solar research was obtained. Cost estimates were provided assuming capacity 100 MW. These options were: Central Receiver, Cylindrical Trough, Parabolic Dish Non-Brayton, Parabolic Dish Brayton, Fixed Mirror Distributed Focus, Dispersed Photovoltaic ERDA Goal, and Dispersed Photovoltaic Present Quote. Three scenarios were used to analyze all of the solar options relative to conventional fossil systems and nuclear alternatives. A total of thirty-two different options were considered. Results andmore » conclusions are presented. (MHR)« less

[Role of stem cell transplantation in treatment of primary cutaneous T‑cell lymphoma].

PubMed

Stranzenbach, R; Theurich, S; Schlaak, M

2017-09-01

Within the heterogeneous group of cutaneous T‑cell lymphomas (CTCL) the therapeutic options for advanced and progressive forms are particularly limited. The therapeutic value of hematopoietic stem cell transplantation in CTCL was analyzed. A literature search using the keywords "hematopoietic stem cell transplantation" and "cutaneous T‑cell lymphoma" was performed in PubMed. Studies between 1990 and 2017 were taken into account. The studies identified were analyzed for relevance and being up to date. After reviewing the currently available literature no prospective randomized studies were found. Wu et al. showed a superiority of allogeneic transplantation in a comparison of autologous and allogeneic stem cell transplantation for cutaneous lymphoma. The graft-versus-lymphoma effect plays a significant role in a prolonged progression-free survival after allogeneic transplantation. By using a non-myeloablative conditioning regimen, stem cell transplantation can also be an option for elderly patients. The most extensive long-term data after allogeneic stem cell transplantation were reported by Duarte et al. in 2014. Autologous stem cell transplantation does not currently represent a therapeutic option, whereas allogeneic stem cell transplantation for advanced cutaneous T‑cell lymphoma, using a non-myeloablative conditioning scheme, does represent a therapeutic option. However, there is no consensus on the appropriate patients and the right timing. Morbidity and mortality of complications should be taken into account. Thus, this procedure is currently subject to an individual case decision.

Portable power supply options for positive airway pressure devices.

PubMed

Riaz, Muhammad; Certal, Victor; Camacho, Macario

2015-01-01

Patients with obstructive sleep apnea (OSA) often face the challenge of how to power their positive airway pressure (PAP) devices when alternating current power supplies are not available in remote areas with lack of electricity or frequent power outages. This article elucidates portable power supply options for PAP devices with the aim to increase alternative power source awareness among medical providers. A search of scientific databases (Medline, Scopus, Web of Science, Google Scholar, and the Cochrane Library) was carried out on the topic of alternative portable power supply options for treatment of OSA. Scientific databases listed above yielded only limited results. Most articles were found via Google search. These articles were reviewed for alternative power supply options for OSA patients when alternating current is not available. The power supply options in this article include lead-acid batteries (starter, marine and deep-cycle batteries), lithium ion batteries, solar kits, battery packs, backup power systems, portable generators, and travel-size PAP devices. There are several options to power PAP devices with direct current when alternating current is not available. Knowledgeable primary care physicians especially in rural and remote areas can help OSA patients improve PAP compliance in order to mitigate morbidity and long-term complications of OSA.

Cost-effective particulate control options at Potomac Electric Power Company's Dickerson Station: An integrated approach to current and future particulate limits

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

Christoffersen, S.W.; Rouse, G.T.; Krasnopoler, M.J.

1998-07-01

The Dickerson Generating Station evaluated several particulate control options to identify the most cost-effective option. The study's goals were to: eliminate the particulate scrubber and its high maintenance costs, and incorporate flexibility for low-sulfur coal and possible stricter emission limits. Each of the three Dickerson 190 MW units has a small 37-year-old electrostatic precipitator and a wet particulate scrubber. The study evaluated alternatives to replace the scrubber and enhance ESP performance: Existing ESP alternatives--Extend height of existing ESP; Flue gas conditioning. Scrubber stream alternatives--Partial-flow ESP or pulse jet baghouse. Full-flow alternatives--Supplemental ESP; COHPAC baghouse; replacement ESP or baghouse. A technicalmore » and economic prescreening eliminated some of the options. Capital, operating, and life cycle costs were estimated for the remaining options to determine the most cost-effective alternative. This paper will present the technical and economic evaluations done for this study, including performance and costs.« less

Treatment Options for the Cardinal Symptoms of Disruptive Mood Dysregulation Disorder

PubMed Central

Tourian, Leon; LeBoeuf, Amélie; Breton, Jean-Jacques; Cohen, David; Gignac, Martin; Labelle, Réal; Guile, Jean-Marc; Renaud, Johanne

2015-01-01

Objective: DSM-5 has added a new developmentally appropriate child and adolescent mood disorder subtype called disruptive mood dysregulation disorder (DMDD). The core features of DMDD are temper outbursts (manifested by either verbal rages and/or physical aggression) and unrelenting irritability or anger. Currently, the literature is lacking a thorough review of the possible treatment options for the cardinal symptoms constituting DMDD. The objective of this article is to provide a thorough review of peer-reviewed studies on the subject of pharmacological treatment options for children and adolescents with the cardinal symptoms of DMDD. Methods: Relevant articles for this study were obtained through Pubmed, Medline, PsychINFO and PsychINDEXplus using the key words: “adolescents,” “children,” “paediatric,” “youth,” “irritability,” “temper outbursts,” “aggression,” “rage,” “disruptive behaviour,” “treatment,” “dysphoria,” “autism,” “mental retardation/intellectual disability,” “impulsivity,” “ADHD,” “oppositional defiant disorder,” and “conduct disorder.” A total of 823 studies were generated; only English studies focusing on pharmacological treatment were retained. Results: Currently there are no established guidelines or thorough reviews summarizing the treatment of DMDD. Pharmacotherapeutic treatment options of both aggression and chronic irritability include: antidepressants/selective norepinephrine reuptake inhibitors, mood stabilizers, psychostimulants, antipsychotics, and alpha-2 agonists. Conclusion: Treatment options of severe, persistent irritability in youth are numerous, and a consensual treatment algorithm has not yet emerged from the literature. Further studies and clinical trials are warranted to determine efficacious and safe treatment modalities. PMID:26336379

The Farm Credit Situation: Implications for Agricultural Policy.

ERIC Educational Resources Information Center

Bullock, J. Bruce

1986-01-01

Examines issues regarding current farm finance situation from a public policy perspective: origins and causes of current situation, available policy options for dealing with the problems, and impacts of policy options. (NEC)

[Treatment of asymptomatic carotid artery stenosis: improvement of evidence with new SPACE-2 design necessary].

PubMed

Reiff, T; Amiri, H; Ringleb, P A; Jansen, O; Hacke, W; Eckstein, H H; Fraedrich, G; Mudra, H; Mansmann, U

2013-12-01

Asymptomatic carotid artery stenosis may be treated with carotid endarterectomy (CEA), carotid artery stenting (CAS) or with best medical treatment (BMT) only. Definitive and evidence-based treatment recommendations for one of these options are currently not possible. Studies showing an advantage of CEA over BMT alone do not meet current standards from a pharmacological point of view. On the other hand, more recent data point to a further stroke risk reduction using BMT according to current standards. Studies on carotid artery stenting as a third alternative treatment are partially insufficient, especially when comparing CAS with BMT. Initiated in 2009, the randomized, controlled, multicenter SPACE-2 trial is intended to answer the question about the best treatment option of asymptomatic carotid artery stenosis; however, to increase recruitment rates as a condition for the successful completion of this important study, the trial design had to be modified.

Enhanced chondrocyte culture and growth on biologically inspired nanofibrous cell culture dishes.

PubMed

Bhardwaj, Garima; Webster, Thomas J

2016-01-01

Chondral and osteochondral defects affect a large number of people in which treatment options are currently limited. Due to its ability to mimic the natural nanofibrous structure of cartilage, this current in vitro study aimed at introducing a new scaffold, called XanoMatrix™, for cartilage regeneration. In addition, this same scaffold is introduced here as a new substrate onto which to study chondrocyte functions. Current studies on chondrocyte functions are limited due to nonbiologically inspired cell culture substrates. With its polyethylene terephthalate and cellulose acetate composition, good mechanical properties and nanofibrous structure resembling an extracellular matrix, XanoMatrix offers an ideal surface for chondrocyte growth and proliferation. This current study demonstrated that the XanoMatrix scaffolds promote chondrocyte growth and proliferation as compared with the Corning and Falcon surfaces normally used for chondrocyte cell culture. The XanoMatrix scaffolds also have greater hydrophobicity, three-dimensional surface area, and greater tensile strength, making them ideal candidates for alternative treatment options for chondral and osteochondral defects as well as cell culture substrates to study chondrocyte functions.

Evaluation of advanced propulsion options for the next manned transportation system: Propulsion evolution study

NASA Technical Reports Server (NTRS)

Spears, L. T.; Kramer, R. D.

1990-01-01

The objectives were to examine launch vehicle applications and propulsion requirements for potential future manned space transportation systems and to support planning toward the evolution of Space Shuttle Main Engine (SSME) and Space Transportation Main Engine (STME) engines beyond their current or initial launch vehicle applications. As a basis for examinations of potential future manned launch vehicle applications, we used three classes of manned space transportation concepts currently under study: Space Transportation System Evolution, Personal Launch System (PLS), and Advanced Manned Launch System (AMLS). Tasks included studies of launch vehicle applications and requirements for hydrogen-oxygen rocket engines; the development of suggestions for STME engine evolution beyond the mid-1990's; the development of suggestions for STME evolution beyond the Advanced Launch System (ALS) application; the study of booster propulsion options, including LOX-Hydrocarbon options; the analysis of the prospects and requirements for utilization of a single engine configuration over the full range of vehicle applications, including manned vehicles plus ALS and Shuttle C; and a brief review of on-going and planned LOX-Hydrogen propulsion technology activities.

Students' Use of Optional Online Reviews and Its Relationship to Summative Assessment Outcomes in Introductory Biology

ERIC Educational Resources Information Center

Carpenter, Shana K.; Rahman, Shuhebur; Lund, Terry J. S.; Armstrong, Patrick I.; Lamm, Monica H.; Reason, Robert D.; Coffman, Clark R.

2017-01-01

Retrieval practice has been shown to produce significant enhancements in student learning of course information, but the extent to which students make use of retrieval to learn information on their own is unclear. In the current study, students in a large introductory biology course were provided with optional online review questions that could be…

Mobile Technology Education Laboratory: An Alternative for Elementary Technology Education in a Restructuring School District in Central California.

ERIC Educational Resources Information Center

Britton, Steven M.

The purpose of this study was to explore what options exist for a school district that has chosen to implement or reinforce an elementary technology education program. The option selected was a mobile technology education laboratory. A mobile laboratory can offer the advantages of financial flexibility, currentness, ability to serve a large…

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

PubMed

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

2017-04-11

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

Natural selection can favour 'irrational' behaviour.

PubMed

McNamara, J M; Trimmer, P C; Houston, A I

2014-01-01

Understanding decisions is the fundamental aim of the behavioural sciences. The theory of rational choice is based on axiomatic principles such as transitivity and independence of irrelevant alternatives (IIA). Empirical studies have demonstrated that the behaviour of humans and other animals often seems irrational; there can be a lack of transitivity in choice and seemingly irrelevant alternatives can alter decisions. These violations of transitivity and IIA undermine rational choice theory. However, we show that an individual that is maximizing its rate of food gain can exhibit failure of transitivity and IIA. We show that such violations can be caused because a current option may disappear in the near future or a better option may reappear soon. Current food options can be indicative of food availability in the near future, and this key feature can result in apparently irrational behaviour.

Part-time employment in Jordan as a nursing policy solution.

PubMed

Al-Motlaq, M; Azar, N; Squires, A

2017-03-01

Explore the potential of a part-time work option for nurses as a strategy for managing domestic markets in Jordan by examining perceptions of working nurses and nursing students in the context of current social and cultural variables. Unemployment among Jordanian nurses has become a reality in recent years. However, labor markets literature in nursing rarely studies what kind of policy responses should occur during a surplus of nurses. A cross-sectional design structured the study. The perceptions of nurses and students were measured through a questionnaire developed specifically for the purpose of this exploratory study. Both nurses (n = 51) and students (n = 56) supported the introduction of the new suggested part-time option. However, students were more willing to start working or transfer into part-time work, take payment on hourly basis, and support colleagues to transfer into part-time work. Different solutions were also suggested by participants. The results were useful for providing the foundational data to further study the viability of a part-time work option for Jordanian nurses. The results show how optimistic current and future Jordanian nurses are regarding this employment option. For countries that may need to diversify their employment models due to excess supply of nurses and to address gender imbalances, this work may help inform policy development. Both employed and unemployed nurses will benefit if health care managers consider its application. The flexibility of this option may help improve the quality of life of many nurses. The results of this study provide nursing leaders and managers with foundational evidence that may be applicable in the Jordanian health sector. Although further studies are recommended, nursing leaders and policy makers should consider such a solution. © 2016 International Council of Nurses.

Examination of commercial aviation operational energy conservation strategies

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

None

Forty-seven fuel conservation strategies are identified for commercial aviation and the fuel saving potential, costs, constraints, and current implementation levels of these options are examined. This assessment is based on a comprehensive review of published data and discussions with representatives from industry and government. Analyses were performed to quantify the fuel saving potential of each option, and to assess the fuel savings achieved to date by the airline industry. Those options requiring further government support for option implementation were identified, rated, and ranked in accordance with a rating methodology developed in the study. Finally, recommendations are made for future governmentmore » efforts in the area of fuel conservation in commercial aviation.« less

77 FR 21402 - Airworthiness Directives; Sikorsky Aircraft Corporation Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... option is to conduct an eddy current inspection and the other option is to conduct a visual inspection... blade sanding inspection rather than the eddy current inspection, at an average labor rate of $85 per.... (1) Inspect by using either an eddy current inspection in accordance with paragraphs B.(1)(a) through...

Recent update of the 2017 Korean Association for the Study of the Liver (KASL) treatment guidelines of chronic hepatitis C: comparison of guidelines from other continents, 2017 AASLD/IDSA and 2016 EASL.

PubMed

Yeon, Jong Eun

2018-05-02

The paradigm for the treatment of chronic hepatitis C (CHC) has been changed due to the development of direct acting antivirals (DAAs) of hepatitis C virus (HCV). The high sustained virologic response rate and ease of administration makes the DAAs approach ideal to contribute to the complete eradication of HCV. Currently, treatment options for individual patients vary depending on the genotype or subtype of HCV, presence or absence of liver cirrhosis, previous experience of antiviral treatment or resistance associated substitutions. Because of drug avalilability, cost-effectiveness, preference, compliance and greater possibility of desirable effects and presumed patient-important outcomes may vary between countries, treatment options for individual patients are different. The review focuses on the comparing the current treatment options for CHC in other continents with the 2017 Korea Association for the Study of the Liver guidelines.

Age differences in the effect of framing on risky choice: A meta-analysis

PubMed Central

Best, Ryan; Charness, Neil

2015-01-01

The framing of decision scenarios in terms of potential gains versus losses has been shown to influence choice preferences between sure and risky options. Normative cognitive changes associated with aging have been known to affect decision-making, which has led to a number of studies investigating the influence of aging on the effect of framing. Mata, Josef, Samanez-Larkin, and Hertwig (2011) systematically reviewed the available literature using a meta-analytic approach, but did not include tests of homogeneity nor subsequent moderator variable analyses. The current review serves to extend the previous analysis to include such tests as well as update the pool of studies available for analysis. Results for both positively and negatively framed conditions were reviewed using two meta-analyses encompassing data collected from 3,232 subjects across 18 studies. Deviating from the previous results, the current analysis finds a tendency for younger adults to choose the risky option more often than older adults for positively framed items. Moderator variable analyses find this effect to likely be driven by the specific decision scenario, showing a significant effect with younger adults choosing the risky option more often in small-amount financial and large-amount mortality-based scenarios. For negatively framed items, the current review found no overall age difference in risky decision making, confirming the results from the prior meta-analysis. Moderator variable analyses conducted to address heterogeneity found younger adults to be more likely than older adults to choose the risky option for negatively framed high-amount mortality-based decision scenarios. Practical implications for older adults are discussed. PMID:26098168

Age differences in the effect of framing on risky choice: A meta-analysis.

PubMed

Best, Ryan; Charness, Neil

2015-09-01

The framing of decision scenarios in terms of potential gains versus losses has been shown to influence choice preferences between sure and risky options. Normative cognitive changes associated with aging have been known to affect decision making, which has led to a number of studies investigating the influence of aging on the effect of framing. Mata, Josef, Samanez-Larkin, and Hertwig (2011) systematically reviewed the available literature using a meta-analytic approach, but did not include tests of homogeneity or subsequent moderator variable analyses. The current review serves to extend the previous analysis to include such tests as well as update the pool of studies available for analysis. Results for both positively and negatively framed conditions were reviewed using 2 meta-analyses encompassing data collected from 3,232 subjects across 18 studies. Deviating from the previous results, the current analysis found a tendency for younger adults to choose the risky option more often than older adults for positively framed items. Moderator variable analyses found this effect likely to be driven by the specific decision scenario, showing a significant effect, with younger adults choosing the risky option more often in small-amount financial and large-amount mortality-based scenarios. For negatively framed items, the current review found no overall age difference in risky decision making, confirming the results from the prior meta-analysis. Moderator variable analyses conducted to address heterogeneity found younger adults to be more likely than older adults to choose the risky option for negatively framed high-amount mortality-based decision scenarios. Practical implications for older adults are discussed. (c) 2015 APA, all rights reserved).

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network.

PubMed

Grass, Fabian; Martin, David; Montemurro, Michael; Mathevet, Patrice; Wolfer, Anita; Coukos, George; Demartines, Nicolas; Hübner, Martin

2018-06-13

The present survey aimed to evaluate current opinion and practice regarding peritoneal metastasis (PM), satisfaction with available treatment options, and need for new therapeutic approaches. This was a qualitative study conducted between October 2016 and October 2017 in the Réseau Suisse Romand d'Oncologie including 101 members of various oncological specialties. Participants' demographics, current practice, knowledge, and satisfaction regarding available treatment options and need for new treatment options were assessed by semantic differential scales through 33 closed questions with automatic reminders at 4-, 8-, 12-, and 16-week intervals. Twenty-seven participants (27%) completed the survey. Participants were gastrointestinal or gynecologic oncologists and surgeons. Most participants (67%) evaluated their knowledge on PM as moderate, while 22% considered themselves as experts. Clinical usefulness of systemic chemotherapy and hyperthermic intraperitoneal chemotherapy was judged to be moderate to high for PM of ovarian and colorectal origin and moderate to poor for gastric origin. Satisfaction with available treatment options was 6/10 (interquartile range [IQR] 4-7) for ovarian, 5/10 (IQR 3-7) for colorectal, and 3/10 (IQR 1-3) for gastric PM. Treatment strategies varied widely for typical case vignettes. The need for new treatment modalities was rated as 8/10 (IQR 6-10). Usefulness of and satisfaction with available treatment options for PM were rated as moderate at best by oncological experts, and treatment strategies differed importantly among participants. There appears to be a clear need for standardization and new treatment modalities. © 2018 S. Karger AG, Basel.

Scleral Lenses in the Management of Corneal Irregularity and Ocular Surface Disease.

PubMed

Shorter, Ellen; Harthan, Jennifer; Nau, Cherie B; Nau, Amy; Barr, Joseph T; Hodge, David O; Schornack, Muriel M

2017-09-29

To describe current practice patterns regarding the use of scleral lens therapy in the management of corneal irregularity and ocular surface disease among eye care providers who fit scleral lenses. The Scleral Lenses in Current Ophthalmic Practice: an Evaluation (SCOPE) study group conducted an electronic survey of eye care providers from January 15 to March 31, 2015. Respondents ranked management options for corneal irregularity in the order in which they would generally consider their use. Respondents also ranked options for the management of ocular surface disease in the order in which they would use each of the treatments. Results for each option were analyzed as percentage first-place ranking; percentage first-, second-, or third-place ranking; and mean rank score. Survey responses were obtained from 723 providers who had fit 5 or more scleral lenses. Of these respondents, 629 ranked options for management of corneal irregularity and 612 ranked options for management of ocular surface disease. Corneal rigid gas-permeable lenses were the first option for management of corneal irregularity for 44% of respondents, and scleral lenses were the first option for 34% of respondents. Lubricant drops were the first therapeutic recommendation for ocular surface disease for 84% of respondents, and scleral lenses were ranked first by 6% of respondents. Scleral lenses rank second only to corneal rigid gas-permeable lenses for management of corneal irregularity. Scleral lenses are generally considered after other medical intervention and before surgery for the management of ocular surface disease.

Preeradication vaccine policy options for poliovirus infection and disease control.

PubMed

Thompson, Kimberly M; Pallansch, Mark A; Duintjer Tebbens, Radboud J; Wassilak, Steve G; Kim, Jong-Hoon; Cochi, Stephen L

2013-04-01

With the circulation of wild poliovirus (WPV) types 1 and 3 continuing more than a decade after the original goal of eradicating all three types of WPVs by 2000, policymakers consider many immunization options as they strive to stop transmission in the remaining endemic and outbreak areas and prevent reintroductions of live polioviruses into nonendemic areas. While polio vaccination choices may appear simple, our analysis of current options shows remarkable complexity. We offer important context for current and future polio vaccine decisions and policy analyses by developing decision trees that clearly identify potential options currently used by countries as they evaluate national polio vaccine choices. Based on a comprehensive review of the literature we (1) identify the current vaccination options that national health leaders consider for polio vaccination, (2) characterize current practices and factors that appear to influence national and international choices, and (3) assess the evidence of vaccine effectiveness considering sources of variability between countries and uncertainties associated with limitations of the data. With low numbers of cases occurring globally, the management of polio risks might seem like a relatively low priority, but stopping live poliovirus circulation requires making proactive and intentional choices to manage population immunity in the remaining endemic areas and to prevent reestablishment in nonendemic areas. Our analysis shows remarkable variability in the current national polio vaccine product choices and schedules, with combination vaccine options containing inactivated poliovirus vaccine and different formulations of oral poliovirus vaccine making choices increasingly difficult for national health leaders. © 2013 Society for Risk Analysis.

Evidence-Based Recommendations for Fertility Preservation Options for Inclusion in Treatment Protocols for Pediatric and Adolescent Patients Diagnosed With Cancer.

PubMed

Fernbach, Alison; Lockart, Barbara; Armus, Cheryl L; Bashore, Lisa M; Levine, Jennifer; Kroon, Leah; Sylvain, Genevieve; Rodgers, Cheryl

2014-07-01

As survival rates improve for pediatric cancers, increased attention has been paid to late effects of cancer therapy, in particular, infertility. Fertility preservation options are available for pre- and postpubertal cancer patients; however, many providers lack knowledge regarding options. The aim of this article is to provide a comprehensive synthesis of current evidence and recommendations regarding fertility preservation options for children, adolescents, and young adults undergoing cancer treatment. A systematic search was performed to identify fertility preservation evidence. Fifty-three studies and 4 clinical guidelines were used for the review. Final recommendations consisted of 2 strong and 1 weak recommendation for both female and male fertility preservation options. The treatment team should be knowledgeable about fertility preservation so that they can educate patients and families about available fertility preservation options. It is important to consider and discuss all available fertility options with patients at the time of diagnosis. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Apathy in schizophrenia as a deficit in the generation of options for action.

PubMed

Hartmann, Matthias N; Kluge, Agne; Kalis, Annemarie; Mojzisch, Andreas; Tobler, Philippe N; Kaiser, Stefan

2015-05-01

Negative symptoms are a core feature of schizophrenia and have been grouped into 2 factors: a motivational factor, which we refer to as apathy, and a diminished expression factor. Recent studies have shown that apathy is closely linked to functional outcome. However, knowledge about its mechanisms and its relation to decision-making is limited. In the current study, we examined whether apathy in schizophrenia is associated with predecisional deficits, that is, deficits in the generation of options for action. We applied verbal protocol analysis to investigate the quantity of options generated in ill-structured real world scenarios in 30 patients with schizophrenia or schizoaffective disorder and 21 healthy control participants. Patients generated significantly fewer options than control participants and clinical apathy ratings correlated negatively with the quantity of generated options. We show that the association between measures of psychopathology and option generation is most pronounced in regard to apathy symptoms and that it is only partially mediated by deficits in verbal fluency. This study provides empirical support for dysfunctional option generation as a possible mechanism for apathy in schizophrenia. Our data emphasize the potential importance of predecisional stages in the development and persistence of apathy symptoms in neuropsychiatric disorders and might also inform the development of novel treatment options in the realm of cognitive remediation. (c) 2015 APA, all rights reserved).

Human Transportation System (HTS) study: Executive summary

NASA Technical Reports Server (NTRS)

Lance, N.; Geyer, M. S.; Gaunce, M. T.

1993-01-01

Work completed under the Human Transportation System Study is summarized. This study was conducted by the New Initiatives Office at JSC with the technical support of Boeing, General Dynamics, Lockheed, McDonnell-Douglas, Martin Marietta, and Rockwell. The study was designed to generate information on determining the appropriate path to follow for new system development to meet the Nation's space transportation needs. The study evaluates 18 transportation architecture options using a parametric set of mission requirements. These options include use of current systems as well as proposed systems to assess the impact of various considerations, such as the cost of alternate access, or the benefit of separating people and cargo. The architecture options are compared to each other with six measurable evaluation criteria or attributes. They are the following: funding profile, human safety, probability of mission success, architecture cost risk, launch schedule confidence, and environmental impact. Values for these attributes are presented for the architecture options, with pertinent conclusions and recommendations.

Human Transportation System (HTS) study, volume 2

NASA Technical Reports Server (NTRS)

Lance, N.; Geyer, M. S.; Gaunce, M. T.

1993-01-01

This report summarizes work completed under the Human Transportation System Study. This study was conducted by the New Initiatives Office at JSC with the technical support of Boeing, General Dynamics, Lockheed, McDonnell-Douglas, Martin Marietta, and Rockwell. The study was designed to generate information on determining the appropriate path to follow for new system development to meet the Nation's space transportation needs. The study evaluates 18 transportation architecture options using a parametric set of mission requirements. These options include use of current systems (e.g., Shuttle, Titan, etc. ) as well as proposed systems (e.g., PLS, Single-Stage-to-Orbit, etc.) to assess the impact of various considerations, such as the cost of alternate access, or the benefit of separating people and cargo. The architecture options are compared to each other with six measurable evaluation criteria or attributes. They are: funding profile, human safety, probability of mission success, architecture cost risk, launch schedule confidence, and environmental impact. Values for these attributes are presented for the architecture options, with pertinent conclusions and recommendations.

Human Transportation System (HTS) study, volume 1

NASA Technical Reports Server (NTRS)

Lance, N.; Geyer, M. S.; Gaunce, M. T.

1993-01-01

Work completed under the Human Transportation System Study is summarized. This study was conducted by the New Initiatives Office at JSC with the technical support of Boeing, General Dynamics, Lockheed, McDonnell-Douglas, Martin Marietta, and Rockwell. The study was designed to generate information on determining the appropriate path to follow for new system development to meet the Nation's space transportation needs. The study evaluates 18 transportation architecture options using a parametric set of mission requirements. These options include use of current systems as well as proposed systems to assess the impact of various considerations, such as the cost of alternate access, or the benefit of separating people and cargo. The architecture options are compared to each other with six measurable evaluation criteria or attributes. They are the following: funding profile, human safety, probability of mission success, architecture cost risk, launch schedule confidence, and environmental impact. Values for these attributes are presented for the architecture options, with pertinent conclusions and recommendations.

Development of X-Ray Microcalorimeter Imaging Spectrometers for the X-Ray Surveyor Mission Concept

NASA Technical Reports Server (NTRS)

Bandler, Simon R.; Adams, Joseph S.; Chervenak, James A.; Datesman, Aaron M.; Eckart, Megan E.; Finkbeiner, Fred M.; Kelley, Richard L.; Kilbourne, Caroline A.; Betncourt-Martinez, Gabriele; Miniussi, Antoine R.;

Mars Sample Return Architecture Assessment Study

NASA Astrophysics Data System (ADS)

Centuori, S.; Hermosín, P.; Martín, J.; De Zaiacomo, G.; Colin, S.; Godfrey, A.; Myles, J.; Johnson, H.; Sachdev, T.; Ahmed, R.

2018-04-01

Current paper presents the results of ESA funded activity "Mars Sample Return Architecture Assessment Study" carried-out by DEIMOS Space, Lockheed Martin UK Ampthill, and MDA Corporation, where more than 500 mission design options have been studied.

Involving Corporations in Dispensing During Mass Prophylaxis

DTIC Science & Technology

2007-03-01

BLANK xi LIST OF TABLES Table 3.1 SWOT for Current Public Health Response Option............................ 34 Table 3.2 SWOT for the Postal...Service Option .................................................. 36 Table 3.3 SWOT for the Corporate Support Option...39 Table 3.4 SWOT for the Composite Support Option .......................................... 41 xii

Environmental and economic analyses of waste disposal options for traditional markets in Indonesia.

PubMed

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.

Options for accounting carbon sequestration in German forests

PubMed Central

Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

2009-01-01

Background The Accra climate change talks held from 21–27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. Results This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 – 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. Conclusion The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences. PMID:19650896

Options for accounting carbon sequestration in German forests.

PubMed

Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

2009-08-03

The Accra climate change talks held from 21-27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 - 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences.

75 FR 27611 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

...) are registered trademarks of The NASDAQ OMX Group, Inc. (which with its affiliates are the... Registered Options Traders (on-floor) and Specialists; (ii) amending the current options transaction charge for Registered Options Traders (on-floor) and Specialists and applying that charge and the options...

78 FR 49563 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... futures on all of the volatility indexes that underlie volatility index options trading on CBOE. Currently, volatility index (security) futures expirations correspond to each volatility index options expiration months...-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed Rule To Amend Rule...

Surgical Management of Hemorrhoids

PubMed Central

Agbo, S. P.

2011-01-01

Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

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...

Advanced Management of Severe Keloids.

PubMed

Hagele, Thomas; Nyanda, Hoka; Patel, Nishit; Russell, Nicole; Cohen, George; Nelson, Christopher

2017-01-01

Keloids negatively impact the health and quality of life of many affected dermatologic patients. Treating keloids is often difficult, and suboptimal responses are frequent. Fortunately, there are many treatment options available to the clinician that may lead to improved clinical outcomes. We present a review of currently available therapeutic options. Intralesional steroid injection remains the first-line treatment for keloids. Imiquimod, direct interferon therapy, or intralesional 5-flurouracil may alleviate the need for excessive corticosteroid therapy. Radiation and laser therapy are emerging therapeutic options that have demonstrated efficacy in reviewed studies. Given the unsatisfactory outcomes associated with pressure dressings, vitamin E, ablative laser, and surgical excision, these options should be avoided in keloid management. Further research is needed to evaluate the efficacy and recurrence associated with the reviewed therapeutics.

76 FR 66209 - Airworthiness Directives; Sikorsky Aircraft Corporation (Sikorsky) Model S-92A Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... option is to conduct an eddy current inspection and the other option is to conduct a visual inspection... eddy current inspection, at an average labor rate of $85 per work hour. Required parts would cost about... using either an eddy current inspection in accordance with paragraphs B.(1)(a) through B.(1)(o) or using...

Toxic Overload: The Waste Disposal Dilemma.

ERIC Educational Resources Information Center

Knox, Robert J.

1991-01-01

The role of the Environmental Protection Agency as ombudsman concerning waste disposal is examined with respect to both the current options of source reduction and recycling as pollution prevention, and alternative approaches that expand upon these current options, particularly with respect to toxic and medical waste. (JJK)

Contribution of Sudanese medical diaspora to the healthcare delivery system in Sudan: exploring options and barriers.

PubMed

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.

Study of an Audio Playback Machine Storage, Distribution, and Repair System. Options for Machine Operation. Study II, Part 1, Phase 2, Final Report.

ERIC Educational Resources Information Center

ManTech Technical Services Corp., Fairfax, VA.

This report presents the results of a management study of audio playback equipment operations conducted by the National Library Service, Library of Congress, its associated network of state and local machine lending agencies (MLA), and other parties that play a role in current operations. The objectives were to document current operations,…

High-performance superconductors for Fusion Nuclear Science Facility

DOE PAGES

Zhai, Yuhu; Kessel, Chuck; Barth, Christian; ...

2016-11-09

High-performance superconducting magnets play an important role in the design of the next step large-scale, high-field fusion reactors such as the fusion nuclear science facility (FNSF) and the spherical tokamak (ST) pilot plant beyond ITER. Here, Princeton Plasma Physics Laboratory is currently leading the design studies of the FNSF and the ST pilot plant study. ITER, which is under construction in the south of France, utilizes the state-of-the-art low temperature superconducting magnet technology based on the cable-in-conduit conductor design, where over a thousand multifilament Nb 3Sn superconducting strands are twisted together to form a high-current-carrying cable inserted into a steelmore » jacket for coil windings. We present design options of the high-performance superconductors in the winding pack for the FNSF toroidal field magnet system based on the toroidal field radial build from the system code. For the low temperature superconductor options, the advanced J cNb 3Sn RRP strands (J c > 1000 A/mm 2 at 16 T, 4 K) from Oxford Superconducting Technology are under consideration. For the high-temperature superconductor options, the rectangular-shaped high-current HTS cable made of stacked YBCO tapes will be considered to validate feasibility of TF coil winding pack design for the ST-FNSF magnets.« less

High-performance superconductors for Fusion Nuclear Science Facility

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

Zhai, Yuhu; Kessel, Chuck; Barth, Christian

High-performance superconducting magnets play an important role in the design of the next step large-scale, high-field fusion reactors such as the fusion nuclear science facility (FNSF) and the spherical tokamak (ST) pilot plant beyond ITER. Here, Princeton Plasma Physics Laboratory is currently leading the design studies of the FNSF and the ST pilot plant study. ITER, which is under construction in the south of France, utilizes the state-of-the-art low temperature superconducting magnet technology based on the cable-in-conduit conductor design, where over a thousand multifilament Nb 3Sn superconducting strands are twisted together to form a high-current-carrying cable inserted into a steelmore » jacket for coil windings. We present design options of the high-performance superconductors in the winding pack for the FNSF toroidal field magnet system based on the toroidal field radial build from the system code. For the low temperature superconductor options, the advanced J cNb 3Sn RRP strands (J c > 1000 A/mm 2 at 16 T, 4 K) from Oxford Superconducting Technology are under consideration. For the high-temperature superconductor options, the rectangular-shaped high-current HTS cable made of stacked YBCO tapes will be considered to validate feasibility of TF coil winding pack design for the ST-FNSF magnets.« less

Stockbridge Munsee Community Health and Wellness Center and the Mohican Family Center Renewable Energy and Energy Efficiency Feasibility Study

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

DeRocher, Andy; Barrnett, Michael

2014-03-14

The results of the Renewable Energy and Energy Efficiency Feasibility Study of Stockbridge Munsee Community’s Health and Wellness Center (HWC) indicate that a variety of renewable energy options and energy conservation measures (ECMs) exist for the facility. A requirement of the Request for Proposal for this study was to assess renewable energy options that could offset 30 to 100 percent of the HWC’s energy use. This study identifies that a geothermal system is the most cost effective renewable energy option available to decrease the HWC’s energy consumption by 30 to 100 percent. Currently the HWC performs in the lowest 8more » percent of buildings in its building category, as scored in the EPA portfolio manager benchmarking tool. Multiple ECM opportunities have been identified with paybacks of less than five years to yield an estimated 25-percent decrease in annual energyconsumption. The ECMs within this payback period are estimated to save $26,800 per year with an implementation cost of just $4,650 (0.2 year payback). For the Mohican Family Center document: The results of the Renewable Energy and Energy Efficiency Feasibility Study of Stockbridge Munsee Community’s Mohican Family Center (MFC) indicate that a variety of renewable energy options and energy conservation measures (ECMs) exist for the facility. A requirement of the Request for Proposal for this study was to assess renewable energy options that could offset 30 to 100 percent of the MFC’s energy use. This study identifies that a geothermal system is the most cost effective renewable energy option available to decrease the MFC’s energy consumption by 30 to 100 percent. Currently the MFC performs better than 80 percent of buildings in its building category, as scored in the EPA portfolio manager benchmarking tool. Multiple ECM opportunities have been identified with short term paybacks to yield an estimated 13-percent decrease in energy consumption. The ECMs within this payback period are estimated to save $3,100 per year with an implementation cost of under $20,000.« less

Efficient Trajectory Options Allocation for the Collaborative Trajectory Options Program

NASA Technical Reports Server (NTRS)

Rodionova, Olga; Arneson, Heather; Sridhar, Banavar; Evans, Antony

2017-01-01

The Collaborative Trajectory Options Program (CTOP) is a Traffic Management Initiative (TMI) intended to control the air traffic flow rates at multiple specified Flow Constrained Areas (FCAs), where demand exceeds capacity. CTOP allows flight operators to submit the desired Trajectory Options Set (TOS) for each affected flight with associated Relative Trajectory Cost (RTC) for each option. CTOP then creates a feasible schedule that complies with capacity constraints by assigning affected flights with routes and departure delays in such a way as to minimize the total cost while maintaining equity across flight operators. The current version of CTOP implements a Ration-by-Schedule (RBS) scheme, which assigns the best available options to flights based on a First-Scheduled-First-Served heuristic. In the present study, an alternative flight scheduling approach is developed based on linear optimization. Results suggest that such an approach can significantly reduce flight delays, in the deterministic case, while maintaining equity as defined using a Max-Min fairness scheme.

Industry-Related Day Care: Trends and Options.

ERIC Educational Resources Information Center

Verzaro-Lawrence, Marce; And Others

1982-01-01

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

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

Current Therapeutic Options for Esophageal Motor Disorders as Defined by the Chicago Classification.

PubMed

Zerbib, Frank; Roman, Sabine

2015-07-01

With the development of high-resolution manometry and specific metrics to characterize esophageal motility, the Chicago Classification has become the gold standard for the diagnosis of esophageal motor disorders. Major and significant disorders, that is, never observed in healthy subjects, are achalasia, esophagogastric junction outflow obstruction, distal esophageal spasm, absent peristalsis, and hypercontractile (Jackhammer) esophagus. Achalasia subtyping is relevant to predict the response to endoscopic and surgical therapies as several studies suggest that, pneumatic dilation is less effective than Heller myotomy, in type III achalasia. Peroral endoscopic myotomy, initially developed in expert centers, is a promising technique for the treatment of achalasia. The medical therapeutic options for distal esophageal spasm and hypercontractile esophagus are smooth muscle relaxants and pain modulators. Intraesophageal injection of botulinum toxin might be an interesting option for treatment of these disorders but further studies are required to determine the optimal injection protocol and the best candidates based on manometric patterns. The treatment of hypotensive motility disorders is disappointing and relies mainly on dietary and lifestyle changes as no effective esophageal prokinetic is currently available.

76 FR 77046 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... Change Relating to the Firm Related Equity Option Cap December 5, 2011. Pursuant to Section 19(b)(1) of... ``Equity Options Fees'' to apply the Firm Related Equity Option Cap to certain proprietary orders of... Equity Option Cap to proprietary orders of certain affiliates of member organizations. Currently, Firms...

76 FR 16646 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

...-Settled Foreign Currency Option Fees, in Section III of the Fee Schedule, with Singly Listed Options \\3...\\. The Exchange currently assesses fees for sector index options and U.S. Dollar-Settled foreign currency... U.S. Dollar-Settled Foreign Currency Option Fees.'' \\4\\ BKX represents the KBW Bank Index. \\5\\ RUT...

Analysis of selected photovoltaic systems and storage options for residential applications in hot, humid climates

NASA Astrophysics Data System (ADS)

Lau, A. S.; Hill, J. M.; Ball, D. E.

1982-08-01

The relationship is studied between photovoltaic (PV) generated power and its on-site use as a function of total array size for an energy-efficient house in the hot, humid climates of Miami and Houston. Options in addition to be the full-roof system using a direct current (dc) to alternating current (ac) inverter are studied in an effort to identify applications which are less expensive and which rely less on utility sellback. The results show that common residential loads in this climate lead to high on-site utilization. For the various PV applications studied, array sizes are identified which can be fully potential is identified both in the house structure and the domestic water heater. Using projected 1986 costs, the economics of selected systems were studied for Miami. Only one of the system sizes was found to be marginally competitive with utility supplied power.

Nerve Agents: What They Are, How They Work, How to Counter Them.

PubMed

Costanzi, Stefano; Machado, John-Hanson; Mitchell, Moriah

2018-05-16

Nerve agents are organophosphorus chemical warfare agents that exert their action through the irreversible inhibition of acetylcholinesterase, with a consequent overstimulation of cholinergic transmission followed by its shutdown. Beyond warfare, they have notoriously been employed in acts of terrorism as well as high profile assassinations. After a brief historical introduction on the development and deployment of nerve agents, this review provides a survey of their chemistry, the way they affect cholinergic transmission, the available treatment options, and the current directions for their improvement. As the review illustrates, despite their merits, the currently available treatment options present several shortcomings. Current research directions involve the search for improved antidotes, antagonists of the nicotinic receptors, small-molecule pretreatment options, as well as bioscavengers as macromolecular pretreatment options. These efforts are making good progress in many different directions and, hopefully, will lead to a lower target susceptibility, thus reducing the appeal of nerve agents as chemical weapons.

Review of Systemic Treatment Options for Adult Atopic Dermatitis.

PubMed

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.

Medical management of heavy menstrual bleeding

PubMed Central

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

Choice in experiential learning: True preferences or experimental artifacts?

PubMed

Ashby, Nathaniel J S; Konstantinidis, Emmanouil; Yechiam, Eldad

2017-03-01

The rate of selecting different options in the decisions-from-feedback paradigm is commonly used to measure preferences resulting from experiential learning. While convergence to a single option increases with experience, some variance in choice remains even when options are static and offer fixed rewards. Employing a decisions-from-feedback paradigm followed by a policy-setting task, we examined whether the observed variance in choice is driven by factors related to the paradigm itself: Continued exploration (e.g., believing options are non-stationary) or exploitation of perceived outcome patterns (i.e., a belief that sequential choices are not independent). Across two studies, participants showed variance in their choices, which was related (i.e., proportional) to the policies they set. In addition, in Study 2, participants' reported under-confidence was associated with the amount of choice variance in later choices and policies. These results suggest that variance in choice is better explained by participants lacking confidence in knowing which option is better, rather than methodological artifacts (i.e., exploration or failures to recognize outcome independence). As such, the current studies provide evidence for the decisions-from-feedback paradigm's validity as a behavioral research method for assessing learned preferences. Copyright © 2017 Elsevier B.V. All rights reserved.

Contemporary European Studies: A Model for Interdisciplinary Studies.

ERIC Educational Resources Information Center

Dannerbeck, Francis J.

1989-01-01

Describes the University of South Carolina's (Columbia) Contemporary European Studies program, which drew on current course offerings and existing financial resources to provide study about post-French Revolution European languages, cultures, politics, history, geography, and economics. Options exist at many other institutions to create broadly…

Travel and Tourism Industry: Program Options for City College of San Francisco.

ERIC Educational Resources Information Center

City Coll. of San Francisco, CA.

In an effort to determine the current occupational outlook and resulting implications for education and training, the City College of San Francisco (CCSF), in California, undertook a study of current trends in the travel and tourism industry. This report provides findings from the project, which involved consultation with local and national…

76 FR 63976 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... proposed change is intended to attract more customer volume to the Exchange in the SPY option class and to allow CBOE market-makers to better compete for order flow. CBOE noted that the SPY option class is... class. CBOE believes that the current demographics of electronic SPY option order flow is more driven by...

75 FR 33374 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... proposes to amend its Fees Schedule to establish fees for transactions in all S&P 500 Dividend Index... transactions in DVS options to all options on the S&P 500 Dividend Index, regardless of the specified accrual period.\\6\\ Currently the established transaction fees for DVS options are as follows: \\6\\ See Securities...

Current treatment for vitreous floaters.

PubMed

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.

Personal Access Satellite System (PASS) study. Fiscal year 1989 results

NASA Technical Reports Server (NTRS)

Sue, Miles K. (Editor)

1990-01-01

The Jet Propulsion Laboratory is exploring the potential and feasibility of a personal access satellite system (PASS) that will offer the user greater freedom and mobility than existing or currently planned communications systems. Studies performed in prior years resulted in a strawman design and the identification of technologies that are critical to the successful implementation of PASS. The study efforts in FY-89 were directed towards alternative design options with the objective of either improving the system performance or alleviating the constraints on the user terminal. The various design options and system issues studied this year and the results of the study are presented.

Restoration of Secondary Containment in Double Shell Tank (DST) Pits

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

SHEN, E.J.

2000-10-05

Cracks found in many of the double-shell tank (DST) pump and valve pits bring into question the ability of the pits to provide secondary containment and remain in compliance with State and Federal regulations. This study was commissioned to identify viable options for maintain/restoring secondary containment capability in these pits. The basis for this study is the decision analysis process which identifies the requirements to be met and the desired goals (decision criteria) that each option will be weighed against. A facilitated workshop was convened with individuals knowledgeable of Tank Farms Operations, engineering practices, and safety/environmental requirements. The outcome ofmore » this workshop was the validation or identification of the critical requirements, definition of the current problem, identification and weighting of the desired goals, baselining of the current repair methods, and identification of potential alternate solutions. The workshop was followed up with further investigations into the potential solutions that were identified in the workshop and through other efforts. These solutions are identified in the body of this report. Each of the potential solutions were screened against the list of requirements and only those meeting the requirements were considered viable options. To expand the field of viable options, hybrid concepts that combine the strongest features of different individual approaches were also examined. Several were identified. The decision analysis process then ranked each of the viable options against the weighted decision criteria, which resulted in a recommended solution. The recommended approach is based upon installing a sprayed on coating system.« less

A Power Conversion Concept for the Jupiter Icy Moons Orbiter

NASA Technical Reports Server (NTRS)

Mason, Lee S.

2003-01-01

The Jupiter Icy Moons Orbiter (JIMO) mission is currently under study by the Office of Space Science under the Project Prometheus Program. JIMO is examining the use of Nuclear Electric Propulsion (NEP) to carry scientific payloads to three Jovian moons. A potential power system concept includes dual 100 kWe Brayton converters, a deployable pumped loop heat rejection subsystem, and a 400 Vac Power Management and Distribution (PMAD) bus. Many trades were performed in aniving at this candidate power system concept. System-level studies examined design and off-design operating modes, determined startup requirements, evaluated subsystem redundancy options, and quantified the mass and radiator area of reactor power systems from 20 to 200 kWe. In the Brayton converter subsystem, studies were performed to investigate converter packaging options, and assess the induced torque effects on spacecraft dynamics due to rotating machinery. In the heat rejection subsystem, design trades were conducted on heat transport approaches, material and fluid options, and deployed radiator geometries. In the PMAD subsystem, the overall electrical architecture was defined and trade studies examined distribution approaches, voltage levels, and cabling options.

77 FR 67040 - Self-Regulatory Organizations; BOX Options Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... Proposal Regarding Quote Mitigation November 2, 2012. Pursuant to Section 19(b)(1) under the Securities... (Quote Mitigation) and refine the current quote mitigation strategy for its options trading facility, BOX Market LLC (``BOX'') by replacing the current quote mitigation rule with a ``holdback timer'' mechanism...

Space station needs, attributes and architectural options study. Briefing material, mid-term review

NASA Technical Reports Server (NTRS)

1982-01-01

User mission requirements and their relationship to the current space transportation system are examined as a means of assuring the infusion of corporate ideas and knowledge in the space station program. Specific tasks include developing strategies to develop user consistency; determine DOD implication and requirements; and foster industry involvement in the space station. Mission alternatives; accrued benefits; program options; system attributes and characteristics; and a recommended plan for space station evolution are covered.

Requirements Doc for Refurb of JASPER Facility in B131HB

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

Knittel, Kenn M.

The Joint Actinide Shock Physics Experimental Research (JASPER) Program target fabrication facility is currently located in building 131 (B131) of the Lawrence Livermore National Laboratory (LLNL). A portion of this current facility has been committed to another program as part of a larger effort to consolidate LLNL capabilities into newer facilities. This facility assembles precision targets for scientific studies at the Nevada National Security Site (NNSS). B131 is also going through a modernization project to upgrade the infrastructure and abate asbestos. These activities will interrupt the continuous target fabrication efforts for the JASPER Program. Several options are explored to meetmore » the above conflicting requirements, with the final recommendation to prepare a new facility for JASPER target fabrication operations before modernization efforts begin in the current facility assigned to JASPER. This recommendation fits within all schedule constraints and minimizes the disruption to the JASPER Program. This option is not without risk, as it requires moving an aged, precision coordinate measuring machine, which is essential to the JASPER Program’s success. The selected option balances the risk to the machine with continuity of operations.« less

Code inspection instructional validation

NASA Technical Reports Server (NTRS)

Orr, Kay; Stancil, Shirley

1992-01-01

The Shuttle Data Systems Branch (SDSB) of the Flight Data Systems Division (FDSD) at Johnson Space Center contracted with Southwest Research Institute (SwRI) to validate the effectiveness of an interactive video course on the code inspection process. The purpose of this project was to determine if this course could be effective for teaching NASA analysts the process of code inspection. In addition, NASA was interested in the effectiveness of this unique type of instruction (Digital Video Interactive), for providing training on software processes. This study found the Carnegie Mellon course, 'A Cure for the Common Code', effective for teaching the process of code inspection. In addition, analysts prefer learning with this method of instruction, or this method in combination with other methods. As is, the course is definitely better than no course at all; however, findings indicate changes are needed. Following are conclusions of this study. (1) The course is instructionally effective. (2) The simulation has a positive effect on student's confidence in his ability to apply new knowledge. (3) Analysts like the course and prefer this method of training, or this method in combination with current methods of training in code inspection, over the way training is currently being conducted. (4) Analysts responded favorably to information presented through scenarios incorporating full motion video. (5) Some course content needs to be changed. (6) Some content needs to be added to the course. SwRI believes this study indicates interactive video instruction combined with simulation is effective for teaching software processes. Based on the conclusions of this study, SwRI has outlined seven options for NASA to consider. SwRI recommends the option which involves creation of new source code and data files, but uses much of the existing content and design from the current course. Although this option involves a significant software development effort, SwRI believes this option will produce the most effective results.

Treatment Options for Gastrointestinal Carcinoid Tumors

MedlinePlus

... have any of these signs or symptoms. Imaging studies and tests that examine the blood and urine are used ... or after starting their cancer treatment. Follow-up tests may be needed. ... is a research study meant to help improve current treatments or obtain ...

Treatment Option Overview (Gastrointestinal Carcinoid Tumors)

MedlinePlus

... have any of these signs or symptoms. Imaging studies and tests that examine the blood and urine are used ... or after starting their cancer treatment. Follow-up tests may be needed. ... is a research study meant to help improve current treatments or obtain ...

Roadwaste management : a tool for developing district plans.

DOT National Transportation Integrated Search

2000-10-01

The Oregon Department of Transportation (ODOT) conducted a study to examine roadwaste management options. Phase 1 consisted of a thorough review of regulations and standards, roadwaste characterization, current management practices, and new technolog...

75 FR 30451 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

... May 14, 2010. The ODD currently contains general disclosures on the characteristics and risks of...-linked securities. Accordingly, the ODD disclosure only covers the characteristics and risks of options...; Order Granting Approval of Accelerated Delivery of Supplement to the Options Disclosure Document...

The Implications of Real Options on ERP-Enabled Adoption

ERIC Educational Resources Information Center

Nwankpa, Joseph K.

2012-01-01

Current research on Enterprise Resource Planning (ERP) systems and real options focuses on valuation and justification issues that manager's face prior to project approval with existing literature attempting to demonstrate that ERP systems as technology positioning investments have option-like characteristics thus making such ERP systems…

Ventromedial prefrontal and anterior cingulate cortex adopt choice and default reference frames during sequential multialternative choice

PubMed Central

Boorman, Erie D; Rushworth, Matthew F; Behrens, Tim E

2013-01-01

Although damage to medial frontal cortex causes profound decision-making impairments, it has been difficult to pinpoint the relative contributions of key anatomical subdivisions. Here we use fMRI to examine the contributions of human ventromedial prefrontal cortex (vmPFC) and dorsal anterior cingulate cortex (dACC) during sequential choices between multiple alternatives – two key features of choices made in ecological settings. By carefully constructing options whose current value at any given decision was dissociable from their longer-term value, we were able to examine choices in current and long-term frames of reference. We present evidence showing that activity at choice and feedback in vmPFC and dACC was tied to the current choice and the best long-term option, respectively. vmPFC, mid-cingulate, and PCC encoded the relative value between the chosen and next-best option at each sequential decision, whereas dACC encoded the relative value of adapting choices from the option with the highest value in the longer-term. Furthermore, at feedback we identify temporally dissociable effects that predict repetition of the current choice and adaptation away from the long-term best option in vmPFC and dACC, respectively. These functional dissociations at choice and feedback suggest that sequential choices are subject to competing cortical mechanisms. PMID:23392656

Asteroid Redirect Robotic Mission: Robotic Boulder Capture Option Overview

NASA Technical Reports Server (NTRS)

Mazanek, Daniel D.; Merrill, Raymond G.; Belbin, Scott P.; Reeves, David M.; Earle, Kevin D.; Naasz, Bo J.; Abell, Paul A.

2014-01-01

The National Aeronautics and Space Administration (NASA) is currently studying an option for the Asteroid Redirect Robotic Mission (ARRM) that would capture a multi-ton boulder (typically 2-4 meters in size) from the surface of a large (is approximately 100+ meter) Near-Earth Asteroid (NEA) and return it to cislunar space for subsequent human and robotic exploration. This alternative mission approach, designated the Robotic Boulder Capture Option (Option B), has been investigated to determine the mission feasibility and identify potential differences from the initial ARRM concept of capturing an entire small NEA (4-10 meters in size), which has been designated the Small Asteroid Capture Option (Option A). Compared to the initial ARRM concept, Option B allows for centimeter-level characterization over an entire large NEA, the certainty of target NEA composition type, the ability to select the boulder that is captured, numerous opportunities for mission enhancements to support science objectives, additional experience operating at a low-gravity planetary body including extended surface contact, and the ability to demonstrate future planetary defense strategies on a hazardous-size NEA. Option B can leverage precursor missions and existing Agency capabilities to help ensure mission success by targeting wellcharacterized asteroids and can accommodate uncertain programmatic schedules by tailoring the return mass.

The role of gist and verbatim memory in complex decision making: Explaining the unconscious-thought effect.

PubMed

Abadie, Marlène; Waroquier, Laurent; Terrier, Patrice

2017-05-01

Previous research showed that the unconscious-thought effect , which refers to an improvement in complex decision making following a distraction period, was moderated by the presentation format of pieces of information about different options. The aim of the current study was to replicate this finding and further examine the memory representations underlying decision making following a distraction or a deliberation period. Results showed that, when the information was presented blocked per option, participants were better able to differentiate the best option from the others after a distraction period than immediately after the information presentation or after a deliberation period. In addition, distracted participants retrieved more gist representations of the options when the information was presented per option. By contrast, participants were better able to differentiate the best option from the others after a deliberation period when the information was presented per attribute. Participants who deliberated also retrieved more verbatim representations when the information was presented per attribute. Finally, mediation analyses indicated that the accuracy of the evaluations of the options depends on gist memory when distracted but on verbatim memory when deliberating. These findings suggest that the effectiveness of distraction or deliberation depends on the memory representations of the different options. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Fertility preservation options in breast cancer patients.

PubMed

Kasum, Miro; von Wolff, Michael; Franulić, Daniela; Čehić, Ermin; Klepac-Pulanić, Tajana; Orešković, Slavko; Juras, Josip

2015-01-01

The purpose of this review is to analyse current options for fertility preservation in young women with breast cancer (BC). Considering an increasing number of BC survivors, owing to improvements in cancer treatment and delaying of childbearing, fertility preservation appears to be an important issue. Current fertility preservation options in BC survivors range from well-established standard techniques to experimental or investigational interventions. Among the standard options, random-start ovarian stimulation protocol represents a new technique, which significantly decreases the total time of the in vitro fertilisation cycle. However, in patients with oestrogen-sensitive tumours, stimulation protocols using aromatase inhibitors are currently preferred over tamoxifen regimens. Cryopreservation of embryos and oocytes are nowadays deemed the most successful techniques for fertility preservation in BC patients. GnRH agonists during chemotherapy represent an experimental method for fertility preservation due to conflicting long-term outcome results regarding its safety and efficacy. Cryopreservation of ovarian tissue, in vitro maturation of immature oocytes and other strategies are considered experimental and should only be offered within the context of a clinical trial. An early pretreatment referral to reproductive endocrinologists and oncologists should be suggested to young BC women at risk of infertility, concerning the risks and benefits of fertility preservation options.

A prototype software methodology for the rapid evaluation of biomanufacturing process options.

PubMed

Chhatre, Sunil; Francis, Richard; O'Donovan, Kieran; Titchener-Hooker, Nigel J; Newcombe, Anthony R; Keshavarz-Moore, Eli

2007-10-01

A three-layered simulation methodology is described that rapidly evaluates biomanufacturing process options. In each layer, inferior options are screened out, while more promising candidates are evaluated further in the subsequent, more refined layer, which uses more rigorous models that require more data from time-consuming experimentation. Screening ensures laboratory studies are focused only on options showing the greatest potential. To simplify the screening, outputs of production level, cost and time are combined into a single value using multi-attribute-decision-making techniques. The methodology was illustrated by evaluating alternatives to an FDA (U.S. Food and Drug Administration)-approved process manufacturing rattlesnake antivenom. Currently, antivenom antibodies are recovered from ovine serum by precipitation/centrifugation and proteolyzed before chromatographic purification. Alternatives included increasing the feed volume, replacing centrifugation with microfiltration and replacing precipitation/centrifugation with a Protein G column. The best alternative used a higher feed volume and a Protein G step. By rapidly evaluating the attractiveness of options, the methodology facilitates efficient and cost-effective process development.

Fixed or mixed: a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program

PubMed Central

2013-01-01

Background Despite the widespread use of multiple-choice assessments in medical education assessment, current practice and published advice concerning the number of response options remains equivocal. This article describes an empirical study contrasting the quality of three 60 item multiple-choice test forms within the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP). The three forms are described below. Methods The first form featured four response options per item. The second form featured three response options, having removed the least functioning option from each item in the four-option counterpart. The third test form was constructed by retaining the best performing version of each item from the first two test forms. It contained both three and four option items. Results Psychometric and educational factors were taken into account in formulating an approach to test construction for the FSEP. The four-option test performed better than the three-option test overall, but some items were improved by the removal of options. The mixed-option test demonstrated better measurement properties than the fixed-option tests, and has become the preferred test format in the FSEP program. The criteria used were reliability, errors of measurement and fit to the item response model. Conclusions The position taken is that decisions about the number of response options be made at the item level, with plausible options being added to complete each item on both psychometric and educational grounds rather than complying with a uniform policy. The point is to construct the better performing item in providing the best psychometric and educational information. PMID:23453056

Fixed or mixed: a comparison of three, four and mixed-option multiple-choice tests in a Fetal Surveillance Education Program.

PubMed

Zoanetti, Nathan; Beaves, Mark; Griffin, Patrick; Wallace, Euan M

2013-03-04

Despite the widespread use of multiple-choice assessments in medical education assessment, current practice and published advice concerning the number of response options remains equivocal. This article describes an empirical study contrasting the quality of three 60 item multiple-choice test forms within the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Fetal Surveillance Education Program (FSEP). The three forms are described below. The first form featured four response options per item. The second form featured three response options, having removed the least functioning option from each item in the four-option counterpart. The third test form was constructed by retaining the best performing version of each item from the first two test forms. It contained both three and four option items. Psychometric and educational factors were taken into account in formulating an approach to test construction for the FSEP. The four-option test performed better than the three-option test overall, but some items were improved by the removal of options. The mixed-option test demonstrated better measurement properties than the fixed-option tests, and has become the preferred test format in the FSEP program. The criteria used were reliability, errors of measurement and fit to the item response model. The position taken is that decisions about the number of response options be made at the item level, with plausible options being added to complete each item on both psychometric and educational grounds rather than complying with a uniform policy. The point is to construct the better performing item in providing the best psychometric and educational information.

Option pricing: Stock price, stock velocity and the acceleration Lagrangian

NASA Astrophysics Data System (ADS)

Baaquie, Belal E.; Du, Xin; Bhanap, Jitendra

2014-12-01

The industry standard Black-Scholes option pricing formula is based on the current value of the underlying security and other fixed parameters of the model. The Black-Scholes formula, with a fixed volatility, cannot match the market's option price; instead, it has come to be used as a formula for generating the option price, once the so called implied volatility of the option is provided as additional input. The implied volatility not only is an entire surface, depending on the strike price and maturity of the option, but also depends on calendar time, changing from day to day. The point of view adopted in this paper is that the instantaneous rate of return of the security carries part of the information that is provided by implied volatility, and with a few (time-independent) parameters required for a complete pricing formula. An option pricing formula is developed that is based on knowing the value of both the current price and rate of return of the underlying security which in physics is called velocity. Using an acceleration Lagrangian model based on the formalism of quantum mathematics, we derive the pricing formula for European call options. The implied volatility of the market can be generated by our pricing formula. Our option price is applied to foreign exchange rates and equities and the accuracy is compared with Black-Scholes pricing formula and with the market price.

Achalasia: current therapeutic options

PubMed Central

Arora, Zubin; Thota, Prashanthi N.; Sanaka, Madhusudhan R.

2017-01-01

Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia. Management of achalasia mainly involves improving the esophageal outflow in order to provide symptomatic relief to patients. The most effective treatment options for achalasia include pneumatic dilation, Heller myotomy and peroral endoscopic myotomy (POEM), with the latter increasingly emerging as the treatment of choice for many patients. This review focusses on evidence for current and emerging treatment options for achalasia with a particular emphasis on POEM. PMID:28717439

Propellant Depots: The Future of Space Exploration

NASA Astrophysics Data System (ADS)

Crenwelge, Drew

NASA is currently exploring several options for mankind's return to the lunar surface and beyond. The selected option must stimulate both commercial and international involvement, support future missions to the Moon and other destinations, and above all, fit within the current budget profile. Contrary to the current Constellation approach, this paper describes the option of using an in-space propellant depot architecture that can refuel or top-off visiting vehicles at EML1, and how it fits within NASA's new space exploration criteria. In addition to receiving and transferring fuel, the propellant depot will also provide cryogenic propellant storage and management that utilizes flight proven technologies in conjunction with technologies currently under development. The propellant depot system, propellant management and acquisition devices, thermodynamic analysis, and key enabling technologies are also discussed. Depot design concepts along with an overview of a future lunar mission sequence are also presented.

In-Space Transportation for GEO Space Solar Power Satellites

NASA Technical Reports Server (NTRS)

Martin, James A.; Donnahue, Benjamin B.; Henley, Mark W.

1999-01-01

This report summarizes results of study tasks to evaluate design options for in-space transportation of geostationary Space Solar Power Satellites. Referring to the end-to-end architecture studies performed in 1988, this current activity focuses on transportation of Sun Tower satellite segments from an initial low Earth orbit altitude to a final position in geostationary orbit (GEO; i.e., 35,786 km altitude, circular, equatorial orbit). This report encompasses study activity for In-Space Transportation of GEO Space Solar Power (SSP) Satellites including: 1) assessment of requirements, 2) design of system concepts, 3) comparison of alternative system options, and 4) assessment of potential derivatives.

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

Rossi, Adriana; et al.

Long-range beam-beam (LRBB) interactions can be a source of emittance growth and beam losses in the LHC during physics and will become even more relevant with the smaller '* and higher bunch intensities foreseen for the High Luminosity LHC upgrade (HL-LHC), in particular if operated without crab cavities. Both beam losses and emittance growth could be mitigated by compensat-ing the non-linear LRBB kick with a correctly placed current carrying wire. Such a compensation scheme is currently being studied in the LHC through a demonstration test using current-bearing wires embedded into col-limator jaws, installed either side of the high luminosity interactionmore » regions. For HL-LHC two options are considered, a current-bearing wire as for the demonstrator, or electron lenses, as the ideal distance between the particle beam and compensating current may be too small to allow the use of solid materials. This paper reports on the ongoing activities for both options, covering the progress of the wire-in-jaw collimators, the foreseen LRBB experiments at the LHC, and first considerations for the design of the electron lenses to ultimately replace material wires for HL-LHC.« less

Economical and environmental analysis of thermal and photovoltaic solar energy as source of heat for industrial processes

NASA Astrophysics Data System (ADS)

Pérez-Aparicio, Elena; Lillo-Bravo, Isidoro; Moreno-Tejera, Sara; Silva-Pérez, Manuel

2017-06-01

Thermal energy for industrial processes can be generated using thermal (ST) or photovoltaic (PV) solar energy. ST energy has traditionally been the most favorable option due to its cost and efficiency. Current costs and efficiencies values make the PV solar energy become an alternative to ST energy as supplier of industrial process heat. The aim of this study is to provide a useful tool to decide in each case which option is economically and environmentally the most suitable alternative. The methodology used to compare ST and PV systems is based on the calculation of the levelized cost of energy (LCOE) and greenhouse gas emissions (GHG) avoided by using renewable technologies instead of conventional sources of energy. In both cases, these calculations depend on costs and efficiencies associated with ST or PV systems and the conversion factor from thermal or electrical energy to GHG. To make these calculations, a series of hypotheses are assumed related to consumer and energy prices, operation, maintenance and replacement costs, lifetime of the system or working temperature of the industrial process. This study applies the methodology at five different sites which have been selected taking into account their radiometric and meteorological characteristics. In the case of ST energy three technologies are taken into account, compound parabolic concentrator (CPC), linear Fresnel collector (LFC) and parabolic trough collector (PTC). The PV option includes two ways of use of generated electricity, an electrical resistance or a combination of an electrical resistance and a heat pump (HP). Current values of costs and efficiencies make ST system remains as the most favorable option. These parameters may vary significantly over time. The evolution of these parameters may convert PV systems into the most favorable option for particular applications.

Female pattern alopecia: current perspectives

PubMed Central

Levy, Lauren L; Emer, Jason J

2013-01-01

Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss. PMID:24039457

78 FR 10228 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... transaction fee for XSP index options. Currently, the Exchange has a $0.18 customer transaction fee per... customer transaction fees for transactions in XSP index options. Eliminating the customer transaction fee... opportunity to pay lower fees for such transactions and provide greater incentives for customers to trade XSP...

78 FR 11243 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-15

.... Specifically, the Exchange is proposing to increase the threshold in which it waives customer transaction fees, implement a $0.25 marketing fee for trading in SPY and QQQ options, and eliminate the complex order... customer transaction fee in ``ETF, ETN and HOLDRs Options.'' Currently, the Exchange waives transaction...

77 FR 67044 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

... report also contained information and analysis of FLEX Index Options trading patterns. The Exchange also... Effectiveness of Proposed Rule Change Related to Extending the FLEX Exercise Settlement Values Pilot November 2... regarding permissible exercise settlement values for FLEX Index Options, which pilot program is currently...

Aerospace engineering educational program

NASA Technical Reports Server (NTRS)

Craft, William; Klett, David; Lai, Steven

1992-01-01

The principle goal of the educational component of NASA CORE is the creation of aerospace engineering options in the mechanical engineering program at both the undergraduate and graduate levels. To accomplish this goal, a concerted effort during the past year has resulted in detailed plans for the initiation of aerospace options in both the BSME and MSME programs in the fall of 1993. All proposed new courses and the BSME aerospace option curriculum must undergo a lengthy approval process involving two cirriculum oversight committees (School of Engineering and University level) and three levels of general faculty approval. Assuming approval is obtained from all levels, the options will officially take effect in Fall '93. In anticipation of this, certain courses in the proposed curriculum are being offered during the current academic year under special topics headings so that current junior level students may graduate in May '94 under the BSME aerospace option. The proposed undergraduate aerospace option curriculum (along with the regular mechanical engineering curriculum for reference) is attached at the end of this report, and course outlines for the new courses are included in the appendix.

Treatment Options for Childhood Extracranial Germ Cell Tumors

MedlinePlus

... menstrual periods . In females, unusual vaginal bleeding. Imaging studies and blood tests are used to detect (find) and diagnose childhood ... or after starting their cancer treatment. Follow-up tests may be needed. ... trial is a research study meant to help improve current treatments or obtain ...

Hierarchical competitions subserving multi-attribute choice

PubMed Central

Hunt, Laurence T; Dolan, Raymond J; Behrens, Timothy EJ

2015-01-01

Valuation is a key tenet of decision neuroscience, where it is generally assumed that different attributes of competing options are assimilated into unitary values. Such values are central to current neural models of choice. By contrast, psychological studies emphasize complex interactions between choice and valuation. Principles of neuronal selection also suggest competitive inhibition may occur in early valuation stages, before option selection. Here, we show behavior in multi-attribute choice is best explained by a model involving competition at multiple levels of representation. This hierarchical model also explains neural signals in human brain regions previously linked to valuation, including striatum, parietal and prefrontal cortex, where activity represents competition within-attribute, competition between attributes, and option selection. This multi-layered inhibition framework challenges the assumption that option values are computed before choice. Instead our results indicate a canonical competition mechanism throughout all stages of a processing hierarchy, not simply at a final choice stage. PMID:25306549

A review on technological options of waste to energy for effective management of municipal solid waste.

PubMed

Kumar, Atul; Samadder, S R

2017-11-01

Approximately one-fourth population across the world rely on traditional fuels (kerosene, natural gas, biomass residue, firewood, coal, animal dung, etc.) for domestic use despite significant socioeconomic and technological development. Fossil fuel reserves are being exploited at a very fast rate to meet the increasing energy demands, so there is a need to find alternative sources of energy before all the fossil fuel reserves are depleted. Waste to energy (WTE) can be considered as a potential alternative source of energy, which is economically viable and environmentally sustainable. The present study reviewed the current global scenario of WTE technological options (incineration, pyrolysis, gasification, anaerobic digestion, and landfilling with gas recovery) for effective energy recovery and the challenges faced by developed and developing countries. This review will provide a framework for evaluating WTE technological options based on case studies of developed and developing countries. Unsanitary landfilling is the most commonly practiced waste disposal option in the developing countries. However, developed countries have realised the potential of WTE technologies for effective municipal solid waste management (MSWM). This review will help the policy makers and the implementing authorities involved in MSWM to understand the current status, challenges and barriers for effective management of municipal solid waste. This review concluded WTE as a potential renewable source of energy, which will partly meet the energy demand and ensure effective MSWM. Copyright © 2017 Elsevier Ltd. All rights reserved.

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study

PubMed Central

Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-01-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes. PMID:28207061

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.

PubMed

Helova, Anna; Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-03-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.

A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam.

PubMed

Cashin, Cheryl; Phuong, Nguyen Khanh; Shain, Ryan; Oanh, Tran Thi Mai; Thuy, Nguyen Thi

2015-01-01

Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocation across health care providers in three provinces in Vietnam, as well as on the total expenditure of the provincial branches of the public health insurance agency (Provincial Social Security [PSS]). The results show that currently more than 50% of PSS spending is concentrated at the provincial level with less than half at the district level. There is also a high degree of financial risk on district hospitals with the current fund-holding arrangement. Results of the simulation model show that several alternative scenarios for provider payment reform could improve the current payment system by reducing the high financial risk currently borne by district hospitals without dramatically shifting the current level and distribution of PSS expenditure. The results of the simulation analysis provided an empirical basis for health policy-makers in Vietnam to assess different provider payment reform options and make decisions about new models to support health system objectives.

Surgical options in benign parotid tumors: a proposal for classification.

PubMed

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.

17 CFR 240.15c3-1a - Options (Appendix A to 17 CFR 240.15c3-1).

Code of Federal Regulations, 2013 CFR

2013-04-01

... Regulations Under the Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c3-1a... and down) in the current market value of the underlying instrument equal to the percentage... life of the option; and (6) The current term structure of interest rates. (C) The term major market...

17 CFR 240.15c3-1a - Options (Appendix A to 17 CFR 240.15c3-1).

Code of Federal Regulations, 2010 CFR

2010-04-01

... Regulations Under the Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c3-1a... and down) in the current market value of the underlying instrument equal to the percentage... life of the option; and (6) The current term structure of interest rates. (C) The term major market...

17 CFR 240.15c3-1a - Options (Appendix A to 17 CFR 240.15c3-1).

Code of Federal Regulations, 2011 CFR

2011-04-01

... Regulations Under the Securities Exchange Act of 1934 Rules Relating to Over-The-Counter Markets § 240.15c3-1a... and down) in the current market value of the underlying instrument equal to the percentage... life of the option; and (6) The current term structure of interest rates. (C) The term major market...

[Endometriosis Update 2016].

PubMed

Imesch, Patrick; Fink, Daniel

2016-03-02

Endometriosis is a common gynecologic benign disease, affecting 6–10% of women of reproductive age. The disease is often associated with dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The exact mechanism of the pathogenesis of endometriosis has not yet been fully elucidated, therefore, current medical therapeutic options are more symptom-oriented than causal. The aim of the present work is to summarize the current diagnostic and therapeutic options.

Attitudes of GPs towards Older Adults Psychology Services in the Scottish Highlands.

PubMed

Todman, Jonathan P F; Law, Jim; MacDougall, Andrew

2011-01-01

The mental health of older adults is of increasing concern in an aging population and GPs are frequently the gatekeepers to specialist mental health services. Psychotherapy, social interventions and bibliotherapy all have an evidence-base for treating depression and anxiety in the elderly, as does pharmacological treatment. However, the referral rate from GPs for an Older Adults Clinical Psychology service in the Scottish Highlands in the months prior to the study had been very low and the reasons for this were not clear. General practitioners may have felt that depression and anxiety are 'understandable' in older adults and are therefore unsuitable for treatment, or they may have felt that psycho-pharmacotherapy treatments are more effective than the psychotherapy treatment options. Alternatively, local issues associated with the remote location of many NHS Highland GP practices and patients may have prevented them referring. Therefore, the current study aimed to elicit the therapeutic preferences of Highland GPs, the perceived availability of these options and an estimate of the prevalence of older adults in the area suffering from mild or moderate mental health problems. Questionnaires including brief quantitative and qualitative questions were sent to all 284 GPs in the area with 119 (46%) were completed and returned. Responses from GPs suggested that many patients with depression or anxiety may not be referred. The GPs indicated that social therapeutic options are seen to be as effective as pharmacological options and more effective than other psychological and bibliotherapy options. However, GPs indicated that they were substantially more likely to prescribe pharmacological options than other forms of therapy. The GPs suggested that lower waiting times and a more localised service would increase the likelihood of a referral being made. The current study suggests that low awareness of psychological service provision among GPs may have resulted in fewer referrals, rather than low confidence in psychotherapies for this population. The GPs' preference for social interventions may reflect the particular risk of isolation of the elderly in remote communities and may be worthy of consideration when developing services in these areas.

Expanding the Paradigm: Postsecondary Education Options for Individuals with Autism Spectrum Disorder and Intellectual Disabilities

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,…

78 FR 66796 - Self-Regulatory Organizations: Miami International Securities Exchange LLC; Notice of Filing and...

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...

Fertility concerns in men with genitourinary malignancies: Treatment dilemmas, fertility options, and medicolegal considerations.

PubMed

Polland, Allison; Berookhim, Boback M

2016-09-01

With increasing genitourinary cancer survivorship in patients of reproductive age, fertility preservation has become a greater focus in the management of these patients. We performed a review of articles pertaining to male infertility, fertility preservation, and genitourinary cancers. The aim was to review causes of infertility in patients with cancer, current options for fertility preservation, research that may expand preservation options, and ethical as well as medicolegal considerations. There are multiple causes of infertility in male patients with cancer, including the malignancy itself, and the treatments required to achieve a potential cure. Surgery can affect the normal pathways for erection, emission, and ejaculation. Chemotherapy can have a profound negative effect on spermatogenesis by causing chromosomal aberrations, maturation arrest, mutagenesis, and impaired spermatozoa motility. Radiation can cause cellular apoptosis with resultant reduction in spermatogonial stem cells. There are numerous methods to secure fertility before cancer treatment with the aid of cryopreservation ranging from simple patient-provided semen samples to complex sperm retrieval techniques. Research in the field of spermatogenic stem cells may lead to improved treatment options such as autotransplant of stem cells for repopulation of the testes after cancer treatment. Early discussion of possible fertility effects in patients undergoing genitourinary cancer treatment is critical in this era of increasing survivorship. Although current cancer treatments can cause infertility, there are well-established options for fertility preservation and current research will likely lead to improved treatment options. Copyright © 2016 Elsevier Inc. All rights reserved.

Analyses related to the development of DSM-5 criteria for substance use related disorders: 3. An assessment of Pathological Gambling criteria.

PubMed

Denis, Cécile; Fatséas, Mélina; Auriacombe, Marc

2012-04-01

The DSM-5 Substance-Related Disorders Work Group proposed to include Pathological Gambling within the current Substance-Related Disorders section. The objective of the current report was to assess four possible sets of diagnostic criteria for Pathological Gambling. Gamblers (N=161) were defined as either Pathological or Non-Pathological according to four classification methods. (a) Option 1: the current DSM-IV criteria for Pathological Gambling; (b) Option 2: dropping the "Illegal Acts" criterion, while keeping the threshold at 5 required criteria endorsed; (c) Option 3: the proposed DSM-5 approach, i.e., deleting "Illegal Acts" and lowering the threshold of required criteria from 5 to 4; (d) Option 4: to use a set of Pathological Gambling criteria modeled on the DSM-IV Substance Dependence criteria. Cronbach's alpha and eigenvalues were calculated for reliability, Phi, discriminant function analyses, correlations and multivariate regression models were performed for validity and kappa coefficients were calculated for diagnostic consistency of each option. All criteria sets were reliable and valid. Some criteria had higher discriminant properties than others. The proposed DSM-5 criteria in Options 2 and 3 performed well and did not appear to alter the meanings of the diagnoses of Pathological Gambling from DSM-IV. Future work should further explore if Pathological Gambling might be assessed using the same criteria as those used for Substance Use Disorders. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options.

PubMed

Card, Alan J; Simsekler, Mecit Can Emre; Clark, Michael; Ward, James R; Clarkson, P John

2014-01-01

Risk assessment is widely used to improve patient safety, but healthcare workers are not trained to design robust solutions to the risks they uncover. This leads to an overreliance on the weakest category of risk control recommendations: administrative controls. Increasing the proportion of non-administrative risk control options (NARCOs) generated would enable (though not ensure) the adoption of more robust solutions. Experimentally assess a method for generating stronger risk controls: The Generating Options for Active Risk Control (GO-ARC) Technique. Participants generated risk control options in response to two patient safety scenarios. Scenario 1 (baseline): All participants used current practice (unstructured brainstorming). Scenario 2: Control group used current practice; intervention group used the GO-ARC Technique. To control for individual differences between participants, analysis focused on the change in the proportion of NARCOs for each group. Proportion of NARCOs decreased from 0.18 at baseline to 0.12. Intervention group: Proportion increased from 0.10 at baseline to 0.29 using the GO-ARC Technique. Results were statistically significant. There was no decrease in the number of administrative controls generated by the intervention group. The Generating Options for Active Risk Control (GO-ARC) Technique appears to lead to more robust risk control options.

Option Grids to facilitate shared decision making for patients with Osteoarthritis of the knee: protocol for a single site, efficacy trial.

PubMed

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.

Current options and future possibilities for the treatment of dyskinesia and motor fluctuations in Parkinson's disease.

PubMed

Cenci, M A; Ohlin, K E; Odin, P

2011-09-01

Dyskinesia and motor fluctuations affect up to 90% of patients with Parkinson's disease (PD) within ten years of L-DOPA pharmacotherapy, and represent a major challenge to a successful clinical management of this disorder. There are currently two main treatment options for these complications, namely, deep brain electrical stimulation or continuous infusion of dopaminergic agents. The latter is achieved using either subcutaneous apomorphine infusion or enteric L-DOPA delivery. Some patients also benefit from the antidyskinetic effect of amantadine as an adjunct to L-DOPA treatment. Ongoing research in animal models of PD aims at discovering additional, novel treatment options that can either prevent or reverse dyskinesia and motor fluctuations. Alternative methods of continuous L-DOPA delivery (including gene therapy), and pharmacological agents that target nondopaminergic receptor systems are currently under intense experimental scrutiny. Because clinical response profiles show large individual variation in PD, an increased number of treatment options for dyskinesia and motor fluctuations will eventually allow for antiparkinsonian and antidyskinetic therapies to be tailor-made to the needs of different patients and/or PD subtypes.

Non-pharmacological treatment options for refractory epilepsy: an overview of human treatment modalities and their potential utility in dogs.

PubMed

Martlé, Valentine; Van Ham, Luc; Raedt, Robrecht; Vonck, Kristl; Boon, Paul; Bhatti, Sofie

2014-03-01

Refractory epilepsy is a common disorder both in humans and dogs and treatment protocols are difficult to optimise. In humans, different non-pharmacological treatment modalities currently available include surgery, the ketogenic diet and neurostimulation. Surgery leads to freedom from seizures in 50-75% of patients, but requires strict patient selection. The ketogenic diet is indicated in severe childhood epilepsies, but efficacy is limited and long-term compliance can be problematic. In the past decade, various types of neurostimulation have emerged as promising treatment modalities for humans with refractory epilepsy. Currently, none of these treatment options are used in routine daily clinical practice to treat dogs with the condition. Since many dogs with poorly controlled seizures do not survive, the search for alternative treatment options for canine refractory epilepsy should be prioritised. This review provides an overview of non-pharmacological treatment options for human refractory epilepsy. The current knowledge and limitations of these treatments in canine refractory epilepsy is also discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

UFO-a multi-analyser option for IN12

NASA Astrophysics Data System (ADS)

Schmidt, Wolfgang; Rheinstädter, Maikel C.; Raymond, Stephane; Ohl, Michael

2004-07-01

The IN12 instrument is operated by FZ Jülich in collaboration with CEA Grenoble as a CRG-B instrument at the Institut Laue Langevin in Grenoble. As a three-axis spectrometer for cold neutrons it is dedicated for high-resolution studies of low-energy excitations. In the past years the instrument has been continuously improved and it has demonstrated its excellent performance for neutron scattering research. To meet further challenges as a state-of-the-art instrument in the next funding period we will propose to upgrade IN12 with a multi-analyser option similar to planned or existing RITA-type instruments. IN12 will then be optionally equipped with an array of individual analyser blades which can be positioned separately in order to map the scattered beam on a user-chosen path in (Q,ω)-space. We refer to this set-up as IN12-UFO (universal focusing option). Both, the feasibility and the scientific case are currently being studied. On the conference we will show details of the planned instrumental set-up and demonstrate its flexibility and multiplex advantages for specific physical applications.

Augmentation treatment in major depressive disorder: focus on aripiprazole

PubMed Central

Nelson, J Craig; Pikalov, Andrei; Berman, Robert M

2008-01-01

Major depressive disorder (MDD) is a disabling psychiatric condition for which effective treatment remains an outstanding need. Antidepressants are currently the mainstay of treatment for depression; however, almost two-thirds of patients will fail to achieve remission with initial treatment. As a result, a range of augmentation and combination strategies have been used in order to improve outcomes for patients. Despite the popularity of these approaches, limited data from double-blind, randomized, placebo-controlled studies are available to allow clinicians to determine which are the most effective augmentation options or which patients are most likely to respond to which options. Recently, evidence has shown that adjunctive therapy with atypical antipsychotics has the potential for beneficial antidepressant effects in the absence of psychotic symptoms. In particular, aripiprazole has shown efficacy as an augmentation option with standard antidepressant therapy in two, large, randomized, double-blind studies. Based on these efficacy and safety data, aripiprazole was recently approved by the FDA as adjunctive therapy for MDD. The availability of this new treatment option should allow more patients with MDD to achieve remission and, ultimately, long-term, successful outcomes. PMID:19183784

Space transfer concepts and analyses for exploration missions: Technical directive 10

NASA Technical Reports Server (NTRS)

Woodcock, Gordon R.

1992-01-01

The current technical effort is part of the third phase of a broad-scoped and systematic study of space transfer concepts for human lunar and Mars missions. The study addressed issues that were raised during the previous phases but specifically on launch vehicle size trades and MEV options.

Cost-effectiveness analysis of Option B+ for HIV prevention and treatment of mothers and children in Malawi.

PubMed

Fasawe, Olufunke; Avila, Carlos; Shaffer, Nathan; Schouten, Erik; Chimbwandira, Frank; Hoos, David; Nakakeeto, Olive; De Lay, Paul

2013-01-01

The Ministry of Health in Malawi is implementing a pragmatic and innovative approach for the management of all HIV-infected pregnant women, termed Option B+, which consists of providing life-long antiretroviral treatment, regardless of their CD4 count or clinical stage. Our objective was to determine if Option B+ represents a cost-effective option. A decision model simulates the disease progression of a cohort of HIV-infected pregnant women receiving prophylaxis and antiretroviral therapy, and estimates the number of paediatric infections averted and maternal life years gained over a ten-year time horizon. We assess the cost-effectiveness from the Ministry of Health perspective while taking into account the practical realities of implementing ART services in Malawi. If implemented as recommended by the World Health Organization, options A, B and B+ are equivalent in preventing new infant infections, yielding cost effectiveness ratios between US$ 37 and US$ 69 per disability adjusted life year averted in children. However, when the three options are compared to the current practice, the provision of antiretroviral therapy to all mothers (Option B+) not only prevents infant infections, but also improves the ten-year survival in mothers more than four-fold. This translates into saving more than 250,000 maternal life years, as compared to mothers receiving only Option A or B, with savings of 153,000 and 172,000 life years respectively. Option B+ also yields favourable incremental cost effectiveness ratios (ICER) of US$ 455 per life year gained over the current practice. In Malawi, Option B+ represents a favorable policy option from a cost-effectiveness perspective to prevent future infant infections, save mothers' lives and reduce orphanhood. Although Option B+ would require more financial resources initially, it would save societal resources in the long-term and represents a strategic option to simplify and integrate HIV services into maternal, newborn and child health programmes.

Multirole cargo aircraft options and configurations. [economic analysis

NASA Technical Reports Server (NTRS)

Conner, D. W.; Vaughan, J. C., III

1979-01-01

A future requirements and advanced market evaluation study indicates derivatives of current wide-body aircraft, using 1980 advanced technology, would be economically attractive through 2008, but new dedicated airfreighters incorporating 1990 technology, would offer little or no economic incentive. They would be economically attractive for all payload sizes, however, if RD and T costs could be shared in a joint civil/military arrangement. For the 1994-2008 cargo market, option studies indicate Mach 0.7 propfans would be economically attractive in trip cost, aircraft price and airline ROI. Spanloaders would have an even lower price and higher ROI but would have a relatively high trip cost because of aerodynamic inefficiencies. Dedicated airfreighters using propfans at Mach 0.8 cruise, laminar flow control, or cryofuels, would not provide any great economic benefits. Air cushion landing gear configurations are identified as an option for avoiding runway constraints on airport requirements and/or operational constraints are noted.

Sulfur mustard skin lesions: A systematic review on pathomechanisms, treatment options and future research directions.

PubMed

Rose, Dorothee; Schmidt, Annette; Brandenburger, Matthias; Sturmheit, Tabea; Zille, Marietta; Boltze, Johannes

2018-09-01

Sulfur mustard (SM) is a chemical warfare, which has been used for one hundred years. However, its exact pathomechanisms are still incompletely understood and there is no specific therapy available so far. In this systematic review, studies published between January 2000 and July 2017 involving pathomechanisms and experimental treatments of SM-induced skin lesions were analyzed to summarize current knowledge on SM pathology, to provide an overview on novel treatment options, and to identify promising targets for future research to more effectively counter SM effects. We suggest that future studies should focus on (I) systemic effects of SM intoxication due to its distribution throughout the body, (II) removal of SM depots that continuously release active compound contributing to chronic skin damage, and (III) therapeutic options that counteract the pleiotropic effects of SM. Copyright © 2017 Elsevier B.V. All rights reserved.

Ankle arthritis: review of diagnosis and operative management.

PubMed

Grunfeld, Robert; Aydogan, Umur; Juliano, Paul

2014-03-01

The diagnostic and therapeutic options for ankle arthritis are reviewed. The current standard of care for nonoperative options include the use of nonsteroidal antiinflammatory drugs, corticosteroid injections, orthotics, and ankle braces. Other modalities lack high-quality research studies to delineate their appropriateness and effectiveness. The gold standard for operative intervention in end-stage degenerative arthritis remains arthrodesis, but evidence for the superiority in functional outcomes of total ankle arthroplasty is increasing. The next few years will enable more informed decisions and, with more prospective high-quality studies, the most appropriate patient population for total ankle arthroplasty can be identified. Copyright © 2014 Elsevier Inc. All rights reserved.

School Partners in ILLINET. Automation Options for School Library Resource Sharing in Illinois. Final Report [and] Partners in ILLINET. Special Report.

ERIC Educational Resources Information Center

Howrey, Mary M.

This study was funded by the Library Services and Construction Act (LSCA) to enable the Illinois School Library Media Association (ISLMA) to plan the automation of the state's school libraries. The research was intended to identify current national programs of interest to ISLMA, identify current automation programs within Illinois library systems,…

Economic impacts of current-use assessment of rural land in the east Texas pineywoods region

Treesearch

Clifford A. Hickman; Kevin D. Crowther

1991-01-01

Those provisions of Texas law that authorize optional current-use property tax assessment for forest and other rural land were studied to: (1) estimate the extent of adoption by qualifying property owners, (2) estimate the effects on assessments and taxes of enrolled land, (3) estimate the impacts on revenues received by local units of government, (4) estimate the...

Surgical treatment of hemorrhoids: a critical appraisal of the current options.

PubMed

Cerato, Marlise Mello; Cerato, Nilo Luiz; Passos, Patrícia; Treigue, Alberto; Damin, Daniel C

2014-01-01

Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

Endometriosis: Survey of Current Diagnostic and Therapeutic Options and Latest Research Work

PubMed Central

Juhasz-Böss, I.; Laschke, M. W.; Müller, F.; Rosenbaum, P.; Baum, S.; Solomayer, E. F.; Ulrich, U.

2014-01-01

Endometriosis is one of the most frequent benign diseases in women of child-bearing age. The main symptoms are chronic upper abdominal pain and infertility. However, the aetiology and pathogenesis of endometriosis are as yet insufficiently clarified. Thus, therapy is mainly symptomatic with laparoscopic surgery being the gold standard. The aim of drug therapy is to achieve a hypo-oestrogenic condition. In cases of severe endometriosis and a desire to have children there is often an indication for assisted reproduction. The present article illustrates almost all current aspects on the diagnosis of and therapy of endometriosis. From the clinical viewpoint, emphasis is placed on the rare cases of deeply infiltrating endometriosis that are, however, accompanied with a high morbidity. Current therapeutic options in cases of infertility are also presented in more detail. Furthermore, special attention is paid to the latest research results from both clinical and basic research fields in order to demonstrate our current knowledge on the pathogenesis and, where possible, potentially related therapeutic options. PMID:25221341

Mission and Design Sensitivities for Human Mars Landers Using Hypersonic Inflatable Aerodynamic Decelerators

NASA Technical Reports Server (NTRS)

Polsgrove, Tara P.; Thomas, Herbert D.; Dwyer Ciancio, Alicia; Collins, Tim; Samareh, Jamshid

2017-01-01

Landing humans on Mars is one of NASA's long term goals. NASA's Evolvable Mars Campaign (EMC) is focused on evaluating architectural trade options to define the capabilities and elements needed to sustain human presence on the surface of Mars. The EMC study teams have considered a variety of in-space propulsion options and surface mission options. Understanding how these choices affect the performance of the lander will allow a balanced optimization of this complex system of systems problem. This paper presents the effects of mission and vehicle design options on lander mass and performance. Beginning with Earth launch, options include fairing size assumptions, co-manifesting elements with the lander, and Earth-Moon vicinity operations. Capturing into Mars orbit using either aerocapture or propulsive capture is assessed. For entry, descent, and landing both storable as well as oxygen and methane propellant combinations are considered, engine thrust level is assessed, and sensitivity to landed payload mass is presented. This paper focuses on lander designs using the Hypersonic Inflatable Aerodynamic Decelerators, one of several entry system technologies currently considered for human missions.

Sustainability of UK shale gas in comparison with other electricity options: Current situation and future scenarios.

PubMed

Cooper, Jasmin; Stamford, Laurence; Azapagic, Adisa

2018-04-01

Many countries are considering exploitation of shale gas but its overall sustainability is currently unclear. Previous studies focused mainly on environmental aspects of shale gas, largely in the US, with scant information on socio-economic aspects. To address this knowledge gap, this paper integrates for the first time environmental, economic and social aspects of shale gas to evaluate its overall sustainability. The focus is on the UK which is on the cusp of developing a shale gas industry. Shale gas is compared to other electricity options for the current situation and future scenarios up to the year 2030 to investigate whether it can contribute towards a more sustainable electricity mix in the UK. The results obtained through multi-criteria decision analysis suggest that, when equal importance is assumed for each of the three sustainability aspects shale gas ranks seventh out of nine electricity options, with wind and solar PV being the best and coal the worst options. However, it outranks biomass and hydropower. Changing the importance of the sustainability aspects widely, the ranking of shale gas ranges between fourth and eighth. For shale gas to become the most sustainable option of those assessed, large improvements would be needed, including a 329-fold reduction in environmental impacts and 16 times higher employment, along with simultaneous large changes (up to 10,000 times) in the importance assigned to each criterion. Similar changes would be needed if it were to be comparable to conventional or liquefied natural gas, biomass, nuclear or hydropower. The results also suggest that a future electricity mix (2030) would be more sustainable with a lower rather than a higher share of shale gas. These results serve to inform UK policy makers, industry and non-governmental organisations. They will also be of interest to other countries considering exploitation of shale gas. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

Treatment-resistant Late-life Depression: Challenges and Perspectives

PubMed Central

Knöchel, Christian; Alves, Gilberto; Friedrichs, Benedikt; Schneider, Barbara; Schmidt-Rechau, Anna; Wenzlera, Sofia; Schneider, Angelina; Prvulovic, David; Carvalho, André F.; Oertel-Knöchel, Viola

2015-01-01

The current Review article provides a narrative review about the neurobiological underpinnings and treatment of treatment resistant late-life depression (TRLLD). The manuscript focuses on therapeutic targets of late-life depression, which include pharmacological, psychological, biophysical and exercise treatment approaches. Therefore, we summarize available evidences on that kind of therapies for patients suffering from late-life depression. The search for evidences of therapeutic options of late-life depression were done using searching websites as “pubmed”, and using the searching terms “depression”, “late-life depression”, “treatment”, “biophysical therapy”, “exercise therapy”, “pharmacological therapy” and “psychological therapy”. To the end, we summarize and discuss current data, providing some directions for further research. Treatment recommendations for elderly depressive patients favour a multimodal approach, containing psychological, pharmacological and secondary biophysical therapeutic options. Particularly, a combination of psychotherapy and antidepressant medication reflects the best therapeutic option. However, mostly accepted and used is the pharmacological treatment although evidence suggests that the drug therapy is not as effective as it is in younger depressive patients. Further studies employing larger samples and longer follow-up periods are necessary and may focus on comparability of study designs and involve novel approaches to establish the validity and reliability of multimodal treatment programs. PMID:26467408

Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design.

PubMed

Rush, A John; Fava, Maurizio; Wisniewski, Stephen R; Lavori, Philip W; Trivedi, Madhukar H; Sackeim, Harold A; Thase, Michael E; Nierenberg, Andrew A; Quitkin, Frederic M; Kashner, T Michael; Kupfer, David J; Rosenbaum, Jerrold F; Alpert, Jonathan; Stewart, Jonathan W; McGrath, Patrick J; Biggs, Melanie M; Shores-Wilson, Kathy; Lebowitz, Barry D; Ritz, Louise; Niederehe, George

2004-02-01

STAR*D is a multisite, prospective, randomized, multistep clinical trial of outpatients with nonpsychotic major depressive disorder. The study compares various treatment options for those who do not attain a satisfactory response with citalopram, a selective serotonin reuptake inhibitor antidepressant. The study enrolls 4000 adults (ages 18-75) from both primary and specialty care practices who have not had either a prior inadequate response or clear-cut intolerance to a robust trial of protocol treatments during the current major depressive episode. After receiving citalopram (level 1), participants without sufficient symptomatic benefit are eligible for randomization to level 2 treatments, which entail four switch options (sertraline, bupropion, venlafaxine, cognitive therapy) and three citalopram augment options (bupropion, buspirone, cognitive therapy). Those who receive cognitive therapy (switch or augment options) at level 2 without sufficient improvement are eligible for randomization to one of two level 2A switch options (venlafaxine or bupropion). Level 2 and 2A participants are eligible for random assignment to two switch options (mirtazapine or nortriptyline) and to two augment options (lithium or thyroid hormone) added to the primary antidepressant (citalopram, bupropion, sertraline, or venlafaxine) (level 3). Those without sufficient improvement at level 3 are eligible for level 4 random assignment to one of two switch options (tranylcypromine or the combination of mirtazapine and venlafaxine). The primary outcome is the clinician-rated, 17-item Hamilton Rating Scale for Depression, administered at entry and exit from each treatment level through telephone interviews by assessors masked to treatment assignments. Secondary outcomes include self-reported depressive symptoms, physical and mental function, side-effect burden, client satisfaction, and health care utilization and cost. Participants with an adequate symptomatic response may enter the 12-month naturalistic follow-up phase with brief monthly and more complete quarterly assessments.

Evaluation of low wind modeling approaches for two tall-stack databases.

PubMed

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.

Expensing options solves nothing.

PubMed

Sahlman, William A

2002-12-01

The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system.

DNA vaccines in veterinary use

PubMed Central

Redding, Laurel; Werner, David B

2015-01-01

DNA vaccines represent a new frontier in vaccine technology. One important application of this technology is in the veterinary arena. DNA vaccines have already gained a foothold in certain fields of veterinary medicine. However, several important questions must be addressed when developing DNA vaccines for animals, including whether or not the vaccine is efficacious and cost effective compared with currently available options. Another important question to consider is how to apply this developing technology in a wide range of different situations, from the domestic pet to individual fish in fisheries with several thousand animals, to wildlife programs for disease control. In some cases, DNA vaccines represent an interesting option for vaccination, while in others, currently available options are sufficient. This review will examine a number of diseases of veterinary importance and the progress being made in DNA vaccine technology relevant to these diseases, and we compare these with the conventional treatment options available. PMID:19722897

Wet soil cover applicability and design

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

Hunter, F.; Feenstra, S.; Hwang, D.

1996-12-31

As part of a focused feasibility study for the Tyson Superfund site, Daekyoo Hwang, then with ERM, developed a flooding/flushing option. It was not considered a viable option due to concerns over contaminated groundwater control. The concept, however, had several attractive features: control of VOC emissions; the downward movement of water prevents contamination of the overlying clean soil by the upward movement of contaminated soil vapor; and some natural attenuation of the contaminated lagoon area soils. The new concept employs a near saturated soil layer to prevent VOC emission and the downward movement of water to prevent contamination of surfacemore » soil. The wet soil cover became one of five alternatives submitted as part of the focused feasibility study. It was selected as the remedial option for the site by the USEPA. The study was reviewed by the public and they also were positive as to the use of a wet soil cover to control VOC emissions at the site. The wet soil cover is currently being designed by Smith Environmental.« less

New and current preventive treatment options in actinic keratosis.

PubMed

Arenberger, P; Arenbergerova, M

2017-09-01

Actinic keratosis (AK) is a characteristic skin lesion on skin areas of subjects with mainly phototype I and phototype II, or with specific genetic factors and who are exposed to prolonged ultraviolet radiation. AK may be considered a precursor of in situ squamous cell carcinoma (SCC), a type of non-melanoma skin cancer (NMSC). However, it is still not possible to predict which AK lesions will develop into SCC. Early treatment of AK is therefore recommended. Despite the increasing number of patients with AK developing into SCC, to date, there is still no clear suggestion of therapeutic strategy for AK. Current treatment consists of a multitude of topical lesion-directed or field-directed therapies or a combination of both. Recently, orally administered nicotinamide has shown to significantly reduce rates of new NMSC and AK in high-risk patients. This study aims to provide an update on the most relevant information about AK and to provide an insight into current and new treatment options. © 2017 European Academy of Dermatology and Venereology.

Angina pectoris: current therapy and future treatment options.

PubMed

Parikh, Raj; Kadowitz, Philip J

2014-02-01

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

National Intelligent Transportation Systems Program Plan: Five-Year Horizon

DOT National Transportation Integrated Search

2013-06-01

This white paper is a follow-up to the Volpe Center report for FHWA, Ridesharing Options Analysis and Practitioners Toolkit. The white paper provides an update to current ridesharing options and further explores technology and policy develop...

Toxin-Based Drug May Be New Option for Rare Leukemia

Cancer.gov

In patients with hairy cell leukemia, the toxin-based treatment moxetumomab pasudotox may be an effective new treatment option. As this Cancer Currents post explains, the drug looked to be highly effective in a large clinical trial.

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers

PubMed Central

Dobie, Robert A; Wojcik, Nancy C

2015-01-01

Objectives The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999–2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Methods Regression analysis was used to derive new age-correction values using audiometric data from the 1999–2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20–75 years. Results The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20–75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61–75 years. Conclusions Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. PMID:26169804

Age correction in monitoring audiometry: method to update OSHA age-correction tables to include older workers.

PubMed

Dobie, Robert A; Wojcik, Nancy C

2015-07-13

The US Occupational Safety and Health Administration (OSHA) Noise Standard provides the option for employers to apply age corrections to employee audiograms to consider the contribution of ageing when determining whether a standard threshold shift has occurred. Current OSHA age-correction tables are based on 40-year-old data, with small samples and an upper age limit of 60 years. By comparison, recent data (1999-2006) show that hearing thresholds in the US population have improved. Because hearing thresholds have improved, and because older people are increasingly represented in noisy occupations, the OSHA tables no longer represent the current US workforce. This paper presents 2 options for updating the age-correction tables and extending values to age 75 years using recent population-based hearing survey data from the US National Health and Nutrition Examination Survey (NHANES). Both options provide scientifically derived age-correction values that can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Regression analysis was used to derive new age-correction values using audiometric data from the 1999-2006 US NHANES. Using the NHANES median, better-ear thresholds fit to simple polynomial equations, new age-correction values were generated for both men and women for ages 20-75 years. The new age-correction values are presented as 2 options. The preferred option is to replace the current OSHA tables with the values derived from the NHANES median better-ear thresholds for ages 20-75 years. The alternative option is to retain the current OSHA age-correction values up to age 60 years and use the NHANES-based values for ages 61-75 years. Recent NHANES data offer a simple solution to the need for updated, population-based, age-correction tables for OSHA. The options presented here provide scientifically valid and relevant age-correction values which can be easily adopted by OSHA to expand their regulatory guidance to include older workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Case Study: Online Continuing Education for New Librarians

ERIC Educational Resources Information Center

Hendrix, Beth R.; McKeal, Alyse E.

2017-01-01

Continuing education is vital for new librarians to gain skills and knowledge beyond library school. Professional development offered free in an online environment is often the best option for staying current on the issues and trends necessary for young librarians to grow and flourish. This paper presents a case study of an online professional…

Creating Better Educational and Employment Opportunities for Rural Young People.

ERIC Educational Resources Information Center

Kenyon, Peter; Sercombe, Howard; Black, Alan; Lhuede, Dominica

This study explores current education, training, and employment issues and opportunities for rural youth in Australia, and suggests ways in which relevant education, training, and employment options and prospects can be generated for rural youth. Specifically, this study documents the ways that economic and social changes in rural communities have…

From Affinity and Beyond: A Study of Online Literacy Conversations and Communities

ERIC Educational Resources Information Center

Albers, Peggy; Pace, Christi L.; Odo, Dennis Murphy

2016-01-01

Digital technologies make possible new avenues for sharing and accessing literacy research and practices worldwide. Among the myriad of options available, web seminars have become popular online learning venues. The current investigation is part of Global Conversations in Literacy Research (GCLR), a longitudinal and qualitative study now in its…

School Choice: The Perceptions of Rural Public School Educators

ERIC Educational Resources Information Center

Brabham, Jessica Marlene

2010-01-01

This study identified the feelings and beliefs that rural educators possess about the options of school choice, via vouchers, as currently discussed by federal and state governments. The sample of this study consisted of 250 educators, representing 10 different schools, who completed a school choice survey developed by the researcher. A comparison…

The incremental cost of switching from Option B to Option B+ for the prevention of mother-to-child transmission of HIV.

PubMed

O'Brien, Lisa; Shaffer, Nathan; Sangrujee, Nalinee; Abimbola, Taiwo O

2014-03-01

To estimate the incremental cost over 5 years of a policy switch from the Option B to the Option B+ protocol for the prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV). Data from cost studies and other published sources were used to determine the cost, per woman and per cohort (1000 breastfeeding and 1000 non-breastfeeding women), of switching from Option B (maternal triple antiretroviral [ARV] regimen during pregnancy and breastfeeding plus daily nevirapine for the infant for 6 weeks) to Option B+ (maternal triple ARV regimen initiated during pregnancy and continued for life). The variables used to model the different scenarios were maternal CD4+ T lymphocyte (CD4+ cell) count (350-500 versus > 500 cells/µl), rate of decline in CD4+ cells (average, rapid, slow), breastfeeding status (yes, no) and breastfeeding duration (12, 18 or 24 months). For women with CD4+ cell counts of 350-500 cells/µl, the incremental cost per 1000 women was 157,345 United States dollars (US$) for breastfeeding women and US$ 92,813 for non-breastfeeding women. For women with CD4+ cell counts > 500 cells/µl, the incremental cost per 1000 women ranged from US$ 363,443 to US$ 484,591 for breastfeeding women and was US$ 605,739 for non-breastfeeding women. From a cost perspective, a policy switch from Option B to Option B+ is feasible in PMTCT programme settings where resources are currently being allocated to Option B.

Effective treatment options for musculoskeletal pain in primary care: A systematic overview of current evidence

PubMed Central

Hill, Jonathan C.; Foster, Nadine E.; Protheroe, Joanne

2017-01-01

Background & aims Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care. Methods A systematic search was conducted. Initial searches identified clinical guidelines, clinical pathways and systematic reviews. Additional searches found recently published trials and those addressing gaps in the evidence base. Data on study populations, interventions, and outcomes of intervention on pain and function were extracted. Quality of systematic reviews was assessed using AMSTAR, and strength of evidence rated using a modified GRADE approach. Results Moderate to strong evidence suggests that exercise therapy and psychosocial interventions are effective for relieving pain and improving function for musculoskeletal pain. NSAIDs and opioids reduce pain in the short-term, but the effect size is modest and the potential for adverse effects need careful consideration. Corticosteroid injections were found to be beneficial for short-term pain relief among patients with knee and shoulder pain. However, current evidence remains equivocal on optimal dose, intensity and frequency, or mode of application for most treatment options. Conclusion This review presents a comprehensive summary and critical assessment of current evidence for the treatment of pain presentations in primary care. The evidence synthesis of interventions for common musculoskeletal pain presentations shows moderate-strong evidence for exercise therapy and psychosocial interventions, with short-term benefits only from pharmacological treatments. Future research into optimal dose and application of the most promising treatments is needed. PMID:28640822

Human Mars Lander Design for NASA's Evolvable Mars Campaign

NASA Technical Reports Server (NTRS)

Polsgrove, Tara; Chapman, Jack; Sutherlin, Steve; Taylor, Brian; Fabisinski, Leo; Collins, Tim; Cianciolo Dwyer, Alicia; Samareh, Jamshid; Robertson, Ed; Studak, Bill;

Carbon tax and greenhouse gas control : options and considerations for Congress

DOT National Transportation Integrated Search

2009-02-23

This report prepared by the Congressional Research Service discusses the current policy tools available for use in bridging the gap between a carbon tax and a cap-and-trade program, implementation issues and options for revenue distribution.

The origins of options.

PubMed

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.

The Origins of Options

PubMed Central

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

Active treatment for food allergy.

PubMed

Kobernick, Aaron K; Burks, A Wesley

2016-10-01

Food allergy has grown in rapidly in prevalence, currently affecting 5% of adults and 8% of children. Management strategy is currently limited to 1) food avoidance and 2) carrying and using rescue intramuscular epinephrine/adrenaline and oral antihistamines in the case of accidental ingestion; there is no FDA approved treatment. Recently, oral, sublingual and epicutaneous immunotherapy have been developed as active treatment of food allergy, though none have completed phase 3 study. Efficacy and safety studies of immunotherapy have been variable, though there is clearly signal that immunotherapy will be a viable option to desensitize patients. The use of bacterial adjuvants, anti-IgE monoclonal antibodies, and Chinese herbal formulations either alone or in addition to immunotherapy may hold promise as future options for active treatment. Active prevention of food allergy through early introduction of potentially offending foods in high-risk infants will be an important means to slow the rising incidence of sensitization. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Photovoltaic and thermal energy conversion for solar powered satellites

NASA Technical Reports Server (NTRS)

Von Tiesenhausen, G. F.

1976-01-01

A summary is provided concerning the most important aspects of present investigations related to a use of solar power satellites (SPS) as a future source of terrestrial energy. General SPS characteristics are briefly considered, early work is reviewed, and a description of current investigations is presented. System options presently under study include a photovoltaic array, a thermionic system, and a closed Brayton cycle. Attention is given to system reference options, basic building blocks, questions of system analysis and engineering, photovoltaic conversion, and the utility interface. It is concluded that an SPS may be cost effective compared to terrestrial systems by 1995.

Treatment options for demodex blepharitis: patient choice and efficacy.

PubMed

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.

Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

NASA Technical Reports Server (NTRS)

Niederhaus, Charles E.; Barlow, Karen L.; Griffin, DeVon W.; Miller, Fletcher J.

2008-01-01

This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified.

New therapeutic solutions for Behçet's syndrome.

PubMed

Vitale, Antonio; Rigante, Donato; Lopalco, Giuseppe; Emmi, Giacomo; Bianco, Maria Teresa; Galeazzi, Mauro; Iannone, Florenzo; Cantarini, Luca

2016-07-01

Behçet's syndrome (BS) is a systemic inflammatory disorder characterized by a wide range of potential clinical manifestations with no gold-standard therapy. However, the recent classification of BS at a crossroads between autoimmune and autoinflammatory syndromes has paved the way to new further therapeutic opportunities in addition to anti-tumor necrosis factor agents. This review provides a digest of all current experience and evidence about pharmacological agents recently described as having a role in the treatment of BS, including interleukin (IL)-1 inhibitors, tocilizumab, rituximab, alemtuzumab, ustekinumab, interferon-alpha-2a, and apremilast. IL-1 inhibitors currently represent the most studied agents among the latest treatment options for BS, proving to be effective, safe and with an acceptable retention on treatment. However, since BS is a peculiar disorder with clinical features responding to certain treatments that in turn can worsen other manifestations, identifying new treatment options for patients unresponsive to the current drug armamentarium is of great relevance. A number of agents have been studied in the last decade showing changing fortunes in some cases and promising results in others. The latter will potentially provide their contribution for better clinical management of BS, improving patients' quality of life and long-term outcome.

Stress urinary incontinence in women: Current and emerging therapeutic options

PubMed Central

Shamout, Samer; Campeau, Lysanne

2017-01-01

Surgical management of stress urinary incontinence (SUI) is most commonly achieved by midurethral synthetic sling (MUS) insertion as a first-line surgical option. A great deal of research continues to evolve new management strategies to reach an optimal balance of high efficacy and minimal adverse events. This expert opinion review provides a brief and comprehensive discussion of recent advances and ongoing research in the management of SUI, with an emphasis on single-incision mini-slings, vaginal laser treatment, and cell-based therapy. It is based on data obtained from numerous published meta-analyses and original studies identified through literature search. Single-incision mini-slings appear equally effective initially compared with standard MUS (retropubic or transobturator) for the treatment of female SUI; however, this efficacy lacks durability evidence beyond one-year followup. There is a lack of sufficient clinical evidence to currently confirm long-term safety and effectiveness of cell-therapy and non-ablative vaginal laser therapy, besides suggestion of apparent initial safety. There are still significant challenges to overcome before widespread clinical practice of the latter two modalities. Future research should be aimed at identifying groups of patients who might benefit from these minimally invasive therapeutic options. PMID:28616118

Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

PubMed

Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

2015-03-01

The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use.

Editorial Commentary: Graft Removal Versus Retention for Septic Arthritis After Anterior Cruciate Ligament Reconstruction: Accounting for Patient Preference Flips the Script on Current Practice.

PubMed

Cote, Mark P

2018-03-01

Septic arthritis is a rare but potentially devastating complication after anterior cruciate ligament (ACL) reconstruction. Studies examining surgical treatment options including graft retention and removal are largely inconclusive. Although the literature indicated that 43.8% of patients who have the graft removed later go on to have a revision ACL reconstruction compared with only 6.5% among those whose graft is retained, this expected-value decision analysis found removal to be the optimal treatment for patients with septic arthritis after ACL reconstruction. This is largely based on patient preference to avoid a late reoperation for residual knee infection. These findings support the concept of utility when considering treatment options for patients with a septic knee. For some, avoiding a late reoperation for a persistent infection is the most important factor and as such graft removal may be the most appropriate treatment to produce a positive outcome among these patients despite the fact that currently, an attempt at graft retention could represent the generally preferred treatment option among practicing surgeons. Copyright © 2017. Published by Elsevier Inc.

SURGICAL TREATMENT OF HEMORRHOIDS: A CRITICAL APPRAISAL OF THE CURRENT OPTIONS

PubMed Central

CERATO, Marlise Mello; CERATO, Nilo Luiz; PASSOS, Patrícia; TREIGUE, Alberto; DAMIN, Daniel C.

2014-01-01

Introduction Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results. PMID:24676303

The challenge of Propionibacterium acnes and revision shoulder arthroplasty: a review of current diagnostic options.

PubMed

Shields, Margaret V; Abdullah, Leath; Namdari, Surena

2016-06-01

Propionibacterium acnes is the most common cause of infection after shoulder arthroplasty. Whereas there are several methods that can aid in the diagnosis of P. acnes infection, there is not a single "gold standard" because of the difficulties inherent in identifying this bacterium. We present an evidence-based discussion of the demographic, clinical, and radiographic predictors of P. acnes infection and review the current options for diagnosis. This review was written after a comprehensive analysis of the current literature related to shoulder periprosthetic joint infection and P. acnes identification. Of the techniques reviewed, α-defensin had the highest sensitivity in detecting P. acnes infection (63%). C-reactive protein level and erythrocyte sedimentation rate were often normal in cases of infection. Whereas P. acnes can be challenging to successfully diagnose, there are several options that are considered preferable because of their higher sensitivities and specificities. The current gold standard is intraoperative culture, but major advances in molecular techniques may provide future improvements in diagnostic accuracy. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

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)

Weighing the Evidence: A Meta-Analysis of Bilingual Education in Arizona

ERIC Educational Resources Information Center

Rolstad, Kellie; Mahoney, Kate S.; Glass, Gene V.

2005-01-01

This article reviews the current policy context in the state of Arizona for program options for English language learners and produces a meta-analysis of studies on the effectiveness of bilingual education that have been conducted in the state in or after 1985. The study presents an analysis of a sample of evaluation studies (N = 4), which…

Optimal behaviour can violate the principle of regularity.

PubMed

Trimmer, Pete C

2013-07-22

Understanding decisions is a fundamental aim of behavioural ecology, psychology and economics. The regularity axiom of utility theory holds that a preference between options should be maintained when other options are made available. Empirical studies have shown that animals violate regularity but this has not been understood from a theoretical perspective, such decisions have therefore been labelled as irrational. Here, I use models of state-dependent behaviour to demonstrate that choices can violate regularity even when behavioural strategies are optimal. I also show that the range of conditions over which regularity should be violated can be larger when options do not always persist into the future. Consequently, utility theory--based on axioms, including transitivity, regularity and the independence of irrelevant alternatives--is undermined, because even alternatives that are never chosen by an animal (in its current state) can be relevant to a decision.

Context-dependent decisions among options varying in a single dimension.

PubMed

Morgan, Kate V; Hurly, T Andrew; Bateson, Melissa; Asher, Lucy; Healy, Susan D

2012-02-01

Contrary to theories of rational choice, adding alternatives to a choice set can change the choices made by both humans and animals. This is usually done by adding an inferior decoy to a choice set of two favoured options that are characterized on two distinct dimensions. We presented wild, free-living rufous hummingbirds (Selasphorus rufus) with choices between two or three options that varied in a single dimension only. The options varied in concentration, in volume or in corolla length. When the options varied in concentration, the addition of a medium option to a choice set of a low and a high concentration caused birds to increase their preference for the high option. However, they decreased their preference for the high concentration option when a low option was added to a choice set of high and medium concentrations. When the options varied only in volume, the addition of a high volume option to a choice set of low and medium options decreased the birds' preference for the medium option. We saw no effects of adding a third option when the options varied in corolla length alone. Hummingbirds, then, make context-dependent decisions even when the options vary in only a single dimension although which effect occurs seems to depend on the dimension being manipulated. None of the current theories alone adequately explain these results. Copyright © 2011 Elsevier B.V. All rights reserved.

The order of information processing alters economic gain-loss framing effects.

PubMed

Kwak, Youngbin; Huettel, Scott

2018-01-01

Adaptive decision making requires analysis of available information during the process of choice. In many decisions that information is presented visually - which means that variations in visual properties (e.g., salience, complexity) can potentially influence the process of choice. In the current study, we demonstrate that variation in the left-right positioning of risky and safe decision options can influence the canonical gain-loss framing effect. Two experiments were conducted using an economic framing task in which participants chose between gambles and certain outcomes. The first experiment demonstrated that the magnitude of the gain-loss framing effect was greater when the certain option signaling the current frame was presented on the left side of the visual display. Eye-tracking data during task performance showed a left-gaze bias for initial fixations, suggesting that the option presented on the left side was processed first. Combination of eye-tracking and choice data revealed that there was a significant effect of direction of first gaze (i.e. left vs. right) as well as an interaction between gaze direction and identity of the first fixated information (i.e. certain vs. gamble) regardless of frame. A second experiment presented the gamble and certain options in a random order, with a temporal delay between their presentations. We found that the magnitude of gain-loss framing was larger when the certain option was presented first, regardless of left and right positioning, only in individuals with lower risk-taking tendencies. The effect of presentation order on framing was not present in high risk-takers. These results suggest that the sequence of visual information processing as well as their left-right positioning can bias choices by changing the impact of the presented information during risky decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

Mission and Design Sensitivities for Human Mars Landers Using Hypersonic Inflatable Aerodynamic Decelerators

NASA Technical Reports Server (NTRS)

Polsgrove, Tara P.; Thomas, Herbert D.; Collins, Tim; Dwyer Cianciolo, Alicia; Samareh, Jamshid

2017-01-01

Landing humans on Mars is one of NASA's long term goals. The Evolvable Mars Campaign (EMC) is focused on evaluating architectural trade options to define the capabilities and elements needed for a sustainable human presence on the surface of Mars. The EMC study teams have considered a variety of in-space propulsion options and surface mission options. As we seek to better understand how these choices affect the performance of the lander, this work informs and influences requirements for transportation systems to deliver the landers to Mars and enable these missions. This paper presents the effects of mission and vehicle design options on lander mass and performance. Beginning with Earth launch, options include fairing size assumptions, co-manifesting other elements with the lander, and Earth-Moon vicinity operations. Capturing into Mars orbit using either aerocapture or propulsive capture is assessed. For entry, descent, and landing both storable as well as oxygen and methane propellant combinations are considered, engine thrust level is assessed, and sensitivity to landed payload mass is presented. This paper focuses on lander designs using the Hypersonic Inflatable Aerodynamic Decelerators (HIAD), one of several entry system technologies currently considered for human missions.

Astrobiological relevance and feasibility of a sample collection mission to the atmosphere of Venus

NASA Astrophysics Data System (ADS)

Schulze-Makuch, Dirk; Irwin, Louis N.; Irwin, Troy

2002-11-01

The lower cloud level of the Venusian atmosphere is an environmental niche that could harbor microbial life. Particularly the mode 3 particles that are enriched in this atmospheric layer are of astrobiological interest. We propose here a sample collection mission to the atmosphere of Venus and evaluate three mission options. The first option is a Stardust-type spacecraft used for sample collection, the second option is a Rotating Probe Tether System, and the third option is a Parachute Drop - Balloon Floatation System. Given the current state of technology, the result of our preliminary analysis is that the Parachute Drop - Balloon Floatation Mission is the most feasible and practical option.

Solar Electric and Chemical Propulsion Technology Applications to a Titan Orbiter/Lander Mission

NASA Technical Reports Server (NTRS)

Cupples, Michael

2007-01-01

Several advanced propulsion technology options were assessed for a conceptual Titan Orbiter/Lander mission. For convenience of presentation, the mission was broken into two phases: interplanetary and Titan capture. The interplanetary phase of the mission was evaluated for an advanced Solar Electric Propulsion System (SEPS), while the Titan capture phase was evaluated for state-of-art chemical propulsion (NTO/Hydrazine), three advanced chemical propulsion options (LOX/Hydrazine, Fluorine/Hydrazine, high Isp mono-propellant), and advanced tank technologies. Hence, this study was referred to as a SEPS/Chemical based option. The SEPS/Chemical study results were briefly compared to a 2002 NASA study that included two general propulsion options for the same conceptual mission: an all propulsive based mission and a SEPS/Aerocapture based mission. The SEP/Chemical study assumed identical science payload as the 2002 NASA study science payload. The SEPS/Chemical study results indicated that the Titan mission was feasible for a medium launch vehicle, an interplanetary transfer time of approximately 8 years, an advanced SEPS (30 kW), and current chemical engine technology (yet with advanced tanks) for the Titan capture. The 2002 NASA study showed the feasibility of the mission based on a somewhat smaller medium launch vehicle, an interplanetary transfer time of approximately 5.9 years, an advanced SEPS (24 kW), and advanced Aerocapture based propulsion technology for the Titan capture. Further comparisons and study results were presented for the advanced chemical and advanced tank technologies.

Alternatives to clearcutting of old growth in southeast Alaska.

Treesearch

Sally. Duncan

1999-01-01

This issue of Science Findings examines the results of a study designed to provide a broad array of silvicultural options for land managers. Pacific Northwest Research Station scientist Mike McClellan is leading the study and has found that timber harvesting by using alternatives to clearcutting is viable in the current marketplace and technically feasible across a...

A Study of Changes in the Library and Information Science Curriculum with Evaluation of Its Practicality

ERIC Educational Resources Information Center

Noh, Younghee; Ahn, In-Ja; Choi, Sang-Ki

2012-01-01

Purpose: This study analyzed the process of changes in Korean Library and Information Science curriculum and evaluated the courses currently available by using a perception survey of librarians in the field. It also explored a possible demand for new courses, while suggesting compulsory, core, and optional courses for Bachelor's degree curriculum…

Job Satisfaction, Quality of Work Life and Work Motivation in Employees with Intellectual Disability: A Systematic Review

ERIC Educational Resources Information Center

Kocman, Andreas; Weber, Germain

2018-01-01

Background: Current research on employment options for people with Intellectual Disability emphasizes the importance of employee needs and satisfaction. The study aims at systematically reviewing the literature on job satisfaction and related constructs. Methods: A systematic literature search was conducted. Studies were included if (i) they are…

Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

PubMed Central

Pruden, Amy; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K.; Graham, David W.; Lazorchak, James M.; Suzuki, Satoru; Silley, Peter; Snape, Jason R.; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

2013-01-01

Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action. PMID:23735422

Current management of hepatocellular carcinoma

PubMed Central

Tabrizian, Parissa; Roayaie, Sasan; Schwartz, Myron E

2014-01-01

Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and leading cause of death among patients with cirrhosis. Treatment guidelines are based according to the Barcelona Clinic Liver Cancer staging system. The choice among therapeutic options that include liver resection, liver transplantation, locoregional, and systemic treatments must be individualized for each patient. The aim of this paper is to review the outcomes that can be achieved in the treatment of HCC with the heterogeneous therapeutic options currently available in clinical practice. PMID:25132740

Assessing climate adaptation options and uncertainties for cereal systems in West Africa

NASA Astrophysics Data System (ADS)

Guan, K.; Sultan, B.; Biasutti, M.; Lobell, D. B.

2015-12-01

The already fragile agriculture production system in West Africa faces further challenges in meeting food security in the coming decades, primarily due to a fast increasing population and risks of climate change. Successful adaptation of agriculture should not only benefit in the current climate but should also reduce negative (or enhance positive) impacts for climate change. Assessment of various possible adaptation options and their uncertainties provides key information for prioritizing adaptation investments. Here, based on the several robust aspects of climate projections in this region (i.e. temperature increases and rainfall pattern shifts), we use two well-validated crop models (i.e. APSIM and SARRA-H) and an ensemble of downscaled climate forcing to assess five possible and realistic adaptation options (late sowing, intensification, thermal time increase, water harvesting and increased resilience to heat stress) in West Africa for the staple crop production of sorghum. We adopt a new assessment framework to account for both the impacts of adaptation options in current climate and their ability to reduce impacts of future climate change, and also consider changes in both mean yield and its variability. Our results reveal that most proposed "adaptation options" are not more beneficial in the future than in the current climate, i.e. not really reduce the climate change impacts. Increased temperature resilience during grain number formation period is the main adaptation that emerges. We also find that changing from the traditional to modern cultivar, and later sowing in West Sahel appear to be robust adaptations.

Spasticity Management in Disorders of Consciousness

PubMed Central

Laureys, Steven

2017-01-01

Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage. Objectives: Our aim was to review the occurrence of spasticity in patients with disorders of consciousness and the therapeutic interventions used to treat it. Methods: We conducted a systematic review using the PubMed online database. It returned 157 articles. After applying our inclusion criteria (i.e., studies about patients in coma, unresponsive wakefulness syndrome or minimally conscious state, with spasticity objectively reported as a primary or secondary outcome), 18 studies were fully reviewed. Results: The prevalence of spasticity in patients with disorders of consciousness ranged from 59% to 89%. Current treatment options include intrathecal baclofen and soft splints. Several treatment options still need further investigation; including acupuncture, botulin toxin or cortical activation by thalamic stimulation. Conclusion: The small number of articles available in the current literature highlights that spasticity is poorly studied in patients with disorders of consciousness although it is one of the most common motor disorders. While treatments such as intrathecal baclofen and soft splints seem effective, large randomized controlled trials have to be done and new therapeutic options should be explored. PMID:29232836

Attitudes to current oral contraceptive use and future developments: the women's perspective.

PubMed

Fuchs, N; Prinz, H; Koch, U

1996-09-01

The study was planned to determine current trends in contraceptive usage and to examine the attitudes, needs and preferences of women with respect to oral contraceptives. Semi-structured interviews were carried out with women (n = 1201, aged 16-45 years) in Germany, the UK and France. The study revealed that oral contraceptives were the most popular method of contraception employed, followed by condoms, and that the majority of respondents were aged 16-19 years when they first used an oral contraceptive. An important finding of the study was that an oral contraceptive was first used only after having sexual intercourse for the first time (within 1 year), emphasizing the importance of effective contraceptive information and education for adolescents. Regarding non-contraceptive health benefits, protection from ovarian and endometrial cancer was perceived by respondents to be of the greatest importance; however, few women were spontaneously aware of this benefit. When given a number of different oral contraceptive intake options to assess, the established 'once daily for 21 consecutive days' option remained the most popular, although a 'once weekly' alternative was cited by many women. When asked about the preferred frequency of menstrual bleeding, there was a polarization between women favoring the normal monthly bleed and those wanting a 'no-bleed' regimen. Women are poorly informed about oral contraceptive use, and are largely unaware of the important long-term non-contraceptive benefits. Many women would prefer alternative pill intake options and a significant number would favor a 'no-bleed' regimen.

Triple-negative breast cancer: treatment challenges and solutions

PubMed Central

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

Creating a Visualization Powerwall

NASA Technical Reports Server (NTRS)

Miller, B. H.; Lambert, J.; Zamora, K.

1996-01-01

From Introduction: This paper presents the issues of constructing a Visualization Powerwall. For each hardware component, the requirements, options an our solution are presented. This is followed by a short description of each pilot project. In the summary, current obstacles and options discovered along the way are presented.

Data transmission options for VMT data and fee collection centers.

DOT National Transportation Integrated Search

2002-11-01

The Oregon Road User Fee Task Force (RUFTF) is charged with developing a design for revenue collection for Oregon's roads and highways that will replace the current system for revenue collection for all light vehicles in the state. One option under c...

Reconstruction of the midface and maxilla.

PubMed

Dalgorf, Dustin; Higgins, Kevin

2008-08-01

To review the current classification systems and reconstructive options available for restoration of maxillectomy defects. Defects involving the midface can have a great functional and aesthetic impact on the patient. Adequate restoration of the complex three-dimensional maxillary structure is required to replace form and function of the native tissue. An in-depth discussion of appropriate recipient vessel selection and reconstructive options are included in this article. The superficial temporal vessel system is presented as a reliable anastomosis site for restoration of midfacial defects. In addition, the complications of vein grafting, arteriovenous fistula loops and alternative recipient vessels sites are addressed to manage the challenge of the vessel-depleted neck. The current indications, advantages and disadvantages of local, regional and free-flap reconstructive options available for maxillectomy defects are highlighted in order to aid the surgeon in appropriate flap selection. A myriad of reconstructive options are available to restore maxillectomy defects. The surgeon must consider each defect and the needs of the individual patient when choosing the best suited reconstructive technique.

Revisiting policy on chronic HCV treatment under the Thai Universal Health Coverage: An economic evaluation and budget impact analysis.

PubMed

Rattanavipapong, Waranya; Anothaisintawee, Thunyarat; Teerawattananon, Yot

2018-01-01

Thailand is encountering challenges to introduce the high-cost sofosbuvir for chronic hepatitis C treatment as part of the Universal Health Care's benefit package. This study was conducted in respond to policy demand from the Thai government to assess the value for money and budget impact of introducing sofosbuvir-based regimens in the tax-based health insurance scheme. The Markov model was constructed to assess costs and benefits of the four treatment options that include: (i) current practice-peginterferon alfa (PEG) and ribavirin (RBV) for 24 weeks in genotype 3 and 48 weeks for other genotypes; (ii) Sofosbuvir plus peginterferon alfa and ribavirin (SOF+PEG-RBV) for 12 weeks; (iii) Sofosbuvir and daclatasvir (SOF+DCV) for 12 weeks; (iv) Sofosbuvir and ledipasvir (SOF+LDV) for 12 weeks for non-3 genotypes and SOF+PEG-RBV for 12 weeks for genotype 3 infection. Given that policy options (ii) and (iii) are for pan-genotypic infection, the cost of genotype testing was applied only for policy options (i) and (iv). Results reveal that all sofosbuvir-based regimens had greater quality adjusted life years (QALY) gains compared with the current treatment, therefore associated with lower lifetime costs and more favourable health outcomes. Additionally, among the three regimens of sofosbuvir, SOF+PEG-RBV for genotype 3 and SOF+LDV for non-3 genotype are the most cost-effective treatment option with the threshold of 160,000 THB per QALY gained. The results of this study had been used in policy discussion which resulted in the recent inclusion of SOF+PEG-RBV for genotype 3 and SOF+LDV for non-3 genotype in the Thailand's benefit package.

[Cost-effectiveness ratio of using rapid tests for malaria diagnosis in the Peruvian Amazon].

PubMed

Rosas Aguirre, Angel Martín; Llanos Zavalaga, Luis Fernando; Trelles de Belaunde, Miguel

2009-05-01

To determine the cost-effectiveness ratios of three options for diagnosing malaria at the local health provider in 50 communities near the Peruvian Amazon. Calculation of the incremental cost-effectiveness ratios of three options for diagnosing malaria-not using rapid tests, using rapid tests, and accessing microscopy-in patients presenting with fever in 50 communities near Iquitos in the Peruvian Amazon, communities with limited access to microscopy that depend on a network of local health providers. The incremental costs and effects of the two latter options were calculated and compared with the first option (currently in use). By dividing the incremental costs among the incremental effects, the incremental cost-effectiveness ratio was calculated. Using rapid tests would save the Ministry of Health of Peru: US$191 for each new case of Plasmodium falciparum malaria treated promptly and appropriately; US$31 per new case of P. vivax malaria treated promptly and appropriately; US$1,051 per case of acute malaria averted; and US$17,655 for each death avoided. Access to microscopy by all the communities would generate an additional cost of: US$198 per new case of P. falciparum malaria treated promptly and appropriately; US$31 per new case of P. vivax malaria treated promptly and appropriately; US$1,086 per case of acute malaria averted; and US$18,255 for each death avoided. The use of rapid tests by local health providers can improve the effectiveness of malaria diagnosis in patients with fever in the 50 communities studied, at a cost lower than the current method. The recommendation is to expand the use of rapid tests among the health providers in communities similar to those studied.

Risks and risk governance in unconventional shale gas development.

PubMed

Small, Mitchell J; Stern, Paul C; Bomberg, Elizabeth; Christopherson, Susan M; Goldstein, Bernard D; Israel, Andrei L; Jackson, Robert B; Krupnick, Alan; Mauter, Meagan S; Nash, Jennifer; North, D Warner; Olmstead, Sheila M; Prakash, Aseem; Rabe, Barry; Richardson, Nathan; Tierney, Susan; Webler, Thomas; Wong-Parodi, Gabrielle; Zielinska, Barbara

2014-01-01

A broad assessment is provided of the current state of knowledge regarding the risks associated with shale gas development and their governance. For the principal domains of risk, we identify observed and potential hazards and promising mitigation options to address them, characterizing current knowledge and research needs. Important unresolved research questions are identified for each area of risk; however, certain domains exhibit especially acute deficits of knowledge and attention, including integrated studies of public health, ecosystems, air quality, socioeconomic impacts on communities, and climate change. For these, current research and analysis are insufficient to either confirm or preclude important impacts. The rapidly evolving landscape of shale gas governance in the U.S. is also assessed, noting challenges and opportunities associated with the current decentralized (state-focused) system of regulation. We briefly review emerging approaches to shale gas governance in other nations, and consider new governance initiatives and options in the U.S. involving voluntary industry certification, comprehensive development plans, financial instruments, and possible future federal roles. In order to encompass the multiple relevant disciplines, address the complexities of the evolving shale gas system and reduce the many key uncertainties needed for improved management, a coordinated multiagency federal research effort will need to be implemented.

Designing flexible engineering systems utilizing embedded architecture options

NASA Astrophysics Data System (ADS)

Pierce, Jeff G.

This dissertation develops and applies an integrated framework for embedding flexibility in an engineered system architecture. Systems are constantly faced with unpredictability in the operational environment, threats from competing systems, obsolescence of technology, and general uncertainty in future system demands. Current systems engineering and risk management practices have focused almost exclusively on mitigating or preventing the negative consequences of uncertainty. This research recognizes that high uncertainty also presents an opportunity to design systems that can flexibly respond to changing requirements and capture additional value throughout the design life. There does not exist however a formalized approach to designing appropriately flexible systems. This research develops a three stage integrated flexibility framework based on the concept of architecture options embedded in the system design. Stage One defines an eight step systems engineering process to identify candidate architecture options. This process encapsulates the operational uncertainty though scenario development, traces new functional requirements to the affected design variables, and clusters the variables most sensitive to change. The resulting clusters can generate insight into the most promising regions in the architecture to embed flexibility in the form of architecture options. Stage Two develops a quantitative option valuation technique, grounded in real options theory, which is able to value embedded architecture options that exhibit variable expiration behavior. Stage Three proposes a portfolio optimization algorithm, for both discrete and continuous options, to select the optimal subset of architecture options, subject to budget and risk constraints. Finally, the feasibility, extensibility and limitations of the framework are assessed by its application to a reconnaissance satellite system development problem. Detailed technical data, performance models, and cost estimates were compiled for the Tactical Imaging Constellation Architecture Study and leveraged to complete a realistic proof-of-concept.

The incremental cost of switching from Option B to Option B+ for the prevention of mother-to-child transmission of HIV

PubMed Central

Shaffer, Nathan; Sangrujee, Nalinee; Abimbola, Taiwo O

2014-01-01

Abstract Objective To estimate the incremental cost over 5 years of a policy switch from the Option B to the Option B+ protocol for the prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV). Methods Data from cost studies and other published sources were used to determine the cost, per woman and per cohort (1000 breastfeeding and 1000 non-breastfeeding women), of switching from Option B (maternal triple antiretroviral [ARV] regimen during pregnancy and breastfeeding plus daily nevirapine for the infant for 6 weeks) to Option B+ (maternal triple ARV regimen initiated during pregnancy and continued for life). The variables used to model the different scenarios were maternal CD4+ T lymphocyte (CD4+ cell) count (350–500 versus > 500 cells/µl), rate of decline in CD4+ cells (average, rapid, slow), breastfeeding status (yes, no) and breastfeeding duration (12, 18 or 24 months). Findings For women with CD4+ cell counts of 350–500 cells/µl, the incremental cost per 1000 women was 157 345 United States dollars (US$) for breastfeeding women and US$ 92 813 for non-breastfeeding women. For women with CD4+ cell counts > 500 cells/µl, the incremental cost per 1000 women ranged from US$ 363 443 to US$ 484 591 for breastfeeding women and was US$ 605 739 for non-breastfeeding women. Conclusion From a cost perspective, a policy switch from Option B to Option B+ is feasible in PMTCT programme settings where resources are currently being allocated to Option B. PMID:24700975

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.

Ada Compiler Validation Summary Report. Certificate Number: 920918S1. 11274 U.S. Navy Ada/M, Version 4.5 (/NO OPTIMIZE) VAX 8550/8600/8650 (Cluster) = Enhanced Processor (EP) AN/UYK-44 (Bare Board)

DTIC Science & Technology

1992-10-27

Institute of Standards and Technology Gaithersburg, MD USA 1 ELECTE I= 7 . PERFORMING ORGANIZATION NAME(S) AND ADDRESS(E JUN 3 1993U . , PERFORMING...Standard [Ada83) using the current Ada Compiler Validation Capability (ACVC). This Validation Summary Report ( VSR ) gives an account of the testing of... 7 - Control Part (Redirection) Options F.14 Compiler Options F-59 LINKER OPTIONS The linker options of this Ada implementation, as described inl this

Contemporary management of cancer of the oral cavity

PubMed Central

Genden, Eric M.; Silver, Carl E.; Takes, Robert P.; Suárez, Carlos; Owen, Randall P.; Haigentz, Missak; Stoeckli, Sandro J.; Shaha, Ashok R.; Rapidis, Alexander D.; Rodrigo, Juan Pablo; Rinaldo, Alessandra

2010-01-01

Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers. PMID:20155361

Updated CDC Recommendations for Using Artemether-Lumefantrine for the Treatment of Uncomplicated Malaria in Pregnant Women in the United States.

PubMed

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.

Noah’s Ark Conservation Will Not Preserve Threatened Ecological Communities under Climate Change

PubMed Central

Harris, Rebecca Mary Bernadette; Carter, Oberon; Gilfedder, Louise; Porfirio, Luciana Laura; Lee, Greg; Bindoff, Nathaniel Lee

2015-01-01

Background Effective conservation of threatened ecological communities requires knowledge of where climatically suitable habitat is likely to persist into the future. We use the critically endangered Lowland Grassland community of Tasmania, Australia as a case study to identify options for management in cases where future climatic conditions become unsuitable for the current threatened community. Methods We model current and future climatic suitability for the Lowland Themeda and the Lowland Poa Grassland communities, which make up the listed ecological community. We also model climatic suitability for the structurally dominant grass species of these communities, and for closely related grassland and woodland communities. We use a dynamically downscaled regional climate model derived from six CMIP3 global climate models, under the A2 SRES emissions scenario. Results All model projections showed a large reduction in climatically suitable area by mid-century. Outcomes are slightly better if closely related grassy communities are considered, but the extent of suitable area is still substantially reduced. Only small areas within the current distribution are projected to remain climatically suitable by the end of the century, and very little of that area is currently in good condition. Conclusions As the climate becomes less suitable, a gradual change in the species composition, structure and habitat quality of the grassland communities is likely. Conservation management will need to focus on maintaining diversity, structure and function, rather than attempting to preserve current species composition. Options for achieving this include managing related grassland types to maintain grassland species at the landscape-scale, and maximising the resilience of grasslands by reducing further fragmentation, weed invasion and stress from other land uses, while accepting that change is inevitable. Attempting to maintain the status quo by conserving the current structure and composition of Lowland Grassland communities is unlikely to be a viable management option in the long term. PMID:25881302

Noah's Ark conservation will not preserve threatened ecological communities under climate change.

PubMed

Harris, Rebecca Mary Bernadette; Carter, Oberon; Gilfedder, Louise; Porfirio, Luciana Laura; Lee, Greg; Bindoff, Nathaniel Lee

2015-01-01

Effective conservation of threatened ecological communities requires knowledge of where climatically suitable habitat is likely to persist into the future. We use the critically endangered Lowland Grassland community of Tasmania, Australia as a case study to identify options for management in cases where future climatic conditions become unsuitable for the current threatened community. We model current and future climatic suitability for the Lowland Themeda and the Lowland Poa Grassland communities, which make up the listed ecological community. We also model climatic suitability for the structurally dominant grass species of these communities, and for closely related grassland and woodland communities. We use a dynamically downscaled regional climate model derived from six CMIP3 global climate models, under the A2 SRES emissions scenario. All model projections showed a large reduction in climatically suitable area by mid-century. Outcomes are slightly better if closely related grassy communities are considered, but the extent of suitable area is still substantially reduced. Only small areas within the current distribution are projected to remain climatically suitable by the end of the century, and very little of that area is currently in good condition. As the climate becomes less suitable, a gradual change in the species composition, structure and habitat quality of the grassland communities is likely. Conservation management will need to focus on maintaining diversity, structure and function, rather than attempting to preserve current species composition. Options for achieving this include managing related grassland types to maintain grassland species at the landscape-scale, and maximising the resilience of grasslands by reducing further fragmentation, weed invasion and stress from other land uses, while accepting that change is inevitable. Attempting to maintain the status quo by conserving the current structure and composition of Lowland Grassland communities is unlikely to be a viable management option in the long term.

Air pollution control residues from waste incineration: current UK situation and assessment of alternative technologies.

PubMed

Rani, D Amutha; Boccaccini, A R; Deegan, D; Cheeseman, C R

2008-11-01

Current disposal options for APC residues in the UK and alternative treatment technologies developed world-wide have been reviewed. APC residues are currently landfilled in the UK where they undergo in situ solidification, although the future acceptability of this option is uncertain because the EU waste acceptance criteria (WAC) introduce strict limits on leaching that are difficult to achieve. Other APC residue treatment processes have been developed which are reported to reduce leaching to below relevant regulatory limits. The Ferrox process, the VKI process, the WES-PHix process, stabilisation/solidification using cementitious binders and a range of thermal treatment processes are reviewed. Thermal treatment technologies convert APC residues combined with other wastes into inert glass or glass-ceramics that encapsulate heavy metals. The waste management industry will inevitably use the cheapest available option for treating APC residues and strict interpretation and enforcement of waste legislation is required if new, potentially more sustainable technologies are to become commercially viable.

Information Technology Training within Traineeships: Options for TAFE-Based Courses.

ERIC Educational Resources Information Center

Hall, W.; And Others

A study explored ways in which traineeship courses could be designed to include training in information technology. The skills and performance standards required of information technology training in the printing, tourism, banking, construction, and computer industries were identified. Next, the current provision of such training in Australia and…

Revitalizing the Small Town Mainstreet. Hard Times: Communities in Transition.

ERIC Educational Resources Information Center

Cook, Edward A.; Bentley, Marion T.

Presenting a base of general information that local business people and government officials involved with downtown revitalization should be familiar with in order to understand the range of options available and factors that will influence the outcomes of any revitalization program, the paper summarizes current theories, trends, studies, and…

The T(ea) Test: Scripted Stories Increase Statistical Method Selection Skills

ERIC Educational Resources Information Center

Hackathorn, Jana; Ashdown, Brien

2015-01-01

To teach statistics, teachers must attempt to overcome pedagogical obstacles, such as dread, anxiety, and boredom. There are many options available to teachers that facilitate a pedagogically conducive environment in the classroom. The current study examined the effectiveness of incorporating scripted stories and humor into statistical method…

Agreement Reflexes of Emerging Optionality in Heritage Speaker Spanish

ERIC Educational Resources Information Center

Pascual Cabo, Diego

2013-01-01

This study contributes to current trends of heritage speaker (HS) acquisition research by examining the syntax of psych-predicates in HS Spanish. Broadly defined, psych-predicates communicate states of emotions (e.g., to love) and have traditionally been categorized as belonging to one of three classes: class I--"temere" "to…

Preferences for Training Options: A Conjoint Analysis

ERIC Educational Resources Information Center

Gan, Chui Goh; Lee, Julie Anne; Soutar, Geoffrey N.

2009-01-01

Singapore is a growing educational hub for the Asia Pacific region. However, no prior research has examined how Singaporean managers trade off attributes of training programs when making executive training decisions. The current study used conjoint analysis to identify the most important attributes of training programs as word of mouth, trainers'…

Aquaculture: A Component of Low Cost Sanitation Technology

NASA Technical Reports Server (NTRS)

Edwards, P.

1985-01-01

The paper discusses all phases of aquaculture, including commercial viability, sanitary and biological considerations, public health, financial/economic and sociological aspects. Current studies are detailed and options are discussed for their potential applicability to developing countries, considering requirements for capital and labor skills as well as physical needs such as land.

Identifying Priorities for Post-Secondary Education in Qatar. Research Brief

ERIC Educational Resources Information Center

Stasz, Cathleen; Eide, Eric R.; Martorell, Francisco; Salem, Hanine; Constant, Louay; Goldman, Charles A.; Moini, Joy S.; Nadareishvili, Vazha

2007-01-01

Although Qatar has improved its post-secondary educational opportunities, the country's efforts have not undergone a broad strategic review. This study analyzed the extent to which the current offerings can meet the country's future needs and identified priorities for developing further educational options. Researchers found that Qataris' current…

Atmospheric Nitrogen Deposition Loadings to the Chesapeake Bay: An Initial Analysis of the Cost Effectiveness of Control Options (1996)

EPA Pesticide Factsheets

This report examines the cost effectiveness of control options which reduce nitrate deposition to the Chesapeake watershed and to the tidal Bay. The report analyzes current estimates of the reductions expected in the ozone transport region.

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)

Making choices impairs subsequent self-control: a limited-resource account of decision making, self-regulation, and active initiative.

PubMed

Vohs, Kathleen D; Baumeister, Roy F; Schmeichel, Brandon J; Twenge, Jean M; Nelson, Noelle M; Tice, Dianne M

2008-05-01

The current research tested the hypothesis that making many choices impairs subsequent self-control. Drawing from a limited-resource model of self-regulation and executive function, the authors hypothesized that decision making depletes the same resource used for self-control and active responding. In 4 laboratory studies, some participants made choices among consumer goods or college course options, whereas others thought about the same options without making choices. Making choices led to reduced self-control (i.e., less physical stamina, reduced persistence in the face of failure, more procrastination, and less quality and quantity of arithmetic calculations). A field study then found that reduced self-control was predicted by shoppers' self-reported degree of previous active decision making. Further studies suggested that choosing is more depleting than merely deliberating and forming preferences about options and more depleting than implementing choices made by someone else and that anticipating the choice task as enjoyable can reduce the depleting effect for the first choices but not for many choices. (c) 2008 APA, all rights reserved

Abdominal aortic aneurysm: An update

PubMed

Chuen, Jason; Theivendran, Mayo

2018-05-01

Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Treatment options have expanded in recent years to increase the range of morphology suitable for endovascular aneurysm repair (EVAR), and with potential implications on treatment thresholds. This article is the first of two that will outline current treatment options for AAA, including areas of controversy and research in AAA disease, to inform the development of Australasian clinical guidelines and health policy. Medical therapy options remain limited and no aneurysm-specific pharmacotherapy is currently available. Recent years have witnessed a significant shift in AAA surgery from open repair to EVAR and expansion of EVAR techniques. General management of cardiovascular risk factors remains key to reducing all-cause mortality for patients with AAA.

Promising personalized therapeutic options for diffuse large B-cell Lymphoma Subtypes with oncogene addictions.

PubMed

Steinhardt, James J; Gartenhaus, Ronald B

2012-09-01

Currently, two major classification systems segregate diffuse large B-cell lymphoma (DLBCL) into subtypes based on gene expression profiles and provide great insights about the oncogenic mechanisms that may be crucial for lymphomagenesis as well as prognostic information regarding response to current therapies. However, these current classification systems primarily look at expression and not dependency and are thus limited to inductive or probabilistic reasoning when evaluating alternative therapeutic options. The development of a deductive classification system that identifies subtypes in which all patients with a given phenotype require the same oncogenic drivers, and would therefore have a similar response to a rational therapy targeting the essential drivers, would significantly advance the treatment of DLBCL. This review highlights the putative drivers identified as well as the work done to identify potentially dependent populations. These studies integrated genomic analysis and functional screens to provide a rationale for targeted therapies within defined populations. Personalizing treatments by identifying patients with oncogenic dependencies via genotyping and specifically targeting the responsible drivers may constitute a novel approach for the treatment of DLBCL. ©2012 AACR.

PANDAS: A systematic review of treatment options.

PubMed

Farhood, Zachary; Ong, Adrian A; Discolo, Christopher M

2016-10-01

Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) is a rare but important condition for pediatric otolaryngologists to recognize. Several treatment options exist including tonsillectomy, antibiotic treatment/prophylaxis, intravenous immunoglobulin (IVIG), and psychiatric medications/therapy. A systematic review of the PubMed, EMBASE, and Scopus databases was performed searching for articles that focused exclusively on the aforementioned treatment modalities in the PANDAS population. Review articles, single patient case reports, and studies examining the natural history or diagnostic strategies were excluded. Five articles regarding tonsillectomy treatments with level of evidence (LOE) 4 were found but no clear benefit could be determined. Three articles were selected involving the use of antibiotic therapy. One prospective study and one double-blind randomized control trial (DB RCT) supported the use of antibiotics but a separate DB RCT showed no benefit. Two selected articles described the use of IVIG: one unblinded RCT and one retrospective study. One prospective study on cognitive-behavioral therapy (CBT) showed benefit in PANDAS. There is a paucity of high-level studies regarding this rare disorder and no hard treatment recommendations can be made. Tonsillectomy should only be performed in those who are surgical candidates based on current published guidelines. Antibiotics are an option but provide uncertain benefit. CBT remains a low-risk option. Studies support the use of IVIG, however more investigation is needed prior to widespread adoption of this treatment given its potential risks. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Radiofrequency ablation in primary non-small cell lung cancer: What a radiologist needs to know

PubMed Central

Bhatia, Shivank; Pereira, Keith; Mohan, Prasoon; Narayanan, Govindarajan; Wangpaichitr, Medhi; Savaraj, Niramol

2016-01-01

Lung cancer continues to be one of the leading causes of death worldwide. In advanced cases of lung cancer, a multimodality approach is often applied, however with poor local control rates. In early non-small cell lung cancer (NSCLC), surgery is the standard of care. Only 15-30% of patients are eligible for surgical resection. Improvements in imaging and treatment delivery systems have provided new tools to better target these tumors. Stereotactic body radiation therapy (SBRT) has evolved as the next best option. The role of radiofrequency ablation (RFA) is also growing. Currently, it is a third-line option in stage 1 NSCLC, when SBRT cannot be performed. More recent studies have demonstrated usefulness in recurrent tumors and some authors have also suggested combination of RFA with other modalities in larger tumors. Following the National Lung Screening Trial (NLST), screening by low-dose computed tomography (CT) has demonstrated high rates of early-stage lung cancer detection in high-risk populations. Hence, even considering the current role of RFA as a third-line option, in view of increasing numbers of occurrences detected, the number of potential RFA candidates may see a steep uptrend. In view of all this, it is imperative that interventional radiologists be familiar with the techniques of lung ablation. The aim of this article is to discuss the procedural technique of RFA in the lung and review the current evidence regarding RFA for NSCLC. PMID:27081229

Waste minimisation in a hard chromiun plating Small Medium Enterprise (SME).

PubMed

Viguri, J R; Andrés, A; Irabien, A

2002-01-01

The high potential of waste stream minimisation in the metal finishing sector justifies specific studies of Small and Medium Enterprises (SME). In this work, the minimisation options of the wastes generated in a hard chromium plating activity have been analysed. The study has been performed in a small job shop company, which works in batch mode with big pieces. A process flowsheet after connecting the unit operations and determining the process inputs (raw and secondary materials) and outputs (waste streams) has been carried out. The main properties, quantity and current management of the waste streams have been shown. The obvious lack of information has been identified and finally the waste minimisation options that could be adopted by the company have been recorded.

Modelling coastal processes and morphological changes of the UK east coast in support of coastal decision-making

NASA Astrophysics Data System (ADS)

Li, Xiaorong; Leonardi, Nicoletta; Brown, Jennifer; Plater, Andy

2017-04-01

The coastline of Eastern England is home to about one quarter of the UK's coastal habitats, including intertidal salt marshes, tidal flats and sand dunes. These geomorphic features are of great importance to the local wildlife, global biodiversity, marine environment and human society and economy. Due to sea-level rise and the occurrence of extreme weather conditions, the coastline of Eastern England is under high risk of erosion and recession, which could lead to tidal inundation of sites such as the RSPB Minsmere Reserve and power generation infrastructure at Sizewell. This research responds to the need for sustainable shoreline management plans of the UK east coast through sensitivity studies at the Dunwich-Sizewell area, Suffolk, UK. Particular interest is on the long-term morphodynamic response of the study area to possible environmental variations associated with global climate change. Key coastal processes, i.e. current, waves and sediment transport, and morphological evolution are studied using a process-based numerical model under the following scenarios: current mean sea level + calm wave conditions, current mean sea level + storms, sea level rise + calm wave conditions, and sea level rise + storms, all with a 'do nothing' management plan which allows the coastal environment to exist and respond dynamically. As a further aspect of this research, rules will be generalized for reduced-complexity, system-based modelling. Alternative management plans, including 'managed realignment' and 'advance the line', are also investigated in this research under the same environmental forcing scenarios, for the purposes of protection of infrastructure of national importance and conservation of wetland habitats. Both 'hard' and 'soft' engineering options, such as groynes and beach nourishment respectively, are considered. A more ecohydrological option which utilizes aquatic plant communities for wave energy dissipation and sediment trapping is also studied. The last option requires the numerical models to be modified based on understandings obtained through analysis of on-site observations and laboratory measurements.

Comparison of three different options for immediate treatment of painful temporomandibular disorders: a randomized, controlled pilot trial.

PubMed

Giannakopoulos, Nikolaos N; Katsikogianni, Eleni N; Hellmann, Daniel; Eberhard, Lydia; Leckel, Michael; Schindler, Hans J; Schmitter, Marc

2016-08-01

The purpose of this study was to compare the short-term effectiveness of three different types of immediate, non-pharmacological intervention for alleviation of the painful symptoms of temporomandibular disorders (TMD). Thirty-six patients (mean age 41.6 ± 16.7 years, 25 females) diagnosed with non-dysfunctional painful TMD received counselling and subsequently were randomly allocated to three treatment groups: patients in Group A received prefabricated oral splints with water-filled elastic pads (Aqualizer(®)), those in Group B were provided with vacuum-formed co-polyester oral splints and those in Group C were given appointments to receive Michigan-type hard splints. Clinical examination was conducted, at baseline and after 2 weeks, by use of the RDC/TMD. Current pain intensity was determined by evaluation of graded chronic pain status (GCPS) on a numerical rating scale (NRS). Active maximum mouth opening without pain (AMMOP) was also measured. Paired sample t-tests and one-way analysis of variance with a significance level of p ≤ 0.05 were conducted. After 2 weeks, overall mean current pain was reduced by 41.95% (p < 0.001). Current pain reduction was significant for Group B (66.6%, p < 0.001) but not for Groups A (37.88%, p = 0.56) and C (22.29%, p = 0.26). After 2 weeks, current pain level for Group B was significantly lower than that for Group C (p = 0.041). Overall, there was a statistically significant increase of AMMOP (p = 0.01). All therapeutic options were pain-reducing. The results from this study suggest that cost-effective and time-effective intervention of counselling combined with use of a vacuum-formed splint is a favourable option for initial, short-term treatment of painful TMD.

Supporting the labor force participation of older adults: an international survey of policy options.

PubMed

Barusch, Amanda S; Luptak, Marilyn; Hurtado, Marcella

2009-01-01

The unprecedented aging of the world's population challenges many institutions, including labor markets and public pension programs. This study was conducted to survey expert opinions regarding conditions and policies that affect employment of older adults. Eighty-nine respondents from 26 nations responded to an Internet survey regarding their own experiences with the aging labor force; factors that encouraged or discouraged labor force participation of older adults; and government responses to these issues. Respondents identified barriers to employment of older adults and described their governments' responses. Findings illuminate a range of current policy options and suggest possible opportunities for innovation.

29 CFR 2590.701-6 - Special enrollment periods.

Code of Federal Regulations, 2011 CFR

2011-07-01

... benefit packages—an HMO option and an indemnity option. Self-only and family coverage are available under... in this paragraph (b)(2)(i) if a person becomes a dependent of the individual through marriage, birth... dependent of the participant through marriage, birth, adoption, or placement for adoption. (v) Current...

29 CFR 2590.701-6 - Special enrollment periods.

Code of Federal Regulations, 2012 CFR

2012-07-01

... benefit packages—an HMO option and an indemnity option. Self-only and family coverage are available under... in this paragraph (b)(2)(i) if a person becomes a dependent of the individual through marriage, birth... dependent of the participant through marriage, birth, adoption, or placement for adoption. (v) Current...

29 CFR 2590.701-6 - Special enrollment periods.

Code of Federal Regulations, 2013 CFR

2013-07-01

... benefit packages—an HMO option and an indemnity option. Self-only and family coverage are available under... in this paragraph (b)(2)(i) if a person becomes a dependent of the individual through marriage, birth... dependent of the participant through marriage, birth, adoption, or placement for adoption. (v) Current...

76 FR 72488 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... investment and risk management strategies and decisions. The Exchange further believes this proposed rule change will provide investors with additional Weekly option classes for investment, trading and risk management purposes. Therefore, the Exchange requests a modest expansion of the current Weeklys Program. The...

The space station power system

NASA Technical Reports Server (NTRS)

1989-01-01

The requirements for electrical power by the proposed Space Station Freedom are discussed. The options currently under consideration are examined. The three power options are photovoltaic, solar dynamic, and a hybrid system. Advantages and disadvantages of each system are tabulated. Drawings and artist concepts of the Space Station configuration are provided.

The Community Options Program: An Evaluation of Early Implementation Experience.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Health and Social Services, Madison.

This document contains a preliminary report on the implementation of Wisconsin's Community Options Program (COP), a program designed both to divert persons from entering nursing homes and to deinstitutionalize current nursing home residents who can be effectively served by community-based alternatives. The introduction of this report provides a…

Small-diameter utilization issues and opportunities

Treesearch

John Rusty Dramm

1999-01-01

This presentation provides a thought-provoking look at options for utilizing small- diameter wood to help reduce the widespread risk of catastrophic wildfire throughout the West while providing economic recovery of timber-depressed communities and sustaining viable forest products industry. Potentially viable utilization and marketing options are explored and current...

RF System Requirements for a Medium-Energy Electron-Ion Collider (MEIC) at JLab

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

Rimmer, Robert A; Hannon, Fay E; Guo, Jiquan

2015-09-01

JLab is studying options for a medium energy electron-ion collider that could fit on the JLab site and use CEBAF as a full-energy electron injector. A new ion source, linac and booster would be required, together with collider storage rings for the ions and electrons. In order to achieve the maximum luminosity these will be high-current storage rings with many bunches. We present the high-level RF system requirements for the storage rings, ion booster ring and high-energy ion beam cooling system, and describe the technology options under consideration to meet them. We also present options for staging that might reducemore » the initial capital cost while providing a smooth upgrade path to a higher final energy. The technologies under consideration may also be useful for other proposed storage ring colliders or ultimate light sources.« less

Testing necessary regional frontal contributions to value assessment and fixation-based updating.

PubMed

Vaidya, Avinash R; Fellows, Lesley K

2015-12-14

Value-based decisions are biased by the time people spend viewing each option: Options fixated longer are chosen more often, even when previously rated as less appealing. This bias is thought to reflect 'value updating' as new evidence is accumulated. Prior work has shown that ventromedial prefrontal cortex (PFC) carries a fixation-dependent value comparison signal, while other studies implicate dorsomedial PFC in representing the value of alternative options. Here, we test whether these regions are necessary for fixation-related value updating in 33 people with frontal lobe damage and 27 healthy controls performing a simple choice task. We show that damage to dorsomedial PFC leads to an exaggerated influence of fixations on choice, while damage to ventromedial or lateral PFC has no effect on this bias. These findings suggest a critical role for dorsomedial, and not ventromedial PFC, in mediating the relative influence of current fixations and a priori value on choice.

Understanding the cellular basis and pathophysiology of Peyronie’s disease to optimize treatment for erectile dysfunction

PubMed Central

Alzubaidi, Raidh

2017-01-01

Erectile dysfunction (ED) is a common condition that significantly impacts a man’s physical and psychological well-being. ED is often associated with Peyronie’s disease (PD), which is an abnormal curvature of the penis. Delayed treatment of or surgical invention for PD often results in ED and therefore unsatisfied patients. The pathophysiology of PD is incompletely understood, but has been studied extensively and based on our current understanding of PD physiology, many medical treatment options have been proposed. In this paper, we will review what is known about the pathophysiology of PD and the medical treatment options that have been trialed as a result. More investigations in regards to the basic science of PD need to be carried out in order to elucidate the exact mechanisms of the fibrosis, and propose new, more successful treatment options which should be implemented prior to the onset of ED. PMID:28217450

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes.

PubMed

Sangkum, P; Levy, J; Yafi, F A; Hellstrom, W J G

2015-05-01

Urethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized. © 2015 American Society of Andrology and European Academy of Andrology.

Long-Acting Antiretrovirals: Where Are We now?

PubMed

Nyaku, Amesika N; Kelly, Sean G; Taiwo, Babafemi O

2017-04-01

Current HIV treatment options require daily use of combination antiretroviral drugs. Many persons living with HIV experience treatment fatigue and suboptimal adherence as a result. Long-acting antiretroviral drugs are being developed to expand options for HIV treatment. Here, we review the agents in development, and evaluate data from recent clinical trials. In addition, we anticipate challenges to successful widespread use of long-acting antiretrovirals. Parenteral nanosuspensions of cabotegravir and rilpivirine, and dapivirine vaginal ring are the farthest in clinical development. Long-acting modalities in earlier development stages employ drug-loaded implants, microparticles, or targeted mutagenesis, among other innovations. Long-acting antiretroviral drugs promise new options for HIV prevention and treatment, and ways to address poor adherence and treatment fatigue. Further studies will identify the long-acting agents or combinations that are suitable for routine use. Creative solutions will be needed for anticipated implementation challenges.

Optimal behaviour can violate the principle of regularity

PubMed Central

Trimmer, Pete C.

2013-01-01

Understanding decisions is a fundamental aim of behavioural ecology, psychology and economics. The regularity axiom of utility theory holds that a preference between options should be maintained when other options are made available. Empirical studies have shown that animals violate regularity but this has not been understood from a theoretical perspective, such decisions have therefore been labelled as irrational. Here, I use models of state-dependent behaviour to demonstrate that choices can violate regularity even when behavioural strategies are optimal. I also show that the range of conditions over which regularity should be violated can be larger when options do not always persist into the future. Consequently, utility theory—based on axioms, including transitivity, regularity and the independence of irrelevant alternatives—is undermined, because even alternatives that are never chosen by an animal (in its current state) can be relevant to a decision. PMID:23740781

Challenges and Solutions to Assisting Older Adults in Completing the GED: A Study of What the Experts Say

ERIC Educational Resources Information Center

Brinkley-Etzkorn, Karen E.

2016-01-01

The purpose of this study was to investigate the challenges and solutions encountered by Adult Basic Education (ABE) programs currently serving older adults seeking a GED credential in states where this is the only high school equivalency option available. The following questions guided this research: (1) what are the perceived characteristics and…

Application of stakeholder-based and modelling approaches for supporting robust adaptation decision making under future climatic uncertainty and changing urban-agricultural water demand

NASA Astrophysics Data System (ADS)

Bhave, Ajay; Dessai, Suraje; Conway, Declan; Stainforth, David

2016-04-01

Deep uncertainty in future climate change and socio-economic conditions necessitates the use of assess-risk-of-policy approaches over predict-then-act approaches for adaptation decision making. Robust Decision Making (RDM) approaches embody this principle and help evaluate the ability of adaptation options to satisfy stakeholder preferences under wide-ranging future conditions. This study involves the simultaneous application of two RDM approaches; qualitative and quantitative, in the Cauvery River Basin in Karnataka (population ~23 million), India. The study aims to (a) determine robust water resources adaptation options for the 2030s and 2050s and (b) compare the usefulness of a qualitative stakeholder-driven approach with a quantitative modelling approach. For developing a large set of future scenarios a combination of climate narratives and socio-economic narratives was used. Using structured expert elicitation with a group of climate experts in the Indian Summer Monsoon, climatic narratives were developed. Socio-economic narratives were developed to reflect potential future urban and agricultural water demand. In the qualitative RDM approach, a stakeholder workshop helped elicit key vulnerabilities, water resources adaptation options and performance criteria for evaluating options. During a second workshop, stakeholders discussed and evaluated adaptation options against the performance criteria for a large number of scenarios of climatic and socio-economic change in the basin. In the quantitative RDM approach, a Water Evaluation And Planning (WEAP) model was forced by precipitation and evapotranspiration data, coherent with the climatic narratives, together with water demand data based on socio-economic narratives. We find that compared to business-as-usual conditions options addressing urban water demand satisfy performance criteria across scenarios and provide co-benefits like energy savings and reduction in groundwater depletion, while options reducing agricultural water demand significantly affect downstream water availability. Water demand options demonstrate potential to improve environmental flow conditions and satisfy legal water supply requirements for downstream riparian states. On the other hand, currently planned large scale infrastructural projects demonstrate reduced value in certain scenarios, illustrating the impacts of lock-in effects of large scale infrastructure. From a methodological perspective, we find that while the stakeholder-driven approach revealed robust options in a resource-light manner and helped initiate much needed interaction amongst stakeholders, the modelling approach provides complementary quantitative information. The study reveals robust adaptation options for this important basin and provides a strong methodological basis for carrying out future studies that support adaptation decision making.

On Adopting a Proactive Approach to the Disposition of Mars Orbiters

NASA Astrophysics Data System (ADS)

Rummel, John; Shotwell, Robert; Price, Hoppy

2016-07-01

There are currently three U.S. orbiters at Mars plus two orbiters from other nations. At the end of each mission, it is desirable to dispose of the vehicle in a condition where it would present no hazard to other orbiters and to potential future crewed vehicles, while meeting planetary protection constraints. There is currently no way to accurately track and confirm positions of these orbiters after they are no longer being actively tracked from Earth, and due to the extremely "bumpy" nature of the Martian gravity field the position of these vehicles rapidly becomes unknowable . The current COSPAR Planetary Protection Policy for Mars includes a throwback to an earlier era of planetary exploration. The Policy's provisions for the disposition of Mars orbiters includes an option "to meet orbital lifetime requirements" of 20 years (at 99% probability) and 50 years (at 95% probability) after launch (which we will call option 1), or option 2, requiring total (surface, mated, and encapsulated) bioburden levels of ≤ 5 x 10 ^{5} spores - which may be discounted by the number of spores thought to be destroyed during the eventual deorbit of the spacecraft. Reference to DeVincenzi et al (1996) illustrates that the current orbital lifetime requirements in option 1 are directly tied to the notion of a "period of exploration," rather than to any explicit expectation of bioload reduction. Under the current regime, all orbiters comply with option 1, orbital lifetime, or option 2, prior to launch, which generally includes an approved bioburden reduction program prior to launch. As part of option 2, a break up/burn up analysis is also performed, covering the event of an uncontrolled re-entry at arrival or during the orbital mission itself. It has been suggested that we should be seeing an increasing tempo of Mars operations, with an emphasis on making maximum use of communications orbiters in particular. It can be shown that for many orbiters, deorbiting can take quite a bit less delta-V than orbit raising (e.g., to >500 km) to extend their lifetime, so deorbiting (with an attendant focus on increasing burnup and breakup to limit microbial contamination) could provide for possibly years more relay support, as well as a more explicit step for bioburden reduction. Deorbiting can also provide for a more positive termination, eliminates future risk of orbital debris generation around Mars, and ends the possibility of re-entering in an uncontrolled fashion and uncontrolled location later. This paper lays out the issues and options associated with an emphasis on option 2 as the preferred orbiter disposal strategy for Category III missions to Mars. The expectation is that valuable orbits can be better protected for future explorers, and that controls over the contamination of Mars by orbiters can be improved if COSPAR adopts this re-emphasis on behalf of the agencies which are now planning future missions to Mar. Ref. DeVincenzi, D. L., P. D. Stabekis, and J. Barengoltz, Refinement of planetary protection policy for Mars missions, Adv. Space Res. 18: 311-316, 1996.

Visible scintillation photodetector device incorporating chalcopyrite semiconductor crystals

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

Stowe, Ashley C.; Burger, Arnold

2017-04-04

A photodetector device, including: a scintillator material operable for receiving incident radiation and emitting photons in response; a photodetector material coupled to the scintillator material operable for receiving the photons emitted by the scintillator material and generating a current in response, wherein the photodetector material includes a chalcopyrite semiconductor crystal; and a circuit coupled to the photodetector material operable for characterizing the incident radiation based on the current generated by the photodetector material. Optionally, the scintillator material includes a gamma scintillator material and the incident radiation received includes gamma rays. Optionally, the photodetector material is further operable for receiving thermalmore » neutrons and generating a current in response. The circuit is further operable for characterizing the thermal neutrons based on the current generated by the photodetector material.« less

Adaptation Pathway of Low Impact Development Planning under Climate Change for a Sustainable Rural Community

NASA Astrophysics Data System (ADS)

Chen, P. Y.; Tung, C. P.

2016-12-01

The study focuses on developing the methodology of adaptation pathway for storm water management in a community scale. Following previous results on adaptation procedures including problem and goal setup, current risk assessment and analysis, future risk assessment and analysis, and adaptation options identification and evaluation, the study aims at analyzing adaptation pathway planning and implementation, namely the fifth step, for applying low impact development (LID). Based on the efficacy analyses of the feasible adaptation options, an adaptation pathway map can be build. Each pathway is a combination of the adaptation measures arranged in certain order. The developed adaptation pathway map visualizes the relative effectiveness and the connection of the adaptation measures. In addition, the tipping points of the system can be clearly identified and the triggers can be defined accordingly. There are multiple choices of pathways in an adaptation pathway map, which can be referred as pathway candidates. To ensure the applicability and operability, the methodology of adaptation pathway analysis is applied to a case study. Required information for developing an adaptation pathway map includes the scores of the adaptation options on the criteria, namely the effects, costs, immediacy, and side effect. Feasible adaptation options for the design case are dredging, pipeline expansion, pumping station, LID and detention pond. By ranking the options according to the criteria, LID is found dominating dredging and pumping station in this case. The information of the pathway candidates can be further used by the stakeholders to select the most suitable and promising pathway.

Adoption of alternative financing strategies to increase the diffusion of picture archiving and communication systems into the radiology marketplace.

PubMed

Reiner, B; Siegel, E; McKay, P

2000-05-01

The objective of the study was to evaluate current marketplace conditions and strategies employed by major picture archiving and communication systems (PACS) vendors in the creation of alternative financing strategies, to enhance the diffusion of filmless imaging. Data were collected from the major PACS vendors in the forms of survey questionnaires and review of existing leases. Topics evaluated in the survey included current financing options available, foreseeable changes in PACS financing, role of third-party financiers, and creation of risk-sharing arrangements. Generic leases were also reviewed evaluating the presence or absence of several key variables including technology obsolescence protection, hardware/software upgrades, end-of-term options, determination of fair market value, functionality/acceptance testing, uptime guarantees, and workflow management consulting. Eight of the 10 PACS vendors surveyed participated in the data collection. The vast majority of current PACS implementations (60% to 90%) occur through direct purchase, with conventional leasing (operating or capital) accounting for only 5% to 30% of PACS installations. The majority of respondents view fee-for-lease arrangements and other forms of risk sharing as increasing importance for future PACS financing. The specific targets for such risk-sharing arrangements consist of small hospital and privately owned imaging centers. Leases currently offered range in duration from 3 to 5 years and frequently offer technology obsolescence protection with upgrades, multiple end-of-term options, and some form of acceptance testing. A number of important variables frequently omitted from leases include uptime guarantees, flexibility in changing financing or vendors, and incorporation of expected productivity/operational efficiency gains. As vendors strive to increase the penetration of PACS into the radiology marketplace, there will be a shift from conventional financing (loan or purchase) to leasing. Fee-for-use leasing and other forms of risk sharing have the greatest potential in smaller hospitals, which do not have the financial resources to pursue conventional financing options. Potential PACS customers must be cautious when entering into these alternative financing strategies, to ensure that appropriate safeguards are incorporated, in order to minimize downside risk.

Managing hydroclimatological risk to water supply with option contracts and reservoir index insurance

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.

Pharmacological treatment options for cryopyrin-associated periodic syndromes.

PubMed

Landmann, Emmanuelle C; Walker, Ulrich A

2017-08-01

Cryopyrin-associated periodic syndromes (CAPS) are rare monogenic autoinflammatory diseases, comprising a spectrum of phenotypes of varying severity. CAPS are associated with gain-of-function mutations in the NLRP3 inflammasome, a multiprotein complex critical for the activation of IL-1ß, and are characterized by episodes of fever, urticaria-like rash, musculoskeletal, ocular, and neurological symptoms. Areas covered: Accounting for the pivotal role of IL-1ß in the pathogenesis of CAPS, three therapeutic options, all blocking the action of IL-1ß, are currently approved: anakinra, a recombinant IL-1 receptor antagonist, the IL-1 trap rilonacept and canakinumab, a monoclonal anti-IL-1ß antibody. All agents reduce or even resolve clinical symptoms, biochemical activity markers and improve quality of life in CAPS. This review also covers pharmacokinetic, pharmacodynamic and safety aspects of the approved drugs and the potential utility of IL-1β blockers in a wide range of other conditions with an autoinflammatory component. Expert commentary: Due to the success story of current pharmaceutics, the therapeutic options in CAPS are not expected to expand in the near future. Prospective observational studies are needed to confirm long-term efficacy and sustained benefit. New IL-1ß blockers will likely address unmet clinical needs in other autoinflammatory conditions.

Neuropathic pain and SCI: Identification and treatment strategies in the 21st century.

PubMed

Hatch, Maya N; Cushing, Timothy R; Carlson, Gregory D; Chang, Eric Y

2018-01-15

Pain is a common complication in patients following spinal cord injury (SCI), with studies citing up to 80% of patients reporting some form of pain. Neuropathic pain (NP) makes up a substantial percentage of all pain symptoms in patients with SCI and is often complex. Given the high prevalence of NP in patients with SCI, proper identification and treatment is imperative. Indeed, identification of pain subtypes is a vital step toward determining appropriate treatment. A variety of pharmacological and non-pharmacological treatments can be undertaken including antiepileptics, tricyclic antidepressants, opioids, transcranial direct current stimulation, and invasive surgical procedures. Despite all the available treatment options and advances in the field of SCI medicine, providing adequate treatment of NP after SCI continues to be challenging. It is therefore extremely important for clinicians to have a strong foundation in the identification of SCI NP, as well as an understanding of appropriate treatment options. Here, we highlight the definitions and classification tools available for NP identification, and discuss current treatment options. We hope that this will not only provide a better understanding of NP for physicians in various subspecialties, but that it will also help guide future research on this subject. Copyright © 2017 Elsevier B.V. All rights reserved.

Current status in the treatment options for esophageal achalasia

PubMed Central

Chuah, Seng-Kee; Chiu, Chien-Hua; Tai, Wei-Chen; Lee, Jyong-Hong; Lu, Hung-I; Changchien, Chi-Sin; Tseng, Ping-Huei; Wu, Keng-Liang

2013-01-01

Recent advances in the treatment of achalasia include the use of high-resolution manometry to predict the outcome of patients and the introduction of peroral endoscopic myotomy (POEM). The first multicenter randomized, controlled, 2-year follow-up study conducted by the European Achalasia Trial group indicated that laparoscopic Heller myotomy (LHM) was not superior to pneumatic dilations (PD). Publications on the long-term success of laparoscopic surgery continue to emerge. In addition, laparoscopic single-site surgery is applicable to advanced laparoscopic operations such as LHM and anterior fundoplication. The optimal treatment option is an ongoing matter of debate. In this review, we provide an update of the current progress in the treatment of esophageal achalasia. Unless new conclusive data prove otherwise, LHM is considered the most durable treatment for achalasia at the expense of increased reflux-associated complications. However, PD is the first choice for non-surgical treatment and is more cost-effective. Repeated PD according to an “on-demand” strategy based on symptom recurrence can achieve long-term remission. Decision making should be based on clinical evidence that identifies a subcategory of patients who would benefit from specific treatment options. POEM has shown promise but its long-term efficacy and safety need to be assessed further. PMID:24023484

Current status in the treatment options for esophageal achalasia.

PubMed

Chuah, Seng-Kee; Chiu, Chien-Hua; Tai, Wei-Chen; Lee, Jyong-Hong; Lu, Hung-I; Changchien, Chi-Sin; Tseng, Ping-Huei; Wu, Keng-Liang

2013-09-07

Recent advances in the treatment of achalasia include the use of high-resolution manometry to predict the outcome of patients and the introduction of peroral endoscopic myotomy (POEM). The first multicenter randomized, controlled, 2-year follow-up study conducted by the European Achalasia Trial group indicated that laparoscopic Heller myotomy (LHM) was not superior to pneumatic dilations (PD). Publications on the long-term success of laparoscopic surgery continue to emerge. In addition, laparoscopic single-site surgery is applicable to advanced laparoscopic operations such as LHM and anterior fundoplication. The optimal treatment option is an ongoing matter of debate. In this review, we provide an update of the current progress in the treatment of esophageal achalasia. Unless new conclusive data prove otherwise, LHM is considered the most durable treatment for achalasia at the expense of increased reflux-associated complications. However, PD is the first choice for non-surgical treatment and is more cost-effective. Repeated PD according to an "on-demand" strategy based on symptom recurrence can achieve long-term remission. Decision making should be based on clinical evidence that identifies a subcategory of patients who would benefit from specific treatment options. POEM has shown promise but its long-term efficacy and safety need to be assessed further.

Improvement of automatic control system for high-speed current collectors

NASA Astrophysics Data System (ADS)

Sidorov, O. A.; Goryunov, V. N.; Golubkov, A. S.

2018-01-01

The article considers the ways of regulation of pantographs to provide quality and reliability of current collection at high speeds. To assess impact of regulation was proposed integral criterion of the quality of current collection, taking into account efficiency and reliability of operation of the pantograph. The study was carried out using mathematical model of interaction of pantograph and catenary system, allowing to assess contact force and intensity of arcing at the contact zone at different movement speeds. The simulation results allowed us to estimate the efficiency of different methods of regulation of pantographs and determine the best option.

Ground Vibration Testing Options for Space Launch Vehicles

NASA Technical Reports Server (NTRS)

Patterson, Alan; Smith, Robert K.; Goggin, David; Newsom, Jerry

2011-01-01

New NASA launch vehicles will require development of robust systems in a fiscally-constrained environment. NASA, Department of Defense (DoD), and commercial space companies routinely conduct ground vibration tests as an essential part of math model validation and launch vehicle certification. Although ground vibration testing must be a part of the integrated test planning process, more affordable approaches must also be considered. A study evaluated several ground vibration test options for the NASA Constellation Program flight test vehicles, Orion-1 and Orion-2, which concluded that more affordable ground vibration test options are available. The motivation for ground vibration testing is supported by historical examples from NASA and DoD. The approach used in the present study employed surveys of ground vibration test subject-matter experts that provided data to qualitatively rank six test options. Twenty-five experts from NASA, DoD, and industry provided scoring and comments for this study. The current study determined that both element-level modal tests and integrated vehicle modal tests have technical merits. Both have been successful in validating structural dynamic math models of launch vehicles. However, element-level testing has less overall cost and schedule risk as compared to integrated vehicle testing. Future NASA launch vehicle development programs should anticipate that some structural dynamics testing will be necessary. Analysis alone will be inadequate to certify a crew-capable launch vehicle. At a minimum, component and element structural dynamic tests are recommended for new vehicle elements. Three viable structural dynamic test options were identified. Modal testing of the new vehicle elements and an integrated vehicle test on the mobile launcher provided the optimal trade between technical, cost, and schedule.

Occupational therapy with people with depression: using nominal group technique to collate clinician opinion.

PubMed

Hitch, Danielle; Taylor, Michelle; Pepin, Genevieve

2015-05-01

This aim of this study was to obtain a consensus from clinicians regarding occupational therapy for people with depression, for the assessments and practices they use that are not currently supported by research evidence directly related to functional performance. The study also aimed to discover how many of these assessments and practices were currently supported by research evidence. Following a previously reported systematic review of assessments and practices used in occupational therapy for people with depression, a modified nominal group technique was used to discover which assessments and practices occupational therapists currently utilize. Three online surveys gathered initial data on therapeutic options (survey 1), which were then ranked (survey 2) and re-ranked (survey 3) to gain the final consensus. Twelve therapists completed the first survey, whilst 10 clinicians completed both the second and third surveys. Only 30% of the assessments and practices identified by the clinicians were supported by research evidence. A consensus was obtained on a total of 35 other assessments and interventions. These included both occupational-therapy-specific and generic assessments and interventions. Principle conclusion. Very few of the assessments and interventions identified were supported by research evidence directly related to functional performance. While a large number of options were generated, the majority of these were not occupational therapy specific.

Vending Assessment and Program Implementation in Four Iowa Worksites.

PubMed

Lillehoj, Catherine J; Nothwehr, Faryle; Shipley, Kala; Voss, Carol

2015-11-01

The worksite food environment, including vending options, has been explored as an important contributor to dietary decisions made every day. The current study describes the vending environment, and efforts to change it, in four Iowa worksites using a series of case studies. Data were gathered by local coordinators as part of the Iowa Community Transformation Grant project. Data were collected from three sources. First, the Nutrition Environment Measures Survey-Vending was used to assess healthy vending options in worksite machines before and after the intervention. Second, employee vending behavior was evaluated with a pre-, post-intervention survey. Items assessed attitudes and behaviors regarding vending, plus awareness and reaction to intervention activities. Third, program coordinators documented vending machine intervention strategies used, such as social marketing materials and product labels. The Nutrition Environment Measures Survey-Vending documented that the majority of vending options did not meet criteria for healthfulness. The vending survey found that employees were generally satisfied with the healthier items offered. Some differences were noted over time at the four worksites related to employee behavior and attitudes concerning healthy options. There were also differences in intervention implementation and the extent of changes made by vending companies. Overall, findings demonstrate that a large percentage of employees are constrained in their ability to access healthy foods due to limited worksite vending options. There also remain challenges to making changes in this environment. Findings have implications for public health practitioners to consider when designing healthy vending interventions in worksites. © 2015 Society for Public Health Education.

Women in Vocational Education. Project Baseline Supplemental Report.

ERIC Educational Resources Information Center

Steele, Marilyn

Reviewing the current status of women in vocational education, the study determines whether there is a cause-effect relationship between school practices and limited job options for women in the world of work. According to a review and analysis of available data, schools at all levels are operating separate vocational education programs for women.…

A Mixed Methods Study of Online Course Facilitators' Perceptions of Mobile Technology, Design, and TPaCK Affordances

ERIC Educational Resources Information Center

Teague, Helen Louise

2017-01-01

The increase in mobile technology options for students in post-secondary, continuing education influences how instructors design and implement courses, specifically online courses (Sozcu, Ipek, & Kinay, 2016). Much of the current research addresses technological, pedagogical, and content knowledge (TPaCK), course design, and/or mobile…

Space transfer concepts and analyses for exploration missions, phase 4

NASA Technical Reports Server (NTRS)

Woodcock, Gordon R.

1993-01-01

Earlier studies carried out under this contract covered a wide range of lunar and Mars transportation options, and lunar rove concepts and technology needs. The current report discusses the activities conducted under Technical Directives 16 and 17. Mars transportation was addressed as well as a review and update of architectures and propulsion systems.

Australian Biology Test Item Bank, Years 11 and 12. Volume II: Year 12.

ERIC Educational Resources Information Center

Brown, David W., Ed.; Sewell, Jeffrey J., Ed.

This document consists of test items which are applicable to biology courses throughout Australia (irrespective of course materials used); assess key concepts within course statement (for both core and optional studies); assess a wide range of cognitive processes; and are relevant to current biological concepts. These items are arranged under…

Status and potential of terrestrial carbon sequestration in West Virginia

Treesearch

Benktesh D. Sharma; Jingxin Wang

2011-01-01

Terrestrial ecosystem management offers cost-effective ways to enhance carbon (C) sequestration. This study utilized C stock and C sequestration in forest and agricultural lands, abandoned mine lands, and harvested wood products to estimate the net current annual C sequestration in West Virginia. Several management options within these components were simulated using a...

A Rasch Analysis of the Substance Abuse Subtle Screening Inventory-3

ERIC Educational Resources Information Center

Hill, Tara M.; Laux, John M.; Stone, Gregory; Dupuy, Paula; Scott, Holly

2013-01-01

Rasch analysis of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3; F. G. Miller & Lazowski, 1999) indicated that the SASSI-3 meets fundamental measurement properties; however, the authors of the current study recommend the elimination of nonfunctioning items and the improvement of response options for the face valid scales to…

Australian Biology Test Item Bank, Years 11 and 12. Volume I: Year 11.

ERIC Educational Resources Information Center

Brown, David W., Ed.; Sewell, Jeffrey J., Ed.

This document consists of test items which are applicable to biology courses throughout Australia (irrespective of course materials used); assess key concepts within course statement (for both core and optional studies); assess a wide range of cognitive processes; and are relevant to current biological concepts. These items are arranged under…

Defining Continuous Improvement and Cost Minimization Possibilities through School Choice Experiments

ERIC Educational Resources Information Center

Merrifield, John

2009-01-01

Studies of existing best practices cannot determine whether the current "best" schooling practices could be even better, less costly, or more effective and/or improve at a faster rate, but we can discover a cost effective menu of schooling options and each item's minimum cost through market accountability experiments. This paper describes…

Recent trends in preservative treatments for timber bridges

Treesearch

James P. Wacker

2004-01-01

An overview of wood preservatives currently used for timber bridges is presented through a series of case studies from different regions of the United States. New wood species and preservative treatment options for timber bridges have made choosing the appropriate preservative more complicated. The compatibility of wood species and preservative treatment is often...

Current Options for the Treatment of Food Allergy

PubMed Central

Lanser, Bruce J.; Wright, Benjamin L.; Orgel, Kelly A.; Vickery, Brian P.; Fleischer, David M.

2016-01-01

Food allergy is increasing in prevalence; as a result, there is intense focus on developing safe and effective therapies. Current methods of specific immunotherapy include oral, sublingual, and epicutaneous, while nonspecific methods that have been investigated include: Chinese herbal medicine, probiotics, and anti-IgE antibodies. Although some studies have demonstrated efficacy in inducing desensitization, questions regarding safety and the potential for achieving immune tolerance remain. Although some of these therapies demonstrate promise, further investigation is required before their incorporation into routine clinical practice. PMID:26456449

Health financing options for Fiji's health system.

PubMed

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.

76 FR 64984 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-19

... trading day's last sale price was greater than $100) in premium in each of the front two expiration months... options whose underlying stock's previous trading day's last sale price was greater than $100) in premium... other exchanges employing similar pricing schemes.\\18\\ \\18\\ The Boston Options Exchange currently...

Vocational Options for Deaf-Blind Youth Through Community-Based Training. Project ADVANCE.

ERIC Educational Resources Information Center

McGinnity, Betsy L.

Project ADVANCE currently provides vocational training to 26 deaf-blind adolescents and young adults attending Perkins School for the Blind in Watertown, Massachusetts. The project has developed community work sites in four different vocational options: (1) competitive employment, (2) a student operated small business, (3) sheltered enclave within…

26 CFR 1.401(a)(4)-4 - Nondiscriminatory availability of benefits, rights, and features.

Code of Federal Regulations, 2010 CFR

2010-04-01

... this section and the effective availability requirement of paragraph (c) of this section. Paragraph (d... with respect to an optional form of benefit or a social security supplement is disregarded in determining whether the optional form of benefit or the social security supplement is currently available to...

76 FR 19165 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

...\\ Additionally, the Exchange proposes to increase the number of option classes on individual stocks for which the... underlying stock is traded. Currently, Exchange Rule 6.4 at Commentary .03 permits the listing of options... security and meet their investment, trading and risk management requirements. [[Page 19166

Current Challenges Facing Secondary Education and Transition Services: What Research Tells Us.

ERIC Educational Resources Information Center

Johnson, David R.; Stodden, Robert A.; Emanuel, Ellen J.; Luecking, Richard; Mack, Mary

2002-01-01

The transition challenges discussed are to ensure that (1) students have access to the full range of curriculum options and learning experiences; (2) high school graduation decisions are based on meaningful indicators of learning; (3) students have access to postsecondary education, employment, and independent living options; (4) student and…

76 FR 17485 - Meeting Notice Correction-Federal Interagency Committee on Emergency Medical Services; Correction...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... (FICEMS) to be held as a stakeholder input call-in session to receive input regarding the current and... options for establishing or designating a Federal lead office or agency for EMS. The National Security Staff Resilience Directorate has requested that FICEMS engage with stakeholders and develop an options...

77 FR 76578 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... volatility level. Occasionally, certain market activity occurs that makes it difficult to effect these types... options and a combination strategy outside of the currently prevailing market quotes in the individual... settlement price.\\10\\ In essence, CME has a market for complex, multi-part order strategies that is entirely...

76 FR 28264 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... Effectiveness of Proposed Rule Change Relating to the Strategy Fee Cap and Clarifications to the CBOE Fees... Chicago Board Options Exchange, Incorporated (``CBOE'' or ``Exchange'') proposes to amend its strategy fee... Statutory Basis for, the Proposed Rule Change 1. Purpose The Exchange currently caps market-maker and broker...

Recycling Academic Calendars. AAHE-ERIC/Higher Education Research Currents, October 1979.

ERIC Educational Resources Information Center

Eddy, Margot Sanders

The experiences of a variety of postsecondary institutions using different academic calendar options are examined. Several calendar options are described: the traditional semester, the early semester, 4-1-4, the quarter system, the trimester plan, composite plans, and year-round plans. The traditional semester calendar begins in mid-September and…

Family Life Education. Grade 7. An Optional Health Education Unit.

ERIC Educational Resources Information Center

Manitoba Dept. of Education and Training, Winnipeg.

The Family Life Education optional unit of the Manitoba (Canada) Health Education curriculum reflects the current emphasis in health education on preventive medicine, total well-being, and the assumption of individual responsibility for health. The unit as a whole consists of four components: an overview and three grade level guides designed for…

Current Government Actions and Potential Policy Options for Reducing Obesity in Queensland Schools.

PubMed

Alsharairi, Naser A

2018-01-29

School nutrition policies provide promising avenues towards the improvement of children's eating habits and the prevention of obesity. Childhood obesity rates and related chronic diseases are increasing in Queensland, in part as a result of unhealthy eating habits and lack of physical activity. There is a very high investment by the Queensland government in maintaining healthy weight and promoting nutrition and physical activity among schoolchildren through delivering a range of initiatives across the state. However, there is a lack of evidence concerning the effectiveness of nutrition/physical education and parental involvement programs addressing obesity delivered in Queensland schools. This paper can be used to guide government and policy-makers regarding the most effective policy options that will promote healthy eating and physical activity among Queensland schoolchildren. The aim of this paper is to: (i) summarize current evidence on Queensland government responses to obesity; and (ii) discuss potential policy options that could support healthy eating and regular physical activity, and examine the evidence base for each option and suggest new areas for future research.

Counseling women with early pregnancy failure: utilizing evidence, preserving preference.

PubMed

Wallace, Robin R; Goodman, Suzan; Freedman, Lori R; Dalton, Vanessa K; Harris, Lisa H

2010-12-01

To apply principles of shared decision-making to EPF management counseling. To present a patient treatment priority checklist developed from review of available literature on patient priorities for EPF management. Review of evidence for patient preferences; personal, emotional, physical and clinical factors that may influence patient priorities for EPF management; and the clinical factors, resources, and provider bias that may influence current practice. Women have strong and diverse preferences for EPF management and report higher satisfaction when treated according to these preferences. However, estimates of actual treatment patterns suggest that current practice does not reflect the evidence for safety and acceptability of all options, or patient preferences. Multiple practice barriers and biases exist that may be influencing provider counseling about options for EPF management. Choosing management for EPF is a preference-sensitive decision. A patient-centered approach to EPF management should incorporate counseling about all treatment options. Providers can integrate a counseling model into EPF management practice that utilizes principles of shared decision-making and an organized method for eliciting patient preferences, priorities, and concerns about treatment options. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Modulating activity in the prefrontal cortex changes decision-making for risky gains and losses: a transcranial direct current stimulation study.

PubMed

Ye, Hang; Chen, Shu; Huang, Daqiang; Wang, Siqi; Luo, Jun

2015-06-01

When making choices under uncertainty, people usually consider both the risks and benefits of each option. Previous studies have found that weighing of risks and benefits during decision-making involves a complex neural network that includes the dorsolateral prefrontal cortex (DLPFC), but the causal effect of this network on risk decision-making has remained unclear. This experiment was based on a risk-measurement table designed to provide a direct measure of risk preference, with a weighted value of the choices (denoted as weighted risk aversion, WRA) as an index of the participant's degree of risk aversion. We studied whether bifrontal transcranial direct current stimulation (tDCS) applied over the right and left prefrontal cortex can change the balance of risky vs. safe responses under both gain frame and loss frame. A total of 60 volunteers performed risk tasks while receiving either anodal over the right with cathodal over the left DLPFC, anodal over the left with cathodal over the right DLPFC, or sham stimulation. The participants tended to choose more risky options in the gain frame and more safe options in the loss frame after the right anodal/left cathodal tDCS. We also found that right anodal/left cathodal tDCS significantly decreased the WRA values compared with those associated with sham stimulation. These findings extend the notion that DLPFC activity is critical for risk decision-making, indicating an asymmetric role of the right DLPFC in the gain frame vs. the loss frame of risk decision-making. Copyright © 2015 Elsevier B.V. All rights reserved.

Definition study of a Variable Cycle Experimental Engine (VCEE) and associated test program and test plan

NASA Technical Reports Server (NTRS)

Allan, R. D.

1978-01-01

The Definition Study of a Variable Cycle Experimental Engine (VCEE) and Associated Test Program and Test Plan, was initiated to identify the most cost effective program for a follow-on to the AST Test Bed Program. The VCEE Study defined various subscale VCE's based on different available core engine components, and a full scale VCEE utilizing current technology. The cycles were selected, preliminary design accomplished and program plans and engineering costs developed for several program options. In addition to the VCEE program plans and options, a limited effort was applied to identifying programs that could logically be accomplished on the AST Test Bed Program VCE to extend the usefulness of this test hardware. Component programs were provided that could be accomplished prior to the start of a VCEE program.

Health preferences and decision-making needs of disadvantaged women.

PubMed

Bunn, Helen; Lange, Ilta; Urrutia, Mila; Campos, Maria Sylvia; Campos, Solange; Jaimovich, Sonia; Campos, Cecilia; Jacobsen, Mary Jane; Gaboury, Isabelle

2006-11-01

This paper reports the results of a survey of disadvantaged women in La Pintana, a municipality of Santiago, Chile, to determine their health decision-making needs. Research is needed as there is no published community-based study focusing specifically on health decision-making needs of disadvantaged women. From April to November 1999, we conducted a cross-sectional interview survey of women registered at primary healthcare centres in La Pintana, an impoverished municipality of Santiago, Chile. The survey participants were 554 adult women over 15 years of age. Seventy-five percent reported making current health-related decisions. Types of decisions were primarily about navigation: where, when and from whom to seek care. The most common role in decision-making was sharing the decision with others, specifically husbands and other family members. Fifty-four percent experienced decisional conflict or uncertainty about options. Those reporting more manifestations of decisional conflict were more likely to lack information on available options, pros and cons of the options, and chances of benefits and harms associated with the options; they were also more likely to be unclear about what was important to them, to feel pressure from others, lack skill or ability in decision-making and be older. The most common strategies used when making all types of decisions were obtaining information on options and recommendations, and getting support from others. Participants preferred to receive information about options through counselling from their physicians, rather than nurses, from printed materials and from discussion groups of people facing the same decision. The majority of disadvantaged women were actively involved in decision-making and needed decision support to navigate the healthcare system. Nurses should play a more pivotal role in providing health decision support. This study needs to be replicated in other countries and cultural contexts.

Conservative care as a treatment option for patients aged 75 years and older with CKD stage V: a National survey in the Netherlands.

PubMed

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.

Cost/benefit trade-offs for reducing the energy consumption of commercial air transportation (RECAT)

NASA Technical Reports Server (NTRS)

Gobetz, F. W.; Leshane, A. A.

1976-01-01

The RECAT study evaluated the opportunities for reducing the energy requirements of the U.S. domestic air passenger transport system through improved operational techniques, modified in-service aircraft, derivatives of current production models, or new aircraft using either current or advanced technology. Each of these fuel-conserving alternatives was investigated individually to test its potential for fuel conservation relative to a hypothetical baseline case in which current, in-production aircraft types are assumed to operate, without modification and with current operational techniques, into the future out to the year 2000. Consequently, while the RECAT results lend insight into the directions in which technology can best be pursued for improved air transport fuel economy, no single option studied in the RECAT program is indicative of a realistic future scenario.

Health and economic consequences of different options for timing the coordinated global cessation of the three oral poliovirus vaccine serotypes.

PubMed

Thompson, Kimberly M; Duintjer Tebbens, Radboud J

2015-09-17

World leaders remain committed to globally-coordinated oral poliovirus vaccine (OPV) cessation following successful eradication of wild polioviruses, but the best timing and strategy for implementation depend on existing and emerging conditions. Using an existing integrated global poliovirus risk management model, we explore alternatives to the current timing plan of coordinated cessation of each OPV serotype (i.e., OPV1, OPV2, and OPV3 cessation for serotypes 1, 2, and 3, respectively). We assume the current timing plan involves OPV2 cessation in 2016 followed by OPV1 and OPV3 cessation in 2019 and we compare this to alternative timing options, including cessation of all three serotypes in 2018 or 2019, and cessation of both OPV2 and OPV3 in 2017 followed by OPV1 in 2019. If Supplemtal Immunization Activity frequency remains sufficiently high through cessation of the last OPV serotype, then all OPV cessation timing options prevent circulating vaccine-derived poliovirus (cVDPV) outbreaks after OPV cessation of any serotype. The various OPV cessation timing options result in relatively modest differences in expected vaccine-associated paralytic poliomyelitis cases and expected total of approximately 10-13 billion polio vaccine doses used. However, the expected amounts of vaccine of different OPV formulations needed changes dramatically with each OPV cessation timing option. Overall health economic impacts remain limited for timing options that only change the OPV formulation but preserve the currently planned year for cessation of the last OPV serotype and the global introduction of inactivated poliovirus vaccine (IPV) introduction. Earlier cessation of the last OPV serotype or later global IPV introduction yield approximately $1 billion in incremental net benefits due to saved vaccination costs, although the logistics of implementation of OPV cessation remain uncertain and challenging. All countries should maintain the highest possible levels of population immunity to transmission for each poliovirus serotype prior to the coordinated cessation of the OPV serotype to manage cVDPV risks. If OPV2 cessation gets delayed, then global health leaders should consider other OPV cessation timing options.

Early pregnancy failure management among family physicians.

PubMed

Wallace, Robin; Dehlendorf, Christine; Vittinghoff, Eric; Gold, Katherine J; Dalton, Vanessa K

2013-03-01

Family physicians, as primary care providers for reproductive-aged women, frequently initiate or refer patients for management of early pregnancy failure (EPF). Safe and effective options for EPF treatment include expectant management, medical management with misoprostol, and aspiration in the office or operating room. Current practice does not appear to reflect patient preferences or to utilize the most cost-effective treatments. We compared characteristics and practice patterns among family physicians who do and do not provide multiple options for EPF care. We performed a secondary analysis of a national survey of women's health providers to describe demographic and practice characteristics among family physicians who care for women with EPF. We used multivariate logistic regression to identify correlates of providing more than one option for EPF management. The majority of family physicians provide only one option for EPF; expectant management was most frequently used among our survey respondents. Misoprostol and office-based aspiration were rarely used. Providing more than one option for EPF management was associated with more years in practice, smaller county population, larger proportions of Medicaid patients, intrauterine contraception provision, and prior training in office-based aspiration. Family physicians are capable of providing a comprehensive range of options for EPF management in the outpatient setting but few providers currently do so. To create a more patient-centered and cost-effective model of care for EPF, additional resources should be directed at education, skills training, and system change initiatives to prepare family physicians to offer misoprostol and office-based aspiration to women with EPF.

The I Don't Know Option in the Vocabulary Size Test

ERIC Educational Resources Information Center

Zhang, Xian

2013-01-01

The current study evaluates guessing behaviors in a vocabulary size test (VST) and examines whether including an "I don't know" in a VST may have an impact on the results of the test. One-hundred-fifty first-year students at a university in China took part in the study. They were randomly assigned to three groups. Each group took a…

RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME IV - SITE SPECIFIC STUDIES FOR MO, MS, NC, NH, NJ, NY, OH

EPA Science Inventory

The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME V - SITE SPECIFIC STUDIES FOR PA, SC, TN, VA, WI, WV

EPA Science Inventory

The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME II - SITE SPECIFIC STUDIES FOR AL, DE. FL, GA, IL

EPA Science Inventory

The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME III - SITE SPECIFIC STUDIES FOR IN, KY, MA, MD, MI, MN

EPA Science Inventory

The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

Men Considering (and Choosing) Teaching as a Career: What Accounts for Their Decision to Become a Teacher?

ERIC Educational Resources Information Center

Keck Frei, Andrea; Berweger, Simone; Bieri Buschor, Christine

2017-01-01

The aim of the current study is to better understand the decision-making of men considering teaching as a career option. By means of a longitudinal study (n = 226), we examined the persistence of male academic high-school students in Switzerland interested in teaching during transition to higher education. For 85 men attending information events…

White Earth Biomass/Biogas Feasibility Study

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

Triplett, Michael

2015-03-12

The White Earth Nation examined the feasibility of cost savings and fossil energy reduction through the installation of biogas/biomass boiler at the tribal casino. The study rejected biogas options due to availability and site constraints, but found a favorable environment for technical and financial feasibility of installing a 5 MMBtu hot water boiler system to offset 60-70 percent of current fuel oil and propane usage.

Forest fire advanced system technology (FFAST) conceptual design study

NASA Technical Reports Server (NTRS)

Nichols, J. David; Warren, John R.

1987-01-01

The National Aeronautics and Space Administration's Jet Propulsion Laboratory (JPL) and the U.S. Department of Agriculture (USDA) Forest Service completed a conceptual design study that defined an integrated forest fire detection and mapping system that will be based upon technology available in the 1990s. Potential system configuration options in emerging and advanced technologies related to the conceptual design were identified and recommended for inclusion as preferred system components. System component technologies identified for an end-to-end system include airborne mounted, thermal infrared (IR) linear array detectors, automatic onboard georeferencing and signal processing, geosynchronous satellite communications links, and advanced data integration and display. Potential system configuration options were developed and examined for possible inclusion in the preferred system configuration. The preferred system configuration will provide increased performance and be cost effective over the system currently in use. Forest fire management user requirements and the system component emerging technologies were the basis for the system configuration design. The conceptual design study defined the preferred system configuration that warrants continued refinement and development, examined economic aspects of the current and preferred system, and provided preliminary cost estimates for follow-on system prototype development.

Understanding women's uptake and adherence in Option B+ for prevention of mother-to-child HIV transmission in Papua, Indonesia: A qualitative study.

PubMed

Lumbantoruan, Christina; Kermode, Michelle; Giyai, Aloisius; Ang, Agnes; Kelaher, Margaret

2018-01-01

Despite a more proactive approach to reducing new HIV infections in infants through lifelong treatment (Option B+ policy) for infected pregnant women, prevention of mother-to-child transmission of HIV (PMTCT) has not been fully effective in Papua, Indonesia. Mother-to-child transmission (MTCT) is the second greatest risk factor for HIV infection in the community, and an elimination target of <1% MTCT has not yet been achieved. The purpose of this study was to improve understanding of the implementation of Option B+ for PMTCT in Papua through investigation of facilitators and barriers to women's uptake and adherence to antiretroviral therapy (ART) in the program. This information is vital for improving program outcomes and success of program scale up in similar settings in Papua. In-depth interviews were conducted with 20 women and 20 PMTCT health workers at two main referral hospitals for PMTCT in Papua. Development of interview guides was informed by the socio-ecological framework. Qualitative data were managed with NVivo11 software and themes were analysed using template analysis. Factors influencing women's uptake and adherence in Option B+ for PMTCT were identified through final analysis of key themes. Factors that motivated PMTCT uptake and adherence were good quality post-test HIV counselling, belief in the efficacy of antiretroviral (ARV) attained through personal or peer experiences, and a partner who did not prevent women from seeking PMTCT care. Key barriers for PMTCT participation included doubts about ARV efficacy, particularly for asymptomatic women, unsupportive partners who actively prevented women from seeking treatment, and women's concerns about community stigma and discrimination. Results suggest that PMTCT program success is determined by facilitators and barriers from across the spectrum of the socio-ecological model. While roll out of Option B+ as current national policy for pregnant women in Papua has improved detection and enrolment of HIV-positive women, health facilities need to address various existing and potential issues to ensure long-term adherence of women beyond the current PMTCT program, including during pregnancy, childbirth and breastfeeding.

[Uveitis associated with juvenile idiopathic arthritis : Optimization of immunomodulatory therapy].

PubMed

Heiligenhaus, A; Tappeiner, C; Walscheid, K; Heinz, C

2016-05-01

Uveitis associated with juvenile idiopathic arthritis (JIA-associated uveitis) is a vision-threatening disorder with a high complication rate. Besides early diagnosis within screening programs an adequate therapy is essential for improvement of the long-term prognosis. Corticosteroid therapy is often insufficient. In addition to conventional immunosuppression, immunomodulatory drugs, so-called biologicals, are novel highly effective treatment modalities. A systematic search of the literature was carried out for biologicals currently used in the treatment of JIA-associated uveitis. Review of current publications, summary of treatment guidelines and discussion of treatment options for therapy refractive patients. In accordance with the current recommendations tumor necrosis factor (TNF) inhibitors are administered if uveitis inactivity cannot be achieved with topical corticosteroids and in the next stage with immunosuppressants (methotrexate preferred). According to the currently available data adalimumab is then preferred. When the effectiveness of TNF inhibitors ceases during long-term administration and/or recurrences, other biological response modifiers are attractive treatment options (e. g. lymphocyte inhibitors or specific receptor antagonists). The TNF inhibitors are of major importance for the treatment of JIA-associated uveitis. Prospective studies and registries would be desirable in order to be able to compare the value of TNF inhibitors and other biologicals and for optimization of treatment recommendations.

Chemotherapy and biological treatment options in breast cancer patients with brain metastasis: an update.

PubMed

Arslan, Cagatay; Dizdar, Omer; Altundag, Kadri

2014-08-01

Breast cancer (BC) is the second most common cause of CNS metastasis. Ten to 20% of all, and 38% of human epidermal growth factor-2(+), metastatic BC patients experience brain metastasis (BM). Prolonged survival with better control of systemic disease and limited penetration of drugs to CNS increased the probability of CNS metastasis as a sanctuary site of relapse. Treatment of CNS disease has become an important component of overall disease control and quality of life. Current standard therapy for BM is whole-brain radiotherapy, surgery, stereotactic body radiation therapy for selected cases, corticosteroids and systemic chemotherapy. Little progress has been made in chemotherapy for the treatment of BM in patients with BC. Nevertheless, new treatment choices have emerged. In this review, we aimed to update current and future treatment options in systemic treatment for BM of BC. Cornerstone local treatment options for BM of BC are radiotherapy and surgery in selected cases. Efficacy of cytotoxic chemotherapeutics is limited. Among targeted therapies, lapatinib has activity in systemic treatment of BM particularly when used in combination with capecitabine. Novel agents are currently investigated.

Transputer parallel processing at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Ellis, Graham K.

1989-01-01

The transputer parallel processing lab at NASA Lewis Research Center (LeRC) consists of 69 processors (transputers) that can be connected into various networks for use in general purpose concurrent processing applications. The main goal of the lab is to develop concurrent scientific and engineering application programs that will take advantage of the computational speed increases available on a parallel processor over the traditional sequential processor. Current research involves the development of basic programming tools. These tools will help standardize program interfaces to specific hardware by providing a set of common libraries for applications programmers. The thrust of the current effort is in developing a set of tools for graphics rendering/animation. The applications programmer currently has two options for on-screen plotting. One option can be used for static graphics displays and the other can be used for animated motion. The option for static display involves the use of 2-D graphics primitives that can be called from within an application program. These routines perform the standard 2-D geometric graphics operations in real-coordinate space as well as allowing multiple windows on a single screen.

Market-Based Indian Grid Integration Study Options: Preprint

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

Stoltenberg, B.; Clark, K.; Negi, S. K.

2012-03-01

The Indian state of Gujarat is forecasting solar and wind generation expansion from 16% to 32% of installed generation capacity by 2015. Some states in India are already experiencing heavy wind power curtailment. Understanding how to integrate variable generation (VG) into the grid is of great interest to local transmission companies and India's Ministry of New and Renewable Energy. This paper describes the nature of a market-based integration study and how this approach, while new to Indian grid operation and planning, is necessary to understand how to operate and expand the grid to best accommodate the expansion of VG. Second,more » it discusses options in defining a study's scope, such as data granularity, generation modeling, and geographic scope. The paper also explores how Gujarat's method of grid operation and current system reliability will affect how an integration study can be performed.« less

Treatment Option Overview (Melanoma)

MedlinePlus

... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2018 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

A National Survey of Parent Perspectives on Use of Patient Portals for Their Children’s Health Care

PubMed Central

Costello, L.E.; Gebremariam, A.; Dombkowski, K.J.

2015-01-01

Summary Objectives To assess parents’ current utilization and future willingness to use patient portals to interact with their child’s health care provider. Methods A cross-sectional survey of a nationally representative sample of US parents was conducted using an established online panel. Bivariate analyses assessed associations between current utilization and future willingness to use patient portals, parental concerns, and demographic variables. Results Among the 1,420 parent respondents, 40% did not know whether their child’s health practice offers the option of setting up a patient portal for their child. Of the 21% of parents who reported being offered the option of setting up a patient portal for their child, 59% had done so. Among parents who had the option but chose not to set up a patient portal for their child, lack of time and low perceived need were the main reasons cited. Current use and likelihood of future use was highest for viewing lab results and immunization records. The most common concern about patient portals was the security of the child portal system. Conclusions Current use of patient portals by parents is low. Only about half of parents currently using or likely to use a portal perceive value in using portals for certain tasks, which suggests that providers will need to continue traditional communication mechanisms to reach their entire patient population. PMID:25848417

Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges

PubMed Central

Salem, Haitham; Nagpal, Caesa; Pigott, Teresa; Teixeira, Antonio Lucio

2017-01-01

Background: Akathisia continues to be a significant challenge in current neurological and psychiatric practice. Prompt and accurate detection is often difficult and there is a lack of consensus concerning the neurobiological basis of akathisia. No definitive treatment has been established for akathisia despite numerous preclinical and clinical studies. Method: We reviewed antipsychotic-induced akathisia including its clinical presentation, proposed underlying pathophysiology, current and under investigation therapeutic strategies. Conclusion: Despite the initial promise that second generation antipsychotics would be devoid of akathisia effects, this has not been confirmed. Currently, there are limited therapeutic options for the clinical practice and the evidence supporting the most widely used treatments (beta blockers, anticholinergic drugs) is still absent or inconsistent. PMID:27928948

IgE-based Immunotherapy of Cancer -A Comparative Oncology Approach

PubMed Central

Singer, Josef; Jensen-Jarolim, Erika

2014-01-01

Antibody-based immunotherapies are important therapy options in human oncology. Although human humoral specific immunity is constituted of five different immunoglobulin classes, currently only IgG-based immunotherapies have proceeded to clinical application. This review, however, discusses the benefits and difficulties of IgE-based immunotherapy of cancer, with special emphasis on how to translate promising preclinical results into clinical studies. Pursuing the “Comparative Oncology” approach, novel drug candidates are investigated in clinical trials with veterinary cancer patients, most often dogs. By this strategy drug development could be speeded up, animal experiments could be reduced and novel therapy options could be introduced benefitting humans as well as man’s best friend. PMID:25264496

[Arm rehabilitation : Current concepts and therapeutic options].

PubMed

Platz, T; Schmuck, L

2016-10-01

Arm paralysis after a stroke is a major cause of impairment. Presentation of therapeutic options and the efficacy in arm rehabilitation after stroke. Based on a systematic critical appraisal of randomized controlled trials (RCT) the therapeutic procedures for arm paralysis after stroke in the context of their effectiveness are introduced, including robotic therapy, mirror therapy, constraint-induced movement therapy (CIMT), arm basis training, arm ability training, neuromuscular electrical stimulation, bilateral and task-specific training, mental training and transcranial stimulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Several therapeutic procedures with proven efficacy are currently available for arm rehabilitation after stroke. Their differential indications are presented and associated with conclusions for clinical practice.

Treatment of Diabetes Mellitus Using iPS Cells and Spice Polyphenols

PubMed Central

Chen, Liang

2017-01-01

Diabetes mellitus is a chronic disease that threatens human health. The disease is caused by a metabolic disorder of the endocrine system, and long-term illness can lead to tissue and organ damage to the cardiovascular, endocrine, nervous, and urinary systems. Currently, the disease prevalence is 11.4%, the treatment rate is 48.2%, and the mortality rate is 2.7% worldwide. Comprehensive and effective control of diabetes, as well as the use of insulin, requires further study to develop additional treatment options. Here, we reviewed the current reprogramming of somatic cells using specific factors to induced pluripotent stem (iPS) cells capable of repairing islet β cell damage in diabetes patients to treat patients with type 1 diabetes mellitus. We also discuss the shortcomings associated with clinical use of iPS cells. Additionally, certain polyphenols found in spices might improve glucose homeostasis and insulin resistance in diabetes patients, thereby constituting promising options for the treatment of type 2 diabetes. PMID:28758131

Treatment of Diabetes Mellitus Using iPS Cells and Spice Polyphenols.

PubMed

Ge, Qi; Chen, Liang; Chen, Keping

2017-01-01

Diabetes mellitus is a chronic disease that threatens human health. The disease is caused by a metabolic disorder of the endocrine system, and long-term illness can lead to tissue and organ damage to the cardiovascular, endocrine, nervous, and urinary systems. Currently, the disease prevalence is 11.4%, the treatment rate is 48.2%, and the mortality rate is 2.7% worldwide. Comprehensive and effective control of diabetes, as well as the use of insulin, requires further study to develop additional treatment options. Here, we reviewed the current reprogramming of somatic cells using specific factors to induced pluripotent stem (iPS) cells capable of repairing islet β cell damage in diabetes patients to treat patients with type 1 diabetes mellitus. We also discuss the shortcomings associated with clinical use of iPS cells. Additionally, certain polyphenols found in spices might improve glucose homeostasis and insulin resistance in diabetes patients, thereby constituting promising options for the treatment of type 2 diabetes.

Legalizing a market for cannabis for pleasure: Colorado, Washington, Uruguay and beyond.

PubMed

Room, Robin

2014-03-01

Colorado, Washington state and Uruguay are currently designing legal non-medical markets for cannabis. These clearly contravene the 1961 and 1988 drug conventions; options for what may happen next are discussed. The current provisions in the three regulatory schemes are summarized. From a public health perspective, the emphasis should be on holding down consumption with regulatory measures, but the public health agenda does not seem to be a strong consideration in the implementation of the US schemes, and they are paying little attention to what can be learned from the history of alcohol and tobacco regulation. While alternative paths to a cannabis market under the conventions are noted, the legalization initiatives underline the need to revise the drug conventions, making prohibition of domestic markets an optional matter. Such changes would also ease the path for including alcohol under the conventions, which would be an important step forward in global health. © 2013 Society for the Study of Addiction.

Projecting the effects of long-term care policy on the labor market participation of primary informal family caregivers of elderly with disability: insights from a dynamic simulation model.

PubMed

Ansah, John P; Matchar, David B; Malhotra, Rahul; Love, Sean R; Liu, Chang; Do, Young

2016-03-23

Using Singapore as a case study, this paper aims to understand the effects of the current long-term care policy and various alternative policy options on the labor market participation of primary informal family caregivers of elderly with disability. A model of the long-term care system in Singapore was developed using System Dynamics methodology. Under the current long-term care policy, by 2030, 6.9 percent of primary informal family caregivers (0.34 percent of the domestic labor supply) are expected to withdraw from the labor market. Alternative policy options reduce primary informal family caregiver labor market withdrawal; however, the number of workers required to scale up long-term care services is greater than the number of caregivers who can be expected to return to the labor market. Policymakers may face a dilemma between admitting more foreign workers to provide long-term care services and depending on primary informal family caregivers.

Success Rates and Immunologic Responses of Autogenic, Allogenic, and Xenogenic Treatments to Repair Articular Cartilage Defects

PubMed Central

Revell, Christopher M.

2009-01-01

This review examines current approaches available for articular cartilage repair, not only in terms of their regeneration potential, but also as a function of immunologic response. Autogenic repair techniques, including osteochondral plug transplantation, chondrocyte implantation, and microfracture, are the most widely accepted clinical treatment options due to the lack of immunogenic reactions, but only moderate graft success rates have been reported. Although suspended allogenic chondrocytes are shown to evoke an immune response upon implantation, allogenic osteochondral plugs and tissue-engineered grafts using allogenic chondrocytes exhibit a tolerable immunogenic response. Additionally, these repair techniques produce neotissue with success rates approaching those of currently available autogenic repair techniques, while simultaneously obviating their major hindrance of donor tissue scarcity. To date, limited research has been performed with xenogenic tissue, although several studies demonstrate the potential for its long-term success. This article focuses on the various treatment options for cartilage repair and their associated success rates and immunologic responses. PMID:19063664

What weight loss treatment options do geriatric patients with overweight and obesity want to consider?

PubMed

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.

All Roads Lead to Rome: Update on Rome III Criteria and New Treatment Options

PubMed Central

Shih, David Q.; Kwan, Lola Y.

2010-01-01

The recently published Rome III criteria reflect current understanding of functional gastrointestinal disorders. These criteria include definitions of these conditions and their pathophysiologic subtypes and offer guidelines for their management. At the 2006 Annual Scientific Meeting of the American College of Gastroenterology, a panel of experts discussed these criteria as they pertain to irritable bowel syndrome, functional dyspepsia, and chronic constipation. This article reviews the panel’s findings, highlights the differences between the Rome II and III criteria, and summarizes best treatment options currently available to practitioners and their patients. PMID:21544252

Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature.

PubMed

Gardani, Marco; Bertozzi, Nicolò; Grieco, Michele Pio; Pesce, Marianna; Simonacci, Francesco; Santi, PierLuigi; Raposio, Edoardo

2017-09-01

One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of "the ideal breast size", although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article.

Management of complications of Dupuytren contracture.

PubMed

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.

Transdermal rivastigmine in the treatment of Alzheimer's disease: current and future directions.

PubMed

Amanatkar, Hamid Reza; Grossberg, George Thomas

2014-10-01

Despite the fact that the prevalence of Alzheimer's disease (AD) is exponentially increasing, we have not yet been able to develop a new treatment to modify the course of the disease. This vacuum makes the traditional cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonist the only accessible pharmacotherapy options for the treatment of this disease. Among these medications, the only available transdermal patch at this time is the rivastigmine patch. This patch provides significantly lower gastrointestinal adverse effects. A higher tolerability rate provides the option for physicians to continue treatment with higher doses of rivastigmine in advanced stages of AD. Moreover, ease of use, easy-to-follow schedule, less administration time spent by the caregiver result in greater adherent to the treatment. This article aims to provide a comprehensive drug profile for transdermal rivastigmine, to review currently available treatment options, and to try to anticipate future treatment directions for AD.

Urolift - minimally invasive surgical BPH management.

PubMed

Pushkaran, Anish; Stainer, Victoria; Muir, Gordon; Shergill, Iqbal S

2017-03-01

An ideal treatment option for symptomatic Benign Prostatic Hyperplasia (BPH) should relieve lower urinary tract symptoms (LUTS) and restore Quality of Life (QoL). Currently available medical therapies and surgical options for symptomatic BPH have side effects that adversely affects quality of life. Prostatic urethral lift (PUL) is a novel endourology procedure that promises to relieve LUTS without the aforementioned side effects. Areas covered: We diligently reviewed all the published literature on PUL, till July 2016 using standard search criteria. Expert commentary: There is good quality evidence to establish the efficiency of PUL in treating symptomatic BPH without adversely affecting the QoL. Based on the current literature, PUL can be considered as an option for those symptomatic BPH patients with small or medium size prostates (< 80 ml) without median lobe enlargement, who failed on medical therapy or are intolerant to it and wish to preserve their sexual function.

NASA electrothermal auxiliary propulsion technology

NASA Technical Reports Server (NTRS)

Stone, J. R.

1986-01-01

Electrothermal auxiliary propulsion systems provide high performance options which can have major mission benefits. There are several electrothermal concepts which offer a range of characteristics and benefits. Resistojets are the highest thrust to power option and are currently operational at mission average values of specific impulse, I sub sp approximately 295 sec. Long life, multipropellant resistojets are being developed for the space station, and resistojet technology advancements are being pursued to improve the I sub sp by more than 20 percent for resistojets used in satellite applications. Direct current arcjets have the potential of I sub sp over 400 sec with storable propellants and should provide over 1000 sec with hydrogen. Advanced concepts are being investigated to provide high power density options and possible growth to primary propulsion applications. Broad based experimental and analytical research and technology programs of NASA are summarized and recent significant advances are reviewed.

Evaluating State Options for Reducing Medicaid Churning

PubMed Central

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

Alternative skid trail retirement options for steep terrain logging

Treesearch

Mathew F. Smidt; Randall K. Kolka

2001-01-01

In winter 1999-2000 trials of deep tillage and recontouring of skid trails were implemented on three sites in northeastern Kentucky, USA to examine their potential as skid trail retirement options. While effective, current Best Management Practices (BMPs) for trail retirement do not address two potential benefits of retirement: recovery of normal hill slope hydrology...

Alternative skid trail retirement options for steep terrain logging

Treesearch

Mathew F. Smidt; Randall K. Kelka

2001-01-01

In winter 1999-2000 trials of deep tillage and recontouring of skid trails were implemented on three sites in northeastern Kentucky, USA to examine their potential as skid trail retirement options. While effective, current Best Management Practices (BMPs) for trail retirement do not address two potential benefits of retirement: recovery of normal hill slope\\r\\...

Digital ureteroscopes: technology update

PubMed Central

Gridley, Chad M; Knudsen, Bodo E

2017-01-01

The field of ureteroscopy has undergone a continual evolution since the first ureteroscopes were introduced. Over the past 10 years, we have entered into the digital era of ureteroscopy with both semirigid and flexible options becoming available. The following review looks at the benefits and drawbacks of digital flexible ureteroscopes as well as the current commercially available options. PMID:28203551

78 FR 47449 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Approving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-70076; File No. SR-OCC-2013-09] Self-Regulatory Organizations; The Options Clearing Corporation; Order Approving Proposed Rule Change, as Modified by Amendment No. 1, To Separate the Powers and Duties Currently Combined in the Office of OCC's Chairman Into Two Offices, Chairman and President, an...

78 FR 50477 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... them in sequence for entry into the System for execution. Each of Phlx's current connection offerings... connectivity and installation fees for a 10Gb Ultra low latency fiber connection option, and provide a waiver... bandwidth options for connectivity to the Exchange, including a 40Gb fiber connection, a 10Gb fiber...

78 FR 69468 - Self-Regulatory Organizations; Miami International Securities Exchange LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... option class (a ``Post-Halt Notification'') following a regulatory halt, trading pause or market-wide trading halt. Currently, the Exchange's Trading Operations staff at the MIAX Help Desk issues a Post-Halt...(a). The Post-Halt Notification states the time at which trading in the option class or classes is...

75 FR 47874 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... decrease the current $.0035 per contract fee to each member for all options transactions executed or... exceed costs. The ORF is imposed upon all such 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...

76 FR 52032 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-19

... purpose of making markets in options contracts traded on the Exchange and that is vested with the rights... Exchange currently offers an order-based market making interface for the BATS Options trading platform... to introduce a bulk-quoting interface for market makers in order to offer an additional market making...

76 FR 23632 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-27

..., CBOE calculates the CBOE Gold ETF Volatility Index (``GVZ''), which is based on the VIX methodology applied to options on the SPDR Gold Trust (``GLD''). The current filing would permit $0.50 strike price... other exchange-traded fund (``ETF'') options. See Rule 903, Commentary .05 Volatility indexes are...

Effect of the Range of Response Options on Answers to Biographical Inventory Items

ERIC Educational Resources Information Center

Kirnan, Jean Powell; Edler, Erin; Carpenter, Allison

2007-01-01

The range of response options has been shown to influence the answers given in self-report instruments that measure behaviors ranging from television viewing to sexual partners. The current research extends this line of inquiry to 36 quantitative items extracted from a biographical inventory used in personnel selection. A total of 92…

State Children's Cabinets and Councils--Elements of Success Issue 1: Structural Options

ERIC Educational Resources Information Center

Gaines, Elizabeth; Faigley, Ian; Pittman, Karen

2008-01-01

Elements of Success 1: Structural Options outlines the range of current children's cabinet and council structures in place and offers tips and warnings for getting the most effective structure in place. This issue brief builds heavily on interviews conducted by the Forum and on the detailed documentation work done by Susan Robison for the National…

75 FR 2572 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... Exchange proposes to amend its Schedule of Fees and Charges to implement new royalty fees associated with... Schedule'') to implement new royalty fees associated with Nasdaq 100 Index Options (``NDX'') and Mini-NDX Options (``MNX''). On January 4, 2010, the current royalty fee of $0.16 for MNX and NDX contracts will...

77 FR 72895 - Self-Regulatory Organizations; BOX Options Exchange, LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... Rule Change To Increase the Maximum Term for LEAPS to Fifteen Years November 30, 2012. Pursuant to... maximum term for Long-Term Equity Options Series (``LEAPS'') to fifteen years. The text of the proposed... rule change is to increase the maximum term for all LEAPS. Currently, the maximum term on BOX for...

77 FR 59029 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-25

... Period for Commission Action on Proposed Rule Change To Increase the Maximum Term for LEAPS to Fifteen... proposed rule change to increase the maximum term for Long-Term Equity Options Series (``LEAPS'') to... to the comment. Currently, the maximum term for equity and interest rate LEAPS is three years and the...

77 FR 67723 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Granting...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

... Rule Change To Increase the Maximum Term for LEAPS to Fifteen Years November 6, 2012. I. Introduction... change to increase the maximum term for Long-Term Equity Options Series (``LEAPS'') to fifteen years. The.... Description of the Proposal Currently, the maximum term for equity and interest rate LEAPS is 36 months (three...

Underreporting of high-risk water and sanitation practices undermines progress on global targets.

PubMed

Vedachalam, Sridhar; MacDonald, Luke H; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J

2017-01-01

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly and repeatedly monitor critical development metrics.

Underreporting of high-risk water and sanitation practices undermines progress on global targets

PubMed Central

Vedachalam, Sridhar; MacDonald, Luke H.; Shiferaw, Solomon; Seme, Assefa; Schwab, Kellogg J.

2017-01-01

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly and repeatedly monitor critical development metrics. PMID:28489904

Does provision of point-of-care CD4 technology and early knowledge of CD4 levels affect early initiation and retention on antiretroviral treatment in HIV-positive pregnant women in the context of Option B+ for PMTCT?

PubMed

Mangwiro, Alexio-Zambezi; Makomva, Kudzai; Bhattacharya, Antoinette; Bhattacharya, Gaurav; Gotora, Tendai; Owen, Mila; Mushavi, Angela; Mangwanya, Douglas; Zinyowera, Sekesai; Rusakaniko, Simbarashe; Mugurungi, Owen; Zizhou, Simukai; Busumani, William; Masuka, Nyasha

2014-11-01

Evidence for Elimination (E4E) is a collaborative project established in 2012 as part of the INSPIRE (INtegrating and Scaling up PMTCT through Implementation REsearch) initiative. E4E is a cluster-randomized trial with 2 arms; Standard of care and "POC Plus" [in which point-of-care (POC) CD4 devices and related counseling support are provided]; aimed at improving retention-in-care of HIV-infected pregnant women and mothers. In November 2013, Zimbabwe adopted Option B+ for HIV-positive pregnant women under which antiretroviral treatment eligibility is no longer based on CD4 count. However, Ministry of Health and Child Care guidelines still require baseline and 6-monthly CD4 testing for treatment monitoring, until viral load testing becomes widely available. Considering the current limited capacity for viral-load testing, the significant investments in CD4 testing already made and the historical reliance on CD4 by health care workers for determining eligibility for antiretroviral treatment, E4E seeks to compare the impact of the provision of POC CD4 technology and early knowledge of CD4 levels on retention-in-care at 12 months, with the current standard of routine, laboratory-based CD4 testing. The study also compares rates of initiation and time-to-initiation between the 2 arms and according to level of maternal CD4 count, the cost of retaining HIV-positive pregnant women in care and the acceptability and feasibility of POC CD4 in the context of Option B+. Outcome measures are derived from routine health systems data. E4E will provide data on POC CD4 testing and retention-in-care associated with Option B+ and serve as an early learning platform to inform implementation of Option B+ in Zimbabwe.

RETROFIT COSTS FOR SO2 AND NOX CONTROL OPTIONS AT 200 COAL-FIRED PLANTS, VOLUME I - INTRODUCTION AND METHODOLOGY

EPA Science Inventory

The report gives results of a study, the objective of which was to significantly improve engineering cost estimates currently being used to evaluate the economic effects of applying SO2 and NOx controls at 200 large SO2-emitting coal-fired utility plants. To accomplish the object...

Public Attitudes toward Education in Ontario, 1982. Fourth OISE Survey. Informal Series/51.

ERIC Educational Resources Information Center

Livingstone, D. W.; And Others

Results of the Ontario Institute for Studies in Education 1982 Survey, intended primarily to offer ongoing profiles of mass attitudes on major issues of current educational reform, are reported. In addition to documenting trends in public support for general curricular and financing options, the survey focuses on attitudes towards alternative ways…

Computer simulation modeling of recreation use: Current status, case studies, and future directions

Treesearch

David N. Cole

2005-01-01

This report compiles information about recent progress in the application of computer simulation modeling to planning and management of recreation use, particularly in parks and wilderness. Early modeling efforts are described in a chapter that provides an historical perspective. Another chapter provides an overview of modeling options, common data input requirements,...

Attitudes towards Industrial Training in the BEng. Course in Building Services Engineering at Hong Kong Polytechnic.

ERIC Educational Resources Information Center

Yeung, Y. N. Au; And Others

1993-01-01

A survey of staff, industrial sector members, and current and past students in a Hong Kong Polytechnic cooperative education program investigated perceptions of the academic and nonacademic values of the system and the needs of local industries. Program design options are considered, including part-time and full-time study. (MSE)

Examining Teachers' Self-Described Responses to Student Behavior through the Lens of Catholic Social Teaching Principles

ERIC Educational Resources Information Center

Mucci, Angela Marie

2015-01-01

The current study examined how teacher beliefs about the tenets of Catholic Social Teaching (CST)--dignity of the human person, seeking the common good, and preferential option for the poor and vulnerable--affected self-described responses to student behavior problems. In-depth interviews with seven secondary Catholic school teachers were analyzed…

The Job Training Partnership Act and Computer-Assisted Instruction. Research Report 88-13.

ERIC Educational Resources Information Center

Education Turnkey Systems, Inc., Falls Church, VA.

A study sought to (1) determine the current and potential instructional application of computers in Job Training Partnership Act (JTPA) Titles II, III, and IV programs; and (2) present policy options that would increase the effective use of this technology in employment and training programs. Research methodology involved conducting an assessment…

A review of double-diffusion wood preservation suitable for Alaska.

Treesearch

K. Josephine Pavia

2006-01-01

Currently, all treated lumber used in Alaska is imported from the 48 contiguous states and Canada because there are no wood-treating facilities in Alaska. This report explores conventional and alternative wood-treating methods and reviews previous studies and laboratory tests on treated wood. In investigating wood treatment as a possible processing option for Alaska...

The Role of Gist and Verbatim Memory in Complex Decision Making: Explaining the Unconscious-Thought Effect

ERIC Educational Resources Information Center

Abadie, Marlène; Waroquier, Laurent; Terrier, Patrice

2017-01-01

Previous research showed that the "unconscious-thought effect", which refers to an improvement in complex decision making following a distraction period, was moderated by the presentation format of pieces of information about different options. The aim of the current study was to replicate this finding and further examine the memory…

Correction Methods for Organic Carbon Artifacts when Using Quartz-Fiber Filters in Large Particulate Matter Monitoring Networks: The Regression Method and Other Options

EPA Science Inventory

Sampling and handling artifacts can bias filter-based measurements of particulate organic carbon (OC). Several measurement-based methods for OC artifact reduction and/or estimation are currently used in research-grade field studies. OC frequently is not artifact-corrected in larg...

On the Effectiveness of and Preference for Punishment and Extinction Components of Function-Based Interventions

ERIC Educational Resources Information Center

Hanley, Gregory P.; Piazza, Cathleen C.; Fisher, Wayne W.; Maglieri, Kristen A.

2005-01-01

The current study describes an assessment sequence that may be used to identify individualized, effective, and preferred interventions for severe problem behavior in lieu of relying on a restricted set of treatment options that are assumed to be in the best interest of consumers. The relative effectiveness of functional communication training…

Laser treatment of cutaneous angiokeratomas: A systematic review.

PubMed

Nguyen, Jannett; Chapman, Lance W; Korta, Dorota Z; Zachary, Christopher B

2017-11-01

Angiokeratomas can present therapeutic challenges, especially in cases of extensive lesions, where traditional surgical methods carry high risks of scarring and hemorrhage. Argon, pulsed dye (PDL), neodymium-doped yttrium aluminum garnet (Nd:YAG), copper vapor, potassium titanyl phosphate, carbon dioxide, and erbium-doped yttrium aluminum garnet (Er:YAG) lasers have emerged as alternative options. To review the use and efficacy of lasers in treating angiokeratomas. A PubMed search identified randomized clinical trials, cohort studies, case series, and case reports involving laser treatment of cutaneous angiokeratomas. Twenty-five studies were included. Quality ratings were assigned using the Oxford Centre for Evidence-Based Medicine scheme. Several laser modalities are effective in treating multiple variants of angiokeratomas. Vascular lasers like PDL, Nd:YAG, and argon are the most studied and of these, PDL offers the safest side effect profile. Nd:YAG may be more effective for hyperkeratotic angiokeratomas. Combination treatment with multiple laser modalities has also demonstrated some success. Lasers are a promising treatment option for angiokeratomas, but current use is limited by the lack of treatment guidelines. There are limited high quality studies comparing laser treatments to each other and to non-laser options. Additional studies are needed to establish guidelines and to optimize laser parameters. © 2017 Wiley Periodicals, Inc.

Treatment Option Overview (Small Cell Lung Cancer)

MedlinePlus

... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2018 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

Treatment Options for Adult Hodgkin Lymphoma

MedlinePlus

... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2018 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

The psychometric properties of Observer OPTION(5), an observer measure of shared decision making.

PubMed

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.

Environmental and economic assessment of a road safety product made with virgin and recycled HDPE: a comparative study.

PubMed

L Simões, Carla; Costa Pinto, Lígia M; Bernardo, C A

2013-01-15

The development of value-added products made from post-consumer plastic recyclates has become an important goal in the quest for a sustainable society. To attain such goal, tools with higher accuracy and wider scope are increasingly necessary. The present work describes the application of a Life Cycle Assessment (LCA)/Life Cycle Costing (LCC) integrated model, with inclusion of externalities (environmental and social costs), to Anti-Glare Lamellae (AGL) made with High Density Polyethylene (HDPE). It compares an AGL currently manufactured from virgin HDPE (current AGL) with an alternative one made with recycled HDPE (optional AGL). The results obtained show that neither the current nor the optional AGL depict the best environmental performance in all impact categories. Nevertheless, there is a clear overall environmental and economic advantage in replacing virgin HDPE with recycled HDPE. The present work also makes evident that the LCA/LCC integrated model allows the identification of economic and environmental win-win and trade-off situations related to the full life cycle of products. As such, its results can be used as valuable guidelines in product development. Copyright © 2012 Elsevier Ltd. All rights reserved.

Systems engineering approach to environmental risk management: A case study of depleted uranium at test area C-64, Eglin Air Force Base, Florida. Master`s thesis

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

Carter, C.M.; Fortmann, K.M.; Hill, S.W.

1994-12-01

Environmental restoration is an area of concern in an environmentally conscious world. Much effort is required to clean up the environment and promote environmentally sound methods for managing current land use. In light of the public consciousness with the latter topic, the United States Air Force must also take an active role in addressing these environmental issues with respect to current and future USAF base land use. This thesis uses the systems engineering technique to assess human health risks and to evaluate risk management options with respect to depleted uranium contamination in the sampled region of Test Area (TA) C-64more » at Eglin Air Force Base (AFB). The research combines the disciplines of environmental data collection, DU soil concentration distribution modeling, ground water modeling, particle resuspension modeling, exposure assessment, health hazard assessment, and uncertainty analysis to characterize the test area. These disciplines are required to quantify current and future health risks, as well as to recommend cost effective ways to increase confidence in health risk assessment and remediation options.« less

Surgery for malignant pleural mesothelioma: an international guidelines review

PubMed Central

Cardillo, Giuseppe; Zirafa, Carmelina Cristina; Carleo, Francesco; Facciolo, Francesco; Fontanini, Gabriella; Mutti, Luciano; Melfi, Franca

2018-01-01

Currently there is no universally accepted surgical therapy for malignant pleural mesothelioma (MPM). The goal of surgery in this dismal disease is a macroscopic complete resection (MCR) and there are two types of intervention with a curative intent. At one side, there is the extrapleural pneumonectomy (EPP) which consists in an en-bloc resection of the lung, pleura, pericardium and diaphragm and at the other side, there is pleurectomy/decortication (P/D) a lung-sparing surgery. Initially, EPP was considered the only surgical option with a curative aim, but during the decades P/D have acquired a role of increasing importance in MPM therapy. Several randomized prospective trials are required to establish the best strategy in the treatment of pleural mesothelioma. Although which is the best surgical option remains unclear, the International Mesothelioma Interest Group (IMIG), recently have stated that the type of surgery depends on clinical factors and on individual surgical judgment and expertise. Moreover, according to the current evidence, the surgery should be performed in high-volume centres within multimodality protocols. The aim of this study is to examine the currently available international guidelines in the surgical diagnosis and treatment of MPM. PMID:29507797

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

PubMed

Udedibia, Emeka; Kaminetsky, Jed

2014-12-01

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

Hyperhidrosis: review of recent advances and new therapeutic options for primary hyperhidrosis.

PubMed

Brown, Ashley L; Gordon, Jennifer; Hill, Samantha

2014-08-01

Primary focal hyperhidrosis is a common condition that negatively impacts quality of life for many pediatric patients and can be challenging to treat. Standard treatments for hyperhidrosis can be used with success in many patients, and newer therapies and techniques offer options that have demonstrated efficacy and safety. This review highlights standard therapies for primary focal hyperhidrosis as well as the most recent technique advancements and alternative treatment options. The standard approach to treating primary focal hyperhidrosis remains initiation of topical preparations, followed by advancement to systemic medications, local administration of medication and/or surgical procedures. Recent studies focus on enhancing tolerability of topical preparations as well as evaluating the efficacy of neuromodulator injections, oral anticholinergic medications and laser therapy. Microwave technology has also been introduced for the treatment of focal hyperhidrosis with promising results. Many therapies exist for hyperhidrosis, and each treatment plan must be evaluated on a patient-by-patient basis. Advances in standard therapies and emergence of new treatment techniques are the main emphases of current published literature on hyperhidrosis. This article presents recent therapeutic options as well as updates on more established strategies to help practitioners treat this challenging condition.

Study on Alternative Cargo Launch Options from the Lunar Surface

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

Cheryl A. Blomberg; Zamir A. Zulkefli; Spencer W. Rich

In the future, there will be a need for constant cargo launches from Earth to Mars in order to build, and then sustain, a Martian base. Currently, chemical rockets are used for space launches. These are expensive and heavy due to the amount of necessary propellant. Nuclear thermal rockets (NTRs) are the next step in rocket design. Another alternative is to create a launcher on the lunar surface that uses magnetic levitation to launch cargo to Mars in order to minimize the amount of necessary propellant per mission. This paper investigates using nuclear power for six different cargo launching alternatives,more » as well as the orbital mechanics involved in launching cargo to a Martian base from the moon. Each alternative is compared to the other alternative launchers, as well as compared to using an NTR instead. This comparison is done on the basis of mass that must be shipped from Earth, the amount of necessary propellant, and the number of equivalent NTR launches. Of the options, a lunar coil launcher had a ship mass that is 12.7% less than the next best option and 17 NTR equivalent launches, making it the best of the presented six options.« less

Soft tissue reconstruction of the oral cavity: a review of current options.

PubMed

Rigby, Matthew H; Taylor, S Mark

2013-08-01

This article provides an overview of the principles of soft tissue reconstruction of the oral cavity, and reviews the recent clinical outcomes for described options. For small defects of the oral cavity, healing by secondary intention and primary closure are both excellent options and may provide functionally superior results. In defects where a split-thickness skin graft is appropriate, acellular dermis may provide results that are at least as good at lower cost. Free flaps, particularly the radial forearm and the anterolateral thigh, have become the mainstays of oral cavity soft tissue reconstruction for larger defects. Recent clinical series suggest that relatively novel regional flaps provide a reasonable alternative to free flap reconstructions for moderate and some large soft tissue defects. Soft tissue reconstruction of the oral cavity is a complex task with significant functional implications. There are a large number of reconstructive options available. Systematic appraisal of the defect and options allows the reconstructive surgeon to optimize functional potential by choosing the most appropriate reconstructive option.

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.

Age, Loss Minimization, and the Role of Probability for Decision-Making.

PubMed

Best, Ryan; Freund, Alexandra M

2018-04-05

Older adults are stereotypically considered to be risk averse compared to younger age groups, although meta-analyses on age and the influence of gain/loss framing on risky choices have not found empirical evidence for age differences in risk-taking. The current study extends the investigation of age differences in risk preference by including analyses on the effect of the probability of a risky option on choices in gain versus loss situations. Participants (n = 130 adults aged 19-80 years) chose between a certain option and a risky option of varying probability in gain- and loss-framed gambles with actual monetary outcomes. Only younger adults displayed an overall framing effect. Younger and older adults responded differently to probability fluctuations depending on the framing condition. Older adults were more likely to choose the risky option as the likelihood of avoiding a larger loss increased and as the likelihood of a larger gain decreased. Younger adults responded with the opposite pattern: they were more likely to choose the risky option as the likelihood of a larger gain increased and as the likelihood of avoiding a (slightly) larger loss decreased. Results suggest that older adults are more willing to select a risky option when it increases the likelihood that larger losses be avoided, whereas younger adults are more willing to select a risky option when it allows for slightly larger gains. This finding supports expectations based on theoretical accounts of goal orientation shifting away from securing gains in younger adulthood towards maintenance and avoiding losses in older adulthood. Findings are also discussed in respect to the affective enhancement perspective and socioemotional selectivity theory. © 2018 S. Karger AG, Basel.

78 FR 4042 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-18

... provides an option for a high frequency eddy current inspection for cracking of the critical fastener holes... for a high frequency eddy current inspection for cracking of the critical fastener holes, and repair..., August 9, 2007)), do a high frequency eddy current (HFEC) inspection for cracking of the four critical...

Options for flight testing rocket-based combined-cycle (RBCC) engines

NASA Technical Reports Server (NTRS)

Olds, John

1996-01-01

While NASA's current next-generation launch vehicle research has largely focused on advanced all-rocket single-stage-to-orbit vehicles (i.e. the X-33 and it's RLV operational follow-on), some attention is being given to advanced propulsion concepts suitable for 'next-generation-and-a-half' vehicles. Rocket-based combined-cycle (RBCC) engines combining rocket and airbreathing elements are one candidate concept. Preliminary RBCC engine development was undertaken by the United States in the 1960's. However, additional ground and flight research is required to bring the engine to technological maturity. This paper presents two options for flight testing early versions of the RBCC ejector scramjet engine. The first option mounts a single RBCC engine module to the X-34 air-launched technology testbed for test flights up to about Mach 6.4. The second option links RBCC engine testing to the simultaneous development of a small-payload (220 lb.) two-stage-to-orbit operational vehicle in the Bantam payload class. This launcher/testbed concept has been dubbed the W vehicle. The W vehicle can also serve as an early ejector ramjet RBCC launcher (albeit at a lower payload). To complement current RBCC ground testing efforts, both flight test engines will use earth-storable propellants for their RBCC rocket primaries and hydrocarbon fuel for their airbreathing modes. Performance and vehicle sizing results are presented for both options.

Technical opportunities to reduce global anthropogenic emissions of nitrous oxide

NASA Astrophysics Data System (ADS)

Winiwarter, Wilfried; Höglund-Isaksson, Lena; Klimont, Zbigniew; Schöpp, Wolfgang; Amann, Markus

2018-01-01

We describe a consistent framework developed to quantify current and future anthropogenic emissions of nitrous oxide and the available technical abatement options by source sector for 172 regions globally. About 65% of the current emissions derive from agricultural soils, 8% from waste, and 4% from the chemical industry. Low-cost abatement options are available in industry, wastewater, and agriculture, where they are limited to large industrial farms. We estimate that by 2030, emissions can be reduced by about 6% ±2% applying abatement options at a cost lower than 10 €/t CO2-eq. The largest abatement potential at higher marginal costs is available from agricultural soils, employing precision fertilizer application technology as well as chemical treatment of fertilizers to suppress conversion processes in soil (nitrification inhibitors). At marginal costs of up to 100 €/t CO2-eq, about 18% ±6% of baseline emissions can be removed and when considering all available options, the global abatement potential increases to about 26% ±9%. Due to expected future increase in activities driving nitrous oxide emissions, the limited technical abatement potential available means that even at full implementation of reduction measures by 2030, global emissions can be at most stabilized at the pre-2010 level. In order to achieve deeper reductions in emissions, considerable technological development will be required as well as non-technical options like adjusting human diets towards moderate animal protein consumption.

America's Climate Choices: Adapting to the Impacts of Climate Change (Invited)

NASA Astrophysics Data System (ADS)

Wilbanks, T.; Yohe, G.; Mengelt, C.; Casola, J.

2010-12-01

At the request of Congress, the National Academy of Sciences convened a series of coordinated activities to provide advice on actions and strategies that the nation can take to respond to climate change. As part of this suite of activities, this study assessed, this study assessed how the nation can begin to adapt to the impacts of climate change. Much of the nation’s experience to date in managing and protecting its people, resources, and infrastructure is based on the historic record of climate variability during a period of relatively stable climate. Adaptation to climate change calls for a new paradigm - one that considers a range of possible future climate conditions and associated impacts. The Adapting to the Impacts of Climate Change report calls for action at all levels of government, NGOs, and the private sector to assess vulnerabilities to the impacts of climate change and identify options for adaptation. Current adaptation efforts are hampered by a lack of solid information about the benefits, costs, and effectiveness of various adaptation options, by uncertainty about future climate change impacts at a scale necessary for decision-making, and by a lack of coordination. The report outlines a risk management framework that can be applied to assess vulnerabilities, compare and evaluate potential adaptation options, recognizing that decision makers across the country are likely to pursue a diverse set of adaptation measures. A major research effort is needed to improve knowledge about current and future vulnerabilities, explore new adaptation options, and better inform adaptation decisions. Therefore, the report also emphasizes the need to continually re-assess adaptation decisions as the experience and knowledge regarding effective adaptation evolves. A national adaptation strategy is needed in which the federal government would support and enhance adaptation activities undertaken by state, local, tribal, and private entities; identify and modify policies that might provide incentives for maladaptive behavior; bolster scientific research regarding adaptation; and encourage adaptation on a global scale through national programs with international components.

Gender and Programming.

PubMed

Crittenden, Courtney A; Koons-Witt, Barbara A

2017-05-01

The current study examines U.S. prison programming availability and participation by gender on a national level. The authors build upon previous literature by using national-level data, something that has been done in very limited cases previously. The main concern of this study is gender and its effects on programming availability and participation. The U.S. corrections field has undergone major changes in regard to population trends, fiscal constraints, policies, and research over the last few decades without a large-scale examination of the effects of these changes on programming across the United States. In this study, multiple types of programming areas were examined and results indicated that often female prisons (i.e., prisons housing only females) were more likely to offer programs (e.g., mental health options) and women were more likely to participate in many programming options compared with male prisons and men, respectively. We discuss the possible reasons for this and implications for future research.

[Drooling therapy in children with neurological disorders].

PubMed

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.

Current Therapeutic Approach to Hypertrophic Scars

PubMed Central

Mokos, Zrinka Bukvić; Jović, Anamaria; Grgurević, Lovorka; Dumić-Čule, Ivo; Kostović, Krešimir; Čeović, Romana; Marinović, Branka

2017-01-01

Abnormal scarring and its accompanying esthetic, functional, and psychological sequelae still pose significant challe nges. To date, there is no satisfactory prevention or treatment option for hypertrophic scars (HSs), which is mostly due to not completely comprehending the mechanisms underlying their formation. That is why the apprehension of regular and controlled physiological processes of scar formation is of utmost importance when facing hypertrophic scarring, its pathophysiology, prevention, and therapeutic approach. When treating HSs and choosing the best treatment and prevention modality, physicians can choose from a plethora of therapeutic options and many commercially available products, among which currently there is no efficient option that can successfully overcome impaired skin healing. This article reviews current therapeutic approach and emerging therapeutic strategies for the management of HSs, which should be individualized, based on an evaluation of the scar itself, patients’ expectations, and practical, evidence-based guidelines. Clinicians are encouraged to combine various prevention and treatment modalities where combination therapy that includes steroid injections, 5-fluorouracil, and pulsed-dye laser seems to be the most effective. On the other hand, the current therapeutic options are usually empirical and their results are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a particular factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extracellular matrix has a crucial role in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may throw up new therapeutic approach for reduction or prevention of HSs with functionally and cosmetically acceptable outcome. PMID:28676850

Treatment Option Overview (Mycosis Fungoides and the Sezary Syndrome)

MedlinePlus

... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2018 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

Treatment Option Overview (Non-Small Cell Lung Cancer)

MedlinePlus

... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2018 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

A Review and Update of Treatment Options and Controversies in the Management of Hepatocellular Carcinoma.

PubMed

Dhir, Mashaal; Melin, Alyson A; Douaiher, Jeffrey; Lin, Chi; Zhen, Weining Ken; Hussain, Shahid M; Geschwind, Jean-Francois H; Doyle, Maria B Majella; Abou-Alfa, Ghassan K; Are, Chandrakanth

2016-06-01

To review the current management, outline recent advances and address controversies in the management of hepatocellular carcinoma (HCC). The treatment of HCC is multidisciplinary involving hepatologists, surgeons, medical oncologists, radiation oncologists, radiologists, interventional radiologists, and other disciplines. Each of these disciplines brings its unique perspective and differing opinions that add to controversies in the management of HCC. A focused literature review was performed to identify recent studies on the management of HCC and thereby summarize relevant information on the various therapeutic modalities and controversies involved in the treatment of HCC. The main treatment algorithms continue to rely on hepatic resection or transplantation with controversies involving patients harboring early stage disease and borderline hepatic function. The other treatment strategies include locoregional therapies, radiation, and systemic therapy used alone or in combination with other treatment modalities. Recent advances in locoregional therapies, radiation, and systemic therapies have provided better therapeutic options with curative intent potential for some locoregional therapies. Further refinements in combination therapies such as algorithms consisting of locoregional therapies and systemic or radiation therapies are likely to add additional options and improve survival. The management of HCC has witnessed significant strides with advances in existing options and introduction of several new treatment modalities of various combinations. Further refinements in these treatment options combined with enrollment in clinical trials are essential to improve the management and outcomes of patients with HCC.

Impacts of fleet types and charging modes for electric vehicles on emissions under different penetrations of wind power

NASA Astrophysics Data System (ADS)

Chen, Xinyu; Zhang, Hongcai; Xu, Zhiwei; Nielsen, Chris P.; McElroy, Michael B.; Lv, Jiajun

2018-05-01

Current Chinese policy promotes the development of both electricity-propelled vehicles and carbon-free sources of power. Concern has been expressed that electric vehicles on average may emit more CO2 and conventional pollutants in China. Here, we explore the environmental implications of investments in different types of electric vehicle (public buses, taxis and private light-duty vehicles) and different modes (fast or slow) for charging under a range of different wind penetration levels. To do this, we take Beijing in 2020 as a case study and employ hourly simulation of vehicle charging behaviour and power system operation. Assuming the slow-charging option, we find that investments in electric private light-duty vehicles can result in an effective reduction in the emission of CO2 at several levels of wind penetration. The fast-charging option, however, is counter-productive. Electrifying buses and taxis offers the most effective option to reduce emissions of NOx, a major precursor for air pollution.

Capturing and Explaining Preference Heterogeneity for Wetland Management Options in the Kilombero Valley, Tanzania

NASA Astrophysics Data System (ADS)

Speelman, Stijn; Mombo, Felister; Vandermeulen, Valerie; Phillip, Damas; Van Huylenbroeck, Guido

2015-01-01

Wetland degradation has recently received considerable research attention. Although wetlands are valuable ecosystems, their actual value is difficult to measure because the services they provide often do not have market values. The current study seeks to investigate the preferences for wetland management options in the Kilombero Valley, central Tanzania using choice modeling. The results show that both respondents from the Kilombero Valley and Morogoro Municipality desire improvements in the condition of the wetlands. This indicates that the ongoing degradation is not socially optimal. A second finding is that the preferences for wetland conservation are heterogeneous and can be linked to livelihood characteristics. Communities living in the area, for example, are highly dependent on the wetland for their livelihood and would be impacted by conservation measures. Therefore, in order to reduce the pressure on wetlands, it is necessary and imperative to explore the options for alternative income-generating activities or to focus, for example, on technologies to improve efficiency and effectiveness in crop production.

Sustainable sewerage servicing options for peri-urban areas with failing septic systems.

PubMed

Sharma, A K; Tjandraatmadja, G; Grant, A L; Grant, T; Pamminger, F

2010-01-01

The provision of water and wastewater services to peri-urban areas faces very different challenges to providing services to cities. Sustainable solutions for such areas are increasingly being sought, in order to solve the environmental and health risks posed by failing septic systems. These solutions should have the capability to reduce potable water demand, provide fit for purpose reuse options, and minimise impacts on the local and global environment. A methodology for the selection of sustainable sewerage servicing systems and technologies is presented in this paper. This paper describes the outcomes of applying this methodology to a case study in rural community near Melbourne, Australia, and describes the economic and environmental implications of various sewerage servicing options. Applying this methodology has found that it is possible to deliver environmental improvements at a lower community cost, by choosing servicing configurations not historically used by urban water utilities. The selected solution is currently being implemented, with the aim being to generate further transferable learnings for the water industry.

The next $120,000: a case study to illustrate analysis of alternative farm investments in fixed assets.

PubMed

St-Pierre, N R; Shoemaker, D; Jones, L R

2000-05-01

Dairy scientists specializing in the area of farm management are increasingly involved in analysis of farm investments in fixed assets. There have been instances where the wrong procedures were used to assess investments in fixed assets, leading to erroneous and possibly disastrous conclusions. A detailed case study of a dairy farm facing the decision of where best to invest an unexpected $120,000 windfall is used to illustrate the various facets of financial analysis. Indicators of profitability, liquidity, solvency, repayment capacity, and financial efficiency are explained and applied to the farm case to produce a detailed analysis of the current financial position of the firm. Long-range budgets of four alternate investment options and their impact on all financial indicators are presented. The four options are: 1) to pay down debt, 2) to purchase an additional 100 cows, 3) to install automatic milk yield recording in the parlor, and 4) to build new heifer facilities. All four investments are profitable. Therefore, an analysis limited to profitability indicators would conclude that any of the four options is a good investment. However, liquidity and financial efficiency issues showed that the option of purchasing 100 cows is far superior to the three others. We conclude that a complete and thorough financial analysis is required to evaluate the impact of long-run investments in fixed assets.

Greenhouse gas emission reduction: A case study of Sri Lanka

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

Meier, P.; Munasinghe, M.

1995-12-31

In this paper we describe a case study for Sri Lanka that explores a wide range of options for reducing greenhouse gas (GHG) emissions. Options range from renewable technologies to carbon taxes and transportation sector initiatives. We find that setting electricity prices to reflect long-run marginal cost has a significant beneficial impact on the environment, and the expected benefits predicted on theoretical grounds are confirmed by the empirical results. Pricing reform also has a much broader impact than physical approaches to demand side management, although several options such as compact fluorescent lighting appear to have great potential. Options to reducemore » GHG emissions are limited as Sri Lanka lacks natural gas, and nuclear power is not practical until the system reaches a much larger size. Building the few remaining large hydro facilities would significantly reduce GHG emissions, but these would require costly resettlement programs. Given the inevitability for fossil-fuel base load generation, both clean coal technologies such as pressurized fluidized bed combustion, as well as steam-cycle residual oil fueled plants merit consideration as alternatives to the conventional pulverized coal-fired plants currently being considered. Transportation sector measures necessary to ameliorate local urban air pollution problems, such as vehicle inspection and maintenance programs, also bring about significant reductions of GHG emissions. 51 refs., 10 figs., 3 tabs.« less

Decision analysis and drug development portfolio management: uncovering the real options value of your projects.

PubMed

Rosati, Nicoletta

2002-04-01

Project selection and portfolio management are particularly challenging in the pharmaceutical industry due to the high risk - high stake nature of the drug development process. In the recent years, scholars and industry experts have agreed that traditional Net-Present-Value evaluation of the projects fails to capture the value of managerial flexibility, and encouraged adopting a real options approach to recover the missed value. In this paper, we take a closer look at the drug development process and at the indices currently used to rank projects. We discuss the economic value of information and of real options arising in drug development and present decision analysis as an ideal framework for the implementation of real options valuation.

The Fundamental Uncertainty of Business: Real Options

NASA Astrophysics Data System (ADS)

Dyer, James S.

The purpose of this paper is to discuss the manner in which uncertainty is currently evaluated in business, with an emphasis on economic measures. In recent years, the accepted approach for the valuation of capital investment decisions has become one based on the theory of real options. From the standpoint of this workshop, the interesting aspect of real options is its focus on the flexibility of management to respond to changes in the environment as a feature of an alternative that has unique value, known as "option value." While this may not be surprising to most participants in this workshop, it does represent a radical change in traditional thinking about risk in business, where efforts have primarily been focused on the elimination of risk when possible.

Multi-mesh gear dynamics program evaluation and enhancements

NASA Technical Reports Server (NTRS)

Boyd, L. S.; Pike, J.

1985-01-01

A multiple mesh gear dynamics computer program was continually developed and modified during the last four years. The program can handle epicyclic gear systems as well as single mesh systems with internal, buttress, or helical tooth forms. The following modifications were added under the current funding: variable contact friction, planet cage and ring gear rim flexibility options, user friendly options, dynamic side bands, a speed survey option and the combining of the single and multiple mesh options into one general program. The modified program was evaluated by comparing calculated values to published test data and to test data taken on a Hamilton Standard turboprop reduction gear-box. In general, the correlation between the test data and the analytical data is good.

Silencing the roadblocks to effective triple-negative breast cancer treatments by siRNA nanoparticles.

PubMed

Parvani, Jenny G; Jackson, Mark W

2017-04-01

Over the past decade, RNA interference (RNAi) has been ubiquitously utilized to study biological function in vitro ; however, limitations were associated with its utility in vivo More recently, small interfering RNA (siRNA) nanoparticles with improved biocompatibility have gained prevalence as a potential therapeutic option for the treatment of various diseases. The adaptability of siRNA nanoparticles enables the delivery of virtually any siRNA, which is especially advantageous for therapeutic applications in heterogeneous diseases that lack unifying molecular features, such as triple-negative breast cancer (TNBC). TNBC is an aggressive subtype of breast cancer that is stratified by the lack of estrogen receptor/progesterone receptor expression and HER2 amplification. There are currently no FDA-approved targeted therapies for the treatment of TNBCs, making cytotoxic chemotherapy the only treatment option available to these patients. In this review, we outline the current status of siRNA nanoparticles in clinical trials for cancer treatment and discuss the promising preclinical approaches that have utilized siRNA nanoparticles for TNBC treatment. Next, we address TNBC subtype-specific therapeutic interventions and highlight where and how siRNA nanoparticles fit into these strategies. Lastly, we point out ongoing challenges in the field of siRNA nanoparticle research that, if addressed, would significantly improve the efficacy of siRNA nanoparticles as a therapeutic option for cancer treatment. © 2017 Society for Endocrinology.

Attitudes of the German General Population toward Early Diagnosis of Dementia – Results of a Representative Telephone Survey

PubMed Central

Luck, Tobias; Luppa, Melanie; Sieber, Jennifer; Schomerus, Georg; Werner, Perla; König, Hans-Helmut; Riedel-Heller, Steffi G.

2012-01-01

Background Early detection of dementia has clearly improved. Even though none of the currently available treatments for the most common form of dementia, Alzheimer’s dementia, promises a cure, early diagnosis provides several benefits for patients, caregivers, and health care systems. This study aimed to describe attitudes toward early diagnosis of dementia in the German general population. Methods A representative telephone survey of the German population aged 18+ years (n = 1,002) was conducted in 2011. Results The majority of respondents (69%) would be willing to be examined for early diagnosis of dementia. Almost two thirds reported that they would prefer their general practitioner (GP) as the first source of professional help. More than half of the respondents (55%) stated their belief that dementia could be prevented. Respondents mostly indicated psychosocial prevention options. Conclusions Our findings suggest that the general population in Germany is very open to early diagnosis of dementia; however, this seems connected with large expectations on the effectiveness of prevention options. Dementia awareness campaigns may be employed to carefully inform the public about the prevention options currently available and their efficacy. To exploit GPs’ potential as a gatekeeper for early detection of dementia, their ability to identify patients with antecedent and mild stages of the disease must be improved. PMID:23209827

Premature ejaculation: do we have effective therapy?

PubMed

Serefoglu, Ege Can; Saitz, Theodore R; Trost, Landon; Hellstrom, Wayne J G

2013-03-01

Premature ejaculation (PE) is the most common sexual dysfunction, with the majority of PE patients remaining undiagnosed and undertreated. Despite its prevalence, there is a current paucity of data regarding available treatment options and mechanisms. The objective of the current investigation is to review and summarize pertinent literature on therapeutic options for the treatment of PE, including behavioral/psychologic, oral pharmacotherapy, and surgery. A pubmed search was conducted on articles reporting data on available treatment options for PE. Articles describing potential mechanisms of action were additionally included for review. Preference was given towards randomized, controlled trials, when available. PE remains an underdiagnosed and undertreated disease process, with limited data available regarding potential underlying mechanisms and long-term outcomes of treatment options. Psychological/behavioral therapies, including the stop-start, squeeze, and pelvic floor rehabilitation techniques have demonstrated improvements in short-term series, with decreased efficacy with additional follow-up. Topical therapies, which are commonly utilized result in prolonged intravaginal ejaculatory latency time (IELT) at the expense of potential penile/vaginal Hypothesia. Oral therapies similarly demonstrate improved IELTs with variable side effect profiles and include selective serotonin reuptake inhibitors (daily or on demand), phosphodiesterase-5 inhibitors, alpha-1 adrenergic antagonists, and tramadol. Alternative therapies such as acupuncture have shown benefits in limited studies. Surgery is not commonly performed and is not recommended by available guidelines. PE is a common condition, with limited data available regarding its underlying pathophysiology and treatment. Available therapies include topical, oral, behavioral/psychologic modification, or a combination thereof. Additional research is required to assess the optimal treatment strategies and algorithms as well as to better define the mechanisms for PE and its management.

Premature ejaculation: do we have effective therapy?

PubMed Central

Serefoglu, Ege Can; Saitz, Theodore R.; Trost, Landon

2013-01-01

Introduction Premature ejaculation (PE) is the most common sexual dysfunction, with the majority of PE patients remaining undiagnosed and undertreated. Despite its prevalence, there is a current paucity of data regarding available treatment options and mechanisms. The objective of the current investigation is to review and summarize pertinent literature on therapeutic options for the treatment of PE, including behavioral/psychologic, oral pharmacotherapy, and surgery. Methods A pubmed search was conducted on articles reporting data on available treatment options for PE. Articles describing potential mechanisms of action were additionally included for review. Preference was given towards randomized, controlled trials, when available. Results PE remains an underdiagnosed and undertreated disease process, with limited data available regarding potential underlying mechanisms and long-term outcomes of treatment options. Psychological/behavioral therapies, including the stop-start, squeeze, and pelvic floor rehabilitation techniques have demonstrated improvements in short-term series, with decreased efficacy with additional follow-up. Topical therapies, which are commonly utilized result in prolonged intravaginal ejaculatory latency time (IELT) at the expense of potential penile/vaginal Hypothesia. Oral therapies similarly demonstrate improved IELTs with variable side effect profiles and include selective serotonin reuptake inhibitors (daily or on demand), phosphodiesterase-5 inhibitors, alpha-1 adrenergic antagonists, and tramadol. Alternative therapies such as acupuncture have shown benefits in limited studies. Surgery is not commonly performed and is not recommended by available guidelines. Conclusions PE is a common condition, with limited data available regarding its underlying pathophysiology and treatment. Available therapies include topical, oral, behavioral/psychologic modification, or a combination thereof. Additional research is required to assess the optimal treatment strategies and algorithms as well as to better define the mechanisms for PE and its management. PMID:26816723

Body dysmorphic disorder.

PubMed

Fang, Angela; Matheny, Natalie L; Wilhelm, Sabine

2014-09-01

Body dysmorphic disorder (BDD) can be a severe and often debilitating psychiatric disorder that has been largely under-recognized and underdiagnosed. Pharmacologic and nonpharmacologic treatment options are available but limited. This review aims to provide an updated overview of the psychopathology and epidemiology of BDD, with an emphasis on current pharmacologic and nonpharmacologic treatment options for BDD. Copyright © 2014 Elsevier Inc. All rights reserved.

76 FR 27117 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... exchange-traded fund (``ETF'') option classes traded on C2. Currently, transactions fees as set out in the... maker rebate and pay a liquidity removing taker rate of $.25 per contract; C2 Market-Makers receive a liquidity making rebate of $.25 per contract and pay a liquidity removing taker rate of $.34 per contract...

78 FR 53490 - Self-Regulatory Organizations; Chicago Mercantile Exchange Inc.; Notice of Filing and Immediate...

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2012-08-15

...; and (iii) establish a fee of $0.10 per contract for NYSE Amex Options Market Maker executions of SPY... than SPY would continue to pay the existing transaction charges, as provided in the Fee Schedule. 2... for SPY options are currently $0.25 per contract, which, when coupled with the proposed $0.10 per...

76 FR 5846 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

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2011-02-02

... Change Relating to Firm Related Equity Option Cap, Active SQF Port Fees and Other Membership Fees January... Schedule to: (i) Allow Firms to cap their equity option transaction charges, per month, when such Firms are... Specialized Quote Feed (``SQF'') Port Fee and also extended the current $40,000 per month cap from March 31...

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2013-09-04

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42 CFR 435.134 - Individuals who would be eligible except for the increase in OASDI benefits under Pub. L. 92-336...

Code of Federal Regulations, 2013 CFR

2013-10-01

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2010-12-28

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77 FR 47890 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Proposed...

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... Increase the Maximum Term for LEAPS to Fifteen Years August 6, 2012. Pursuant to Section 19(b)(1) of the... maximum term for Long-Term Equity Options Series (``LEAPS'') to fifteen years. The text of the proposed... purpose of the proposed rule change is to increase the maximum term for all LEAPS. Currently, the maximum...

NOAA Photo Library - NOAA's Ark/Animals Album

Science.gov Websites

options banner CATALOG View ALL images contained in the collection. Click on thumbnails to view larger images. ALBUMS Images are arranged by themes. Click on thumbnails to view larger images. Note that not all images are contained in the albums - select the above option to view ALL current images. NOAA's

Treatment options for moderate-to-very severe chronic obstructive pulmonary disease.

PubMed

Cazzola, Mario; Rogliani, Paola; Ora, Josuel; Matera, Maria Gabriella

2016-01-01

The appropriate drug management of COPD is still based on the use of bronchodilators, possibly associated with an anti-inflammatory agent. However, there are still fundamental questions that require clarification to optimise their use and major unmet clinical needs that must be addressed. The advances obtained with the pharmacological options currently consolidated and the different approaches that are often used in an attempt to respond to unmet therapeutic needs are reviewed Expert opinion: In view of the unsatisfactory status of current treatments for COPD, there is an urgent need for alternative and more effective therapeutic approaches that will help to relieve patient symptoms and affect the natural course of COPD, inhibiting chronic inflammation and reversing the disease process or preventing its progression. However, new pharmacologic options have proved difficult to develop. Therefore, it is mandatory to optimize the use of the treatment options at our disposal. However, there are still fundamental questions regarding their use, including the step-up and step-down pharmacological approach, that require clarification to optimise the use of these drugs. It is likely that phenotyping COPD patients would help in identifying the right treatment for each COPD patient and improve the effectiveness of therapies.

Dental practice websites: creating a Web presence.

PubMed

Miller, Syrene A; Forrest, Jane L

2002-07-01

Web technology provides an opportunity for dentists to showcase their practice philosophy, quality of care, office setting, and staff in a creative manner. Having a Website provides a practice with innovative and cost-effective communications and marketing tools for current and potential patients who use the Internet. The main benefits of using a Website to promote one's practice are: Making office time more productive, tasks more timely, follow-up less necessary Engaging patients in an interactive and visual learning process Providing online forms and procedure examples for patients Projecting a competent and current image Tracking the usage of Web pages. Several options are available when considering the development of a Website. These options range in cost based on customization of the site and ongoing support services, such as site updates, technical assistance, and Web usage statistics. In most cases, Websites are less expensive than advertising in the phone book. Options in creating a Website include building one's own, employing a company that offers Website templates, and employing a company that offers customized sites. These development options and benefits will continue to grow as individuals access the Web and more information and sites become available.

Cost-effectiveness of World Health Organization 2010 Guidelines for Prevention of Mother-to-Child HIV Transmission in Zimbabwe

PubMed Central

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

Multimodal corridor and capacity analysis manual. Final report

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

NONE

1998-12-31

This report presents the results of research carried out under NCHRP Project 8-31, Long-Term Availability of Multimodal Corridor Capacity. The report is presented as a manual on multimodal corridor and capacity analysis. Because transportation-system and corridor capacity for freight and passengers is critical for meeting current and future transportation demand, this manual will provide much needed assistance to a wide range of practitioners, particularly those engaged in performance analysis, capacity management, needs studies, systems planning, and corridor development planning--including major investment studies. It provides information regarding capacity analysis approaches for highways, rail, pipelines, and waterways and presents available options formore » enhancing corridor capacity and performance through various strategies such as new capacity development, freeing up unused capacity, or control of travel demand. Evaluation methods for these options are included.« less

Haemodialysis plastic cannulae - a possible alternative to traditional metal needles?

PubMed

Parisotto, Maria Teresa; Pelliccia, Francesco; Bedenbender-Stoll, Eva; Gallieni, Maurizio

2016-09-21

Haemodialysis plastic cannulae for arteriovenous fistulae (AVF) have been used for many years in Japan and recently this technique was introduced in Australia. Find answers to the following questions:What are the pros and cons of plastic cannulae versus traditional metal needles for AVF and arteriovenous graft (AVG)? Is the use of plastic cannulae instead of traditional metal needles an option for European dialysis units as well? If it is an option, for which patients should plastic cannulae be used? Literature search via PubMed and Google. Due to the characteristics of plastic cannulae, they seem to be well suited for restless patients, patients with unpredictable behaviour, children, and patients who are allergic to metal.However, the evidence base provided by studies on the use of cannulae is currently weak. More controlled randomised studies are needed.

Nonreconstruction Options for Treating Medial Ulnar Collateral Ligament Injuries of the Elbow in Overhead Athletes.

PubMed

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.

Prizes for innovation of new medicines and vaccines.

PubMed

Love, James; Hubbard, Tim

2009-01-01

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

Transcranial direct current stimulation (tDCS) and language

PubMed Central

Monti, Alessia; Ferrucci, Roberta; Fumagalli, Manuela; Mameli, Francesca; Cogiamanian, Filippo; Ardolino, Gianluca; Priori, Alberto

2013-01-01

Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique inducing prolonged brain excitability changes and promoting cerebral plasticity, is a promising option for neurorehabilitation. Here, we review progress in research on tDCS and language functions and on the potential role of tDCS in the treatment of post-stroke aphasia. Currently available data suggest that tDCS over language-related brain areas can modulate linguistic abilities in healthy individuals and can improve language performance in patients with aphasia. Whether the results obtained in experimental conditions are functionally important for the quality of life of patients and their caregivers remains unclear. Despite the fact that important variables are yet to be determined, tDCS combined with rehabilitation techniques seems a promising therapeutic option for aphasia. PMID:23138766

A licence to vape: Is it time to trial of a nicotine licensing scheme to allow Australian adults controlled access to electronic cigarettes devices and refill solutions containing nicotine?

PubMed

Gartner, Coral; Hall, Wayne

2015-06-01

Australia has some of the most restrictive laws concerning use of nicotine in e-cigarettes. The only current legal option for Australians to legally possess and use nicotine for vaping is with a medical prescription and domestic supply is limited to compounding pharmacies that prepare medicines for specific patients. An alternative regulatory option that could be implemented under current drugs and poisons regulations is a 'nicotine licensing' scheme utilising current provisions for 'dangerous poisons'. This commentary discusses how such a scheme could be used to trial access to nicotine solutions for vaping outside of a 'medicines framework' in Australia. Copyright © 2015 Elsevier B.V. All rights reserved.

Bladder stone management: an update.

PubMed

Cicione, Antonio; DE Nunzio, Cosimo; Manno, Stefano; Damiano, Rocco; Posti, Alessandro; Lima, Estevao; Tubaro, Andrea; Balloni, Filippo

2018-02-01

Bladder stone (BS) is a rare disease curable with several options. Herein, we reviewed the specific literature in order to update the current BS management. A comprehensive systematic MEDLINE search was performed for English language reports published before April 2017 using the BS related terms, i.e. bladder-vesical calculi, lithotripsy. Then manuscripts references were screened to identify unfounded studies. Studies regarding BS in children were excluded. Retrieved studies were classified according to their main item as: etiology, diagnosis, treatment, treatment in specific illnesses and advances in BS management. Treatment option was mainly related to stone size and number as well as concomitant causative disease. However, stone nature was not analyzed in all the retrieved studies. Both trans-urethral and percutaneous lithotripsy were efficacy for stone fragmentation although the last one was suggested to avoid urethral injuries. Holmiun:Yag laser lithotripsy has made stone fragmentation feasible by using local anesthesia however in selected patients only. The urological dogma to perform concomitant prostate surgery in men with BS has been recently questioned by some observational case-series studies however, the lack of randomization and long follow up preserve that knowledge. Bladder stone is a rare and ancient disease. Nowadays new technologies have been developed in the effort to make less invasive stone treatment. The retrieved studies show that stone fragmentation can be archived by using several surgical approaches and devices whereas comparative randomized studies are still unavailable to identify the best option.

Spirituality, religiosity and addiction recovery: current perspectives.

PubMed

Castaldelli-Maia, Joao Mauricio; Beraldo, Livia; Ventriglio, Antonio; de Andrade, Arthur Guerra; da Silva, Antonio Geraldo; Torales, Julio; Goncalves, Priscila Dib; Bhugra, Dinesh

2018-06-11

Substance use disorders are an important public health problem with a multifactorial etiology and limited effective treatment options. Within this context, spirituality-based approaches may provide interesting and useful options in managing substance use disorders. This kind of intervention can have positive effects in alleviating some core symptoms associated with substance use, such as aggressiveness. Improvement in cessation rates for alcohol, cocaine and opioid use disorders have also been described in some clinical studies. However, spirituality may not play a beneficial role in some subgroups, such as among individuals with crack cocaine and cannabis use disorders. A widely available intervention for alcohol use disorders is Alcoholics Anonymous (AA), which can be seen as a spirituality-based intervention. Spirituality also seems to be especially beneficial for minorities such as Latinos, African-Americans and Native-Americans. Moreover, spiritual-based interventions are also helpful alternatives in many rural environments where conventional healthcare for substance use disorders may not be easily available. However, spiritual-based interventions may be considered as a possible adjunctive therapeutic option to conventional treatments. There is a need for prospective studies outside U.S., especially where spiritual-based approaches are available. It may be difficult to carry out randomized controlled trials because of the nature of the spiritual/religious dimensions. However, prospective studies that evaluate mediation effect of spirituality and religiosity on recovery would be helpful. Qualitative studies combined with quantitative design offer excellent options to evaluate the recovery process, especially among special populations. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Controlling the spread of carbapenemase-producing Gram-negatives: therapeutic approach and infection control.

PubMed

Carmeli, Y; Akova, M; Cornaglia, G; Daikos, G L; Garau, J; Harbarth, S; Rossolini, G M; Souli, M; Giamarellou, H

2010-02-01

Although the rapid spread of carbapenemase-producing Gram-negatives (CPGNs) is providing the scientific community with a great deal of information about the molecular epidemiology of these enzymes and their genetic background, data on how to treat multidrug-resistant or extended drug-resistant carbapenemase-producing Enterobacteriaceae and how to contain their spread are still surprisingly limited, in spite of the rapidly increasing prevalence of these organisms and of their isolation from patients suffering from life-threatening infections. Limited clinical experience and several in vitro synergy studies seem to support the view that antibiotic combinations should be preferred to monotherapies. But, in light of the data available to date, it is currently impossible to quantify the real advantage of drug combinations in the treatment of these infections. Comprehensive clinical studies of the main therapeutic options, broken down by pathogen, enzyme and clinical syndrome, are definitely lacking and, as carbapenemases keep spreading, are urgently needed. This spread is unveiling the substantial unpreparedness of European public health structures to face this worrisome emergency, although experiences from different countries-chiefly Greece and Israel-have shown that CPGN transmission and cross-infection can cause a substantial threat to the healthcare system. This unpreparedness also affects the treatment of individual patients and infection control policies, with dramatic scarcities of both therapeutic options and infection control measures. Although correct implementation of such measures is presumably cumbersome and expensive, the huge clinical and public health problems related to CPGN transmission, alongside the current scarcity of therapeutic options, seem to fully justify this choice.

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

PubMed

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

2016-09-01

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

A review of ropinirole prolonged release in Parkinson’s disease

PubMed Central

Nashatizadeh, Muhammad M; Lyons, Kelly E; Pahwa, Rajesh

2009-01-01

Ropinirole prolonged release is a once-daily, 24-hour formulation of ropinirole, a non-ergot dopamine agonist. It is approved as monotherapy and as an adjunct to levodopa in the treatment of Parkinson’s disease (PD). Several potential advantages of ropinirole prolonged release compared to the immediate release formulation include maintaining more consistent dopaminergic activity with steadier plasma levels, increased tolerability, greater compliance from a simpler once-daily dosing regimen and ease in dose titration. In a randomized, double-blind, non-inferiority, crossover study, ropinirole prolonged release was shown to have comparable efficacy and tolerability to immediate release ropinirole in early PD patients, with significantly greater compliance. Subjects were converted overnight between ropinirole formulations without loss of efficacy and with good tolerability. In a randomized, double-blind, placebo-controlled study in advanced PD, daily “off” time was reduced by an average of 2.1 hours with ropinirole prolonged release compared to 0.4 hours with placebo. Patients on ropinirole prolonged release were also more likely to require less daily levodopa. Ropinirole prolonged release is well tolerated with a similar adverse effect profile to other non-ergot dopamine agonists. The most common adverse effects include dyskinesia, nausea, dizziness, hallucinations, somnolence, abdominal pain or discomfort and orthostatic hypotension. Ropinirole prolonged release is a safe and effective treatment option for both early and advanced PD. This manuscript briefly reviews the current pharmacological treatment options for PD and provides a more detailed review of the currently available data regarding ropinirole prolonged release as a treatment option for PD. PMID:19503779

Treatment Options for Recurrent Mycosis Fungoides and the Sezary Syndrome

MedlinePlus

... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Events Cancer Currents Blog All Press Releases 2018 ... Events Scientific Meetings & Lectures Conferences Advisory Board Meetings Social Media Cancer Currents Blog About NCI NCI Overview History ...

Development of Less Toxic Treatment Strategies for Metastatic and Drug-Resistant Breast Cancer Using Noninvasive Optical Monitoring

DTIC Science & Technology

2017-09-01

models has been evaluated, with one good option, the Py230 cell lines, as our choice for use in future studies . We have conducted the first study ... Study of Progressive Resistance Major Task 6: dDOS fabrication Subtask 15: Design /Fabricate dDOS system and new custom dDOS probe 6-24 Dr...until year 3 of the study , based on current accrual trends with our clinical collaborators at the Boston Medical Center for different projects, the

A Curriculum Guide to Applications of Science to Technology for Able Learners.

ERIC Educational Resources Information Center

VanTassel-Baska, Joyce, Ed.; And Others

This curriculum guide was developed with the intention of providing an enrichment option for gifted and talented learners who are interested in pursuing current issues and topics in the fields of mathematics and science. The scope of the guide is meant to encompass a year's study of a set of topics which apply mathematics to science and…

Getting the Most out of Pay-Per-View: A Feasibility Study and Discussion of Mediated and Unmediated Options

ERIC Educational Resources Information Center

Hosburgh, Nathan

2012-01-01

The increasing costs of science, technology, and medical journals, combined with decreasing or stagnant budgets, have forced libraries to take a hard look at current journal subscriptions. Even when budgets remain stable or increase, they may not keep pace with the escalating costs of subscriptions from various publishers. In the face of potential…

Climatic change and assisted migration: Strategic options for forest and conservation nurseries

Treesearch

Mary I. Williams; R. Kasten Dumroese

2013-01-01

In light of current studies (for example, Gray and Hamann 2012; Zhu and others 2012) that show climate will change faster than plants can adapt or migrate naturally, it begs the question, "What does this mean for forestry, specifically forest and conservation nurseries?" Growing trees that just survive may become more important than promoting fast growth...

The Use of Adventure Therapy in Community-Based Mental Health: Decreases in Problem Severity among Youth Clients

ERIC Educational Resources Information Center

Tucker, Anita R.; Javorski, Steve; Tracy, Julie; Beale, Bobbi

2013-01-01

Background: There is an increasing need to identify effective mental health treatment practices for children and adolescents in community-based settings, due to current mixed findings of existing interventions. This study looked at adventure therapy (AT) as a viable option to meet this need. Objective: Using a sample of 1,135 youth from a…

Reviews of Data on Science Resources, No. 29. Current and Future Utilization of Scientific and Technical Personnel in Energy-Related Activities.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. Div. of Science Resources Studies.

This National Science Foundation (NSF) bulletin summarizes the NSF program of energy manpower studies that assessed the impact of past energy developments and future options for scientific and technical manpower. This document summarizes the utilization of scientific personnel in energy-related activities in private industry in 1975 and shortages…

Syntactic Reflexes of Emerging Optionality in Spanish as a Heritage Language: The Case of Dative-Experiencer Verbs

ERIC Educational Resources Information Center

Pascual y Cabo, Diego

2016-01-01

This study contributes to current trends of heritage speaker bilingualism research by examining the syntax of so-called Spanish dative-experiencer predicates ("gustar"-like verbs). Building on previous findings (e.g., Silva-Corvalán 1994; Toribio and Nye 2006), it is hypothesized that Spanish heritage speakers can project an optional…

Biology: A Secondary School Syllabus with Major Emphasis on Fundamental Concepts. 1976 Reprint.

ERIC Educational Resources Information Center

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

This syllabus, which has evolved from the New York State Experimental Biology program, includes a basic core and six optional extended areas designed to be interesting and meaningful to the types of students currently taking the Regents Examination in Biology. The seven core unit topics are: (1) The Study of Life; (2) Maintenance in Animals; (3)…

Space Station power system issues

NASA Technical Reports Server (NTRS)

Giudici, R. J.

1985-01-01

Issues governing the selection of power systems for long-term manned Space Stations intended solely for earth orbital missions are covered briefly, drawing on trade study results from both in-house and contracted studies that have been conducted over nearly two decades. An involvement, from the Program Development Office at MSFC, with current Space Station concepts began in late 1982 with the NASA-wide Systems Definition Working Group and continued throughout 1984 in support of various planning activities. The premise for this discussion is that, within the confines of the current Space Station concept, there is good reason to consider photovoltaic power systems to be a venerable technology option for both the initial 75 kW and 300 kW (or much greater) growth stations. The issue of large physical size required by photovoltaic power systems is presented considering mass, atmospheric drag, launch packaging and power transmission voltage as being possible practicality limitations. The validity of searching for a cross-over point necessitating the introduction of solar thermal or nuclear power system options as enabling technologies is considered with reference to programs ranging from the 4.8 kW Skylab to the 9.5 gW Space Power Satellite.

Current options in inguinal hernia repair in adult patients

PubMed Central

Kulacoglu, H

2011-01-01

Inguinal hernia is a very common problem. Surgical repair is the current approach, whereas asymptomatic or minimally symptomatic hernias may be good candidate for watchful waiting. Prophylactic antibiotics can be used in centers with high rate of wound infection. Local anesthesia is a suitable and economic option for open repairs, and should be popularized in day-case setting. Numerous repair methods have been described to date. Mesh repairs are superior to "nonmesh" tissue-suture repairs. Lichtenstein repair and endoscopic/laparoscopic techniques have similar efficacy. Standard polypropylene mesh is still the choice, whereas use of partially absorbable lightweight meshes seems to have some advantages. PMID:22435019

Current Concepts in the Management of Ankle Osteoarthritis: A Systematic Review.

PubMed

Bloch, Benjamin; Srinivasan, Suresh; Mangwani, Jitendra

2015-01-01

Ankle osteoarthritis is less common than hip or knee osteoarthritis; however, it is a relatively common presentation and is predominantly related to previous trauma. Treatments have traditionally consisted of temporizing measures such as analgesia, physiotherapy, and injections until operative treatment in the form of arthrodesis is required. More recently, interest has been increasing in both nonoperative and alternative operative options, including joint-sparing surgery, minimal access arthrodesis, and new arthroplasty designs. The present systematic instructional review has summarized the current evidence for the treatment options available for ankle osteoarthritis. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Tic Disorders and PANDAS.

PubMed

Blackburn, Joanna S

2018-04-01

Tics are the most common movement disorder in childhood and are a frequent reason for referral to child neurology clinics. The purpose of this review is to examine the phenomenology of tics, discuss what is known regarding their genetic and pathophysiological causes and to evaluate current treatment options. The evidence for the evaluation and treatment of the controversial diagnosis of pediatric autoimmune neuropsychiatric disorders associated with group A streptococci (PANDAS) will also be reviewed. With improved understanding of tic disorders, their etiology and response to current treatment options, we may be able to more effectively diagnose them and identify novel treatment strategies. Copyright © 2018 Elsevier Inc. All rights reserved.

Inferior Vena Cava Filters: Guidelines, Best Practice, and Expanding Indications

PubMed Central

DeYoung, Elliot; Minocha, Jeet

2016-01-01

Vena caval interruption, currently accomplished by percutaneous image-guided insertion of an inferior vena cava (IVC) filter, is an important therapeutic option in the management of selected patients with venous thromboembolism. The availability of optional (or retrievable) filters, in particular, has altered the practice patterns for IVC filters, with a shift to these devices and expansion of indications for filter placement. As new devices have become available and clinicians have become more familiar and comfortable with IVC filters, the indications for filter placement have continued to evolve and expand. This article reviews current guidelines and expanding indications for IVC filter placement. PMID:27247472

Thermal management system options for high power space platforms

NASA Technical Reports Server (NTRS)

Sadunas, J. A.; Lehtinen, A.; Parish, R.

1985-01-01

Thermal Management System (TMS) design options for a high power (75kWe), low earth orbit, multimodule space platform were investigated. The approach taken was to establish a baseline TMS representative of current technology, and to make incremental improvements through successive subsystem trades that lead to a candidate TMS. The TMS trades included centralized and decentralized transport, single-phase and two-phase transport, alternate working fluids, liquid loop and heat pipe radiators, deployed fixed, body mounted and steerable radiators, and thermal storage. The subsystem options were evaluated against criteria such as weight, TMS power requirement, reliability, system isothermality penalty, and growth potential.

Space Civil Engineering option - A progress report

NASA Technical Reports Server (NTRS)

Criswell, Marvin E.; Sadeh, Willy Z.

1992-01-01

Space Civil Engineering is an emerging engineering discipline that focuses on extending and expanding Civil Engineering to the development, operation, and maintenance of infrastructures on celestial bodies. Space Civil Engineering is presently being developed as a new discipline within the Department of Civil Engineering at Colorado State University and with support of the NASA Space Grant College Program. Academic programs geared toward creating Space Civil Engineering Options at both undergraduate and graduate levels are being formulated. Basic ideas and concepts and the current status of the curriculum in the Space Civil Engineering Option primarily at the undergraduate level are presented.

Temporary Mechanical Circulatory Support: A Review of the Options, Indications, and Outcomes

PubMed Central

Gilotra, Nisha A; Stevens, Gerin R

2014-01-01

Cardiogenic shock remains a challenging disease entity and is associated with significant morbidity and mortality. Temporary mechanical circulatory support (MCS) can be implemented in an acute setting to stabilize acutely ill patients with cardiomyopathy in a variety of clinical situations. Currently, several options exist for temporary MCS. We review the indications, contraindications, clinical applications, and evidences for a variety of temporary circulatory support options, including the intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), CentriMag blood pump, and percutaneous ventricular assist devices (pVADs), specifically the TandemHeart and Impella. PMID:25674024

A maximum (non-extensive) entropy approach to equity options bid-ask spread

NASA Astrophysics Data System (ADS)

Tapiero, Oren J.

2013-07-01

The cross-section of options bid-ask spreads with their strikes are modelled by maximising the Kaniadakis entropy. A theoretical model results with the bid-ask spread depending explicitly on the implied volatility; the probability of expiring at-the-money and an asymmetric information parameter (κ). Considering AIG as a test case for the period between January 2006 and October 2008, we find that information flows uniquely from the trading activity in the underlying asset to its derivatives. Suggesting that κ is possibly an option implied measure of the current state of trading liquidity in the underlying asset.

The Potential of Geothermal as a Major Supplier of U.S. Primary Energy using EGS technology

NASA Astrophysics Data System (ADS)

Tester, J. W.

2012-12-01

Recent national focus on the value of increasing our supply of indigenous, renewable energy underscores the need for re-evaluating all alternatives, particularly those that are large and well-distributed nationally. To transition from our current hydrocarbon-based energy system, we will need to expand and diversify the portfolio of options we currently have. One such option that has been undervalued and often ignored completely in national assessments is geothermal energy from both conventional hydrothermal resources and enhanced or engineered geothermal systems (EGS). Although geothermal energy is currently used for both electric and non-electric applications worldwide from conventional hydrothermal resources and in groundsource heat pumps, most of the emphasis in the US has been generating electricity. For example, a 2006 MIT-led study focused on the potential for EGS to provide 100,000 MWe of base-load electric generating capacity in the US by 2050. Since that time, a Cornell-led study has evaluated the potential for geothermal to meet the more than 25 EJ per year demand in the US for low temperature thermal energy for heating and other direct process applications Field testing of EGS in the US, Europe, and Australia is reviewed to outline what remains to be done for large-scale deployment. Research, Development and Demonstration (RD&D) needs in five areas important to geothermal deployment on a national scale will be reviewed: 1. Resource - estimating the magnitude and distribution of the US resource 2. Reservoir Technology - establishing requirements for extracting and utilizing energy from EGS reservoirs including drilling, reservoir design and stimulation 3. Utilization - exploring end use options for district heating, electricity generation and co-generation. 4. Environmental impacts and tradeoffs -- dealing with water and land use and seismic risk and quantifying the reduction in carbon emissions with increased deployment 5. Economics - projecting costs for EGS supplied electricity as a function of invested R&D and deployment in evolving US energy markets

An emerging treatment option for glaucoma: Rho kinase inhibitors

PubMed Central

Wang, Sean K; Chang, Robert T

2014-01-01

Rho kinase (ROCK) inhibitors are a novel potential class of glaucoma therapeutics with multiple compounds currently in Phase II and III US Food and Drug Administration trials in the United States. These selective agents work by relaxing the trabecular meshwork through inhibition of the actin cytoskeleton contractile tone of smooth muscle. This results in increased aqueous outflow directly through the trabecular meshwork, achieving lower intraocular pressures in a range similar to prostaglandins. There are also animal studies indicating that ROCK inhibitors may improve blood flow to the optic nerve, increase ganglion cell survival, and reduce bleb scarring in glaucoma surgery. Given the multiple beneficial effects for glaucoma patients, ROCK inhibitors are certainly a highly anticipated emerging treatment option for glaucoma. PMID:24872673

When familiar social partners are selected in open-ended situations: further tests of the socioemotional selectivity theory.

PubMed

Dudley, Nikki M; Multhaup, Kristi S

2005-01-01

Socioemotional selectivity theory (SST; Carstensen, 1995, Current Directions in Psychological Science, 4, 151-156) predicts that novel social partners are preferred in open-ended situations, whereas familiar social partners are preferred in future-limited situations. The authors attempted to generalize past research to new familiar and novel partner options. Studies 1 (N=144; undergraduates, community-dwelling adults ages 65 to 95) and 2 (N=336 community-dwelling participants ages 11 to 89) indicated that young and older participants in a future-limited situation preferred familiar partners. However, with different social partner options than have been used in previous research, young participants in an open-ended situation also preferred a familiar partner, contrary to the predictions of SST.

Early ART initiation among HIV-positive pregnant women in central Mozambique: a stepped wedge randomized controlled trial of an optimized Option B+ approach.

PubMed

Cowan, James F; Micek, Mark; Cowan, Jessica F Greenberg; Napúa, Manuel; Hoek, Roxanne; Gimbel, Sarah; Gloyd, Stephen; Sherr, Kenneth; Pfeiffer, James T; Chapman, Rachel R

2015-04-30

Despite effective prevention strategies and increasing investments in global health, maternal to child transmission (MTCT) of HIV remains a significant problem globally, especially in sub-Saharan Africa. In 2012, there were 94,000 HIV-positive pregnant women in Mozambique. Approximately 15% of these women transmitted HIV to their newborn infants, resulting in nearly 14,000 new pediatric HIV infections that year. To address this issue, in 2013, the Mozambican Ministry of Health implemented the World Health Organization-recommended "Option B+" strategy in which all newly diagnosed HIV-positive pregnant women are counseled to initiate combination anti-retroviral therapy (ART) immediately upon diagnosis regardless of CD4 count and to continue treatment for life. Given the limited experience with Option B+ in sub-Saharan Africa, few rigorous pragmatic trials have studied this new treatment strategy. This study utilizes an initial formative research process involving patient and health care provider interviews and focus groups, workforce assessments, value stream mapping, and commodity utilization assessments to understand the strengths and weaknesses in the current Option B+ care cascade. The formative research is intended to guide identification and prioritization of key workflow modifications and the development of an enhanced adherence and retention package. These two components are bundled into a defined intervention implemented and evaluated across six health facilities utilizing a stepped wedge randomized controlled trial study design. The overall objective of this trial is to develop and test a pilot intervention in central Mozambique to implement the new Option B+ guidelines with high fidelity and increase the proportion of HIV-positive pregnant women in target antenatal clinics (ANC) who start ART prior to delivery and are retained in care. This pragmatic study utilizes research strategies that have the potential to meaningfully improve the Option B+ care cascade in central Mozambique and to decrease the MTCT of HIV. This trial is designed to identify critical low-cost improvement strategies that can be bundled into a defined intervention. If this intervention has a measurable impact, it can be rapidly scaled up to other ANC in Mozambique and sub-Saharan Africa. ClinicalTrials.gov: NCT02371265.

Acceptance and use of eight arsenic-safe drinking water options in Bangladesh.

PubMed

Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B; Mosler, Hans-Joachim

2013-01-01

Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option.

Acceptance and Use of Eight Arsenic-Safe Drinking Water Options in Bangladesh

PubMed Central

Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B.; Mosler, Hans-Joachim

2013-01-01

Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to increase the acceptance and use of each arsenic-safe water option. PMID:23326477

New Media in Student Recruiting: Bright Promise, Current Realities.

ERIC Educational Resources Information Center

Stoner, Michael

1996-01-01

Explores current options for using the World Wide Web and interactive media for undergraduate recruiting. Discusses some technological issues concerning market penetration of technologies, and explores the issue of return on investment. Currently available data do not support spending a lot of money on Web pages, although CD-ROM or floppy disks…

77 FR 42040 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... comparable to the obligations proposed in this filing: Market-Makers % Time % Series Classes CBOE (current........ 60 All classes collectively. PMMs % Time % Series Classes CBOE (current rule) 99% of the time... % Time % Series Classes CBOE (current rule) 99% of the time required to 90% * Class-by-class. provide...

77 FR 37332 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-21

... the high frequency eddy current inspection for cracking of the critical fastener holes, and repair if... of the bulkhead, and repair if necessary; and proposed an option to the high frequency eddy current...-15152 (72 FR 44753, August 9, 2007)), do a high frequency eddy current (HFEC) inspection for cracking of...

Reusable Agena study. Volume 1: Executive summary. [space shuttle Agena upper stage tug concept

NASA Technical Reports Server (NTRS)

1974-01-01

The shuttle Agena upper stage interim tug concept is based on a building block approach. These building block concepts are extensions of existing ascent Agena configurations. Several current improvements, have been used in developing the shuttle/Agena upper stage concepts. High-density acid is used as the Agena upper stage oxidizer. The baffled injector is used in the main engine. The DF-224 is a fourth generation computer currently in development and will be flight proven in the near future. The Agena upper stage building block concept uses the current Agena as a baseline, adds an 8.5-inch (21.6 cm) extension to the fuel tank for optimum mixture ratio, uses monomethyl hydrazine as fuel, exchanges a 150:1 nozzle extension for the existing 45:1, exchanges an Autonetics DF-224 for the existing Honeywell computer, and adds a star sensor for guidance update. These modifications to the current Agena provide a 5-foot (1.52m) diameter shuttle/Agena upper stage that will fly all Vandenberg Air Force Base missions in the reusable mode without resorting to a kick motor. The delta V velocity of the Agena is increased by use of a strap-on propellant tank option. This option provides a shuttle/Agena upper stage with the capability to place almost 3900 pounds (1769 kg) into geosynchronous orbit (24 hour period) without the aid of kick motors.

The Role of Specialized Schools for Students with Visual Impairments in the Continuum of Placement Options: The Right Help, at the Right Time, in the Right Place

ERIC Educational Resources Information Center

McMahon, Eugene

2014-01-01

Introduction: This study examined the current role of specialized schools for students with visual impairments and compares these results to a 1994 study. Methods: Two surveys were used to gather data from specialized schools that were members of the Council of Schools for the Blind (COSB). The first survey gathered information about current…

Environmental & economic life cycle assessment of current & future sewage sludge to energy technologies.

PubMed

Mills, N; Pearce, P; Farrow, J; Thorpe, R B; Kirkby, N F

2014-01-01

The UK Water Industry currently generates approximately 800GWh pa of electrical energy from sewage sludge. Traditionally energy recovery from sewage sludge features Anaerobic Digestion (AD) with biogas utilisation in combined heat and power (CHP) systems. However, the industry is evolving and a number of developments that extract more energy from sludge are either being implemented or are nearing full scale demonstration. This study compared five technology configurations: 1 - conventional AD with CHP, 2 - Thermal Hydrolysis Process (THP) AD with CHP, 3 - THP AD with bio-methane grid injection, 4 - THP AD with CHP followed by drying of digested sludge for solid fuel production, 5 - THP AD followed by drying, pyrolysis of the digested sludge and use of the both the biogas and the pyrolysis gas in a CHP. The economic and environmental Life Cycle Assessment (LCA) found that both the post AD drying options performed well but the option used to create a solid fuel to displace coal (configuration 4) was the most sustainable solution economically and environmentally, closely followed by the pyrolysis configuration (5). Application of THP improves the financial and environmental performance compared with conventional AD. Producing bio-methane for grid injection (configuration 3) is attractive financially but has the worst environmental impact of all the scenarios, suggesting that the current UK financial incentive policy for bio-methane is not driving best environmental practice. It is clear that new and improving processes and technologies are enabling significant opportunities for further energy recovery from sludge; LCA provides tools for determining the best overall options for particular situations and allows innovation resources and investment to be focused accordingly. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Design of monocular head-mounted displays for increased indoor firefighting safety and efficiency

NASA Astrophysics Data System (ADS)

Wilson, Joel; Steingart, Dan; Romero, Russell; Reynolds, Jessica; Mellers, Eric; Redfern, Andrew; Lim, Lloyd; Watts, William; Patton, Colin; Baker, Jessica; Wright, Paul

2005-05-01

Four monocular Head-Mounted Display (HMD) prototypes from the Fire Information and Rescue Equipment (FIRE) project at UC Berkeley are presented. The FIRE project aims to give firefighters a system of information technology tools for safer and more efficient firefighting in large buildings. The paper begins by describing the FIRE project and its use of a custom wireless sensor network (WSN) called SmokeNet for personnel tracking. The project aims to address urban/industrial firefighting procedures in need of improvement. Two "user-needs" studies with the Chicago and Berkeley Fire Departments are briefly presented. The FIRE project"s initial HMD prototype designs are then discussed with regard to feedback from the user-needs studies. These prototypes are evaluated in their potential costs and benefits to firefighters and found to need improvement. Next, some currently available commercial HMDs are reviewed and compared in their cost, performance, and potential for use by firefighters. Feedback from the Berkeley Fire Department user-needs study, in which the initial prototypes were demonstrated, is compiled into a concept selection matrix for the next prototypes. This matrix is used to evaluate a variety of HMDs, including some of the commercial units presented, and to select the best design options. Finally, the current prototypes of the two best design options are presented and discussed.

Current and emerging treatments for the management of myasthenia gravis

PubMed Central

Sathasivam, Sivakumar

2011-01-01

Myasthenia gravis is an autoimmune neuromuscular disorder. There are several treatment options, including symptomatic treatment (acetylcholinesterase inhibitors), short-term immunosuppression (corticosteroids), long-term immunosuppression (azathioprine, cyclosporine, cyclophosphamide, methotrexate, mycophenolate mofetil, rituximab, tacrolimus), rapid acting short-term immunomodulation (intravenous immunoglobulin, plasma exchange), and long-term immunomodulation (thymectomy). This review explores in detail these different treatment options. Potential future treatments are also discussed. PMID:21845054

Pectus Excavatum: A Review of Diagnosis and Current Treatment Options.

PubMed

Abid, Irfaan; Ewais, MennatAllah M; Marranca, Joseph; Jaroszewski, Dawn E

2017-02-01

Osteopathic medicine places a special emphasis on the musculoskeletal system, and understanding how chest wall structure may influence function is critical. Pectus excavatum is a common congenital chest wall defect in which the sternum is depressed posteriorly. Patients may present with complaints of chest wall discomfort, exercise intolerance, and tachycardia. The medical implications, diagnosis, and treatment options for patients with pectus excavatum are reviewed.

Establishing Teacher Competencies in Early Care and Education: A Review of Current Models and Options for California. Building California's Preschool for All Workforce. A Series of Policy Briefs

ERIC Educational Resources Information Center

Bellm, Dan

2005-01-01

This policy brief provides guidelines grouped into five areas: personal and professional behavior; classroom environment; health, safety and nutrition; working with families and communities; and administration and management. The document discusses the topics that teacher competencies generally cover, options for how they might be developed and…

77 FR 42038 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... market in 60% of the non-adjusted option series \\4\\ of each registered class that have a time to... time series Classes C2 (current rule) 99 of the time........ 60 Class-by-class. NOM 90 of a trading day... required to provide continuous quotes for the same amount of time in the same percentage of series as...

Fidaxomicin in Clostridium difficile infection: latest evidence and clinical guidance

PubMed Central

2014-01-01

The incidence of Clostridium difficile infection (CDI) has risen 400% in the last decade. It currently ranks as the third most common nosocomial infection. CDI has now crossed over as a community-acquired infection. The major failing of current therapeutic options for the management of CDI is recurrence of disease after the completion of treatment. Fidaxomicin has been proven to be superior to vancomycin in successful sustained clinical response to therapy. Improved outcomes may be due to reduced collateral damage to the gut microflora by fidaxomicin, bactericidal activity, inhibition of Clostridial toxin formation and inhibition of new sporulation. This superiority is maintained in groups previously reported as being at high risk for CDI recurrence including those: with relapsed infection after a single treatment course; on concomitant antibiotic therapy; aged >65 years; with cancer; and with chronic renal insufficiency. Because the acquisition cost of fidaxomicin far exceeds that of metronidazole or vancomycin, in order to rationally utilize this agent, it should be targeted to those populations who are at high risk for relapse and in whom the drug has demonstrated superiority. In this manuscript is reviewed the changing epidemiology of CDI, current treatment options for this infection, proposed benefits of fidaxomicin over currently available antimicrobial options, available analysis of cost effectiveness of the drug, and is given recommendations for judicious use of the drug based upon the available published literature. PMID:24587892

Fidaxomicin in Clostridium difficile infection: latest evidence and clinical guidance.

PubMed

Mullane, Kathleen

2014-03-01

The incidence of Clostridium difficile infection (CDI) has risen 400% in the last decade. It currently ranks as the third most common nosocomial infection. CDI has now crossed over as a community-acquired infection. The major failing of current therapeutic options for the management of CDI is recurrence of disease after the completion of treatment. Fidaxomicin has been proven to be superior to vancomycin in successful sustained clinical response to therapy. Improved outcomes may be due to reduced collateral damage to the gut microflora by fidaxomicin, bactericidal activity, inhibition of Clostridial toxin formation and inhibition of new sporulation. This superiority is maintained in groups previously reported as being at high risk for CDI recurrence including those: with relapsed infection after a single treatment course; on concomitant antibiotic therapy; aged >65 years; with cancer; and with chronic renal insufficiency. Because the acquisition cost of fidaxomicin far exceeds that of metronidazole or vancomycin, in order to rationally utilize this agent, it should be targeted to those populations who are at high risk for relapse and in whom the drug has demonstrated superiority. In this manuscript is reviewed the changing epidemiology of CDI, current treatment options for this infection, proposed benefits of fidaxomicin over currently available antimicrobial options, available analysis of cost effectiveness of the drug, and is given recommendations for judicious use of the drug based upon the available published literature.

Hyperhidrosis: an update on prevalence and severity in the United States.

PubMed

Doolittle, James; Walker, Patricia; Mills, Thomas; Thurston, Jane

2016-12-01

Current published estimates of the prevalence of hyperhidrosis in the United States are outdated and underestimate the true prevalence of the condition. The objectives of this study are to provide an updated estimate of the prevalence of hyperhidrosis in the US population and to further assess the severity and impact of sweating on those affected by the condition. For the purposes of obtaining prevalence, a nationally representative sample of 8160 individuals were selected using an online panel, and information as to whether or not they experience hyperhidrosis was obtained. The 393 individuals (210 female, 244 non-Hispanic white, 27 black, mean age 40.3, SE 0.64) who indicated that they have hyperhidrosis were asked further questions, including body areas impacted, severity of symptoms, age of onset, and socioemotional impact of the condition. Current results estimate the prevalence of hyperhidrosis at 4.8 %, which represents approximately 15.3 million people in the United States. Of these, 70 % report severe excessive sweating in at least one body area. In spite of this, only 51 % have discussed their excessive sweating with a healthcare professional. The main reasons are a belief that hyperhidrosis is not a medical condition and that no treatment options exist. The current study's findings with regard to age of onset and prevalence by body area generally align with the previous research. However, current findings suggest that the severity and prevalence are both higher than previously thought, indicating a need for greater awareness of the condition and its associated treatment options among medical professionals.

Manchester Coding Option for SpaceWire: Providing Choices for System Level Design

NASA Technical Reports Server (NTRS)

Rakow, Glenn; Kisin, Alex

2014-01-01

This paper proposes an optional coding scheme for SpaceWire in lieu of the current Data Strobe scheme for three reasons. First reason is to provide a straightforward method for electrical isolation of the interface; secondly to provide ability to reduce the mass and bend radius of the SpaceWire cable; and thirdly to provide a means for a common physical layer over which multiple spacecraft onboard data link protocols could operate for a wide range of data rates. The intent is to accomplish these goals without significant change to existing SpaceWire design investments. The ability to optionally use Manchester coding in place of the current Data Strobe coding provides the ability to DC balanced the signal transitions unlike the SpaceWire Data Strobe coding; and therefore the ability to isolate the electrical interface without concern. Additionally, because the Manchester code has the clock and data encoded on the same signal, the number of wires of the existing SpaceWire cable could be optionally reduced by 50. This reduction could be an important consideration for many users of SpaceWire as indicated by the already existing effort underway by the SpaceWire working group to reduce the cable mass and bend radius by elimination of shields. However, reducing the signal count by half would provide even greater gains. It is proposed to restrict the data rate for the optional Manchester coding to a fixed data rate of 10 Megabits per second (Mbps) in order to make the necessary changes simple and still able to run in current radiation tolerant Field Programmable Gate Arrays (FPGAs). Even with this constraint, 10 Mbps will meet many applications where SpaceWire is used. These include command and control applications and many instruments applications with have moderate data rate. For most NASA flight implementations, SpaceWire designs are in rad-tolerant FPGAs, and the desire to preserve the heritage design investment is important for cost and risk considerations. The Manchester coding option can be accommodated in existing designs with only changes to the FPGA.

A comparative review of the options for treatment of erectile dysfunction: which treatment for which patient?

PubMed

Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios G

2005-01-01

The field of erectile dysfunction (ED) has been revolutionised over the last two decades. Several treatment options are available today, most of which are associated with high efficacy rates and favourable safety profiles. A MEDLINE search was undertaken in order to evaluate all currently available data on treatment modalities for ED. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil, vardenafil) are currently the first-choice of most physicians and patients for the treatment of ED. PDE5 inhibitors have differences in their pharmacological profiles, the most obvious being the long duration of action of tadalafil, but there are no data supporting superiority for any one of them in terms of efficacy or safety. Sublingual apomorphine has limited efficacy compared with the PDE5 inhibitors, and its use is limited to patients with mild ED. Treatment failures with oral drugs may be due to medication, clinician and patient issues. The physician needs to address all of these issues in order to identify true treatment failures. Patients who are truly unresponsive to oral drugs may be offered other treatment options.Intracavernous injections of alprostadil alone, or in combination with other vasoactive agents (papaverine and phentolamine), remain an excellent treatment option, with proven efficacy and safety over time. Topical pharmacotherapy is appealing in nature, but currently available formulations have limited efficacy. Vacuum constriction devices may be offered mainly to elderly patients with occasional intercourse attempts, as younger patients show limited preference because of the unnatural erection that is associated with this treatment modality. Penile prostheses are generally the last treatment option offered, because of invasiveness, cost and non-reversibility; however, they are associated with high satisfaction rates in properly selected patients. All treatment options are associated with particular strengths and weaknesses. A patient-centred approach based on patient needs and expectations is necessary for the management of ED. The clinician must educate the patient and provide a supportive environment for shared decision making. The management strategy must be supplemented by careful follow-up in order to identify changes in patient health and relationship/emotional status that may necessitate treatment optimisation.

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

PubMed Central

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

2014-01-01

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

All of the above: When multiple correct response options enhance the testing effect.

PubMed

Bishara, Anthony J; Lanzo, Lauren A

2015-01-01

Previous research has shown that multiple choice tests often improve memory retention. However, the presence of incorrect lures often attenuates this memory benefit. The current research examined the effects of "all of the above" (AOTA) options. When such options are correct, no incorrect lures are present. In the first three experiments, a correct AOTA option on an initial test led to a larger memory benefit than no test and standard multiple choice test conditions. The benefits of a correct AOTA option occurred even without feedback on the initial test; for both 5-minute and 48-hour retention delays; and for both cued recall and multiple choice final test formats. In the final experiment, an AOTA question led to better memory retention than did a control condition that had identical timing and exposure to response options. However, the benefits relative to this control condition were similar regardless of the type of multiple choice test (AOTA or not). Results suggest that retrieval contributes to multiple choice testing effects. However, the extra testing effect from a correct AOTA option, rather than being due to more retrieval, might be due simply to more exposure to correct information.

Surgical Treatment Options for Subacute Ischemia of the Hand: Case Report and Literature Review

PubMed Central

Dunn, Ashley A.; Belek, Kyle A.; Devcic, Zlatko; Rathnayake, Samira; Kuo, Jennifer H.; Kuri, Mauricio; Chang, David S.; Hansen, Scott L.

2010-01-01

Purpose: The most effective surgical approach to the treatment of digital ischemia has not yet been established. The purpose of this study is to review currently accepted options for revascularization in acute and chronic settings of digital ischemia, and to augment this discussion by describing the approach of our surgical team in a unique case of subacute ischemia. Operative Technique: To restore blood flow to a patient's ischemic hand, we performed a microvascular reconstruction, using a reverse interpositional vein graft with 3 anastomoses: the ulnar artery was used for inflow and the superficial palmar arch and the common digital artery were used for outflow. Results: The patient experienced immediate postoperative pain relief. Blood flow was restored, which prevented digital amputation. The graft remained patent at 18 months' follow-up and the patient exhibited normal motor and sensory function. Conclusions: Surgical reconstruction of the hand is a viable treatment option for carefully selected patients presenting with subacute digital ischemia. Other medical and surgical techniques have been described in the recent literature, but further study is needed to determine the long-term success of newer microsurgical interventions. PMID:20396617

Quinault Indian Nation Comprehensive Biomass Strategic Planning Project

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

Cardenas, Jesus

The overall purposes of the Quinault Indian Nation’s Comprehensive Biomass Strategic Planning Project were to: (1) Identify and confirm community and tribal energy needs; (2) Conducting an inventory of sustainable biomass feedstock availability; (3) Development of a biomass energy vision statement with goals and objectives; (4) Identification and assessment of biomass options for both demand-side and supply side that are viable to the Quinault Indian Nation (QIN); and (5) Developing a long-term biomass strategy consistent with the long-term overall energy goals of the QIN. This Comprehensive Biomass Strategic Planning Project is consistent with the QIN’s prior two-year DOE Renewable Energymore » Study from 2004 through 2006. That study revealed that the most viable options to the QIN’s renewable energy options were biomass and energy efficiency best practices. QIN's Biomass Strategic Planning Project is focused on using forest slash in chipped form as feedstock for fuel pellet manufacturing in support of a tribal biomass heating facility. This biomass heating facility has been engineered and designed to heat existing tribal facilities as well as tribal facilities currently being planned including a new K-12 School.« less

Improved Measures of Integrated Information

PubMed Central

Tegmark, Max

2016-01-01

Although there is growing interest in measuring integrated information in computational and cognitive systems, current methods for doing so in practice are computationally unfeasible. Existing and novel integration measures are investigated and classified by various desirable properties. A simple taxonomy of Φ-measures is presented where they are each characterized by their choice of factorization method (5 options), choice of probability distributions to compare (3 × 4 options) and choice of measure for comparing probability distributions (7 options). When requiring the Φ-measures to satisfy a minimum of attractive properties, these hundreds of options reduce to a mere handful, some of which turn out to be identical. Useful exact and approximate formulas are derived that can be applied to real-world data from laboratory experiments without posing unreasonable computational demands. PMID:27870846

Youth with cerebral palsy with differing upper limb abilities: how do they access computers?

PubMed

Davies, T Claire; Chau, Tom; Fehlings, Darcy L; Ameratunga, Shanthi; Stott, N Susan

2010-12-01

To identify the current level of awareness of different computer access technologies and the choices made regarding mode of access by youth with cerebral palsy (CP) and their families. Survey. Two tertiary-level rehabilitation centers in New Zealand and Canada. Youth (N=60) with CP, Manual Ability Classification Scale (MACS) levels I to V, age 13 to 25 years. Not applicable. Questionnaire. Fifty (83%) of the 60 youth were aware of at least 1 available assistive technology (AT), such as touch screens and joysticks. However, only 34 youth (57%) were familiar with the accessibility options currently available in the most common operating systems. Thirty-three (94%) of 35 youth who were MACS I and II used a standard mouse and keyboard, while few chose to use assistive technology or accessibility options. In contrast, 10 (40%) of 25 youth who were MACS III to V used a variety of assistive technologies such as touch screens, joysticks, trackballs, and scanning technologies. This group also had the highest use of accessibility options, although only 15 (60%) of the 25 were aware of them. Most youth with CP were aware of, and used, assistive technologies to enhance their computer access but were less knowledgeable about accessibility options. Accessibility options allow users to modify their own computer interface and can thus enhance computer access for youth with CP. Clinicians should be knowledgeable enough to give informed advice in this area of computer access, thus ensuring that all youth with CP can benefit from both AT and accessibility options, as required. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Electric chiller handbook. Final report

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

NONE

1998-02-01

Electric chillers have dominated the market for large commercial cooling systems due to their history of reliable, economical operation. The phaseout of CFCs and deregulation of the utility industry are two factors that significantly impact the chiller market. The CFC phaseout is resulting in the upgrading or replacement of thousands of electric chillers nationwide. In a deregulated environment, utilities are finding increasing need to provide services that can win and retain new customers. Utility representatives need current information on applying and selecting cost-effective chiller systems. The objective of this report was to develop a comprehensive handbook that helps utility technicalmore » and marketing staff, their customers, and design professionals evaluate and select the best options for chilled-water systems in commercial buildings. Investigators used a variety of industry data sources to develop market-share information for electric and gas chiller systems and to determine applications according to building age, type, and region. Discussions with chiller manufacturers provided information on product availability, performance, and ownership cost. Using EPRI`s COMTECH software, investigators performed comprehensive cost analyses for placement of large and small chillers in three representative cities. Case studies of actual installations support these analyses. Electric Chiller Handbook provides a single source of current information on all major issues associated with chiller selection and application. Key issues include chiller availability and markets, rated performance, future viability of various refrigerant options, the cost-effectiveness of alternative chillers, and chilled-water system optimization. The Handbook also describes available hardware, outlines the features and costs of gas-fired competitive systems, and provides methods and comparisons of life-cycle costing of various chiller system options. Analyses of chiller features and economics show that electric chillers are preferable to gas chillers in the large majority of applications, consistent with current market trends. Furthermore, today`s chillers offer a wide range of efficiencies and refrigerant options to serve cooling system needs for the 20-year lifetime of the chiller. Finally, new higher-efficiency models of electric chillers offer very attractive paybacks.« less

An algorithmic approach for the treatment of severe uncontrolled asthma

PubMed Central

Zervas, Eleftherios; Samitas, Konstantinos; Papaioannou, Andriana I.; Bakakos, Petros; Loukides, Stelios; Gaga, Mina

2018-01-01

A small subgroup of patients with asthma suffers from severe disease that is either partially controlled or uncontrolled despite intensive, guideline-based treatment. These patients have significantly impaired quality of life and although they constitute <5% of all asthma patients, they are responsible for more than half of asthma-related healthcare costs. Here, we review a definition for severe asthma and present all therapeutic options currently available for these severe asthma patients. Moreover, we suggest a specific algorithmic treatment approach for the management of severe, difficult-to-treat asthma based on specific phenotype characteristics and biomarkers. The diagnosis and management of severe asthma requires specialised experience, time and effort to comprehend the needs and expectations of each individual patient and incorporate those as well as his/her specific phenotype characteristics into the management planning. Although some new treatment options are currently available for these patients, there is still a need for further research into severe asthma and yet more treatment options. PMID:29531957

Policy Options for Addressing Health System and Human Resources for Health Crisis in Liberia Post-Ebola Epidemic.

PubMed

Budy, Fidel C T

2015-01-01

Qualified healthcare workers within an effective health system are critical in promoting and achieving greater health outcomes such as those espoused in the Millennium Development Goals. Liberia is currently struggling with the effects of a brutal 14-year long civil war that devastated health infrastructures and caused most qualified health workers to flee and settle in foreign countries. The current output of locally trained health workers is not adequate for the tasks at hand. The recent Ebola Virus Disease (EVD) exposed the failings of the Liberian healthcare system. There is limited evidence of policies that could be replicated in Liberia to encourage qualified diaspora Liberian health workers to return and contribute to managing the phenomenon. This paper reviews the historical context for the human resources for health crisis in Liberia; it critically examines two context-specific health policy options to address the crisis, and recommends reverse brain drain as a policy option to address the immediate and critical crisis facing the health care sector in Liberia.

Next Step for STEP

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

Wood, Claire; Bremner, Brenda

2013-08-09

The Siletz Tribal Energy Program (STEP), housed in the Tribe’s Planning Department, will hire a data entry coordinator to collect, enter, analyze and store all the current and future energy efficiency and renewable energy data pertaining to administrative structures the tribe owns and operates and for homes in which tribal members live. The proposed data entry coordinator will conduct an energy options analysis in collaboration with the rest of the Siletz Tribal Energy Program and Planning Department staff. An energy options analysis will result in a thorough understanding of tribal energy resources and consumption, if energy efficiency and conservation measuresmore » being implemented are having the desired effect, analysis of tribal energy loads (current and future energy consumption), and evaluation of local and commercial energy supply options. A literature search will also be conducted. In order to educate additional tribal members about renewable energy, we will send four tribal members to be trained to install and maintain solar panels, solar hot water heaters, wind turbines and/or micro-hydro.« less

Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement.

PubMed

Aherne, Declan; Farrant, Katie; Hickey, Louise; Hickey, Emma; McGrath, Lisa; McGrath, Deirdre

2016-08-18

Medical practitioners and students are at increased risk of a number of personal and psychological problems. Stress and anxiety due to work-load and study requirements are common and self-care methods are important in maintaining well-being. The current study examines perceptions of and satisfaction ratings with a mindfulness based stress reduction (MBSR) programme for 1(st) year (compulsory) and 2(nd) year (optional) Graduate Entry Medical School students. A mixed method pre and post study of Year 1 (n = 140) and Year 2 (n = 88) medical students completing a 7 week MBSR course compared student satisfaction ratings. Thematic analysis of feedback from the students on their perception of the course was also carried out. Year 1 students (compulsory course) were less satisfied with content and learning outcomes than Year 2 students (optional course) (p < .0005). Thematic analysis of year 1 student feedback identified themes including great concept, poorly executed; and less discussion, more practice. Year 2 themes included session environment and satisfaction with tutors. The MBSR course was associated with high levels of satisfaction and positive feedback when delivered on an optional basis. Catering for the individual needs of the participant and promoting a safe environment are core elements of a successful self-care programme.

Transport safety for older people: a study of their experiences, perceptions and management needs.

PubMed

Peel, Nancye; Westmoreland, Jacky; Steinberg, Margaret

2002-03-01

With evidence of increasing accident risk due to age-related declines in health and cognition affecting driver performance, there is a need for research promoting safe mobility of older people. The present study aimed to identify transport options and licensing issues for a group of older people in an Australian community. Ninety-five participants aged 75 and over were interviewed about their driving status and accident record and tested for cognitive ability. After stratification on cognitive level and driver status (current, ex-driver or non-driver), 30 were selected for further in-depth interviews concerning demographics, license status and impact of change, travel options available and used, and travel characteristics. Considerable reliance on the motor vehicle as the mode of transport and the decision to cease driving were major quality-of-life issues. There was little evidence of planning and support in making the decision to stop driving. Some differences in transport decisions on the basis of cognitive level were evident; however, people with severely compromised cognitive ability (and, therefore, unable to give informed consent) had been excluded. The study suggested the need for resources to assist older people/carers/health professionals to plan for the transition from driver to non-driver and to manage alternative transport options more effectively.

Management of Parkinson׳s disease: Current and future pharmacotherapy.

PubMed

Kakkar, Ashish Kumar; Dahiya, Neha

2015-03-05

Parkinson׳s disease (PD) is chronic progressive neurodegenerative disorder characterized by profound loss of dopaminergic neurons in the nigrostriatal pathway. It is recognized by the cardinal clinical features of bradykinesia, rigidity, tremor and postural instability. Current therapeutic options are primarily dopamine replacement strategies that only provide symptomatic improvement without affecting progressive neuronal loss. These treatments often fail to provide sustained clinical benefit and most patients develop motor fluctuations and dyskinesias as the disease progresses. Additionally, non-motor symptoms such as autonomic disturbances, sensory alterations, olfactory dysfunction, mood disorders, sleep disturbances and cognitive impairment cause considerable functional disability in these patients and these features often fail to respond to standard dopaminergic treatments. This mini review outlines the current pharmacotherapeutic options for PD and highlights the emerging experimental therapies in various phases of clinical development. Copyright © 2015 Elsevier B.V. All rights reserved.

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

Chung, Ching-Yen; Chu, Peter; Gadh, Rajit

Currently, when Electric Vehicles (EVs) are charging, they only have the option to charge at a selected current or not charge. When during the day there is a power shortage, the charging infrastructure should have the options to either shut off the power to the charging stations or to lower the power to the EVs in order to satisfy the needs of the grid. There is a need for technology that controls the current being disbursed to these electric vehicles. This paper proposes a design for a smart charging infrastructure capable of providing power to several EVs from one circuitmore » by multiplexing power and providing charge control. The smart charging infrastructure includes the server and the smart charging station. With this smart charging infrastructure, the shortage of energy in a local grid could be solved by our EV management system« less

Mitigation potential and cost in tropical forestry - relative role for agroforestry

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

Makundi, Willy R.; Sathaye, Jayant A.

2004-01-01

This paper summarizes studies of carbon mitigation potential (MP) and costs of forestry options in seven developing countries with a focus on the role of agroforestry. A common methodological approach known as comprehensive mitigation assessment process (COMAP) was used in each study to estimate the potential and costs between 2000 and 2030. The approach requires the projection of baseline and mitigation land-use scenarios derived from the demand for forest products and forestland for other uses such as agriculture and pasture. By using data on estimated carbon sequestration, emission avoidance, costs and benefits, the model enables one to estimate cost effectivenessmore » indicators based on monetary benefit per t C, as well as estimates of total mitigation costs and potential when the activities are implemented at equilibrium level. The results show that about half the MP of 6.9 Gt C (an average of 223 Mt C per year) between 2000 and 2030 in the seven countries could be achieved at a negative cost, and the other half at costs not exceeding $100 per t C. Negative cost indicates that non-carbon revenue is sufficient to offset direct costs of about half of the options. The agroforestry options analyzed bear a significant proportion of the potential at medium to low cost per t C when compared to other options. The role of agroforestry in these countries varied between 6% and 21% of the MP, though the options are much more cost effective than most due to the low wage or opportunity cost of rural labor. Agroforestry options are attractive due to the large number of people and potential area currently engaged in agriculture, but they pose unique challenges for carbon and cost accounting due to the dispersed nature of agricultural activities in the tropics, as well as specific difficulties arising from requirements for monitoring, verification, leakage assessment and the establishment of credible baselines.« less

Strategy for the Identification of an INL Comprehensive Utility Corridor

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

John Reisenauer

2011-05-01

This report documents the strategy developed to identify a comprehensive utility corridor (CUC) on the Idaho National Laboratory (INL) Site. The strategy established the process for which the Campus Development Office will evaluate land management issues. It is a process that uses geographical information system geospatial technology to layer critical INL mission information in a way that thorough evaluations can be conducted and strategies developed. The objective of the CUC Project was to develop a process that could be implemented to identify potential utility corridor options for consideration. The process had to take into account all the missions occurring onmore » the INL and other land-related issues. The process for developing a CUC strategy consists of the following four basic elements using geographical information system capabilities: 1. Development of an INL base layer map; this base layer map geospatially references all stationary geographical features on INL and sitewide information. 2. Development of current and future mission land-use need maps; this involved working with each directorate to identify current mission land use needs and future land use needs that project 30 years into the future. 3. Development of restricted and potential constraint maps; this included geospatially mapping areas such as wells, contaminated areas, firing ranges, cultural areas, ecological areas, hunting areas, easement, and grazing areas. 4. Development of state highway and power line rights of way map; this included geospatially mapping rights-of-way along existing state highways and power lines running through the INL that support INL operations. It was determined after completing and evaluating the geospatial information that the area with the least impact to INL missions was around the perimeter of the INL Site. Option 1, in this document, identifies this perimeter; however, it does not mean the entire perimeter is viable. Many places along the perimeter corridor cannot be used or are not economically viable. Specific detailed studies will need to be conducted on a case-by-case basis to clearly identify which sections along the perimeter can and cannot be used. Option 2, in this document, identifies areas along existing highways that could be a viable option. However, discussions would have to take place with the State of Idaho to use their easement as part of the corridor and mission impact would need to be evaluated if a specific request was made to the Department of Energy, Idaho Operations Office. Option 3, in this document, is a combination of Options 1 and 2. This option provides the most flexibility to minimize impacts to INL missions. As with the other two options, discussions and agreements with the State of Idaho would be needed and any specific route would need to be thoroughly evaluated for impact, implementation, and operability beyond just a strategy.« less

Applying Real Options for Evaluating Investments in ERP Systems

NASA Astrophysics Data System (ADS)

Nakagane, Jun; Sekozawa, Teruji

This paper intends to verify effectiveness of real options approach for evaluating investments in Enterprise Resource Planning systems (ERP) and proves how important it is to disclose shadow options potentially embedded in ERP investment. The net present value (NPV) method is principally adopted to evaluate the value of ERP. However, the NPV method assumes no uncertainties exist in the object. It doesn't satisfy the current business circumstances which are filled with dynamic issues. Since the 1990s the effectiveness of option pricing models for Information System (IS) investment to solve issues in the NPV method has been discussed in the IS literature. This paper presents 3 business cases to review the practical advantages of such techniques for IS investments, especially ERP investments. The first case is EDI development. We evaluate the project by a new approach with lighting one of shadow options, EDI implementation. In the second case we reveal an ERP investment has an “expanding option” in a case of eliminating redundancy. The third case describes an option to contract which is deliberately slotted in ERP development to prepare transferring a manufacturing facility.

76 FR 67510 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-01

... (``QIX'') Expirations.\\10\\ In the current situation, the Exchange merely proposes to apply the precedent... continue, under current rules, for an additional fifteen minutes until 3:15 p.m. and will not be priced on...

Quadriceps Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A Systematic Review.

PubMed

Hurley, Eoghan T; Calvo-Gurry, Manuel; Withers, Dan; Farrington, Shane K; Moran, Ray; Moran, Cathal J

2018-05-01

To systematically review the current evidence to ascertain whether quadriceps tendon autograft (QT) is a viable option in anterior cruciate ligament reconstruction. A literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Cohort studies comparing QT with bone-patellar tendon-bone autograft (BPTB) or hamstring tendon autograft (HT) were included. Clinical outcomes were compared, with all statistical analyses performed using IBM SPSS Statistics for Windows, version 22.0, with P < .05 being considered statistically significant. We identified 15 clinical trials with 1,910 patients. In all included studies, QT resulted in lower rates of anterior knee pain than BPTB. There was no difference in the rate of graft rupture between QT and BPTB or HT in any of the studies reporting this. One study found that QT resulted in greater knee stability than BPTB, and another study found increased stability compared with HT. One study found that QT resulted in improved functional outcomes compared with BPTB, and another found improved outcomes compared with HT, but one study found worse outcomes compared with BPTB. Current literature suggests QT is a viable option in anterior cruciate ligament reconstruction, with published literature showing comparable knee stability, functional outcomes, donor-site morbidity, and rerupture rates compared with BPTB and HT. Level III, systematic review of Level I, II, and III studies. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Benefits and work-schedule options in hospital pharmacy practice.

PubMed

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)

Evaluating cardiac risk: exposure response analysis in early clinical drug development.

PubMed

Grenier, Julie; Paglialunga, Sabina; Morimoto, Bruce H; Lester, Robert M

2018-01-01

The assessment of a drug's cardiac liability has undergone considerable metamorphosis by regulators since International Council for Harmonization of Technical Requirement for Pharmaceuticals for Human Use E14 guideline was introduced in 2005. Drug developers now have a choice in how proarrhythmia risk can be evaluated; the options include a dedicated thorough QT (TQT) study or exposure response (ER) modeling of intensive electrocardiogram (ECG) captured in early clinical development. The alternative approach of ER modeling was incorporated into a guidance document in 2015 as a primary analysis tool which could be utilized in early phase dose escalation studies as an option to perform a dedicated TQT trial. This review will describe the current state of ER modeling of intensive ECG data collected during early clinical drug development; the requirements with regard to the use of a positive control; and address the challenges and opportunities of this alternative approach to assessing QT liability.

Depressive states amplify both upward and downward counterfactual thinking.

PubMed

Feng, Xue; Gu, Ruolei; Liang, Fucheng; Broster, Lucas S; Liu, Yunzhe; Zhang, Dandan; Luo, Yue-jia

2015-08-01

Depression has been linked to counterfactual thinking in many behavioral studies, but the direction of this effect remains disputed. In the current study, the relationship between depression and counterfactual thinking was examined using the event-related potential (ERP) technique. In a binary choice gambling task, outcome feedback of the chosen option and that of the alternative option were both provided, so as to elicit the process of counterfactual comparison. By investigating ERP signals in response to outcome presentation, we discovered that when the fictive outcome was better or worse than the factual outcome, the amplitude of the P3 component was positively correlated with individual levels of depression, but not levels of anxiety. These results indicate that depression strengthens both upward counterfactual thinking and downward counterfactual thinking. The implication of this finding to clinical research is discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Simulation as a planning tool for job-shop production environment

NASA Astrophysics Data System (ADS)

Maram, Venkataramana; Nawawi, Mohd Kamal Bin Mohd; Rahman, Syariza Abdul; Sultan, Sultan Juma

2015-12-01

In this paper, we made an attempt to use discrete event simulation software ARENA® as a planning tool for job shop production environment. We considered job shop produces three types of Jigs with different sequence of operations to study and improve shop floor performance. The sole purpose of the study is to identifying options to improve machines utilization, reducing job waiting times at bottleneck machines. First, the performance of the existing system was evaluated by using ARENA®. Then identified improvement opportunities by analyzing base system results. Second, updated the model with most economical options. The proposed new system outperforms with that of the current base system by 816% improvement in delay times at paint shop by increase 2 to 3 and Jig cycle time reduces by Jig1 92%, Jig2 65% and Jig3 41% and hence new proposal was recommended.

Reforming options for hydrogen production from fossil fuels for PEM fuel cells

NASA Astrophysics Data System (ADS)

Ersoz, Atilla; Olgun, Hayati; Ozdogan, Sibel

PEM fuel cell systems are considered as a sustainable option for the future transport sector in the future. There is great interest in converting current hydrocarbon based transportation fuels into hydrogen rich gases acceptable by PEM fuel cells on-board of vehicles. In this paper, we compare the results of our simulation studies for 100 kW PEM fuel cell systems utilizing three different major reforming technologies, namely steam reforming (SREF), partial oxidation (POX) and autothermal reforming (ATR). Natural gas, gasoline and diesel are the selected hydrocarbon fuels. It is desired to investigate the effect of the selected fuel reforming options on the overall fuel cell system efficiency, which depends on the fuel processing, PEM fuel cell and auxiliary system efficiencies. The Aspen-HYSYS 3.1 code has been used for simulation purposes. Process parameters of fuel preparation steps have been determined considering the limitations set by the catalysts and hydrocarbons involved. Results indicate that fuel properties, fuel processing system and its operation parameters, and PEM fuel cell characteristics all affect the overall system efficiencies. Steam reforming appears as the most efficient fuel preparation option for all investigated fuels. Natural gas with steam reforming shows the highest fuel cell system efficiency. Good heat integration within the fuel cell system is absolutely necessary to achieve acceptable overall system efficiencies.

Default neglect in attempts at social influence.

PubMed

Zlatev, Julian J; Daniels, David P; Kim, Hajin; Neale, Margaret A

2017-12-26

Current theories suggest that people understand how to exploit common biases to influence others. However, these predictions have received little empirical attention. We consider a widely studied bias with special policy relevance: the default effect, which is the tendency to choose whichever option is the status quo. We asked participants (including managers, law/business/medical students, and US adults) to nudge others toward selecting a target option by choosing whether to present that target option as the default. In contrast to theoretical predictions, we find that people often fail to understand and/or use defaults to influence others, i.e., they show "default neglect." First, in one-shot default-setting games, we find that only 50.8% of participants set the target option as the default across 11 samples ( n = 2,844), consistent with people not systematically using defaults at all. Second, when participants have multiple opportunities for experience and feedback, they still do not systematically use defaults. Third, we investigate beliefs related to the default effect. People seem to anticipate some mechanisms that drive default effects, yet most people do not believe in the default effect on average, even in cases where they do use defaults. We discuss implications of default neglect for decision making, social influence, and evidence-based policy.

Treatments for Pulmonary Ricin Intoxication: Current Aspects and Future Prospects

PubMed Central

Gal, Yoav; Mazor, Ohad; Falach, Reut; Sapoznikov, Anita; Kronman, Chanoch; Sabo, Tamar

2017-01-01

Ricin, a plant-derived toxin originating from the seeds of Ricinus communis (castor beans), is one of the most lethal toxins known, particularly if inhaled. Ricin is considered a potential biological threat agent due to its high availability and ease of production. The clinical manifestation of pulmonary ricin intoxication in animal models is closely related to acute respiratory distress syndrome (ARDS), which involves pulmonary proinflammatory cytokine upregulation, massive neutrophil infiltration and severe edema. Currently, the only post-exposure measure that is effective against pulmonary ricinosis at clinically relevant time-points following intoxication in pre-clinical studies is passive immunization with anti-ricin neutralizing antibodies. The efficacy of this antitoxin treatment depends on antibody affinity and the time of treatment initiation within a limited therapeutic time window. Small-molecule compounds that interfere directly with the toxin or inhibit its intracellular trafficking may also be beneficial against ricinosis. Another approach relies on the co-administration of antitoxin antibodies with immunomodulatory drugs, thereby neutralizing the toxin while attenuating lung injury. Immunomodulators and other pharmacological-based treatment options should be tailored according to the particular pathogenesis pathways of pulmonary ricinosis. This review focuses on the current treatment options for pulmonary ricin intoxication using anti-ricin antibodies, disease-modifying countermeasures, anti-ricin small molecules and their various combinations. PMID:28972558

Treatments for Pulmonary Ricin Intoxication: Current Aspects and Future Prospects.

PubMed

Gal, Yoav; Mazor, Ohad; Falach, Reut; Sapoznikov, Anita; Kronman, Chanoch; Sabo, Tamar

2017-10-03

Ricin, a plant-derived toxin originating from the seeds of Ricinus communis (castor beans), is one of the most lethal toxins known, particularly if inhaled. Ricin is considered a potential biological threat agent due to its high availability and ease of production. The clinical manifestation of pulmonary ricin intoxication in animal models is closely related to acute respiratory distress syndrome (ARDS), which involves pulmonary proinflammatory cytokine upregulation, massive neutrophil infiltration and severe edema. Currently, the only post-exposure measure that is effective against pulmonary ricinosis at clinically relevant time-points following intoxication in pre-clinical studies is passive immunization with anti-ricin neutralizing antibodies. The efficacy of this antitoxin treatment depends on antibody affinity and the time of treatment initiation within a limited therapeutic time window. Small-molecule compounds that interfere directly with the toxin or inhibit its intracellular trafficking may also be beneficial against ricinosis. Another approach relies on the co-administration of antitoxin antibodies with immunomodulatory drugs, thereby neutralizing the toxin while attenuating lung injury. Immunomodulators and other pharmacological-based treatment options should be tailored according to the particular pathogenesis pathways of pulmonary ricinosis. This review focuses on the current treatment options for pulmonary ricin intoxication using anti-ricin antibodies, disease-modifying countermeasures, anti-ricin small molecules and their various combinations.

Sociolinguistics: Current Trends and Prospects; Report of the 23rd Annual Round Table Meeting on Linguistics and Language Studies. Monograph Series on Language and Linguistics No. 25.

ERIC Educational Resources Information Center

Shuy, Roger W., Ed.

The papers included in this volume discuss the relationship of sociolinguistics to social interaction, sociolinguistic surveys, the intersection of sociolinguistics with education, and the influence of linguistics and sociology on sociolinguistics. The papers include: "Optional Rules in Grammar" (Fraser); "The Structure of Polylectal Grammars"…

Post-Secondary Education in the South Pacific: Present Patterns and Future Options. Educational Development in the Small States of the Commonwealth Series.

ERIC Educational Resources Information Center

Crocombe, Ron; Crocombe, Marjorie Tuainekore

This book contains the results of a study examining post-secondary education in the South Pacific by surveying the number of educational opportunities currently offered, by analyzing key trends, and by comparing developments in the Cook Islands and the Solomon Islands. Following an introductory section on terminology and the region, the first main…

Mars ISRU for Production of Mission Critical Consumables - Options, Recent Studies, and Current State of the Art

NASA Technical Reports Server (NTRS)

Sanders, G. B.; Paz, A.; Oryshchyn, L.; Araghi, K.; Muscatello, A.; Linne, D.; Kleinhenz, J.; Peters, T.

2015-01-01

In 1978, a ground breaking paper titled, "Feasibility of Rocket Propellant Production on Mars" by Ash, Dowler, and Varsi discussed how ascent propellants could be manufactured on the Mars surface from carbon dioxide collected from the atmosphere to reduce launch mass. Since then, the concept of making mission critical consumables such as propellants, fuel cell reactants, and life support consumables from local resources, commonly known as In-Situ Resource Utilization (ISRU), for robotic and human missions to Mars has been studied many times. In the late 1990's, NASA initiated a series of Mars Human Design Reference Missions (DRMs), the first of which was released in 1997. These studies primarily focused on evaluating the impact of making propellants on Mars for crew ascent to Mars orbit, but creating large caches of life support consumables (water & oxygen) as a backup for regenerative life support systems for long-duration surface stays (>500 days) was also considered in Mars DRM 3.0. Until science data from the Mars Odyssey orbiter and subsequent robotic missions revealed that water may be widely accessable across the surface of Mars, prior Mars ISRU studies were limited to processing Mars atmospheric resources (carbon dioxide, nitrogen, argon, oxygen, and water vapor). In December 2007, NASA completed the Mars Human Design Reference Architecture (DRA) 5.0 study which considered water on Mars as a potential resource for the first time in a human mission architecture. While knowledge of both water resources on Mars and the hardware required to excavate and extract the water were very preliminary, the study concluded that a significant reduction in mass and significant enhancements to the mission architecture were possible if Mars water resources were utilized. Two subsequent Mars ISRU studies aimed at reexamining ISRU technologies, processing options, and advancements in the state-of-the-art since 2007 and to better understand the volume and packaging associated with Mars ISRU systems further substantiated the preliminary results from the Mars DRA 5.0 study. This paper will provide an overview of Mars ISRU consumable production options, the analyses, results, and conclusions from the Mars DRA 5.0 (2007), Mars Collaborative (2013), and Mars ISRU Payload for the Supersonic Retro Propulsion (2014) mission studies, and the current state-of-the-art of Mars ISRU technologies and systems. The paper will also briefly discuss the mission architectural implications associated with Mars resource and ISRU processing options.

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

PubMed

Wenger, Jeffrey B; Weller, Christian E

2014-09-01

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

Risk-sensitive choice in humans as a function of an earnings budget.

PubMed Central

Pietras, C J; Hackenberc, T D

2001-01-01

Risky choice in 3 adult humans was investigated across procedural manipulations designed to model energy-budget manipulations conducted with nonhumans. Subjects were presented with repeated choices between a fixed and a variable number of points. An energy budget was simulated by use of an earnings budget, defined as the number of points needed within a block of trials for points to be exchanged for money. During positive earnings-budget conditions, exclusive preference for the fixed option met the earnings requirement. During negative earnings-budget conditions, exclusive preference for the certain option did not meet the earnings requirement, but choice for the variable option met the requirement probabilistically. Choice was generally risk averse (the fixed option was preferred) when the earnings budget was positive and risk prone (the variable option was preferred) when the earnings budget was negative. Furthermore, choice was most risk prone during negative earnings-budget conditions in which the earnings requirement was most stringent. Local choice patterns were also frequently consistent with the predictions of a dynamic optimization model, indicating that choice was simultaneously sensitive to short-term choice contingencies, current point earnings, and the earnings requirement. Overall, these results show that the patterns of risky choice generated by energy-budget variables can also be produced by choice contingencies that do not involve immediate survival, and that risky choice in humans may be similar to that shown in nonhumans when choice is studied under analogous experimental conditions. PMID:11516113

Same-sex reproduction: medical treatment options and psychosocial considerations.

PubMed

Greenfeld, Dorothy A; Seli, Emre

2016-06-01

This review provides an overview of the historical significance of assisted reproduction for gay men and women, discusses current reproductive options for same-sex couples, addresses psychosocial considerations unique to these couples, and reviews the current literature addressing medical and psychosocial aspects of same-sex reproduction. Growing numbers of men and women openly self-identify as gay and lesbian. Accompanying this openness is an increased public acceptance of same-sex relationships and same-sex marriage. The combination of gay/lesbian self-determination and mounting public acceptance of same-sex unions has led these individuals and couples to increasingly seek parenthood through assisted reproduction. Recent studies describe relationship satisfaction in gay couples after assisted reproduction and more positive functioning and less stress associated with parenthood when compared with heterosexual parents. Motivations for parenthood are the same for same-sex couples and heterosexual couples alike. However, achieving the goal of parenthood can be a much greater endeavor medically and psychologically for same-sex couples. Fertility treatment centers increasingly recognize issues unique to gay men and women and are increasingly welcoming.

Long-term management of type 2 diabetes with glucagon-like peptide-1 receptor agonists.

PubMed

Courtney, Hamish; Nayar, Rahul; Rajeswaran, Chinnadorai; Jandhyala, Ravi

2017-01-01

Continuously reducing excess blood glucose is a primary goal for the management of type 2 diabetes (T2D). Most patients with T2D require glucose-lowering medications to achieve and maintain adequate glycemic control; however, treatment failure may occur, limiting treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are an emerging therapeutic class that can be prescribed for patients instead of basal insulin after the failure of oral therapies. Recent studies have focused on the durability and tolerability of long-term GLP-1RA therapy. This review summarizes the key efficacy and safety findings from prospective phase 3 clinical studies of at least 76 weeks' duration for the GLP-1RAs currently approved in the United States and the European Union (albiglutide, dulaglutide, exenatide twice daily [BID], exenatide once weekly [QW], liraglutide, and lixisenatide). Currently, most of the long-term data are from uncontrolled extension studies, and continuous patient benefit has been observed for up to 3 years with multiple GLP-1RAs. Four-year comparative data demonstrated a longer time to treatment failure for exenatide BID than for sulfonylurea, and 3-year comparative extension data demonstrated greater glycated hemoglobin (HbA1c) reductions and weight loss with exenatide QW than with insulin glargine. Currently, the longest extension study for a GLP-1RA is the DURATION-1 study of exenatide QW, with >7 years of clinical data available. Data from DURATION-1 demonstrated that continuous HbA1c reductions and weight loss were observed for the patients continuing on the treatment, with no unexpected adverse events. Taken together, these data support GLP-1RAs as a long-term noninsulin treatment option after the failure of oral therapies.

Focal therapy in prostate cancer: the current situation

PubMed Central

Jácome-Pita, FX; Sánchez-Salas, R; Barret, E; Amaruch, N; Gonzalez-Enguita, C; Cathelineau, X

2014-01-01

Prostate cancer is one of the most significant pathologies in the field of urology. The adoption of screening strategies and improvements in biopsies have resulted in an increase in early-stage tumour detection. Radical global therapies provide very good oncological results in localised prostate cancer. However, excess treatment in low- and, in some cases, intermediate-risk groups affects the quality of life of these patients. In the case of localised prostate cancer, focal therapies offer a minimally invasive option with good results with respect to established treatments. Although this is currently not a standard treatment, it represents the therapeutic approach with the greatest potential. This literature review has the following objectives: to define selection criteria for patients who are candidates for focal therapy, to assess the current situation and results of the different therapeutic options, and to define procedures in cases of recurrence and for follow-ups. We concluded that focal therapy is a viable therapeutic alternative for localised prostate cancer, specifically cryosurgery and high-intensity targeted ultrasound, which have acceptable oncologic results and a lower comorbidity compared with global treatments. Studies with a high level of scientific evidence are still needed to validate these results. Acquisition of evidence A search was carried out on the Medline (PubMed), EMBASE, Web of Science and Cochrane databases of all papers published before 31 July 2013. We included clinical studies and literature reviews that evaluated primary focal therapy for prostate cancer confirmed by biopsy and excluded focal rescue therapy studies. The keywords used were focal therapy and prostate cancer. Initially, we found 42 articles; 15 studies were excluded because they did not meet the minimum criteria for inclusion. A total of 1350 cases were treated throughout 27 studies. PMID:24944577

[Conservative treatment of nonspecific, chronic low back pain : Evidence of the efficacy - a systematic literature review].

PubMed

Bredow, J; Bloess, K; Oppermann, J; Boese, C K; Löhrer, L; Eysel, P

2016-07-01

Non-specific chronic low back pain (NSCLBP): Which conservative therapy shows an evident effectiveness - A review of the current literature. Our results are based on literature reviews of current randomised control studies, reviews and meta-analysis drawn from the Cochrane Library and Medline-Database between the years 2004 until 2015. German and English Studies were included. We focused on different conservative Treatments of NSCLBP, which are listed at, the NVL-Guidelines. Based on the given evidence we evaluated their effectiveness. As part of the review we identified 4657 Publications, 85 were included in this study. Therapeutic options such as bed rest, TENS, Massage, Spine Supports, Back Schools and Antidepressants showed no evident effectiveness. Injections, NSAR analgesic therapy, Thermotherapy and Opioid analgesic therapy indicated a short-time effectiveness. A long term success (> 6 weeks) however, can not be shown. Only the Movement therapy can, in the summation of the included studies, postulate an evident (Evidence Level I) long-term effect treating NSCLBP. Only a few therapy options indicate a significant evident effectiveness for treating NSCLBP conservatively. At short notice methods such as injection therapy, thermo-therapy and analgesic therapies with NSAR and/or opioids help coping the acute phase. In the long term only movement therapy seems to provide an evident effectiveness. In the case of therapy-refractory NSCLBP a multimodal therapy should be considered.

How to Define Family Meals in "Shokuiku" (Food and Nutrition Education).

PubMed

Takimoto, Hidemi; Sarukura, Nobuko; Ishikawa-Takata, Kazuko

2015-01-01

The Japanese government has set 11 targets to promote "Shokuiku." However, among the 11 targets, only two targets (frequency of shared family meals and the proportion of breakfast skipping in children and young men) are quantitative goals. The increase in children eating alone is often lamented in the popular media, but the methodology for identifying the status of family meals ("Kyoshoku"), or how the responses should be validated, is rarely discussed. In the current review, we attempt to clarify how a family meal and survey responses are defined, by searching literature published after 2009, using the following keywords: "family meals" or "shared meals," in the PubMed database for English. For literature published in Japanese, we searched the Igakuchuo-Zassi Database and Google Scholar for relevant studies. In the English literature, questions were likely to focus on whether a dinner or any meal was eaten together with family members living together, while Japanese literature was more focused on "breakfast or dinner" eaten together with family members. The response options varied across different studies, such as the number of family meals a week, or the number of days (per week) these family meals were eaten. We found it quite difficult to compare across the studies, as there is no standardized definition or response options for "family meals." Further studies are needed in order to develop a standardized method to assess the current status of "family meals."

Employer Supported Child Care: An Idea Whose Time Has Come. A Conference on Child Care as an Employee Benefit (Costs and Benefits, Successful Programs, Company Options, Current Issues). Conference Proceedings.

ERIC Educational Resources Information Center

Haiman, Peter, Ed.; Sud, Gian, Ed.

Many aspects of employer-sponsored child care programs--including key issues, costs and benefits, programmatic options, and implementation strategies--are discussed in these conference proceedings. Public policy issues, legal aspects of child care as an employee benefit, tax incentives for corporate child care, and funding sources for child care…

78 FR 65400 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... currently offers three Ethernet connection options, a 1 Gb connection at a cost of $500 per month, a 10 Gb connection at a cost of $4,000 per month, and a 10 Gb low latency connection at a cost of $7,000 per month... option to enable a more efficient connection to the Exchange. The growth in the size of consolidated and...

Information systems for material flow management in construction processes

NASA Astrophysics Data System (ADS)

Mesároš, P.; Mandičák, T.

2015-01-01

The article describes the options for the management of material flows in the construction process. Management and resource planning is one of the key factors influencing the effectiveness of construction project. It is very difficult to set these flows correctly. The current period offers several options and tools to do this. Information systems and their modules can be used just for the management of materials in the construction process.

Homeless Mentally Ill: Problems and Options in Estimating Numbers and Trends. Report to the Chairman, Committee on Labor and Human Resources, U.S. Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Program Evaluation and Methodology Div.

In response to a request by the United States Senate Committee on Labor and Human Resources, the General Accounting Office (GAO) examined the methodological soundness of current population estimates of the number of homeless chronically mentally ill persons, and proposed several options for estimating the size of this population. The GAO reviewed…

Prophylactic Therapy for Hereditary Angioedema.

PubMed

Longhurst, Hilary; Zinser, Emily

2017-08-01

Long-term prophylaxis is needed in many patients with hereditary angioedema and poses many challenges. Attenuated androgens are effective in many but are limited by side effect profiles. There is less evidence for efficacy of tranexamic acid and progestagens; however, the small side effect profile makes tranexamic acid an option for prophylaxis in children and progestagens an option for women. C1 inhibitor is beneficial, but at present requires intravenous delivery and may need dose titration for maximum efficacy. Short-term prophylaxis should be considered for all procedures. New therapies are promising in overcoming many problems encountered with current options for long-term prophylaxis. Copyright © 2017 Elsevier Inc. All rights reserved.