Effect of novel patient interaction on students' performance of pregnancy options counseling.

PubMed

Shaddeau, Angela; Nimz, Abigail; Sheeder, Jeanelle; Tocce, Kristina

2015-01-01

Although options counseling is a fundamental skill for medical providers, previous research has identified gaps in medical school reproductive health education. To determine if a 1-h novel patient interaction (NPI) improves student performance when caring for a standardized patient with an unintended pregnancy. From September 2012 to June 2013 we randomized third-year medical students at the University of Colorado School of Medicine to the standard curriculum plus an NPI, or the standard curriculum only. The NPI consisted of a 1-h small-group session with a patient who discussed her experiences with options counseling and her decision to terminate her pregnancy. Students completed an Objective Structured Clinical Examination (OSCE) at the rotation's end, which included options counseling. The primary outcome was the proportion of participants achieving 'excellence' on the OSCE checklist. 'Excellence' was defined as a score ≥90%. Examinations were flagged as 'unsatisfactory encounters' if core competencies were not addressed. OSCE standardized patients and evaluators were blinded to group assignment. In total, 135 students were eligible and randomized: 75 to NPI; 60 to control. During the OSCE, few students achieved 'excellence' (24% NPI vs. 28% control, p=0.57).There were no differences between scores for components of options counseling. More students in the control group 'appeared somewhat uncomfortable' delivering the pregnancy test results (5% NPI vs. 18% control, p=0.006). More than half (54%) of the intervention group and 67% of controls had 'unsatisfactory encounters' (p=0.16), almost exclusively due to omission of adoption. Most students addressed abortion (96% NPI vs. 92% control, p=0.29). A 1-h NPI does not improve medical students' performance of pregnancy options counseling and the option of adoption is routinely omitted. Adoption is clearly an area that needs greater attention when designing comprehensive reproductive health curriculum for medical students.

Enhancing emotion-based learning in decision-making under uncertainty.

PubMed

Alarcón, David; Amián, Josué G; Sánchez-Medina, José A

2015-01-01

The Iowa Gambling Task (IGT) is widely used to study decision-making differences between several clinical and healthy populations. Unlike the healthy participants, clinical participants have difficulty choosing between advantageous options, which yield long-term benefits, and disadvantageous options, which give high immediate rewards but lead to negative profits. However, recent studies have found that healthy participants avoid the options with a higher frequency of losses regardless of whether or not they are profitable in the long run. The aim of this study was to control for the confounding effect of the frequency of losses between options to improve the performance of healthy participants on the IGT. Eighty healthy participants were randomly assigned to the original IGT or a modified version of the IGT that diminished the gap in the frequency of losses between options. The participants who used the modified IGT version learned to make better decisions based on long-term profit, as indicated by an earlier ability to discriminate good from bad options, and took less time to make their choices. This research represents an advance in the study of decision making under uncertainty by showing that emotion-based learning is improved by controlling for the loss-frequency bias effect.

Investigating the Variables in a Mock Exam Study Session Designed to Improve Student Exam Performance in an Undergraduate Behavior Modification and Therapy Course

ERIC Educational Resources Information Center

Dotson, Wesley H.

2010-01-01

The purpose of the present study was to identify components of an optional mock exam review session (e.g. requiring students to write answers, providing students grading keys for questions) responsible for improvements in student performance on application-based short-essay exams in an undergraduate behavior modification course. Both…

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.

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

Duro, Francisco Rodrigo; Garcia Blas, Javier; Isaila, Florin

This paper explores novel techniques for improving the performance of many-task workflows based on the Swift scripting language. We propose novel programmer options for automated distributed data placement and task scheduling. These options trigger a data placement mechanism used for distributing intermediate workflow data over the servers of Hercules, a distributed key-value store that can be used to cache file system data. We demonstrate that these new mechanisms can significantly improve the aggregated throughput of many-task workflows with up to 86x, reduce the contention on the shared file system, exploit the data locality, and trade off locality and load balance.

An Initial Comparison of Selected Earth Departure Options for Solar Electric Propulsion Missions

NASA Technical Reports Server (NTRS)

Merrill, Raymond Gabriel; Komar, D. R.; Qu, Min; Chrone, Jon; Strange, Nathan; Landau, Damon

2012-01-01

Earth departure options such as the location for deployment, aggregation, and crew rendezvous as well as the type of propulsion leveraged for each mission phase effect overall mission performance metrics such as number of critical maneuvers, mass of propellant to achieve departure, and initial mass required in low Earth orbit. This paper identifies and compares a subset of tactical options for deployment, crew rendezvous, and Earth departure that leverage electric propulsion and hybrid chemical electric propulsion with a goal of improving system efficiency. Departure maneuver specific limitations and penalties are then identified for missions to specific targets for human interplanetary missions providing a better understanding of the impact of decisions related to aggregation and rendezvous locations as well as Earth departure maneuvers on overall system performance.

High performance cryogenic turboexpanders

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

Agahi, R.R.; Ershaghi, B.; Lin, M.C.

1996-12-31

The use of turboexpanders for deep cryogenic temperatures has been constrained because of thermal efficiency limitations. This limited thermal efficiency was mostly due to mechanical constraints. Recent improvements in analytical techniques, bearing technology, and design features have made it possible to design and operate turboexpanders at more favorable conditions, such as of higher rotational speeds. Several turboexpander installations in helium and hydrogen processes have shown a significant improvement in plant performance over non-turboexpander options.

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.

Effects of emotion on prospection during decision-making.

PubMed

Worthy, Darrell A; Byrne, Kaileigh A; Fields, Sherecce

2014-01-01

In two experiments we examined the role of emotion, specifically worry, anxiety, and mood, on prospection during decision-making. Worry is a particularly relevant emotion to study in the context of prospection because high levels of worry may make individuals more aversive toward the uncertainty associated with the prospect of obtaining future improvements in rewards or states. Thus, high levels of worry might lead to reduced prospection during decision-making and enhance preference for immediate over delayed rewards. In Experiment 1 participants performed a two-choice dynamic decision-making task where they were required to choose between one option (the decreasing option) which provided larger immediate rewards but declines in future states, and another option (the increasing option) which provided smaller immediate rewards but improvements in future states, making it the optimal choice. High levels of worry were associated with poorer performance in the task. Additionally, fits of a sophisticated reinforcement-learning model that incorporated both reward-based and state-based information suggested that individuals reporting high levels of worry gave greater weight to the immediate rewards they would receive on each trial than to the degree to which each action would lead to improvements in their future state. In Experiment 2 we found that high levels of worry were associated with greater delay discounting using a standard delay discounting task. Combined, the results suggest that high levels of worry are associated with reduced prospection during decision-making. We attribute these results to high worriers' aversion toward the greater uncertainty associated with attempting to improve future rewards than to maximize immediate reward. These results have implications for researchers interested in the effects of emotion on cognition, and suggest that emotion strongly affects the focus on temporal outcomes during decision-making.

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

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

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

Balance and Gait Impairment: Sensor-Based Assessment for Patients With Peripheral Neuropathy.

PubMed

Campbell, Grace; Skubic, Marjorie A

2018-06-01

Individuals with peripheral neuropathy (PN) frequently experience balance and gait impairments that can lead to poor physical function, falls, and injury. Nurses are aware that patients with cancer experience balance and gait impairments but are unsure of optimal assessment and management strategies. This article reviews options for balance and gait assessment for patients diagnosed with cancer experiencing PN, describes advantages and limitations of the various options, and highlights innovative, clinically feasible technologies to improve clinical assessment and management. The literature was reviewed to identify and assess the gold standard quantitative measures for assessing balance and gait. Gold standard quantitative measures are burdensome for patients and not often used in clinical practice. Sensor-based technologies improve balance and gait assessment options by calculating precise impairment measures during performance of simple clinical tests at the point of care.

The performance of the progressive resolution optimizer (PRO) for RapidArc planning in targets with low-density media.

PubMed

Kan, Monica W K; Leung, Lucullus H T; Yu, Peter K N

2013-11-04

A new version of progressive resolution optimizer (PRO) with an option of air cavity correction has been implemented for RapidArc volumetric-modulated arc therapy (RA). The purpose of this study was to compare the performance of this new PRO with the use of air cavity correction option (PRO10_air) against the one without the use of the air cavity correction option (PRO10_no-air) for RapidArc planning in targets with low-density media of different sizes and complexities. The performance of PRO10_no-air and PRO10_air was initially compared using single-arc plans created for four different simple heterogeneous phantoms with virtual targets and organs at risk. Multiple-arc planning of 12 real patients having nasopharyngeal carcinomas (NPC) and ten patients having non-small cell lung cancer (NSCLC) were then performed using the above two options for further comparison. Dose calculations were performed using both the Acuros XB (AXB) algorithm with the dose to medium option and the analytical anisotropic algorithm (AAA). The effect of using intermediate dose option after the first optimization cycle in PRO10_air and PRO10_no-air was also investigated and compared. Plans were evaluated and compared using target dose coverage, critical organ sparing, conformity index, and dose homogeneity index. For NSCLC cases or cases for which large volumes of low-density media were present in or adjacent to the target volume, the use of the air cavity correction option in PRO10 was shown to be beneficial. For NPC cases or cases for which small volumes of both low- and high-density media existed in the target volume, the use of air cavity correction in PRO10 did not improve the plan quality. Based on the AXB dose calculation results, the use of PRO10_air could produce up to 18% less coverage to the bony structures of the planning target volumes for NPC cases. When the intermediate dose option in PRO10 was used, there was negligible difference observed in plan quality between optimizations with and without using the air cavity correction option.

Analysis of Technological Innovation and Environmental Performance Improvement in Aviation Sector

PubMed Central

Lee, Joosung; Mo, Jeonghoon

2011-01-01

The past oil crises have caused dramatic improvements in fuel efficiency in all industrial sectors. The aviation sector—aircraft manufacturers and airlines—has also made significant efforts to improve the fuel efficiency through more advanced jet engines, high-lift wing designs, and lighter airframe materials. However, the innovations in energy-saving aircraft technologies do not coincide with the oil crisis periods. The largest improvement in aircraft fuel efficiency took place in the 1960s while the high oil prices in the 1970s and on did not induce manufacturers or airlines to achieve a faster rate of innovation. In this paper, we employ a historical analysis to examine the socio-economic reasons behind the relatively slow technological innovation in aircraft fuel efficiency over the last 40 years. Based on the industry and passenger behaviors studied and prospects for alternative fuel options, this paper offers insights for the aviation sector to shift toward more sustainable technological options in the medium term. Second-generation biofuels could be the feasible option with a meaningful reduction in aviation’s lifecycle environmental impact if they can achieve sufficient economies of scale. PMID:22016716

Analysis of technological innovation and environmental performance improvement in aviation sector.

PubMed

Lee, Joosung; Mo, Jeonghoon

2011-09-01

The past oil crises have caused dramatic improvements in fuel efficiency in all industrial sectors. The aviation sector-aircraft manufacturers and airlines-has also made significant efforts to improve the fuel efficiency through more advanced jet engines, high-lift wing designs, and lighter airframe materials. However, the innovations in energy-saving aircraft technologies do not coincide with the oil crisis periods. The largest improvement in aircraft fuel efficiency took place in the 1960s while the high oil prices in the 1970s and on did not induce manufacturers or airlines to achieve a faster rate of innovation. In this paper, we employ a historical analysis to examine the socio-economic reasons behind the relatively slow technological innovation in aircraft fuel efficiency over the last 40 years. Based on the industry and passenger behaviors studied and prospects for alternative fuel options, this paper offers insights for the aviation sector to shift toward more sustainable technological options in the medium term. Second-generation biofuels could be the feasible option with a meaningful reduction in aviation's lifecycle environmental impact if they can achieve sufficient economies of scale.

A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

PubMed

Westgard, James O

2017-03-01

A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of center-cut separations applying simulated moving bed chromatography with 8 zones.

PubMed

Santos da Silva, Francisco Vitor; Seidel-Morgenstern, Andreas

2016-07-22

Different multi-column options to perform continuous chromatographic separations of ternary mixtures have been proposed in order to overcome limitations of batch chromatography. One attractive option is given by simulated moving bed chromatography (SMB) with 8 zones, a process that offers uninterrupted production, and, potentially, improved economy. As in other established ternary separation processes, the separation sequence is crucial for the performance of the process. This problem is addressed here by computing and comparing optimal performances of the two possibilities assuming linear adsorption isotherms. The conclusions are presented in a decision tree which can be used to guide the selection of system configuration and operation. Copyright © 2016 Elsevier B.V. All rights reserved.

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.

PSK Shift Timing Information Detection Using Image Processing and a Matched Filter

DTIC Science & Technology

2009-09-01

phase shifts are enhanced.  Develop, design, and test the resulting phase shift identification scheme. xx  Develop, design, and test an optional...and the resulting phase shift identification algorithm is investigated for SNR levels in the range -2dB to 12 dB. Detection performances are derived...test the resulting phase shift identification scheme.  Develop, design, and test an optional analysis window overlapping technique to improve phase

Reforming Teacher Pay

ERIC Educational Resources Information Center

Burns, Susan Freeman; Gardner, Catherine D.

2010-01-01

A recent Google search for information regarding performance pay in education produced 6.1 million results. This number should come as no surprise given the current level of interest in incentives as a popular reform option in public education. Supporters believe pay-for-performance programs encourage less effective teachers to improve and will…

Evaluation of different signal processing options in unilateral and bilateral cochlear freedom implant recipients using R-Space background noise.

PubMed

Brockmeyer, Alison M; Potts, Lisa G

2011-02-01

Difficulty understanding in background noise is a common complaint of cochlear implant (CI) recipients. Programming options are available to improve speech recognition in noise for CI users including automatic dynamic range optimization (ADRO), autosensitivity control (ASC), and a two-stage adaptive beamforming algorithm (BEAM). However, the processing option that results in the best speech recognition in noise is unknown. In addition, laboratory measures of these processing options often show greater degrees of improvement than reported by participants in everyday listening situations. To address this issue, Compton-Conley and colleagues developed a test system to replicate a restaurant environment. The R-SPACE™ consists of eight loudspeakers positioned in a 360 degree arc and utilizes a recording made at a restaurant of background noise. The present study measured speech recognition in the R-SPACE with four processing options: standard dual-port directional (STD), ADRO, ASC, and BEAM. A repeated-measures, within-subject design was used to evaluate the four different processing options at two noise levels. Twenty-seven unilateral and three bilateral adult Nucleus Freedom CI recipients. The participants' everyday program (with no additional processing) was used as the STD program. ADRO, ASC, and BEAM were added individually to the STD program to create a total of four programs. Participants repeated Hearing in Noise Test sentences presented at 0 degrees azimuth with R-SPACE restaurant noise at two noise levels, 60 and 70 dB SPL. The reception threshold for sentences (RTS) was obtained for each processing condition and noise level. In 60 dB SPL noise, BEAM processing resulted in the best RTS, with a significant improvement over STD and ADRO processing. In 70 dB SPL noise, ASC and BEAM processing had significantly better mean RTSs compared to STD and ADRO processing. Comparison of noise levels showed that STD and BEAM processing resulted in significantly poorer RTSs in 70 dB SPL noise compared to the performance with these processing conditions in 60 dB SPL noise. Bilateral participants demonstrated a bilateral improvement compared to the better monaural condition for both noise levels and all processing conditions, except ASC in 60 dB SPL noise. The results of this study suggest that the use of processing options that utilize noise reduction, like those available in ASC and BEAM, improve a CI recipient's ability to understand speech in noise in listening situations similar to those experienced in the real world. The choice of the best processing option is dependent on the noise level, with BEAM best at moderate noise levels and ASC best at loud noise levels for unilateral CI recipients. Therefore, multiple noise programs or a combination of processing options may be necessary to provide CI users with the best performance in a variety of listening situations. American Academy of Audiology.

Advanced reactors and associated fuel cycle facilities: safety and environmental impacts.

PubMed

Hill, R N; Nutt, W M; Laidler, J J

2011-01-01

The safety and environmental impacts of new technology and fuel cycle approaches being considered in current U.S. nuclear research programs are contrasted to conventional technology options in this paper. Two advanced reactor technologies, the sodium-cooled fast reactor (SFR) and the very high temperature gas-cooled reactor (VHTR), are being developed. In general, the new reactor technologies exploit inherent features for enhanced safety performance. A key distinction of advanced fuel cycles is spent fuel recycle facilities and new waste forms. In this paper, the performance of existing fuel cycle facilities and applicable regulatory limits are reviewed. Technology options to improve recycle efficiency, restrict emissions, and/or improve safety are identified. For a closed fuel cycle, potential benefits in waste management are significant, and key waste form technology alternatives are described. Copyright © 2010 Health Physics Society

Paying It Forward: A Technical Assistance Guide for Developing and Implementing Performance-Based Scholarships. The Performance-Based Scholarship Demonstration

ERIC Educational Resources Information Center

Welbeck, Rashida; Ware, Michelle; Cerna, Oscar; Valenzuela, Ireri

2014-01-01

Difficulties in paying for college and in maintaining good academic performance are two major hurdles to college graduation for low-income students. In recent years, state and federal budgets for postsecondary education have been cut significantly, limiting the options policymakers, education leaders, and communities have to improve rates of…

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.

Passive versus active hazard detection and avoidance systems

NASA Astrophysics Data System (ADS)

Neveu, D.; Mercier, G.; Hamel, J.-F.; Simard Bilodeau, V.; Woicke, S.; Alger, M.; Beaudette, D.

2015-06-01

Upcoming planetary exploration missions will require advanced guidance, navigation and control technologies to reach landing sites with high precision and safety. Various technologies are currently in development to meet that goal. Some technologies rely on passive sensors and benefit from the low mass and power of such solutions while others rely on active sensors and benefit from an improved robustness and accuracy. This paper presents two different hazard detection and avoidance (HDA) system design approaches. The first architecture relies only on a camera as the passive HDA sensor while the second relies, in addition, on a Lidar as the active HDA sensor. Both options use in common an innovative hazard map fusion algorithm aiming at identifying the safest landing locations. This paper presents the simulation tools and reports the closed-loop software simulation results obtained using each design option. The paper also reports the Monte Carlo simulation campaign that was used to assess the robustness of each design option. The performance of each design option is compared against each other in terms of performance criteria such as percentage of success, mean distance to nearest hazard, etc. The applicability of each design option to planetary exploration missions is also discussed.

School Choice Participation Rates: Which Districts Are Pressured?

ERIC Educational Resources Information Center

Ni, Yongmei; Arsen, David

2011-01-01

School choice policies are intended to provide students in poorly performing schools the option of transferring to a better school. The associated loss of funding to new competitors is expected, in turn, to benefit students who remain in their assigned schools by spurring improved performance among the educators in them. The prospects for such…

Sustainable water use and management options in a water-stressed river basin in Kenya

NASA Astrophysics Data System (ADS)

Hirpa, Feyera; Dadson, Simon; Dyer, Ellen; Barbour, Emily; Charles, Katrina; Hope, Robert

2017-04-01

Sustainable water resource is critical for maintaining healthy ecosystems and supporting socio-economic sectors. Hydro-climatic change and variability, population growth as well as new infrastructure developments create water security risks. Therefore, evidence-based management decisions are necessary to improve water security and meet the future water demands of multiple competing sectors. In this work we perform water resource modelling in order to investigate the impact of increasing water demand (expanding agriculture, booming industry, growing population) on the sustainable water use in Turkwel river basin, located in arid north-western Kenya. We test different management options to determine those that meet the water demands of the concerned sectors whilst minimising environmental impact. We perform scenario analysis using Water Evaluation And Planning (WEAP) model to explore different ranges of climate conditions, population growth rates, irrigation scale, reservoir operations, and economic development. The results can be used as a scientific guideline for the policy makers who decide the alternative management options that ensure the sustainable water use in the basin. The work is part of the REACH - improving water security for the poor program (http://reachwater.org.uk/), aiming to support a pathway to sustainable growth and poverty reduction

Cardiomyoplasty: first clinical case with new cardiomyostimulator.

PubMed

Chekanov, Valeri S; Sands, Duane E; Brown, Conville S; Brum, Fernando; Arzuaga, Pedro; Gava, Sebastian; Eugenio, Ferdinand P; Melamed, Vladimir; Spencer, Howard W

2002-09-01

Dynamic cardiomyoplasty was performed in a patient using a new cardio-myostimulator (LD-PACE II) designed to enable a novel stimulation regimen that utilizes a new range of stimulation options, including cessation during sleep. After treatment, left ventricular ejection fraction improved in 24 months from 15% to 25% and New York Heart Association classification improved from class IV to II.

Balance improvement after physical therapy training using specially developed serious games for cerebral palsy children: preliminary results.

PubMed

Bonnechère, Bruno; Omelina, Lubos; Jansen, Bart; Van Sint Jan, Serge

2017-02-01

Cerebral palsy (CP) leads to various clinical signs mainly induced by muscle spasticity and muscle weakness. Among these ones impaired balance and posture are very common. Traditional physical therapy exercise programs are focusing on this aspect, but it is difficult to motivate patients to regularly perform these exercises, especially at home without therapist supervision. Specially developed serious games (SG) could therefore be an interesting option to motivate children to perform specific exercise for balance improvement. Ten CP children participated in this study. Patients received four sessions of SG included into conventional therapy (1 session of 30 min a week during 4 weeks). Trunk control and balance were assessed using Trunk Control Motor Scale (TCMS) before and after interventions. Children presented a significant improvement in TCMS global score after interventions [37.6 (8.7) and 39.6 (9.5) before and after interventions, respectively, p = 0.04]. SG could therefore be an interesting option to integrate in the conventional treatment of CP children. Implication for Rehabilitation Cerebral palsy (CP) leads to balance issues. Rehabilitation exercises are not performed (enough) at home. Serious games (SG) could increase patients' motivation. SG increase balance control of CP children.

Survey of Advanced Booster Options for Potential Shuttle Derivative Vehicles

NASA Technical Reports Server (NTRS)

Sackheim, Robert L.; Ryan, Richard; Threet, Ed; Kennedy, James W. (Technical Monitor)

2001-01-01

A never-ending major goal for the Space Shuttle program is to continually improve flight safety, as long as this launch system remains in operational service. One of the options to improve system safety and to enhance vehicle performance as well, that has been seriously studied over the past several decades, is to replace the existing strap-on four segment solid rocket boosters (SRB's) with more capable units. A number of booster upgrade options have been studied in some detail, ranging from five segment solids through hybrids and a wide variety of liquid strap-ons (both pressure and pump fed with various propellants); all the way to a completely reusable liquid fly back booster (complete with air breathing engines for controlled landing and return). All of these possibilities appear to offer improvements in varying degrees; and each has their strengths and weaknesses from both programmatic and technical points of view. The most beneficial booster upgrade/design, if the shuttle program were to continue long enough to justify the required investment, would be an approach that greatly increased both vehicle and crew safety. This would be accomplished by increasing the minimum range/minimum altitude envelope that would readily allow abort to orbit (ATO), possibly even to zero/zero, and possibly reduce or eliminate the Return to Launch Site (RTLS) and even the Trans Atlantic Landing (TAL) abort mode requirements. This paper will briefly survey and discuss all of the various booster'upgrade options studied previously, and compare their relative attributes. The survey will explicitly discuss, in summary comparative form, options that include: five segment solids; several hybrid possibilities; pressure and/or pump-fed liquids using either LO2/kerosene, H2O/kerosene and LO2/J2, any of which could be either fully expendable, partly or fully reusable; and finally a fully reusable liquid fly back booster system, with a number of propellant and propulsion system options. Performance and configuration comparison illustrations and tables will be included to provide a comprehensive survey for the paper.

The performance of the progressive resolution optimizer (PRO) for RapidArc planning in targets with low‐density media

PubMed Central

Leung, Lucullus H.T.; Yu, Peter K.N.

2013-01-01

A new version of progressive resolution optimizer (PRO) with an option of air cavity correction has been implemented for RapidArc volumetric‐modulated arc therapy (RA). The purpose of this study was to compare the performance of this new PRO with the use of air cavity correction option (PRO10_air) against the one without the use of the air cavity correction option (PRO10_no‐air) for RapidArc planning in targets with low‐density media of different sizes and complexities. The performance of PRO10_no‐air and PRO10_air was initially compared using single‐arc plans created for four different simple heterogeneous phantoms with virtual targets and organs at risk. Multiple‐arc planning of 12 real patients having nasopharyngeal carcinomas (NPC) and ten patients having non‐small cell lung cancer (NSCLC) were then performed using the above two options for further comparison. Dose calculations were performed using both the Acuros XB (AXB) algorithm with the dose to medium option and the analytical anisotropic algorithm (AAA). The effect of using intermediate dose option after the first optimization cycle in PRO10_air and PRO10_no‐air was also investigated and compared. Plans were evaluated and compared using target dose coverage, critical organ sparing, conformity index, and dose homogeneity index. For NSCLC cases or cases for which large volumes of low‐density media were present in or adjacent to the target volume, the use of the air cavity correction option in PROIO was shown to be beneficial. For NPC cases or cases for which small volumes of both low‐ and high‐density media existed in the target volume, the use of air cavity correction in PRO10 did not improve the plan quality. Based on the AXB dose calculation results, the use of PRO10_air could produce up to 18% less coverage to the bony structures of the planning target volumes for NPC cases. When the intermediate dose option in PRO10 was used, there was negligible difference observed in plan quality between optimizations with and without using the air cavity correction option. PACS number: 87.55.D‐, 87.55.de, 87.56.N‐

Improved specificity of TALE-based genome editing using an expanded RVD repertoire.

PubMed

Miller, Jeffrey C; Zhang, Lei; Xia, Danny F; Campo, John J; Ankoudinova, Irina V; Guschin, Dmitry Y; Babiarz, Joshua E; Meng, Xiangdong; Hinkley, Sarah J; Lam, Stephen C; Paschon, David E; Vincent, Anna I; Dulay, Gladys P; Barlow, Kyle A; Shivak, David A; Leung, Elo; Kim, Jinwon D; Amora, Rainier; Urnov, Fyodor D; Gregory, Philip D; Rebar, Edward J

2015-05-01

Transcription activator-like effector (TALE) proteins have gained broad appeal as a platform for targeted DNA recognition, largely owing to their simple rules for design. These rules relate the base specified by a single TALE repeat to the identity of two key residues (the repeat variable diresidue, or RVD) and enable design for new sequence targets via modular shuffling of these units. A key limitation of these rules is that their simplicity precludes options for improving designs that are insufficiently active or specific. Here we address this limitation by developing an expanded set of RVDs and applying them to improve the performance of previously described TALEs. As an extreme example, total conversion of a TALE nuclease to new RVDs substantially reduced off-target cleavage in cellular studies. By providing new RVDs and design strategies, these studies establish options for developing improved TALEs for broader application across medicine and biotechnology.

Test-Enhanced Learning in an Immunology and Infectious Disease Medicinal Chemistry/Pharmacology Course.

PubMed

Hernick, Marcy

2015-09-25

Objective. To develop a series of active-learning modules that would improve pharmacy students' performance on summative assessments. Design. A series of optional online active-learning modules containing questions with multiple formats for topics in a first-year (P1) course was created using a test-enhanced learning approach. A subset of module questions was modified and included on summative assessments. Assessment. Student performance on module questions improved with repeated attempts and was predictive of student performance on summative assessments. Performance on examination questions was higher for students with access to modules than for those without access to modules. Module use appeared to have the most impact on low performing students. Conclusion. Test-enhanced learning modules with immediate feedback provide pharmacy students with a learning tool that improves student performance on summative assessments and also may improve metacognitive and test-taking skills.

Test-Enhanced Learning in an Immunology and Infectious Disease Medicinal Chemistry/Pharmacology Course

PubMed Central

2015-01-01

Objective. To develop a series of active-learning modules that would improve pharmacy students’ performance on summative assessments. Design. A series of optional online active-learning modules containing questions with multiple formats for topics in a first-year (P1) course was created using a test-enhanced learning approach. A subset of module questions was modified and included on summative assessments. Assessment. Student performance on module questions improved with repeated attempts and was predictive of student performance on summative assessments. Performance on examination questions was higher for students with access to modules than for those without access to modules. Module use appeared to have the most impact on low performing students. Conclusion. Test-enhanced learning modules with immediate feedback provide pharmacy students with a learning tool that improves student performance on summative assessments and also may improve metacognitive and test-taking skills. PMID:27168610

Do Work Placements Improve Final Year Academic Performance or Do High-Calibre Students Choose to Do Work Placements?

ERIC Educational Resources Information Center

Jones, C. M.; Green, J. P.; Higson, H. E.

2017-01-01

This study investigates whether the completion of an optional sandwich work placement enhances student performance in final year examinations. Using Propensity Score Matching, our analysis departs from the literature by controlling for self-selection. Previous studies may have overestimated the impact of sandwich work placements on performance…

Features and selection of vascular access devices.

PubMed

Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

Decision-making in healthy children, adolescents and adults explained by the use of increasingly complex proportional reasoning rules.

PubMed

Huizenga, Hilde M; Crone, Eveline A; Jansen, Brenda J

2007-11-01

In the standard Iowa Gambling Task (IGT), participants have to choose repeatedly from four options. Each option is characterized by a constant gain, and by the frequency and amount of a probabilistic loss. Crone and van der Molen (2004) reported that school-aged children and even adolescents show marked deficits in IGT performance. In this study, we have re-analyzed the data with a multivariate normal mixture analysis to show that these developmental changes can be explained by a shift from unidimensional to multidimensional proportional reasoning (Siegler, 1981; Jansen & van der Maas, 2002). More specifically, the results show a gradual shift with increasing age from (a) guessing with a slight tendency to consider frequency of loss to (b) focusing on frequency of loss, to (c) considering both frequency and amount of probabilistic loss. In the latter case, participants only considered options with low-frequency loss and then chose the option with the lowest amount of loss. Performance improved in a reversed task, in which punishment was placed up front and gain was delivered unexpectedly. In this reversed task, young children are guessing with already a slight tendency to consider both the frequency and amount of gain; this strategy becomes more pronounced with age. We argue that these findings have important implications for the interpretation of IGT performance, as well as for methods to analyze this performance.

Laser Ranging for Effective and Accurate Tracking of Space Debris in Low Earth Orbits

NASA Astrophysics Data System (ADS)

Blanchet, Guillaume; Haag, Herve; Hennegrave, Laurent; Assemat, Francois; Vial, Sophie; Samain, Etienne

2013-08-01

The paper presents the results of preliminary design options for an operational laser ranging system adapted to the measurement of the distance of space debris. Thorough analysis of the operational parameters is provided with identification of performance drivers and assessment of enabling design options. Results from performance simulation demonstrate how the range measurement enables improvement of the orbit determination when combined with astrometry. Besides, experimental results on rocket-stage class debris in LEO were obtained by Astrium beginning of 2012, in collaboration with the Observatoire de la Côte d'Azur (OCA), by operating an experimental laser ranging system supported by the MéO (Métrologie Optique) telescope.

Improving Learning through Interventions of Student-Generated Questions and Concept Maps

ERIC Educational Resources Information Center

Berry, Jack W.; Chew, Stephen L.

2008-01-01

Using the principles of the scholarship of teaching and learning, we evaluated 2 learning strategies to determine if they could improve student exam performance in general psychology. After the second of 3 exams, we gave students the option of participating in a specific learning activity and assessed its impact using the third exam. In Study 1,…

Holistic, model-based optimization of edge leveling as an enabler for lithographic focus control: application to a memory use case

NASA Astrophysics Data System (ADS)

Hasan, T.; Kang, Y.-S.; Kim, Y.-J.; Park, S.-J.; Jang, S.-Y.; Hu, K.-Y.; Koop, E. J.; Hinnen, P. C.; Voncken, M. M. A. J.

2016-03-01

Advancement of the next generation technology nodes and emerging memory devices demand tighter lithographic focus control. Although the leveling performance of the latest-generation scanners is state of the art, challenges remain at the wafer edge due to large process variations. There are several customer configurable leveling control options available in ASML scanners, some of which are application specific in their scope of leveling improvement. In this paper, we assess the usability of leveling non-correctable error models to identify yield limiting edge dies. We introduce a novel dies-inspec based holistic methodology for leveling optimization to guide tool users in selecting an optimal configuration of leveling options. Significant focus gain, and consequently yield gain, can be achieved with this integrated approach. The Samsung site in Hwaseong observed an improved edge focus performance in a production of a mid-end memory product layer running on an ASML NXT 1960 system. 50% improvement in focus and a 1.5%p gain in edge yield were measured with the optimized configurations.

Design options for improved performance with high-density carbon ablators and low-gas fill hohlraum targets

NASA Astrophysics Data System (ADS)

Berzak Hopkins, L.; Divol, L.; Lepape, S.; Meezan, N. B.; Dewald, E.; Ho, D.; Khan, S.; Pak, A.; Ralph, J.; Ross, J. S.

2016-10-01

Recent simulation-based and experimental work using high-density carbon ablators in unlined uranium hohlraums with 0.3 mg/cc helium fill have demonstrated round implosions with minimal evolution of Legendre moment P2 during burn. To extend this promising work, design studies have been performed to explore potential performance improvements with larger capsules, while maintaining similar case-to-capsule target ratios. We present here the results of these design studies, which will motivate a series of upcoming experiments at the National Ignition Facility. Prepared by LLNL under Contract DE-AC52-07NA27344.

Assessment of the USCENTCOM Medical Distribution Structure

PubMed Central

Welser, William; Yoho, Keenan D.; Robbins, Marc; Peltz, Eric; Van Roo, Ben D.; Resnick, Adam C.; Harper, Ronald E.

2012-01-01

Abstract This study examined whether there might be a medical supply and distribution structure for U.S. Central Command (USCENTCOM) that would maintain or improve performance while reducing costs. The authors evaluated the likely performance and cost implications of the range of possibilities, considering both the medical and nonmedical logistics structures, for providing medical supplies to support medical activities in USCENTCOM. They found that three options would preserve or improve performance while either lowering or not increasing costs. Additionally, they considered how the value of these solutions would likely change with future shifts in USCENTCOM operations. PMID:28083245

Advancing non-directive pregnancy options counseling skills: A pilot Study on the use of blended learning with an online module and simulation.

PubMed

Lupi, Carla; Ward-Peterson, Melissa; Chang, Winnie

2016-10-01

Limitations on didactic time pose barriers to teaching non-directive pregnancy options counseling. This study set out to explore the use of an online module to support trainee performance in a pregnancy options counseling standardized-patient exercise implemented among third-year medical students, and to examine the effect of clinical experience on student performance. An online module was developed. A convenience sample of forty-six student performances in a family medicine clerkship participated in a standardized patient exercise. Trained faculty rated performances. Students completed a self-assessment and provided feedback on the online module. Chi-square and Mann-Whitney-U tests were used to analyze data. Three coders qualitatively examined narrative student comments. Thirty-four students passed, 11 achieved a minimal pass, and one failed. The mean global rating from faculty was 2.8 (pass). Students with prior clinical experience significantly outperformed those without on the global rating scale with mean scores of 3.1 compared to 2.7, respectively (p=.044). All students agreed that the online module helped prepare them for the exercise. Qualitative analysis of students' feedback on the module revealed strengths in content and pedagogy. In their self-assessments, all but two students referred to content explicitly conveyed in the module. All students agreed that an online module supported their performance of non-directive pregnancy options counseling skills. Prior clinical experience was associated with improved performance. This module, along with the simulated exercise, can be implemented as a blended learning exercise without additional faculty teaching effort in standardized patient resource centers. Students agreed that an online module facilitates simulated performance of non-directive pregnancy options counseling skills. Future work should compare the impact of this approach to others, and explore the additional training needed to maintain and build on initial learning. Copyright © 2016 Elsevier Inc. All rights reserved.

Consistent Performance Differences between Children and Adults Despite Manipulation of Cue-Target Variables

PubMed Central

Bauer, Jessie-Raye; Martinez, Joel E.; Roe, Mary Abbe; Church, Jessica A.

2017-01-01

Two behavioral experiments assessed the plasticity and short-term improvement of task switching in 215 children and adults. Specifically, we studied manipulations of cued attention to different features of a target stimulus as a way to assess the development of cognitive flexibility. Each experiment had multiple levels of difficulty via manipulation of number of cued features (2–4) and number of response options (2 or 4). Working memory demand was manipulated across the two experiments. Impact of memory demand and task level manipulations on task accuracy and response times were measured. There were three overall goals: First, these task manipulations (number of cued features, response choices, and working memory load) were tested to assess the stability of group differences in performance between children ages 6–16 years and adults 18–27 years, with the goal of reducing age group differences. Second, age-related transitions to adult-level performance were examined within subgroups of the child sample. Third, short-term improvement from the beginning to the end of the study session was measured to probe whether children can improve with task experience. Attempts to use task manipulations to reduce age differences in cued task switching performance were unsuccessful: children performed consistently worse and were more susceptible to task manipulations than adults. However, across both studies, adult-like performance was observed around mid-adolescence, by ages 13-16 years. Certain task manipulations, especially increasing number of response options when working memory demand was low, produced differences from adults even in the oldest children. Interestingly, there was similar performance improvement with practice for both child and adult groups. The higher memory demand version of the task (Experiment 2) prompted greater short-term improvement in accuracy and response times than the lower memory demand version (Experiment 1). These results reveal stable differences in cued switching performance over development, but also relative flexibility within a given individual over time. PMID:28824489

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.

Option pricing for stochastic volatility model with infinite activity Lévy jumps

NASA Astrophysics Data System (ADS)

Gong, Xiaoli; Zhuang, Xintian

2016-08-01

The purpose of this paper is to apply the stochastic volatility model driven by infinite activity Lévy processes to option pricing which displays infinite activity jumps behaviors and time varying volatility that is consistent with the phenomenon observed in underlying asset dynamics. We specially pay attention to three typical Lévy processes that replace the compound Poisson jumps in Bates model, aiming to capture the leptokurtic feature in asset returns and volatility clustering effect in returns variance. By utilizing the analytical characteristic function and fast Fourier transform technique, the closed form formula of option pricing can be derived. The intelligent global optimization search algorithm called Differential Evolution is introduced into the above highly dimensional models for parameters calibration so as to improve the calibration quality of fitted option models. Finally, we perform empirical researches using both time series data and options data on financial markets to illustrate the effectiveness and superiority of the proposed method.

Battling Budget Woes.

ERIC Educational Resources Information Center

Agron, Joe, Ed.

1999-01-01

Discusses how various school districts are addressing school quality on tight budgets. Options discussed include use of portable classrooms, streamlining non-educational services, leasing and performance contracting, and energy improvements and working with power utilities to cut costs. Argues for adopting and enforcing ISO 9000 standards to…

Novel algorithm implementations in DARC: the Durham AO real-time controller

NASA Astrophysics Data System (ADS)

Basden, Alastair; Bitenc, Urban; Jenkins, David

2016-07-01

The Durham AO Real-time Controller has been used on-sky with the CANARY AO demonstrator instrument since 2010, and is also used to provide control for several AO test-benches, including DRAGON. Over this period, many new real-time algorithms have been developed, implemented and demonstrated, leading to performance improvements for CANARY. Additionally, the computational performance of this real-time system has continued to improve. Here, we provide details about recent updates and changes made to DARC, and the relevance of these updates, including new algorithms, to forthcoming AO systems. We present the computational performance of DARC when used on different hardware platforms, including hardware accelerators, and determine the relevance and potential for ELT scale systems. Recent updates to DARC have included algorithms to handle elongated laser guide star images, including correlation wavefront sensing, with options to automatically update references during AO loop operation. Additionally, sub-aperture masking options have been developed to increase signal to noise ratio when operating with non-symmetrical wavefront sensor images. The development of end-user tools has progressed with new options for configuration and control of the system. New wavefront sensor camera models and DM models have been integrated with the system, increasing the number of possible hardware configurations available, and a fully open-source AO system is now a reality, including drivers necessary for commercial cameras and DMs. The computational performance of DARC makes it suitable for ELT scale systems when implemented on suitable hardware. We present tests made on different hardware platforms, along with the strategies taken to optimise DARC for these systems.

The Role of Efficient XML Interchange (EXI) in Navy Wide-Area Network (WAN) Optimization

DTIC Science & Technology

2015-03-01

compress, and re-encrypt data to continue providing optimization through compression; however, that capability requires careful consideration of...optimization 23 of encrypted data requires a careful analysis and comparison of performance improvements and IA vulnerabilities. It is important...Contained EXI capitalizes on multiple techniques to improve compression, and they vary depending on a set of EXI options passed to the codec

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.

A Program Manager’s Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs. The RAND Toolkit, Volume 4

DTIC Science & Technology

2014-01-01

Hughes EFX, Boerstler H, O’Connor EJ. “Assessing the Impact of Continuous Quality Improvement/ Total Quality Management : Concept versus...facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity. Gery...RAND Program Manager’s Guide helps managers assess program performance, consider options for improvement, implement solutions, then assess whether the

The Development of a Graphical Notation for the Formal Specification of Software

DTIC Science & Technology

1990-12-01

the language. A detailed user survey should be performed after the language implementation is complete to determine the effectiveness of the graphical...productivity. ’Ihere is no better way to improve programmer productivity than to help the programmer to avoid performing the work in the first place. This is...optional prototyping phase is performed ) to develop a computer program (2:40). In 1985, Robert Balzer proposed the program transformation lifecycle

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.

Binding oneself to the mast: stimulating frontopolar cortex enhances precommitment

PubMed Central

Ugazio, Giuseppe; Crockett, Molly J.; Ruff, Christian C.; Kalenscher, Tobias; Tobler, Philippe N.

2017-01-01

Abstract Humans often give in to temptations that are in conflict with valuable long-term goals like health or saving for the future. Such willpower failures represent a prevalent problem in everyday life and in many psychiatric disorders. Strategies that increase resistance to temptations could therefore improve overall societal well-being. One important strategy is to voluntarily precommit, i.e. to restrict one’s future action space by removing the tempting short-term option from the choice set, thereby leaving only the long-term option for implementation. The neural mechanisms necessary to implement precommitment have remained unknown. Here, we test whether anodal transcranial direct current stimulation (tDCS) over the frontopolar cortex (FPC) can improve precommitment. Participants performed a self-control task in which they could precommit to obtain a delayed larger reward by removing an immediately available smaller reward from the future choice options. We found that anodal stimulation over FPC selectively increased the propensity to precommit. In contrast, tDCS had no effects on non-binding decisions, impulse control or reward preference. Our data establish a causal role for the FPC in the implementation of precommitment, revealing a novel route to improving resistance against temptations. PMID:28170049

Philanthropy as a source of funding for nursing initiatives.

PubMed

Kleinpell, Ruth M; Start, Rachel; McIntosh, Erik; Worobec, Sophia; Llewellyn, Jane

2014-01-01

Nurse leaders are challenged with ensuring that research and evidence-based practices are being integrated into clinical care. Initiatives such as the Magnet Recognition Program have helped reinforce the importance of advancing nursing practices to integrate best practices, conduct quality improvement initiatives, improve performance metrics, and involve bedside nurses in conducting research and evidence-based practice projects. While seeking research funding is an option for some initiatives, other strategies such as seeking funding from grateful patients or from philanthropic resources are becoming important options for nurse leaders to pursue, as the availability of funding from traditional sources such as professional organizations or federal funding becomes more limited. In addition, more institutions are seeking and applying for funding, increasing the pool of candidates who are vying for existing funding. Seeking alternative sources of funding, such as through philanthropy, becomes a viable option. This article reviews important considerations in seeking funding from philanthropic sources for nursing initiatives. Examples from a multiyear project that focused on promoting a healthy work environment and improving nursing morale are used to highlight strategies that were used to solicit, obtain, and secure extension funding from private foundation funding to support the initiative.

Magnetic Resonance-Guided Focused Ultrasound Neurosurgery for Essential Tremor: A Health Technology Assessment

PubMed Central

Schaink, Alexis; Li, Chunmei; Gajic-Veljanoski, Olga; Wells, David; Higgins, Caroline

2018-01-01

Background The standard treatment option for medication-refractory essential tremor is invasive neurosurgery. A new, noninvasive alternative is magnetic resonance-guided focused ultrasound (MRgFUS) neurosurgery. We aimed to determine the effectiveness, safety, and cost-effectiveness of MRgFUS neurosurgery for the treatment of moderate to severe, medication-refractory essential tremor in Ontario. We also spoke with people with essential tremor to gain an understanding of their experiences and thoughts regarding treatment options, including MRgFUS neurosurgery. Methods We performed a systematic review of the clinical literature published up to April 11, 2017, that examined MRgFUS neurosurgery alone or compared with other interventions for the treatment of moderate to severe, medication-refractory essential tremor. We assessed the risk of bias of each study and the quality of the body of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We performed a systematic review of the economic literature and created Markov cohort models to assess the cost-effectiveness of MRgFUS neurosurgery compared with other treatment options, including no surgery. We also estimated the budget impact of publicly funding MRgFUS neurosurgery in Ontario for the next 5 years. To contextualize the potential value of MRgFUS neurosurgery as a treatment option for essential tremor, we spoke with people with essential tremor and their families. Results Nine studies met our inclusion criteria for the clinical evidence review. In noncomparative studies, MRgFUS neurosurgery was found to significantly improve tremor severity and quality of life and to significantly reduce functional disability (GRADE: very low). It was also found to be significantly more effective than a sham procedure (GRADE: high). We found no significant difference in improvements in tremor severity, functional disability, or quality of life between MRgFUS neurosurgery and deep brain stimulation (GRADE: very low). We found no significant difference in improvement in tremor severity compared with radiofrequency thalamotomy (GRADE: low). MRgFUS neurosurgery has a favourable safety profile. We estimated that MRgFUS neurosurgery has a mean cost of $23,507 and a mean quality-adjusted survival of 3.69 quality-adjusted life-years (QALYs). We also estimated that the mean costs and QALYs of radiofrequency thalamotomy and deep brain stimulation are $14,978 and 3.61 QALYs, and $57,535 and 3.94 QALYs, respectively. For people ineligible for invasive neurosurgery, we estimated the incremental cost-effectiveness ratio (ICER) of MRgFUS neurosurgery compared with no surgery as $43,075 per QALY gained. In people eligible for invasive neurosurgery, the ICER of MRgFUS neurosurgery compared with radiofrequency thalamotomy is $109,795 per QALY gained; when deep brain stimulation is compared with MRgFUS neurosurgery, the ICER is $134,259 per QALY gained. Of note however, radiofrequency thalamotomy is performed very infrequently in Ontario. We also estimated that the budget impact of publicly funding MRgFUS neurosurgery in Ontario at the current case load (i.e., 48 cases/year) would be about $1 million per year for the next 5 years. People with essential tremor who had undergone MRgFUS neurosurgery reported positive experiences with the procedure. The tremor reduction they experienced improved their ability to perform activities of daily living and improved their quality of life. Conclusions MRgFUS neurosurgery is an effective and generally safe treatment option for moderate to severe, medication-refractory essential tremor. It provides a treatment option for people ineligible for invasive neurosurgery and offers a noninvasive option for all people considering neurosurgery. For people ineligible for invasive neurosurgery, MRgFUS neurosurgery is cost-effective compared with no surgery. In people eligible for invasive neurosurgery, MRgFUS neurosurgery may be one of several reasonable options. Publicly funding MRgFUS neurosurgery for the treatment of moderate to severe, medication-refractory essential tremor in Ontario at the current case load would have a net budget impact of about $1 million per year for the next 5 years. People with essential tremor who had undergone MRgFUS neurosurgery reported positive experiences. They liked that it was a noninvasive procedure and reported a substantial reduction in tremor that resulted in an improvement in their quality of life. PMID:29805721

One-year outcomes of women started on antiretroviral therapy during pregnancy before and after the implementation of Option B+ in Malawi: A retrospective chart review

PubMed Central

Kamuyango, Alfred A.; Hirschhorn, Lisa R; Wang, Wenjia; Jansen, Perry; Hoffman, Risa M.

2015-01-01

Objective To compare one-year outcomes of women started on antiretroviral therapy (ART) during pregnancy in the pre-Option B+ era to those in the Option B+ era. Methods A retrospective chart review was performed at three sites in Malawi. Women were included in the ‘pre-Option B+’ cohort if they started ART during pregnancy for a CD4 count < 350 cells/mm3 or WHO 3/4 condition and in the ‘Option B+’ cohort if they started ART during pregnancy regardless of CD4 count or clinical stage. One-year outcomes were compared using Fisher's exact and ANOVA F-tests. Results A higher proportion of women in the pre-Option B+ cohort started ART at WHO stage 3/4 (11.9% versus 1.1%, P < 0.001), switched ART regimens (5.9% versus 0%, P = 0.002), or died in the first year after starting treatment (3.9% versus .5%, P = 0.05). While more women in the Option B+ cohort had poor adherence or defaulted, these differences were not significant. Conclusions At our study sites, the transition to Option B+ has been associated with ART initiation in women with less advanced HIV infection, improved medication tolerability, and lower mortality. Further research is needed to better understand outcomes of Option B+. PMID:25774326

One-year outcomes of women started on antiretroviral therapy during pregnancy before and after the implementation of Option B+ in Malawi: A retrospective chart review.

PubMed

Kamuyango, Alfred A; Hirschhorn, Lisa R; Wang, Wenjia; Jansen, Perry; Hoffman, Risa M

2014-09-01

To compare one-year outcomes of women started on antiretroviral therapy (ART) during pregnancy in the pre-Option B+ era to those in the Option B+ era. A retrospective chart review was performed at three sites in Malawi. Women were included in the 'pre-Option B+' cohort if they started ART during pregnancy for a CD4 count < 350 cells/mm 3 or WHO 3/4 condition and in the 'Option B+' cohort if they started ART during pregnancy regardless of CD4 count or clinical stage. One-year outcomes were compared using Fisher's exact and ANOVA F-tests. A higher proportion of women in the pre-Option B+ cohort started ART at WHO stage 3/4 (11.9% versus 1.1%, P < 0.001), switched ART regimens (5.9% versus 0%, P = 0.002), or died in the first year after starting treatment (3.9% versus .5%, P = 0.05). While more women in the Option B+ cohort had poor adherence or defaulted, these differences were not significant. At our study sites, the transition to Option B+ has been associated with ART initiation in women with less advanced HIV infection, improved medication tolerability, and lower mortality. Further research is needed to better understand outcomes of Option B+.

Cost-effectiveness Analysis on Measures to Improve China's Coal-fired Industrial Boiler

DOE PAGES

Liu, Manzhi; Shen, Bo; Han, Yafeng; ...

2015-08-01

Tackling coal-burning industrial boiler is becoming one of the key programs to solve the environmental problem in China. Assessing the economics of various options to address coal-fired boiler is essential to identify cost-effective solutions. This paper discusses our work in conducting a cost-effectiveness analysis on various types of improvement measures ranging from energy efficiency retrofits to switch from coal to other fuels in China. Sensitivity analysis was also performed in order to understand the impacts of some economic factors such as discount rate and energy price on the economics of boiler improvement options. The results show that nine out ofmore » 14 solutions are cost-effective, and a lower discount rate and higher energy price will result in more energy efficiency measures being cost-effective. Both monetary and non-monetary barriers to energy-efficiency improvement are discussed and policies to tackle these barriers are recommended. Our research aims at providing a methodology to assess cost-effective solutions to boiler problems.« less

Professionals' and laypersons' appreciation of various options for Class III surgical correction.

PubMed

Fabré, M; Mossaz, C; Christou, P; Kiliaridis, S

2010-08-01

The objectives of this study were to evaluate the assessments of maxillofacial surgeons, orthodontists, and laypersons on the predicted aesthetic outcome of various surgical options in Class III correction and the associations between certain initial cephalometric values and the judges' preferred option. Pre-surgical lateral headfilms and coloured profile photographs of 18 skeletal Class III Caucasian adult patients (10 males and 8 females) with a mean age of 24.5 years were used. The headfilms were hand traced and digitized. Conventional cephalometric analysis was performed. Computerized predictions of three surgical options, mandibular setback, Le Fort I advancement, and bimaxillary surgery, were made. For each case, the pre-surgical profile photograph with the three predictions was presented on a printed page. The questionnaire was sent to 51 maxillofacial surgeons (response rate 45.1 per cent), 78 orthodontists (response rate 71.8 per cent), and 61 laypersons (response rate 100 per cent) to aesthetically evaluate the pre-surgical photographs and the surgical predictions by placing a mark along a 10-graded visual analogue scale (VAS) using a standard profile for calibration. Confidence interval was calculated for each patient. An independent samples t-test was used to detect initial cephalometric values associated with the judges' preferred option and analysis of variance/Tukey's honestly significant differences to evaluate differences between judges. Intra-observer reliability was assessed with a paired t-test. All treatment predictions led to improved scoring of facial aesthetics with the exception of the setback option for three patients. For 14 patients, general agreement for the preferred option existed between the three groups of judges. Laypersons tended to give lower improvement scores than professionals. Overjet, nasofacial, and nasomental angles were important in decision making between the mandibular setback and Le Fort I options (the more negative the overjet, the larger the nasofacial angle, the smaller the nasomental angle, the greater the preference for the Le Fort I option). Wits appraisal seemed to be important in decision making between the mandibular setback and bimaxillary options (the more negative the Wits appraisal, the greater the preference for the latter option).

Optimizing parameter choice for FSL-Brain Extraction Tool (BET) on 3D T1 images in multiple sclerosis.

PubMed

Popescu, V; Battaglini, M; Hoogstrate, W S; Verfaillie, S C J; Sluimer, I C; van Schijndel, R A; van Dijk, B W; Cover, K S; Knol, D L; Jenkinson, M; Barkhof, F; de Stefano, N; Vrenken, H

2012-07-16

Brain atrophy studies often use FSL-BET (Brain Extraction Tool) as the first step of image processing. Default BET does not always give satisfactory results on 3DT1 MR images, which negatively impacts atrophy measurements. Finding the right alternative BET settings can be a difficult and time-consuming task, which can introduce unwanted variability. To systematically analyze the performance of BET in images of MS patients by varying its parameters and options combinations, and quantitatively comparing its results to a manual gold standard. Images from 159 MS patients were selected from different MAGNIMS consortium centers, and 16 different 3DT1 acquisition protocols at 1.5 T or 3T. Before running BET, one of three pre-processing pipelines was applied: (1) no pre-processing, (2) removal of neck slices, or (3) additional N3 inhomogeneity correction. Then BET was applied, systematically varying the fractional intensity threshold (the "f" parameter) and with either one of the main BET options ("B" - bias field correction and neck cleanup, "R" - robust brain center estimation, or "S" - eye and optic nerve cleanup) or none. For comparison, intracranial cavity masks were manually created for all image volumes. FSL-FAST (FMRIB's Automated Segmentation Tool) tissue-type segmentation was run on all BET output images and on the image volumes masked with the manual intracranial cavity masks (thus creating the gold-standard tissue masks). The resulting brain tissue masks were quantitatively compared to the gold standard using Dice overlap coefficient (DOC). Normalized brain volumes (NBV) were calculated with SIENAX. NBV values obtained using for SIENAX other BET settings than default were compared to gold standard NBV with the paired t-test. The parameter/preprocessing/options combinations resulted in 20,988 BET runs. The median DOC for default BET (f=0.5, g=0) was 0.913 (range 0.321-0.977) across all 159 native scans. For all acquisition protocols, brain extraction was substantially improved for lower values of "f" than the default value. Using native images, optimum BET performance was observed for f=0.2 with option "B", giving median DOC=0.979 (range 0.867-0.994). Using neck removal before BET, optimum BET performance was observed for f=0.1 with option "B", giving median DOC 0.983 (range 0.844-0.996). Using the above BET-options for SIENAX instead of default, the NBV values obtained from images after neck removal with f=0.1 and option "B" did not differ statistically from NBV values obtained with gold-standard. Although default BET performs reasonably well on most 3DT1 images of MS patients, the performance can be improved substantially. The removal of the neck slices, either externally or within BET, has a marked positive effect on the brain extraction quality. BET option "B" with f=0.1 after removal of the neck slices seems to work best for all acquisition protocols. Copyright © 2012 Elsevier Inc. All rights reserved.

A Program Manager's Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs.

PubMed

Ryan, Gery W; Farmer, Carrie M; Adamson, David M; Weinick, Robin M

2014-01-01

Between 2001 and 2011, the U.S. Department of Defense has implemented numerous programs to support service members and their families in coping with the stressors from a decade of the longstanding conflicts in Iraq and Afghanistan. These programs, which address both psychological health and traumatic brain injury (TBI), number in the hundreds and vary in their size, scope, and target population. To ensure that resources are wisely invested and maximize the benefits of such programs, RAND developed a tool to help assess program performance, consider options for improvement, implement solutions, then assess whether the changes worked, with the intention of helping those responsible for managing or implementing programs to conduct assessments of how well the program is performing and to implement solutions for improving performance. Specifically, the tool is intended to provide practical guidance in program improvement and continuous quality improvement for all programs.

MontePython 3: Parameter inference code for cosmology

NASA Astrophysics Data System (ADS)

Brinckmann, Thejs; Lesgourgues, Julien; Audren, Benjamin; Benabed, Karim; Prunet, Simon

2018-05-01

MontePython 3 provides numerous ways to explore parameter space using Monte Carlo Markov Chain (MCMC) sampling, including Metropolis-Hastings, Nested Sampling, Cosmo Hammer, and a Fisher sampling method. This improved version of the Monte Python (ascl:1307.002) parameter inference code for cosmology offers new ingredients that improve the performance of Metropolis-Hastings sampling, speeding up convergence and offering significant time improvement in difficult runs. Additional likelihoods and plotting options are available, as are post-processing algorithms such as Importance Sampling and Adding Derived Parameter.

Eco-efficiency assessment of options for metal recovery from incineration residues: a conceptual framework.

PubMed

Meylan, Grégoire; Spoerri, Andy

2014-01-01

Residues from municipal solid waste (MSW) incineration in Switzerland have been a hot topic in recent years, both in the research and practice communities. Regarded by many as an economically and environmentally sound solution to this issue, technological retrofitting of existing grate incinerators has the dual purpose of enhancing the metal recovery of bottom and fly ashes and improving the inertization of residues to be landfilled. How does context influence the economic and environmental performance of this particular technological option? Under which conditions would this technological option be implemented nationwide in the future? What are stakeholders' views on sustainable transitions of MSW incineration? We propose a three-stage methodological procedure to address these questions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Electric Vehicle Battery Development Gains Momentum - Continuum Magazine

Science.gov Websites

to improve and accelerate battery design and boost EDV performance and consumer appeal - and chemistry, cell design, and battery pack options for particular vehicle platforms Factor in electrochemical separate, competitive, validated, and easy-to-use CAEBAT software tools for battery pack design. The three

Liberal Grading Improves Evaluations But Not Performance.

ERIC Educational Resources Information Center

Vasta, Ross; Sarmiento, Robert F.

Two grading distributions--a liberal and a more stringent curve--were compared between two sections of an undergraduate psychology course. The two classes were team taught and treated as similarly as possible. Four unit exams and an optional final were administered, with one section consistently receiving a more lenient grade distribution. No…

Geoexchange: Getting it Right

ERIC Educational Resources Information Center

Johnson, William C.; Ormond, Paul

2013-01-01

If properly installed, optimized geoexchange systems can be one of the most cost effective, powerful options to accomplish the goal of improved energy efficiency and reduced carbon emissions. Accurately quantifying field performance is an important step in designing a system that is the proper size and capacity. The authors share the real life…

Educational Charter Schools: A Civil Rights Mirage?

ERIC Educational Resources Information Center

Frankenberg, Erica

2011-01-01

The idea of charter schools arose as a means to allow for innovation by creating schools that were free from traditional regulations, but were held accountable for their performance. More recently, however, charter school advocates have suggested that increasing school choice options will create competition that improves the quality of education…

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

Some practical universal noiseless coding techniques, part 2

NASA Technical Reports Server (NTRS)

Rice, R. F.; Lee, J. J.

1983-01-01

This report is an extension of earlier work (Part 1) which provided practical adaptive techniques for the efficient noiseless coding of a broad class of data sources characterized by only partially known and varying statistics (JPL Publication 79-22). The results here, while still claiming such general applicability, focus primarily on the noiseless coding of image data. A fairly complete and self-contained treatment is provided. Particular emphasis is given to the requirements of the forthcoming Voyager II encounters of Uranus and Neptune. Performance evaluations are supported both graphically and pictorially. Expanded definitions of the algorithms in Part 1 yield a computationally improved set of options for applications requiring efficient performance at entropies above 4 bits/sample. These expanded definitions include as an important subset, a somewhat less efficient but extremely simple "FAST' compressor which will be used at the Voyager Uranus encounter. Additionally, options are provided which enhance performance when atypical data spikes may be present.

Mind the Gap: Summary of Window Residential Retrofit Solutions

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

Petersen, Joseph M.; Cort, Katherine A.; Widder, Sarah H.

Improving the insulation, solar heat gain, and infiltration characteristics of windows in a home has the potential to significantly improve the overall thermal performance by reducing heat transfer through the window and also by decreasing infiltration of outdoor air into the home. As approximately 43% of existing homes still have single-pane clear windows (~50 million houses) and millions of other homes have only double-pane clear windows (Cort 2013), improving window performance also presents a significant opportunity for energy savings in the residential sector. Today, various energy-saving window retrofit opportunities are available to homeowners, ranging from window coverings and storm panelsmore » to highly-insulating triple-pane R-5 window replacements. Many of these technologies have been evaluated in the field, in the “Lab Homes” at Pacific Northwest National Laboratory, and through modeling to prove their cost-effectiveness and performance in different climate regions. Recently, the Pacific Northwest’s Regional Technical Forum approved a utility measure for low- emissivity storm windows based on such data. This action represents a watershed moment for increasing the variety and prevalence of fenestration options in utility programs, especially for the low-income demographic. This paper will review various window retrofit options, the most recent field test and modeling data regarding their performance and cost-effectiveness, and discuss future rating efforts. This information is useful for utilities and energy-efficiency program managers to help effectively implement incentive measures for these technologies.« less

Modelled female sale options demonstrate improved profitability in northern beef herds.

PubMed

Niethe, G E; Holmes, W E

2008-12-01

To examine the impact of improving the average value of cows sold, the risk of decreasing the number weaned, and total sales on the profitability of northern Australian cattle breeding properties. Gather, model and interpret breeder herd performances and production parameters on properties from six beef-producing regions in northern Australia. Production parameters, prices, costs and herd structure were entered into a herd simulation model for six northern Australian breeding properties that spay females to enhance their marketing options. After the data were validated by management, alternative management strategies were modelled using current market prices and most likely herd outcomes. The model predicted a close relationship between the average sale value of cows, the total herd sales and the gross margin/adult equivalent. Keeping breeders out of the herd to fatten generally improves their sale value, and this can be cost-effective, despite the lower number of progeny produced and the subsequent reduction in total herd sales. Furthermore, if the price of culled cows exceeds the price of culled heifers, provided there are sufficient replacement pregnant heifers available to maintain the breeder herd nucleus, substantial gains in profitability can be obtained by decreasing the age at which cows are culled from the herd. Generalised recommendations on improving reproductive performance are not necessarily the most cost-effective strategy to improve breeder herd profitability. Judicious use of simulation models is essential to help develop the best turnoff strategies for females and to improve station profitability.

Fast Sealift and Maritime Prepositioning Options for Improving Sealift Capabilities

DTIC Science & Technology

1991-01-01

cargo ships with speeds of 22 to 25 knots as fas* The eight existing T- AKRs , which have a speed of 30... cargo than in the case of no ship attrition. 2.0 ---- Without -- attrition --- • attrition 0- 1.0- High -capacity Low-cost Improved MPS( A ) SES T- AKR ...fast sealift and maritime prepositioning ships and evaluates their performance in terms of speed and the ability to make cumulative cargo deliveries

Diesel plant retrofitting options to enhance decentralized electricity supply in Indonesia

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

Baring-Gould, E I; Barley, C D; Drouilhet, S

1997-09-01

Over the last 20 years, the government of Indonesia has undertaken an extensive program to provide electricity to the population of that country. The electrification of rural areas has been partially achieved through the use of isolated diesel systems, which account for about 20% of the country`s generated electricity. Due to many factors related to inefficient power production with diesels, the National Renewable Energy Laboratory, in conjunction with PLN, the Indonesian national utility, Community Power Corporation, and Idaho Power Company, analyzed options for retrofitting existing diesel power systems. This study considered the use of different combinations of advanced diesel control,more » the addition of wind generators, photovoltaics and batteries to reduce the systems of overall cost and fuel consumption. This analysis resulted in a general methodology for retrofitting diesel power systems. This paper discusses five different retrofitting options to improve the performance of diesel power systems. The systems considered in the Indonesian analysis are cited as examples for the options discussed.« less

Performance evaluation of GIM-TEC assimilation of the IRI-Plas model at two equatorial stations in the American sector

NASA Astrophysics Data System (ADS)

Adebiyi, S. J.; Adebesin, B. O.; Ikubanni, S. O.; Joshua, B. W.

2017-05-01

Empirical models of the ionosphere, such as the International Reference Ionosphere (IRI) model, play a vital role in evaluating the environmental effect on the operation of space-based communication and navigation technologies. The IRI extended to Plasmasphere (IRI-Plas) model can be adjusted with external data to update its electron density profile while still maintaining the overall integrity of the model representations. In this paper, the performance of the total electron content (TEC) assimilation option of the IRI-Plas at two equatorial stations, Jicamarca, Peru (geographic: 12°S, 77°W, dip angle 0.8°) and Cachoeira Paulista, Brazil (Geographic: 22.7°S, 45°W, dip angle -26°), is examined during quiet and disturbed conditions. TEC, F2 layer critical frequency (foF2), and peak height (hmF2) predicted when the model is operated without external input were used as a baseline in our model evaluation. Results indicate that TEC predicted by the assimilation option generally produced smaller estimation errors compared to the "no extra input" option during quiet and disturbed conditions. Generally, the error is smaller at the equatorial trough than near the crest for both quiet and disturbed days. With assimilation option, there is a substantial improvement of storm time estimations when compared with quiet time predictions. The improvement is, however, independent on storm's severity. Furthermore, the modeled foF2 and hmF2 are generally poor with TEC assimilation, particularly the hmF2 prediction, at the two locations during both quiet and disturbed conditions. Consequently, IRI-Plas model assimilated with TEC value only may not be sufficient where more realistic instantaneous values of peak parameters are required.

"The Types of Kids We Get Are Different"--The Distinguishing Characteristics of School Choosers in Detroit, Michigan

ERIC Educational Resources Information Center

Hamlin, Daniel

2018-01-01

Providing improved educational options for low-income African American families has been one of the primary objectives of the charter school movement. However, among demographically similar families, school choosers may possess subtle advantages compared to nonchoosers, leading to biased estimates of charter school performance in nonexperimental…

Window Insulation: How to Sort Through the Options.

ERIC Educational Resources Information Center

Miller, Barbara

This two-part report explores the efforts of businesses and individuals to improve the thermal performance of windows. Part I discusses the basics of what makes a window product insulate or save energy. Topic areas addressed include saving energy lost through windows, key components of window insulation, three basic types of window insulation,…

Improving Workplace-Based Assessment and Feedback by an E-Portfolio Enhanced with Learning Analytics

ERIC Educational Resources Information Center

van der Schaaf, Marieke; Donkers, Jeroen; Slof, Bert; Moonen-van Loon, Joyce; van Tartwijk, Jan; Driessen, Eric; Badii, Atta; Serban, Ovidiu; Ten Cate, Olle

2017-01-01

Electronic portfolios (E-portfolios) are crucial means for workplace-based assessment and feedback. Although E-portfolios provide a useful approach to view each learner's progress, so far options for personalized feedback and potential data about a learner's performances at the workplace often remain unexploited. This paper advocates that…

Meeting the needs of an ever-demanding market.

PubMed

Rigby, Richard

2002-04-01

Balancing cost and performance in packaging is critical. This article outlines techniques to assist in this whilst delivering added value and product differentiation. The techniques include a rigorous statistical process capable of delivering cost reduction and improved quality and a computer modelling process that can save time when validating new packaging options.

42 CFR 438.358 - Activities related to external quality review.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Validation of performance improvement projects required by the State to comply with requirements set forth in § 438.240(b)(1) and that were underway during the preceding 12 months. (2) Validation of MCO or PIHP... derived during the preceding 12 months from the following optional activities: (1) Validation of encounter...

42 CFR 438.358 - Activities related to external quality review.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Validation of performance improvement projects required by the State to comply with requirements set forth in § 438.240(b)(1) and that were underway during the preceding 12 months. (2) Validation of MCO or PIHP... derived during the preceding 12 months from the following optional activities: (1) Validation of encounter...

42 CFR 438.358 - Activities related to external quality review.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Validation of performance improvement projects required by the State to comply with requirements set forth in § 438.240(b)(1) and that were underway during the preceding 12 months. (2) Validation of MCO or PIHP... derived during the preceding 12 months from the following optional activities: (1) Validation of encounter...

42 CFR 438.358 - Activities related to external quality review.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Validation of performance improvement projects required by the State to comply with requirements set forth in § 438.240(b)(1) and that were underway during the preceding 12 months. (2) Validation of MCO or PIHP... derived during the preceding 12 months from the following optional activities: (1) Validation of encounter...

Long-term Results of an Analytical Assessment of Student Compounded Preparations

PubMed Central

Roark, Angie M.; Anksorus, Heidi N.

2014-01-01

Objective. To investigate the long-term (ie, 6-year) impact of a required remake vs an optional remake on student performance in a compounding laboratory course in which students’ compounded preparations were analyzed. Methods. The analysis data for several preparations made by students were compared for differences in the analyzed content of the active pharmaceutical ingredient (API) and the number of students who successfully compounded the preparation on the first attempt. Results. There was a consistent statistical difference in the API amount or concentration in 4 of the preparations (diphenhydramine, ketoprofen, metoprolol, and progesterone) in each optional remake year compared to the required remake year. As the analysis requirement was continued, the outcome for each preparation approached and/or attained the expected API result. Two preparations required more than 1 year to demonstrate a statistical difference. Conclusion. The analytical assessment resulted in a consistent, long-term improvement in student performance during the 5-year period after the optional remake policy was instituted. Our assumption is that investment in such an assessment would result in a similar benefits at other colleges and schools of pharmacy. PMID:26056402

Lunar lander and return propulsion system trade study

NASA Technical Reports Server (NTRS)

Hurlbert, Eric A.; Moreland, Robert; Sanders, Gerald B.; Robertson, Edward A.; Amidei, David; Mulholland, John

1993-01-01

This trade study was initiated at NASA/JSC in May 1992 to develop and evaluate main propulsion system alternatives to the reference First Lunar Outpost (FLO) lander and return-stage transportation system concept. Thirteen alternative configurations were developed to explore the impacts of various combinations of return stage propellants, using either pressure or pump-fed propulsion systems and various staging options. Besides two-stage vehicle concepts, the merits of single-stage and stage-and-a-half options were also assessed in combination with high-performance liquid oxygen and liquid hydrogen propellants. Configurations using an integrated modular cryogenic engine were developed to assess potential improvements in packaging efficiency, mass performance, and system reliability compared to non-modular cryogenic designs. The selection process to evaluate the various designs was the analytic hierarchy process. The trade study showed that a pressure-fed MMH/N2O4 return stage and RL10-based lander stage is the best option for a 1999 launch. While results of this study are tailored to FLO needs, the design date, criteria, and selection methodology are applicable to the design of other crewed lunar landing and return vehicles.

Thrust augmentation options for the Beta 2 two-stage-to-orbit vehicle

NASA Technical Reports Server (NTRS)

Snyder, Christopher A.

1993-01-01

NASA LeRC is continuing to study propulsion concepts for a horizontal takeoff and landing, fully reusable, two-stage-to-orbit vehicle. This will be capable of launching and returning a 10,000 pound payload to a 100 nautical mile polar orbit using low-risk technology. The vehicle, Beta 2, is a derivative of the USAF/Boeing Beta vehicle which was designed to deliver a 50,000 pound payload to a similar orbit. Beta 2 stages at Mach 6.5 and about 100,000 ft altitude. The propulsion system for the booster is an over/under turbine bypass engine/ramjet configuration. In this paper, several options for thrust augmentation were studied in order to improve the performance of this engine where there was a critical need. Options studies were turbine engine overspeed in the transonic region, water injection at a various turbine engine locations also during the transonic region, and water injection at the turbine engine face during high speed operation. The methodology, constraints, propulsion performance, and mission study results are presented.

Long-term Results of an Analytical Assessment of Student Compounded Preparations.

PubMed

Roark, Angie M; Anksorus, Heidi N; Shrewsbury, Robert P

2014-11-15

To investigate the long-term (ie, 6-year) impact of a required remake vs an optional remake on student performance in a compounding laboratory course in which students' compounded preparations were analyzed. The analysis data for several preparations made by students were compared for differences in the analyzed content of the active pharmaceutical ingredient (API) and the number of students who successfully compounded the preparation on the first attempt. There was a consistent statistical difference in the API amount or concentration in 4 of the preparations (diphenhydramine, ketoprofen, metoprolol, and progesterone) in each optional remake year compared to the required remake year. As the analysis requirement was continued, the outcome for each preparation approached and/or attained the expected API result. Two preparations required more than 1 year to demonstrate a statistical difference. The analytical assessment resulted in a consistent, long-term improvement in student performance during the 5-year period after the optional remake policy was instituted. Our assumption is that investment in such an assessment would result in a similar benefits at other colleges and schools of pharmacy.

Anaerobic digestion of thermal-alkaline-pretreated cephalosporin bacterial residues for methane production.

PubMed

Li, Guixia; Zhong, Weizhang; Wang, Rui; Chen, Jiaqi; Li, Zaixing

2017-08-01

Optimum anaerobic conditions of cephalosporin bacterial residues after thermal-alkaline pretreatment were determined by orthogonal experiments. And through biochemical methane potential tests (BMPs) for cephalosporin bacterial residues, the ability for bacterial degradation of cephalosporin was also evaluated. The thermal-alkaline pretreatment with the optimum values of 6% NaOH at 105 °C for 15 min significantly improved digestion performance. With the thermal-alkaline pretreatment, the specific methane yield of the pretreated cephalosporin bacterial residue increased by 254.79% compared with that of the un-pretreated cephalosporin bacterial residue. The results showed that anaerobic digestion of thermal-alkaline-pretreated cephalosporin bacterial residues could be one of the options for efficient methane production and waste treatment. This work investigates the thermal-alkaline pretreatment of cephalosporin bacterial residues, which can increase their methane yield by 254.79% compared with no pretreatment. The digestion performance is significantly improved under the condition of 6% NaOH at 105 °C for 15 min. The results show that anaerobic digestion of thermal-alkaline-pretreated cephalosporin bacterial residues could be one of the options for efficient methane production and waste treatment.

Utilization of waste heat in trucks for increased fuel economy

NASA Technical Reports Server (NTRS)

Leising, C. J.; Purohit, G. P.; Degrey, S. P.; Finegold, J. G.

1978-01-01

The waste heat utilization concepts include preheating, regeneration, turbocharging, turbocompounding, and Rankine engine compounding. Predictions are based on fuel-air cycle analyses, computer simulation, and engine test data. All options are evaluated in terms of maximum theoretical improvements, but the Diesel and adiabatic Diesel are also compared on the basis of maximum expected improvement and expected improvement over a driving cycle. The study indicates that Diesels should be turbocharged and aftercooled to the maximum possible level. The results reveal that Diesel driving cycle performance can be increased by 20% through increased turbocharging, turbocompounding, and Rankine engine compounding. The Rankine engine compounding provides about three times as much improvement as turbocompounding but also costs about three times as much. Performance for either can be approximately doubled if applied to an adiabatic Diesel.

Adapting to a Changing Colorado River: Making Future Water Deliveries More Reliable Through Robust Management Strategies

NASA Astrophysics Data System (ADS)

Groves, D.; Bloom, E.; Fischbach, J. R.; Knopman, D.

2013-12-01

The U.S. Bureau of Reclamation and water management agencies representing the seven Colorado River Basin States initiated the Colorado River Basin Study in January 2010 to evaluate the resiliency of the Colorado River system over the next 50 years and compare different options for ensuring successful management of the river's resources. RAND was asked to join this Basin Study Team in January 2012 to help develop an analytic approach to identify key vulnerabilities in managing the Colorado River basin over the coming decades and to evaluate different options that could reduce this vulnerability. Using a quantitative approach for planning under uncertainty called Robust Decision Making (RDM), the RAND team assisted the Basin Study by: identifying future vulnerable conditions that could lead to imbalances that could cause the basin to be unable to meet its water delivery objectives; developing a computer-based tool to define 'portfolios' of management options reflecting different strategies for reducing basin imbalances; evaluating these portfolios across thousands of future scenarios to determine how much they could improve basin outcomes; and analyzing the results from the system simulations to identify key tradeoffs among the portfolios. This talk will describe RAND's contribution to the Basin Study, focusing on the methodologies used to to identify vulnerabilities for Upper Basin and Lower Basin water supply reliability and to compare portfolios of options. Several key findings emerged from the study. Future Streamflow and Climate Conditions Are Key: - Vulnerable conditions arise in a majority of scenarios where streamflows are lower than historical averages and where drought conditions persist for eight years or more. - Depending where the shortages occur, problems will arise for delivery obligations for the upper river basin and the lower river basin. The lower river basin is vulnerable to a broader range of plausible future conditions. Additional Investments in Infrastructure and Efficiency Could Improve Performance and Reduce Risk: - Different portfolios of water-supply and demand-reduction options offer performance trade-offs. - Different types of options in the portfolios, such as conservation, desalination, or water banking, would affect future outcomes and costs of implementation. - Analysis of all the portfolios identified important near-term, high-priority options that should be implemented in the near future, including municipal, industrial, and agricultural conservation. Other Solutions May Be Required: - If future hydrologic conditions develop in a manner consistent with the more pessimistic projections, the Basin is increasingly likely to face vulnerable conditions. The region may need to consider additional management options.

Magnetic suspension and balance system advanced study

NASA Technical Reports Server (NTRS)

Boom, R. W.; Eyssa, Y. M.; Mcintosh, G. E.; Abdelsalam, M. K.

1985-01-01

An improved compact design for a superconducting magnetic suspension and balance system for an 8 ft. x 8 ft. transonic wind tunnel is developed. The original design of an MSBS in NASA Cr-3802 utilized 14 external superconductive coils and a superconductive solenoid in the airplane test model suspended in a wind tunnel. The improvements are in the following areas: test model solenoid options, dynamic force limits on the model, magnet cooling options, structure and cryogenic designs, power supply specifications, and cost and performance evaluations. The improvements are: MSBS cost reduction of 28%, weight; reduction of 43%, magnet system ampere-meter reduction of 38%, helium liquifier capacity reduction by 33%, magnet system stored energy reduction by 55%, AC loss to liquid helium reduced by 76%, system power supply reduced by 68%, test coil pole strength increased by 19%, wing magnetization increased by 40%, and control frequency limit increased by 200% from 10 Hz to 30 Hz. The improvements are due to: magnetic holmium coil forms in the test model, better rare earth permanent magnets in the wings, fiberglass-epoxy structure replacing stainless steel, better coil configuration, and new saddle roll coil design.

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.

Speech perception for adult cochlear implant recipients in a realistic background noise: effectiveness of preprocessing strategies and external options for improving speech recognition in noise.

PubMed

Gifford, René H; Revit, Lawrence J

2010-01-01

Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects' preferred listening programs as well as with the addition of either Beam preprocessing (Cochlear Corporation) or the T-Mic accessory option (Advanced Bionics). In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested "Everyday," "Noise," and "Focus" preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Options available in current cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise with both Cochlear Corporation and Advanced Bionics systems. For Cochlear Corporation recipients, Focus preprocessing yields the best speech-recognition performance in a complex listening environment; however, it is recommended that Noise preprocessing be used as the new default for everyday listening environments to avoid the need for switching programs throughout the day. For Advanced Bionics recipients, the T-Mic offers significantly improved performance in noise and is recommended for everyday use in all listening environments. American Academy of Audiology.

A multicriteria decision analysis of augmentative treatment of upper limbs in persons with tetraplegia.

PubMed

Hummel, J M Marjan; Snoek, Govert J; van Til, Janine A; van Rossum, Wouter; Ijzerman, Maarten J

2005-01-01

This study supported the evaluation by a rehabilitation team of the performance of two treatment options that improve the arm-hand function in subjects with sixth cervical vertebra (C6) level Motor Group 2 tetraplegia. The analytic hierarchy process, a technique for multicriteria decision analysis, was used by a rehabilitation team and potential recipients to quantitatively compare a new technology, Functional Elec trical Stimulation (FES), with conventional surgery. Perform-ance was measured by functional improvement, treatment load, risks, user-friendliness, and social outcomes. Functional improvement after FES was considered better than that after conventional surgery. However, the rehabilitation team's overall rating for conventional surgery was slightly higher than that for FES (57% vs 44%). Compared with the rehabilitation team, potential recipients gave greater weight to burden of treatment and less weight to functional improvement. This study shows that evaluation of new technology must be more comprehensive than the evaluation of functional improvement alone, and that patient preferences may differ from those of the rehabilitation team.

Chronic orchialgia: Review of treatments old and new

PubMed Central

Tojuola, Bayo; Layman, Jeffrey; Kartal, Ibrahim; Gudelogul, Ahmet; Brahmbhatt, Jamin; Parekattil, Sijo

2016-01-01

Introduction: Chronic orchialgia is historically and currently a challenging disease to treat. It is a diagnostic and therapeutic challenge for physicians. Conservative therapy has served as the first line of treatment. For those who fail conservative therapy, surgical intervention may be required. We aim to provide a review of currently available surgical options and novel surgical treatment options. Methods: A review of current literature was performed using PubMed. Literature discussing treatment options for chronic orchialgia were identified. The following search terms were used to identify literature that was relevant to this review: Chronic orchialgia, testicular pain, scrotal content pain, and microsurgical denervation of the spermatic cord (MDSC). Results: The incidence of chronic orchialgia has been increasing over time. In the USA, it affects up to 100,000 men per year due to varying etiologies. The etiology of chronic orchialgia can be a confounding problem. Conservative therapy should be viewed as the first line therapy. Studies have reported poor success rates. Current surgical options for those who fail conservative options include varicocelectomy, MDSC, epididymectomy, and orchiectomy. Novel treatment options include microcryoablation of the peri-spermatic cord, botox injection, and amniofix injection. Conclusion: Chronic orchialgia has been and will continue to be a challenging disease to treat due to its multiple etiologies and variable treatment outcomes. Further studies are needed to better understand the problem. Treatment options for patients with chronic orchialgia are improving. Additional studies are warranted to better understand the long-term durability of this treatment options. PMID:26941490

Does training with 3D videos improve decision-making in team invasion sports?

PubMed

Hohmann, Tanja; Obelöer, Hilke; Schlapkohl, Nele; Raab, Markus

2016-01-01

We examined the effectiveness of video-based decision training in national youth handball teams. Extending previous research, we tested in Study 1 whether a three-dimensional (3D) video training group would outperform a two-dimensional (2D) group. In Study 2, a 3D training group was compared to a control group and a group trained with a traditional tactic board. In both studies, training duration was 6 weeks. Performance was measured in a pre- to post-retention design. The tests consisted of a decision-making task measuring quality of decisions (first and best option) and decision time (time for first and best option). The results of Study 1 showed learning effects and revealed that the 3D video group made faster first-option choices than the 2D group, but differences in the quality of options were not pronounced. The results of Study 2 revealed learning effects for both training groups compared to the control group, and faster choices in the 3D group compared to both other groups. Together, the results show that 3D video training is the most useful tool for improving choices in handball, but only in reference to decision time and not decision quality. We discuss the usefulness of a 3D video tool for training of decision-making skills outside the laboratory or gym.

Gastroesophageal Reflux Management with the LINX® System for Gastroesophageal Reflux Disease Following Laparoscopic Sleeve Gastrectomy.

PubMed

Desart, Kenneth; Rossidis, Georgios; Michel, Michael; Lux, Tamara; Ben-David, Kfir

2015-10-01

Laparoscopic sleeve gastrectomy (LSG) has gained significant popularity in the USA, and consequently resulted in patients experiencing new-onset gastroesophageal reflux disease (GERD) following this bariatric procedure. Patients with GERD refractory to medical therapy present a more challenging situation limiting the surgical options to further treat the de novo GERD symptoms since the gastric fundus to perform a fundoplication is no longer an option. The aim of this study is to determine if the LINX® magnetic sphincter augmentation system is a safe and effective option for patients with new gastroesophageal reflux disease following laparoscopic sleeve gastrectomy. This study was conducted at the University Medical Center. This is a retrospective review of seven consecutive patients who had a laparoscopic LINX® magnetic sphincter device placement for patients with refractory gastroesophageal reflux disease after laparoscopic sleeve gastrectomy between July 2014 and April 2015. All patients were noted to have self-reported greatly improved gastroesophageal reflux symptoms 2-4 weeks after their procedure. They were all noted to have statistically significant improved severity and frequency of their reflux, regurgitation, epigastric pain, sensation of fullness, dysphagia, and cough symptoms in their postoperative GERD symptoms compared with their preoperative evaluation. This is the first reported pilot case series, illustrating that the LINX® device is a safe and effective option in patients with de novo refractory gastroesophageal reflux disease after a laparoscopic sleeve gastrectomy despite appropriate weight loss.

Summit on Improving the Economics of America's Nuclear Power Plants

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

Collins, John; Mason, Charles

The Summit on Improving the Economics of America’s Nuclear Power Plants was convened May 19, 2016, by Secretary of Energy Ernest Moniz and co-sponsored by Idaho Senator Mike Crapo to stress the importance of existing nuclear reactors in meeting our nation’s energy goals. The summit was also designed to identify and discuss policy options that can be pursued at federal and state levels to address economic challenges, as well as technical options that utilities can use to improve the economic competitiveness of operating nuclear power plants (NPPs) and avoid early plant retirements that are driven by temporary market conditions. Themore » owners of NPPs face difficult economic decisions and are working to improve the performance of existing NPPs. However, it soon became clear that some of the actions taken by states and regional markets have had an impact on the economic viability of existing power plants, including carbon free NPPs. Summit speakers identified concepts and actions that could be taken at state and federal levels to improve the economics of the existing fleet within these regulated and restructured electricity markets. This report summarizes the speeches, concepts, and actions taken.« less

Numerical performance and throughput benchmark for electronic structure calculations in PC-Linux systems with new architectures, updated compilers, and libraries.

PubMed

Yu, Jen-Shiang K; Hwang, Jenn-Kang; Tang, Chuan Yi; Yu, Chin-Hui

2004-01-01

A number of recently released numerical libraries including Automatically Tuned Linear Algebra Subroutines (ATLAS) library, Intel Math Kernel Library (MKL), GOTO numerical library, and AMD Core Math Library (ACML) for AMD Opteron processors, are linked against the executables of the Gaussian 98 electronic structure calculation package, which is compiled by updated versions of Fortran compilers such as Intel Fortran compiler (ifc/efc) 7.1 and PGI Fortran compiler (pgf77/pgf90) 5.0. The ifc 7.1 delivers about 3% of improvement on 32-bit machines compared to the former version 6.0. Performance improved from pgf77 3.3 to 5.0 is also around 3% when utilizing the original unmodified optimization options of the compiler enclosed in the software. Nevertheless, if extensive compiler tuning options are used, the speed can be further accelerated to about 25%. The performances of these fully optimized numerical libraries are similar. The double-precision floating-point (FP) instruction sets (SSE2) are also functional on AMD Opteron processors operated in 32-bit compilation, and Intel Fortran compiler has performed better optimization. Hardware-level tuning is able to improve memory bandwidth by adjusting the DRAM timing, and the efficiency in the CL2 mode is further accelerated by 2.6% compared to that of the CL2.5 mode. The FP throughput is measured by simultaneous execution of two identical copies of each of the test jobs. Resultant performance impact suggests that IA64 and AMD64 architectures are able to fulfill significantly higher throughput than the IA32, which is consistent with the SpecFPrate2000 benchmarks.

An intercalated BSc degree is associated with higher marks in subsequent medical school examinations.

PubMed

Cleland, Jennifer A; Milne, Andrew; Sinclair, Hazel; Lee, Amanda J

2009-05-19

To compare medical students on a modern MBChB programme who did an optional intercalated degree with their peers who did not intercalate; in particular, to monitor performance in subsequent undergraduate degree exams. This was a retrospective, observational study of anonymised databases of medical student assessment outcomes. Data were accessed for graduates, University of Aberdeen Medical School, Scotland, UK, from the years 2003 to 2007 (n = 861). The main outcome measure was marks for summative degree assessments taken after intercalating. Of 861 medical students, 154 (17.9%) students did an intercalated degree. After adjustment for cohort, maturity, gender and baseline (3rd year) performance in matching exam type, having done an IC degree was significantly associated with attaining high (18-20) common assessment scale (CAS) marks in three of the six degree assessments occurring after the IC students rejoined the course: the 4th year written exam (p < 0.001), 4th year OSCE (p = 0.001) and the 5th year Elective project (p = 0.010). Intercalating was associated with improved performance in Years 4 and 5 of the MBChB. This improved performance will further contribute to higher academic ranking for Foundation Year posts. Long-term follow-up is required to identify if doing an optional intercalated degree as part of a modern medical degree is associated with following a career in academic medicine.

An intercalated BSc degree is associated with higher marks in subsequent medical school examinations

PubMed Central

Cleland, Jennifer A; Milne, Andrew; Sinclair, Hazel; Lee, Amanda J

2009-01-01

Background To compare medical students on a modern MBChB programme who did an optional intercalated degree with their peers who did not intercalate; in particular, to monitor performance in subsequent undergraduate degree exams. Methods This was a retrospective, observational study of anonymised databases of medical student assessment outcomes. Data were accessed for graduates, University of Aberdeen Medical School, Scotland, UK, from the years 2003 to 2007 (n = 861). The main outcome measure was marks for summative degree assessments taken after intercalating. Results Of 861 medical students, 154 (17.9%) students did an intercalated degree. After adjustment for cohort, maturity, gender and baseline (3rd year) performance in matching exam type, having done an IC degree was significantly associated with attaining high (18–20) common assessment scale (CAS) marks in three of the six degree assessments occurring after the IC students rejoined the course: the 4th year written exam (p < 0.001), 4th year OSCE (p = 0.001) and the 5th year Elective project (p = 0.010). Conclusion Intercalating was associated with improved performance in Years 4 and 5 of the MBChB. This improved performance will further contribute to higher academic ranking for Foundation Year posts. Long-term follow-up is required to identify if doing an optional intercalated degree as part of a modern medical degree is associated with following a career in academic medicine. PMID:19454007

A noise power spectrum study of a new model-based iterative reconstruction system: Veo 3.0.

PubMed

Li, Guang; Liu, Xinming; Dodge, Cristina T; Jensen, Corey T; Rong, X John

2016-09-08

The purpose of this study was to evaluate performance of the third generation of model-based iterative reconstruction (MBIR) system, Veo 3.0, based on noise power spectrum (NPS) analysis with various clinical presets over a wide range of clinically applicable dose levels. A CatPhan 600 surrounded by an oval, fat-equivalent ring to mimic patient size/shape was scanned 10 times at each of six dose levels on a GE HD 750 scanner. NPS analysis was performed on images reconstructed with various Veo 3.0 preset combinations for comparisons of those images reconstructed using Veo 2.0, filtered back projection (FBP) and adaptive statistical iterative reconstruc-tion (ASiR). The new Target Thickness setting resulted in higher noise in thicker axial images. The new Texture Enhancement function achieved a more isotropic noise behavior with less image artifacts. Veo 3.0 provides additional reconstruction options designed to allow the user choice of balance between spatial resolution and image noise, relative to Veo 2.0. Veo 3.0 provides more user selectable options and in general improved isotropic noise behavior in comparison to Veo 2.0. The overall noise reduction performance of both versions of MBIR was improved in comparison to FBP and ASiR, especially at low-dose levels. © 2016 The Authors.

How Charter Schools Do, and Don't, Inspire Change in Traditional Public School Districts

ERIC Educational Resources Information Center

Linick, Matthew; Lubienski, Christopher

2013-01-01

For some, charter schools represent the hope of improved student learning and performance. It is hoped to understand the theory of change underlying charter schools relative to the actual evidence on their impact. In order to address this issue, the authors examine the logic of organizational change and competitive options, drawing on evidence…

Whose Choice? Student Experiences and Outcomes in the New Orleans School Marketplace. Research Brief

ERIC Educational Resources Information Center

Adamson, Frank; Cook-Harvey, Channa; Darling-Hammond, Linda

2015-01-01

As charters and other public and private schools of choice have created a new landscape in many urban areas across the country, some districts have adopted the idea of creating "portfolios" of options. Central to the philosophy of a portfolio district is continuous improvement, as lowest-performing schools are transformed or replaced. In…

75 FR 10873 - Energy Conservation Program: Energy Conservation Standards for Small Electric Motors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

... design option to be technologically feasible if it is in use by the respective industry or if research.... Baseline Motor Performance 3. Higher Efficiency Motor Designs a. Electrical Steel b. Thermal Analysis c... a variety of provisions designed to improve energy efficiency. Part A of Title III (42 U.S.C. 6291...

Whose Choice?: Student Experiences and Outcomes in the New Orleans School Marketplace

ERIC Educational Resources Information Center

Adamson, Frank; Cook-Harvey, Channa; Darling-Hammond, Linda

2015-01-01

As charters and other public and private schools of choice have created a new landscape in many urban areas across the country, some districts have adopted the idea of creating "portfolios" of options. Central to the philosophy of a portfolio district is continuous improvement, as lowest-performing schools are transformed or replaced.…

Risk Informed Margins Management as part of Risk Informed Safety Margin Characterization

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

Curtis Smith

2014-06-01

The ability to better characterize and quantify safety margin is important to improved decision making about Light Water Reactor (LWR) design, operation, and plant life extension. A systematic approach to characterization of safety margins and the subsequent margin management options represents a vital input to the licensee and regulatory analysis and decision making that will be involved. In addition, as research and development in the LWR Sustainability (LWRS) Program and other collaborative efforts yield new data, sensors, and improved scientific understanding of physical processes that govern the aging and degradation of plant SSCs needs and opportunities to better optimize plantmore » safety and performance will become known. To support decision making related to economics, readability, and safety, the Risk Informed Safety Margin Characterization (RISMC) Pathway provides methods and tools that enable mitigation options known as risk informed margins management (RIMM) strategies.« less

JT8D engine performance retention

NASA Technical Reports Server (NTRS)

James, A. D.; Weisel, D. R.

1981-01-01

The attractive performance retention characteristics of the JT8D engine are described. Because of its moderate bypass ratio and turbine temperature, and stiff structural design, the performance retention versus flight cycles of the JT8D engine sets a standard that is difficult for other engines to equal. In addition, the significant benefits of refurbishment of the JT8D engine are presented. Cold section refurbishment offers thrust specific fuel consumption improvements of up to 2 percent and payback in less than a year, making a very attractive investment option for the airlines.

Silicon Solar Cell Efficiency Improvement Employing the Photoluminescent, Down-Shifting Effects of Carbon and CdTe Quantum Dots (Open Access Publisher’s Version)

DTIC Science & Technology

2016-03-21

ORIGINAL PAPER Silicon solar cell efficiency improvement employing the photoluminescent, down-shifting effects of carbon and CdTe quantum dots Elias...smaller influence on solar cell performance, they are con- sidered to be a more attractive option due to their afford- ability and minimal impact in the...Photovoltaics Solar cells Introduction There is a generalized trend to demonstrate higher solar cell efficiency with more affordable devices to promote

Influence of 2D and 3D view on performance and time estimation in minimal invasive surgery.

PubMed

Blavier, A; Nyssen, A S

2009-11-01

This study aimed to evaluate the impact of two-dimensional (2D) and three-dimensional (3D) images on time performance and time estimation during a surgical motor task. A total of 60 subjects without any surgical experience (nurses) and 20 expert surgeons performed a fine surgical task with a new laparoscopic technology (da Vinci robotic system). The 80 subjects were divided into two groups, one using 3D view option and the other using 2D view option. We measured time performance and asked subjects to verbally estimate their time performance. Our results showed faster performance in 3D than in 2D view for novice subjects while the performance in 2D and 3D was similar in the expert group. We obtained a significant interaction between time performance and time evaluation: in 2D condition, all subjects accurately estimated their time performance while they overestimated it in the 3D condition. Our results emphasise the role of 3D in improving performance and the contradictory feeling about time evaluation in 2D and 3D. This finding is discussed in regard with the retrospective paradigm and suggests that 2D and 3D images are differently processed and memorised.

ENGINEL: A single rotor turbojet engine cycle match performance program

NASA Technical Reports Server (NTRS)

Lovell, W. A.

1977-01-01

ENGINEL is a computer program which was developed to generate the design and off-design performance of a single rotor turbojet engine with or without afterburning using a cycle match procedure. It is capable of producing engine performance over a wide range of altitudes and Mach numbers. The flexibility, of operating with a variable geometry turbine, for improved off-design fuel consumption or with a fixed geometry turbine as in conventional turbojets, has been incorporated. In addition, the option of generation engine performance with JP4, liquid hydrogen or methane as fuel is provided.

A New Technique for Surgical Treatment of Proximal Hamstring Tendinopathy in a Triathlon Athlete.

PubMed

Costa, Lincoln Paiva; Barros, Antônio Augusto Guimarães; Vassalo, Carlos Cesar; Sonnery-Cottet, Bertrand; Barbosa, Victor Atsushi Kasuya; Temponi, Eduardo Frois

2016-01-01

Proximal hamstring tendinopathy (PHT) is the result of chronic overload caused by repetitive eccentric contraction. Surgical treatment becomes an option for patients with chronic symptoms that do not respond to conservative treatment. This report describes a case of a 48-year-old man, an amateur triathlete, with deep gluteal pain in the left hip for 12 months, leading to a decline in sports performance. Magnetic resonance imaging revealed abnormalities that suggested a PHT. Surgery was indicated following the failure of conservative treatments. Debridement of the conjoint tendon and its reinsertion associated with semimembranosus tenotomy showed good results and is thus an option for the treatment of this pathology after 12 months of follow-up. This article provides surgeons with a new surgical option for this debilitating condition with clinical and functional improvement after 12 months of follow-up.

A New Technique for Surgical Treatment of Proximal Hamstring Tendinopathy in a Triathlon Athlete

PubMed Central

Costa, Lincoln Paiva; Barros, Antônio Augusto Guimarães; Vassalo, Carlos Cesar; Sonnery-Cottet, Bertrand; Barbosa, Victor Atsushi Kasuya; Temponi, Eduardo Frois

2016-01-01

Introduction: Proximal hamstring tendinopathy (PHT) is the result of chronic overload caused by repetitive eccentric contraction. Surgical treatment becomes an option for patients with chronic symptoms that do not respond to conservative treatment. Case Report: This report describes a case of a 48-year-old man, an amateur triathlete, with deep gluteal pain in the left hip for 12 months, leading to a decline in sports performance. Magnetic resonance imaging revealed abnormalities that suggested a PHT. Surgery was indicated following the failure of conservative treatments. Debridement of the conjoint tendon and its reinsertion associated with semimembranosus tenotomy showed good results and is thus an option for the treatment of this pathology after 12 months of follow-up. Conclusion: This article provides surgeons with a new surgical option for this debilitating condition with clinical and functional improvement after 12 months of follow-up. PMID:28507970

The engineering options for mitigating the climate impacts of aviation.

PubMed

Williams, Victoria

2007-12-15

Aviation is a growing contributor to climate change, with unique impacts due to the altitude of emissions. If existing traffic growth rates continue, radical engineering solutions will be required to prevent aviation becoming one of the dominant contributors to climate change. This paper reviews the engineering options for mitigating the climate impacts of aviation using aircraft and airspace technologies. These options include not only improvements in fuel efficiency, which would reduce carbon dioxide (CO2) emissions, but also measures to reduce non-CO2 impacts including the formation of persistent contrails. Integrated solutions to optimize environmental performance will require changes to airframes, engines, avionics, air traffic control systems and airspace design. While market-based measures, such as offset schemes and emissions trading, receive growing attention, this paper sets out the crucial role of engineering in the challenge to develop a 'green air traffic system'.

Assessing CO2 Mitigation Options Utilizing Detailed Electricity Characteristics and Including Renewable Generation

NASA Astrophysics Data System (ADS)

Bensaida, K.; Alie, Colin; Elkamel, A.; Almansoori, A.

2017-08-01

This paper presents a novel techno-economic optimization model for assessing the effectiveness of CO2 mitigation options for the electricity generation sub-sector that includes renewable energy generation. The optimization problem was formulated as a MINLP model using the GAMS modeling system. The model seeks the minimization of the power generation costs under CO2 emission constraints by dispatching power from low CO2 emission-intensity units. The model considers the detailed operation of the electricity system to effectively assess the performance of GHG mitigation strategies and integrates load balancing, carbon capture and carbon taxes as methods for reducing CO2 emissions. Two case studies are discussed to analyze the benefits and challenges of the CO2 reduction methods in the electricity system. The proposed mitigations options would not only benefit the environment, but they will as well improve the marginal cost of producing energy which represents an advantage for stakeholders.

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.

CAM-SE: A scalable spectral element dynamical core for the Community Atmosphere Model.

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

Dennis, John; Edwards, Jim; Evans, Kate J

2012-01-01

The Community Atmosphere Model (CAM) version 5 includes a spectral element dynamical core option from NCAR's High-Order Method Modeling Environment. It is a continuous Galerkin spectral finite element method designed for fully unstructured quadrilateral meshes. The current configurations in CAM are based on the cubed-sphere grid. The main motivation for including a spectral element dynamical core is to improve the scalability of CAM by allowing quasi-uniform grids for the sphere that do not require polar filters. In addition, the approach provides other state-of-the-art capabilities such as improved conservation properties. Spectral elements are used for the horizontal discretization, while most othermore » aspects of the dynamical core are a hybrid of well tested techniques from CAM's finite volume and global spectral dynamical core options. Here we first give a overview of the spectral element dynamical core as used in CAM. We then give scalability and performance results from CAM running with three different dynamical core options within the Community Earth System Model, using a pre-industrial time-slice configuration. We focus on high resolution simulations of 1/4 degree, 1/8 degree, and T340 spectral truncation.« less

Research into telecommunications options for people with physical disabilities.

PubMed

Nguyen, Toan; Garrett, Rob; Downing, Andrew; Walker, Lloyd; Hobbs, David

2007-01-01

People with a disability do not have equitable access to the modern telecommunication medium. Many experience difficulty typing, handling the phone, dialing, or answering calls. For those who are unable to speak, the only option is to type messages using whatever functional control site exists on their body. The provision of accessible mobile phones for people with disabilities can significantly improve their quality of life through an increased range of accessible activities, and mobile phones can improve their independence, safety, security and self-esteem. This research was aimed at providing practical ways for people with a disability to participate in the extensive community of home and mobile phone users. The outcomes of 10 participants taking part in the evaluation and trial of off-the-shelf telecommunication options are presented. Nine out of 10 participants showed high to very high results in terms of their overall performance and satisfaction with the use of the telecommunication equipment provided. With the processes and support covering equipment matching, education, training, and delivery, current off-the-shelf solutions can help people with disabilities to effectively communicate with other members of our society and to access the same range of information systems and services enjoyed by able-bodied members of the community.

Flexibility in Flood Management Design: Proactive Planning Under Climate Change Uncertainty

NASA Astrophysics Data System (ADS)

Smet, K.; de Neufville, R.; van der Vlist, M.

2015-12-01

This paper presents an innovative, value-enhancing procedure for effective planning and design of long-lived flood management infrastructure given uncertain future flooding threats due to climate change. Designing infrastructure that can be adapted over time is a method to safeguard the efficacy of current design decisions given uncertainty about rates and future impacts of climate change. This paper explores the value of embedding "options" in a physical structure, where an option is the right but not the obligation to do something at a later date (e.g. over-dimensioning a floodwall foundation now facilitates a future height addition in response to observed increases in sea level; building of extra pump bays in a pumping station now enables the addition of pumping capacity whenever increased precipitation warrants an expansion.) The proposed procedure couples a simulation model that captures future climate induced changes to the hydrologic operating environment of a structure, with an economic model that estimates the lifetime economic performance of alternative investments. The economic model uses Real "In" Options analysis, a type of cash flow analysis that quantifies the implicit value of options and the flexibility they provide. This procedure is demonstrated using replacement planning for the multi-functional pumping station IJmuiden on the North Sea Canal in the Netherlands. Flexibility in design decisions is modelled, varying the size and specific options included in the new structure. Results indicate that the incorporation of options within the structural design has the potential to improve its economic performance, as compared to more traditional, "build it once and build it big" designs where flexibility is not an explicit design criterion. The added value resulting from the incorporation of flexibility varies with the range of future conditions considered, as well as the options examined. This procedure could be applied more broadly to explore investment strategies for the design of other flood management structures.

Flexibility in flood management design: proactive planning under uncertainty

NASA Astrophysics Data System (ADS)

Smet, K.; de Neufville, R.; van der Vlist, M.

2016-12-01

This paper presents a value-enhancing approach for proactive planning and design of long-lived flood management infrastructure given uncertain future flooding threats. Designing infrastructure that can be adapted over time is a method to safeguard the efficacy of current design decisions given future uncertainties. We explore the value of embedding "options" in a physical structure, where an option is the right but not the obligation to do something at a later date (e.g. over-dimensioning a floodwall foundation now facilitates a future height addition in response to observed increases in sea level; building extra pump bays in a drainage pumping station enables the easy addition of pumping capacity whenever increased precipitation warrants an expansion.) The proposed approach couples a simulation model that captures future climate induced changes to the hydrologic operating environment of a structure, with an economic model that estimates the lifetime economic performance of alternative investment strategies. The economic model uses Real "In" Options analysis, a type of cash flow analysis that quantifies the implicit value of options and the flexibility they provide. We demonstrate the approach using replacement planning for the multi-functional pumping station IJmuiden on the North Sea Canal in the Netherlands. The analysis models flexibility in design decisions, varying the size and specific options included in the new structure. Results indicate that the incorporation of options within the structural design has the potential to improve its economic performance, as compared to more traditional, "build it once and build it big" designs where flexibility is not an explicit design criterion. The added value resulting from the incorporation of flexibility varies with the range of future conditions considered, and the specific options examined. This approach could be applied to explore investment strategies for the design of other flood management structures, as well as be expanded to look more at flexibility within an infrastructure network rather than a single structure. Flexibility in flood management design:proactive planning under uncertainty

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.

Public Health Analysis Transport Optimization Model v. 1.0

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

Beyeler, Walt; Finley, Patrick; Walser, Alex

PHANTOM models logistic functions of national public health systems. The system enables public health officials to visualize and coordinate options for public health surveillance, diagnosis, response and administration in an integrated analytical environment. Users may simulate and analyze system performance applying scenarios that represent current conditions or future contingencies what-if analyses of potential systemic improvements. Public health networks are visualized as interactive maps, with graphical displays of relevant system performance metrics as calculated by the simulation modeling components.

Intrauterine transfusion and non-invasive treatment options for hemolytic disease of the fetus and newborn - review on current management and outcome.

PubMed

Zwiers, Carolien; van Kamp, Inge; Oepkes, Dick; Lopriore, Enrico

2017-04-01

Hemolytic disease of the fetus and newborn (HDFN) remains a serious pregnancy complication which can lead to severe fetal anemia, hydrops and perinatal death. Areas covered: This review focusses on the current prenatal management, treatment with intrauterine transfusion (IUT) and promising non-invasive treatment options for HDFN. Expert commentary: IUTs are the cornerstone in prenatal management of HDFN and have significantly improved perinatal outcome in the past decades. IUT is now a relatively safe procedure, however the risk of complications is still high when performed early in the second trimester. Non-invasive management using intravenous immunoglobulin may be a safe alternative and requires further investigation.

Shuttle Liquid Fly Back Booster Configuration Options

NASA Technical Reports Server (NTRS)

Healy, T. J., Jr.

1998-01-01

This paper surveys the basic configuration options available to a Liquid Fly Back Booster (LFBB), integrated with the Space Shuttle system. The background of the development of the LFBB concept is given. The influence of the main booster engine (BME) installations and the Fly Back Engine (FBE) installation on the aerodynamic configurations are also discussed. Limits on the LFBB configuration design space imposed by the existing Shuttle flight and ground elements are also described. The objective of the paper is to put the constrains and design space for an LFBB in perspective. The object of the work is to define LFBB configurations that significantly improve safety, operability, reliability and performance of the Shuttle system and dramatically lower operations costs.

Testing rank-dependent utility theory for health outcomes.

PubMed

Oliver, Adam

2003-10-01

Systematic violations of expected utility theory (EU) have been reported in the context of both money and health outcomes. Rank-dependent utility theory (RDU) is currently the most popular and influential alternative theory of choice under circumstances of risk. This paper reports a test of the descriptive performance of RDU compared to EU in the context of health. When one of the options is certain, violations of EU that can be explained by RDU are found. When both options are risky, no evidence that RDU is a descriptive improvement over EU is found, though this finding may be due to the low power of the tests. Copyright 2002 John Wiley & Sons, Ltd.

Surgical versus nonsurgical treatment of lumbar degenerative kyphosis.

PubMed

Goh, Tae Sik; Shin, Jong Ki; Youn, Myung Soo; Lee, Hong Seok; Kim, Taek Hoon; Lee, Jung Sub

2017-08-01

Surgery is widely performed for lumbar degenerative kyphosis (LDK), but its effectiveness as compared with nonsurgical treatment has not been demonstrated. In this prospective study, surgical candidates with LDK were enrolled at three spine centres. Two treatment options were performed either surgery using a pedicle subtraction osteotomy or nonsurgical care. Outcomes were measured using a Visual analogue scale (VAS) of back pain as a primary endpoint, the Oswestry disability index (ODI), the 36-item short-form health survey (SF-36), sagittal vertical axis (SVA) and treatment-related complications. Of the 126 LDK patients treated during the reference period, 97 patients were enrolled (47 in the surgical group and 50 in the nonsurgical group). Surgical group produced statistically reduced VAS of back pain and better functional outcomes than nonsurgical group since 12 months after treatment, but the rate of serious complications was higher after surgery. Interestingly, both surgical and nonsurgical groups had improved outcomes in terms of pain intensity and function at the 2-year follow-up period. Surgery might be a preferred treatment option for LDK, but great caution is needed. And conservative treatment could be the considerable treatment option for LDK who is unwilling or has poor medical condition to operate.

Cleaner production options for reducing industrial waste: the case of batik industry in Malang, East Java-Indonesia

NASA Astrophysics Data System (ADS)

Sirait, M.

2018-01-01

The aim of this research is to conduct cleaner production options for improving the environmental performance during the production of batik industry, the case of UKM batik, Malang, East Java. Batik industry is one of small and medium textile industry which has contribution to economic growth in Malang. However, during production the batik, it generates wastewater that has potential to decrease the environmental performance. Wastewater from Celaket batik industry has BOD, COD, TSS, and pH level is far larger than the threshold of water quality standard as a result of use chemical substance during the dyes processing. In order to prevent generating wastewater, this study utilized cleaner production options, such as substitution of input material.Substitution of input material for dyes process was implemented by replacement chemical dyes (e.g.indigosol, nafthol, rapid) with natural dyes (e.g. Indigofero Tintoria). Modifying of technology/equipment was conducted by developing wastewater treatment equipment to reduce waste of batik production. The implementation of this strategy was carried out by changing input material from chemical dyes with natural dyes. The CP uptake could reduce significantly the environmental impact in term of reduction of COD, BOD, and TSS.

School Restructuring Options Under No Child Left Behind: "What Works When?" Reopening as a Charter School

ERIC Educational Resources Information Center

Center for Comprehensive School Reform and Improvement, 2005

2005-01-01

Several years after the passage of the No Child Left Behind Act of 2001 (NCLB), there are persistently low-performing schools in every state that face increasingly strong consequences for failing to improve student achievement sufficiently. In particular, schools that fail to make adequate yearly progress (AYP) for five consecutive years must…

P.L. 110-140, "Energy Independence and Security Act of 2007" (2007)

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

None

2007-12-13

An act to move the United States toward greater energy independence and security, to increase the production of clean renewable fuels, to protect consumers, to increase the efficiency of products, buildings, and vehicles, to promote research on and deploy greenhouse gas capture and storage options, and to improve the energy performance of the Federal Government, and for other purposes.

Comparative Study Of Resonator Optics For Lidar Applications

NASA Technical Reports Server (NTRS)

Tratt, David M.; Menzies, Robert T.

1992-01-01

Report discusses overall transmit/receive performances of laser-radar transceivers. Gaussian case and hard-edged case selected for comparison because of their practical importance. Intercomparison shows that for multi-joule-output pulsed CO2 lasers, Gaussian profiled optics offers little improvement over hard-edged option, while greater hardiness and superior energy extraction capability of latter constitutes strong argument in favor of its application.

Grading technologies for the manufacture of innovative cutting blades

NASA Astrophysics Data System (ADS)

Rostek, Tim; Homberg, Werner

2018-05-01

Cutting blades for harvesting applications are used in a variety of agricultural machines. These parts are in contact with highly abrasive lawn clippings and often wear out within hours which results in high expensive re-sharpening maintenance. This paper relates to manufacturing techniques enhancing the durability of cutting blades based on a structural analysis of the prevailing wear mechanisms containing chipping and abrasive wear. Each mechanism results in specific demands on the cutting edge's mechanical characteristics. The design of evaluation methods respectively is one issue of the paper. This is basis for approaches to improve the cutting edge performance on purpose. On option to improve abrasive wear resistance and, thus, service life is the application of locally graded steel materials as semi-finished products for self-sharpening cutting blades. These materials comprise a layered structure consisting of a hard, wear resistant layer and a relatively softer layer which is lesser wear resistant. As the cutting blade is subjected to wear conditions, the less wear resistant layer wears faster than the relatively more wear resistant harder layer revealing a durable cross section of the cutting edge and, thus, cutting performance. Anyways, chipping is another key issue on the cutting edge's lifetime. Here, the cutting edges cross section by means of geometry and grind respectively as well as its mechanical properties matter. FEM analysis reveal innovative options to optimize the cross section of the blade as well as thermomechanical strengthening add further strength to reduce chipping. This paper contains a comprehensive strategy to improve cutting blades with use of innovative manufacturing technologies which apply application-specific graded mechanical characteristics and, thus, significantly improved performance characteristics.

Using an Optionally Piloted Aircraft for Airborne Gravity Observations with the NOAA GRAV-D Project

NASA Astrophysics Data System (ADS)

Youngman, M.; Johnson, J. A.; van Westrum, D.; Damiani, T.

2017-12-01

The U.S. National Geodetic Survey's (NGS) Gravity for the Redefintion of the American Vertical Datum (GRAV-D) project is collecting airborne gravity data to support a 1 cm geoid. Started in 2008, this project will collect airborne gravity data over the entire U.S. and territories by 2022. As of June 30, 2017, the project was almost 62% complete. With recent technological developments, NGS has been exploring using unmanned aircraft for airborne gravity measurements. This presentation will focus on results from two surveys over the U.S. Appalachian and Rocky Mountains using the Aurora Centaur Optionally Piloted Aircraft and the Micro-g Lacoste Turnkey Airborne Gravimeter System 7 (TAGS7). Collecting high quality data as well as dealing with remote locations has been a challenge for the GRAV-D project and the field of airborne gravity in general. Unmanned aircraft could potentially improve data quality, handle hard to reach locations, and reduce pilot fatigue. The optionally piloted Centaur aircraft is an attractive option because it is not restricted in U.S. airspace and delivers high quality gravity data. Specifically, the Centaur meets U.S. Federal Aviation Administration regulations for Unmanned Aircraft Systems (UAS) by using a safety pilot on board to maintain line of sight and the ability to take control in the event of an emergency. Even though this is a sizeable UAS, most traditional gravimeters are too large and heavy for the platform. With a smaller and lighter design, the TAGS7 was used for its ability to conform to the aircraft's size restrictions, with the added benefit of upgraded performance capabilities. Two surveys were performed with this aircraft and gravimeter, one in April and one in August to September of 2017. Initial results indicate that the high-gain, fast response of the Centaur autopilot (optimized for flights without passengers), coupled with the full-force feedback sensor of the TAGS7, provides superior performance in all conditions, and allows for acquisition in periods of higher turbulence that were inaccessible before. Based on these surveys this technology has the potential to improve data quality and decrease costs of airborne gravity surveying.

Item response analysis of the Positive and Negative Syndrome Scale

PubMed Central

Santor, Darcy A; Ascher-Svanum, Haya; Lindenmayer, Jean-Pierre; Obenchain, Robert L

2007-01-01

Background Statistical models based on item response theory were used to examine (a) the performance of individual Positive and Negative Syndrome Scale (PANSS) items and their options, (b) the effectiveness of various subscales to discriminate among individual differences in symptom severity, and (c) the appropriateness of cutoff scores recently recommended by Andreasen and her colleagues (2005) to establish symptom remission. Methods Option characteristic curves were estimated using a nonparametric item response model to examine the probability of endorsing each of 7 options within each of 30 PANSS items as a function of standardized, overall symptom severity. Our data were baseline PANSS scores from 9205 patients with schizophrenia or schizoaffective disorder who were enrolled between 1995 and 2003 in either a large, naturalistic, observational study or else in 1 of 12 randomized, double-blind, clinical trials comparing olanzapine to other antipsychotic drugs. Results Our analyses show that the majority of items forming the Positive and Negative subscales of the PANSS perform very well. We also identified key areas for improvement or revision in items and options within the General Psychopathology subscale. The Positive and Negative subscale scores are not only more discriminating of individual differences in symptom severity than the General Psychopathology subscale score, but are also more efficient on average than the 30-item total score. Of the 8 items recently recommended to establish symptom remission, 1 performed markedly different from the 7 others and should either be deleted or rescored requiring that patients achieve a lower score of 2 (rather than 3) to signal remission. Conclusion This first item response analysis of the PANSS supports its sound psychometric properties; most PANSS items were either very good or good at assessing overall severity of illness. These analyses did identify some items which might be further improved for measuring individual severity differences or for defining remission thresholds. Findings also suggest that the Positive and Negative subscales are more sensitive to change than the PANSS total score and, thus, may constitute a "mini PANSS" that may be more reliable, require shorter administration and training time, and possibly reduce sample sizes needed for future research. PMID:18005449

Real options analysis for land use management: Methods, application, and implications for policy.

PubMed

Regan, Courtney M; Bryan, Brett A; Connor, Jeffery D; Meyer, Wayne S; Ostendorf, Bertram; Zhu, Zili; Bao, Chenming

2015-09-15

Discounted cash flow analysis, including net present value is an established way to value land use and management investments which accounts for the time-value of money. However, it provides a static view and assumes passive commitment to an investment strategy when real world land use and management investment decisions are characterised by uncertainty, irreversibility, change, and adaptation. Real options analysis has been proposed as a better valuation method under uncertainty and where the opportunity exists to delay investment decisions, pending more information. We briefly review the use of discounted cash flow methods in land use and management and discuss their benefits and limitations. We then provide an overview of real options analysis, describe the main analytical methods, and summarize its application to land use investment decisions. Real options analysis is largely underutilized in evaluating land use decisions, despite uncertainty in policy and economic drivers, the irreversibility and sunk costs involved. New simulation methods offer the potential for overcoming current technical challenges to implementation as demonstrated with a real options simulation model used to evaluate an agricultural land use decision in South Australia. We conclude that considering option values in future policy design will provide a more realistic assessment of landholder investment decision making and provide insights for improved policy performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sex differences in the use of social information emerge under conditions of risk.

PubMed

Brand, Charlotte O; Brown, Gillian R; Cross, Catharine P

2018-01-01

Social learning provides an effective route to gaining up-to-date information, particularly when information is costly to obtain asocially. Theoretical work predicts that the willingness to switch between using asocial and social sources of information will vary between individuals according to their risk tolerance. We tested the prediction that, where there are sex differences in risk tolerance, altering the variance of the payoffs of using asocial and social information differentially influences the probability of social information use by sex. In a computer-based task that involved building a virtual spaceship, men and women ( N  = 88) were given the option of using either asocial or social sources of information to improve their performance. When the asocial option was risky (i.e., the participant's score could markedly increase or decrease) and the social option was safe (i.e., their score could slightly increase or remain the same), women, but not men, were more likely to use the social option than the asocial option. In all other conditions, both women and men preferentially used the asocial option to a similar degree. We therefore found both a sex difference in risk aversion and a sex difference in the preference for social information when relying on asocial information was risky, consistent with the hypothesis that levels of risk-aversion influence the use of social information.

Sex differences in the use of social information emerge under conditions of risk

PubMed Central

Brand, Charlotte O.; Brown, Gillian R.

2018-01-01

Social learning provides an effective route to gaining up-to-date information, particularly when information is costly to obtain asocially. Theoretical work predicts that the willingness to switch between using asocial and social sources of information will vary between individuals according to their risk tolerance. We tested the prediction that, where there are sex differences in risk tolerance, altering the variance of the payoffs of using asocial and social information differentially influences the probability of social information use by sex. In a computer-based task that involved building a virtual spaceship, men and women (N = 88) were given the option of using either asocial or social sources of information to improve their performance. When the asocial option was risky (i.e., the participant’s score could markedly increase or decrease) and the social option was safe (i.e., their score could slightly increase or remain the same), women, but not men, were more likely to use the social option than the asocial option. In all other conditions, both women and men preferentially used the asocial option to a similar degree. We therefore found both a sex difference in risk aversion and a sex difference in the preference for social information when relying on asocial information was risky, consistent with the hypothesis that levels of risk-aversion influence the use of social information. PMID:29312821

Speech Perception for Adult Cochlear Implant Recipients in a Realistic Background Noise: Effectiveness of Preprocessing Strategies and External Options for Improving Speech Recognition in Noise

PubMed Central

Gifford, René H.; Revit, Lawrence J.

2014-01-01

Background Although cochlear implant patients are achieving increasingly higher levels of performance, speech perception in noise continues to be problematic. The newest generations of implant speech processors are equipped with preprocessing and/or external accessories that are purported to improve listening in noise. Most speech perception measures in the clinical setting, however, do not provide a close approximation to real-world listening environments. Purpose To assess speech perception for adult cochlear implant recipients in the presence of a realistic restaurant simulation generated by an eight-loudspeaker (R-SPACE™) array in order to determine whether commercially available preprocessing strategies and/or external accessories yield improved sentence recognition in noise. Research Design Single-subject, repeated-measures design with two groups of participants: Advanced Bionics and Cochlear Corporation recipients. Study Sample Thirty-four subjects, ranging in age from 18 to 90 yr (mean 54.5 yr), participated in this prospective study. Fourteen subjects were Advanced Bionics recipients, and 20 subjects were Cochlear Corporation recipients. Intervention Speech reception thresholds (SRTs) in semidiffuse restaurant noise originating from an eight-loudspeaker array were assessed with the subjects’ preferred listening programs as well as with the addition of either Beam™ preprocessing (Cochlear Corporation) or the T-Mic® accessory option (Advanced Bionics). Data Collection and Analysis In Experiment 1, adaptive SRTs with the Hearing in Noise Test sentences were obtained for all 34 subjects. For Cochlear Corporation recipients, SRTs were obtained with their preferred everyday listening program as well as with the addition of Focus preprocessing. For Advanced Bionics recipients, SRTs were obtained with the integrated behind-the-ear (BTE) mic as well as with the T-Mic. Statistical analysis using a repeated-measures analysis of variance (ANOVA) evaluated the effects of the preprocessing strategy or external accessory in reducing the SRT in noise. In addition, a standard t-test was run to evaluate effectiveness across manufacturer for improving the SRT in noise. In Experiment 2, 16 of the 20 Cochlear Corporation subjects were reassessed obtaining an SRT in noise using the manufacturer-suggested “Everyday,” “Noise,” and “Focus” preprocessing strategies. A repeated-measures ANOVA was employed to assess the effects of preprocessing. Results The primary findings were (i) both Noise and Focus preprocessing strategies (Cochlear Corporation) significantly improved the SRT in noise as compared to Everyday preprocessing, (ii) the T-Mic accessory option (Advanced Bionics) significantly improved the SRT as compared to the BTE mic, and (iii) Focus preprocessing and the T-Mic resulted in similar degrees of improvement that were not found to be significantly different from one another. Conclusion Options available in current cochlear implant sound processors are able to significantly improve speech understanding in a realistic, semidiffuse noise with both Cochlear Corporation and Advanced Bionics systems. For Cochlear Corporation recipients, Focus preprocessing yields the best speech-recognition performance in a complex listening environment; however, it is recommended that Noise preprocessing be used as the new default for everyday listening environments to avoid the need for switching programs throughout the day. For Advanced Bionics recipients, the T-Mic offers significantly improved performance in noise and is recommended for everyday use in all listening environments. PMID:20807480

Comparing species decisions in a dichotomous choice task: adjusting task parameters improves performance in monkeys.

PubMed

Prétôt, Laurent; Bshary, Redouan; Brosnan, Sarah F

2016-07-01

In comparative psychology, both similarities and differences among species are studied to better understand the evolution of their behavior. To do so, we first test species in tasks using similar procedures, but if differences are found, it is important to determine their underlying cause(s) (e.g., are they due to ecology, cognitive ability, an artifact of the study, and/or some other factor?). In our previous work, primates performed unexpectedly poorly on an apparently simple two-choice discrimination task based on the natural behavior of cleaner fish, while the fish did quite well. In this task, if the subjects first chose one of the options (ephemeral) they received both food items, but if they chose the other (permanent) option first, the ephemeral option disappeared. Here, we test several proposed explanations for primates' relatively poorer performance. In Study 1, we used a computerized paradigm that differed from the previous test by removing interaction with human experimenters, which may be distracting, and providing a more standardized testing environment. In Study 2, we adapted the computerized paradigm from Study 1 to be more relevant to primate ecology. Monkeys' overall performance in these adapted tasks matched the performance of the fish in the original study, showing that with the appropriate modifications they can solve the task. We discuss these results in light of comparative research, which requires balancing procedural similarity with considerations of how the details of the task or the context may influence how different species perceive and solve tasks differently.

Regression modeling of particle size distributions in urban storm water: advancements through improved sample collection methods

USGS Publications Warehouse

Fienen, Michael N.; Selbig, William R.

2012-01-01

A new sample collection system was developed to improve the representation of sediment entrained in urban storm water by integrating water quality samples from the entire water column. The depth-integrated sampler arm (DISA) was able to mitigate sediment stratification bias in storm water, thereby improving the characterization of suspended-sediment concentration and particle size distribution at three independent study locations. Use of the DISA decreased variability, which improved statistical regression to predict particle size distribution using surrogate environmental parameters, such as precipitation depth and intensity. The performance of this statistical modeling technique was compared to results using traditional fixed-point sampling methods and was found to perform better. When environmental parameters can be used to predict particle size distributions, environmental managers have more options when characterizing concentrations, loads, and particle size distributions in urban runoff.

Towards Design of Sustainable Energy Systems in Developing Countries: Centralized and Localized Options

NASA Astrophysics Data System (ADS)

Kursun, Berrin

Energy use in developing countries is projected to equal and exceed the demand in developed countries in the next five years. Growing concern about environmental problems, depletion and price fluctuation of fossil fuels pushes the efforts for meeting energy demand in an environmentally friendly and sustainable way. Hence, it is essential to design energy systems consisting of centralized and localized options that generate the optimum energy mix to meet this increasing energy demand in a sustainable manner. In this study, we try to answer the question, "How can the energy demand in Rampura village be met sustainably?" via two centralized clean coal (CCC) technology and three localized energy technology options analyzed. We perform the analysis of these energy technologies through joint use of donor-side analysis technique emergy analysis (EA) and user-side analysis technique life cycle assessment (LCA). Sustainability of such an energy combination depends on its reliance on renewable inputs rather than nonrenewable or purchased inputs. CCC technologies are unsustainable energy systems dependent on purchased external inputs almost 100%. However, increased efficiency and significantly lower environmental impacts of CCC technologies can lead to more environmentally benign utilization of coal as an energy source. CCC technologies supply electricity at a lower price compared to the localized energy options investigated. Localized energy options analyzed include multi-crystalline solar PV, floating drum biogas digester and downdraft biomass gasifier. Solar PV has the lowest water and land use, however, solar electricity has the highest price with a high global warming potential (GWP). Contrary to general opinion, solar electricity is highly non-renewable. Although solar energy is a 100% renewable natural resource, materials utilized in the production of solar panels are mostly non-renewable purchased inputs causing the low renewability of solar electricity. Best sustainability results are obtained for full capacity operation in anaerobic digestion and for single fuel mode (SFM) operation in biomass gasification. For both of the processes, cost of electricity reduces 2-3 times if they are operated properly. However, there is not enough ipomea to run the biomass gasifier in SFM in Rampura, hence optimum operation scheme is ideal dual fuel mode (DFM) operation for the biomass gasifier analyzed. Emergy analysis of Rampura village and its subsystems reveal that sustainability is not achieved both at the village and in the subsystems levels since they are highly dependent on non-renewable material and energy inputs. To improve the overall sustainability in Rampura, dependency on purchased inputs fodder, fertilizer and diesel, non-renewable cooking fuel wood should be reduced. In satisfying energy demand in Rampura, biogas cooking and 70% biogas cooking scenarios perform better than electricity options in all of the objectives considered. Other than minimum land and water use objectives, electricity-RM and electricity-GM scenarios overlap and do not have a significant difference in terms of performance. Based on these results, the best option to meet the energy demand in Rampura would be to meet all the cooking energy with direct use of biogas. However, 70% biogas cooking scenario may be a more practical option since it both satisfies energy demand in an environmentally benign manner and satisfies the cultural needs of Rampura people. When 30% of cooking is performed by utilizing improved biomass cook stoves in the traditional way, the biogas potential becomes enough to meet all the remaining energy demand (70% of cooking, lighting and irrigation) in Rampura, hence energy security and reliability are ensured. Furthermore, utilizing biogas for cooking enables more agricultural residues to be available as fodder and eases the pressure on environment due to excessive woody biomass harvesting. Additionally, CH4 emissions from cow dung are avoided via production of biogas while the sanitation improves in the area. The GHG emissions related to cooking with inefficient cook stoves are also significantly mitigated through the use of biogas and improved biomass cook stoves. Energy demand in developing countries is subject to increase with increasing prosperity and consumerism. This increasing energy demand will necessitate the utilization of centralized energy options even in the rural areas of developing countries in the near future. Utilizing centralized clean coal technologies to meet this demand can ease energy related environmental problems, especially global warming significantly. And, adopting conscious and renewable energy oriented consumption patterns, avoiding consumption beyond the carrying capacity of these regions can contribute to achieve global level sustainability and ease the environmental burdens and problems in the developing countries.

Furthering the Validity of a Tool to Assess Simulated Pregnancy Options Counseling Skills.

PubMed

Lupi, Carla; Ward-Peterson, Melissa; Coxe, Stefany; Minor, Suzanne; Eliacin, Irmanie; Obeso, Vivian

2016-10-01

To further the validity of a tool to assess nondirective pregnancy options counseling skills. Using a cross-sectional design, we explored four sources of construct validity evidence for an objective structured clinical examination for training and assessment of nondirective pregnancy options counseling: content, response process, internal structure, and relations to other variables. Content of the previously developed tool was enhanced through input from five family medicine educators. The objective structured clinical examination was implemented in a family medicine clerkship with third-year medical students from 2014 to 2015 using trained raters. Response process was addressed after a pilot round. Three new raters evaluated videotapes of 46 performances. Cronbach's alpha, intraclass correlation coefficients, and Spearman's rho were estimated with 95% confidence intervals. The content validity was affirmed. Cronbach's alpha was 0.71. According to Landis and Koch's criteria, all but two items unique to the clinical situation of pregnancy options counseling generated substantial to perfect agreement (0.62-1.00). Relations to other variables within the checklist were strong, ranging from 0.66 to 0.87. This tool for assessing pregnancy options counseling skills has excellent content and strong internal structure. Further work to improve the Global Rating Scale may be necessary for summative use.

Factors associated with retention in Option B+ in Malawi: a case control study.

PubMed

Hoffman, Risa M; Phiri, Khumbo; Parent, Julie; Grotts, Jonathan; Elashoff, David; Kawale, Paul; Yeatman, Sara; Currier, Judith S; Schooley, Alan

2017-04-27

There are limited data on factors associated with retention in Option B+. We sought to explore the characteristics of women retained in Option B+ in Malawi, with a focus on the role of HIV disclosure, awareness of partner HIV status, and knowledge around the importance of Option B+ for maternal-child health. Methods We performed a case-control study of HIV-infected women in Malawi initiated on antiretroviral therapy (ART) under Option B+. Cases were enrolled if they met criteria for default from Option B+ (out of ART for >60 days), and controls were enrolled in approximately 3:1 ratio if they were retained in care for at least 12 months. We surveyed socio-demographic characteristics, HIV disclosure and awareness of partner HIV status, self-report about receiving pre-ART education, and knowledge of Option B+. Univariate logistic regression was performed to determine factors associated with retention. Multivariate logistic regression model was used to evaluate the relationship between HIV disclosure, Option B+ knowledge, and retention after adjusting for age, schooling, and travel time to clinic. We enrolled 50 cases and 153 controls. Median age was 30 years (interquartile range (IQR) 25-34), and the majority (82%) initiated ART during pregnancy at a median gestational age of 24 weeks (IQR 16-28). Ninety-one per cent of the cases (39/43) who started ART during pregnancy defaulted by three months postpartum. HIV disclosure to the primary sex partner was more common among women retained in care (100% versus 78%, p  < 0.001). Odds of retention were significantly higher among women with: age >25 years (odds ratio (OR) 2.44), completion of primary school (OR 3.06), awareness of partner HIV status (OR 5.20), pre-ART education (OR 6.17), higher number of correct answers to Option B+ knowledge questions (OR 1.82), and support while taking ART (OR 3.65). Pre-ART education and knowledge were significantly correlated ( r  = 0.43, p  < 0.001). In multivariate analysis, awareness of partner HIV status (OR 4.07, 95% confidence interval (CI) 1.51-10.94, p  = 0.02) and Option B+ knowledge (OR 1.60, 95% CI 1.15-2.23, p  = 0.004) remained associated with retention. Interventions that address partner disclosure and strengthen pre-ART education around the benefits of ART for maternal and child health should be evaluated to improve retention in Malawi's Option B+ programme.

Factors associated with retention in Option B+ in Malawi: a case control study

PubMed Central

Hoffman, Risa M; Phiri, Khumbo; Parent, Julie; Grotts, Jonathan; Elashoff, David; Kawale, Paul; Yeatman, Sara; Currier, Judith S; Schooley, Alan

2017-01-01

Abstract Introduction: There are limited data on factors associated with retention in Option B+. We sought to explore the characteristics of women retained in Option B+ in Malawi, with a focus on the role of HIV disclosure, awareness of partner HIV status, and knowledge around the importance of Option B+ for maternal–child health. Methods: We performed a case-control study of HIV-infected women in Malawi initiated on antiretroviral therapy (ART) under Option B+. Cases were enrolled if they met criteria for default from Option B+ (out of ART for >60 days), and controls were enrolled in approximately 3:1 ratio if they were retained in care for at least 12 months. We surveyed socio-demographic characteristics, HIV disclosure and awareness of partner HIV status, self-report about receiving pre-ART education, and knowledge of Option B+. Univariate logistic regression was performed to determine factors associated with retention. Multivariate logistic regression model was used to evaluate the relationship between HIV disclosure, Option B+ knowledge, and retention after adjusting for age, schooling, and travel time to clinic. Results: We enrolled 50 cases and 153 controls. Median age was 30 years (interquartile range (IQR) 25–34), and the majority (82%) initiated ART during pregnancy at a median gestational age of 24 weeks (IQR 16–28). Ninety-one per cent of the cases (39/43) who started ART during pregnancy defaulted by three months postpartum. HIV disclosure to the primary sex partner was more common among women retained in care (100% versus 78%, p < 0.001). Odds of retention were significantly higher among women with: age >25 years (odds ratio (OR) 2.44), completion of primary school (OR 3.06), awareness of partner HIV status (OR 5.20), pre-ART education (OR 6.17), higher number of correct answers to Option B+ knowledge questions (OR 1.82), and support while taking ART (OR 3.65). Pre-ART education and knowledge were significantly correlated (r = 0.43, p < 0.001). In multivariate analysis, awareness of partner HIV status (OR 4.07, 95% confidence interval (CI) 1.51–10.94, p = 0.02) and Option B+ knowledge (OR 1.60, 95% CI 1.15–2.23, p = 0.004) remained associated with retention. Conclusions: Interventions that address partner disclosure and strengthen pre-ART education around the benefits of ART for maternal and child health should be evaluated to improve retention in Malawi’s Option B+ programme. PMID:28453243

Fast reactor core concepts to improve transmutation efficiency

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

Fujimura, Koji; Kawashima, Katsuyuki; Itooka, Satoshi

Fast Reactor (FR) core concepts to improve transmutation efficiency were conducted. A heterogeneous MA loaded core was designed based on the 1000MWe-ABR breakeven core. The heterogeneous MA loaded core with Zr-H loaded moderated targets had a better transmutation performance than the MA homogeneous loaded core. The annular pellet rod design was proposed as one of the possible design options for the MA target. It was shown that using annular pellet MA rods mitigates the self-shielding effect in the moderated target so as to enhance the transmutation rate.

Generating Options for Active Risk Control (GO-ARC): introducing a novel technique.

PubMed

Card, Alan J; Ward, James R; Clarkson, P John

2014-01-01

After investing significant amounts of time and money in conducting formal risk assessments, such as root cause analysis (RCA) or failure mode and effects analysis (FMEA), healthcare workers are left to their own devices in generating high-quality risk control options. They often experience difficulty in doing so, and tend toward an overreliance on administrative controls (the weakest category in the hierarchy of risk controls). This has important implications for patient safety and the cost effectiveness of risk management operations. This paper describes a before and after pilot study of the Generating Options for Active Risk Control (GO-ARC) technique, a novel tool to improve the quality of the risk control options generation process. The quantity, quality (using the three-tiered hierarchy of risk controls), variety, and novelty of risk controls generated. Use of the GO-ARC technique was associated with improvement on all measures. While this pilot study has some notable limitations, it appears that the GO-ARC technique improved the risk control options generation process. Further research is needed to confirm this finding. It is also important to note that improved risk control options are a necessary, but not sufficient, step toward the implementation of more robust risk controls. © 2013 National Association for Healthcare Quality.

Impact of Virtual Patients as Optional Learning Material in Veterinary Biochemistry Education.

PubMed

Kleinsorgen, Christin; von Köckritz-Blickwede, Maren; Naim, Hassan Y; Branitzki-Heinemann, Katja; Kankofer, Marta; Mándoki, Míra; Adler, Martin; Tipold, Andrea; Ehlers, Jan P

2018-01-01

Biochemistry and physiology teachers from veterinary faculties in Hannover, Budapest, and Lublin prepared innovative, computer-based, integrative clinical case scenarios as optional learning materials for teaching and learning in basic sciences. These learning materials were designed to enhance attention and increase interest and intrinsic motivation for learning, thus strengthening autonomous, active, and self-directed learning. We investigated learning progress and success by administering a pre-test before exposure to the virtual patients (vetVIP) cases, offered vetVIP cases alongside regular biochemistry courses, and then administered a complementary post-test. We analyzed improvement in cohort performance and level of confidence in rating questions. Results of the performance in biochemistry examinations in 2014, 2015, and 2016 were correlated with the use of and performance in vetVIP cases throughout biochemistry courses in Hannover. Surveys of students reflected that interactive cases helped them understand the relevance of basic sciences in veterinary education. Differences between identical pre- and post-tests revealed knowledge improvement (correct answers: +28% in Hannover, +9% in Lublin) and enhanced confidence in decision making ("I don't know" answers: -20% in Hannover, -7.5% in Lublin). High case usage and voluntary participation (use of vetVIP cases in Hannover and Lublin >70%, Budapest <1%; response rates in pre-test 72% and post-test 48%) indicated a good increase in motivation for the subject of biochemistry. Despite increased motivation, there was only a weak correlation between performance in final exams and performance in the vetVIP cases. Case-based e-learning could be extended and generated cases should be shared across veterinary faculties.

Water Resources Planning under Uncertainty: A "Real Options" Approach

NASA Astrophysics Data System (ADS)

Jeuland, M. A.; Whittington, D.

2011-12-01

This research develops a real options approach for planning new water resources developments, in infrastructure construction and system operation, under uncertainty. The approach treats the planning problem as a series of staged decisions - the selection of new projects; their scale, timing and sequencing; and finally their operating rules - each of which is characterized by varying levels of irreversibility. The performance of different configurations of the system is then assessed along the various dimensions of the decision space, using simulation methods. The methodology is then made operational using an existing hydrological simulation model that can be used to study the example of hydropower development options in the Blue Nile in Ethiopia. The model includes physical linkages between climate change and system hydrology, and allows users to test the sensitivity of the basin-wide economic consequences of dams, which consist of energy generation, changes in irrigation crop-water demand, the value of flood control, and other basin-wide impacts, to climate change or changes in runoff, as well as to other uncertainties. The analysis shows that, from an economic perspective, there is no single optimal system configuration across a range of future climate conditions deemed plausible for this basin. For example, small infrastructures perform best in scenarios with reduced runoff into the river, whereas large ones are best when runoff increases. The real options framework therefore becomes useful for helping to identify configurations that are both more robust to poor outcomes and still contain sufficient flexibility to capture high upside benefits should favorable future conditions arise. The framework could readily be extended to explore a range of features that could be usefully built into water resources projects more generally, to improve the long-term economic performance of such investments.

Applying a multi-criteria genetic algorithm framework for brownfield reuse optimization: improving redevelopment options based on stakeholder preferences.

PubMed

Morio, Maximilian; Schädler, Sebastian; Finkel, Michael

2013-11-30

The reuse of underused or abandoned contaminated land, so-called brownfields, is increasingly seen as an important means for reducing the consumption of land and natural resources. Many existing decision support systems are not appropriate because they focus mainly on economic aspects, while neglecting sustainability issues. To fill this gap, we present a framework for spatially explicit, integrated planning and assessment of brownfield redevelopment options. A multi-criteria genetic algorithm allows us to determine optimal land use configurations with respect to assessment criteria and given constraints on the composition of land use classes, according to, e.g., stakeholder preferences. Assessment criteria include sustainability indicators as well as economic aspects, including remediation costs and land value. The framework is applied to a case study of a former military site near Potsdam, Germany. Emphasis is placed on the trade-off between possibly conflicting objectives (e.g., economic goals versus the need for sustainable development in the regional context of the brownfield site), which may represent different perspectives of involved stakeholders. The economic analysis reveals the trade-off between the increase in land value due to reuse and the costs for remediation required to make reuse possible. We identify various reuse options, which perform similarly well although they exhibit different land use patterns. High-cost high-value options dominated by residential land use and low-cost low-value options with less sensitive land use types may perform equally well economically. The results of the integrated analysis show that the quantitative integration of sustainability may change optimal land use patterns considerably. Copyright © 2013 Elsevier Ltd. All rights reserved.

Aviation Security: Vulnerabilities in, and Alternatives for, Preboard Screening Security Operations

DTIC Science & Technology

2001-09-25

establishing the certification program. This regulation is particularly significant because it is to include requirements mandated by the Airport Security Improvement...Assessment of Airport Security Screener Performance and Retention, Sept. 15, 2000. Page 8 GAO-01-1171T Criteria for Assessing Shifting responsibility for...airline and airport security officials to assess each option for reassigning screening responsibility against the key criteria- Specifically, we asked

Latest advancements in the acetylation of wood fibers to improve performance of wood composites

Treesearch

R. M. Rowell; R. Simonson

2004-01-01

A new procedure has been developed for the rapid continuous acetylation of lignocellulosic fiber. A limited amount of acetic anhydride is applied to the fiber before the fiber goes through a reactor at high temperature. The acetylated fiber is then stripped in a first step with superheated vapor of anhydride/acetic acid and, optionally, in a second step with...

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality

PubMed Central

Zaldivar, R.; Aiello, F.; Madrid-Costa, D.

2017-01-01

Keratoconus provides a decrease of quality of life to the patients who suffer from it. The treatment used as well as the method to correct the refractive error of these patients may influence on the impact of the disease on their quality of life. The purpose of this review is to describe the evidence about the conservative surgical treatment for keratoconus aiming to therapeutic and refractive effect. The visual rehabilitation for keratoconic corneas requires addressing three concerns: halting the ectatic process, improving corneal shape, and minimizing the residual refractive error. Cross-linking can halt the disease progression, intrastromal corneal ring segments can improve the corneal shape and hence the visual quality and reduce the refractive error, PRK can correct mild-moderate refractive error, and intraocular lenses can correct from low to high refractive error associated with keratoconus. Any of these surgical options can be performed alone or combined with the other techniques depending on what the case requires. Although it could be considered that the surgical option for the refracto-therapeutic treatment of the keratoconus is a reality, controlled, randomized studies with larger cohorts and longer follow-up periods are needed to determine which refractive procedure and/or sequence are most suitable for each case. PMID:29403662

Nuclear Fuel Cycle Options Catalog: FY16 Improvements and Additions

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

Price, Laura L.; Barela, Amanda Crystal; Schetnan, Richard Reed

2016-08-31

The United States Department of Energy, Office of Nuclear Energy, Fuel Cycle Technology Program sponsors nuclear fuel cycle research and development. As part of its Fuel Cycle Options campaign, the DOE has established the Nuclear Fuel Cycle Options Catalog. The catalog is intended for use by the Fuel Cycle Technologies Program in planning its research and development activities and disseminating information regarding nuclear energy to interested parties. The purpose of this report is to document the improvements and additions that have been made to the Nuclear Fuel Cycle Options Catalog in the 2016 fiscal year.

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2013-10-01 2013-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2012-10-01 2012-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2011-10-01 2011-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2010-10-01 2010-10-01 false Optional disclosure of nonconfidential information...

42 CFR 480.121 - Optional disclosure of nonconfidential information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality... 42 Public Health 4 2014-10-01 2014-10-01 false Optional disclosure of nonconfidential information...

Projected techno-economic improvements for advanced solar thermal power plants

NASA Technical Reports Server (NTRS)

Fujita, T.; Manvi, R.; Roschke, E. J.

1979-01-01

The projected characteristics of solar thermal power plants (with outputs up to 10 MWe) employing promising advanced technology subsystems/components are compared to current (or pre-1985) steam-Rankine systems. Improvements accruing to advanced technology development options are delineated. The improvements derived from advanced systems result primarily from achieving high efficiencies via solar collector systems which (1) capture a large portion of the available insolation and (2) concentrate this captured solar flux to attain high temperatures required for high heat engine/energy conversion performance. The most efficient solar collector systems employ two-axis tracking. Attractive systems include the central receiver/heliostat and the parabolic dish.

Development of the Upgraded DC Brush Gear Motor for Spacebus Platforms

NASA Technical Reports Server (NTRS)

Berning, Robert H.; Viout, Olivier

2010-01-01

The obsolescence of materials and processes used in the manufacture of traditional DC brush gear motors has necessitated the development of an upgraded DC brush gear motor (UBGM). The current traditional DC brush gear motor (BGM) design was evaluated using Six-Sigma process to identify potential design and production process improvements. The development effort resulted in a qualified UBGM design which improved manufacturability and reduced production costs. Using Six-Sigma processes and incorporating lessons learned during the development process also improved motor performance for UBGM making it a more viable option for future use as a deployment mechanism in space flight applications.

Coupling Adaptation Tipping Points and Engineering Options: New Insights for Resilient Water Infrastructure Replacement Planning

NASA Astrophysics Data System (ADS)

Smet, K.; de Neufville, R.; van der Vlist, M.

2017-12-01

This work presents an innovative approach for replacement planning for aging water infrastructure given uncertain future conditions. We draw upon two existing methodologies to develop an integrated long-term replacement planning framework. We first expand the concept of Adaptation Tipping Points to generate long-term planning timelines that incorporate drivers of investment related to both internal structural processes as well as changes in external operating conditions. Then, we use Engineering Options to explore different actions taken at key moments in this timeline. Contrasting to the traditionally more static approach to infrastructure design, designing the next generation of infrastructure so it can be changed incrementally is a promising method to safeguard current investments given future uncertainty. This up-front inclusion of structural options in the system actively facilitates future adaptation, transforming uncertainty management in infrastructure planning from reactive to more proactive. A two-part model underpins this approach. A simulation model generates diverse future conditions, allowing development of timelines of intervention moments in the structure's life. This feeds into an economic model, evaluating the lifetime performance of different replacement strategies, making explicit the value of different designs and their flexibility. A proof of concept study demonstrates this approach for a pumping station. The strategic planning timelines for this structure demonstrate that moments when capital interventions become necessary due to reduced functionality from structural degradation or changed operating conditions are widely spread over the structure's life. The disparate timing of these necessary interventions supports an incremental, adaptive mindset when considering end-of-life and replacement decisions. The analysis then explores different replacement decisions, varying the size and specific options included in the proposed new structure. Results show that incremental adaptive designs and incorporating options can improve economic performance, as compared to traditional, "build it once & build it big" designs. The benefit from incorporating flexibility varies with structural functionality, future conditions and the specific options examined.

Implementation of a lightning data assimilation technique in the Weather Research and Forecasting (WRF) model for improving precipitation prediction

NASA Astrophysics Data System (ADS)

Giannaros, Theodore; Kotroni, Vassiliki; Lagouvardos, Kostas

2015-04-01

Lightning data assimilation has been recently attracting increasing attention as a technique implemented in numerical weather prediction (NWP) models for improving precipitation forecasts. In the frame of TALOS project, we implemented a robust lightning data assimilation technique in the Weather Research and Forecasting (WRF) model with the aim to improve the precipitation prediction in Greece. The assimilation scheme employs lightning as a proxy for the presence or absence of deep convection. In essence, flash data are ingested in WRF to control the Kain-Fritsch (KF) convective parameterization scheme (CPS). When lightning is observed, indicating the occurrence of convective activity, the CPS is forced to attempt to produce convection, whereas the CPS may be optionally be prevented from producing convection when no lightning is observed. Eight two-day precipitation events were selected for assessing the performance of the lightning data assimilation technique. The ingestion of lightning in WRF was carried out during the first 6 h of each event and the evaluation focused on the consequent 24 h, constituting a realistic setup that could be used in operational weather forecasting applications. Results show that the implemented assimilation scheme can improve model performance in terms of precipitation prediction. Forecasts employing the assimilation of flash data were found to exhibit more skill than control simulations, particularly for the intense (>20 mm) 24 h rain accumulations. Analysis of results also revealed that the option not to suppress the KF scheme in the absence of observed lightning, leads to a generally better performance compared to the experiments employing the full control of the CPS' triggering. Overall, the implementation of the lightning data assimilation technique is found to improve the model's ability to represent convection, especially in situations when past convection has modified the mesoscale environment in ways that affect the occurrence and evolution of subsequent convection.

Case series of 17 modified Weil's osteotomies for Freiberg's and Köhler's II AVN, with AOFAS scoring pre- and post-operatively.

PubMed

Edmondson, M C; Sherry, K R; Afolayan, J; Armitage, A R; Skyrme, A D

2011-03-01

Treatment for metatarsal head avascular necrosis is largely conservative. For severe or refractory cases there are various surgical options. We have performed a 'modified Weil's osteotomy' of the distal metatarsal in order to manage this problem. We present the largest case series, to our knowledge, with 17 such cases. The patients were scored pre- and post-operatively using the AOFAS Forefoot scoring system. We found that this procedure provided a mean score improvement of 36 points, with a complication rate of 5.9%. We would advocate this modified osteotomy as an effective, reliable and safe treatment option. Copyright © 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Workstation table crashworthiness tests

DOT National Transportation Integrated Search

2013-12-31

This report describes results from the Option C component of a research program aimed at improving crashworthiness of passenger train workstation tables. Research conducted in the Base, Option A, and Option B components of the program was focused on ...

Surgical treatment of obesity.

PubMed

Puzziferri, Nancy; Blankenship, Jeanne; Wolfe, Bruce M

2006-02-01

The surgical treatment of obesity has existed for over 50 yr. Surgical options have evolved from high-risk procedures infrequently performed, to safe, effective procedures increasingly performed. The operations used today provide significant durable weight loss, resolution or marked improvement of obesity-related comorbidities, and enhanced quality of life for the majority of patients. The effect of bariatric surgery on the neurohormonal regulation of energy homeostasis is not fully understood. Despite its effectiveness, less than 1% of obese patients are treated surgically. The perception that obesity surgery is unsafe remains a deterrent to care.

Anterior Insula Activity Predicts the Influence of Positively-Framed Messages on Decision Making

PubMed Central

Krawitz, Adam; Fukunaga, Rena; Brown, Joshua W.

2010-01-01

The neural mechanisms underlying the influence of persuasive messages on decision making are largely unknown. We address this using event-related functional magnetic resonance imaging to investigate how informative messages alter risk appraisal during choice. Participants performed the Iowa Gambling Task while viewing a positively-framed, negatively-framed, or control message about the options. Right anterior insula correlated with improvement in choice behavior due to the positively-framed, but not the negatively-framed, message. With the positively-framed message there was increased activation proportional to message effectiveness when less-preferred options were chosen, consistent with a role in the prediction of adverse outcomes. In addition, dorsomedial and left dorsolateral prefrontal cortex correlated with overall decision quality regardless of message type. The dorsomedial region mediated the relationship between right anterior insula and decision quality with the positively-framed messages. These findings suggest a network of frontal brain regions that integrate informative messages into the evaluation of options during decision-making. PMID:20805540

Photodynamic therapy: new treatment for recalcitrant Malassezia folliculitis.

PubMed

Lee, Jin Woong; Kim, Beom Joon; Kim, Myeung Nam

2010-02-01

Malassezia folliculitis commonly has been treated with oral antifungal medications. However, it has many therapeutic weaknesses such as infection relapse, drug resistance, or adverse effects like hepatotoxicity and gastrointestinal discomfort. Hence, there remains an ongoing need for alternative treatments for recalcitrant Malassezia folliculitis. Recently, many dermatologists suggest photodynamic therapy (PDT) as an alternative therapeutic option for its antimicrobial effect. To investigate the efficacy of methyl 5-aminolevulinic acid (MAL)-PDT for the treatment of recalcitrant Malassezia folliculitis. Six Korean patients aged 23-47 years with recalcitrant Malassezia folliculitis were enrolled in this study. The patients enrolled in this study either refused oral medication or were unable to take oral antifungal agents due to hepatotoxicity concerns. Thus, we offered these patients MAL-PDT as an alternative treatment option. For all patients, photographs of the lesion(s) were taken prior to initiating treatment. MAL cream (Metvix, Galderma, France) was applied to each lesion (located on the patients' trunks) and covered with an adhesive occlusive dressing polyurethane film (Tegaderm, 3M Healthcare, St. Paul, MN). After 3 hours, the cream was wiped off and illumination was performed immediately thereafter with non-coherent red light using light-emitting diodes (Aktilite lamp, PhotoCure, Oslo, Norway, average wavelength 630 nm, light dose 37 J/cm(2)). Illumination was performed for 7.5 minutes. Patients underwent totally three sessions of MAL-PDT at 2-week intervals. One month after the last PDT treatment, patients returned to the hospital and lesions were photographed. After three sessions of MAL-PDT, inflammatory lesions had decreased and improved obviously in four patients, had improved slightly in one patient, and had not improved in one patient. MAL-PDT may be an effective treatment option for patients with recalcitrant Malassezia folliculitis. However, the data on MAL-PDT are still limited, and additional controlled trials including multiple patients will be necessary to verify the results of this pilot study.

Understanding Mechanisms of Resistance in the Epithelial Growth Factor Receptor in Non‐Small Cell Lung Cancer and the Role of Biopsy at Progression

PubMed Central

Villaruz, Liza C.; Ross, Jeffrey

2016-01-01

Abstract Molecular profiling and the discovery of drugs that target specific activating mutations have allowed the personalization of treatment for non‐small cell lung cancer (NSCLC). The epithelial growth factor receptor (EGFR) is frequently over‐expressed and/or aberrantly activated in different cancers, including NSCLC. The most common activating mutations of EGFR in NSCLC fall within the tyrosine kinase‐binding domain. Three oral EGFR tyrosine kinase inhibitors (TKIs) have been approved by the U.S. Food and Drug Administration (FDA) for first‐line use in patients with EGFR mutation‐positive NSCLC (exon 19 deletions or exon 21 [L858R] substitution mutations), as detected by an FDA‐approved test. However, disease progression is common and is often the result of secondary mutations, of which the EGFR T790M mutation is the most prevalent. Few options were available upon progression until the introduction of osimertinib, a kinase inhibitor that targets the T790M mutation, which was recently approved for use in patients with metastatic EGFR T790M mutation‐positive NSCLC, as detected by an FDA‐approved test, who progressed on or after EGFR TKI therapy. With the introduction of osimertinib, outcomes can now be improved in select patients. Therefore, performing a biopsy at progression to determine the underlying molecular cause of the acquired resistance is important for the enabling of individualized options that may provide the greatest opportunity for improved outcomes. This review discusses the latest updates in molecular testing at progression and outlines treatment options for this difficult‐to‐treat population. Implications for Practice. Although the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs)—gefitinib, erlotinib, and afatinib—have changed the treatment paradigm for non‐small cell lung cancer among those with EGFR mutation positive disease, most patients experience progression after approximately 12 months of treatment. Until recently, options were limited for patients who progressed, but improvements in molecular profiling and the approval of osimertinib, which targets the resistance mutation T790M, afford the opportunity for improved outcomes in many patients with this mutation. This article explains the options available after progression on initial EGFR TKI therapy and the importance of molecular testing at progression in making treatment decisions. PMID:27821794

Comparing Item Performance on Three- Versus Four-Option Multiple Choice Questions in a Veterinary Toxicology Course.

PubMed

Royal, Kenneth; Dorman, David

2018-06-09

The number of answer options is an important element of multiple-choice questions (MCQs). Many MCQs contain four or more options despite the limited literature suggesting that there is little to no benefit beyond three options. The purpose of this study was to evaluate item performance on 3-option versus 4-option MCQs used in a core curriculum course in veterinary toxicology at a large veterinary medical school in the United States. A quasi-experimental, crossover design was used in which students in each class were randomly assigned to take one of two versions (A or B) of two major exams. Both the 3-option and 4-option MCQs resulted in similar psychometric properties. The findings of our study support earlier research in other medical disciplines and settings that likewise concluded there was no significant change in the psychometric properties of three option MCQs when compared to the traditional MCQs with four or more options.

Option Price Estimates for Water Quality Improvements: A Contingent Valuation Study for the Monongahela River (1985)

EPA Pesticide Factsheets

This paper presents the findings from a contingent valuation survey designed to estimate the option price bids for the improved recreation resulting from enhanced water quality in the Pennsylvania portion of the Monongahela River.

Some practical universal noiseless coding techniques, part 3, module PSl14,K+

NASA Technical Reports Server (NTRS)

Rice, Robert F.

1991-01-01

The algorithmic definitions, performance characterizations, and application notes for a high-performance adaptive noiseless coding module are provided. Subsets of these algorithms are currently under development in custom very large scale integration (VLSI) at three NASA centers. The generality of coding algorithms recently reported is extended. The module incorporates a powerful adaptive noiseless coder for Standard Data Sources (i.e., sources whose symbols can be represented by uncorrelated non-negative integers, where smaller integers are more likely than the larger ones). Coders can be specified to provide performance close to the data entropy over any desired dynamic range (of entropy) above 0.75 bit/sample. This is accomplished by adaptively choosing the best of many efficient variable-length coding options to use on each short block of data (e.g., 16 samples) All code options used for entropies above 1.5 bits/sample are 'Huffman Equivalent', but they require no table lookups to implement. The coding can be performed directly on data that have been preprocessed to exhibit the characteristics of a standard source. Alternatively, a built-in predictive preprocessor can be used where applicable. This built-in preprocessor includes the familiar 1-D predictor followed by a function that maps the prediction error sequences into the desired standard form. Additionally, an external prediction can be substituted if desired. A broad range of issues dealing with the interface between the coding module and the data systems it might serve are further addressed. These issues include: multidimensional prediction, archival access, sensor noise, rate control, code rate improvements outside the module, and the optimality of certain internal code options.

Final Technical Report

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

Stoessel, Chris

2013-11-13

This project developed a new high-performance R-10/high SHGC window design, reviewed market positioning and evaluated manufacturing solutions required for broad market adoption. The project objectives were accomplished by: identifying viable technical solutions based on modeling of modern and potential coating stacks and IGU designs; development of new coating material sets for HM thin film stacks, as well as improved HM IGU designs to accept multiple layers of HM films; matching promising new coating designs with new HM IGU designs to demonstrate performance gains; and, in cooperation with a window manufacturer, assess the potential for high-volume manufacturing and cost efficiency ofmore » a HM-based R-10 window with improved solar heat gain characteristics. A broad view of available materials and design options was applied to achieve the desired improvements. Gated engineering methodologies were employed to guide the development process from concept generation to a window demonstration. The project determined that a slightly de-rated window performance allows formulation of a path to achieve the desired cost reductions to support end consumer adoption.« less

Endovascular Management of Central Retinal Arterial Occlusion.

PubMed

Agarwal, Nitin; Gala, Nihar B; Baumrind, Benjamin; Hansberry, David R; Thabet, Ahmad M; Gandhi, Chirag D; Prestigiacomo, Charles J

2016-11-01

Central retinal artery occlusion (CRAO) is an ophthalmologic emergency due to the sudden cessation of circulation to the inner retinal layer. Without immediate treatment, permanent blindness may ensue. Several treatment options exist, ranging from noninvasive medical management to thrombolysis. Nonetheless, ongoing debate exists regarding the best therapeutic strategy. The authors present the case of a 78-year-old woman with a medical history of hypercholesterolemia and rheumatoid arthritis who experienced complete loss of vision in her left eye. Following ophthalmologic evaluation demonstrating left CRAO, anterior chamber paracentesis was performed. Endovascular intervention was performed via local intra-arterial fibrinolysis with alteplase. Her vision returned to 20/20 following the procedure. In general, conventional therapies have not significantly improved patient outcomes. Several management options exist for CRAO. In general, conservative measures have not been reported to yield better patient outcomes as compared to the natural history of this medical emergency. Endovascular approaches are another option as observed with this case reported. In cases of CRAO, therapeutic strategies such as intra-arterial fibrinolysis utilize a local infusion of reactive tissue plasminogen activator directly at the site of occlusion via catheterization of the ophthalmic artery. Although several case series do show promising results after treating CRAO with intra-arterial fibrinolysis, further studies are required given the reports of complications.

77 FR 3828 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Granting Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... Organizations; The Options Clearing Corporation; Order Granting Approval of Accelerated Delivery of Supplement to the Options Disclosure Document Reflecting Certain Changes to Disclosure Regarding Relative Performance Options January 19, 2012. On August 15, 2011, The Options Clearing Corporation (``OCC'') submitted...

48 CFR 317.207 - Exercise of options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Exercise of options. 317... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 317.207 Exercise of options. (h) Before exercising an option for a subsequent performance period/additional quantity under a multiple-year contract...

Preliminary Results From the C-Pulse OPTIONS HF European Multicenter Post-Market Study.

PubMed

Schulz, Antonia; Krabatsch, Thomas; Schmitto, Jan D; Hetzer, Roland; Seidel, Mirko; Dohmen, Pascal M; Hotz, Holger

2016-02-18

BACKGROUND The C-Pulse System is an extra-aortic balloon counterpulsation device. It is used to treat patients with heart failure disease in NYHA functional class III or ambulatory class IV. MATERIAL AND METHODS We present preliminary site-reported 6-month data from 3 centers in Germany as part of the prospective observational post-market OPTIONS HF study. RESULTS Between May 2013 and March 2014, the C-Pulse System was implanted in 8 patients (7 male) with a mean age of 61.6±9.3 years. Four had ischemic and 4 had non-ischemic cardiomyopathy. No stroke, myocardial infarction, major bleeding, or major infection due to the device were reported. One patient developed non-device-related refractory tachycardia with worsening heart failure 12 h after surgery and underwent left ventricular assist device implantation. Within 6 months of observation, functional status improved from NYHA III to II in 5 patients, and 2 remained in NYHA III. Mean left ventricular ejection fraction increased from 24.3±7.9% to 44.5±4.5% (p<0.0001). Mean Kansas City Cardiomyopathy Questionnaire overall score improved from 28.6±19.1 to 59.1±22.5 (p=0.0183). Six-minute walk test was performed in 6 out of 7 patients at follow-up. The mean distance improved from 252.0±85.1 m to 279.2±87.5 m (p>0.05). One patient was weaned off the device after 6 months of support. CONCLUSIONS The C-Pulse System provides a therapeutic option for patients with moderate-to-severe heart failure and seems to improve quality of life and cardiac function over time.

Enrichment Zoning Options for the Small Nuclear Rocket Engine (SNRE)

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

Bruce G. Schnitzler; Stanley K. Borowski

2010-07-01

Advancement of U.S. scientific, security, and economic interests through a robust space exploration program requires high performance propulsion systems to support a variety of robotic and crewed missions beyond low Earth orbit. In NASA’s recent Mars Design Reference Architecture (DRA) 5.0 study (NASA-SP-2009-566, July 2009), nuclear thermal propulsion (NTP) was again selected over chemical propulsion as the preferred in-space transportation system option because of its high thrust and high specific impulse (-900 s) capability, increased tolerance to payload mass growth and architecture changes, and lower total initial mass in low Earth orbit. An extensive nuclear thermal rocket technology development effortmore » was conducted from 1955-1973 under the Rover/NERVA Program. The Small Nuclear Rocket Engine (SNRE) was the last engine design studied by the Los Alamos National Laboratory during the program. At the time, this engine was a state-of-the-art design incorporating lessons learned from the very successful technology development program. Past activities at the NASA Glenn Research Center have included development of highly detailed MCNP Monte Carlo transport models of the SNRE and other small engine designs. Preliminary core configurations typically employ fuel elements with fixed fuel composition and fissile material enrichment. Uniform fuel loadings result in undesirable radial power and temperature profiles in the engines. Engine performance can be improved by some combination of propellant flow control at the fuel element level and by varying the fuel composition. Enrichment zoning at the fuel element level with lower enrichments in the higher power elements at the core center and on the core periphery is particularly effective. Power flattening by enrichment zoning typically results in more uniform propellant exit temperatures and improved engine performance. For the SNRE, element enrichment zoning provided very flat radial power profiles with 551 of the 564 fuel elements within 1% of the average element power. Results for this and alternate enrichment zoning options for the SNRE are compared.« less

Standard CMMI Appraisal Method for Process Improvement (SCAMPI) A, Version 1.3: Method Definition Document

DTIC Science & Technology

2011-03-01

performance of Federal Government Contract Number FA8721-05- C -0003 with Carnegie Mellon University for the operation of the Software Engineering... C Roles and Responsibilities 195 Appendix D Reporting Requirements and Options 201 Appendix E Managed Discovery 203 Appendix F Scoping and...Upgrade Team (SUT) • Mary Busby , Lockheed Martin • Palma Buttles-Valdez, Software Engineering Institute • Paul Byrnes, Integrated System Diagnostics

Better Assessment of Operational Suitability. Volume 2. Case Studies

DTIC Science & Technology

1992-01-01

August to 25 October 1988. Although declared operationally effective and suitable by OTEA, a Corrective Action Plan (CAP) was instituted on 5 December 1988...to correct performance deficiencies encountered in FOT&E. The option year 3 procureiaent was exercised on 8 December 1988. An OTEA assessment of the...Hughes developed and tested airframe design modifications to correct deficiencies noted in DT POT I, to improve flight handling characteristics, and to

High Temperature Irradiation-Resistant Thermocouple Performance Improvements

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

Joshua Daw; Joy Rempe; Darrell Knudson

2009-04-01

Traditional methods for measuring temperature in-pile degrade at temperatures above 1100 ºC. To address this instrumentation need, the Idaho National Laboratory (INL) developed and evaluated the performance of a high temperature irradiation-resistant thermocouple (HTIR-TC) that contains alloys of molybdenum and niobium. Data from high temperature (up to 1500 ºC) long duration (up to 4000 hours) tests and on-going irradiations at INL’s Advanced Test Reactor demonstrate the superiority of these sensors to commercially-available thermocouples. However, several options have been identified that could further enhance their reliability, reduce their production costs, and allow their use in a wider range of operating conditions.more » This paper presents results from on-going Idaho National Laboratory (INL)/University of Idaho (UI) efforts to investigate options to improve HTIR-TC ductility, reliability, and resolution by investigating specially-formulated alloys of molybdenum and niobium and alternate diameter thermoelements (wires). In addition, on-going efforts to evaluate alternate fabrication approaches, such as drawn and loose assembly techniques will be discussed. Efforts to reduce HTIR-TC fabrication costs, such as the use of less expensive extension cable will also be presented. Finally, customized HTIR-TC designs developed for specific customer needs will be summarized to emphasize the varied conditions under which these sensors may be used.« less

Integrating fisheries approaches and household utility models for improved resource management.

PubMed

Milner-Gulland, E J

2011-01-25

Natural resource management is littered with cases of overexploitation and ineffectual management, leading to loss of both biodiversity and human welfare. Disciplinary boundaries stifle the search for solutions to these issues. Here, I combine the approach of management strategy evaluation, widely applied in fisheries, with household utility models from the conservation and development literature, to produce an integrated framework for evaluating the effectiveness of competing management strategies for harvested resources against a range of performance metrics. I demonstrate the strengths of this approach with a simple model, and use it to examine the effect of manager ignorance of household decisions on resource management effectiveness, and an allocation tradeoff between monitoring resource stocks to reduce observation uncertainty and monitoring users to improve compliance. I show that this integrated framework enables management assessments to consider household utility as a direct metric for system performance, and that although utility and resource stock conservation metrics are well aligned, harvest yield is a poor proxy for both, because it is a product of household allocation decisions between alternate livelihood options, rather than an end in itself. This approach has potential far beyond single-species harvesting in situations where managers are in full control; I show that the integrated approach enables a range of management intervention options to be evaluated within the same framework.

Speech Intelligibility in Various Noise Conditions with the Nucleus® 5 CP810 Sound Processor.

PubMed

Dillier, Norbert; Lai, Wai Kong

2015-06-11

The Nucleus(®) 5 System Sound Processor (CP810, Cochlear™, Macquarie University, NSW, Australia) contains two omnidirectional microphones. They can be configured as a fixed directional microphone combination (called Zoom) or as an adaptive beamformer (called Beam), which adjusts the directivity continuously to maximally reduce the interfering noise. Initial evaluation studies with the CP810 had compared performance and usability of the new processor in comparison with the Freedom™ Sound Processor (Cochlear™) for speech in quiet and noise for a subset of the processing options. This study compares the two processing options suggested to be used in noisy environments, Zoom and Beam, for various sound field conditions using a standardized speech in noise matrix test (Oldenburg sentences test). Nine German-speaking subjects who previously had been using the Freedom speech processor and subsequently were upgraded to the CP810 device participated in this series of additional evaluation tests. The speech reception threshold (SRT for 50% speech intelligibility in noise) was determined using sentences presented via loudspeaker at 65 dB SPL in front of the listener and noise presented either via the same loudspeaker (S0N0) or at 90 degrees at either the ear with the sound processor (S0NCI+) or the opposite unaided ear (S0NCI-). The fourth noise condition consisted of three uncorrelated noise sources placed at 90, 180 and 270 degrees. The noise level was adjusted through an adaptive procedure to yield a signal to noise ratio where 50% of the words in the sentences were correctly understood. In spatially separated speech and noise conditions both Zoom and Beam could improve the SRT significantly. For single noise sources, either ipsilateral or contralateral to the cochlear implant sound processor, average improvements with Beam of 12.9 and 7.9 dB in SRT were found. The average SRT of -8 dB for Beam in the diffuse noise condition (uncorrelated noise from both sides and back) is truly remarkable and comparable to the performance of normal hearing listeners in the same test environment. The static directivity (Zoom) option in the diffuse noise condition still provides a significant benefit of 5.9 dB in comparison with the standard omnidirectional microphone setting. These results indicate that CI recipients may improve their speech recognition in noisy environments significantly using these directional microphone-processing options.

Reasoning and mathematical skills contribute to normatively superior decision making under risk: evidence from the game of dice task.

PubMed

Pertl, Marie-Theres; Zamarian, Laura; Delazer, Margarete

2017-08-01

In this study, we assessed to what extent reasoning improves performance in decision making under risk in a laboratory gambling task (Game of Dice Task-Double, GDT-D). We also investigated to what degree individuals with above average mathematical competence decide better than those with average mathematical competence. Eighty-five participants performed the GDT-D and several numerical tasks. Forty-two individuals were asked to calculate the probabilities and the outcomes associated with the different options of the GDT-D before performing it. The other 43 individuals performed the GDT-D at the beginning of the test session. Both reasoning and mathematical competence had a positive effect on decision making. Different measures of mathematical competence correlated with advantageous performance in decision making. Results suggest that decision making under explicit risk conditions improves when individuals are encouraged to reflect about the contingencies of a decision situation. Interventions based on numerical reasoning may also be useful for patients with difficulties in decision making.

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.

Maintenance of Certification Part IV Quality-Improvement Project for Hypertension Control: A Preliminary Retrospective Analysis

PubMed Central

Kolasinski, Vallerie A; Price, David W

2015-01-01

Context: A Maintenance of Certification Part IV project was created on the basis of an existing, multifaceted hypertension improvement program. Objective: To evaluate the impact of the Maintenance of Certification project, the effects of the improvement options on blood pressure control in hypertensive patients, and the participants’ perception of the workload related to participation in the project. Design: Nonexperimental retrospective analysis. Setting: Kaiser Permanente hospitals and medical office buildings in Northern California. Intervention: Participants used one or more options from a defined menu of strategies to attempt to increase the percentage of hypertensive patients on their patient panels who had controlled blood pressure. Main Outcome Measure: Proportion of hypertensive patients with blood pressure ≤ 139/89 mm Hg. Results: Fifty-two American Board of Family Medicine and 19 American Board of Internal Medicine certified physicians completed projects. Mean panel blood pressure control improved from 79.49% (standard deviation [SD] = 11.32) to 84.64% (SD = 7.80). The choice of improvement option was not associated with the level of improvement or with the participants’ perception of the workload related to completing the project. Conclusion: Project participants improved the care of their patients without an increased perceived burden to their practice. We found no association between the choice of improvement option and either the level of improvement or the perception of workload. PMID:25785642

TRISO Fuel Performance: Modeling, Integration into Mainstream Design Studies, and Application to a Thorium-fueled Fusion-Fission Hybrid Blanket

NASA Astrophysics Data System (ADS)

Powers, Jeffrey J.

2011-12-01

This study focused on creating a new tristructural isotropic (TRISO) coated particle fuel performance model and demonstrating the integration of this model into an existing system of neutronics and heat transfer codes, creating a user-friendly option for including fuel performance analysis within system design optimization and system-level trade-off studies. The end product enables both a deeper understanding and better overall system performance of nuclear energy systems limited or greatly impacted by TRISO fuel performance. A thorium-fueled hybrid fusion-fission Laser Inertial Fusion Energy (LIFE) blanket design was used for illustrating the application of this new capability and demonstrated both the importance of integrating fuel performance calculations into mainstream design studies and the impact that this new integrated analysis had on system-level design decisions. A new TRISO fuel performance model named TRIUNE was developed and verified and validated during this work with a novel methodology established for simulating the actual lifetime of a TRISO particle during repeated passes through a pebble bed. In addition, integrated self-consistent calculations were performed for neutronics depletion analysis, heat transfer calculations, and then fuel performance modeling for a full parametric study that encompassed over 80 different design options that went through all three phases of analysis. Lastly, side studies were performed that included a comparison of thorium and depleted uranium (DU) LIFE blankets as well as some uncertainty quantification work to help guide future experimental work by assessing what material properties in TRISO fuel performance modeling are most in need of improvement. A recommended thorium-fueled hybrid LIFE engine design was identified with an initial fuel load of 20MT of thorium, 15% TRISO packing within the graphite fuel pebbles, and a 20cm neutron multiplier layer with beryllium pebbles in flibe molten salt coolant. It operated at a system power level of 2000 MWth, took about 3.5 years to reach full plateau power, and was capable of an End of Plateau burnup of 38.7 %FIMA if considering just the neutronic constraints in the system design; however, fuel performance constraints led to a maximum credible burnup of 12.1 %FIMA due to a combination of internal gas pressure and irradiation effects on the TRISO materials (especially PyC) leading to SiC pressure vessel failures. The optimal neutron spectrum for the thorium-fueled blanket options evaluated seemed to favor a hard spectrum (low but non-zero neutron multiplier thicknesses and high TRISO packing fractions) in terms of neutronic performance but the fuel performance constraints demonstrated that a significantly softer spectrum would be needed to decrease the rate of accumulation of fast neutron fluence in order to improve the maximum credible burnup the system could achieve.

Space Shuttle development update

NASA Technical Reports Server (NTRS)

Brand, V.

1984-01-01

The development efforts, since the STS-4 flight, in the Space Shuttle (SS) program are presented. The SS improvements introduced in the last two years include lower-weight loads, communication through the Tracking and Data Relay Satellite, expanded extravehicular activity capability, a maneuvering backpack and the manipulator foot restraint, the improvements in thermal projection system, the 'optional terminal area management targeting' guidance software, a rendezvous system with radar and star tracker sensors, and improved on-orbit living conditions. The flight demonstrations include advanced launch techniques (e.g., night launch and direct insertion to orbit); the on-orbit demonstrations; and added entry and launching capabilities. The entry aerodynamic analysis and entry flight control fine tuning are described. Reusability, improved ascent performance, intact abort and landing flexibility, rollout control, and 'smart speedbrakes' are among the many improvements planned for the future.

Ultrasonic Imaging Techniques for Breast Cancer Detection

NASA Astrophysics Data System (ADS)

Goulding, N. R.; Marquez, J. D.; Prewett, E. M.; Claytor, T. N.; Nadler, B. R.

2008-02-01

Improving the resolution and specificity of current ultrasonic imaging technology is needed to enhance its relevance to breast cancer detection. A novel ultrasonic imaging reconstruction method is described that exploits classical straight-ray migration. This novel method improves signal processing for better image resolution and uses novel staging hardware options using a pulse-echo approach. A breast phantom with various inclusions is imaged using the classical migration method and is compared to standard computed tomography (CT) scans. These innovative ultrasonic methods incorporate ultrasound data acquisition, beam profile characterization, and image reconstruction. For an ultrasonic frequency of 2.25 MHz, imaged inclusions of approximately 1 cm are resolved and identified. Better resolution is expected with minor modifications. Improved image quality and resolution enables earlier detection and more accurate diagnoses of tumors thus reducing the number of biopsies performed, increasing treatment options, and lowering remission percentages. Using these new techniques the inclusions in the phantom are resolved and compared to the results of standard methods. Refinement of this application using other imaging techniques such as time-reversal mirrors (TRM), synthetic aperture focusing technique (SAFT), decomposition of the time reversal operator (DORT), and factorization methods is also discussed.

Electrically-Assisted Turbocharger Development for Performance and Emissions

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

Bailey, Milton

2000-08-20

Turbocharger transient lag inherently imposes a tradeoff between a robust engine response to transient load shifts and exhaust emissions. By itself, a well matched turbocharger for an engine has limited flexibility in improving this transient response. Electrically-assisted turbocharging has been seen as an attractive option to improve response and lower transient emissions. This paper presents the results of a multi-year joint CRADA between DDC and ORNL. Virtual lab diesel simulation models characterized the performance improvement potential of an electrically assisted turbocharger technology. Operating requirements to reduce transient duration between load shift time by up to 50% were determined. A turbomachinemore » has been conceptualized with an integrated motor-generator, providing transient burst boost plus energy recovery capability. Numerous electric motor designs were considered, and a prototype motor was developed, fabricated, and is undergoing tests. Power controls have been designed and fabricated.« less

An improved computer program for calculating the theoretical performance parameters of a propeller type wind turbine. An appendix to the final report on feasibility of using wind power to pump irrigation water (Texas). [PROP Code

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

Barieau, R.E.

1977-03-01

The PROP Program of Wilson and Lissaman has been modified by adding the Newton-Raphson Method and a Step Wise Search Method, as options for the method of solution. In addition, an optimization method is included. Twist angles, tip speed ratio and the pitch angle may be varied to produce maximum power coefficient. The computer program listing is presented along with sample input and output data. Further improvements to the program are discussed.

[Report from the CFEF seminar on fetal biometry (June 2017)].

PubMed

Collège Français d'échographie Fœtale Cfef

2017-10-01

This article reports the conclusions and recommendations resulting from the seminar organized in Paris on June 15, 2017 by the scientific committee of the French College of Fetal Ultrasound (CFEF). The purpose of this meeting was to audit the practices in screening for SGA and IUGR fetuses in France and to discuss ways to improve ultrasound screening. A review of charts, references, standards and common practices was performed. The potential new biometric tools applicable in France were reviewed and analyzed. Eventually, options and recommendations for improvement are proposed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Development of SiC/SiC composites by PIP in combination with RS

NASA Astrophysics Data System (ADS)

Kotani, Masaki; Kohyama, Akira; Katoh, Yutai

2001-02-01

In order to improve the mechanical performances of SiC/SiC composite, process improvement and modification of polymer impregnation and pyrolysis (PIP) and reaction sintering (RS) process were investigated. The fibrous prepregs were prepared by a polymeric intra-bundle densification technique using Tyranno-SA™ fiber. For inter-bundle matrix, four kinds of process options utilizing polymer pyrolysis and reaction sintering were studied. The process conditions were systematically optimized through fabricating monoliths. Then, SiC/SiC composites were fabricated using optimized inter-bundle matrix slurries in each process for the first inspection of process requirements.

Performance tuning Weather Research and Forecasting (WRF) Goddard longwave radiative transfer scheme on Intel Xeon Phi

NASA Astrophysics Data System (ADS)

Mielikainen, Jarno; Huang, Bormin; Huang, Allen H.

2015-10-01

Next-generation mesoscale numerical weather prediction system, the Weather Research and Forecasting (WRF) model, is a designed for dual use for forecasting and research. WRF offers multiple physics options that can be combined in any way. One of the physics options is radiance computation. The major source for energy for the earth's climate is solar radiation. Thus, it is imperative to accurately model horizontal and vertical distribution of the heating. Goddard solar radiative transfer model includes the absorption duo to water vapor,ozone, ozygen, carbon dioxide, clouds and aerosols. The model computes the interactions among the absorption and scattering by clouds, aerosols, molecules and surface. Finally, fluxes are integrated over the entire longwave spectrum.In this paper, we present our results of optimizing the Goddard longwave radiative transfer scheme on Intel Many Integrated Core Architecture (MIC) hardware. The Intel Xeon Phi coprocessor is the first product based on Intel MIC architecture, and it consists of up to 61 cores connected by a high performance on-die bidirectional interconnect. The coprocessor supports all important Intel development tools. Thus, the development environment is familiar one to a vast number of CPU developers. Although, getting a maximum performance out of MICs will require using some novel optimization techniques. Those optimization techniques are discusses in this paper. The optimizations improved the performance of the original Goddard longwave radiative transfer scheme on Xeon Phi 7120P by a factor of 2.2x. Furthermore, the same optimizations improved the performance of the Goddard longwave radiative transfer scheme on a dual socket configuration of eight core Intel Xeon E5-2670 CPUs by a factor of 2.1x compared to the original Goddard longwave radiative transfer scheme code.

Fuel and Core Design Options to Overcome the Heavy Metal Loading Limit and Improve Performance and Safety of Liquid Salt Cooled Reactors

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

Petrovic, Bojan; Maldonado, Ivan

2016-04-14

The research performed in this project addressed the issue of low heavy metal loading and the resulting reduced cycle length with increased refueling frequency, inherent to all FHR designs with solid, non-movable fuel based on TRISO particles. Studies performed here focused on AHTR type of reactor design with plate (“plank”) fuel. Proposal to FY12 NEUP entitled “Fuel and Core Design Options to Overcome the Heavy Metal Loading Limit and Improve Performance and Safety of Liquid Salt Cooled Reactors” was selected for award, and the 3-year project started in August 2012. A 4-month NCE was granted and the project completed onmore » December 31, 2015. The project was performed by Georgia Tech (Prof. Bojan Petrovic, PI) and University of Tennessee (Prof. Ivan Maldonado, Co-PI), with a total funding of $758,000 over 3 years. In addition to two Co-PIs, the project directly engaged 6 graduate students (at doctoral or MS level) and 2 postdoctoral researchers. Additionally, through senior design projects and graduate advanced design projects, another 23 undergraduate and 12 graduate students were exposed to and trained in the salt reactor technology. We see this as one of the important indicators of the project’s success and effectiveness. In the process, 1 journal article was published (with 3 journal articles in preparation), together with 8 peer-reviewed full conference papers, 8 peer-reviewed extended abstracts, as well as 1 doctoral dissertation and 2 master theses. The work included both development of models and methodologies needed to adequately analyze this type of reactor, fuel, and its fuel cycle, as well as extensive analyses and optimization of the fuel and core design.« less

Optimization of the strength of the efavirenz/lamivudine/abacavir fixed-dose combination for paediatric patients.

PubMed

Bouazza, Naïm; Cressey, Tim R; Foissac, Frantz; Bienczak, Andrzej; Denti, Paolo; McIlleron, Helen; Burger, David; Penazzato, Martina; Lallemant, Marc; Capparelli, Edmund V; Treluyer, Jean-Marc; Urien, Saïk

2017-02-01

Child-friendly, low-cost, solid, oral fixed-dose combinations (FDCs) of efavirenz with lamivudine and abacavir are urgently needed to improve clinical management and drug adherence for children. Data were pooled from several clinical trials and therapeutic drug monitoring datasets from different countries. The number of children/observations was 505/3667 for efavirenz. Population pharmacokinetic analyses were performed using a non-linear mixed-effects approach. For abacavir and lamivudine, data from 187 and 920 subjects were available (population pharmacokinetic models previously published). Efavirenz/lamivudine/abacavir FDC strength options assessed were (I) 150/75/150, (II) 120/60/120 and (III) 200/100/200 mg. Monte Carlo simulations of the different FDC strengths were performed to determine the optimal dose within each of the WHO weight bands based on drug efficacy/safety targets. The probability of being within the target efavirenz concentration range 12 h post-dose (1-4 mg/L) varied between 56% and 60%, regardless of FDC option. Option I provided a best possible balance between efavirenz treatment failure and toxicity risks. For abacavir and lamivudine, simulations showed that for option I >75% of subjects were above the efficacy target. According to simulations, a paediatric efavirenz/lamivudine/abacavir fixed-dose formulation of 150 mg efavirenz, 75 mg lamivudine and 150 mg abacavir provided the most effective and safe concentrations across WHO weight bands, with the flexibility of dosage required across the paediatric population. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Effectiveness of Standardized Patient Simulations in Teaching Clinical Communication Skills to Dental Students.

PubMed

McKenzie, Carly T; Tilashalski, Ken R; Peterson, Dawn Taylor; White, Marjorie Lee

2017-10-01

The aim of this study was to investigate dental students' long-term retention of clinical communication skills learned in a second-year standardized patient simulation at one U.S. dental school. Retention was measured by students' performance with an actual patient during their fourth year. The high-fidelity simulation exercise focused on clinical communication skills took place during the spring term of the students' second year. The effect of the simulation was measured by comparing the fourth-year clinical performance of two groups: those who had participated in the simulation (intervention group; Class of 2016) and those who had not (no intervention/control group; Class of 2015). In the no intervention group, all 47 students participated; in the intervention group, 58 of 59 students participated. Both instructor assessments and students' self-assessments were used to evaluate the effectiveness of key patient interaction principles as well as comprehensive presentation of multiple treatment options. The results showed that students in the intervention group more frequently included cost during their treatment option presentation than did students in the no intervention group. The instructor ratings showed that the intervention group included all key treatment option components except duration more frequently than did the no intervention group. However, the simulation experience did not result in significantly more effective student-patient clinical communication on any of the items measured. This study presents limited evidence of the effectiveness of a standardized patient simulation to improve dental students' long-term clinical communication skills with respect to thorough presentation of treatment options to a patient.

A noise power spectrum study of a new model‐based iterative reconstruction system: Veo 3.0

PubMed Central

Li, Guang; Liu, Xinming; Dodge, Cristina T.; Jensen, Corey T.

2016-01-01

The purpose of this study was to evaluate performance of the third generation of model‐based iterative reconstruction (MBIR) system, Veo 3.0, based on noise power spectrum (NPS) analysis with various clinical presets over a wide range of clinically applicable dose levels. A CatPhan 600 surrounded by an oval, fat‐equivalent ring to mimic patient size/shape was scanned 10 times at each of six dose levels on a GE HD 750 scanner. NPS analysis was performed on images reconstructed with various Veo 3.0 preset combinations for comparisons of those images reconstructed using Veo 2.0, filtered back projection (FBP) and adaptive statistical iterative reconstruction (ASiR). The new Target Thickness setting resulted in higher noise in thicker axial images. The new Texture Enhancement function achieved a more isotropic noise behavior with less image artifacts. Veo 3.0 provides additional reconstruction options designed to allow the user choice of balance between spatial resolution and image noise, relative to Veo 2.0. Veo 3.0 provides more user selectable options and in general improved isotropic noise behavior in comparison to Veo 2.0. The overall noise reduction performance of both versions of MBIR was improved in comparison to FBP and ASiR, especially at low‐dose levels. PACS number(s): 87.57.‐s, 87.57.Q‐, 87.57.C‐, 87.57.nf, 87.57.C‐, 87.57.cm PMID:27685118

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

Financing Energy Upgrades for K-12 School Districts: A Guide to Tapping into Funding for Energy Efficiency and Renewable Energy Improvements

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

Goggio Borgeson, Merrian; Zimring, Mark

This guide focuses on clean energy financing options for school administrators, facility managers, and other K-12 school decision makers who are considering investments in high performance school projects. This guide explicitly focuses on comprehensive energy upgrades, those that involve multiple measures and are targeted toward achieving significant energy savings. Successful implementation of clean energy upgrades in schools is a matter of understanding the opportunity, making the commitment, and creatively tapping into available financing. This guide attempts to provide the foundation needed for successful projects in U.S. schools. It walks through the financing options available to K-12 schools and provides casemore » studies of six school districts from around the country.« less

Effective multi-level, multi-sector, school-based obesity prevention programming improves weight, blood pressure, and academic performance, especially among low-income, minority children.

PubMed

Hollar, Danielle; Lombardo, Michelle; Lopez-Mitnik, Gabriella; Hollar, Theodore L; Almon, Marie; Agatston, Arthur S; Messiah, Sarah E

2010-05-01

Successfully addressing childhood onset obesity requires multilevel (individual, community, and governmental), multi-agency collaboration. The Healthier Options for Public Schoolchildren (HOPS)/OrganWise Guys (OWG) quasi-experimental controlled pilot study (four intervention schools, one control school, total N=3,769; 50.2% Hispanic) was an elementary school-based obesity prevention intervention designed to keep children at a normal, healthy weight, and improve health status and academic achievement. The HOPS/OWG included the following replicable, holistic components: (1) modified dietary offerings, (2) nutrition/lifestyle educational curricula; (3) physical activity component; and (4) wellness projects. Demographic, anthropometric (body mass index [BMI]), blood pressure, and academic data were collected during the two-year study period (2004-6). Statistically significant improvements in BMI, blood pressure, and academic scores, among low-income Hispanic and White children in particular, were seen in the intervention versus controls. Holistic school-based obesity prevention interventions can improve health outcomes and academic performance, in particular among high-risk populations.

Excellence in Teacher Education: Options for a Federal Partnership.

ERIC Educational Resources Information Center

Florio, David H.

An overview of options available for Federal cooperation in the improvement of teacher education considers possible areas in which government support may be effective. These include: (1) recruitment of talented students; (2) financial support for prospective teachers; (3) improvement grants to schools of education; (4) grants supporting…

Improving Dementia Long-Term Care

PubMed Central

Shih, Regina A.; Concannon, Thomas W.; Liu, Jodi L.; Friedman, Esther M.

2014-01-01

Abstract In 2010, 15 percent of Americans older than age 70 had dementia, and the number of new dementia cases among those 65 and older is expected to double by the year 2050. As the baby boomer generation ages, many older adults will require dementia-related long-term services and supports (LTSS). This blueprint is the only national document to date that engages local, state, and national stakeholders to specifically focus on policy options at the intersection of dementia and LTSS. The authors undertook five major tasks that resulted in a prioritized list of policy options and research directions to help decisionmakers improve the dementia LTSS delivery system, workforce, and financing. These were to (1) identify weaknesses in the LTSS system that may be particularly severe for persons with dementia; (2) review national and state strategies addressing dementia or LTSS policy; (3) identify policy options from the perspective of a diverse group of stakeholders; (4) evaluate the policy options; and (5) prioritize policy options by impact and feasibility. Stakeholders identified 38 policy options. RAND researchers independently evaluated these options against prespecified criteria, settling on 25 priority options. These policy options can be summarized into five objectives for the dementia LTSS system: (1) increase public awareness of dementia to reduce stigma and promote earlier detection; (2) improve access to and use of LTSS; (3) promote high-quality, person- and caregiver-centered care; (4) provide better support for family caregivers of people with dementia; and (5) reduce the burden of dementia LTSS costs on individuals and families. This policy blueprint provides a foundation upon which to build consensus among a larger set of stakeholders to set priorities and the sequencing of policy recommendations. PMID:28083331

Initial Business Case Analysis of Two Integrated Heat Pump HVAC Systems for Near-Zero-Energy Homes

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

Baxter, Van D

2006-11-01

The long range strategic goal of the Department of Energy's Building Technologies (DOE/BT) Program is to create, by 2020, technologies and design approaches that enable the construction of net-zero energy homes at low incremental cost (DOE/BT 2005). A net zero energy home (NZEH) is a residential building with greatly reduced needs for energy through efficiency gains, with the balance of energy needs supplied by renewable technologies. While initially focused on new construction, these technologies and design approaches are intended to have application to buildings constructed before 2020 as well resulting in substantial reduction in energy use for all building typesmore » and ages. DOE/BT's Emerging Technologies (ET) team is working to support this strategic goal by identifying and developing advanced heating, ventilating, air-conditioning, and water heating (HVAC/WH) technology options applicable to NZEHs. Although the energy efficiency of heating, ventilating, and air-conditioning (HVAC) equipment has increased substantially in recent years, new approaches are needed to continue this trend. Dramatic efficiency improvements are necessary to enable progress toward the NZEH goals, and will require a radical rethinking of opportunities to improve system performance. The large reductions in HVAC energy consumption necessary to support the NZEH goals require a systems-oriented analysis approach that characterizes each element of energy consumption, identifies alternatives, and determines the most cost-effective combination of options. In particular, HVAC equipment must be developed that addresses the range of special needs of NZEH applications in the areas of reduced HVAC and water heating energy use, humidity control, ventilation, uniform comfort, and ease of zoning. In FY05 ORNL conducted an initial Stage 1 (Applied Research) scoping assessment of HVAC/WH systems options for future NZEHs to help DOE/BT identify and prioritize alternative approaches for further development. Eleven system concepts with central air distribution ducting and nine multi-zone systems were selected and their annual and peak demand performance estimated for five locations: Atlanta (mixed-humid), Houston (hot-humid), Phoenix (hot-dry), San Francisco (marine), and Chicago (cold). Performance was estimated by simulating the systems using the TRNSYS simulation engine (Solar Energy Laboratory et al. 2006) in two 1800-ft{sup 2} houses--a Building America (BA) benchmark house and a prototype NZEH taken from BEopt results at the take-off (or crossover) point (i.e., a house incorporating those design features such that further progress towards ZEH is through the addition of photovoltaic power sources, as determined by current BEopt analyses conducted by NREL). Results were summarized in a project report, 'HVAC Equipment Design options for Near-Zero-Energy Homes--A Stage 2 Scoping Assessment,' ORNL/TM-2005/194 (Baxter 2005). The 2005 study report describes the HVAC options considered, the ranking criteria used, and the system rankings by priority. Table 1 summarizes the energy savings potential of the highest scoring options from the 2005 study for all five locations.« less

Solar Power System Options for the Radiation and Technology Demonstration Spacecraft

NASA Technical Reports Server (NTRS)

Kerslake, Thomas W.; Haraburda, Francis M.; Riehl, John P.

2000-01-01

The Radiation and Technology Demonstration (RTD) Mission has the primary objective of demonstrating high-power (10 kilowatts) electric thruster technologies in Earth orbit. This paper discusses the conceptual design of the RTD spacecraft photovoltaic (PV) power system and mission performance analyses. These power system studies assessed multiple options for PV arrays, battery technologies and bus voltage levels. To quantify performance attributes of these power system options, a dedicated Fortran code was developed to predict power system performance and estimate system mass. The low-thrust mission trajectory was analyzed and important Earth orbital environments were modeled. Baseline power system design options are recommended on the basis of performance, mass and risk/complexity. Important findings from parametric studies are discussed and the resulting impacts to the spacecraft design and cost.

Standard CMMI (Registered Trademark) Appraisal Method for Process Improvement (SCAMPI (Service Mark)) A, Version 1.3: Method Definition Document

DTIC Science & Technology

2011-03-01

performance of Federal Government Contract Number FA8721-05- C -0003 with Carnegie Mellon University for the operation of the Software Engineering... C Roles and Responsibilities 195 Appendix D Reporting Requirements and Options 201 Appendix E Managed Discovery 203 Appendix F Scoping and...Upgrade Team (SUT) • Mary Busby , Lockheed Martin • Palma Buttles-Valdez, Software Engineering Institute • Paul Byrnes, Integrated System Diagnostics

New Stimulation Strategy to Improve the Bladder Function in Paraplegics: Chronic Experiments in Dogs

DTIC Science & Technology

2001-10-25

urinary system [4]. More recently, neurostimulation and neuromodulation of the sacral nerve root seems to be one of the most promising options to enhance...day. Expelled and residual urine volumes were measured. Also the applied parameters for the continuous low frequency / low amplitude neuromodulation ...VCUG) with neurostimulation was carried out after IVU study. Low-frequency only stimulation During the 7th month, daily stimulations were performed

VA Disability Benefits: Additional Planning Would Enhance Efforts to Improve the Timeliness of Appeals Decisions

DTIC Science & Technology

2017-03-01

manage risks and help ensure successful implementation of significant institutional change. VA officials told GAO that pilot testing—which would...Organization: How Do I Implement Complex Change at Scale? Dallas, TX: McKinsey & Company, May 2011, and Project Management Institute , Inc. A Guide to...options compared in its analysis. We conducted this performance audit from February 2016 to March 2017 in accordance with generally accepted government

An investigation into the optimal number of distractors in single-best answer exams.

PubMed

Kilgour, James M; Tayyaba, Saadia

2016-08-01

In UK medical schools, five-option single-best answer (SBA) questions are the most widely accepted format of summative knowledge assessment. However, writing SBA questions with four effective incorrect options is difficult and time consuming, and consequently, many SBAs contain a high frequency of implausible distractors. Previous research has suggested that fewer than five-options could hence be used for assessment, without deterioration in quality. Despite an existing body of empirical research in this area however, evidence from undergraduate medical education is sparse. The study investigated the frequency of non-functioning distractors in a sample of 480 summative SBA questions at Cardiff University. Distractor functionality was analysed, and then various question models were tested to investigate the impact of reducing the number of distractors per question on examination difficulty, reliability, discrimination and pass rates. A survey questionnaire was additionally administered to 108 students (33 % response rate) to gain insight into their perceptions of these models. The simulation of various exam models revealed that, for four and three-option SBA models, pass rates, reliability, and mean item discrimination remained relatively constant. The average percentage mark however consistently increased by 1-3 % with the four and three-option models, respectively. The questionnaire survey revealed that the student body had mixed views towards the proposed format change. This study is one of the first to comprehensively investigate distractor performance in SBA examinations in undergraduate medical education. It provides evidence to suggest that using three-option SBA questions would maximise efficiency whilst maintaining, or possibly improving, psychometric quality, through allowing a greater number of questions per exam paper.

Working-memory load and temporal myopia in dynamic decision making.

PubMed

Worthy, Darrell A; Otto, A Ross; Maddox, W Todd

2012-11-01

We examined the role of working memory (WM) in dynamic decision making by having participants perform decision-making tasks under single-task or dual-task conditions. In 2 experiments participants performed dynamic decision-making tasks in which they chose 1 of 2 options on each trial. The decreasing option always gave a larger immediate reward but caused future rewards for both options to decrease. The increasing option always gave a smaller immediate reward but caused future rewards for both options to increase. In each experiment we manipulated the reward structure such that the decreasing option was the optimal choice in 1 condition and the increasing option was the optimal choice in the other condition. Behavioral results indicated that dual-task participants selected the immediately rewarding decreasing option more often, and single-task participants selected the increasing option more often, regardless of which option was optimal. Thus, dual-task participants performed worse on 1 type of task but better on the other type. Modeling results showed that single-task participants' data were most often best fit by a win-stay, lose-shift (WSLS) rule-based model that tracked differences across trials, and dual-task participants' data were most often best fit by a Softmax reinforcement learning model that tracked recency-weighted average rewards for each option. This suggests that manipulating WM load affects the degree to which participants focus on the immediate versus delayed consequences of their actions and whether they employ a rule-based WSLS strategy, but it does not necessarily affect how well people weigh the immediate versus delayed benefits when determining the long-term utility of each option.

75 FR 31826 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

... financial products such as securities index options, index futures, and options on index futures to be... futures, options on S&P 500 futures or any other instrument that tracks the performance of or is based on... 24.4.05(A). These definitions would allow financial products such as ETF options, index futures...

Managing Cancer Care: a psycho-educational intervention to improve knowledge of care options and breast cancer self-management.

PubMed

Schulman-Green, Dena; Jeon, Sangchoon

2017-02-01

We tested the feasibility and acceptability of a psycho-educational self-management intervention, Managing Cancer Care: A Personal Guide (MCC), to improve knowledge of care options (curative, palliative, and hospice care) among a range of breast cancer self-management skills. We conducted a one-group, pre-post-test study among women with non-metastatic breast cancer (n = 105). We gave participants the printed, self-guided, seven-module intervention following enrollment. At baseline and 2  months, we measured knowledge of care options, desired and actual role in self-management, medical communication skills, experience and management of transitions, anxiety, depression, uncertainty, and self-efficacy. We conducted interviews to obtain module ratings and qualitative data on strengths and limitations of MCC. Knowledge of care options (δ = 0.40 (1.11), p = 0.0005) and desired role in self-management (δ = -0.28 (1.08), p = 0.0177) significantly improved. Less skilled medical communicators significantly improved their communication (δ = 3.47, standard deviation = 6.58, p = 0.0449). Multivariate modeling showed that changes in our primary outcomes of medical communication and management of transitions seemed to drive positive changes in our secondary outcomes of anxiety, depression, uncertainty, and self-efficacy. Participants highly rated MCC and reported the importance of understanding care options despite non-metastatic disease. MCC is a feasible and acceptable means of improving knowledge of care options and other aspects of breast cancer self-management. The combination of modules offered in MCC appears to have beneficial interactive effects. We are currently testing MCC more rigorously in a randomized controlled trial to explore mediating and moderating relationships. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Simulation of alternate hohlraum shapes for improved inner beam propagation in indirectly-driven ICF implosions

NASA Astrophysics Data System (ADS)

Robey, H. F.; Berzak Hopkins, L. F.

2017-10-01

Recent indirectly-driven ICF experiments performed on the National Ignition Facility have shown that the propagation of the inner beam cones is impeded late in the laser pulse by the growth of a gold bubble, which is initiated at the location where the outer beams hit the hohlraum wall and which expands radially inward into the hohlraum as the implosion progresses. Late in time, this gold bubble intercepts a significant portion of the inner beams reducing the available energy reaching the waist of the hohlraum and affecting the implosion symmetry. Integrated hohlraum simulations of alternate hohlraum shapes using HYDRA are performed to explore options for reducing the impact of the gold bubble on inner beam propagation. The simulations are based on recent NIF implosions using High-Density Carbon (HDC) ablators, which have shown good performance, but which could benefit from improved inner beam propagation. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

Availability of a sports dietitian may lead to improved performance and recovery of NCAA division I baseball athletes.

PubMed

Hull, Michael V; Neddo, Jonathan; Jagim, Andrew R; Oliver, Jonathan M; Greenwood, Mike; Jones, Margaret T

2017-01-01

The purpose was to survey dietary habits (DH) and nutrient timing (NT) practices of baseball student-athletes (mean ±  SD; 20.7 ± 1.4 yr.) from three NCAA Division I institutions, and examine the effect of a sports dietitian (SD) in regard to nutrition practices. Descriptive statistics and Pearson X 2 analyses were run. Responses on 10 DH and 5 NT items differed ( p  ≤ 0.10) between athletes who sought dietary planning from a SD ( n  = 36) versus those who consulted a strength and conditioning coach (SCC, n  = 42). In regard to DH items, the SD group found it easier to eat before activity (92% vs. 71%, p  = 0.03), did not consume fast food (31% vs. 14%, p  = 0.02), caffeinated beverages (57% vs. 46%, p  = 0.02), or soda (56% vs. 37%, p  = 0.10), prepared their own meals more often (86% vs. 73%, p  = 0.07), and took daily multi-vitamins (56% vs. 32%, p  = 0.02). The SCC group ate more at burger locations (21% vs. 6%, p  = 0.02). In regard to NT items, the SD group ate breakfast before training/lifting sessions (67% vs. 37%, p  = 0.02), and had post-workout nutrition options provided (61% vs. 27%, p  = 0.01). The SCC group reported pre-competition meals of fast food (58% vs. 45%, p  = 0.01), and sport coaches who were less aware of healthy food options (39% vs. 65%, p  = 0.05). The SD is as a valuable asset to an intercollegiate athletics program. In the current study, athletes from the SD group consumed less high calorie/low nutrient dense items, ate before exercise, and consumed healthier options post-exercise. The presence of a SD was linked to provision of healthier food options during team trips. The evidence-based eating strategies and dietary plan provided by a SD may lead to improved performance and recovery.

Discussion of Policies for Achieving Continuous Improvement in Community Colleges. Commission on Innovation Policy Discussion Paper Number 1.

ERIC Educational Resources Information Center

BW Associates, Berkeley, CA.

Intended to provide background information and preliminary options for the California Community Colleges' Commission on Innovation, this document describes the principles of Continuous Quality Improvement (CQI) and describes policy options for implementation in the state's community colleges. Following introductory materials, the paper recommends…

76 FR 64174 - Public Input on the Report to Congress on How To Modernize and Improve the System of Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... examples, supporting any opinions or conclusions; (2) approaches and options toward improvement or... out such approaches or options. FOR FURTHER INFORMATION CONTACT: Federal Insurance Office, Department... submit views on: 1. Systemic risk regulation with respect to insurance; 2. Capital standards and the...

Nature of collective decision-making by simple yes/no decision units.

PubMed

Hasegawa, Eisuke; Mizumoto, Nobuaki; Kobayashi, Kazuya; Dobata, Shigeto; Yoshimura, Jin; Watanabe, Saori; Murakami, Yuuka; Matsuura, Kenji

2017-10-31

The study of collective decision-making spans various fields such as brain and behavioural sciences, economics, management sciences, and artificial intelligence. Despite these interdisciplinary applications, little is known regarding how a group of simple 'yes/no' units, such as neurons in the brain, can select the best option among multiple options. One prerequisite for achieving such correct choices by the brain is correct evaluation of relative option quality, which enables a collective decision maker to efficiently choose the best option. Here, we applied a sensory discrimination mechanism using yes/no units with differential thresholds to a model for making a collective choice among multiple options. The performance corresponding to the correct choice was shown to be affected by various parameters. High performance can be achieved by tuning the threshold distribution with the options' quality distribution. The number of yes/no units allocated to each option and its variability profoundly affects performance. When this variability is large, a quorum decision becomes superior to a majority decision under some conditions. The general features of this collective decision-making by a group of simple yes/no units revealed in this study suggest that this mechanism may be useful in applications across various fields.

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

Investigation of non-Gaussian effects in the Brazilian option market

NASA Astrophysics Data System (ADS)

Sosa-Correa, William O.; Ramos, Antônio M. T.; Vasconcelos, Giovani L.

2018-04-01

An empirical study of the Brazilian option market is presented in light of three option pricing models, namely the Black-Scholes model, the exponential model, and a model based on a power law distribution, the so-called q-Gaussian distribution or Tsallis distribution. It is found that the q-Gaussian model performs better than the Black-Scholes model in about one third of the option chains analyzed. But among these cases, the exponential model performs better than the q-Gaussian model in 75% of the time. The superiority of the exponential model over the q-Gaussian model is particularly impressive for options close to the expiration date, where its success rate rises above ninety percent.

Flexible Reporting Options for Skilled Child Abuse Professionals.

ERIC Educational Resources Information Center

Finkelhor, David; Zellman, Gail L.

1991-01-01

Proposed is a system of flexible options for the mandated reporting of child abuse and neglect, to improve compliance with and reduce burdens on the child protective system. Potential benefits and drawbacks of the plan, which would identify and train "registered reporters" and offer the option of explicit deferred investigation, are…

Following your heart or your head: focusing on emotions versus information differentially influences the decisions of younger and older adults.

PubMed

Mikels, Joseph A; Löckenhoff, Corinna E; Maglio, Sam J; Goldstein, Mary K; Garber, Alan; Carstensen, Laura L

2010-03-01

Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information. Instructional manipulations in the emotion-focus condition asked participants to focus on their emotional reactions to the options, report their feelings about the options, and then make a choice. In the information-focus condition, participants were instructed to focus on the specific attributes, report the details about the options, and then make a choice. In a control condition, no directives were given. Manipulation checks indicated that the instructions were successful in eliciting different modes of processing. Decision quality data indicate that younger adults performed better in the information-focus than in the control condition whereas older adults performed better in the emotion-focus and control conditions than in the information-focus condition. Findings support and extend extant theorizing on aging and decision making as well as suggest that interventions to improve decision-making quality should take the age of the decision maker into account.

A Methodology for Improving the Shipyard Planning Process: Using KVA Analysis, Risk Simulation and Strategic Real Options

DTIC Science & Technology

2006-09-30

allocated to intangible assets. With Proctor & Gamble’s $53.5 billion acquisition of Gillette , $31.5 billion or 59% of the total purchase price was... outsourcing , alliances, joint ventures) • Compound Option (platform options) • Sequential Options (stage-gate development, R&D, phased...Comparisons • RO/KVA could enhance outsourcing comparisons between the Government’s Most Efficient Organization (MEO) and private-sector

48 CFR 317.107 - Options.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Options. 317.107 Section... CONTRACT TYPES SPECIAL CONTRACTING METHODS Multi-year Contracting 317.107 Options. When used as part of a multi-year contract, options shall not be used to extend the performance of the original requirement for...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 2 2011-10-01 2011-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 2 2012-10-01 2012-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 2 2013-10-01 2013-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

48 CFR 52.217-8 - Option To Extend Services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 2 2014-10-01 2014-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

Acceptance criteria for urban dispersion model evaluation

NASA Astrophysics Data System (ADS)

Hanna, Steven; Chang, Joseph

2012-05-01

The authors suggested acceptance criteria for rural dispersion models' performance measures in this journal in 2004. The current paper suggests modified values of acceptance criteria for urban applications and tests them with tracer data from four urban field experiments. For the arc-maximum concentrations, the fractional bias should have a magnitude <0.67 (i.e., the relative mean bias is less than a factor of 2); the normalized mean-square error should be <6 (i.e., the random scatter is less than about 2.4 times the mean); and the fraction of predictions that are within a factor of two of the observations (FAC2) should be >0.3. For all data paired in space, for which a threshold concentration must always be defined, the normalized absolute difference should be <0.50, when the threshold is three times the instrument's limit of quantification (LOQ). An overall criterion is then applied that the total set of acceptance criteria should be satisfied in at least half of the field experiments. These acceptance criteria are applied to evaluations of the US Department of Defense's Joint Effects Model (JEM) with tracer data from US urban field experiments in Salt Lake City (U2000), Oklahoma City (JU2003), and Manhattan (MSG05 and MID05). JEM includes the SCIPUFF dispersion model with the urban canopy option and the urban dispersion model (UDM) option. In each set of evaluations, three or four likely options are tested for meteorological inputs (e.g., a local building top wind speed, the closest National Weather Service airport observations, or outputs from numerical weather prediction models). It is found that, due to large natural variability in the urban data, there is not a large difference between the performance measures for the two model options and the three or four meteorological input options. The more detailed UDM and the state-of-the-art numerical weather models do provide a slight improvement over the other options. The proposed urban dispersion model acceptance criteria are satisfied at over half of the field experiments.

Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: a prospective study.

PubMed

Barnes, Darryl E; Beckley, James M; Smith, Jay

2015-01-01

Elbow tendinopathy is the most common cause of elbow pain affecting active populations. Surgical excision is reserved for patients with refractory symptoms. Percutaneous ultrasonic tenotomy performed under local anesthesia also removes degenerated tissue and therefore provides an alternative treatment option to surgical excision. This investigation prospectively documented the safety and 1-year efficacy of ultrasonic percutaneous tenotomy performed by a single operator. Nineteen patients, aged 38 to 67 years, in whom >6 months of conservative management for medial (7) or lateral (12) elbow tendinopathy had failed were prospectively studied. All patients were treated with percutaneous ultrasonic tenotomy of the elbow by a single operator. Visual analog scale (VAS) for pain, the 11-item version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) index, and the Mayo Elbow Performance Score (MEPS) were assessed by an independent observer before treatment and at 6 weeks, 3 months, 6 months, and 12 months after treatment. No procedural complications occurred. Total treatment time was <15 minutes, and ultrasonic energy time averaged 38.6 ± 8.8 seconds per procedure. Average VAS scores were significantly improved from 6.4 to 2.6 at 6 weeks and were 0.7 at 12 months (P < .0001). Similar improvement occurred with the Quick DASH (pretreatment, 44.1; 12 months, 8.6, P < .0001) and MEPS (pretreatment, 59.1; 12 months, 83.4; P < .0001). Percutaneous ultrasonic tenotomy performed under local anesthesia appears to be a safe and effective treatment option for chronic, refractory lateral or medial elbow tendinopathy up to 1 year after the procedure. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Interior and Exterior Low-E Storm Window Installation

ScienceCinema

Witters, Sarah

2018-01-16

Until recently, energy-efficient window retrofit options have largely been limited to repair or replacement; leaving the homeowner to decide between affordability and deeper energy savings. A new and improved low-e storm window boasts a combination of curb appeal and energy efficiency, all for a fraction of the cost of window replacement. A recent whole-home experiment performed by PNNL suggests that attaching low-e storm windows can result in as much energy savings replacing the windows.

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

DTIC Science & Technology

2010-03-30

NUMBER 5e . TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Congressional Research Service,Library of Congress,101...awarded the role to Integrated Coast Guard Systems (ICGS)—an industry team led by Lockheed Martin and Northrop Grumman Ship Systems ( NGSS ). ICGS was...Systems Command] and in April 2009. We continue to build on lessons learned and are making some significant improvements to the Stratton, including

The Air Force Needs to Improve Cost-Effectiveness and Availability of the Joint Surveillance Target Attack Radar System (Redacted)

DTIC Science & Technology

2016-11-01

Target Attack Radar System Objective We determined whether the Air Force made cost-effective purchases on the performance-based logistics contract to... contract to Northrop Grumman Corporation to provide Total System Support Responsibility services to sustain 16 E-8C JSTARS aircraft. These services...customer support. The Total System Support Responsibility contract is valued at $7 billion, with a 6-year base period and 16 annual contract option

Virtual surgical planning, flow simulation, and 3-dimensional electrospinning of patient-specific grafts to optimize Fontan hemodynamics.

PubMed

Siallagan, Dominik; Loke, Yue-Hin; Olivieri, Laura; Opfermann, Justin; Ong, Chin Siang; de Zélicourt, Diane; Petrou, Anastasios; Daners, Marianne Schmid; Kurtcuoglu, Vartan; Meboldt, Mirko; Nelson, Kevin; Vricella, Luca; Johnson, Jed; Hibino, Narutoshi; Krieger, Axel

2018-04-01

Despite advances in the Fontan procedure, there is an unmet clinical need for patient-specific graft designs that are optimized for variations in patient anatomy. The objective of this study is to design and produce patient-specific Fontan geometries, with the goal of improving hepatic flow distribution (HFD) and reducing power loss (P loss ), and manufacturing these designs by electrospinning. Cardiac magnetic resonance imaging data from patients who previously underwent a Fontan procedure (n = 2) was used to create 3-dimensional models of their native Fontan geometry using standard image segmentation and geometry reconstruction software. For each patient, alternative designs were explored in silico, including tube-shaped and bifurcated conduits, and their performance in terms of P loss and HFD probed by computational fluid dynamic (CFD) simulations. The best-performing options were then fabricated using electrospinning. CFD simulations showed that the bifurcated conduit improved HFD between the left and right pulmonary arteries, whereas both types of conduits reduced P loss . In vitro testing with a flow-loop chamber supported the CFD results. The proposed designs were then successfully electrospun into tissue-engineered vascular grafts. Our unique virtual cardiac surgery approach has the potential to improve the quality of surgery by manufacturing patient-specific designs before surgery, that are also optimized with balanced HFD and minimal P loss , based on refinement of commercially available options for image segmentation, computer-aided design, and flow simulations. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Neurocognitive Performance is Not Degraded After Stellate Ganglion Block Treatment for Post-Traumatic Stress Disorder: A Case Series.

PubMed

Mulvaney, Sean W; Lynch, James H; de Leeuw, Jason; Schroeder, Matthew; Kane, Shawn

2015-05-01

To measure key neurocognitive performance effects following stellate ganglion block (SGB) administered to treat post-traumatic stress disorder (PTSD) symptoms. Eleven patients diagnosed, screened, and scheduled for SGB to treat their PTSD symptoms were administered a panel of eight cognitive measures before and 1 to 3 weeks after undergoing this procedure. PTSD symptoms were evaluated using the Posttraumatic Stress Disorder Checklist-Military. One to three weeks post-SGB, none of the patients showed any statistically significant decline in neurocognitive performance. Rather, there was a clear trend in improvement, with four out of eight measures reaching statistical significance following SGB. All patients improved in PTSD symptoms with a mean improvement on Posttraumatic Stress Disorder Checklist-Military of 29. In this case series of 11 patients, SGB effectively treated PTSD symptoms and did not impair reaction time, memory, or concentration. Therefore, SGB should be considered as a viable treatment option for personnel with PTSD symptoms who will be placed in demanding conditions such as combat. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Enhancing Visualization Skills-Improving Options and Success (EnViSIONS) of Engineering and Technology Students

ERIC Educational Resources Information Center

Veurink, N. L.; Hamlin, A. J.; Kampe; J. C. M.; Sorby, S. A.; Blasko, D. G.; Holliday-Darr, K. A.; Kremer, J. D. Trich; Harris, L. V. Abe; Connolly, P. E.; Sadowski, M. A.; Harris, K. S.; Brus, C. P.; Boyle, L. N.; Study, N. E.; Knott, T. W.

2009-01-01

Spatial visualization skills are vital to many careers and in particular to STEM fields. Materials have been developed at Michigan Technological University and Penn State Erie, The Behrend College to assess and develop spatial skills. The EnViSIONS (Enhancing Visualization Skills-Improving Options aNd Success) project is combining these materials…

New Information Technology Directions for American Education. Improving Science and Mathematics Education. Final Report.

ERIC Educational Resources Information Center

Melmed, Arthur S.; Burnham, Robert A.

This report is an analysis of the findings of four workshops exploring the ways interactive technology can be considered an option for improving American education after 25 years of research and development. Sections include: (1) "Manpower Needs and School Problems"; (2) "Science and Technology Option"; (3) "Barriers and Strategy"; and (4) "To…

77 FR 20471 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Order Approving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-04

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66677; File No. SR-C2-2012-006] Self-Regulatory... Improvement Mechanism March 29, 2012. On January 31, 2012, the C2 Options Exchange, Incorporated (``Exchange... C2 Rule 6.51, which relates to the Exchange's Automated Improvement Mechanism (``AIM''). The proposal...

Performance Expectations of Closed-Brayton-Cycle Heat Exchangers in 100-kWe Nuclear Space Power Systems

NASA Technical Reports Server (NTRS)

Barrett, Michael J.

2003-01-01

Performance expectations of closed-Brayton-cycle heat exchangers to be used in 100-kWe nuclear space power systems were forecast. Proposed cycle state points for a system supporting a mission to three of Jupiter s moons required effectiveness values for the heat-source exchanger, recuperator and rejection exchanger (gas cooler) of 0.98,0.95 and 0.97, respectively. Performance parameters such as number of thermal units (Nm), equivalent thermal conductance (UA), and entropy generation numbers (Ns) varied from 11 to 19,23 to 39 kWK, and 0.019 to 0.023 for some standard heat exchanger configurations. Pressure-loss contributions to entropy generation were significant; the largest frictional contribution was 114% of the heat-transfer irreversibility. Using conventional recuperator designs, the 0.95 effectiveness proved difficult to achieve without exceeding other performance targets; a metallic, plate-fin counterflow solution called for 15% more mass and 33% higher pressure-loss than the target values. Two types of gas-coolers showed promise. Single-pass counterflow and multipass cross-counterflow arrangements both met the 0.97 effectiveness requirement. Potential reliability-related advantages of the cross-countefflow design were noted. Cycle modifications, enhanced heat transfer techniques and incorporation of advanced materials were suggested options to reduce system development risk. Carbon-carbon sheeting or foam proved an attractive option to improve overall performance.

An Examination of School Choice and Fifth Grade Science Achievement in Florida

NASA Astrophysics Data System (ADS)

McLarnon, Tara Lynn

Over the past 20 years, a movement to offer greater access and choice in public education has begun to challenge the traditional attendance boundary school system. Public school choice provides an opportunity for parents who do not have the resources to change attendance boundaries but who want additional public school options. Proponents argue that increased competition incentivizes all schools to improve performance. The purpose of this study was to determine whether there were any potential relationships among school choice options and other inputs such as student characteristics when looking at student science achievement. Based on an education production function model, the study focused on the specific output of performance. A conceptual model looking at common inputs related to the outcome of student performance, identified five groups of inputs: school type, student characteristics, learning needs, school characteristics, and teacher quality. Rather than look across states, where policies affecting student performance differ, this study looked exclusively at one large state population. Subjects of the study were fifth grade students in the state of Florida. Utilizing three years of state science assessment data, the roles of school type, selected student demographics, and ELL status were examined using logistic regression and ordinary least squares analysis. Results indicated that, while some subpopulations of students performed better in different school types, school type alone was not a strong predictor of student science achievement.

Performance Expectations of Closed-Brayton-Cycle Heat Exchangers in 100-kWe Nuclear Space Power Systems

NASA Technical Reports Server (NTRS)

Barrett, Michael J.

2003-01-01

Performance expectations of closed-Brayton-cycle heat exchangers to be used in 100-k We nuclear space power systems were forecast. Proposed cycle state points for a system supporting a mission to three of Jupiter's moons required effectiveness values for the heat-source exchanger, recuperator and rejection exchanger (gas cooler) of 0.98, 0.95, and 0.97, respectively. Performance parameters such as number of thermal units (Ntu), equivalent thermal conductance (UA), and entropy generation numbers (Ns) varied from 11 to 19, 23 to 39 kW/K, and 0.019 to 0.023 for some standard heat exchanger configurations. Pressure-loss contributions to entropy generation were significant; the largest frictional contribution was 114% of the heat transfer irreversibility. Using conventional recuperator designs, the 0.95 effectiveness proved difficult to achieve without exceeding other performance targets; a metallic, plate-fin counterflow solution called for 15% more mass and 33% higher pressure-loss than the target values. Two types of gas-coolers showed promise. Single-pass counterflow and multipass cross-counterflow arrangements both met the 0.97 effectiveness requirement. Potential reliability-related advantages of the cross-counterflow design were noted. Cycle modifications, enhanced heat transfer techniques and incorporation of advanced materials were suggested options to reduce system development risk. Carbon-carbon sheeting or foam proved an attractive option to improve overall performance.

Alleviating debilitating, chronic constipation with colostomy after appendicostomy: a case study.

PubMed

Baig, Mirza K; Boyer, Mary Lou; Marquez, Helen; Wexner, Steven D

2005-12-01

Severe chronic constipation is a debilitating condition. Patients not only experience infrequent bowel movements, but also are often frustrated by the sensation of incomplete evacuation; pain; straining; daily use of enemas; and continual concerns regarding diet, fluids, and medications. Diagnostic tests are performed to rule out organic causes of the condition. Common treatment options consist of dietary fiber supplementation, dietary instruction, adequate fluid intake, enemas, and laxatives; additional noninvasive management includes biofeedback training and botulinum toxin type A injections. Surgery is rarely recommended, although a select group of patients may benefit from antegrade continence enema procedure. A female patient presented with a history of long-standing constipation. When antegrade continence enema offered no improvement and other treatment measures failed, she underwent successful laparoscopic-assisted sigmoid resection and end colostomy. This approach may provide options for patients in similar circumstances.

Shipboard fisheries management terminals

NASA Technical Reports Server (NTRS)

Nagler, R. G.; Sager, E. V.

1980-01-01

The needs of the National Marine Fisheries Service (NMGS), National Weather Service, and the U.S. Coast Guard for locational, biological, and environmental data were assessed. The fisheries conservation zones and the yellowfin tuna jurisdiction of the NMFS operates observer programs on foreign and domestic fishing vessels. Data input terminal and data transfer and processing technology are reviewed to establish available capability. A matrix of implementation options is generated to identify the benefits of each option, and preliminary cost estimates are made. Recommendations are made for incremental application of available off the shelf hardware to obtain improved performance and benefits within a well bounded cost. Terminal recommendations are made for three interdependent shipboard units emphasizing: (1) the determination of location and fishing activity; (2) hand held data inputting and formatting in the fishing work areas; and (3) data manipulation, merging, and editing.

Dosing strategies to optimize currently available anti-MRSA treatment options (Part 1: IV options).

PubMed

Hall, Ronald G; Thatcher, Michael; Wei, Wei; Varghese, Shibin; Varughese, Lincy; Ndiulor, Michelle; Payne, Kenna D

2017-05-01

Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a predominant pathogen resulting in significant morbidity and mortality. Optimal dosing of anti-MRSA agents is needed to help prevent the development of antimicrobial resistance and to increase the likelihood of a favorable clinical outcome. Areas covered: This review summarizes the available data for antimicrobials routinely used for MRSA infections that are not administered orally or topically. We make recommendations and highlight the current gaps in the literature. A PubMed (1966 - Present) search was performed to identify relevant literature for this review. Expert commentary: Improvements in MIC determination and therapeutic drug monitoring are needed to fully implement individualized dosing that optimizes antimicrobial pharmacodynamics.Additional data will become available for these agents in regards to effectiveness for severe MRSA infections and pharmacokinetic data for special patient populations.

Acetylcholinesterase inhibitors for the treatment of Wernicke-Korsakoff syndrome--three further cases show response to donepezil.

PubMed

Cochrane, Murray; Cochrane, Ashley; Jauhar, Pramod; Ashton, Elizabeth

2005-01-01

Three patients diagnosed with Wernicke-Korsakoff syndrome were treated with the acetylcholinesterase inhibitor, donepezil, for periods of 6 to 8 months. Cognitive testing [Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog), Mini-mental state examination (MMSE), Clock drawing test and six item 2 min recall] and carer questionnaires [Informant Questionnaire (IQ Code), Neuropsychiatric inventory scale (NPI)] were performed at baseline, mid- and endpoint of the treatment period and post-discontinuation. Progressive partial improvement occurred in cognitive measurements through the treatment period, some of which was sustained after discontinuing donepezil. Carer questionnaires also indicated improvement. Confounding factors necessitate caution when attributing improvements to the medication, but these cases suggest that this option merits further investigation.

Improving Conceptual Design for Launch Vehicles. The Bimese Concept: A Study of Mission and Economic Options

NASA Technical Reports Server (NTRS)

Olds, John R.; Tooley, Jeffrey

1999-01-01

This report summarizes key activities conducted in the third and final year of the cooperative agreement NCC1-229 entitled "Improving Conceptual Design for Launch Vehicles." This project has been funded by the Vehicle Analysis Branch at NASA's Langley Research Center in Hampton, VA. Work has been performed by the Space Systems Design Lab (SSDL) at the Georgia Institute of Technology, Atlanta, GA. Accomplishments during the first and second years of this project have been previously reported in annual progress reports. This report will focus on the third and final year of the three year activity.

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

Pricing of American style options with an adjoint process correction method

NASA Astrophysics Data System (ADS)

Jaekel, Uwe

2005-07-01

Pricing of American options is a more complicated problem than pricing of European options. In this work a formula is derived that allows the computation of the early exercise premium, i.e. the price difference between these two option types in terms of an adjoint process evolving in the reversed time direction of the original process determining the evolution of the European price. We show how this equation can be utilised to improve option price estimates from numerical schemes like finite difference or Monte Carlo methods.

77 FR 67851 - Self-Regulatory Organizations; BOX Options Exchange LLC; Order Approving Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-14

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-68177; File No. SR-BOX-2012-003] Self-Regulatory Organizations; BOX Options Exchange LLC; Order Approving Proposed Rule Change To Amend the Price Improvement Period November 7, 2012. I. Introduction On July 25, 2012, BOX Options Exchange LLC (``Exchange...

Integrated Heat Pump HVAC Systems for Near-Zero-Energy Homes - Business Case Assessment

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

Baxter, Van D

2007-05-01

The long range strategic goal of the Department of Energy's Building Technologies (DOE/BT) Program is to create, by 2020, technologies and design approaches that enable the construction of net-zero energy homes at low incremental cost (DOE/BT 2005). A net zero energy home (NZEH) is a residential building with greatly reduced needs for energy through efficiency gains, with the balance of energy needs supplied by renewable technologies. While initially focused on new construction, these technologies and design approaches are intended to have application to buildings constructed before 2020 as well resulting in substantial reduction in energy use for all building typesmore » and ages. DOE/BT's Emerging Technologies (ET) team is working to support this strategic goal by identifying and developing advanced heating, ventilating, air-conditioning, and water heating (HVAC/WH) technology options applicable to NZEHs. Although the energy efficiency of heating, ventilating, and air-conditioning (HVAC) equipment has increased substantially in recent years, new approaches are needed to continue this trend. Dramatic efficiency improvements are necessary to enable progress toward the NZEH goals, and will require a radical rethinking of opportunities to improve system performance. The large reductions in HVAC energy consumption necessary to support the NZEH goals require a systems-oriented analysis approach that characterizes each element of energy consumption, identifies alternatives, and determines the most cost-effective combination of options. In particular, HVAC equipment must be developed that addresses the range of special needs of NZEH applications in the areas of reduced HVAC and water heating energy use, humidity control, ventilation, uniform comfort, and ease of zoning. In FY05 ORNL conducted an initial Stage 1 (Applied Research) scoping assessment of HVAC/WH systems options for future NZEHs to help DOE/BT identify and prioritize alternative approaches for further development. Eleven system concepts with central air distribution ducting and nine multi-zone systems were selected and their annual and peak demand performance estimated for five locations: Atlanta (mixed-humid), Houston (hot-humid), Phoenix (hot-dry), San Francisco (marine), and Chicago (cold). Performance was estimated by simulating the systems using the TRNSYS simulation engine (Solar Energy Laboratory et al. 2006) in two 1800-ft{sup 2} houses--a Building America (BA) benchmark house and a prototype NZEH taken from BEopt results at the take-off (or crossover) point (i.e., a house incorporating those design features such that further progress towards ZEH is through the addition of photovoltaic power sources, as determined by current BEopt analyses conducted by NREL). Results were summarized in a project report, 'HVAC Equipment Design options for Near-Zero-Energy Homes--A Stage 2 Scoping Assessment', ORNL/TM-2005/194 (Baxter 2005). The 2005 study report describes the HVAC options considered, the ranking criteria used, and the system rankings by priority. Table 1 summarizes the energy savings potential of the highest scoring options from the 2005 study for all five locations. All system options were scored by the ORNL building equipment research team and by William Goetzler of Navigant Consulting. These scores were reviewed by DOE/BT's Residential Integration program leaders and Building America team members. Based on these results, the two centrally ducted integrated heat pump (IHP) systems (air source and ground source versions) were selected for advancement to Stage 2 (Exploratory Development) business case assessments in FY06. This report describes results of these business case assessments. It is a compilation of three separate reports describing the initial business case study (Baxter 2006a), an update to evaluate the impact of an economizer cooling option (Baxter 2006b), and a second update to evaluate the impact of a winter humidification option (Baxter 2007). In addition it reports some corrections made subsequent to release of the first two reports to correct some errors in the TRNSYS building model for Atlanta and in the refrigerant pressure drop calculation in the water-to-refrigerant evaporator module of the ORNL Heat Pump Design Model (HPDM) used for the IHP analyses. These changes resulted in some minor differences between IHP performance as reported in Baxter (2006a, b) and in this report.« less

Micromold methods for fabricating perforated substrates and for preparing solid polymer electrolyte composite membranes

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

Mittelsteadt, Cortney; Argun, Avni; Laicer, Castro

In polymer electrolyte membrane (PEM) fuel cells and electrolyzes, attaining and maintaining high membrane conductivity and durability is crucial for performance and efficiency. The use of low equivalent weight (EW) perfluorinated ionomers is one of the few options available to improve membrane conductivity. However, excessive dimensional changes of low EW ionomers upon application of wet/dry or freeze/thaw cycles yield catastrophic losses in membrane integrity. Incorporation of ionomers within porous, dimensionally-stable perforated polymer electrolyte membrane substrates provides improved PEM performance and longevity. The present invention provides novel methods using micromolds to fabricate the perforated polymer electrolyte membrane substrates. These novel methodsmore » using micromolds create uniform and well-defined pore structures. In addition, these novel methods using micromolds described herein may be used in batch or continuous processing.« less

TRISO Fuel Performance: Modeling, Integration into Mainstream Design Studies, and Application to a Thorium-fueled Fusion-Fission Hybrid Blanket

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

Powers, Jeffrey James

2011-11-30

This study focused on creating a new tristructural isotropic (TRISO) coated particle fuel performance model and demonstrating the integration of this model into an existing system of neutronics and heat transfer codes, creating a user-friendly option for including fuel performance analysis within system design optimization and system-level trade-off studies. The end product enables both a deeper understanding and better overall system performance of nuclear energy systems limited or greatly impacted by TRISO fuel performance. A thorium-fueled hybrid fusion-fission Laser Inertial Fusion Energy (LIFE) blanket design was used for illustrating the application of this new capability and demonstrated both the importancemore » of integrating fuel performance calculations into mainstream design studies and the impact that this new integrated analysis had on system-level design decisions. A new TRISO fuel performance model named TRIUNE was developed and verified and validated during this work with a novel methodology established for simulating the actual lifetime of a TRISO particle during repeated passes through a pebble bed. In addition, integrated self-consistent calculations were performed for neutronics depletion analysis, heat transfer calculations, and then fuel performance modeling for a full parametric study that encompassed over 80 different design options that went through all three phases of analysis. Lastly, side studies were performed that included a comparison of thorium and depleted uranium (DU) LIFE blankets as well as some uncertainty quantification work to help guide future experimental work by assessing what material properties in TRISO fuel performance modeling are most in need of improvement. A recommended thorium-fueled hybrid LIFE engine design was identified with an initial fuel load of 20MT of thorium, 15% TRISO packing within the graphite fuel pebbles, and a 20cm neutron multiplier layer with beryllium pebbles in flibe molten salt coolant. It operated at a system power level of 2000 MW th, took about 3.5 years to reach full plateau power, and was capable of an End of Plateau burnup of 38.7 %FIMA if considering just the neutronic constraints in the system design; however, fuel performance constraints led to a maximum credible burnup of 12.1 %FIMA due to a combination of internal gas pressure and irradiation effects on the TRISO materials (especially PyC) leading to SiC pressure vessel failures. The optimal neutron spectrum for the thorium-fueled blanket options evaluated seemed to favor a hard spectrum (low but non-zero neutron multiplier thicknesses and high TRISO packing fractions) in terms of neutronic performance but the fuel performance constraints demonstrated that a significantly softer spectrum would be needed to decrease the rate of accumulation of fast neutron fluence in order to improve the maximum credible burnup the system could achieve.« less

Distributed Energy Implementation Options

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

Shah, Chandralata N

2017-09-13

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

State-based versus reward-based motivation in younger and older adults.

PubMed

Worthy, Darrell A; Cooper, Jessica A; Byrne, Kaileigh A; Gorlick, Marissa A; Maddox, W Todd

2014-12-01

Recent decision-making work has focused on a distinction between a habitual, model-free neural system that is motivated toward actions that lead directly to reward and a more computationally demanding goal-directed, model-based system that is motivated toward actions that improve one's future state. In this article, we examine how aging affects motivation toward reward-based versus state-based decision making. Participants performed tasks in which one type of option provided larger immediate rewards but the alternative type of option led to larger rewards on future trials, or improvements in state. We predicted that older adults would show a reduced preference for choices that led to improvements in state and a greater preference for choices that maximized immediate reward. We also predicted that fits from a hybrid reinforcement-learning model would indicate greater model-based strategy use in younger than in older adults. In line with these predictions, older adults selected the options that maximized reward more often than did younger adults in three of the four tasks, and modeling results suggested reduced model-based strategy use. In the task where older adults showed similar behavior to younger adults, our model-fitting results suggested that this was due to the utilization of a win-stay-lose-shift heuristic rather than a more complex model-based strategy. Additionally, within older adults, we found that model-based strategy use was positively correlated with memory measures from our neuropsychological test battery. We suggest that this shift from state-based to reward-based motivation may be due to age related declines in the neural structures needed for more computationally demanding model-based decision making.

SVM-Prot 2016: A Web-Server for Machine Learning Prediction of Protein Functional Families from Sequence Irrespective of Similarity.

PubMed

Li, Ying Hong; Xu, Jing Yu; Tao, Lin; Li, Xiao Feng; Li, Shuang; Zeng, Xian; Chen, Shang Ying; Zhang, Peng; Qin, Chu; Zhang, Cheng; Chen, Zhe; Zhu, Feng; Chen, Yu Zong

2016-01-01

Knowledge of protein function is important for biological, medical and therapeutic studies, but many proteins are still unknown in function. There is a need for more improved functional prediction methods. Our SVM-Prot web-server employed a machine learning method for predicting protein functional families from protein sequences irrespective of similarity, which complemented those similarity-based and other methods in predicting diverse classes of proteins including the distantly-related proteins and homologous proteins of different functions. Since its publication in 2003, we made major improvements to SVM-Prot with (1) expanded coverage from 54 to 192 functional families, (2) more diverse protein descriptors protein representation, (3) improved predictive performances due to the use of more enriched training datasets and more variety of protein descriptors, (4) newly integrated BLAST analysis option for assessing proteins in the SVM-Prot predicted functional families that were similar in sequence to a query protein, and (5) newly added batch submission option for supporting the classification of multiple proteins. Moreover, 2 more machine learning approaches, K nearest neighbor and probabilistic neural networks, were added for facilitating collective assessment of protein functions by multiple methods. SVM-Prot can be accessed at http://bidd2.nus.edu.sg/cgi-bin/svmprot/svmprot.cgi.

Helping Struggling Students in Introductory Biology: A Peer-Tutoring Approach That Improves Performance, Perception, and Retention

PubMed Central

Batz, Zachary; Olsen, Brian J.; Dumont, Jonathan; Dastoor, Farahad; Smith, Michelle K.

2015-01-01

The high attrition rate among science, technology, engineering, and mathematics (STEM) majors has long been an area of concern for institutions and educational researchers. The transition from introductory to advanced courses has been identified as a particularly “leaky” point along the STEM pipeline, and students who struggle early in an introductory STEM course are predominantly at risk. Peer-tutoring programs offered to all students in a course have been widely found to help STEM students during this critical transition, but hiring a sufficient number of tutors may not be an option for some institutions. As an alternative, this study examines the viability of an optional peer-tutoring program offered to students who are struggling in a large-enrollment, introductory biology course. Struggling students who regularly attended peer tutoring increased exam performance, expert-like perceptions of biology, and course persistence relative to their struggling peers who were not attending the peer-tutoring sessions. The results of this study provide information to instructors who want to design targeted academic assistance for students who are struggling in introductory courses. PMID:25976652

Assessing Window Replacement Options | Efficient Windows Collaborative

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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.

A quantitative assessment of the Hadoop framework for analyzing massively parallel DNA sequencing data.

PubMed

Siretskiy, Alexey; Sundqvist, Tore; Voznesenskiy, Mikhail; Spjuth, Ola

2015-01-01

New high-throughput technologies, such as massively parallel sequencing, have transformed the life sciences into a data-intensive field. The most common e-infrastructure for analyzing this data consists of batch systems that are based on high-performance computing resources; however, the bioinformatics software that is built on this platform does not scale well in the general case. Recently, the Hadoop platform has emerged as an interesting option to address the challenges of increasingly large datasets with distributed storage, distributed processing, built-in data locality, fault tolerance, and an appealing programming methodology. In this work we introduce metrics and report on a quantitative comparison between Hadoop and a single node of conventional high-performance computing resources for the tasks of short read mapping and variant calling. We calculate efficiency as a function of data size and observe that the Hadoop platform is more efficient for biologically relevant data sizes in terms of computing hours for both split and un-split data files. We also quantify the advantages of the data locality provided by Hadoop for NGS problems, and show that a classical architecture with network-attached storage will not scale when computing resources increase in numbers. Measurements were performed using ten datasets of different sizes, up to 100 gigabases, using the pipeline implemented in Crossbow. To make a fair comparison, we implemented an improved preprocessor for Hadoop with better performance for splittable data files. For improved usability, we implemented a graphical user interface for Crossbow in a private cloud environment using the CloudGene platform. All of the code and data in this study are freely available as open source in public repositories. From our experiments we can conclude that the improved Hadoop pipeline scales better than the same pipeline on high-performance computing resources, we also conclude that Hadoop is an economically viable option for the common data sizes that are currently used in massively parallel sequencing. Given that datasets are expected to increase over time, Hadoop is a framework that we envision will have an increasingly important role in future biological data analysis.

Eco-efficiency improvements in industrial water-service systems: assessing options with stakeholders.

PubMed

Levidow, Les; Lindgaard-Jørgensen, Palle; Nilsson, Asa; Skenhall, Sara Alongi; Assimacopoulos, Dionysis

2014-01-01

The well-known eco-efficiency concept helps to assess the economic value and resource burdens of potential improvements by comparison with the baseline situation. But eco-efficiency assessments have generally focused on a specific site, while neglecting wider effects, for example, through interactions between water users and wastewater treatment (WWT) providers. To address the methodological gap, the EcoWater project has developed a method and online tools for meso-level analysis of the entire water-service value chain. This study investigated improvement options in two large manufacturing companies which have significant potential for eco-efficiency gains. They have been considering investment in extra processes which can lower resource burdens from inputs and wastewater, as well as internalising WWT processes. In developing its methodology, the EcoWater project obtained the necessary information from many agents, involved them in the meso-level assessment and facilitated their discussion on alternative options. Prior discussions with stakeholders stimulated their attendance at a workshop to discuss a comparative eco-efficiency assessment for whole-system improvement. Stakeholders expressed interest in jointly extending the EcoWater method to more options and in discussing investment strategies. In such ways, optimal solutions will depend on stakeholders overcoming fragmentation by sharing responsibility and knowledge.

Increasing home dialysis knowledge through a web-based e-learning program.

PubMed

Bennett, Paul N; Jaeschke, Sadie; Sinclair, Peter M; Kerr, Peter G; Holt, Steve; Schoch, Monica; Fortnum, Debbie; Ockerby, Cherene; Kent, Bridie

2014-06-01

There has been a global decline in the uptake of home-based dialysis therapies in the past 20 years. The ability to provide appropriate information to potential patients in this area may be confounded by a lack of knowledge of home dialysis options. The aim of this study was to develop a web-based education package for health professionals to increase knowledge and positive perceptions of home-based dialysis options. A three-module e-learning package concerning home dialysis was developed under the auspices of the home dialysis first project. These modules were tested on 88 undergraduate health professionals. Changes in attitudes and knowledge of home dialysis were measured using custom designed surveys administered electronically to students who completed the modules. Matched pre and post responses to the survey items were compared using Wilcoxon signed rank tests. The pre survey indicated clear deficits in existing knowledge of home dialysis options. In particular, when asked if haemodialysis could be performed at home, 22% of participants responded 'definitely no' and a further 24% responded 'probably no'. Upon completion of the e-learning, post survey responses indicated statistically significant improvements (P < 0.001) in eight of the nine items. When asked if the e-learning had increased their knowledge about home dialysis, 99% of participants responded 'definitely yes'. A suite of web-based education modules can successfully deliver significant improvements in awareness and knowledge around home dialysis therapies. © 2014 Asian Pacific Society of Nephrology.

Advanced microgrid design and analysis for forward operating bases

NASA Astrophysics Data System (ADS)

Reasoner, Jonathan

This thesis takes a holistic approach in creating an improved electric power generation system for a forward operating base (FOB) in the future through the design of an isolated microgrid. After an extensive literature search, this thesis found a need for drastic improvement of the FOB power system. A thorough design process analyzed FOB demand, researched demand side management improvements, evaluated various generation sources and energy storage options, and performed a HOMERRTM discrete optimization to determine the best microgrid design. Further sensitivity analysis was performed to see how changing parameters would affect the outcome. Lastly, this research also looks at some of the challenges which are associated with incorporating a design which relies heavily on inverter-based generation sources, and gives possible solutions to help make a renewable energy powered microgrid a reality. While this thesis uses a FOB as the case study, the process and discussion can be adapted to aide in the design of an off-grid small-scale power grid which utilizes high-penetration levels of renewable energy.

Options for Auditory Training for Adults with Hearing Loss.

PubMed

Olson, Anne D

2015-11-01

Hearing aid devices alone do not adequately compensate for sensory losses despite significant technological advances in digital technology. Overall use rates of amplification among adults with hearing loss remain low, and overall satisfaction and performance in noise can be improved. Although improved technology may partially address some listening problems, auditory training may be another alternative to improve speech recognition in noise and satisfaction with devices. The literature underlying auditory plasticity following placement of sensory devices suggests that additional auditory training may be needed for reorganization of the brain to occur. Furthermore, training may be required to acquire optimal performance from devices. Several auditory training programs that are readily accessible for adults with hearing loss, hearing aids, or cochlear implants are described. Programs that can be accessed via Web-based formats and smartphone technology are reviewed. A summary table is provided for easy access to programs with descriptions of features that allow hearing health care providers to assist clients in selecting the most appropriate auditory training program to fit their needs.

Feasibility Study for the Ivano-Frankivsk District Heating Repowering: Analysis of Options

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

Markel, L.; Popelka, A.; Laskarevsky, V.

2002-03-20

Part of the U.S. Initiative on Joint Implementation with the Ukraine Inter-Ministerial Commission on Climate Change, financed by the US Department of Energy. The project was implemented by a team consisting of the US company SenTech, Inc. and the Ukrainian company Esco-West. The main objective of the effort was to assess available alternatives of Ivano-Frankivsk (I-F) District Heating repowering and provide information for I-F's investment decision process. This study provides information on positive and negative technical and economic aspects of available options. Three options were analyzed for technical merit and economic performance: 1. Installation of cogeneration system based on Gasmore » Turbine (GT) and Heat Recovery Heat Exchanger with thermal capacity of 30 MW and electrical capacity of 13.5 MW. This Option assumes utilization of five existing boilers with total capacity of 221 MW. Existing boilers will be equipped with modern controls. Equipment in this Option was sized for longest operating hours, about 8000 based on the available summer baseload. 2. Installation of Gas Turbine Combined Cycle (GTCC) and Heat Recovery Steam Generator (HRSG) with thermal capacity 45 MW and electrical capacity of 58.7 MW. This Option assumes utilization of five existing boilers with total capacity of 221 MW. Existing boilers will be equipped with modern controls. The equipment was sized for medium, shoulder season thermal load, and some cooling was assumed during the summer operation for extension of operating hours for electricity production. 3. Retrofit of six existing boilers (NGB) with total thermal capacity of 255.9 MW by installation of modern control system and minor upgrades. This option assumes only heat production with minimum investment. The best economic performance and the largest investment cost would result from alternative GTCC. This alternative has positive Net Present Value (NPV) with discount rate lower than about 12%, and has IRR slightly above 12%. The lowest economic results, and the lowest required investment, would result from alternative NGB. This Option's NPV is negative even at 0% discount rate, and would not become positive even by improving some parameters within a reasonable range. The Option with Gas Turbine displays relatively modest results and the NPV is positive for low discount rate, higher price of sold electricity and lower cost of natural gas. The IRR of this alternative is 9.75%, which is not very attractive. The largest influences on the investment are from the cost of electricity sold to the grid, the heat tariff, and the cost of natural gas. Assuming the implementation of the GTCC alternative, the benefit of the project is also reflected in lower Green House Emissions.« less

Faint Object Spectrograph (FOS) early performance

NASA Technical Reports Server (NTRS)

Harms, Richard; Fitch, John

1991-01-01

The on-orbit performance of the HST + FOS instrument is described and illustrated with examples of initial scientific results. The effects of the spherical aberration from the misfiguring of the HST primary mirror upon isolated point sources and in complex fields such as the nuclei of galaxies are analyzed. Possible means for eliminating the effects of spherical aberration are studied. Concepts include using image enhancement software to extract maximum spatial and spectral information from the existing data as well as several options to repair or compensate for the HST's optical performance. In particular, it may be possible to install corrective optics into the HST which will eliminate the spherical aberration for the FOS and some of the other instruments. The more promising ideas and calculations of the expected improvements in performance are briefly described.

A neurocomputational account of reward and novelty processing and effects of psychostimulants in attention deficit hyperactivity disorder.

PubMed

Sethi, Arjun; Voon, Valerie; Critchley, Hugo D; Cercignani, Mara; Harrison, Neil A

2018-05-01

Computational models of reinforcement learning have helped dissect discrete components of reward-related function and characterize neurocognitive deficits in psychiatric illnesses. Stimulus novelty biases decision-making, even when unrelated to choice outcome, acting as if possessing intrinsic reward value to guide decisions toward uncertain options. Heightened novelty seeking is characteristic of attention deficit hyperactivity disorder, yet how this influences reward-related decision-making is computationally encoded, or is altered by stimulant medication, is currently uncertain. Here we used an established reinforcement-learning task to model effects of novelty on reward-related behaviour during functional MRI in 30 adults with attention deficit hyperactivity disorder and 30 age-, sex- and IQ-matched control subjects. Each participant was tested on two separate occasions, once ON and once OFF stimulant medication. OFF medication, patients with attention deficit hyperactivity disorder showed significantly impaired task performance (P = 0.027), and greater selection of novel options (P = 0.004). Moreover, persistence in selecting novel options predicted impaired task performance (P = 0.025). These behavioural deficits were accompanied by a significantly lower learning rate (P = 0.011) and heightened novelty signalling within the substantia nigra/ventral tegmental area (family-wise error corrected P < 0.05). Compared to effects in controls, stimulant medication improved attention deficit hyperactivity disorder participants' overall task performance (P = 0.011), increased reward-learning rates (P = 0.046) and enhanced their ability to differentiate optimal from non-optimal novel choices (P = 0.032). It also reduced substantia nigra/ventral tegmental area responses to novelty. Preliminary cross-sectional evidence additionally suggested an association between long-term stimulant treatment and a reduction in the rewarding value of novelty. These data suggest that aberrant substantia nigra/ventral tegmental area novelty processing plays an important role in the suboptimal reward-related decision-making characteristic of attention deficit hyperactivity disorder. Compared to effects in controls, abnormalities in novelty processing and reward-related learning were improved by stimulant medication, suggesting that they may be disorder-specific targets for the pharmacological management of attention deficit hyperactivity disorder symptoms.

Status report on nuclear electric propulsion systems

NASA Technical Reports Server (NTRS)

Stearns, J. W.

1975-01-01

Progress in nuclear electric propulsion (NEP) systems for a multipayload multimission vehicle needed in both deep-space missions and a variety of geocentric missions is reviewed. The space system power level is a function of the initial launch vehicle mass, but developments in out-of-core nuclear thermionic direct conversion have broadened design options. Cost, design, and performance parameters are compared for reusable chemical space tugs and NEP reusable space tugs. Improvements in heat pipes, ion engines, and magnetoplasmadynamic arc jet thrust subsystems are discussed.

Stability and refrigeration of magnet cryosystems near 1.8 K using the thermomechanical effect

NASA Technical Reports Server (NTRS)

Frederking, T. H. K.; Chen, W. E. W.; Caspi, S.

1987-01-01

Magnet cryosystem options utilizing the thermomechanical effect of He II and the mechano-caloric effect for refrigeration (referred to as vortex refrigeration) are examined. The performance of the existing He II magnet refrigeration system is briefly reviewed, with attention given to superleak properties, vortex shedding, heat input, and thermodynamic cycle. It is concluded that the possibilities of magnet heat leak use for energetics and stability improvements are promising when He II is selected as magnet coolant.

Fast Fourier Tranformation Algorithms: Experiments with Microcomputers.

DTIC Science & Technology

1986-07-01

is, functions a with a known, discrete Fourier transform A Such functions are given fn [I]. The functions, TF1 , TF2, and TF3, were used and are...the IBM PC, all with TF1 (Eq. 1). ’The compilers provided options to improve performance, as noted, for which a penalty in compiling time has to be...BASIC only. Series I In this series the procedures were as follows: (i) Calculate the input values for TF1 of ar and the modulus Iar (which is

A Man for All Reason: General Larry D. Welch, 12th Chief of Staff, US Air Force

DTIC Science & Technology

2012-06-01

Winton for his countless hours improving my writing. I especially want to thank Generals Larry D. Welch, Charles G. Boyd, John A. Shaud, and...the armed services, limiting both resources and options. Walter Boyne characterized the climate as requiring “some of the most farsighted - and in...many ways difficult - planning in Air Force history.”6 Boyne credited Welch as being just the man capable of performing this task. Welch and his

Lead and Copper Rule Revisions White Paper

EPA Pesticide Factsheets

The Lead and Copper Rule (LCR) Revisions White Paper provides examples of regulatory options to improve the existing rule. The paper highlights key challenges, opportunities, and analytical issues presented by these options.

Greenhouse Gas Mitigation Options Database(GMOD)and Tool

EPA Science Inventory

Greenhouse Gas Mitigation Options Database (GMOD) is a decision support database and tool that provides cost and performance information for GHG mitigation options for the power, cement, refinery, landfill and pulp and paper sectors. The GMOD includes approximately 450 studies fo...

Laboratory studies on the tribology of hard bearing hip prostheses: ceramic on ceramic and metal on metal.

PubMed

Vassiliou, K; Scholes, S C; Unsworth, A

2007-01-01

Total hip replacements offer relief to a great many patients every year around the world. With an expected service life of around 25 years on most devices, and with younger and younger patients undergoing this surgery, it is of great importance to understand the mechanisms of their function. Tribological testing of both conventional and hard bearing joint combinations have been conducted in many centres throughout the world, and, after being initially abandoned owing to premature failures, hard bearing combinations have been revisited as viable options for joint replacements. Improved design, manufacturing procedures, and material compositions have led to improved performance over first-generation designs in both metal-on-metal and ceramic-on-ceramic hip prostheses. This paper offers a review of the work conducted in an attempt to highlight the most important factors affecting joint performance and tribology of hard bearing combinations. The tribological performance of these joints is superior to that of conventional metal- or ceramic-on-polymer designs.

Treatment of primary hip osteoarthritis for the primary care physician and the indications for total hip arthroplasty.

PubMed

Levine, Mathew E; Nace, James; Kapadia, Bhaveen H; Issa, Kimona; Banerjee, Samik; Cherian, Jeffery J; Mont, Michael A

2013-01-01

Osteoarthritis is a degenerative condition that commonly affects knees and hips with an annual incidence of 88 in 100,000 people in the United States. The purpose of this study was to review the clinical presentation of osteoarthritis of the hip as well as the available management options. We reviewed the recent literature in regard to epidemiology, presentation, and treatment options available to patients. Nonoperative treatments include weight loss and low-impact, aerobic exercises. Along with weight loss and exercise, nonsteroidal anti-inflammatory drugs (NSAIDS), narcotics, and intra-articular steroid injections have been used to improve patient's symptoms. Surgical intervention is a viable option; however, indications such as severe pain that is refractory to nonsurgical management, osteophytes, or joint space narrowing on radiographic films, or impairment of function should be present. The most common surgical option, total hip arthroplasty, has been shown to improve a patient's physical and psychological well-being. However, inherent risks are present with surgery and these should be addressed with the patient so a sound decision can be made. Osteoarthritis of the hip can be bothersome to patients, but physicians can begin management with lifestyle changes or pharmaceuticals. In the event nonoperative measures fail to markedly improve quality of life, total hip arthroplasty remains a viable option.

Evaluation of five guidelines for option development in multiple-choice item-writing.

PubMed

Martínez, Rafael J; Moreno, Rafael; Martín, Irene; Trigo, M Eva

2009-05-01

This paper evaluates certain guidelines for writing multiple-choice test items. The analysis of the responses of 5013 subjects to 630 items from 21 university classroom achievement tests suggests that an option should not differ in terms of heterogeneous content because such error has a slight but harmful effect on item discrimination. This also occurs with the "None of the above" option when it is the correct one. In contrast, results do not show the supposedly negative effects of a different-length option, the use of specific determiners, or the use of the "All of the above" option, which not only decreases difficulty but also improves discrimination when it is the correct option.

Great Opportunities for Optional Resources to Improve the Talents of Gifted Bilingual High School Students: Project GO-FOR-IT 1988-89. OREA Report.

ERIC Educational Resources Information Center

Berney, Tomi D.; Hriskos, Constantine

Project GO-FOR-IT (Great Opportunities for Optional Resources to Improve the Talents of Gifted Bilingual High School Students) provided supplemental instruction in English as a Second Language (ESL), content area subjects, and Native Language Arts (NLA) to 259 gifted, limited English proficient (LEP) students at three Brooklyn (New York) high…

A Guide for Starting and Improving Gifted and Talented High School Programs: Program Options, Teaching Strategies, Models, Forms and Examples.

ERIC Educational Resources Information Center

Idaho State Dept. of Education. Special Education Section.

This manual is designed to help Idaho school districts establish or improve programs for gifted and talented (G/T) high school students. It describes specific program options and administrative issues relating to gifted education. Chapter 1, "Starting and Administering a G/T High School Program," answers common questions about G/T high…

New advances in ovarian autotransplantation to restore fertility in cancer patients

PubMed Central

2016-01-01

Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results. PMID:26589603

New advances in ovarian autotransplantation to restore fertility in cancer patients.

PubMed

Salama, Mahmoud; Woodruff, Teresa K

2015-12-01

Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results.

Patient-centered and visual quality outcomes of premium cataract surgery: a systematic review.

PubMed

Wang, Sophia Y; Stem, Maxwell S; Oren, Gale; Shtein, Roni; Lichter, Paul R

2017-06-26

Over 8 million cataract surgeries are performed in the United States and the European Union annually, with many patients choosing to pay out of pocket for premium options including premium intraocular lens implants (IOLs) or laser-assisted cataract surgery (LACS). This report provides a systematic review evaluating patient-centered and visual quality outcomes comparing standard monofocal IOLs to premium cataract surgery options. PubMed and EMBASE were searched for publications published between January 1, 1980, and September 18, 2016, on multifocal, accommodative, and toric IOLs, monovision, and LACS, which reported on 1) dysphotopsias, 2) contrast sensitivity, 3) spectacle independence, 4) vision-related quality of life or patient satisfaction, and 5) IOL exchange. Multifocal lenses achieved higher rates of spectacle independence compared to monofocal lenses but also had higher reported frequency of dysphotopsia and worse contrast sensitivity, especially with low light or glare. Accommodative lenses were not associated with reduced contrast sensitivity or more dysphotopsia but had only modest improvements in spectacle independence compared to monofocal lenses. Studies of monovision did not target a sufficiently myopic outcome in the near-vision eye to achieve the full potential for spectacle independence. Patients reported high levels of overall satisfaction regardless of implanted IOL. No studies correlated patient-reported outcomes with patient expectations. Studies are needed to thoroughly compare patient-reported outcomes with concomitant patient expectations. In light of the substantial patient costs for premium options, patients and their surgeons will benefit from a better understanding of which surgical options best meet patients' expectations and how those expectations can be impacted by premium versus monofocal-including monovision-options.

Posterior cingulate cortex mediates outcome-contingent allocation of behavior

PubMed Central

Hayden, Benjamin Y.; Nair, Amrita C.; McCoy, Allison N.; Platt, Michael L.

2008-01-01

SUMMARY Adaptive decision making requires selecting an action and then monitoring its consequences to improve future decisions. The neuronal mechanisms supporting action evaluation and subsequent behavioral modification, however, remain poorly understood. To investigate the contribution of posterior cingulate cortex (CGp) to these processes, we recorded activity of single neurons in monkeys performing a gambling task in which the reward outcome of each choice strongly influenced subsequent choices. We found that CGp neurons signaled reward outcomes in a nonlinear fashion, and that outcome-contingent modulations in firing rate persisted into subsequent trials. Moreover, firing rate on any one trial predicted switching to the alternative option on the next trial. Finally, microstimulation in CGp following risky choices promoted a preference reversal for the safe option on the following trial. Collectively, these results demonstrate that CGp directly contributes to the evaluative processes that support dynamic changes in decision making in volatile environments. PMID:18940585

Updates in the management of diabetic macular edema.

PubMed

Mathew, Christopher; Yunirakasiwi, Anastasia; Sanjay, Srinivasan

2015-01-01

Diabetes mellitus is a chronic disease which has multiple effects on different end-organs, including the retina. In this paper, we discuss updates on diabetic macular edema (DME) and the management options. The underlying pathology of DME is the leakage of exudates from retinal microaneurysms, which trigger subsequent inflammatory reactions. Both clinical and imaging techniques are useful in diagnosing, classifying, and gauging the severity of DME. We performed a comprehensive literature search using the keywords "diabetes," "macula edema," "epidemiology," "pathogenesis," "optical coherence tomography," "intravitreal injections," "systemic treatment," "hypertension," "hyperlipidemia," "anemia," and "renal disease" and collated a total of 47 relevant articles published in English language. The main modalities of treatment currently in use comprise laser photocoagulation, intravitreal pharmacological and selected systemic pharmacological options. In addition, we mention some novel therapies that show promise in treating DME. We also review systemic factors associated with exacerbation or improvement in DME.

Focal cryotherapy in the treatment of localized prostate cancer.

PubMed

Nguyen, Huy D; Allen, Bryan J; Pow-Sang, Julio M

2013-07-01

The management choice for newly diagnosed localized prostate cancer presents a challenge to both the physician and the patient. Traditionally, surgery and radiation therapy have been the most commonly recommended options. More recently, active surveillance is recommended as the preferred management choice for a subset of men with localized, low-risk cancer. Recent reports also suggest that focal cryotherapy may be considered as a management option for selected cases of clinically localized prostate cancer. A review of the literature on focal cryotherapy from 2002 to 2012 was performed. Outcomes on cancer control, complications, and quality of life were extracted and assessed. The biochemical disease-free survival at 5 years is comparable to whole gland treatment modalities. Complications are minimal and comparable with other local treatment modalities. Focal cryotherapy is safe and effective, and it may improve failure rates in men who initially pursue active surveillance protocols. Early outcomes with cancer control are encouraging.

Evaluation of wireless stimulation of the endocardium, WiSE, technology for treatment heart failure.

PubMed

Seifert, M; Butter, C

2016-06-01

There are several unsolved limitations in delivering cardiac resynchronization therapy. 30-40% of patients fail to have any clinical benefit after 6 months caused by different reasons. Endocardial stimulation rather than conventional epicardial pacing has been shown to: be more physiologically, improve electrical stimulation of the left ventricular, give less dispersion of repolarisation and result in better resynchronization. The Wireless Cardiac Stimulation in Left Ventricle, WiCS-LV, system provides an option for wireless, left ventricular endocardial pacing triggered from a conventional right ventricular pacing spike from a co-implant. Expert commentary: The feasibility of the WiCS-LV system has been successfully demonstrated in a population of failed cardiac resynchronization patients, either failed implantation procedure of a conventional system, non-responder to conventional therapy or upgrade from pacemaker or defibrillator, where a conventional system was not an option. WiCS-LV is innovative technology with promising safety, performance and preliminary efficacy.

Airspace Technology Demonstration 3 (ATD-3): Multi-Flight Common Route (MFCR) Technology Transfer Document Summary Version 1.0

NASA Technical Reports Server (NTRS)

Sheth, Kapil; Bilimoria, Karl; Amer, Maryam M.; Wang, Easter M.

2017-01-01

This summary document and accompanying technology artifacts satisfy the second of three Research Transition Products (RTPs) defined in the ATD-3 Applied Traffic Flow Management (ATFM) Research Transition Team (RTT) Plan. This transfer consists of NASA's Multi-Flight Common Route (MFCR) research for efficient route corrections for en-route weather avoidance. The MFCR concept builds on the experience of the legacy Dynamic Weather Routes (DWR) and focuses on a better balance of potential savings with ATC acceptability, common route corrections options for multiple flights on similar routings, and better use of existing and/or modern automation for communication and coordination of route change options. All of these capabilities are expected to improve system performance significantly in terms of actual delay-reducing clearances issued to flights compared to that of the DWR tool and operating concept.

Improved Devices for Collecting Sweat for Chemical Analysis

NASA Technical Reports Server (NTRS)

Feeback, Daniel L.; Clarke, Mark S. F.

2011-01-01

Improved devices have been proposed for collecting sweat for biochemical analysis especially for determination of the concentration of Ca2+ ions in sweat as a measure of loss of Ca from bones. Unlike commercially available sweat-collection patches used previously in monitoring osteoporosis and in qualitative screening for some drugs, the proposed devices would not allow evaporation of the volatile chemical components (mostly water) of sweat. Moreover, the proposed devices would be designed to enable determination of the volumes of collected sweat. From these volumes and the quantities of Ca2+ and/or other analytes as determined by other means summarized below, one could determine the concentrations of the analytes in sweat. A device according to the proposal would be flexible and would be worn like a commercial sweat-collection patch. It would be made of molded polydimethylsiloxane (silicone rubber) or other suitable material having properties that, for the purpose of analyzing sweat, are similar to those of glass. The die for molding the silicone rubber would be fabricated by a combination of lithography and electroplating. The die would reproducibly form, in the silicone rubber, a precisely defined number of capillary channels per unit area, each channel having a precisely defined volume. Optionally, electrodes for measuring the Ca2+ content of the sweat could be incorporated into the device. The volume of sweat collected in the capillary channels of the device would be determined from (1) the amount of light or radio waves of a given wavelength absorbed by the device and (2) the known geometry of the array of capillary channels. Then, in one of two options, centrifugation would be performed to move the sweat from the capillary tubes to the region containing the electrodes, which would be used to measure the Ca2+ content by a standard technique. In the other option, centrifugation would be performed to remove the sweat from the device to make the sweat available to other analytical instruments for measuring concentrations of substances other than Ca2+.

Improved Devices for Collecting Sweat for Chemical Analysis

NASA Technical Reports Server (NTRS)

Feedback, Daniel L.; Clarke, Mark S. F.

2011-01-01

Improved devices have been proposed for collecting sweat for biochemical analysis - especially for determination of the concentration of Ca2+ ions in sweat as a measure of loss of Ca from bones. Unlike commercially available sweat-collection patches used previously in monitoring osteoporosis and in qualitative screening for some drugs, the proposed devices would not allow evaporation of the volatile chemical components (mostly water) of sweat. Moreover, the proposed devices would be designed to enable determination of the volumes of collected sweat. From these volumes and the quantities of Ca(2+) and/or other analytes as determined by other means summarized below, one could determine the concentrations of the analytes in sweat. A device according to the proposal would be flexible and would be worn like a commercial sweat-collection patch. It would be made of molded polydimethylsiloxane (silicone rubber) or other suitable material having properties that, for the purpose of analyzing sweat, are similar to those of glass. The die for molding the silicone rubber would be fabricated by a combination of lithography and electroplating. The die would reproducibly form, in the silicone rubber, a precisely defined number of capillary channels per unit area, each channel having a precisely defined volume. Optionally, electrodes for measuring the Ca(2+) content of the sweat could be incorporated into the device. The volume of sweat collected in the capillary channels of the device would be determined from (1) the amount of light or radio waves of a given wavelength absorbed by the device and (2) the known geometry of the array of capillary channels. Then, in one of two options, centrifugation would be performed to move the sweat from the capillary tubes to the region containing the electrodes, which would be used to measure the Ca(2+) content by a standard technique. In the other option, centrifugation would be performed to remove the sweat from the device to make the sweat available to other analytical instruments for measuring concentrations of substances other than Ca(2+).

Improving Decision Making for Feeding Options in Advanced Dementia: A Randomized, Controlled Trial

PubMed Central

Hanson, Laura C.; Carey, Timothy S.; Caprio, Anthony J.; Lee, Tae Joon; Ersek, Mary; Garrett, Joanne; Jackman, Anne; Gilliam, Robin; Wessell, Kathryn; Mitchell, Susan L.

2011-01-01

Background Feeding problems are common in dementia, and decision-makers have limited understanding of treatment options. Objectives To test whether a decision aid improves quality of decision-making about feeding options in advanced dementia. Design Cluster randomized controlled trial. Setting 24 nursing homes in North Carolina Participants Residents with advanced dementia and feeding problems and their surrogates. Intervention Intervention surrogates received an audio or print decision aid on feeding options in advanced dementia. Controls received usual care. Measurements Primary outcome was the Decisional Conflict Scale (range 1–5) measured at 3 months; other main outcomes were surrogate knowledge, frequency of communication with providers, and feeding treatment use. Results 256 residents and surrogate decision-makers were recruited. Residents’ average age was 85; 67% were Caucasian and 79% were women. Surrogates’ average age was 59; 67% were Caucasian, and 70% were residents’ children. The intervention improved knowledge scores (16.8 vs 15.1, p<0.001). After 3 months, intervention surrogates had lower Decisional Conflict Scale scores than controls (1.65 vs. 1.90, p<0.001) and more often discussed feeding options with a health care provider (46% vs. 33%, p=0.04). Residents in the intervention group were more likely to receive a dysphagia diet (89% vs.76%, p=0.04), and showed a trend toward increased staff eating assistance (20% vs.10%, p=0.08). Tube feeding was rare in both groups even after 9 months (1 intervention vs. 3 control, p=0.34). Limitations Cluster randomization was necessary to avoid contamination, but limits blinding and may introduce bias by site effect. Conclusion A decision aid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers. PMID:22091750

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

NASA Technical Reports Server (NTRS)

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

2017-01-01

This paper explores the impact of human Mars mission architecture decisions on the design and performance of a lander using the HIAD entry system: (a) Earth departure options, (b) Mars arrival options, (c) Entry Descent and Landing options.

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

Chatterton, Mike

The Recovery Act: Districtwide Geothermal Heating Conversion project performed by the Blaine County School District was part of a larger effort by the District to reduce operating costs, address deferred maintenance items, and to improve the learning environment of the students. This project evaluated three options for the ground source which were Open-Loop Extraction/Re-injection wells, Closed-Loop Vertical Boreholes, and Closed-Loop Horizontal Slinky approaches. In the end the Closed-Loop Horizontal Slinky approach had the lowest total cost of ownership but the majority of the sites associated with this project did not have enough available ground area to install the system somore » the second lowest option was used (Open-Loop). In addition to the ground source, this project looked at ways to retrofit existing HVAC systems with new high efficiency systems. The end result was the installation of distributed waterto- air heat pumps with water-to-water heat pumps installed to act as boilers/chillers for areas with a high ventilation demand such as they gymnasiums. A number of options were evaluated and the lowest total cost of ownership approach was implemented in the majority of the facilities. The facilities where the lowest total cost of ownership approaches was not selected were done to maintain consistency of the systems from facility to facility. This project had a number of other benefits to the Blaine County public. The project utilizes guaranteed energy savings to justify the levy funds expended. The project also developed an educational dashboard that can be used in the classrooms and to educate the community on the project and its performance. In addition, the majority of the installation work was performed by contractors local to Blaine County which acted as an economic stimulus to the area during a period of recession.« less

Analysis of digester design concepts

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

Ashare, E.; Wilson, E. H.

1979-01-29

Engineering economic analyses were performed on various digester design concepts to determine the relative performance for various biomass feedstocks. A comprehensive literature survey describing the state-of-the-art of the various digestion designs is included. The digester designs included in the analyses are CSTR, plug flow, batch, CSTR in series, multi-stage digestion and biomethanation. Other process options investigated included pretreatment processes such as shredding, degritting, and chemical pretreatment, and post-digestion processes, such as dewatering and gas purification. The biomass sources considered include feedlot manure, rice straw, and bagasse. The results of the analysis indicate that the most economical (on a unit gasmore » cost basis) digester design concept is the plug flow reactor. This conclusion results from this system providing a high gas production rate combined with a low capital hole-in-the-ground digester design concept. The costs determined in this analysis do not include any credits or penalties for feedstock or by-products, but present the costs only for conversion of biomass to methane. The batch land-fill type digester design was shown to have a unit gas cost comparable to that for a conventional stirred tank digester, with the potential of reducing the cost if a land-fill site were available for a lower cost per unit volume. The use of chemical pretreatment resulted in a higher unit gas cost, primarily due to the cost of pretreatment chemical. A sensitivity analysis indicated that the use of chemical pretreatment could improve the economics provided a process could be developed which utilized either less pretreatment chemical or a less costly chemical. The use of other process options resulted in higher unit gas costs. These options should only be used when necessary for proper process performance, or to result in production of a valuable by-product.« less

How Successful Is Medicare Advantage?

PubMed Central

Newhouse, Joseph P; McGuire, Thomas G

2014-01-01

Context Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. Methods This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Findings Beneficiaries make “mistakes” in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of “zero-premium” plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Conclusions Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan membership are warranted to move more beneficiaries into MA. PMID:24890251

How successful is Medicare Advantage?

PubMed

Newhouse, Joseph P; McGuire, Thomas G

2014-06-01

Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Beneficiaries make "mistakes" in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of "zero-premium" plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan membership are warranted to move more beneficiaries into MA. © 2014 Milbank Memorial Fund.

Greening America's Capitals - Madison, WI

EPA Pesticide Factsheets

This report discusses design options that could help Madison, WI, improve the Triangle neighborhood by making it easier for residents to get around. Design options could also help protect water quality and create new amenities for residents.

Prostatic arterial embolization: post-procedural follow-up.

PubMed

Fernandes, Lucia; Rio Tinto, Hugo; Pereira, Jose; Duarte, Marisa; Bilhim, Tiago; Martins Pisco, João

2012-12-01

Prostatic arterial embolization (PAE) gained special attention in the past years as a potential minimally invasive technique for benign prostatic hyperplasia. Treatment decisions are based on morbidity and quality-of-life issues and the patient has a central role in decision-making. Medical therapy is a first-line treatment option and surgery is usually performed to improve symptoms and decrease the progression of disease in patients who develop complications or who have inadequately controlled symptoms on medical treatment. The use of validated questionnaires to assess disease severity and sexual function, uroflowmetry studies, prostate-specific antigen and prostate volume measurements are essential when evaluating patients before PAE and to evaluate response to treatment. PAE may be performed safely with minimal morbidity and without associated mortality. The minimally invasive nature of the technique inducing a significant improvement in symptom severity associated with prostate volume reduction and a slight improvement in the sexual function are major advantages. However, as with other surgical therapies for benign prostatic hyperplasia, up to 15% of patients fail to show improvement significantly after PAE, and there is a modest improvement of the peak urinary flow. Copyright © 2012 Elsevier Inc. All rights reserved.

Surgical Treatments on Patients with Anterior Cervical Hyperostosis-Derived Dysphagia

PubMed Central

Song, Ah Rom; Byun, Eunjin; Kim, Youngbae; Park, Kwan Ho; Kim, Kyung Lyul

2012-01-01

Anterior cervical hyperostosis may be a cause of dysphagia. For anterior cervical hyperostosis, medical or surgical treatments can be adhibited in view of the causative mechanisms and intensities of dysphagia. We report 3 cases of cervical hyperostosis-derived progressive dysphagia that underwent operation. Radiologic diagnosis and Video Fluoroscopic Swallowing Study were performed on the three patients for evaluation. One had history of recurrent aspiration pneumonia accompanied by weight loss, another complained of dysphagia only when swallowing pills, and the third experienced recurrence symptom with reossification. All patients reported gradual improvement of dysphagia immediately after their cervical osteophytes were resected through the anterior approach. In relation to postoperative improvement, however, they expressed different degrees of satisfaction according to severity of symptoms. Surgical treatment, performed for the anterior cervical hyperostosis-derived dysphagia, can immediately relieve symptoms of difficulty in swallowing. This might especially be considered as an appropriate treatment option for severe dysphagia. PMID:23185741

To Not Settle for Small Losses: Evidence for an Ecological Aspiration Level of Zero in Dynamic Decision-Making

PubMed Central

Pang, Bo; Blanco, Nathaniel J.; Maddox, W. Todd; Worthy, Darrell A.

2016-01-01

This work aimed to investigate how one’s aspiration level is set in decision-making involving losses and how people respond when all alternatives appear to be below the aspiration level. We hypothesized that the zero point would serve as an ecological aspiration level where losses cause participants to focus on improvements in payoffs. In two experiments, we investigated these issues by combining behavioral studies and computational modeling. Participants chose from two alternatives on each trial. A decreasing option consistently gave a larger immediate payoff, although it caused future payoffs for both options to decrease. Selecting an increasing option caused payoffs for both options to increase on future trials. We manipulated the incentive structure such that in the losses condition the smallest payoff for the decreasing option was a loss, whereas in the gains condition the smallest payoff for the decreasing option was a gain, while the differences in outcomes for the two options were kept equivalent across conditions. Participants selected the increasing option more often in the losses condition than in the gains condition, regardless of whether the increasing option was objectively optimal (Experiment 1) or suboptimal (Experiment 2). Further, computational modeling results revealed that participants in the losses condition exhibited heightened weight to the frequency of positive versus negative prediction errors, suggesting that they were more attentive to improvements and reductions in outcomes than to expected values. This supports our assertion that losses induce aspiration for larger payoffs. We discuss our results in the context of recent theories of how losses shape behavior. PMID:27246089

To not settle for small losses: evidence for an ecological aspiration level of zero in dynamic decision-making.

PubMed

Pang, Bo; Blanco, Nathaniel J; Maddox, W Todd; Worthy, Darrell A

2017-04-01

This work aimed to investigate how one's aspiration level is set in decision-making involving losses and how people respond when all alternatives appear to be below the aspiration level. We hypothesized that the zero point would serve as an ecological aspiration level where losses cause participants to focus on improvements in payoffs. In two experiments, we investigated these issues by combining behavioral studies and computational modeling. Participants chose from two alternatives on each trial. A decreasing option consistently gave a larger immediate payoff, although it caused future payoffs for both options to decrease. Selecting an increasing option caused payoffs for both options to increase on future trials. We manipulated the incentive structure such that in the losses condition the smallest payoff for the decreasing option was a loss, whereas in the gains condition the smallest payoff for the decreasing option was a gain, while the differences in outcomes for the two options were kept equivalent across conditions. Participants selected the increasing option more often in the losses condition than in the gains condition, regardless of whether the increasing option was objectively optimal (Experiment 1) or suboptimal (Experiment 2). Further, computational modeling results revealed that participants in the losses condition exhibited heightened weight to the frequency of positive versus negative prediction errors, suggesting that they were more attentive to improvements and reductions in outcomes than to expected values. This supports our assertion that losses induce aspiration for larger payoffs. We discuss our results in the context of recent theories of how losses shape behavior.

An Update on Modern Approaches to Localized Esophageal Cancer

PubMed Central

Welsh, James; Amini, Arya; Likhacheva, Anna; Erasmus, Jeremy; Gomez, Daniel; Davila, Marta; Mehran, Reza J; Komaki, Ritsuko; Liao, Zhongxing; Hofstetter, Wayne L; Bhutani, Manoop; Ajani, Jaffer A

2014-01-01

Esophageal cancer treatment continues to be a topic of wide debate. Based on improvements in chemotherapy drugs, surgical techniques, and radiotherapy advances, esophageal cancer treatment approaches are becoming more specific to the stage of the tumor and the overall performance status of the patient. While surgery continues to be the standard treatment option for localized disease, the current direction favors multimodality treatment including both radiation and chemotherapy with surgery. In the next few years, we will continue to see improvements in radiation techniques and proton treatment, with more minimally invasive surgical approaches minimizing postoperative side effects, and the discovery of molecular biomarkers to help deliver more specifically targeted medication to treat esophageal cancers. PMID:21365188

Refractory overactive bladder: Beyond oral anticholinergic therapy

PubMed Central

Glinski, Ronald W.; Siegel, Steven

2007-01-01

Objectives: In this review, we discuss the treatment of refractory overactive bladder (OAB) that has not adequately responded to medication therapy and we propose an appropriate care pathway to the treatment of OAB. We also attempt to address the cost of OAB treatments. Materials and Methods: A selective expert review of the current literature on the subject of refractory OAB using MEDLINE was performed and the data is summarized. We also review our experience in treating refractory OAB. The role and outcomes of various treatment options for refractory OAB are discussed and combined therapy with oral anticholinergics is explored. Emerging remedies including intravesical botulinum toxin injection and pudendal neuromodulation are also reviewed, along with conventional surgical options. Results: In general behavioral therapy, pelvic floor electrical stimulation, magnetic therapy and posterior tibial nerve stimulation (PTNS), have shown symptom decreases in 50-80% of patients with OAB. Depending on the study, combination therapy with oral anticholinergics seems to improve efficacy of behavioral therapy and PTNS in approximately 10-30%. In multicenter, long-term randomized controlled trials, sacral neuromodulation has been shown to improve symptoms of OAB and OAB incontinence in up to 80% of the patients treated. Studies involving emerging therapies such as pudendal serve stimulation suggest that there may be a 15-20% increase in efficacy over sacral neuromodulation, but long-term studies are not yet available. Another emerging therapy, botulinum toxin, is also showing similar success in reducing OAB symptoms in 80-90% of patients. Surgical approaches, such as bladder augmentation, are a last resort in the treatment of OAB and are rarely used at this point unless upper tract damage is a concern and all other treatment options have been exhausted. Conclusion: The vast majority of OAB patients can be managed successfully by behavioral options with or without anticholinergic medications. When those fail, neuromodulation or intravesical botulinum toxin therapies are successful alternatives for most of the remaining group. We encourage practitioners responsible for the care of OAB patients to gain experience with these options. More research is needed to assess the cost-effectiveness of various OAB treatments PMID:19675795

BODY SENSING SYSTEM

NASA Technical Reports Server (NTRS)

Mah, Robert W. (Inventor)

2005-01-01

System and method for performing one or more relevant measurements at a target site in an animal body, using a probe. One or more of a group of selected internal measurements is performed at the target site, is optionally combined with one or more selected external measurements, and is optionally combined with one or more selected heuristic information items, in order to reduce to a relatively small number the probable medical conditions associated with the target site. One or more of the internal measurements is optionally used to navigate the probe to the target site. Neural net information processing is performed to provide a reduced set of probable medical conditions associated with the target site.

Should Title 24 Ventilation Requirements Be Amended to include an Indoor Air Quality Procedure?

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

Dutton, Spencer M.; Mendell, Mark J.; Chan, Wanyu R.

Minimum outdoor air ventilation rates (VRs) for buildings are specified in standards, including California?s Title 24 standards. The ASHRAE ventilation standard includes two options for mechanically-ventilated buildings ? a prescriptive ventilation rate procedure (VRP) that specifies minimum VRs that vary among occupancy classes, and a performance-based indoor air quality procedure (IAQP) that may result in lower VRs than the VRP, with associated energy savings, if IAQ meeting specified criteria can be demonstrated. The California Energy Commission has been considering the addition of an IAQP to the Title 24 standards. This paper, based on a review of prior data and newmore » analyses of the IAQP, evaluates four future options for Title 24: no IAQP; adding an alternate VRP, adding an equivalent indoor air quality procedure (EIAQP), and adding an improved ASHRAE-like IAQP. Criteria were established for selecting among options, and feedback was obtained in a workshop of stakeholders. Based on this review, the addition of an alternate VRP is recommended. This procedure would allow lower minimum VRs if a specified set of actions were taken to maintain acceptable IAQ. An alternate VRP could also be a valuable supplement to ASHRAE?s ventilation standard.« less

Increasing physical activity and exercise in lung cancer: reviewing safety, benefits, and application.

PubMed

Bade, Brett C; Thomas, D David; Scott, JoAnn B; Silvestri, Gerard A

2015-06-01

Lung cancer continues to be a difficult disease frequently diagnosed in late stages with a high mortality and symptom burden. In part because of frequent lung comorbidity, even lung cancer survivors often remain symptomatic and functionally limited. Though targeted therapy continues to increase treatment options for advanced-stage disease, symptom burden remains high with few therapeutic options. In the last several decades, exercise and physical activity have arisen as therapeutic options for obstructive lung disease and lung cancer. To date, exercise has been shown to reduce symptoms, increase exercise tolerance, improve quality of life, and potentially reduce length of stay and postoperative complications. Multiple small trials have been performed in perioperative non-small-cell lung cancer patients, although fewer studies are available for patients with advanced-stage disease. Despite the increased interest in this subject over the last few years, a validated exercise regimen has not been established for perioperative or advanced-stage disease. Clinicians underutilize exercise and pulmonary rehabilitation as a therapy, in part because of the lack of evidence-based consensus as to how and when to implement increasing physical activity. This review summarizes the existing evidence on exercise in lung cancer patients.

Project CARE: reducing wet weather overflows to improve beach water quality. Council Action in Respect of the Environment.

PubMed

Heijs, J; Wilkinson, D; Couriel, E

2002-01-01

The people who live in North Shore City (New Zealand) consider the beaches as their greatest asset. Following public outcry on frequent beach pollution caused by wet weather sewer overflows, Project CARE commenced in 1998 to plan the improvements to the city's separated wastewater and stormwater systems to protect the streams and beaches, particularly from a public health perspective. The investigation included building hydrological and hydraulic models to represent the wastewater and stormwater systems and a receiving waters model to simulate the impacts on the beaches. These models were later used to explore options for improvement. It was found that North Shore City has a very leaky wastewater system that is under capacity. The resulting wet weather overflows (12 per year on average) are the most important contributor to the problem although stormwater pollution alone is big enough to cause problems (at a smaller magnitude). A cost optimisation model (iterative process using performance/cost relationships) was then used to assist in identifying the optimal set of improvement works (storage, repair and increased capacity, wastewater treatment plant) to meet different performance targets and to cater for growth up to the year 2050. Cost Benefit analyses, looking at improvements in system performance and water quality, show diminishing returns for performance levels better than 2 overflows per year. The total costs that meet this target are estimated at almost NZ$300M (US$135M).

Analytical pricing of geometric Asian power options on an underlying driven by a mixed fractional Brownian motion

NASA Astrophysics Data System (ADS)

Zhang, Wei-Guo; Li, Zhe; Liu, Yong-Jun

2018-01-01

In this paper, we study the pricing problem of the continuously monitored fixed and floating strike geometric Asian power options in a mixed fractional Brownian motion environment. First, we derive both closed-form solutions and mixed fractional partial differential equations for fixed and floating strike geometric Asian power options based on delta-hedging strategy and partial differential equation method. Second, we present the lower and upper bounds of the prices of fixed and floating strike geometric Asian power options under the assumption that both risk-free interest rate and volatility are interval numbers. Finally, numerical studies are performed to illustrate the performance of our proposed pricing model.

Cardiac I-1c overexpression with reengineered AAV improves cardiac function in swine ischemic heart failure.

PubMed

Ishikawa, Kiyotake; Fish, Kenneth M; Tilemann, Lisa; Rapti, Kleopatra; Aguero, Jaume; Santos-Gallego, Carlos G; Lee, Ahyoung; Karakikes, Ioannis; Xie, Chaoqin; Akar, Fadi G; Shimada, Yuichi J; Gwathmey, Judith K; Asokan, Aravind; McPhee, Scott; Samulski, Jade; Samulski, Richard Jude; Sigg, Daniel C; Weber, Thomas; Kranias, Evangelia G; Hajjar, Roger J

2014-12-01

Cardiac gene therapy has emerged as a promising option to treat advanced heart failure (HF). Advances in molecular biology and gene targeting approaches are offering further novel options for genetic manipulation of the cardiovascular system. The aim of this study was to improve cardiac function in chronic HF by overexpressing constitutively active inhibitor-1 (I-1c) using a novel cardiotropic vector generated by capsid reengineering of adeno-associated virus (BNP116). One month after a large anterior myocardial infarction, 20 Yorkshire pigs randomly received intracoronary injection of either high-dose BNP116.I-1c (1.0 × 10(13) vector genomes (vg), n = 7), low-dose BNP116.I-1c (3.0 × 10(12) vg, n = 7), or saline (n = 6). Compared to baseline, mean left ventricular ejection fraction increased by 5.7% in the high-dose group, and by 5.2% in the low-dose group, whereas it decreased by 7% in the saline group. Additionally, preload-recruitable stroke work obtained from pressure-volume analysis demonstrated significantly higher cardiac performance in the high-dose group. Likewise, other hemodynamic parameters, including stroke volume and contractility index indicated improved cardiac function after the I-1c gene transfer. Furthermore, BNP116 showed a favorable gene expression pattern for targeting the heart. In summary, I-1c overexpression using BNP116 improves cardiac function in a clinically relevant model of ischemic HF.

Cardiac I-1c Overexpression With Reengineered AAV Improves Cardiac Function in Swine Ischemic Heart Failure

PubMed Central

Ishikawa, Kiyotake; Fish, Kenneth M; Tilemann, Lisa; Rapti, Kleopatra; Aguero, Jaume; Santos-Gallego, Carlos G; Lee, Ahyoung; Karakikes, Ioannis; Xie, Chaoqin; Akar, Fadi G; Shimada, Yuichi J; Gwathmey, Judith K; Asokan, Aravind; McPhee, Scott; Samulski, Jade; Samulski, Richard Jude; Sigg, Daniel C; Weber, Thomas; Kranias, Evangelia G; Hajjar, Roger J

2014-01-01

Cardiac gene therapy has emerged as a promising option to treat advanced heart failure (HF). Advances in molecular biology and gene targeting approaches are offering further novel options for genetic manipulation of the cardiovascular system. The aim of this study was to improve cardiac function in chronic HF by overexpressing constitutively active inhibitor-1 (I-1c) using a novel cardiotropic vector generated by capsid reengineering of adeno-associated virus (BNP116). One month after a large anterior myocardial infarction, 20 Yorkshire pigs randomly received intracoronary injection of either high-dose BNP116.I-1c (1.0 × 1013 vector genomes (vg), n = 7), low-dose BNP116.I-1c (3.0 × 1012 vg, n = 7), or saline (n = 6). Compared to baseline, mean left ventricular ejection fraction increased by 5.7% in the high-dose group, and by 5.2% in the low-dose group, whereas it decreased by 7% in the saline group. Additionally, preload-recruitable stroke work obtained from pressure–volume analysis demonstrated significantly higher cardiac performance in the high-dose group. Likewise, other hemodynamic parameters, including stroke volume and contractility index indicated improved cardiac function after the I-1c gene transfer. Furthermore, BNP116 showed a favorable gene expression pattern for targeting the heart. In summary, I-1c overexpression using BNP116 improves cardiac function in a clinically relevant model of ischemic HF. PMID:25023328

Using Data From Ontario's Episode-Based Funding Model to Assess Quality of Chemotherapy.

PubMed

Kaizer, Leonard; Simanovski, Vicky; Lalonde, Carlin; Tariq, Huma; Blais, Irene; Evans, William K

2016-10-01

A new episode-based funding model for ambulatory systemic therapy was implemented in Ontario, Canada on April 1, 2014, after a comprehensive knowledge transfer and exchange strategy with providers and administrators. An analysis of the data from the first year of the new funding model provided an opportunity to assess the quality of chemotherapy, which was not possible under the old funding model. Options for chemotherapy regimens given with adjuvant/curative intent or palliative intent were informed by input from disease site groups. Bundles were developed and priced to enable evidence-informed best practice. Analysis of systemic therapy utilization after model implementation was performed to assess the concordance rate of the treatments chosen with recommended practice. The actual number of cycles of treatment delivered was also compared with expert recommendations. Significant improvement compared with baseline was seen in the proportion of adjuvant/curative regimens that aligned with disease site group-recommended options (98% v 90%). Similar improvement was seen for palliative regimens (94% v 89%). However, overall, the number of cycles of adjuvant/curative therapy delivered was lower than recommended best practice in 57.5% of patients. There was significant variation by disease site and between facilities. Linking funding to quality, supported by knowledge transfer and exchange, resulted in a rapid improvement in the quality of systemic treatment in Ontario. This analysis has also identified further opportunities for improvement and the need for model refinement.

Evolution of physician-hospital alignment models: a case study of comanagement.

PubMed

Sowers, Kevin W; Newman, Paul R; Langdon, Jeffrey C

2013-06-01

Recently, quality, financial, and regulatory demands have driven physicians to seek alignment opportunities with hospitals. The motivation for alignment on the part of physicians and hospitals is now accelerating because the new paradigm under healthcare reform requires an increased focus on improving quality, cost, and efficiency. We (1) identify the key drivers for physician-hospital alignment models; (2) summarize comanagement as a physician-hospital alignment model; and (3) explore a detailed case study of comanagement as an option to better align physicians with hospital goals on quality, safety, and outcomes. A Medline abstract review was performed that identified 45 references that discuss options for physician-hospital alignment. None of the articles identified provide a detailed example of successful alignment structures. A detailed case study of a successful comanagement alignment program is reviewed. The key drivers for alignment are inpatient growth rates, declining reimbursements, and the opportunity to improve quality, decrease costs, and increase efficiency. Two general strategies of alignment involve noneconomic and/or economic integration. In our example, comanagement with economic integration was chosen as the preferred structure for physician-hospital alignment. The choice of structure will vary depending on the existing relationships and governance of the hospital and the physicians in the targeted area of focus. The measure of success in building physician-hospital alignment is measured in improvements in care for the patient, reduced cost of care delivery, and improved relations between physicians and hospital leadership.

ASSESSMENT OF MAST IN EUROPEAN PATIENT-CENTERED TELEMEDICINE PILOTS.

PubMed

Ekeland, Anne Granstrøm; Grøttland, Astrid

2015-01-01

Model for ASsessment of Telemedicine Applications (MAST) is a health technology assessment (HTA) inspired framework for assessing the effectiveness and contribution to quality of telemedicine applications based on rigorous, scientific data. This study reports from a study of how it was used and perceived in twenty-one pilots of the European project RENEWING HEALTH (RH). The objectives of RH were to implement large-scale, real-life test beds for the validation and subsequent evaluation of innovative patient-centered telemedicine services. The study is a contribution to the appraisal of HTA methods. A questionnaire was administered for project leaders of the pilots. It included questions about use and usefulness of MAST for (i) preceding considerations, (ii) evaluation of outcomes within seven domains, and (iii) considerations of transferability. Free text spaces allowed for proposals of improvement. The responses covered all pilots. A quantitative summary of use and a qualitative analysis of usefulness were performed. MAST was used and considered useful for pilot evaluations. Challenges included problems to scientifically determine alternative service options and outcome within the seven domains. Proposals for improvement included process studies and adding domains of technological usability, responsible innovation, health literacy, behavior change, caregiver perspectives and motivational issues of professionals. MAST was used according to its structure. Its usefulness in patient centered pilots can be improved by adding new stakeholder groups. Interdependencies between scientific rigor, resources and timeliness should be addressed. Operational options for improvements include process studies, literature reviews and sequential mini-HTAs for identification of areas for more elaborate investigations.

Expanding the indications of pancreas transplantation alone.

PubMed

Mehrabi, Arianeb; Golriz, Mohammad; Adili-Aghdam, Fatemeh; Hafezi, Mohammadreza; Ashrafi, Maryam; Morath, Christian; Zeier, Martin; Hackert, Thilo; Schemmer, Peter

2014-11-01

Total pancreatectomy (TP) is associated with postoperative endocrine and exocrine insufficiency. Especially, insulin therapy reduces quality of life and may lead to long-term complications. We review the literature with regard to the potential option of pancreas transplantation alone (PTA) after TP in patients with chronic pancreatitis or benign tumors. A MEDLINE search (1958-2013) using the terminologies pancreas transplantation, pancreas transplantation alone, total pancreatectomy, morbidity, mortality, insulin therapy, and quality of life was performed. In addition, the current book and congress publications were reviewed. Total pancreatectomy after benign and borderline tumors as well as chronic pancreatitis is continuously increasing. Despite improvement of exogenous insulin therapy, more than 50% of these patients experience severe glucose control problems, which cause up to 50% long-term mortality. Pancreas transplantation alone can cure both endocrine and exocrine insufficiency and reduce the associated risks. The 3-year graft and patient survival rates after PTA are up to 73% and 100%, respectively. Pancreas transplantation alone after TP in patients with pancreatitis or benign tumors improves the recipient's quality of life and reduces long-term mortality. Considering the amount of available organs and potential candidates, PTA can be a treatment option for patients after TP with chronic pancreatitis or benign tumors.

The Usefulness of 0.2% Topical Nitroglycerin for Chondrodermatitis Nodularis Helicis.

PubMed

Sanz-Motilva, V; Martorell-Calatayud, A; Gutiérrez García-Rodrigo, C; Hueso-Gabriel, L; García-Melgares, M L; Pelufo-Enguix, C; Alfaro-Rubio, A; Vanaclocha-Sebastián, F

2015-09-01

Chondrodermatitis nodularis helicis (CNH) is a painful idiopathic degenerative condition involving the skin and cartilage of the helix or antihelix of the ear. Topical nitroglycerin 2% is a relatively recent treatment option for CNH that has produced good results, although with adverse effects (17% of cases). The use of a lower concentration would probably achieve similar results with fewer adverse effects. The aim of this study was to evaluate the effectiveness and safety of topical nitroglycerin 0.2% in the treatment of CNH. We performed a retrospective observational study of patients treated in 2 Spanish hospitals between 2012 and 2014. The effectiveness of treatment was determined by clinical photography and assessment of symptoms using a verbal numerical rating scale. Of the 29 patients treated, 93% showed clinical improvement. In the group of responders, mean treatment duration was 1.8 months and mean follow-up was 5.9 months. Overall tolerance was good in all cases. Topical nitroglycerin 0.2% is an effective and well-tolerated conservative treatment option that improves the appearance of lesions and provides symptomatic relief in the majority of patients with CNH. Copyright © 2015 Elsevier España, S.L.U. and AEDV. All rights reserved.

Second-line treatments: moving towards an opportunity to improve survival in advanced gastric cancer?

PubMed

Salati, Massimiliano; Di Emidio, Katia; Tarantino, Vittoria; Cascinu, Stefano

2017-01-01

Gastric cancer is the third leading cause of cancer-related death globally with approximately 723 000 deaths every year. Most patients present with advanced unresectable or metastatic disease, only amenable to palliative systemic treatment and a median survival uncommonly exceeding 12 months. Over the last years, the efficacy of chemotherapy combination has plateaued and the introduction of the anti-human epidermal growth factor receptor 2 trastuzumab has resulted in a limited survival gain in the upfront setting. After this positive experience, first-line treatment with new targeted therapies failed to improve the outcome of advanced gastric cancer. On the contrary, second-line options, including monochemotherapy with taxanes or irinotecan and the anti-vascular endothelial growth factor receptor 2 ramucirumab, either alone or combined with paclitaxel, opened new therapeutic rooms for an ever-increasing number of patients who maintain an acceptable performance status across multiple lines. This article provides an updated overview on the current management of advanced gastric cancer and discusses how the different treatment options available may be best combined to favourably impact the outcome of patients following the logic of a treatment strategy.

Active thermal control system evolution

NASA Technical Reports Server (NTRS)

Petete, Patricia A.; Ames, Brian E.

1991-01-01

The 'restructured' baseline of the Space Station Freedom (SSF) has eliminated many of the growth options for the Active Thermal Control System (ATCS). Modular addition of baseline technology to increase heat rejection will be extremely difficult. The system design and the available real estate no longer accommodate this type of growth. As the station matures during its thirty years of operation, a demand of up to 165 kW of heat rejection can be expected. The baseline configuration will be able to provide 82.5 kW at Eight Manned Crew Capability (EMCC). The growth paths necessary to reach 165 kW have been identified. Doubling the heat rejection capability of SSF will require either the modification of existing radiator wings or the attachment of growth structure to the baseline truss for growth radiator wing placement. Radiator performance can be improved by enlarging the surface area or by boosting the operating temperature with a heat pump. The optimal solution will require both modifications. The addition of growth structure would permit the addition of a parallel ATCS using baseline technology. This growth system would simplify integration. The feasibility of incorporating these growth options to improve the heat rejection capacity of SSF is under evaluation.

Second-line treatments: moving towards an opportunity to improve survival in advanced gastric cancer?

PubMed Central

Salati, Massimiliano; Di Emidio, Katia; Tarantino, Vittoria; Cascinu, Stefano

2017-01-01

Gastric cancer is the third leading cause of cancer-related death globally with approximately 723 000 deaths every year. Most patients present with advanced unresectable or metastatic disease, only amenable to palliative systemic treatment and a median survival uncommonly exceeding 12 months. Over the last years, the efficacy of chemotherapy combination has plateaued and the introduction of the anti-human epidermal growth factor receptor 2 trastuzumab has resulted in a limited survival gain in the upfront setting. After this positive experience, first-line treatment with new targeted therapies failed to improve the outcome of advanced gastric cancer. On the contrary, second-line options, including monochemotherapy with taxanes or irinotecan and the anti-vascular endothelial growth factor receptor 2 ramucirumab, either alone or combined with paclitaxel, opened new therapeutic rooms for an ever-increasing number of patients who maintain an acceptable performance status across multiple lines. This article provides an updated overview on the current management of advanced gastric cancer and discusses how the different treatment options available may be best combined to favourably impact the outcome of patients following the logic of a treatment strategy. PMID:29209523

Estimation and prediction under local volatility jump-diffusion model

NASA Astrophysics Data System (ADS)

Kim, Namhyoung; Lee, Younhee

2018-02-01

Volatility is an important factor in operating a company and managing risk. In the portfolio optimization and risk hedging using the option, the value of the option is evaluated using the volatility model. Various attempts have been made to predict option value. Recent studies have shown that stochastic volatility models and jump-diffusion models reflect stock price movements accurately. However, these models have practical limitations. Combining them with the local volatility model, which is widely used among practitioners, may lead to better performance. In this study, we propose a more effective and efficient method of estimating option prices by combining the local volatility model with the jump-diffusion model and apply it using both artificial and actual market data to evaluate its performance. The calibration process for estimating the jump parameters and local volatility surfaces is divided into three stages. We apply the local volatility model, stochastic volatility model, and local volatility jump-diffusion model estimated by the proposed method to KOSPI 200 index option pricing. The proposed method displays good estimation and prediction performance.

Smart Columbus : Systems Engineering Management Plan (SEMP) for Smart Columbus Demonstration Program

DOT National Transportation Integrated Search

2018-01-16

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

7 CFR 1468.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION FARM OPTION General Provisions § 1468.1 Purpose. (a) Through the Conservation Farm Option (CFO), the Commodity Credit Corporation (CCC) provides... concerns, water quality protection or improvement; wetland restoration and protection; wildlife habitat...

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.

Initial Business Case Analysis of Two Integrated Heat Pump HVAC Systems for Near-Zero-Energy Homes -- Update to Include Analyses of an Economizer Option and Alternative Winter Water Heating Control Option

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

Baxter, Van D

2006-12-01

The long range strategic goal of the Department of Energy's Building Technologies (DOE/BT) Program is to create, by 2020, technologies and design approaches that enable the construction of net-zero energy homes at low incremental cost (DOE/BT 2005). A net zero energy home (NZEH) is a residential building with greatly reduced needs for energy through efficiency gains, with the balance of energy needs supplied by renewable technologies. While initially focused on new construction, these technologies and design approaches are intended to have application to buildings constructed before 2020 as well resulting in substantial reduction in energy use for all building typesmore » and ages. DOE/BT's Emerging Technologies (ET) team is working to support this strategic goal by identifying and developing advanced heating, ventilating, air-conditioning, and water heating (HVAC/WH) technology options applicable to NZEHs. Although the energy efficiency of heating, ventilating, and air-conditioning (HVAC) equipment has increased substantially in recent years, new approaches are needed to continue this trend. Dramatic efficiency improvements are necessary to enable progress toward the NZEH goals, and will require a radical rethinking of opportunities to improve system performance. The large reductions in HVAC energy consumption necessary to support the NZEH goals require a systems-oriented analysis approach that characterizes each element of energy consumption, identifies alternatives, and determines the most cost-effective combination of options. In particular, HVAC equipment must be developed that addresses the range of special needs of NZEH applications in the areas of reduced HVAC and water heating energy use, humidity control, ventilation, uniform comfort, and ease of zoning. In FY05 ORNL conducted an initial Stage 1 (Applied Research) scoping assessment of HVAC/WH systems options for future NZEHs to help DOE/BT identify and prioritize alternative approaches for further development. Eleven system concepts with central air distribution ducting and nine multi-zone systems were selected and their annual and peak demand performance estimated for five locations: Atlanta (mixed-humid), Houston (hot-humid), Phoenix (hot-dry), San Francisco (marine), and Chicago (cold). Performance was estimated by simulating the systems using the TRNSYS simulation engine (Solar Energy Laboratory et al. 2006) in two 1800-ft{sup 2} houses--a Building America (BA) benchmark house and a prototype NZEH taken from BEopt results at the take-off (or crossover) point (i.e., a house incorporating those design features such that further progress towards ZEH is through the addition of photovoltaic power sources, as determined by current BEopt analyses conducted by NREL). Results were summarized in a project report, HVAC Equipment Design options for Near-Zero-Energy Homes--A Stage 2 Scoping Assessment, ORNL/TM-2005/194 (Baxter 2005). The 2005 study report describes the HVAC options considered, the ranking criteria used, and the system rankings by priority. In 2006, the two top-ranked options from the 2005 study, air-source and ground-source versions of an integrated heat pump (IHP) system, were subjected to an initial business case study. The IHPs were subjected to a more rigorous hourly-based assessment of their performance potential compared to a baseline suite of equipment of legally minimum efficiency that provided the same heating, cooling, water heating, demand dehumidification, and ventilation services as the IHPs. Results were summarized in a project report, Initial Business Case Analysis of Two Integrated Heat Pump HVAC Systems for Near-Zero-Energy Homes, ORNL/TM-2006/130 (Baxter 2006). The present report is an update to that document. Its primary purpose is to summarize results of an analysis of the potential of adding an outdoor air economizer operating mode to the IHPs to take advantage of free cooling (using outdoor air to cool the house) whenever possible. In addition it provides some additional detail for an alternative winter water heating/space heating (WH/SH) control strategy briefly described in the original report and corrects some minor errors.« less

A survey of pulse shape options for a revised plastic ablator ignition design

NASA Astrophysics Data System (ADS)

Clark, Daniel; Eder, David; Haan, Steven; Hinkel, Denise; Jones, Ogden; Marinak, Michael; Milovich, Jose; Peterson, Jayson; Robey, Harold; Salmonson, Jay; Smalyuk, Vladimir; Weber, Christopher

2014-10-01

Recent experimental results using the ``high foot'' pulse shape on the National Ignition Facility (NIF) have shown encouraging progress compared to earlier ``low foot'' experiments. These results strongly suggest that controlling ablation front instability growth can dramatically improve implosion performance, even in the presence of persistent, large, low-mode distortions. In parallel, Hydro. Growth Radiography experiments have so far validated the techniques used for modeling ablation front growth in NIF experiments. It is timely then to combine these two results and ask how current ignition pulse shapes could be modified so as to improve implosion performance, namely fuel compressibility, while maintaining the stability properties demonstrated with the high foot. This talk presents a survey of pulse shapes intermediate between the low and high foot extremes in search of a more optimal design. From the database of pulse shapes surveyed, a higher picket version of the original low foot pulse shape shows the most promise for improved compression without loss of stability. This work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

Assessment of simulated water balance from Noah, Noah-MP, CLM, and VIC over CONUS using the NLDAS test bed

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

Cai, Xitian; Yang, Zong-Liang; Xia, Youlong

2014-12-27

This study assesses the hydrologic performance of four land surface models (LSMs) for the conterminous United States using the North American Land Data Assimilation System (NLDAS) test bed. The four LSMs are the baseline community Noah LSM (Noah, version 2.8), the Variable Infiltration Capacity (VIC, version 4.0.5) model, the substantially augmented Noah LSM with multiparameterization options (hence Noah-MP), and the Community Land Model version 4 (CLM4). All four models are driven by the same NLDAS-2 atmospheric forcing. Modeled terrestrial water storage (TWS), streamflow, evapotranspiration (ET), and soil moisture are compared with each other and evaluated against the identical observations. Relativemore » to Noah, the other three models offer significant improvements in simulating TWS and streamflow and moderate improvements in simulating ET and soil moisture. Noah-MP provides the best performance in simulating soil moisture and is among the best in simulating TWS, CLM4 shows the best performance in simulating ET, and VIC ranks the highest in performing the streamflow simulations. Despite these improvements, CLM4, Noah-MP, and VIC exhibit deficiencies, such as the low variability of soil moisture in CLM4, the fast growth of spring ET in Noah-MP, and the constant overestimation of ET in VIC.« less

Energy Services Company | Climate Neutral Research Campuses | NREL

Science.gov Websites

different corporate and ownership structures. While many are large engineering or equipment manufacturers Services Company Options Performance-based contracts can take different forms including guaranteed energy different financing options for energy performance contracting, please refer to page 13 of the April 2009

PRELIMINARY PERFORMANCE AND COST ESTIMATES OF MERCURY EMISSION CONTROL OPTIONS FOR ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper discusses preliminary performance and cost estimates of mercury emission control options for electric utility boilers. Under the Clean Air Act Amendments of 1990, EPA had to determine whether mercury emissions from coal-fired power plants should be regulated. To a...

Solid rocket booster performance evaluation model. Volume 1: Engineering description

NASA Technical Reports Server (NTRS)

1974-01-01

The space shuttle solid rocket booster performance evaluation model (SRB-II) is made up of analytical and functional simulation techniques linked together so that a single pass through the model will predict the performance of the propulsion elements of a space shuttle solid rocket booster. The available options allow the user to predict static test performance, predict nominal and off nominal flight performance, and reconstruct actual flight and static test performance. Options selected by the user are dependent on the data available. These can include data derived from theoretical analysis, small scale motor test data, large motor test data and motor configuration data. The user has several options for output format that include print, cards, tape and plots. Output includes all major performance parameters (Isp, thrust, flowrate, mass accounting and operating pressures) as a function of time as well as calculated single point performance data. The engineering description of SRB-II discusses the engineering and programming fundamentals used, the function of each module, and the limitations of each module.

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

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

NASA Astrophysics Data System (ADS)

Bouwes, Nicolaas W., Sr.

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

Predictors of affect following treatment decision-making for prostate cancer: conversations, cognitive processing, and coping.

PubMed

Christie, Kysa M; Meyerowitz, Beth E; Giedzinska-Simons, Antoinette; Gross, Mitchell; Agus, David B

2009-05-01

Research suggests that cancer patients who are more involved in treatment decision-making (TDM) report better quality of life following treatment. This study examines the association and possible mechanisms between prostate cancer patient's discussions about TDM and affect following treatment. We predicted that the length of time patients spent discussing treatment options with social networks and physicians prior to treatment would predict emotional adjustment after treatment. We further predicted that cognitive processing, coping, and patient understanding of treatment options would mediate this association. Fifty-seven patients completed questionnaires prior to treatment and at 1 and 6 months following treatment completion. Findings from the present study suggest that discussing treatment options with others, prior to beginning treatment for prostate cancer, significantly contributed to improvements in affect 1 and 6 months following treatment. Residualized regression analyses indicated that discussing treatment options with patient's social networks predicted a decrease in negative affect 1 and 6 months following treatment, while discussions with physicians predicted an increase in positive affect 1 month following treatment. Patients who spent more time discussing treatment options with family and friends also reported greater pre-treatment social support and emotional expression. Mediation analyses indicated that these coping strategies facilitated cognitive processing (as measured by a decrease in intrusive thoughts) and that cognitive processing predicted improvement in affect. Greater time spent talking with family and friends about treatment options may provide opportunities for patients to cope with their cancer diagnosis and facilitate cognitive processing, which may improve patient distress over time. Copyright (c) 2008 John Wiley & Sons Ltd.

Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review.

PubMed

Appachi, Swathi; Specht, Jessica L; Raol, Nikhila; Lieu, Judith E C; Cohen, Michael S; Dedhia, Kavita; Anne, Samantha

2017-10-01

Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.

Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

PubMed

Yoshihara, Hiroyuki

2014-07-01

Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

Hair loss and regeneration performed on animal models

PubMed Central

ORASAN, MEDA SANDRA; ROMAN, IULIA IOANA; CONEAC, ANDREI; MURESAN, ADRIANA; ORASAN, REMUS IOAN

2016-01-01

Research in the field of reversal hair loss remains a challenging subject. As Minoxidil 2% or 5% and Finasteride are so far the only FDA approved topical treatments for inducing hair regrowth, research is necessary in order to improve therapeutical approach in alopecia. In vitro studies have focused on cultures of a cell type - dermal papilla or organ culture of isolated cell follicles. In vivo research on this topic was performed on mice, rats, hamsters, rabbits, sheep and monkeys, taking into consideration the advantages and disadvantages of each animal model and the depilation options. Further studies are required not only to compare the efficiency of different therapies but more importantly to establish their long term safety. PMID:27547051

Development of a unified guidance system for geocentric transfer. [for solar electric propulsion spacecraft

NASA Technical Reports Server (NTRS)

Cake, J. E.; Regetz, J. D., Jr.

1975-01-01

A method is presented for open loop guidance of a solar electric propulsion spacecraft to geosynchronous orbit. The method consists of determining the thrust vector profiles on the ground with an optimization computer program, and performing updates based on the difference between the actual trajectory and that predicted with a precision simulation computer program. The motivation for performing the guidance analysis during the mission planning phase is discussed, and a spacecraft design option that employs attitude orientation constraints is presented. The improvements required in both the optimization program and simulation program are set forth, together with the efforts to integrate the programs into the ground support software for the guidance system.

Development of a unified guidance system for geocentric transfer. [solar electric propulsion spacecraft

NASA Technical Reports Server (NTRS)

Cake, J. E.; Regetz, J. D., Jr.

1975-01-01

A method is presented for open loop guidance of a solar electric propulsion spacecraft to geosynchronsus orbit. The method consists of determining the thrust vector profiles on the ground with an optimization computer program, and performing updates based on the difference between the actual trajectory and that predicted with a precision simulation computer program. The motivation for performing the guidance analysis during the mission planning phase is discussed, and a spacecraft design option that employs attitude orientation constraints is presented. The improvements required in both the optimization program and simulation program are set forth, together with the efforts to integrate the programs into the ground support software for the guidance system.

MODELING CONCEPTS FOR BMP/LID SIMULATION

EPA Science Inventory

Enhancement of simulation options for stormwater best management practices (BMPs) and hydrologic source control is discussed in the context of the EPA Storm Water Management Model (SWMM). Options for improvement of various BMP representations are presented, with emphasis on inco...

Power generation using sugar cane bagasse: A heat recovery analysis

NASA Astrophysics Data System (ADS)

Seguro, Jean Vittorio

The sugar industry is facing the need to improve its performance by increasing efficiency and developing profitable by-products. An important possibility is the production of electrical power for sale. Co-generation has been practiced in the sugar industry for a long time in a very inefficient way with the main purpose of getting rid of the bagasse. The goal of this research was to develop a software tool that could be used to improve the way that bagasse is used to generate power. Special focus was given to the heat recovery components of the co-generation plant (economizer, air pre-heater and bagasse dryer) to determine if one, or a combination, of them led to a more efficient co-generation cycle. An extensive review of the state of the art of power generation in the sugar industry was conducted and is summarized in this dissertation. Based on this models were developed. After testing the models and comparing the results with the data collected from the literature, a software application that integrated all these models was developed to simulate the complete co-generation plant. Seven different cycles, three different pressures, and sixty-eight distributions of the flue gas through the heat recovery components can be simulated. The software includes an economic analysis tool that can help the designer determine the economic feasibility of different options. Results from running the simulation are presented that demonstrate its effectiveness in evaluating and comparing the different heat recovery components and power generation cycles. These results indicate that the economizer is the most beneficial option for heat recovery and that the use of waste heat in a bagasse dryer is the least desirable option. Quantitative comparisons of several possible cycle options with the widely-used traditional back-pressure turbine cycle are given. These indicate that a double extraction condensing cycle is best for co-generation purposes. Power generation gains between 40 and 100% are predicted for some cycles with the addition of optimum heat recovery systems.

Comparison of High Performance Network Options: EDR InfiniBand vs.100Gb RDMA Capable Ethernet

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

Kachelmeier, Luke Anthony; Van Wig, Faith Virginia; Erickson, Kari Natania

These are the slides for a presentation at the HPC Mini Showcase. This is a comparison of two different high performance network options: EDR InfiniBand and 100Gb RDMA capable ethernet. The conclusion of this comparison is the following: there is good potential, as shown with the direct results; 100Gb technology is too new and not standardized, thus deployment effort is complex for both options; different companies are not necessarily compatible; if you want 100Gb/s, you must get it all from one place.

Advanced small rocket chambers: Option 1, 14 lbf Ir-Re rocket

NASA Technical Reports Server (NTRS)

Jassowski, Donald M.; Gage, Mark L.

1992-01-01

A high performance Ir-Re 14 lbf (62 N) chamber and nozzle which can be a direct replacement for a production engine was designed, built, hot fired and vibration acceptance tested. It passed all acceptance tests satisfactorily and demonstrated a 20 sec increase in specific impulse (Is) over the conventional 14 lbf silicide coated Cb chamber. The high performance engine uses the production valve and injector without modification. Incorporation of a secondary mixing device or Boundary Layer Trip within the combustion chamber results in elimination of the fuel film coolant, improvement in flow uniformity, the 20 sec performance increase, and reduction of a potential source of spacecraft contamination. Measured Is was 305 sec at 75:1 area ratio, with monomenthylhydrazine and nitrogen tetroxide propellants. Qualification tests remain to be done.

Electric Propulsion Performance from Geo-transfer to Geosynchronous Orbits

NASA Technical Reports Server (NTRS)

Dankanich, John W.; Carpenter, Christian B.

2007-01-01

For near-Earth application, solar electric propulsion advocates have focused on Low Earth Orbit (LEO) to Geosynchronous (GEO) low-thrust transfers because of the significant improvement in capability over chemical alternatives. While the performance gain attained from starting with a lower orbit is large, there are also increased transfer times and radiation exposure risk that has hindered the commercial advocacy for electric propulsion stages. An incremental step towards electric propulsion stages is the use of integrated solar electric propulsion systems (SEPS) for GTO to GEO transfer. Thorough analyses of electric propulsion systems options and performance are presented. Results are based on existing or near-term capabilities of Arcjets, Hall thrusters, and Gridded Ion engines. Parametric analyses based on "rubber" thruster and launch site metrics are also provided.

Performance of High-Speed PWM Control Chips at Cryogenic Temperatures

NASA Technical Reports Server (NTRS)

Elbuluk, Malik E.; Gerber, Scott; Hammoud, Ahmad; Patterson, Richard; Overton, Eric

2001-01-01

The operation of power electronic systems at cryogenic temperatures is anticipated in many NASA space missions such as planetary exploration and deep space probes. In addition to surviving the space hostile environment, electronics capable of low temperature operation would contribute to improving circuit performance, increasing system efficiency, and reducing development and launch costs. As part of the NASA Glenn Low Temperature Electronics Program, several commercial high-speed Pulse Width Modulation (PWM) chips have been characterized in terms of their performance as a function of temperature in the range of 25 to -196 C (liquid nitrogen). These chips ranged in their electrical characteristics, modes of control, packaging options, and applications. The experimental procedures along with the experimental data obtained on the investigated chips are presented and discussed.

Development of a Thin Film Primary Surface Heat Exchanger for Advanced Power Cycles

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

Allison, Tim; Beck, Griffin; Bennett, Jeffrey

This project objective is to develop a high-temperature design upgrade for an existing primary surface heat exchanger so that the redesigned hardware is capable of operation in CO 2 at temperatures up to 1,510°F (821°C) and pressure differentials up to 130 psi (9 bar). The heat exchanger is proposed for use as a recuperator in an advanced low-pressure oxy-fuel Brayton cycle that is predicted to achieve over 50% thermodynamic efficiency, although the heat exchanger could also be used in other high-temperature, low-differential pressure cycles. This report describes the progress to date, which includes continuing work performed to select and testmore » new candidate materials for the recuperator redesign, final mechanical and thermal performance analysis results of various redesign concepts, and the preliminary design of a test loop for the redesigned recuperator including a budgetary estimate for detailed test loop design, procurement, and test operation. A materials search was performed in order to investigate high-temperature properties of many candidate materials, including high-temperature strength and nickel content. These properties were used to rank the candidate materials, resulting in a reduced list of nine materials for corrosion testing. Multiple test rigs were considered and analyzed for short-term corrosion testing and Thermal Gravimetric Analysis (TGA) was selected as the most cost-effective option for evaluating corrosion resistance of the candidate materials. In addition, tantalum, niobium, and chromium coatings were identified as potential options for increased corrosion resistance. The test results show that many materials exhibit relatively low weight gain rates, and that niobium and tantalum coatings may improve corrosion resistance for many materials, while chromium coatings appear to oxidize and debond quickly. Metallurgical analysis of alloys was also performed, showing evidence of intergranular attack in 282 that may cause long-term reliability problems in CO 2 service at these temperatures. However, long-term testing in a flowing environment is recommended in order to understand accurately the severity of the attack. Detailed economic modeling of the existing air cycle recuperator and CO 2 cycle recuperator options was also completed, including costs for material, fabrication, fuel, maintenance, and operation. The analysis results show that the increased capital cost for high-temperature materials may be offset by higher cycle efficiencies, decreasing the overall lifetime cost of the system. The economic analysis also examines costs associated with increased pressure drop and material changes for two redesign options. These results show that, even with slightly reduced performance and/or higher material costs, the lifetime cost per energy production may still be reduced by over 12%. The existing recuperator design information was provided by Solar Turbines, Inc. via several models, drawings, and design handoff meetings. Multiple fluid/thermal and structural models were created in order to analyze critical recuperator performance and mechanical strength in critical areas throughout the redesign process. These models were analyzed for a baseline condition (consistent with current Mercury 50 operation) for validation purposes. Results are presented for heat transfer coefficients and pressure drops, matching well with the existing operational data. Simulation of higher-temperature CO 2 conditions was also performed, showing a slight expected increase in both heat transfer and pressure drop. Mechanical analysis results for critical areas on the cross-flow and counter-flow sheets have also been obtained for air and CO 2 cases. These results show similar stresses in both cases but significantly reduced safety factors for the CO 2 case due to reduced yield and creep rupture strengths of alloy 625 at the higher temperatures. A concept brainstorm session and initial down-selection were completed in order to identify promising redesign options for further analysis. Detailed analysis of all promising redesign options was performed via finite element and computational fluid dynamic simulations in order to characterize mechanical and thermal-fluid performance of each option. These options included material change, various sheet thickness configurations, pitch and phasing of cross-flow and counter-flow sheets, and separator sheets. The analysis results have identified two viable redesign options that maintain existing safety margins optimally through a material change to Haynes 282 and (A) sheet thickness increases of 40% on the counter-flow sheet and 75% on the hot side cross-flow corrugation sheet or (B) addition of a separator sheet in the counter-flow section while maintaining the original counter-flow sheet thickness and increasing the cross-flow corrugation sheet thickness by 90% to account for the increase in cell height. While both options satisfy mechanical stress constraints, the separator sheet design has a higher part count, slightly reduced heat transfer, and slightly higher pressure drop than the first option and is not preferred. Finally, several test loop concepts have been developed for different full-scale and reduced-scale recuperator testing options. For each option, various loop components, such as heat exchangers, valves, heaters, and compressors, were evaluated in an effort to maximize utilization of existing resources. All concepts utilize an existing 3-MW CO 2 compressor, heater, and loop coolers, but the concepts vary by incorporating different amounts of new equipment for achieving various flow rates (all concepts operate at design pressure and temperature). The third concept achieves a 1 kg/s test without purchasing any costly equipment (coolers, heaters, blowers, etc.). Since the stacked cell design of the recuperator results in the same flow conditions at each core cell (even for a reduced-scale test). Thus, test loop Concept #3 was selected for the preliminary design. This loop design is detailed within the report, culminating in a budgetary estimate of $1,013,000.00 for the detailed design, construction, commissioning, and operation of a high-temperature recuperator test loop.« less

Optimizing spacecraft design - optimization engine development : progress and plans

NASA Technical Reports Server (NTRS)

Cornford, Steven L.; Feather, Martin S.; Dunphy, Julia R; Salcedo, Jose; Menzies, Tim

2003-01-01

At JPL and NASA, a process has been developed to perform life cycle risk management. This process requires users to identify: goals and objectives to be achieved (and their relative priorities), the various risks to achieving those goals and objectives, and options for risk mitigation (prevention, detection ahead of time, and alleviation). Risks are broadly defined to include the risk of failing to design a system with adequate performance, compatibility and robustness in addition to more traditional implementation and operational risks. The options for mitigating these different kinds of risks can include architectural and design choices, technology plans and technology back-up options, test-bed and simulation options, engineering models and hardware/software development techniques and other more traditional risk reduction techniques.

Banding hemorrhoids using the O'Regan Disposable Bander. Single center experience.

PubMed

Paikos, Dimitrios; Gatopoulou, Anthie; Moschos, John; Koulaouzidis, Anastasios; Bhat, Shivram; Tzilves, Dimitrios; Soufleris, Konstantinos; Tragiannidis, Dimitrios; Katsos, Ioannis; Tarpagos, Anestis

2007-06-01

Hemorrhoids are the most common anorectal disorder in the Western World and are a major cause of active, relapsing or chronic rectal bleeding. Many treatment options have been proposed and tried for early-stage hemorrhoids. There is general agreement that rubber banding ligation (RBL) is safe and effective. To evaluate the effectiveness and complications associated with RBL performed in outpatients for symptomatic hemorrhoids using the O'Regan Disposable Bander device. Sixty consecutive patients underwent hemorrhoid banding with the O'Regan Disposable Bander. The mean time required for one session was 6.2 min; the longest was 10 min. No major complications were noted. Minor early and late bleeding was reported in 10% and 6.7% respectively, but none was severe. Pain occurred in 6.7% but was not severe. In all cases, clinical and endoscopic (range and form scores) improvement was observed and patients of all ages, including the elderly, were found to be tolerant to the procedure. RBL performed in outpatients for symptomatic hemorrhoids using the O'Regan Disposable Bander device is associated with a good response and low complication rate. We recommend the technique as a safe and reliable treatment option.

Nitroglycerin patch for the treatment of chondrodermatitis nodularis helicis: a new therapeutic option.

PubMed

Garrido Colmenero, Cristina; Martínez García, Eliseo; Blasco Morente, Gonzalo; Tercedor Sánchez, Jesús

2014-01-01

Chondrodermatitis nodularis helicis (CNH) is an inflammatory process that affects the skin and cartilage of the ear. At present, there are many treatment options, although they are not always effective. Based on previous studies where nitroglycerin 2% gel was used, we propose the use of nitroglycerin patches. The purpose of this study was to evaluate the effectiveness of nitroglycerin patches in treating CNH. We performed a prospective study in 11 patients diagnosed with CNH treated with nitroglycerin patches 5 mg, 12 hours a day for 2 months. The therapeutic effectivity was determined by the improvement in the appearance and symptoms of the lesion. Seven of 11 patients (63.6%) had a complete response. One of 11 patients (9%) did not respond completely and surgical treatment was performed. Two of 11 patients (18.1%) stopped the treatment because of headache. One of 11 patients (9%) did not complete the treatment because the said patient forgot to apply the patch every night. Transdermal nitroglycerin has demonstrated efficacy in the treatment of the symptoms and lesional appearance of CNH noninvasive manner. The success rate is comparable with other published methods and the rate of adverse effects is acceptable. © 2014 Wiley Periodicals, Inc.

Learning to identify crowded letters: Does the learning depend on the frequency of training?

PubMed Central

Chung, Susana T. L.; Truong, Sandy R.

2012-01-01

Performance for many visual tasks improves with training. The magnitude of improvement following training depends on the training task, number of trials per training session and the total amount of training. Does the magnitude of improvement also depend on the frequency of training sessions? In this study, we compared the learning effect for three groups of normally sighted observers who repeatedly practiced the task of identifying crowded letters in the periphery for six sessions (1000 trials per session), according to three different training schedules — one group received one session of training everyday, the second group received a training session once a week and the third group once every two weeks. Following six sessions of training, all observers improved in their performance of identifying crowded letters in the periphery. Most importantly, the magnitudes of improvement were similar across the three training groups. The improvement was accompanied by a reduction in the spatial extent of crowding, an increase in the size of visual span and a reduction in letter-size threshold. The magnitudes of these accompanied improvements were also similar across the three training groups. Our finding that the effectiveness of visual perceptual learning is similar for daily, weekly and biweekly training has significant implication for adopting perceptual learning as an option to improve visual functions for clinical patients. PMID:23206551

Exponential model for option prices: Application to the Brazilian market

NASA Astrophysics Data System (ADS)

Ramos, Antônio M. T.; Carvalho, J. A.; Vasconcelos, G. L.

2016-03-01

In this paper we report an empirical analysis of the Ibovespa index of the São Paulo Stock Exchange and its respective option contracts. We compare the empirical data on the Ibovespa options with two option pricing models, namely the standard Black-Scholes model and an empirical model that assumes that the returns are exponentially distributed. It is found that at times near the option expiration date the exponential model performs better than the Black-Scholes model, in the sense that it fits the empirical data better than does the latter model.

Does availability of AIR insulin increase insulin use and improve glycemic control in patients with type 2 diabetes?

PubMed

Bergenstal, Richard M; Freemantle, Nick; Leyk, Malgorzata; Cutler, Gordon B; Hayes, Risa P; Muchmore, Douglas B

2009-09-01

In the concordance model, physician and patient discuss treatment options, explore the impact of treatment decisions from the patient's perspective, and make treatment choices together. We tested, in a concordance setting, whether the availability of AIR inhaled insulin (developed by Alkermes, Inc. [Cambridge, MA] and Eli Lilly and Company [Indianapolis, IN]; AIR is a registered trademark of Alkermes, Inc.), as compared with existing treatment options alone, leads to greater initiation and maintenance of insulin therapy and improves glycemic control in patients with type 2 diabetes. This was a 9-month, multicenter, parallel, open-label study in adult, nonsmoking patients with diabetes not optimally controlled by two or more oral antihyperglycemic medications. Patients were randomized to the Standard Options group (n = 516), in which patients chose a regimen from drugs in each major treatment class excluding inhaled insulin, or the Standard Options + AIR insulin group (n = 505), in which patients had the same choices plus AIR insulin. The primary end points were the proportion of patients in each group using insulin at end point and change in hemoglobin A1C (A1C) from baseline to end point. At end point, 53% of patients in the Standard Options group and 59% in the Standard Options + AIR insulin group were using insulin (P = 0.07). Both groups reduced A1C by about 1.2% and reported increased well-being and treatment satisfaction. The most common adverse event with AIR insulin was transient cough. The opportunity to choose AIR insulin did not affect overall use of insulin at end point or A1C outcomes. Regardless of group assignment, utilizing a shared decision-making approach to treatment choices (concordance model), resulted in improved treatment satisfaction and A1C values at end point. Therefore, increasing patient involvement in treatment decisions may improve outcomes.

Student Work Safety Guidelines in Roadside Applications and Work Zones : Safety Guidelines for Transportation Researchers

DOT National Transportation Integrated Search

2018-01-01

The Smart City Demonstration Program is intended to improve access through expanded mobility options in major job centers, enhance visitor experience by better connecting visitors to transportation options, stimulate regional economic prosperity and ...

Retention in care under universal antiretroviral therapy for HIV-infected pregnant and breastfeeding women ('Option B+') in Malawi.

PubMed

Tenthani, Lyson; Haas, Andreas D; Tweya, Hannock; Jahn, Andreas; van Oosterhout, Joep J; Chimbwandira, Frank; Chirwa, Zengani; Ng'ambi, Wingston; Bakali, Alan; Phiri, Sam; Myer, Landon; Valeri, Fabio; Zwahlen, Marcel; Wandeler, Gilles; Keiser, Olivia

2014-02-20

To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') in Malawi. We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21,939), as well as individual-level data on patients who started ART at 19 large facilities (n = 11,534). Of the women who started ART under Option B+ (n = 21,939), 17% appeared to be lost to follow-up 6 months after ART initiation. Most losses occurred in the first 3 months of therapy. Option B+ patients who started therapy during pregnancy were five times more likely than women who started ART in WHO stage 3/4 or with a CD4 cell count 350 cells/μl or less, to never return after their initial clinic visit [odds ratio (OR) 5.0, 95% confidence interval (CI) 4.2-6.1]. Option B+ patients who started therapy while breastfeeding were twice as likely to miss their first follow-up visit (OR 2.2, 95% CI 1.8-2.8). LTF was highest in pregnant Option B+ patients who began ART at large clinics on the day they were diagnosed with HIV. LTF varied considerably between facilities, ranging from 0 to 58%. Decreasing LTF will improve the effectiveness of the Option B+ approach. Tailored interventions, like community or family-based models of care could improve its effectiveness.

Internet platforms for lifelong learning: a continuum of opportunity.

PubMed

Sedory Holzer, Susan E; Kokemueller, Phillip

2007-12-01

Access to knowledge through the Internet has spawned a world of online learning, stimulating a new passion for lifelong learning in academia, professional environments, the workplace, and at home. This article takes a fresh look at the wide spectrum of opportunities for online medical education for physicians. We first explore a continuum of "e-learning" models and then look at the range of platforms used to support these systems. We will also look forward to the options likely to change e-learning in the near future and improve physician performance and patient outcomes.

Improvements To Micro Contact Performance And Reliability

DTIC Science & Technology

2016-12-22

BAKE : □ 1 min 110°C hot plate bake OPTIONAL - For Grayscale Lithography: 1818 COAT: □ Flood wafer with 1818 □ 4 sec spread at 500 rpm...30 sec spin at 4,000 rpm, ramp=200 □ 75 sec 110°C hot plate bake GRAYSCALE PATTERNING: □ Follow grayscale patterning process for patterns...8217 □ 2 min 200°C hot plate bake 1818 COAT: □ Flood wafer with 1818 □ 4 sec spread at 500 rpm □ 30 sec spin at 4,000 rpm, ramp=200 □ 75 sec 110

IRACproc: IRAC Post-BCD Processing

NASA Astrophysics Data System (ADS)

Schuster, Mike; Marengo, Massimo; Patten, Brian

2012-09-01

IRACproc is a software suite that facilitates the co-addition of dithered or mapped Spitzer/IRAC data to make them ready for further analysis with application to a wide variety of IRAC observing programs. The software runs within PDL, a numeric extension for Perl available from pdl.perl.org, and as stand alone perl scripts. In acting as a wrapper for the Spitzer Science Center's MOPEX software, IRACproc improves the rejection of cosmic rays and other transients in the co-added data. In addition, IRACproc performs (optional) Point Spread Function (PSF) fitting, subtraction, and masking of saturated stars.

What is the future of 'organ transplantation' in the head and neck?

PubMed

Lott, David G

2014-10-01

To update readers on the current state and future of head and neck tissue transplantation. Many exciting advances have recently occurred in the field of head and neck transplantation and regenerative medicine. Larynx, face, and trachea transplants have all been successfully performed. Significant advancements in tissue engineering have occurred, including the ability to generate three-dimensional tissue structures. Transplantation of regenerated tissues has been successfully incorporated into airway reconstruction. These exciting advancements set the foundation to expand reconstructive options for dysfunctional tissues and to improve a patient's quality of life.

Controversy about Management of Hydrocephalus - Shunt vs. Endoscopic Third Ventriculostomy.

PubMed

Kumar, Vikas; Bodeliwala, Shaam; Singh, Daljit

2017-08-01

The best management of hydrocephalus is still controversial in the twenty-first century. Shunt treatment for hydrocephalus is the most common procedure performed in neurosurgical practice and is associated with the highest complications rate. But during the last 2 decades, the treatment of hydrocephalus has improved with better shunt devices available today, increased facilities for investigations and newer approaches like endoscopic third ventriculostomy. The recent advances in development of better endoscopes have provided the patient and treating doctor with an option for an alternative surgery for treatment of hydrocephalus.

Pollution prevention opportunity assessment for Facilities Maintenance Team (FMT) paint shop.

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

Klossner, Kristin Ann

This Pollution Prevention Opportunity Assessment (PPOA) was conducted for Sandia National Laboratories/California Facilities Maintenance Team Paint Shop Operations in August and September 2002. The primary purpose of this PPOA is to provide recommendations to assist Paint Shop personnel in reducing the generation of waste and improving the efficiency of their processes. This report contains a summary of the information collected and analyses performed and recommends options for implementation. The Sandia National Laboratories Pollution Prevention staff will continue to work with the Paint Shop to implement the recommendations.

Intelligent single switch wheelchair navigation.

PubMed

Ka, Hyun W; Simpson, Richard; Chung, Younghyun

2012-11-01

We have developed an intelligent single switch scanning interface and wheelchair navigation assistance system, called intelligent single switch wheelchair navigation (ISSWN), to improve driving safety, comfort and efficiency for individuals who rely on single switch scanning as a control method. ISSWN combines a standard powered wheelchair with a laser rangefinder, a single switch scanning interface and a computer. It provides the user with context sensitive and task specific scanning options that reduce driving effort based on an interpretation of sensor data together with user input. Trials performed by 9 able-bodied participants showed that the system significantly improved driving safety and efficiency in a navigation task by significantly reducing the number of switch presses to 43.5% of traditional single switch wheelchair navigation (p < 0.001). All participants made a significant improvement (39.1%; p < 0.001) in completion time after only two trials.

Combination of bioremediation and electrokinetics for the in-situ treatment of diesel polluted soil: A comparison of strategies.

PubMed

Mena Ramírez, Esperanza; Villaseñor Camacho, José; Rodrigo, Manuel A; Cañizares, Pablo

2015-11-15

The aim of this work is to compare different strategies based on electrokinetic soil flushing and bioremediation for the remediation of diesel-polluted soil. Four options were tested at the laboratory scale: single bioremediation (Bio), performed as a control test; a direct combination of electrokinetic soil flushing and biological technologies (EKSF-Bio); EKSF-Bio with daily polarity reversal of the electric field (PR-EKSF-Bio); and a combination of electrokinetic soil flushing and a permeable reactive biological barrier (EKSF-BioPRB). Four batch experiments of 14 days duration were carried out for comparing technologies at room temperature with an electric field of 1.0 V cm(-1) (in EKSF). A diesel degrading microbial consortium was used. The experimental procedure and some specific details, such as the flushing fluids used, varied depending on the strategy. When using the EKSF-Bio option, a high buffer concentration was required to control the pH, causing soil heating, which negatively affected the biological growth and thus the diesel removal. The PR-EKSF-Bio and the EKSF-BioPRB options attained suitable operating conditions and improved the transport processes for biological growth. Polarity reversal was an efficient option for pH, moisture and temperature control. Homogeneous microbial growth was observed, and approximately 20% of the diesel was removed. The BioPRB option was not as efficient as PR-EKSF-Bio in controlling the operating conditions, but the central biobarrier protected the biological activity. Microbial growth was observed not only in the biobarrier but also in a large portion of the soil, and 29% of the diesel was removed in the short remediation test. Copyright © 2015 Elsevier B.V. All rights reserved.

Expertise-Based Differences in Search and Option-Generation Strategies

ERIC Educational Resources Information Center

Raab, Markus; Johnson, Joseph G.

2007-01-01

The current work builds on option-generation research using experts of various skill levels in a realistic task. We extend previous findings that relate an athlete's performance strategy to generated options and subsequent choices in handball. In a 2-year longitudinal study, we present eye-tracking data to independently verify decision strategies…

Reconstruction Options for Pancreaticoduodenectomy in Patients with Prior Roux-en-Y Gastric Bypass.

PubMed

Shah, Mihir M; Martin, Benjamin M; Stetler, Jamil L; Patel, Ankit D; Davis, S Scott; Sarmiento, Juan M; Lin, Edward

2017-11-01

Patients with prior Roux-en-Y gastric bypass (RYGB) operations for weight loss present reconstruction challenges during a pancreaticoduodenectomy (PD). With over 60,000 RYGB performed annually, the increasing odds of encountering such patients during a PD make it imperative to understand the RYGB anatomy and anticipate reconstruction options. This article describes the possible reconstruction options and their rationale. We reviewed our PD reconstruction options, compared them to what have been described in the literature, and derived a consensus from internal conferences comprising bariatric and hepatopancreatobiliary surgeons to describe known reconstruction options. In general, reconstruction options can include one of three options: (1) remnant gastrectomy, (2) preservation of gastric remnant, or (3) reversal of gastric bypass. This article describes individualized reconstruction options for RYGB patients undergoing PD. The reconstruction options can be tailored to the needs of the patient.

Schema Versioning for Multitemporal Relational Databases.

ERIC Educational Resources Information Center

De Castro, Cristina; Grandi, Fabio; Scalas, Maria Rita

1997-01-01

Investigates new design options for extended schema versioning support for multitemporal relational databases. Discusses the improved functionalities they may provide. Outlines options and basic motivations for the new design solutions, as well as techniques for the management of proposed schema versioning solutions, includes algorithms and…

Coupled Solid Rocket Motor Ballistics and Trajectory Modeling for Higher Fidelity Launch Vehicle Design

NASA Technical Reports Server (NTRS)

Ables, Brett

2014-01-01

Multi-stage launch vehicles with solid rocket motors (SRMs) face design optimization challenges, especially when the mission scope changes frequently. Significant performance benefits can be realized if the solid rocket motors are optimized to the changing requirements. While SRMs represent a fixed performance at launch, rapid design iterations enable flexibility at design time, yielding significant performance gains. The streamlining and integration of SRM design and analysis can be achieved with improved analysis tools. While powerful and versatile, the Solid Performance Program (SPP) is not conducive to rapid design iteration. Performing a design iteration with SPP and a trajectory solver is a labor intensive process. To enable a better workflow, SPP, the Program to Optimize Simulated Trajectories (POST), and the interfaces between them have been improved and automated, and a graphical user interface (GUI) has been developed. The GUI enables real-time visual feedback of grain and nozzle design inputs, enforces parameter dependencies, removes redundancies, and simplifies manipulation of SPP and POST's numerous options. Automating the analysis also simplifies batch analyses and trade studies. Finally, the GUI provides post-processing, visualization, and comparison of results. Wrapping legacy high-fidelity analysis codes with modern software provides the improved interface necessary to enable rapid coupled SRM ballistics and vehicle trajectory analysis. Low cost trade studies demonstrate the sensitivities of flight performance metrics to propulsion characteristics. Incorporating high fidelity analysis from SPP into vehicle design reduces performance margins and improves reliability. By flying an SRM designed with the same assumptions as the rest of the vehicle, accurate comparisons can be made between competing architectures. In summary, this flexible workflow is a critical component to designing a versatile launch vehicle model that can accommodate a volatile mission scope.

Improving spacecraft design using a multidisciplinary design optimization methodology

NASA Astrophysics Data System (ADS)

Mosher, Todd Jon

2000-10-01

Spacecraft design has gone from maximizing performance under technology constraints to minimizing cost under performance constraints. This is characteristic of the "faster, better, cheaper" movement that has emerged within NASA. Currently spacecraft are "optimized" manually through a tool-assisted evaluation of a limited set of design alternatives. With this approach there is no guarantee that a systems-level focus will be taken and "feasibility" rather than "optimality" is commonly all that is achieved. To improve spacecraft design in the "faster, better, cheaper" era, a new approach using multidisciplinary design optimization (MDO) is proposed. Using MDO methods brings structure to conceptual spacecraft design by casting a spacecraft design problem into an optimization framework. Then, through the construction of a model that captures design and cost, this approach facilitates a quicker and more straightforward option synthesis. The final step is to automatically search the design space. As computer processor speed continues to increase, enumeration of all combinations, while not elegant, is one method that is straightforward to perform. As an alternative to enumeration, genetic algorithms are used and find solutions by reviewing fewer possible solutions with some limitations. Both methods increase the likelihood of finding an optimal design, or at least the most promising area of the design space. This spacecraft design methodology using MDO is demonstrated on three examples. A retrospective test for validation is performed using the Near Earth Asteroid Rendezvous (NEAR) spacecraft design. For the second example, the premise that aerobraking was needed to minimize mission cost and was mission enabling for the Mars Global Surveyor (MGS) mission is challenged. While one might expect no feasible design space for an MGS without aerobraking mission, a counterintuitive result is discovered. Several design options that don't use aerobraking are feasible and cost effective. The third example is an original commercial lunar mission entitled Eagle-eye. This example shows how an MDO approach is applied to an original mission with a larger feasible design space. It also incorporates a simplified business case analysis.

Advances in Monte-Carlo code TRIPOLI-4®'s treatment of the electromagnetic cascade

NASA Astrophysics Data System (ADS)

Mancusi, Davide; Bonin, Alice; Hugot, François-Xavier; Malouch, Fadhel

2018-01-01

TRIPOLI-4® is a Monte-Carlo particle-transport code developed at CEA-Saclay (France) that is employed in the domains of nuclear-reactor physics, criticality-safety, shielding/radiation protection and nuclear instrumentation. The goal of this paper is to report on current developments, validation and verification made in TRIPOLI-4 in the electron/positron/photon sector. The new capabilities and improvements concern refinements to the electron transport algorithm, the introduction of a charge-deposition score, the new thick-target bremsstrahlung option, the upgrade of the bremsstrahlung model and the improvement of electron angular straggling at low energy. The importance of each of the developments above is illustrated by comparisons with calculations performed with other codes and with experimental data.

Management of chronic myeloid leukemia in blast crisis.

PubMed

Saußele, S; Silver, Richard T

2015-04-01

Due to the high efficacy of BCR-ABL tyrosine kinase inhibition (TKI) in chronic phase (CP) chronic myeloid leukemia (CML), the frequency of blast crisis (BC) is greatly reduced compared to the pre-TKI era. However, TKI treatment of BC has only marginally improved the number of favorable responses, including remissions, which for the most part have only been transitory. Occasionally, they provide a therapeutic window to perform an allogeneic stem cell transplantation (allo-SCT). The challenge remains to improve management of BC with the limited options available. We review and summarize articles pertaining to the treatment of BC CML published after 2002. Additionally, we will discuss whether there is a need for a new definition of BC and/or treatment failure.

 Albumin dialysis with MARS for the treatment of anabolic steroid-induced cholestasis.

PubMed

Díaz, Francia C; Sáez-González, Esteban; Benlloch, Salvador; Álvarez-Sotomayor, Diego; Conde, Isabel; Polo, Begoña; García, María; Rodríguez, María; Prieto, Martín

 Background and aims. Steroid-related hepatotoxicity has become one of the most relevant causes of drug induced liver cholestasis. Some patients do not improve after standard medical treatment (SMT) and may therefore require other approaches, like extracorporeal liver support. We report four cases of patients with pruritus, abnormal liver function tests and biopsy-proven anabolic steroid-induced cholestasis who were unresponsive to SMT. They underwent treatment with albumin dialysis (Molecular Adsorbent Recirculating System -MARS®-). A minimum of two MARS sessions were performed. After MARS® procedure, patients' symptoms improved, as well as liver function tests, thus avoiding liver transplantation. Albumin dialysis appears as a valuable therapeutic option for the management of anabolic steroid-induced cholestasis in patients that are unresponsive to SMT.

A video to improve patient and surrogate understanding of cardiopulmonary resuscitation choices in the ICU: a randomized controlled trial.

PubMed

Wilson, Michael E; Krupa, Artur; Hinds, Richard F; Litell, John M; Swetz, Keith M; Akhoundi, Abbasali; Kashyap, Rahul; Gajic, Ognjen; Kashani, Kianoush

2015-03-01

To determine if a video depicting cardiopulmonary resuscitation and resuscitation preference options would improve knowledge and decision making among patients and surrogates in the ICU. Randomized, unblinded trial. Single medical ICU. Patients and surrogate decision makers in the ICU. The usual care group received a standard pamphlet about cardiopulmonary resuscitation and cardiopulmonary resuscitation preference options plus routine code status discussions with clinicians. The video group received usual care plus an 8-minute video that depicted cardiopulmonary resuscitation, showed a simulated hospital code, and explained resuscitation preference options. One hundred three patients and surrogates were randomized to usual care. One hundred five patients and surrogates were randomized to video plus usual care. Median total knowledge scores (0-15 points possible for correct answers) in the video group were 13 compared with 10 in the usual care group, p value of less than 0.0001. Video group participants had higher rates of understanding the purpose of cardiopulmonary resuscitation and resuscitation options and terminology and could correctly name components of cardiopulmonary resuscitation. No statistically significant differences in documented resuscitation preferences following the interventions were found between the two groups, although the trial was underpowered to detect such differences. A majority of participants felt that the video was helpful in cardiopulmonary resuscitation decision making (98%) and would recommend the video to others (99%). A video depicting cardiopulmonary resuscitation and explaining resuscitation preference options was associated with improved knowledge of in-hospital cardiopulmonary resuscitation options and cardiopulmonary resuscitation terminology among patients and surrogate decision makers in the ICU, compared with receiving a pamphlet on cardiopulmonary resuscitation. Patients and surrogates found the video helpful in decision making and would recommend the video to others.

The liquid rocket booster as an element of the U.S. national space transportation system

NASA Astrophysics Data System (ADS)

Bialla, Paul H.; Simon, Michael C.

Liquid rocket boosters (LRBs) were first considered for the U.S. Space Transportation System (STS) during the early conceptual phases of the Space Shuttle program. However, solid rocket boosters (SRBs) were ultimately selected for the STS, primarily due to near-term economics. Liquid rocket boosters are once again being considered as a possible future upgrade to the Shuttle. This paper addresses the findings of these studies to date, with emphasis on the feasibility, benefits, and implementation strategy for a LRB program. The principal issue relating to LRB feasibility is their ability to be integrated into the STS with minimal vehicle and facility impacts. Booster size has been shown to have a significant influence on compatibility with the STS. The physical dimensions of the Orbiter and STS support facilities place an inherent limitation on the size of any booster to be used with this system. In addition, excessively large diameter boosters can cause increased airloads to be induced on the Orbiter wings, requiring modification of STS launch trajectory and possible performance losses. However, trajectory and performance analyses have indicated that LRBs can be designed within these sizing constraints and still have sufficient performance to meet Space Shuttle mission requirements. In fact, several configurations have been developed to meet a design goal of providing a 20,000 lb performance improvement to low Earth-orbit (LEO), as compared with current SRBs. Several major system trade studies have been performed to establish a baseline design which is most compatible with the existing Space Transportation System. These trades include propellant selection (storable, hydrogen-oxygen, hydrocarbon-oxygen, and advanced propellants); pump-fed vs pressure-fed propellant feed system design; engine selection (Space Shuttle Main Engine, Titan LR-87, and advanced new engines); number of engines per booster; and reusability vs expendability. In general, it was determined through these trade studies that several options exist for designing a LRB that can be integrated into the STS with manageable impacts on STS facilities and operational procedures. While LRBs offer a potential 40% improvement in Shuttle performance, their most significant benefit is the potential improvements they offer in the area of Shuttle safety. This begins during ground handling operations, where LRBs eliminate the need for large quantities of hazardous solid propellants to be emplaced in the Kennedy Space Center Vehicle Assembly Building. In the pre-launch phase, all LRB engines can be ignited on the launch pad and verified prior to release of the STS. During flight, LRB engines can be shut down on command should the need arise. Further, missions could be aborted safely during the boost phase—an option not available with SRBs. A related benefit of LRBs is their ability to accomplish a mission even if one engine fails, assuming the LRB is designed with sufficient performance margin. An implementation plan has been developed which indicates that LRBs can be operational by 1997. The attractive features of the LRB have prompted NASA to include this booster as a principal element of the agency's long range plan for enhancing STS capabilities through an evolutionary program of block changes. The implementation of LRBs offers an attractive option for developing a safer, more reliable, and better performing STS.

Waste battery treatment options: comparing their environmental performance.

PubMed

Briffaerts, K; Spirinckx, C; Van der Linden, A; Vrancken, K

2009-08-01

Waste consumer batteries are recycled using different routes based on hydrometallurgical and pyrometallurgical processes. Two hydrometallurgical and two pyrometallurgical treatment scenarios are compared starting from an average composition of Belgian waste batteries. The environmental performance is compared using life cycle analysis (LCA). The recycling rate is studied through mass balance calculation. Each treatment scenario results in a specific recycling rate. The environmental impact and benefits also vary between the treatment options. There is no such thing as a typical hydrometallurgical or pyrometallurgical treatment. When applying a hydrometallurgical treatment scenario, the focus lies on zinc and iron recycling. When allowing manganese recycling, the energy demand of the hydrometallurgical process increases considerably. Both pyrometallurgical options recycle zinc, iron and manganese. According to the LCA, none of the treatment scenarios performs generally better or worse than the others. Each option has specific advantages and disadvantages. The Batteries Directive 2006/66/EC sets out a recycling rate of 50% for consumer waste batteries. Based on metal recycling alone, the mass balances show that the target is difficult to obtain.

TOPEX satellite concept. TOPEX option study report

NASA Technical Reports Server (NTRS)

Meyer, D. P.; Case, C. M.

1982-01-01

Candidate bus equipment from the Viking, Applications Explorer Mission, and Small Scientific Satellite programs for application to the TOPEX mission options is assessed. Propulsion module equipment and subsystem candidates from the Applications Explorer Mission satellites and the Small Scientific Satellite spacecraft are evaluated for those TOPEX options. Several subsystem concepts appropriate to the TOPEX options are described. These descriptions consider performance characteristics of the subsystems. Cost and availability information on the candidate equipment and subsystems are also provided.

Working-Memory Load and Temporal Myopia in Dynamic Decision Making

ERIC Educational Resources Information Center

Worthy, Darrell A.; Otto, A. Ross; Maddox, W. Todd

2012-01-01

We examined the role of working memory (WM) in dynamic decision making by having participants perform decision-making tasks under single-task or dual-task conditions. In 2 experiments participants performed dynamic decision-making tasks in which they chose 1 of 2 options on each trial. The decreasing option always gave a larger immediate reward…

76 FR 6648 - Self-Regulatory Organizations; The Options Clearing Corporation; Notice of Filing of Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

... accommodate the clearance of options on certain indexes measuring the relative performance of one reference... performance of one reference security or reference index relative to a second reference security or reference..., an Alpha Index may measure the relative total return of two non-ETF securities, two ETFs, or one ETF...

Urban Options Solar Greenhouse Demonstration Project. Final report

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

Cipparone, L.

1980-10-15

The following are included: the design process, construction, thermal performance, horticulture, educational activities, and future plans. Included in appendices are: greenhouse blueprints, insulating curtain details, workshop schedules, sample data forms, summary of performance calculations on the Urban Options Solar Greenhouse, data on vegetable production, publications, news articles on th Solar Greenhouse Project, and the financial statement. (MHR)

Impact of a decision aid on surrogate decision-makers' perceptions of feeding options for patients with dementia.

PubMed

Snyder, E Amanda; Caprio, Anthony J; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C

2013-02-01

In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates' perceptions of feeding options, and to determine whether a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Semistructured interview with prestudy and poststudy design for surrogates in the intervention group. Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Two hundred and fifty-five surrogate decision makers for nursing home residents with advanced dementia and feeding problems, in control (n = 129) and intervention (n = 126) groups. For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options, and the role of surrogates in making these decisions. The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true/false items and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the decisional conflict scale. Before the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical, and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs 16.8; P < .001), decreased expectation of benefits from tube feeding (2.73 vs 2.32; P = .001), and reduced decisional conflict (2.24 vs 1.91; P < .001). Surrogates preferred assisted oral feeding initially and reported more certainty about this choice after the decision aid. A structured decision aid can be used to improve decision making about feeding options in dementia care. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Impact of a Decision Aid on Surrogate Decision-makers’ Perceptions of Feeding Options for Patients with Dementia

PubMed Central

Snyder, E. Amanda; Caprio, Anthony J.; Wessell, Kathryn; Lin, Feng Chang; Hanson, Laura C.

2012-01-01

Objective In advanced dementia, feeding problems are nearly universal, and families face difficult decisions about feeding options. Initial interviews for a randomized trial were used to describe surrogates’ perceptions feeding options, and to determine if a decision aid on feeding options in advanced dementia would improve knowledge, reduce expectation of benefit from tube feeding, and reduce conflict over treatment choices for persons with advanced dementia. Design Semi-structured interview with pre-post study design for surrogates in the intervention group. Setting Twenty-four skilled nursing facilities across North Carolina participating in a cluster randomized trial. Participants Two hundred fifty-five surrogate decision-makers for nursing home residents with advanced dementia and feeding problems, in control (n=129) and intervention (n=126) groups. Intervention For intervention surrogates only, an audiovisual-print decision aid provided information on dementia, feeding problems in dementia, advantages and disadvantages of feeding tubes or assisted oral feeding options and the role of surrogates in making these decisions. Measurements The interview included open-ended items asking surrogates to report advantages and disadvantages of tube feeding and assisted oral feeding. Knowledge of feeding options was measured with 19 true-false items, and items measuring expectation of benefit from tube feeding. Surrogates reported which of these two feeding options they preferred for the person with dementia, and how confident they were in this choice; their level of conflict about the choice was measured using the Decisional Conflict Scale. Results Prior to the decision aid, surrogates described advantages and disadvantages of assisted oral feeding and tube feeding in practical, ethical and medical terms. After review of the decision aid, intervention surrogates had improved knowledge scores (15.5 vs. 16.8; p<0.001), decreased expectation of benefits from tube feeding (2.73 vs. 2.32; p = 0.001) and reduced decisional conflict (2.24 vs. 1.91, p<0.001). Surrogates preferred assisted oral feeding initially, and reported more certainty about this choice after the decision aid. Conclusion A structured decision aid can be used to improve decision-making about feeding options in dementia care. PMID:23273855

Improvements in resist performance towards EUV HVM

NASA Astrophysics Data System (ADS)

Yildirim, Oktay; Buitrago, Elizabeth; Hoefnagels, Rik; Meeuwissen, Marieke; Wuister, Sander; Rispens, Gijsbert; van Oosten, Anton; Derks, Paul; Finders, Jo; Vockenhuber, Michaela; Ekinci, Yasin

2017-03-01

Extreme ultraviolet (EUV) lithography with 13.5 nm wavelength is the main option for sub-10nm patterning in the semiconductor industry. We report improvements in resist performance towards EUV high volume manufacturing. A local CD uniformity (LCDU) model is introduced and validated with experimental contact hole (CH) data. Resist performance is analyzed in terms of ultimate printing resolution (R), line width roughness (LWR), sensitivity (S), exposure latitude (EL) and depth of focus (DOF). Resist performance of dense lines at 13 nm half-pitch and beyond is shown by chemical amplified resist (CAR) and non-CAR (Inpria YA Series) on NXE scanner. Resolution down to 10nm half pitch (hp) is shown by Inpria YA Series resist exposed on interference lithography at the Paul Sherrer Institute. Contact holes contrast and consequent LCDU improvement is achieved on a NXE:3400 scanner by decreasing the pupil fill ratio. State-of-the-art imaging meets 5nm node requirements for CHs. A dynamic gas lock (DGL) membrane is introduced between projection optics box (POB) and wafer stage. The DGL membrane will suppress the negative impact of resist outgassing on the projection optics by 100%, enabling a wider range of resist materials to be used. The validated LCDU model indicates that the imaging requirements of the 3nm node can be met with single exposure using a high-NA EUV scanner. The current status, trends, and potential roadblocks for EUV resists are discussed. Our results mark the progress and the improvement points in EUV resist materials to support EUV ecosystem.

The Impact of Microphysics on Intensity and Structure of Hurricanes

NASA Technical Reports Server (NTRS)

Tao, Wei-Kuo; Shi, Jainn; Lang, Steve; Peters-Lidard, Christa

2006-01-01

During the past decade, both research and operational numerical weather prediction models, e.g. Weather Research and Forecast (WRF) model, have started using more complex microphysical schemes originally developed for high-resolution cloud resolving models (CRMs) with a 1-2 km or less horizontal resolutions. WFW is a next-generation mesoscale forecast model and assimilation system that has incorporated modern software framework, advanced dynamics, numeric and data assimilation techniques, a multiple moveable nesting capability, and improved physical packages. WFW model can be used for a wide range of applications, from idealized research to operational forecasting, with an emphasis on horizontal grid sizes in the range of 1-10 km. The current WRF includes several different microphysics options such as Lin et al. (1983), WSM 6-class and Thompson microphysics schemes. We have recently implemented three sophisticated cloud microphysics schemes into WRF. The cloud microphysics schemes have been extensively tested and applied for different mesoscale systems in different geographical locations. The performances of these schemes have been compared to those from other WRF microphysics options. We are performing sensitivity tests in using WW to examine the impact of six different cloud microphysical schemes on hurricane track, intensity and rainfall forecast. We are also performing the inline tracer calculation to comprehend the physical processes @e., boundary layer and each quadrant in the boundary layer) related to the development and structure of hurricanes.

Los Alamos radiation transport code system on desktop computing platforms

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

Briesmeister, J.F.; Brinkley, F.W.; Clark, B.A.

The Los Alamos Radiation Transport Code System (LARTCS) consists of state-of-the-art Monte Carlo and discrete ordinates transport codes and data libraries. These codes were originally developed many years ago and have undergone continual improvement. With a large initial effort and continued vigilance, the codes are easily portable from one type of hardware to another. The performance of scientific work-stations (SWS) has evolved to the point that such platforms can be used routinely to perform sophisticated radiation transport calculations. As the personal computer (PC) performance approaches that of the SWS, the hardware options for desk-top radiation transport calculations expands considerably. Themore » current status of the radiation transport codes within the LARTCS is described: MCNP, SABRINA, LAHET, ONEDANT, TWODANT, TWOHEX, and ONELD. Specifically, the authors discuss hardware systems on which the codes run and present code performance comparisons for various machines.« less

Nuclear Engine System Simulation (NESS). Version 2.0: Program user's guide

NASA Technical Reports Server (NTRS)

Pelaccio, Dennis G.; Scheil, Christine M.; Petrosky, Lyman

1993-01-01

This Program User's Guide discusses the Nuclear Thermal Propulsion (NTP) engine system design features and capabilities modeled in the Nuclear Engine System Simulation (NESS): Version 2.0 program (referred to as NESS throughout the remainder of this document), as well as its operation. NESS was upgraded to include many new modeling capabilities not available in the original version delivered to NASA LeRC in Dec. 1991, NESS's new features include the following: (1) an improved input format; (2) an advanced solid-core NERVA-type reactor system model (ENABLER 2); (3) a bleed-cycle engine system option; (4) an axial-turbopump design option; (5) an automated pump-out turbopump assembly sizing option; (6) an off-design gas generator engine cycle design option; (7) updated hydrogen properties; (8) an improved output format; and (9) personal computer operation capability. Sample design cases are presented in the user's guide that demonstrate many of the new features associated with this upgraded version of NESS, as well as design modeling features associated with the original version of NESS.

Internal limiting membrane flap transposition for surgical repair of macular holes in primary surgery and in persistent macular holes.

PubMed

Leisser, Christoph; Hirnschall, Nino; Döller, Birgit; Varsits, Ralph; Ullrich, Marlies; Kefer, Katharina; Findl, Oliver

2018-03-01

Classical or temporal internal limiting membrane (ILM) flap transposition with air or gas tamponade are current trends with the potential to improve surgical results, especially in cases with large macular holes. A prospective case series included patients with idiopathic macular holes or persistent macular holes after 23-G pars plana vitrectomy (PPV) and ILM peeling with gas tamponade. In all patients, 23-G PPV and ILM peeling with ILM flap transposition with gas tamponade and postoperative face-down position was performed. In 7 of 9 eyes, temporal ILM flap transposition combined with pedicle ILM flap could be successfully performed and macular holes were closed in all eyes after surgery. The remaining 2 eyes were converted to pedicle ILM flap transposition with macular hole closure after surgery. Three eyes were scheduled as pedicle ILM flap transposition due to previous ILM peeling. In 2 of these eyes, the macular hole could be closed with pedicle ILM flap transposition. In 3 eyes, free ILM flap transposition was performed and in 2 of these eyes macular hole could be closed after surgery, whereas in 1 eye a second surgery, performed as pedicle ILM flap transposition, was performed and led to successful macular hole closure. Use of ILM flaps in surgical repair of macular hole surgery is a new option of treatment with excellent results independent of the diameter of macular holes. For patients with persistent macular holes, pedicle ILM flap transposition or free ILM flap transposition are surgical options.

Does a foot-drop implant improve kinetic and kinematic parameters in the foot and ankle?

PubMed

Daniilidis, Kiriakos; Jakubowitz, Eike; Thomann, Anna; Ettinger, Sarah; Stukenborg-Colsman, Christina; Yao, Daiwei

2017-04-01

Unlike the drop foot therapy with ortheses, the therapeutic effect of an implantable peroneus nerve stimulator (iPNS) is not well described. IPNS is a dynamic therapy option which is placed directly to the motoric part of the peroneal nerve and evokes a dorsiflexion of the paralysed foot. This retrospective study evaluates the kinematics and kinetics in drop foot patients who were treated with an iPNS. 18 subjects (mean age 51.3 years) with a chronic stroke-related drop foot were treated with an implantable peroneal nerve stimulator. After a mean follow-up from 12.5 months, kinematics and kinetics as well as spatiotemporal parameters were evaluated and compared in activated and deactivated iPNS. Therefore, a gait analysis with motion capture system (Vicon Motion System Ltd®, Oxford, UK) and Plug-in-Gait model was performed. The study showed significantly improved results in ankle dorsiflexion from 6.8° to 1.8° at the initial contact and from -7.3° to 0.9° during swing phase (p ≤ 0.004 and p ≤ 0.005, respectively). Likewise, we could measure improved kinetics, i.a. with a statistically significant improvement in vertical ground reaction force at loading response from 99.76 to 106.71 N/kg (p = 0.043). Enhanced spatiotemporal results in cadence, douple support, stride length, and walking speed could also be achieved, but without statistical significance (p > 0.05). The results show statistically significant improvement in ankle dorsiflexion and vertical ground reaction forces. These facts indicate a more gait stability and gait efficacy. Therefore, the use of an iPNS appears an encouraging therapeutic option for patients with a stroke-related drop foot.

Consolidation paclitaxel is more cost-effective than bevacizumab following upfront treatment of advanced epithelial ovarian cancer.

PubMed

Lesnock, Jamie L; Farris, Coreen; Krivak, Thomas C; Smith, Kenneth J; Markman, Maurie

2011-09-01

Randomized trials have demonstrated significant improvements in progression-free survival (PFS) with consolidation paclitaxel (P) and bevacizumab (B) following cytoreduction and adjuvant carboplatin/paclitaxel (CP) for advanced epithelial ovarian cancer (EOC). We sought to evaluate the cost-effectiveness (C/E) of these consolidation strategies. A decision model was developed based on Gynecologic Oncology Group (GOG) protocols #178 and #218. Arm 1 is 6 cycles of CP. Arm 2 is 6 cycles of CP followed by 12 cycles of P (CP+P). Arm 3 is 1 cycle of CP, 5 cycles of CPB, and 16 cycles of B (CPB+B). Parameters include PFS, overall survival (OS), cost, complications (neuropathy for P and bowel perforation for B), and quality-of-life utility values. Sensitivity analyses were performed. The incremental cost-effectiveness ratio (ICER) for CT+T is $13,402/quality adjusted life year (QALY) gained compared to CP. For CPB+B compared to CP, the ICER is $326,530/QALY. When compared simultaneously, CPB+B is dominated, i.e. is more costly and less effective than CP+P. Results were robust to parameter variation. At a willingness to pay threshold of $100,000/QALY, CP+P was the preferred option throughout most of the decision space. Sensitivity analyses suggest that CPB+B would become the preferred option if it were to improve OS by 6.1 years over CP+P. In this model, B consolidation for advanced EOC was associated with a modest improvement in effectiveness that is less than that with P consolidation and more costly. A statistically significant improvement in survival may improve the value of B consolidation. Copyright © 2011 Elsevier Inc. All rights reserved.

Cost-utility analysis of competing treatment strategies for drug-resistant epilepsy in children with Tuberous Sclerosis Complex.

PubMed

Fallah, Aria; Weil, Alexander G; Wang, Shelly; Lewis, Evan; Baca, Christine B; Mathern, Gary W

2016-10-01

The management of drug-resistant epilepsy in children with Tuberous Sclerosis Complex (TSC) is challenging because of the multitude of treatment options, wide range of associated costs, and uncertainty of seizure outcomes. The most cost-effective approach for children whose epilepsy has failed to improve with first-line medical therapy is uncertain. A review of MEDLINE from 1990 to 2015 was conducted. A cost-utility analysis, from a third-party payer perspective, was performed for children with drug-resistant epilepsy that had failed to improve with 2 antiseizure drugs (ASDs) and that was amenable to resective epilepsy surgery, across a time-horizon of 5years. Four strategies were included: (1) resective epilepsy surgery, (2) vagus nerve stimulator (VNS) implantation, (3) ketogenic diet, and (4) addition of a third ASD (specifically, carbamazepine). The incremental cost per quality-adjusted life year (QALY) gained was analyzed. Given a willingness-to-pay (WTP) of $100,000 per QALY, the addition of a third ASD ($6600 for a gain of 4.14 QALYs) was the most cost-effective treatment strategy. In a secondary analysis, if the child whose epilepsy had failed to improve with 3 ASDs, ketogenic diet, addition of a fourth ASD, and resective epilepsy surgery were incrementally cost-effective treatment strategies. Vagus nerve stimulator implantation was more expensive yet less effective than alternative strategies and should not be prioritized. The addition of a third ASD is a universally cost-effective treatment option in the management of children with drug-resistant epilepsy that has failed to improve with 2 ASDs. For children whose epilepsy has failed to improve with 3 ASDs, the most cost-effective treatment depends on the health-care resources available reflected by the WTP. Copyright © 2016 Elsevier Inc. All rights reserved.

EVALUATION AND RECOMMENDATION OF SALTSTONE MIXER AUGER/PADDLES MATERIALS OF CONSTRUCTION FOR IMPROVED WEAR RESISTANCE

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

Mickalonis, J.; Torres, R.

2012-08-15

Wear and corrosion testing were conducted to evaluate alternate materials of construction for the Saltstone mixer auger and paddles. These components have been degraded by wear from the slurry processed in the mixer. Material test options included PVD coatings (TiN, TiCN, and ZrN), weld overlays (Stellite 12 and Ultimet) and higher hardness steels and carbides (D2 and tungsten carbide). The corrosion testing demonstrated that the slurry is not detrimental to the current materials of construction or the new candidates. The ASTM G75 Miller wear test showed that the high hardness materials and the Stellite 12 weld overlay provide superior wearmore » relative to the Astralloy and CF8M stainless steel, which are the current materials of construction, as well as the PVD coatings and Ultimet. The following recommendations are made for selecting new material options and improving the overall wear resistance of the Saltstone mixer components: A Stellite 12 weld overlay or higher hardness steel (with toughness equivalent to Astralloy) be used to improve the wear resistance of the Saltstone mixer paddles; other manufacturing specifications for the mixer need to be considered in this selection. The current use of the Stellite 12 weld overlay be evaluated so that coverage of the 316 auger can be optimized for improved wear resistance of the auger. The wear surfaces of the Saltstone mixer auger and paddles be evaluated so that laboratory data can be better correlated to actual service. The 2-inch Saltstone mixer prototype be used to verify material performance.« less

[Extracorporeal shockwave therapy (ESWT) as therapeutic option in supraspinatus tendon syndrome? One year results of a placebo controlled study].

PubMed

Schmitt, J; Tosch, A; Hünerkopf, M; Haake, M

2002-07-01

Extracorporeal shock wave therapy (ESWT) is seen as a therapeutic option in the treatment of chronic supraspinatus tendinitis by some authors. To test whether ESWT comprising 3 x 2000 pulses with the positive energy flux density ED+ of 0.33 mJ/mm2 is clinically superior to a sham ESWT treatment, a prospective, randomized, single-blinded, placebo-controlled study with an independent observer was performed. Forty patients were treated either by verum ESWT or sham ESWT under local anesthesia. Target criteria were the age-corrected Constant score, pain at rest and during activity on a visual analogue scale, and subjective improvement. Patients who reported no subjective improvement after 12 weeks were deblinded and received verum ESWT if they had belonged to the placebo group (partial crossover). The results of the verum group lie within the range of results for ESWT published by other authors. Patients in the placebo group with local anesthetic showed equally good results. At 12 weeks, and 1 year after intervention, no difference could be found between the verum and placebo groups regarding Constant score, pain, shoulder function, or subjective improvement. The nonresponders to the placebo ESWT continued to show no improvement after receiving verum ESWT. This contradicts a specific ESWT effect. Based on the results of this placebo-controlled study, ESWT appears to have no clinically relevant effect on supraspinatus tendinitis. The study underlines the importance of a control group in evaluating new treatment methods for diseases with unknown natural history.

Option B+ for prevention of vertical HIV transmission has no influence on adverse birth outcomes in a cross-sectional cohort in Western Uganda.

PubMed

Rempis, Eva M; Schnack, Alexandra; Decker, Sarah; Braun, Vera; Rubaihayo, John; Tumwesigye, Nazarius Mbona; Busingye, Priscilla; Harms, Gundel; Theuring, Stefanie

2017-03-07

While most Sub-Saharan African countries are now implementing the WHO-recommended Option B+ protocol for prevention of vertical HIV transmission, there is a lack of knowledge regarding the influence of Option B+ exposure on adverse birth outcomes (ABOs). Against this background, we assessed ABOs among delivering women in Western Uganda. A cross-sectional, observational study was performed within a cohort of 412 mother-newborn-pairs in Virika Hospital, Fort Portal in 2013. The occurrence of stillbirth, pre-term delivery, and small size for gestational age (SGA) was analysed, looking for influencing factors related to HIV-status, antiretroviral drug exposure and duration, and other sociodemographic and clinical parameters. Among 302 HIV-negative and 110 HIV-positive women, ABOs occurred in 40.5%, with stillbirth in 6.3%, pre-term delivery in 28.6%, and SGA in 12.2% of deliveries. For Option B+ intake (n = 59), no significant association was found with stillbirth (OR 0.48, p = 0.55), pre-term delivery (OR 0.97, p = 0.92) and SGA (OR 1.5, p = 0.3) compared to seronegative women. Women enrolled on antiretroviral therapy (ART) before conception (n = 38) had no different risk for ABOs than women on Option B+ or HIV-negative women. Identified risk factors for stillbirth included lack of formal education, poor socio-economic status, long travel distance, hypertension and anaemia. Pre-term delivery risk was increased with poor socio-economic status, primiparity, Malaria and anaemia. The occurrence of SGA was influenced by older age and Malaria. In our study, women on Option B+ showed no difference in ABOs compared to HIV-negative women and to women on ART. We identified several non-HIV/ART-related influencing factors, suggesting an urgent need for improving early risk assessment mechanisms in antenatal care through better screening and triage systems. Our results are encouraging with regard to continued universal scale-up of Option B+ and ART programmes.

75 FR 80084 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-21

... futures or options or derivatives on the foregoing in this subparagraph (b); or (c) CBOE Volatility Index...) interest rate futures or options or derivatives on the foregoing; or (c) CBOE VIX futures. NYSE Arca... (multiple or inverse) performance of an index or indexes of futures contracts or options or derivatives on...

77 FR 33010 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-04

... or options on futures, or any other related derivatives, which the ETP Holder acting as registered... or commodity, related futures or options on futures, or any other related derivatives, in an account... option or a security futures product, whose value is based, in whole or in part, upon the performance of...

76 FR 17727 - Self-Regulatory Organizations; The Options Clearing Corporation; Order Approving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-30

... options on certain indexes measuring the relative performance of one reference security or reference index... one underlying stock and one underlying ETF, which are also traded on the Phlx.\\5\\ An Alpha Index is...-settled, European-style options. In the event of a corporate event that eliminates one of the underlying...

Using organizational and clinical performance data to increase the value of mental health care.

PubMed

Schmidt, Eric M; Krahn, Dean D; McGuire, Marsden H; Tavakoli, Sara; Wright, David M; Solares, Hugo E; Lemke, Sonne; Trafton, Jodie

2017-02-01

U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost. This study describes the initial design and analysis of the Mental Health Management System (MHMS), a performance data and quality improvement tool used by the Veterans Health Administration (VHA) to increase the value of its mental health care. The MHMS evaluates access to and quality of mental health care, organizational structure and efficiency, implementation of innovative treatment options, and, in collaboration with management, resource needs for delivering care. Performance on 31 measures was calculated for all U.S. VHA facilities (N = 139). Pearson correlations revealed that better access to care was significantly associated with fewer mental health provider staffing vacancies (r = -.24) and higher staff-to-patient ratios for psychiatrists (r = .19) and other outpatient mental health providers (r = .27). Higher staff-to-patient ratios were significantly associated with higher performance on a number of patient and provider satisfaction measures (range of r = .18-.51) and continuity of care measures (range of r = .26-.43). Relationships observed between organizational and clinical performance measures suggest that the MHMS is a robust informatics and quality improvement tool that can serve as a model for health systems planning to adopt a value perspective. Future research should expand the MHMS framework to measure patient and health systems costs and psychosocial outcomes, as well as evaluate whether quality improvement solutions implemented as a result of using organizational information leads to higher-value mental health care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Impact of a poka-yoke device on job performance of individuals with cognitive impairments.

PubMed

Erlandson, R F; Noblett, M J; Phelps, J A

1998-09-01

Job performance and production related issues are important not only to successful vocational training and ultimate job placement for individuals with cognitive disabilities, but also for their ability to have expanded vocational options. This study hypothesized that the application of Kaizen philosophy, and poka-yoke techniques in particular, could create job opportunities and improve productivity of individuals with cognitive disabilities. Poka-yoke or error-proofing techniques are part of the collection of Kaizen techniques. Kaizen refers to continuous improvement in performance, cost/effectiveness, and quality. Kaizen strives to empower the worker, increase worker satisfaction, facilitate a sense of accomplishment, and thereby create pride-of-work. These techniques typically reduce the physical and cognitive demands of a task and thereby render the task more accessible. The job was a fuel clamp assembly. A redesigned assembly fixture was the poka-yoke intervention. Consistent with poka-yoke principles, the intervention improved the productivity of everyone attempting the assembly. In particular, the workers in this study showed an 80% increase in productivity and an average percent error drop from 52% to about 1% after the process redesign. Furthermore, the workers showed improved morale, self-esteem, and pride-of-work. Prior to the process redesign, only the higher functioning workers could successfully perform the assembly. After the redesign a greater number of workers could successfully perform the assembly. These results not only validated the study hypothesis, but demonstrated that the success facilitated by applying Kaizen techniques had similar results with individuals with cognitive disabilities as with nondisabled workers.

Oscillatory Reduction in Option Pricing Formula Using Shifted Poisson and Linear Approximation

NASA Astrophysics Data System (ADS)

Nur Rachmawati, Ro'fah; Irene; Budiharto, Widodo

2014-03-01

Option is one of derivative instruments that can help investors improve their expected return and minimize the risks. However, the Black-Scholes formula is generally used in determining the price of the option does not involve skewness factor and it is difficult to apply in computing process because it produces oscillation for the skewness values close to zero. In this paper, we construct option pricing formula that involve skewness by modified Black-Scholes formula using Shifted Poisson model and transformed it into the form of a Linear Approximation in the complete market to reduce the oscillation. The results are Linear Approximation formula can predict the price of an option with very accurate and successfully reduce the oscillations in the calculation processes.

IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

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

William M. Bond; Salih Ersayin

2007-03-30

This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency ofmore » individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern Minnesota, and future proposals are pending with non-taconite mineral processing applications.« less

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

A Case Study on Hydrodynamic Modeling and Design Improvement Evaluation to Manage Debris and Sediment Interference at a Water Intake Structure

NASA Astrophysics Data System (ADS)

Crissman, B. J.; Cunderlik, J. M.; Wong, R. P. L.; Pinero, A.

2017-12-01

Waterford 3 nuclear plant, located in Killona, Louisiana, provides approximately 10% of the state's electricity need. Located along the south bank of the Mississippi River, two miles upstream of the Bonnet Carre Spillway, the plant's single pass through cooling system continuously draws up to 1,000,000 gpm water from the river. On behalf of Entergy Louisiana, the project team evaluated options to improve the aging water intake structure with chronic debris and sediment entrainment issues. The highly complex and dynamic environment in the river coupled with regulatory constraints limited available improvement options: varying river stages allow debris to overflow the intake structure, but the maximum new wall height is restricted to minimize aesthetic intrusion and alteration to levee tie-back; bow waves push debris into the downstream intake wall, but the wall needs to maintain an opening to flush debris out from the intake structure; the river delivers significant sediment load, but any proposed intake structure cannot significantly alter existing bathymetry; EPA Clean Water Act Section 316(b) limited maximum velocity at the intake structure to 0.5 fps for entrainment prevention. To expedite alternative evaluation while providing sufficient data to inform management decision, instead of developing physical models, the project team developed a two-tier approach utilizing the TELEMAC hydrodynamic program to prepare screening analysis in 2D modeling and final evaluation in 3D modeling. The model was built upon the USACE ERDC ADH model, calibrated with river gauge data and peer reviewed by ERDC. TELEMAC, developed by EDF, provides novel features for modeling improvement options, including the recommended design concept, which is a hydraulically optimized intake geometry configured to maintain uniform intake flow while streamlining river flowline for debris and sediment deflection. The design includes submerged inlets with upstream and downstream walls to block floating debris and bed load movement, large intake screens to reduce velocity, and a log-boom debris deflection system that floats with the river level. This project demonstrated a time and cost efficient approach to develop reliable solutions and hydrodynamic data describing design alternatives performance.

Improving Exam Performance in Introductory Biology through the Use of Preclass Reading Guides

PubMed Central

Lieu, Rebekah; Wong, Ashley; Asefirad, Anahita; Shaffer, Justin F.

2017-01-01

High-structure courses or flipped courses require students to obtain course content before class so that class time can be used for active-learning exercises. While textbooks are used ubiquitously in college biology courses for content dissemination, studies have shown that students frequently do not read their textbooks. To address this issue, we created preclass reading guides that provided students with a way to actively engage with the required reading for each day of class. To determine whether reading guide completion before class is associated with increased performance, we surveyed students about their use of reading guides in two sections of a large-enrollment (400+ students) introductory biology course and used multiple linear regression models to identify significant correlations. The results indicated that greater than 80% of students completed the reading guides before class and that full completion of the reading guides before class was significantly positively correlated with exam performance. Reading guides in most cases were used similarly between different student groups (based on gender, ethnicity, and aptitude). These results suggest that optional preclass reading guides may help students stay on track to acquire course content in introductory biology and thus result in improved exam performance. PMID:28747356

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.

Program Implementation of Option B+ at a President's Emergency Plan for AIDS Relief-Supported HIV Clinic Improves Clinical Indicators But Not Retention in Care in Mbarara, Uganda.

PubMed

Miller, Kathleen; Muyindike, Winnie; Matthews, Lynn T; Kanyesigye, Michael; Siedner, Mark J

2017-08-01

2013 WHO guidelines for prevention of mother to child transmission recommend combination antiretroviral therapy (ART) for all pregnant women, regardless of CD4 count (Option B/B+). We conducted a retrospective analysis of data from a government-operated HIV clinic in Mbarara, Uganda before and after implementation of Option B+ to assess the impact on retention in care. We limited our analysis to women not on ART at the time of their first reported pregnancy with CD4 count >350. We fit regression models to estimate relationships between calendar period (Option A vs. Option B+) and the primary outcome of interest, retention in care. One thousand and sixty-two women were included in the analysis. Women were more likely to start ART within 6 months of pregnancy in the Option B+ period (68% vs. 7%, p < 0.0001) and had significantly greater increases in CD4 count 1 year after pregnancy (+172 vs. -5 cells, p < 0.001). However, there was no difference in the proportion of women retained in care 1 year after pregnancy (73% vs. 70%, p = 0.34). In models adjusted for age, distance to clinic, marital status, and CD4 count, Option B+ was associated with a nonsignificant 30% increased odds of retention in care at 1 year [adjusted odds ratio (AOR) = 1.30, 95% CI 0.98-1.73, p = 0.06]. After transition to an Option B+ program, pregnant women with CD4 count >350 were more likely to initiate combination therapy; however, interventions to mitigate losses from HIV care during pregnancy are needed to improve the health of women, children, and families.

Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies

PubMed Central

2014-01-01

Background This study aimed to reveal nurses’ experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Method A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Results Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Conclusion Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover. PMID:24708565

Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies.

PubMed

Dawson, Angela J; Stasa, Helen; Roche, Michael A; Homer, Caroline S E; Duffield, Christine

2014-04-08

This study aimed to reveal nurses' experiences and perceptions of turnover in Australian hospitals and identify strategies to improve retention, performance and job satisfaction. Nursing turnover is a serious issue that can compromise patient safety, increase health care costs and impact on staff morale. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. A qualitative design was used to analyze responses from 362 nurses collected from a national survey of nurses from medical and surgical nursing units across 3 Australian States/Territories. Key factors affecting nursing turnover were limited career opportunities; poor support; a lack of recognition; and negative staff attitudes. The nursing working environment is characterised by inappropriate skill-mix and inadequate patient-staff ratios; a lack of overseas qualified nurses with appropriate skills; low involvement in decision-making processes; and increased patient demands. These issues impacted upon heavy workloads and stress levels with nurses feeling undervalued and disempowered. Nurses described supportive strategies: improving performance appraisals, responsive preceptorship and flexible employment options. Nursing turnover is influenced by the experiences of nurses. Positive steps can be made towards improving workplace conditions and ensuring nurse retention. Improving performance management and work design are strategies that nurse managers could harness to reduce turnover.

Life cycle assessment of three different management options for spent alkaline batteries.

PubMed

Xará, Susana; Almeida, Manuel Fonseca; Costa, Carlos

2015-09-01

The potential environmental impact of Landfilling, Incineration and Recycling of spent household alkaline batteries collected in continental Portugal was compared using LCA methodology and the Recipe Impact Assessment method. Major contributors and improvement opportunities for each system were identified and scenarios for 2012 and 2016 legislation targets were evaluated. For 13 out of the 18 impact categories, the Recycling system is the worst alternative, Incineration is the worst option for 4 and Landfill is the worst option only for one impact category. However if additionally in each system the recovery of materials and energy is taken into account there is a noticeable advantage of the Recycling system for all the impact categories. The environmental profiles for 2012 and 2016 scenarios (25% and 45% recycling rates, respectively) show the dominance of the Recycling system for most of the impact categories. Based on the results of this study, it is questioned whether there are environmental benefits of recycling abroad the household alkaline batteries collected in continental Portugal and, since the low environmental performance of the Recycling system is particularly due to the international transport of the batteries to the recycling plant, is foreseen that a recycling facility located in Portugal, could bring a positive contribution to the environmental impact of the legislation compliance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Conceptual design and analysis of a dynamic scale model of the Space Station Freedom

NASA Technical Reports Server (NTRS)

Davis, D. A.; Gronet, M. J.; Tan, M. K.; Thorne, J.

1994-01-01

This report documents the conceptual design study performed to evaluate design options for a subscale dynamic test model which could be used to investigate the expected on-orbit structural dynamic characteristics of the Space Station Freedom early build configurations. The baseline option was a 'near-replica' model of the SSF SC-7 pre-integrated truss configuration. The approach used to develop conceptual design options involved three sets of studies: evaluation of the full-scale design and analysis databases, conducting scale factor trade studies, and performing design sensitivity studies. The scale factor trade study was conducted to develop a fundamental understanding of the key scaling parameters that drive design, performance and cost of a SSF dynamic scale model. Four scale model options were estimated: 1/4, 1/5, 1/7, and 1/10 scale. Prototype hardware was fabricated to assess producibility issues. Based on the results of the study, a 1/4-scale size is recommended based on the increased model fidelity associated with a larger scale factor. A design sensitivity study was performed to identify critical hardware component properties that drive dynamic performance. A total of 118 component properties were identified which require high-fidelity replication. Lower fidelity dynamic similarity scaling can be used for non-critical components.

Improving Rural Teachers' Attitudes towards Acceleration

ERIC Educational Resources Information Center

Olthouse, Jill M.

2015-01-01

Gifted students see both educational benefits and barriers as a result of living in rural communities. Benefits include increased individual attention and community engagement; barriers include limited curricular options (Lawrence, 2009). Acceleration is an option that has positive academic outcomes but is underused, especially in rural areas.…

School Choice Today.

ERIC Educational Resources Information Center

DeSchryver, Dave

With the increasing demand for better schools, states and communities are providing more options to families. By doing so, they are not only improving educational opportunity for those children, but also having a dramatic impact on how schools operate in their communities. The most important options are full school-choice programs, charter…

The future of rail in Washington state : options for passenger rail in the Pacific Northwest Rail Corridor

DOT National Transportation Integrated Search

1995-01-01

This document, as its title states, is an Options Report for the entire corridor. Until now, portions of : the corridor have been analyzed separately, and improvement strategies developed for distinct : segments. This report presents an overview of t...

Capability and Technology Performance Goals for the Next Step in Affordable Human Exploration of Space

NASA Technical Reports Server (NTRS)

Linne, Diane L.; Sanders, Gerald B.; Taminger, Karen M.

2015-01-01

The capability for living off the land, commonly called in-situ resource utilization, is finally gaining traction in space exploration architectures. Production of oxygen from the Martian atmosphere is called an enabling technology for human return from Mars, and a flight demonstration to be flown on the Mars 2020 robotic lander is in development. However, many of the individual components still require technical improvements, and system-level trades will be required to identify the best combination of technology options. Based largely on work performed for two recent roadmap activities, this paper defines the capability and technology requirements that will need to be achieved before this game-changing capability can reach its full potential.

Large guanidinium cation mixed with methylammonium in lead iodide perovskites for 19% efficient solar cells

NASA Astrophysics Data System (ADS)

Jodlowski, Alexander D.; Roldán-Carmona, Cristina; Grancini, Giulia; Salado, Manuel; Ralaiarisoa, Maryline; Ahmad, Shahzada; Koch, Norbert; Camacho, Luis; de Miguel, Gustavo; Nazeeruddin, Mohammad Khaja

2017-12-01

Organic-inorganic lead halide perovskites have shown photovoltaic performances above 20% in a range of solar cell architectures while offering simple and low-cost processability. Despite the multiple ionic compositions that have been reported so far, the presence of organic constituents is an essential element in all of the high-efficiency formulations, with the methylammonium and formamidinium cations being the sole efficient options available to date. In this study, we demonstrate improved material stability after the incorporation of a large organic cation, guanidinium, into the MAPbI3 crystal structure, which delivers average power conversion efficiencies over 19%, and stabilized performance for 1,000 h under continuous light illumination, a fundamental step within the perovskite field.

Apollo 13 creativity: in-the-box innovation.

PubMed

King, M J

1997-01-01

A study of the Apollo 13 mission, based on the themes showcased in the acclaimed 1995 film, reveals the grace under pressure that is the condition of optimal creativity. "Apollo 13 Creativity" is a cultural and creative problem-solving appreciation of the thinking style that made the Apollo mission succeed: creativity under severe limitations. Although creativity is often considered a "luxury good," of concern mainly for personal enrichment, the arts, and performance improvement, in life-or-death situations it is the critical pathway not only to success but to survival. In this case. the original plan for a moon landing had to be transformed within a matter of hours into a return to earth. By precluding failure as an option at the outset, both space and ground crews were forced to adopt a new perspective on their resources and options to solve for a successful landing. This now-classic problem provides a range of principles for creative practice and motivation applicable in any situation. The extreme situation makes these points dramatically.

Updates in the Management of Diabetic Macular Edema

PubMed Central

Mathew, Christopher; Yunirakasiwi, Anastasia; Sanjay, Srinivasan

2015-01-01

Diabetes mellitus is a chronic disease which has multiple effects on different end-organs, including the retina. In this paper, we discuss updates on diabetic macular edema (DME) and the management options. The underlying pathology of DME is the leakage of exudates from retinal microaneurysms, which trigger subsequent inflammatory reactions. Both clinical and imaging techniques are useful in diagnosing, classifying, and gauging the severity of DME. We performed a comprehensive literature search using the keywords “diabetes,” “macula edema,” “epidemiology,” “pathogenesis,” “optical coherence tomography,” “intravitreal injections,” “systemic treatment,” “hypertension,” “hyperlipidemia,” “anemia,” and “renal disease” and collated a total of 47 relevant articles published in English language. The main modalities of treatment currently in use comprise laser photocoagulation, intravitreal pharmacological and selected systemic pharmacological options. In addition, we mention some novel therapies that show promise in treating DME. We also review systemic factors associated with exacerbation or improvement in DME. PMID:25984537

Next step in antibiotic stewardship: Pharmacist-provided penicillin allergy testing.

PubMed

Gugkaeva, Z; Crago, J S; Yasnogorodsky, M

2017-08-01

Penicillin allergy limits therapeutic options for patients but often disappears over time, leaving patients erroneously labelled allergic and leading to the utilization of broad-spectrum and more expensive antibiotics. Penicillin allergy can be effectively assessed via skin testing. To improve patient access to penicillin allergy testing by implementing a pharmacist-provided service in a hospital setting. Beta-lactams remain a mainstream therapy for many infections due to their effectiveness, low side effects and affordability. Typically, patient access to penicillin allergy testing is limited by the availability of allergy specialists, who traditionally perform such testing. A pharmacist-provided penicillin allergy testing service was implemented at our hospital in 2015 and became a powerful antibiotic stewardship tool. Removing penicillin allergy from patient profiles significantly expanded therapeutic options, expedited discharges and reduced costs of care. Pharmacists can expand patient access to penicillin allergy testing. Pharmacist-provided penicillin allergy testing permitted optimized antibiotic treatment and expedited discharges. © 2017 John Wiley & Sons Ltd.

Slicer Method Comparison Using Open-source 3D Printer

NASA Astrophysics Data System (ADS)

Ariffin, M. K. A. Mohd; Sukindar, N. A.; Baharudin, B. T. H. T.; Jaafar, C. N. A.; Ismail, M. I. S.

2018-01-01

Open-source 3D printer has been one of the popular choices in fabricating 3D models. This technology is easily accessible and low in cost. However, several studies have been made to improve the performance of this low-cost technology in term of the accuracy of the parts finish. This study is focusing on the selection of slicer mode between CuraEngine and Slic3r. The effect on this slicer has been observe in terms of accuracy and surface visualization. The result shows that if the accuracy is the top priority, CuraEngine is the better option to use as contribute more accuracy as well as less filament is needed compared to the Slice3r. Slice3r may be very useful for complicated parts such as hanging structure due to excessive material which act as support material. The study provides basic platform for the user to have an idea which option to be used in fabricating 3D model.

Planar Fully-Depleted-Silicon-On-Insulator technologies: Toward the 28 nm node and beyond

NASA Astrophysics Data System (ADS)

Doris, B.; DeSalvo, B.; Cheng, K.; Morin, P.; Vinet, M.

2016-03-01

This paper presents a comprehensive overview of the research done in the last decade on planar Fully-Depleted-Silicon-On-Insulator (FDSOI) technologies in the frame of the joint development program between IBM, ST Microelectronics and CEA-LETI. In particular, we review the technological developments ranging from substrate engineering to process modules that enable functionality and improve FDSOI performance over several generations. Various multi Vt integration schemes to maximize the benefits of the thin BOX FDSOI platform are discussed. Manufacturability as well as scalability concerns are highlighted and addressed. In addition, this work provides understanding of the performance/power trade-offs for FDSOI circuits and device variability. Finally, clear directions for future application-specific products are given, demonstrating that FDSOI is an attractive CMOS option for next generation high performance and low-power applications.

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.

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.

New paradigms for Salmonella source attribution based on microbial subtyping.

PubMed

Mughini-Gras, Lapo; Franz, Eelco; van Pelt, Wilfrid

2018-05-01

Microbial subtyping is the most common approach for Salmonella source attribution. Typically, attributions are computed using frequency-matching models like the Dutch and Danish models based on phenotyping data (serotyping, phage-typing, and antimicrobial resistance profiling). Herewith, we critically review three major paradigms facing Salmonella source attribution today: (i) the use of genotyping data, particularly Multi-Locus Variable Number of Tandem Repeats Analysis (MLVA), which is replacing traditional Salmonella phenotyping beyond serotyping; (ii) the integration of case-control data into source attribution to improve risk factor identification/characterization; (iii) the investigation of non-food sources, as attributions tend to focus on foods of animal origin only. Population genetics models or simplified MLVA schemes may provide feasible options for source attribution, although there is a strong need to explore novel modelling options as we move towards whole-genome sequencing as the standard. Classical case-control studies are enhanced by incorporating source attribution results, as individuals acquiring salmonellosis from different sources have different associated risk factors. Thus, the more such analyses are performed the better Salmonella epidemiology will be understood. Reparametrizing current models allows for inclusion of sources like reptiles, the study of which improves our understanding of Salmonella epidemiology beyond food to tackle the pathogen in a more holistic way. Copyright © 2017 Elsevier Ltd. All rights reserved.

Telecommunications access--matching available technologies to people with physical disabilities.

PubMed

Nguyen, Toan; Garrett, Rob; Downing, Andrew; Walker, Lloyd; Hobbs, David

2006-03-01

People with a disability do not have equitable access to the modern telecommunication medium. Many experience difficulty typing, handling the phone, dialling or answering calls. For those who are unable to speak, the only option is to type messages using whatever functional control site exists on their body. The provision of accessible mobile phones for people with disabilities can significantly improve their quality of life through an increased range of accessible activities, and can improve their independence, safety, security and self-esteem. This research was aimed at providing practical ways for people with a disability to participate in the extensive community of home and mobile phone users. The outcomes of ten participants taking part in the evaluation and trial of off-the-shelf telecommunication options are presented. Nine out of ten participants showed high to very high results in terms of their overall performance and satisfaction with the use of the telecommunication equipment provided. With the right policies, processes and support through equipment matching, education, training and delivery, current off-the-shelf solutions can help people with disabilities to effectively communicate with other members of our society and to access the same range of information systems and services enjoyed by able-bodied members of the community.

76 FR 1203 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

... elect to have CBOE perform certain marketing services and/or billing services on behalf of the... Participating CBOE TPH, if a Participating Non-CBOE TPH elects to have CBOE perform marketing services on its... default destination for an order to be the U.S. options exchange with the best bid or offer, except CBOE...

When Opting Out Is Not a Choice: Implications for NCLB's Transfer Option from Charlotte, North Carolina

ERIC Educational Resources Information Center

Mickelson, Roslyn Arlin; Southworth, Stephanie

2005-01-01

A key provision of No Child Left Behind is the opportunity for students to transfer from a low-performing school to a high-performing one. Drawing from a case study of school reform in Charlotte, North Carolina, this article examines the implementation and early outcomes of NCLB's voluntary transfer option for the Charlotte-Mecklenburg School…

Cancer and treatment effects on job task performance for gynecological cancer survivors.

PubMed

Nachreiner, Nancy M; Shanley, Ryan; Ghebre, Rahel G

2013-01-01

Over 91,000 new cases of gynecological cancers are expected to be diagnosed in 2013 in the US alone. As cancer detection technology and treatment options improve, the number of working-age cancer survivors continues to grow. To describe US gynecological cancer survivors' perceptions of the effects of cancer and treatment on their job tasks. 104 adult gynecological cancer survivors who were working at the time of their cancer diagnosis, treated at a University-based women's health clinic, diagnosed in the previous 24 months, and spoke English. Women completed written surveys to describe their work experiences following diagnosis. Clinical characteristics were obtained through medical record review. Descriptive statistics and cross tabulations were performed to describe characteristics and associations. Fifteen percent of women had chemotherapy and radiation treatment; 48% had only chemotherapy, 9% only radiation therapy, and 28% had neither. Survivors described the frequency of performing seven job tasks, such as 'intense concentration', 'analyzing data', and 'lifting heavy loads.' Women who had undergone radiation treatment were more likely to indicate limitations for physical tasks; women undergoing chemotherapy were more likely to report limitations in more analytic tasks. Only 29% of women noted an employer-based policy facilitated their return-to-work process. Cancer and treatment have important effects on job performance and may vary by type of treatment. Employer-based policies focusing on improved communication and work accommodations may improve the return to work process.

Using economic policy to tackle chronic disease: options for the Australian Government.

PubMed

Kaplin, Lauren; Thow, Anne Marie

2013-03-01

Australia suffers from one of the highest prevalences among developed countries of persons being overweight and obese, these conditions arising from the overconsumption of energy-dense, nutrient-poor foods that are generally less expensive than healthier options. One potential avenue for intervention is to influence the price of foods such that healthier options are less expensive and, therefore, are an easier choice to make. This article considers the potential for fiscal policies that would realign food prices with health incentives. Through a review of consumption taxes, consumer subsidies, trade policies, agricultural support policies, and other incentive programs as possible avenues for intervention, this article asks what the Commonwealth Government has already done to help improve Australian diets, and looks at where further improvements could be made.

Cash and counseling: a promising option for consumer direction of home- and community-based services and supports.

PubMed

Mahoney, Kevin J; Simon-Rusinowitz, Lori; Simone, Kristin; Zgoda, Karen

2006-01-01

The Cash and Counseling Demonstration began as a 3-state social experiment to test the claims of members of the disability community that, if they had more control over their services, their lives would improve and costs would be no higher. The 2004 expansion to 12 states brings us closer to the tipping point when this option will be broadly available. The original demonstration was a controlled experiment with randomized assignment, supplemented by an ethnographic study and a process evaluation. Consumers managing flexible, individualized budgets were much more satisfied, had fewer unmet needs, and had comparable health outcomes. Access to service and supports was greatly improved. Consumer direction is increasingly accepted as a desirable option in home and community services.

Numerical pricing of options using high-order compact finite difference schemes

NASA Astrophysics Data System (ADS)

Tangman, D. Y.; Gopaul, A.; Bhuruth, M.

2008-09-01

We consider high-order compact (HOC) schemes for quasilinear parabolic partial differential equations to discretise the Black-Scholes PDE for the numerical pricing of European and American options. We show that for the heat equation with smooth initial conditions, the HOC schemes attain clear fourth-order convergence but fail if non-smooth payoff conditions are used. To restore the fourth-order convergence, we use a grid stretching that concentrates grid nodes at the strike price for European options. For an American option, an efficient procedure is also described to compute the option price, Greeks and the optimal exercise curve. Comparisons with a fourth-order non-compact scheme are also done. However, fourth-order convergence is not experienced with this strategy. To improve the convergence rate for American options, we discuss the use of a front-fixing transformation with the HOC scheme. We also show that the HOC scheme with grid stretching along the asset price dimension gives accurate numerical solutions for European options under stochastic volatility.

Improving the moisturizing properties of collagen film by surface grafting of chondroitin sulfate for corneal tissue engineering.

PubMed

Liu, Yang; Lv, Huilin; Ren, Li; Xue, Guanhua; Wang, Yingjun

2016-01-01

Cornea disease is the second cause of blindness and keratoplasty is the most commonly performed option for visual rehabilitation of patients with corneal blindness. However, the clinical treatment has been drastically limited due to a severe shortage of high-quality donor corneas. Although collagen film with outstanding biocompatibility has promising application in corneal tissue engineering, the moisturizing properties of collagen-based materials must be further improved to satisfy the requirements of clinical applications. This paper describes a novel collagen-based film with high moisture capacity reinforced by surface grafting of chondroitin sulfate. The collagen-chondroitin sulfate (abbreviated as Col-CS) film was analyzed by Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy and its hydrophilic property, moisture retention, optical property, and mechanical performance had been tested. The moisture-retaining capacity is found to be improved with the introduction of chondroitin sulfate, and the Col-CS membrane performs better mechanical properties than the collagen film. Moreover, the modified film proves excellent biocompatibility for the proliferation of human corneal epithelial cells in vitro. This Col-CS film with good moisturizing properties can reduce the risk of xerophthalmia and is expected to increase the implant success rate in clinic patients with corneal defects.

75 FR 82109 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... subdivision thereof, or options or other derivatives on any of the foregoing; or (b) interest rate futures or... subdivision thereof, or options or other derivatives on any of the foregoing; or (b) interest rate futures or... (multiple or inverse) performance of an index or indexes of futures contracts or options or derivatives on...

OysterFutures: Integrating Stakeholder Objectives with Natural System Models to Promote Sustainable Natural Resource Policy

NASA Astrophysics Data System (ADS)

North, E. W.; Blair, J.; Cornwell, J. C.; Freitag, A. E.; Gawde, R. K.; Hartley, T. W.; Hood, R. R.; Jones, R. M.; Miller, T. J.; Thomas, J. E.; Wainger, L. A.; Wilberg, M. J.

2016-02-01

Achieving effective natural resource management is challenged by multiple and often competing objectives, a restricted set of policy options, and uncertainty in the performance of those options. Yet, managers need policies that allow continued use of natural resources while ensuring access for future generations and maintenance of ecosystem services. Formal approaches are needed that will assist managers and stakeholders in choosing policy options that have a high likelihood of achieving social, ecological, and economic goals. The goal of this project, OysterFutures, is to address this need by improving the use of predictive models to support sustainable natural resource policy and management. A stakeholder-centered process will be used to build an integrated model that combines estuarine physics, oyster life history, and the ecosystem services that oysters provide (e.g., harvest, water quality) to forecast outcomes under alternative management strategies. Through a series of facilitated meetings, stakeholders will participate in a science-based collaborative process which will allow them to project how well policies are expected to meet their objectives using the integrated model. This iterative process will ensure that the model will incorporate the complex human uses of the ecosystem as well as focus on the outcomes most important to the stakeholders. In addition, a study of the socioeconomic drivers of stakeholder involvement, information flow, use and influence, and policy formation will be undertaken to improve the process, enhance implementation success of recommended policies, and provide new ideas for integrating natural and social sciences, and scientists, in sustainable resource management. In this presentation, the strategy for integrating natural system models, stakeholder views, and sociological studies as well as methods for selecting stakeholders and facilitating stakeholder meetings will be described and discussed.

Vegetation projections for Wind Cave National Park with three future climate scenarios: Final report in completion of Task Agreement J8W07100052

USGS Publications Warehouse

King, David A.; Bachelet, Dominique M.; Symstad, Amy J.

2013-01-01

Since the initial application of MC1 to a small portion of WICA (Bachelet et al. 2000), the model has been altered to improve model performance with the inclusion of dynamic fire. Applying this improved version to WICA required substantial recalibration, during which we have made a number of improvements to MC1 that will be incorporated as permanent changes. In this report we document these changes and our calibration procedure following a brief overview of the model. We compare the projections of current vegetation to the current state of the park and present projections of vegetation dynamics under future climates downscaled from three GCMs selected to represent the existing range in available GCM projections. In doing so, we examine the consequences of different management options regarding fire and grazing, major aspects of biotic management at Wind Cave.

Ultrasound-guided piriformis muscle injection. A new approach.

PubMed

Bevilacqua Alén, E; Diz Villar, A; Curt Nuño, F; Illodo Miramontes, G; Refojos Arencibia, F J; López González, J M

2016-12-01

Piriformis syndrome is an uncommon cause of buttock and leg pain. Some treatment options include the injection of piriformis muscle with local anesthetic and steroids. Various techniques for piriformis muscle injection have been described. Ultrasound allows direct visualization and real time injection of the piriformis muscle. We describe 5 consecutive patients, diagnosed of piriformis syndrome with no improvement after pharmacological treatment. Piriformis muscle injection with local anesthetics and steroids was performed using an ultrasound technique based on a standard technique. All 5 patients have improved their pain measured by numeric verbal scale. One patient had a sciatic after injection that improved in 10 days spontaneously. We describe an ultrasound-guided piriformis muscle injection that has the advantages of being effective, simple, and safe. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

The Fine Wire Technique for Flexor Tenolysis.

PubMed

Rosenblum, Matthew K; Baltodano, Pablo A; Weinberg, Maxene H; Whipple, Lauren A; Gemmiti, Amanda L; Whipple, Richard E

2017-11-01

Flexor tenolysis surgery for flexor digitorum profundus and superficialis adhesions is a common procedure performed by hand surgeons. Releasing these adhered tendons can greatly improve hand function and improve quality of life. Recent evidence, however, has shown that the outcomes of tenolysis surgeries are often suboptimal and can result in relapsing adhesions or even tendon ruptures. This article describes a new technique with potential for reduced complication rates: The Fine Wire Technique for Flexor Tenolysis (FWT). Following FWT, the patient detailed in this article had an excellent recovery of function and no complications: including tendon rupture, infection, hematomas, or any other complications. She reported a major improvement from her preoperative functionality and continues to have this level of success. The wire's thinness allows for a swift tenolysis. The FWT is a new option available to the hand surgeon associated with good functional results. The wire is readily available to the clinician and is also inexpensive.

A historical perspective of Global Warming Potential from Municipal Solid Waste Management.

PubMed

Habib, Komal; Schmidt, Jannick H; Christensen, Per

2013-09-01

The Municipal Solid Waste Management (MSWM) sector has developed considerably during the past century, paving the way for maximum resource (materials and energy) recovery and minimising environmental impacts such as global warming associated with it. The current study is assessing the historical development of MSWM in the municipality of Aalborg, Denmark throughout the period of 1970 to 2010, and its implications regarding Global Warming Potential (GWP(100)), using the Life Cycle Assessment (LCA) approach. Historical data regarding MSW composition, and different treatment technologies such as incineration, recycling and composting has been used in order to perform the analysis. The LCA results show a continuous improvement in environmental performance of MSWM from 1970 to 2010 mainly due to the changes in treatment options, improved efficiency of various treatment technologies and increasing focus on recycling, resulting in a shift from net emission of 618 kg CO(2)-eq.tonne(-1) to net saving of 670 kg CO(2)-eq.tonne(-1) of MSWM. Copyright © 2013 Elsevier Ltd. All rights reserved.

Design options for improving protective gloves for industrial assembly work.

PubMed

Dianat, Iman; Haslegrave, Christine M; Stedmon, Alex W

2014-07-01

The study investigated the effects of wearing two new designs of cotton glove on several hand performance capabilities and compared them against the effects of barehanded, single-layered and double cotton glove conditions when working with hand tools (screwdriver and pliers). The new glove designs were based on the findings of subjective hand discomfort assessments for this type of work and aimed to match the glove thickness to the localised pressure and sensitivity in different areas of the hand as well as to provide adequate dexterity for fine manipulative tasks. The results showed that the first prototype glove and the barehanded condition were comparable and provided better dexterity and higher handgrip strength than double thickness gloves. The results support the hypothesis that selective thickness in different areas of the hand could be applied by glove manufacturers to improve the glove design, so that it can protect the hands from the environment and at the same time allow optimal hand performance capabilities. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

RMG An Open Source Electronic Structure Code for Multi-Petaflops Calculations

NASA Astrophysics Data System (ADS)

Briggs, Emil; Lu, Wenchang; Hodak, Miroslav; Bernholc, Jerzy

RMG (Real-space Multigrid) is an open source, density functional theory code for quantum simulations of materials. It solves the Kohn-Sham equations on real-space grids, which allows for natural parallelization via domain decomposition. Either subspace or Davidson diagonalization, coupled with multigrid methods, are used to accelerate convergence. RMG is a cross platform open source package which has been used in the study of a wide range of systems, including semiconductors, biomolecules, and nanoscale electronic devices. It can optionally use GPU accelerators to improve performance on systems where they are available. The recently released versions (>2.0) support multiple GPU's per compute node, have improved performance and scalability, enhanced accuracy and support for additional hardware platforms. New versions of the code are regularly released at http://www.rmgdft.org. The releases include binaries for Linux, Windows and MacIntosh systems, automated builds for clusters using cmake, as well as versions adapted to the major supercomputing installations and platforms. Several recent, large-scale applications of RMG will be discussed.

The performance-variability paradox, financial decision making, and the curious case of negative Hurst exponents.

PubMed

Guastello, Stephen J; Reiter, Katherine; Shircel, Anton; Timm, Paul; Malon, Matthew; Fabisch, Megan

2014-07-01

This study examined the relationship between performance variability and actual performance of financial decision makers who were working under experimental conditions of increasing workload and fatigue. The rescaled range statistic, also known as the Hurst exponent (H) was used as an index of variability. Although H is defined as having a range between 0 and 1, 45% of the 172 time series generated by undergraduates were negative. Participants in the study chose the optimum investment out of sets of 3 to 5 options that were presented a series of 350 displays. The sets of options varied in both the complexity of the options and number of options under simultaneous consideration. One experimental condition required participants to make their choices within 15 sec, and the other condition required them to choose within 7.5 sec. Results showed that (a) negative H was possible and not a result of psychometric error; (b) negative H was associated with negative autocorrelations in a time series. (c) H was the best predictor of performance of the variables studied; (d) three other significant predictors were scores on an anagrams test and ratings of physical demands and performance demands; (e) persistence as evidenced by the autocorrelations was associated with ratings of greater time pressure. It was concluded, furthermore, that persistence and overall performance were correlated, that 'healthy' variability only exists within a limited range, and other individual differences related to ability and resistance to stress or fatigue are also involved in the prediction of performance.

Hemoadsorption in cardiac shock with biventricular failure and giant-cell myocarditis: A case report.

PubMed

Dogan, Günes; Hanke, Jasmin; Puntigam, Jakob; Haverich, Axel; Schmitto, Jan D

2018-05-01

Giant-cell myocarditis represents a rare and often fatal autoimmune disorder. Despite extracorporeal life support being a valid treatment option, alternatives to control the underlying inflammatory response remain sparse. A new hemoadsorption device (CytoSorb) has recently been introduced to treat patients with an excessive inflammatory response. A 57-year-old patient developed fulminant right heart failure, respiratory insufficiency, hemodynamic instability, and oliguric-anuric renal failure. An extracorporeal life support together with an Impella was implanted for circulatory support. Due to non-pulsatility, acontractility of the left ventricle and a heavily reduced right ventricular function, a left ventricular assist device implantation and change from extracorporeal life support to veno-pulmonary arterial extracorporeal membrane oxygenation was performed. Since adequate hemodynamic stabilization could not be achieved and due to increasing inflammatory mediators and bilirubin levels, the decision was made to additionally integrate a CytoSorb hemoadsorber into the system. The combined treatment resulted in a clear and steady improvement in hemodynamics and the inflammatory condition with marked reductions in all measured parameters throughout the treatment period. Metabolic acidosis resolved and liver function improved. Extracorporeal life support therapy represents a bridging approach to heart transplantation or to cardiac recovery and can be complemented by CytoSorb as an independent therapeutic option. The patient described herein with giant-cell myocarditis and fulminant cardiac failure who received substantial extracorporeal support in combination with CytoSorb hemoadsorption therapy benefited in terms of an improvement of organ function and his inflammatory situation.

Non-adoption of Option B+ for prevention of mother-to-child transmission of HIV in Nigeria: A look at the policymaking process.

PubMed

Olakunde, Babayemi Oluwaseun; Ndukwe, Chinwendu Daniel

2017-02-01

In 2012, the World Health Organization recommended 'Option B+' (lifelong antiretroviral treatment for HIV-infected pregnant women regardless of their CD4 count or WHO clinical stage) for prevention of mother-to-child transmission of HIV-based on its operational and clinical advantages. By 2015, 21 out of the 22 Global Plan priority countries had adopted the Option B+ approach. Despite its huge HIV burden, Nigeria is the only country yet to adopt Option B+. We analyse the policymaking process on Option B+ in Nigeria from 2012-2015, highlighting how factors related to the content (uncertainty about Option B+, lack of local evidence), actors (interest and power) and context (low domestic funding and poor retention in care) affected the policymaking process and present the implications of this decision for improving HIV response in Nigeria.

Competitive Effects of Means-Tested School Vouchers

ERIC Educational Resources Information Center

Figlio, David N.; Hart, Cassandra M. D.

2010-01-01

School choice options--including both voucher and neo-voucher options like tuition tax credit funded scholarship programs--have become increasingly prevalent in recent years (Howell, Peterson, Wolf and Campbell, 2006). One popular argument for school choice policies, drawing from economic theory, is that public schools will improve the education…

77 FR 9274 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-16

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66375; File No. SR-CBOE-2011-117] Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving Proposed Rule Change Relating to Its Automated Improvement Mechanism February 10, 2012. On December 14, 2011, the Chicago Board...

Chapter 13, Policy options: North America

Treesearch

Jane Barr; James Dobrowolski; John Campbell; Philippe Le Prestre; Lori Lynch; Marc Sydnor; Robert Adler; Jose Etcheverry; Alexander Kenny; Catherine Hallmich; Jim Lazar; Russell M. Meyer; Robin Newmark; Janet Peace; Julie A. Suhr Pierce; Stephen Yamasaki

2012-01-01

As previously indicated, GEO-5 shifts the GEO focus from identifying environmental problems to identifying solutions that governments can then prioritize. This chapter provides examples of a number of policy options and market mechanisms that have shown some success in improving environmental conditions in North America. They are organized by priority environmental...

3 CFR - Improving Repayment Options for Federal Student Loan Borrowers

Code of Federal Regulations, 2013 CFR

2013-01-01

... about $26,300. While a college education remains an excellent investment, this debt can be overly... allow income information to be seamlessly transmitted so that borrowers can complete the application at... Options for Federal Student Loan Borrowers Memorandum for the Secretary of Education [and] the Secretary...

77 FR 35241 - Improving Repayment Options for Federal Student Loan Borrowers

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-13

... about $26,300. While a college education remains an excellent investment, this debt can be overly... allow income information to be seamlessly transmitted so that borrowers can complete the application at... Repayment Options for Federal Student Loan Borrowers Memorandum for the Secretary of Education [and] the...

Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

PubMed

Narayan, Anand; Lobner, Katie; Fritz, Jan

2018-02-01

The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Policy options for responding to the growing challenge from obesity (PorGrow) in Poland.

PubMed

Szponar, L; Ciok, J; Dolna, A; Oltarzewski, M

2007-05-01

To explore the perspectives of stakeholders towards a range of policy options to respond to obesity in Poland, a multi-criteria mapping method was used. During structured interviews, stakeholders were invited to appraise policy options by reference to criteria of their own choosing. They also provided relative weightings to their criteria, generating overall rankings of the policy options in relation to each other. Efficacy, feasibility and societal benefits were the groups of criteria deemed most important. There was most consensus in favour of options related to health education, particularly in schools, compared with options that aimed at modifying the environment to prevent obesity, i.e. options around physical activity, modifying the supply and demand for food products, and information-related options. There was little support for technological solutions or institutional reforms. There was broad consensus that to reverse the rising trend in the incidence of obesity, it will be necessary to implement a portfolio of measures, but options related to behaviour change through education are most highly regarded. It will also be necessary to invest in improved surveillance and monitoring of Polish dietary practices, levels of physical activity and obesity in terms of data on height, weight and body mass indexes.

An evaluation of krypton propellant in Hall thrusters

NASA Astrophysics Data System (ADS)

Linnell, Jesse Allen

Due to its high specific impulse and low price, krypton has long sparked interest as an alternate Hall thruster propellant. Unfortunately at the moment, krypton's relatively poor performance precludes it as a legitimate option. This thesis presents a detailed investigation into krypton operation in Hall thrusters. These findings suggest that the performance gap can be decreased to 4% and krypton can finally become a realistic propellant option. Although krypton has demonstrated superior specific impulse, the xenon-krypton absolute efficiency gap ranges between 2 and 15%. A phenomenological performance model indicates that the main contributors to the efficiency gap are propellant utilization and beam divergence. Propellant utilization and beam divergence have relative efficiency deficits of 5 and 8%, respectively. A detailed characterization of internal phenomena is conducted to better understand the xenon-krypton efficiency gap. Krypton's large beam divergence is found to be related to a defocusing equipotential structure and a weaker magnetic field topology. Ionization processes are shown to be linked to the Hall current, the magnetic mirror topology, and the perpendicular gradient of the magnetic field. Several thruster design and operational suggestions are made to optimize krypton efficiency. Krypton performance is optimized for discharge voltages above 500 V and flow rates corresponding to an a greater than 0.015 mg/(mm-s), where alpha is a function of flow rate and discharge channel dimensions (alpha = m˙alphab/Ach). Performance can be further improved by increasing channel length or decreasing channel width for a given flow rate. Also, several magnetic field design suggestions are made to enhance ionization and beam focusing. Several findings are presented that improve the understanding of general Hall thruster physics. Excellent agreement is shown between equipotential lines and magnetic field lines. The trim coil is shown to enhance beam focusing, ionization processes, and electron dynamics. Electron mobility and the Hall parameter are studied and compared to different mobility models. Azimuthal electron current is studied using a fluid and particle drift approach. Analyses of several magnetic field features are conducted and simple tools are suggested for the development of future Hall thrusters. These findings have strong implications for future Hall thruster design, lifetimes, and modeling.

A Comprehensive Assessment of Four Options for Financing Health Care Delivery in Oregon

PubMed Central

White, Chapin; Eibner, Christine; Liu, Jodi L.; Price, Carter C.; Leibowitz, Nora; Morley, Gretchen; Smith, Jeanene; Edlund, Tina; Meyer, Jack

2017-01-01

Abstract This article describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act (ACA) Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the ACA Marketplace. The state could cover all residents under the Single Payer option with little change in overall health care costs, but doing so would require cuts to provider payment rates that could worsen access to care, and implementation hurdles may be insurmountable. The Health Care Ingenuity Plan, a state-managed plan featuring competition among private plans, would also achieve universal coverage and would sever the employer–health insurance link, but the provider payment rates would likely be set too high, so health care costs would increase. The Public Option would be the easiest of the three options to implement, but because it would not affect many people, it would be an incremental improvement to the Status Quo. Policymakers will need to weigh these options against their desire for change to balance the benefits with the trade-offs. PMID:29057151

Evidence for medium chain triglycerides in the treatment of primary intestinal lymphangiectasia.

PubMed

Desai, A P; Guvenc, B H; Carachi, R

2009-08-01

Primary intestinal lymphangiectasia is an uncommon congenital anomaly. It is an intrinsic abnormality of the intestinal lymphatics system. Over the years, various treatment options such as diuretics, albumin transfusions and a medium chain triglycerides (MCT) diet as well as surgical options such as resection of isolated segments and peritoneal-venous shunts have been used. An MCT diet, which is a low fat, high protein diet, is increasingly used in the management of this anomaly. The aim was to review the evidence for medium chain triglycerides as a therapeutic option in patients with primary intestinal lymphangiectasia. A literature search was performed and individual case details were extracted. We found 55 cases, of which 3 were from our own institute. The cases were divided in 2 groups: Group A (n=27) consisted of patients treated with MCT, and Group B (n=28) consisted patients not treated with MCT. Cases were analysed for symptomatic response to MCT as well as mortality. 17 of 27 cases (63%) treated with MCT had complete resolution of symptoms while only 10 of 28 (35.7%) patients in group B showed complete resolution. Mortality for Group A was 1 out of 27 (3.7%), while mortality in group B was 5 of 28 (17.85%) patients. We conclude that, although an MCT diet is not completely curative in all cases, it does improve the symptoms of primary intestinal lymphangiectasia and reduces mortality. Hence it is a valid option in the paediatric age group. Copyright Georg Thieme Verlag KG Stuttgart . New York.

Performance improvement: an active life cycle product management

NASA Astrophysics Data System (ADS)

Cucchiella, Federica; Gastaldi, Massimo; Lenny Koh, S. C.

2010-03-01

The management of the supply chain has gained importance in many manufacturing firms. Operational flexibility can be considered a crucial weapon to increase competitiveness in a turbulent marketplace. It reflects the ability of a firm to properly and rapidly respond to a variable and dynamic environment. For the firm operating in a fashion sector, the management of the supply chain is even more complex because the product life cycle is shorter than that of the firm operating in a non-fashion sector. The increase of firm flexibility level can be reached through the application of the real option theory inside the firm network. In fact, real option may increase the project value by allowing managers to more efficiently direct the production. The real option application usually analysed in literature does not take into account that the demands of products are well-defined by the product life cycle. Working on a fashion sector, the life cycle pattern is even more relevant because of an expected demand that grows according to a constant rate that does not capture the demand dynamics of the underlying fashion goods. Thus, the primary research objective of this article is to develop a model useful for the management of investments in a supply chain operating in a fashion sector where the system complexity is increased by the low level of unpredictability and stability that is proper of the mood phenomenon. Moreover, unlike the traditional model, a real option framework is presented here that considers fashion product characterised by uncertain stages of the production cycle.

Rituximab desensitization in three patients with severe rituximab allergy.

PubMed

Öztürk, Erman; Özyiğit, Leyla Pur; Öztürk, Ayşe Bilge; Akay, Meltem Olga; Çetiner, Mustafa; Ferhanoğlu, Burhan

Rituximab is a chimeric monoclonal antibody that targets CD20 positive B cells and has a positive effect on both overall and progression-free survival in B-cell lymphoid malignancies. Combination rituximab with chemotherapy treatment provide survival improvement. Although rituximab is an important treatment option in hematological malignancies, the risk of allergic reactions is high. These reactions are usually IgE-mediated and can be varied in regard of severity from urticaria to anaphylaxis. It is an option to interrupt the treatment and ommit rituximab therapy who had allergic reactions. Drug desensitization is another option and successful results have been reported by applying desensitization to such reactions. Drug desensitization alters the immune response to induce a state of temporary clinical tolerance to the allergic drug by giving gradual increasing of doses of drug at fixed time intervals. Herein, we present 3 cases successfully treated with rituximab desensitization. The cases were using rituximab with the diagnosis of Burkitt lymphoma, follicular lymphoma, and marginal zone lymphoma, respectively. Two cases had grade 2 and 1 case had grade 3 systemic allergic reaction with rituximab. There was no known allergy history in all 3 cases. All patients tolerated the desensitization protocol. The subsequent treatments of the patients were also given by desensitization protocol. A total of 12 desensitizations were administered to 3 cases. No severe or life-threating reactions were observed in subsequent applications. To date applying desensitization protocols ensure rituximab treatment safely. Rituximab desensitization can be performed at trained allergy centers, and it may be an appropriate option for rituximab allergic patients. Copyright © 2017 Elsevier Inc. All rights reserved.

The selection of the American-Polish joint venture projects for the Krakow program and results of the efforts to date

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

Gyorke, D.F.; Butcher, T.A.

1995-12-31

To implement the Krakow Clean Fossil Fuels and Energy Efficiency Program, eight U.S. firms were selected by the U.S. Department of Energy to market their technologies to reduce pollution from low emission sources in Krakow. The eight U.S. firms were selected by a competitive solicitation that required the proposing firms to themselves provide funding to match or exceed the funding provided by the Program. These U.S. firms and their Polish partner companies have begun sales and cooperative work efforts in Krakow, and some have already made initial equipment installations with measurable performance improvements. Following their efforts as part of themore » Program, these U.S.-Polish joint ventures will market their technologies and achieve the associated environmental benefits elsewhere in Poland and Eastern and Central Europe. As part of the Krakow Program a spreadsheet model was developed to compare technological options for supplying heat to the city by calculation and comparing the heating costs and associated emissions reduction for each option. Comparison of options is made on the basis of the user cost-per-metric ton of equivalent emissions reduction. For all options considered in the Krakow Program, this cost parameter has ranged from -$1469 (best) to $2650 (worst). The costs for technologies associated with the eight projects in the Krakow Program are at the lower end of this range placing these technologies among the most cost effective solutions to the pollution problems from the low emission sources.« less

Breech presentation: an audit project as means of pursuing clinical excellence.

PubMed

Siassakos, D; Anderson, H; Panter, K

2005-10-01

Clinical audit is an effective quality improvement process to evaluate important clinical issues. Breech presentation is such an issue due to its contribution to the rising caesarean section (CS) rate. We set out to assess the management of breech presentation using, as standards, the delivery suite protocol and national guidelines. Our first audit revealed a low success rate of external cephalic version (ECV) and deficient documentation of written consent for ECV, other aspects of care being satisfactory. The results were presented to a multidisciplinary meeting and disseminated to relevant stakeholders. A re-audit was then performed. It confirmed significant improvement in the documentation of consent for ECV. It also revealed a good detection rate of breech, optimal offer rate of ECV and good neonatal outcome. However, uptake of ECV as well as the success rate could both be improved so as to reduce the CS rate for breech presentation. We discuss options for improving the uptake and success rate for ECV.

Pharmacologic management of Alzheimer disease.

PubMed

Downey, Deborah

2008-02-01

Although the diagnosis of AD can be devastating, treatment options exist that can slow the disease's progression and allow patients to continue performing ADLs, thereby improving the quality of life for both patient and caregiver. Research is ongoing, and it is estimated by the Alzheimer's Association that finding a treatment that could delay onset by only 5 years could reduce the number of individuals with AD by nearly 50% over the next 50 years (Alzheimer's Association, 2007). Although pharmacotherapy is not yet a cure, it does remain an important part of a total approach to caring for patients and families affected by AD.

A letter on the state of general practice in England.

PubMed

Majeed, Azeem

2015-01-01

The last few years have been a time of considerable change for general practitioners in England. In 2004, general practitioners negotiated a new contract with the United Kingdom's National Health Service. In came a new pay for performance scheme, along with the option of opting out of after-hours primary care. General practitioners' pay increased and job satisfaction improved. However, rather than then entering a period of stability, general practitioners subsequently found themselves facing even more changes in their working practices. Workload has increased, new responsibilities for commissioning health services have been given to general practitioners, and their income has fallen.

Tracheomalacia.

PubMed

Kugler, Christian; Stanzel, Franz

2014-02-01

Tracheomalacia is excessive collapsibility of the trachea, typically during expiration. Congenital forms are associated with severe symptoms. Milder forms often present after the neonatal period. Adult malacia is mostly associated with chronic obstructive pulmonary disease. Functional bronchoscopy is still not standardized. Dynamic airway CT is a promising tool for noninvasive diagnosis. Bronchoscopy and stent insertion lead to significant improvement, but with a high complication rate. Surgical lateropexia, tracheal resection, and surgical external stabilization are options. Tracheoplasty seems to be the best choice for selected cases of adult malacia. The most commonly performed surgery in children is aortopexy. Copyright © 2014 Elsevier Inc. All rights reserved.

A review of experimental investigations on thermal phenomena in nanofluids

PubMed Central

2011-01-01

Nanoparticle suspensions (nanofluids) have been recommended as a promising option for various engineering applications, due to the observed enhancement of thermophysical properties and improvement in the effectiveness of thermal phenomena. A number of investigations have been reported in the recent past, in order to quantify the thermo-fluidic behavior of nanofluids. This review is focused on examining and comparing the measurements of convective heat transfer and phase change in nanofluids, with an emphasis on the experimental techniques employed to measure the effective thermal conductivity, as well as to characterize the thermal performance of systems involving nanofluids. PMID:21711918

GMTIFS: cryogenic rotary mechanisms for the GMT Integral-Field Spectrograph

NASA Astrophysics Data System (ADS)

Hart, John; Espeland, Brady; Bloxham, Gabe; Boz, Robert; Bundy, Dave; Davies, John; Fordham, Bart; Herald, Nick; Sharp, Rob; Vaccarella, Annino; Vest, Colin

2016-07-01

A representative range of the rotary mechanisms proposed for use in GMTIFS is described. All are driven by cryogenically rated stepper motors. For each mechanism, angular position is measured by means of eddy current sensors arranged to function as a resolver. These measure the linear displacement of a decentered aluminum alloy target in two orthogonal directions, from which angular position is determined as a function of the displacement ratio. Resolver function and performance is described. For each mechanism, the mechanical design is described and the adequacy of positioning repeatability assessed. Options for improvement are discussed.

Extragalactic sources in Cosmic Microwave Background maps

NASA Astrophysics Data System (ADS)

De Zotti, G.; Castex, G.; González-Nuevo, J.; Lopez-Caniego, M.; Negrello, M.; Cai, Z.-Y.; Clemens, M.; Delabrouille, J.; Herranz, D.; Bonavera, L.; Melin, J.-B.; Tucci, M.; Serjeant, S.; Bilicki, M.; Andreani, P.; Clements, D. L.; Toffolatti, L.; Roukema, B. F.

2015-06-01

We discuss the potential of a next generation space-borne CMB experiment for studies of extragalactic sources with reference to COrE+, a project submitted to ESA in response to the call for a Medium-size mission (M4). We consider three possible options for the telescope size: 1 m, 1.5 m and 2 m (although the last option is probably impractical, given the M4 boundary conditions). The proposed instrument will be far more sensitive than Planck and will have a diffraction-limited angular resolution. These properties imply that even the 1 m telescope option will perform substantially better than Planck for studies of extragalactic sources. The source detection limits as a function of frequency have been estimated by means of realistic simulations taking into account all the relevant foregrounds. Predictions for the various classes of extragalactic sources are based on up-to-date models. The most significant improvements over Planck results are presented for each option. COrE+ will provide much larger samples of truly local star-forming galaxies (by about a factor of 8 for the 1 m telescope, of 17 for 1.5 m, of 30 for 2 m), making possible analyses of the properties of galaxies (luminosity functions, dust mass functions, star formation rate functions, dust temperature distributions, etc.) across the Hubble sequence. Even more interestingly, COrE+ will detect, at |b| > 30°, thousands of strongly gravitationally lensed galaxies (about 2,000, 6,000 and 13,000 for the 1 m, 1.5 m and 2 m options, respectively). Such large samples are of extraordinary astrophysical and cosmological value in many fields. Moreover, COrE+ high frequency maps will be optimally suited to pick up proto-clusters of dusty galaxies, i.e. to investigate the evolution of large scale structure at larger redshifts than can be reached by other means. Thanks to its high sensitivity COrE+ will also yield a spectacular advance in the blind detection of extragalactic sources in polarization: we expect that it will detect up to a factor of 40 (1 m option) or of 160 (1.5 m option) more radio sources than can be detected by Planck and, for the first time, from several tens (1 m option) to a few hundreds (1.5 m option) of star forming galaxies. This will open a new window for studies of the global properties of magnetic fields in star forming galaxies and of their relationships with star formation rates.

ECOD: new developments in the evolutionary classification of domains

PubMed Central

Schaeffer, R. Dustin; Liao, Yuxing; Cheng, Hua; Grishin, Nick V.

2017-01-01

Evolutionary Classification Of protein Domains (ECOD) (http://prodata.swmed.edu/ecod) comprehensively classifies protein with known spatial structures maintained by the Protein Data Bank (PDB) into evolutionary groups of protein domains. ECOD relies on a combination of automatic and manual weekly updates to achieve its high accuracy and coverage with a short update cycle. ECOD classifies the approximately 120 000 depositions of the PDB into more than 500 000 domains in ∼3400 homologous groups. We show the performance of the weekly update pipeline since the release of ECOD, describe improvements to the ECOD website and available search options, and discuss novel structures and homologous groups that have been classified in the recent updates. Finally, we discuss the future directions of ECOD and further improvements planned for the hierarchy and update process. PMID:27899594

Experiments in teleoperator and autonomous control of space robotic vehicles

NASA Technical Reports Server (NTRS)

Alexander, Harold L.

1991-01-01

A program of research embracing teleoperator and automatic navigational control of freely flying satellite robots is presented. Current research goals include: (1) developing visual operator interfaces for improved vehicle teleoperation; (2) determining the effects of different visual interface system designs on operator performance; and (3) achieving autonomous vision-based vehicle navigation and control. This research program combines virtual-environment teleoperation studies and neutral-buoyancy experiments using a space-robot simulator vehicle currently under development. Visual-interface design options under investigation include monoscopic versus stereoscopic displays and cameras, helmet-mounted versus panel-mounted display monitors, head-tracking versus fixed or manually steerable remote cameras, and the provision of vehicle-fixed visual cues, or markers, in the remote scene for improved sensing of vehicle position, orientation, and motion.

The upside down world of diabetes care medical economics and what we might do to improve it.

PubMed

Harlan, David M; Hirsch, Irl B

2017-04-01

Increasingly over the past generation, the American healthcare delivery system has received consistently poor marks with regard to public health outcomes and costs. This review by two seasoned diabetes care providers is intended to shed light on the fundamental flaws we believe to underlie that poor performance, and suggest options for better outcomes and cost efficiencies. Despite major advances in diabetes management medications and tools, overall public health with regard to diabetes outcomes remains poor. Efforts focused on controlling costs appear to be exacerbating the problem. For chronic diseases like diabetes, fee-for-service care models are fundamentally flawed and predictably fail. We suggest that a major overhaul of the medical economics underlying diabetes care can improve patient outcomes and decrease costs.

Space Station Systems Analysis Study. Volume 1: Executive summary, part 1 and 2

NASA Technical Reports Server (NTRS)

1977-01-01

The elements of space station programs required to support an operational base theme, a space laboratory theme, and advanced missions relatable to public needs/national interests are defined. Missions satisfying the foregoing requirements are identified, program scenarios/options are established. System options are evaluated for a selected number of program options. Subsystem analysis and programmatic comparisons are performed for selected primary concepts.

Metals and metalloids treatment in contaminated neutral effluents using modified materials.

PubMed

Calugaru, Iuliana Laura; Neculita, Carmen Mihaela; Genty, Thomas; Zagury, Gérald J

2018-04-15

Circumneutral surface water and groundwater can contain hazardous concentrations of metals and metalloids that can threaten organisms in surrounding ecosystems. Extensive research has been conducted over the past two decades to prevent, limit, and treat water pollution. Among the currently available treatment options is the use of natural and residual materials, which is generally regarded as effective and inexpensive. The modification of such materials enhances the removal capacity of metals and metalloids, as well as the physical and chemical stability of the materials and resulting sludge (after treatment). This paper reviews several modified materials that have produced and evaluated in the past twenty years to treat various contaminants in water under specific conditions. Important factors on performance improvement following the modifications are emphasized. Sorption capacity and kinetics, and element removal mechanisms are also discussed. Element recovery, material regeneration, water reuse, evaluation of treatment efficiency for real effluents are also considered, as well as the applicability of these materials in both active and passive treatment systems. Modified natural and residual materials are a promising option for the treatment of metals and metalloids in circumneutral contaminated waters. However, further research is necessary to evaluate their field-scale performance and to properly assess treatment costs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Evaluation of the Intermittent Exotropia Questionnaire using Rasch analysis.

PubMed

Leske, David A; Holmes, Jonathan M; Melia, B Michele

2015-04-01

The Intermittent Exotropia Questionnaire (IXTQ) is a patient, proxy, and parental report of quality of life specific to children with intermittent exotropia. We refine the IXTQ using Rasch analysis to improve reliability and validity. Rasch analysis was performed on responses of 575 patients with intermittent exotropia enrolled from May 15, 2008, through July 24, 2013, and their parents from each of the 4 IXTQ health-related quality-of-life questionnaires (child 5 through 7 years of age and child 8 through 17 years of age, proxy, and parent questionnaires). Questionnaire performance and structure were confirmed in a separate cohort of 379 patients with intermittent exotropia. One item was removed from the 12-item child and proxy questionnaires, and response options in the 8- to 17-year-old child IXTQ and proxy IXTQ were combined into 3 response options for both questionnaires. Targeting was relatively poor for the child and proxy questionnaires. For the parent questionnaire, 3 subscales (psychosocial, function, and surgery) were evident. One item was removed from the psychosocial subscale. Resulting subscales had appropriate targeting. The Rasch-revised IXTQ may be a useful instrument for determining how intermittent exotropia affects health-related quality of life of children with intermittent exotropia and their parents, particularly for cohort studies.

Design of the RWM Feedback Control System for NSTX

NASA Astrophysics Data System (ADS)

Bialek, James; Sabbagh, Steven; Paoletti, Franco

2002-11-01

The National Spherical Torus Experiment ( NSTX ) has been designed to investigate the physics of global mode stabilization at low aspect ratio. Present experiments are now probing performance limits determined by machine configuration and passive stabilization. For example, the ideal no-wall normalized beta limit has already been exceeded by greater than 20stabilized by a nearby perfectly conducting wall are observed to grow at a rate determined by nearby resistive structure. Sustained performance improvements may be obtained by using active feedback to suppress such long wavelength pressure driven instabilities, known as resistive wall modes (RWM). We report on the performance of several design options for an NSTX - RWM feedback control system. The VALEN feedback analysis code has been used to evaluate the performance of these configurations. We explicitly model the vacuum vessel, center stack casing, the 48 copper passive plates, their mounts, active feedback coils and sensor arrays. The highest performance system has both control coils and sensors inside the vacuum vessel. In this case it is possible to reach 94beta limit.

Throughput and Energy Efficiency of a Cooperative Hybrid ARQ Protocol for Underwater Acoustic Sensor Networks

PubMed Central

Ghosh, Arindam; Lee, Jae-Won; Cho, Ho-Shin

2013-01-01

Due to its efficiency, reliability and better channel and resource utilization, cooperative transmission technologies have been attractive options in underwater as well as terrestrial sensor networks. Their performance can be further improved if merged with forward error correction (FEC) techniques. In this paper, we propose and analyze a retransmission protocol named Cooperative-Hybrid Automatic Repeat reQuest (C-HARQ) for underwater acoustic sensor networks, which exploits both the reliability of cooperative ARQ (CARQ) and the efficiency of incremental redundancy-hybrid ARQ (IR-HARQ) using rate-compatible punctured convolution (RCPC) codes. Extensive Monte Carlo simulations are performed to investigate the performance of the protocol, in terms of both throughput and energy efficiency. The results clearly reveal the enhancement in performance achieved by the C-HARQ protocol, which outperforms both CARQ and conventional stop and wait ARQ (S&W ARQ). Further, using computer simulations, optimum values of various network parameters are estimated so as to extract the best performance out of the C-HARQ protocol. PMID:24217359

On the Performance of TCP Spoofing in Satellite Networks

NASA Technical Reports Server (NTRS)

Ishac, Joseph; Allman, Mark

2001-01-01

In this paper, we analyze the performance of Transmission Control Protocol (TCP) in a network that consists of both satellite and terrestrial components. One method, proposed by outside research, to improve the performance of data transfers over satellites is to use a performance enhancing proxy often dubbed 'spoofing.' Spoofing involves the transparent splitting of a TCP connection between the source and destination by some entity within the network path. In order to analyze the impact of spoofing, we constructed a simulation suite based around the network simulator ns-2. The simulation reflects a host with a satellite connection to the Internet and allows the option to spoof connections just prior to the satellite. The methodology used in our simulation allows us to analyze spoofing over a large range of file sizes and under various congested conditions, while prior work on this topic has primarily focused on bulk transfers with no congestion. As a result of these simulations, we find that the performance of spoofing is dependent upon a number of conditions.

DEVICE TECHNOLOGY. Nanomaterials in transistors: From high-performance to thin-film applications.

PubMed

Franklin, Aaron D

2015-08-14

For more than 50 years, silicon transistors have been continuously shrunk to meet the projections of Moore's law but are now reaching fundamental limits on speed and power use. With these limits at hand, nanomaterials offer great promise for improving transistor performance and adding new applications through the coming decades. With different transistors needed in everything from high-performance servers to thin-film display backplanes, it is important to understand the targeted application needs when considering new material options. Here the distinction between high-performance and thin-film transistors is reviewed, along with the benefits and challenges to using nanomaterials in such transistors. In particular, progress on carbon nanotubes, as well as graphene and related materials (including transition metal dichalcogenides and X-enes), outlines the advances and further research needed to enable their use in transistors for high-performance computing, thin films, or completely new technologies such as flexible and transparent devices. Copyright © 2015, American Association for the Advancement of Science.

Space station needs, attributes and architectural options: Architectural options and selection

NASA Technical Reports Server (NTRS)

Nelson, W. G.

1983-01-01

The approach, study results, and recommendations for defining and selecting space station architectural options are described. Space station system architecture is defined as the arrangement of elements (manned and unmanned on-orbit facilities, shuttle vehicles, orbital transfer vehicles, etc.), the number of these elements, their location (orbital inclination and altitude, and their functional performance capability, power, volume, crew, etc.). Architectural options are evaluated based on the degree of mission capture versus cost and required funding rate. Mission capture refers to the number of missions accommodated by the particular architecture.

Hybrid Hydro Renewable Energy Storage Model

NASA Astrophysics Data System (ADS)

Dey, Asit Kr

2018-01-01

This paper aims at presenting wind & tidal turbine pumped-storage solutions for improving the energy efficiency and economic sustainability of renewable energy systems. Indicated a viable option to solve problems of energy production, as well as in the integration of intermittent renewable energies, providing system flexibility due to energy load’s fluctuation, as long as the storage of energy from intermittent sources. Sea water storage energy is one of the best and most efficient options in terms of renewable resources as an integrated solution allowing the improvement of the energy system elasticity and the global system efficiency.

Options for change in the NHS consultant contract.

PubMed

Clarke, R W; Gray, C

The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers.

Options for change in the NHS consultant contract.

PubMed Central

Clarke, R. W.; Gray, C.

1994-01-01

The lead negotiators for the management and consultant sides in an NHS trust in northern England responded to debate in their trust about consultant contracts by offering to research the attitudes of their peers towards a variety of contract options. The options tested included the current contract; models already examined in the trust and elsewhere, such as time sensitive and mild performance related contracts; and some more radical and speculative possibilities, including consultants franchising their services to the trust. Beyond the predictable conclusion that consultants would prefer no change while managers desired it, a time sensitive contract emerged as having potential for successful negotiation. On the other hand, neither consultants nor managers favoured a strict performance related contract or a fee for service contract. There was a strong similarity of opinion between the two groups on the relative salary values of the options, though the consultants consistently priced these higher than the managers. PMID:8086915

Towards elimination of mother-to-child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (Option B+).

PubMed

van Lettow, Monique; Bedell, Richard; Mayuni, Isabell; Mateyu, Gabriel; Landes, Megan; Chan, Adrienne K; van Schoor, Vanessa; Beyene, Teferi; Harries, Anthony D; Chu, Stephen; Mganga, Andrew; van Oosterhout, Joep J

2014-01-01

Malawi introduced a new strategy to improve the effectiveness of prevention of mother-to-child HIV transmission (PMTCT), the Option B+ strategy. We aimed to (i) describe how Option B+ is provided in health facilities in the South East Zone in Malawi, identifying the diverse approaches to service organization (the "model of care") and (ii) explore associations between the "model of care" and health facility-level uptake and retention rates for pregnant women identified as HIV-positive at antenatal (ANC) clinics. A health facility survey was conducted in all facilities providing PMTCT/antiretroviral therapy (ART) services in six of Malawi's 28 districts to describe and compare Option B+ service delivery models. Associations of identified models with program performance were explored using facility cohort reports. Among 141 health facilities, four "models of care" were identified: A) facilities where newly identified HIV-positive women are initiated and followed on ART at the ANC clinic until delivery; B) facilities where newly identified HIV-positive women receive only the first dose of ART at the ANC clinic, and are referred to the ART clinic for follow-up; C) facilities where newly identified HIV-positive women are referred from ANC to the ART clinic for initiation and follow-up of ART; and D) facilities serving as ART referral sites (not providing ANC). The proportion of women tested for HIV during ANC was highest in facilities applying Model A and lowest in facilities applying Model B. The highest retention rates were reported in Model C and D facilities and lowest in Model B facilities. In multivariable analyses, health facility factors independently associated with uptake of HIV testing and counselling (HTC) in ANC were number of women per HTC counsellor, HIV test kit availability, and the "model of care" applied; factors independently associated with ART retention were district location, patient volume and the "model of care" applied. A large variety exists in the way health facilities have integrated PMTCT Option B+ care into routine service delivery. This study showed that the "model of care" chosen is associated with uptake of HIV testing in ANC and retention in care on ART. Further patient-level research is needed to guide policy recommendations.

Towards elimination of mother-to-child transmission of HIV: performance of different models of care for initiating lifelong antiretroviral therapy for pregnant women in Malawi (Option B+)

PubMed Central

van Lettow, Monique; Bedell, Richard; Mayuni, Isabell; Mateyu, Gabriel; Landes, Megan; Chan, Adrienne K; van Schoor, Vanessa; Beyene, Teferi; Harries, Anthony D; Chu, Stephen; Mganga, Andrew; van Oosterhout, Joep J

2014-01-01

Introduction Malawi introduced a new strategy to improve the effectiveness of prevention of mother-to-child HIV transmission (PMTCT), the Option B+ strategy. We aimed to (i) describe how Option B+ is provided in health facilities in the South East Zone in Malawi, identifying the diverse approaches to service organization (the “model of care”) and (ii) explore associations between the “model of care” and health facility–level uptake and retention rates for pregnant women identified as HIV-positive at antenatal (ANC) clinics. Methods A health facility survey was conducted in all facilities providing PMTCT/antiretroviral therapy (ART) services in six of Malawi's 28 districts to describe and compare Option B+ service delivery models. Associations of identified models with program performance were explored using facility cohort reports. Results Among 141 health facilities, four “models of care” were identified: A) facilities where newly identified HIV-positive women are initiated and followed on ART at the ANC clinic until delivery; B) facilities where newly identified HIV-positive women receive only the first dose of ART at the ANC clinic, and are referred to the ART clinic for follow-up; C) facilities where newly identified HIV-positive women are referred from ANC to the ART clinic for initiation and follow-up of ART; and D) facilities serving as ART referral sites (not providing ANC). The proportion of women tested for HIV during ANC was highest in facilities applying Model A and lowest in facilities applying Model B. The highest retention rates were reported in Model C and D facilities and lowest in Model B facilities. In multivariable analyses, health facility factors independently associated with uptake of HIV testing and counselling (HTC) in ANC were number of women per HTC counsellor, HIV test kit availability, and the “model of care” applied; factors independently associated with ART retention were district location, patient volume and the “model of care” applied. Conclusions A large variety exists in the way health facilities have integrated PMTCT Option B+ care into routine service delivery. This study showed that the “model of care” chosen is associated with uptake of HIV testing in ANC and retention in care on ART. Further patient-level research is needed to guide policy recommendations. PMID:25079437

The effectiveness and safety of treatments used for polycystic ovarian syndrome management in adolescents: a systematic review and network meta-analysis protocol.

PubMed

Al Khalifah, Reem A; Flórez, Iván D; Dennis, Brittany; Neupane, Binod; Thabane, Lehana; Bassilious, Ereny

2015-09-23

Polycystic ovarian syndrome (PCOS) is a common reproductive endocrine disease that is seen among adolescent women. Currently, there is limited evidence to support treatment options leading to considerable variation in practice among healthcare specialists. The objective of this study is to review and synthesize all the available evidence on treatment options for PCOS among adolescent women. We will conduct a systematic review of all randomized controlled trials evaluating the use of metformin, oral contraceptive pills as monotherapy, or as combination with pioglitazone, spironolactone, flutamide, and lifestyle interventions in the treatment of PCOS in adolescent women ages 11 to 19 years. The primary outcome measures are menstrual regulation and change hirsutism scores. The secondary outcome measures include acne scores, prevalence of dysglycaemia, BMI, lipid profile, total testosterone level, and adverse events. We will perform literature searches through Ovid Medline, Ovid Embase, and Cochrane Central Register of Controlled Trials (CENTRAL), and gray literature resources. Two reviewers will independently screen titles and abstracts of identified citations, review the full texts of potentially eligible trials, extract information from eligible trials, and assess the risk of bias and quality of the evidence independently. Results of this review will be summarized narratively and quantitatively as appropriate. We will perform a multiple treatment comparison using network meta-analysis to estimate the pooled direct and indirect effects for all PCOS interventions on outcomes if adequate data is available. PCOS treatment poses a clinical challenge to the patients and physicians. This is the first systematic review and network meta-analysis for PCOS treatment in adolescents. We expect that our results will help improve patient care, unify the treatment approaches among specialists, and encourage research for other therapeutic options. PROSPERO CRD42015016148.

A low cost, high performance remotely controlled backhoe/excavator

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

Rizzo, J.

1995-12-31

This paper addresses a state of the art, low cost, remotely controlled backhoe/excavator system for remediation use at hazardous waste sites. The all weather, all terrain, Remote Dig-It is based on a simple, proven construction platform and incorporates state of the art sensors, control, telemetry and other subsystems derived from advanced underwater remotely operated vehicle systems. The system can be towed to a site without the use of a trailer, manually operated by an on board operator or operated via a fiber optic or optional RF communications link by a remotely positioned operator. A proportional control system is piggy backedmore » onto the standard manual control system. The control system improves manual operation, allows rapid manual/remote mode selection and provides fine manual or remote control of all functions. The system incorporates up to 4 separate video links, acoustic obstacle proximity sensors, and stereo audio pickups and an optional differential GPS navigation. Video system options include electronic panning and tilting within a distortion-corrected wide angle field of view. The backhoe/excavator subsystem has a quick disconnect interface feature which allows its use as a manipulator with a wide variety of end effectors and tools. The Remote Dig-It was developed to respond to the need for a low-cost, effective remediation system for use at sites containing hazardous materials. The prototype system was independently evaluated for this purpose by the Army at the Jefferson Proving Ground where it surpassed all performance goals. At the time of this writing, the Remote Dig-It system is currently the only backhoe/excavator which met the Army`s goals for remediation systems for use at hazardous waste sites and it costs a fraction of any known competing offerings.« less

Cloud Retrieval Information Content Studies with the Pre-Aerosol, Cloud and ocean Ecosystem (PACE) Ocean Color Imager (OCI)

NASA Astrophysics Data System (ADS)

Coddington, Odele; Platnick, Steven; Pilewskie, Peter; Schmidt, Sebastian

2016-04-01

The NASA Pre-Aerosol, Cloud and ocean Ecosystem (PACE) Science Definition Team (SDT) report released in 2012 defined imager stability requirements for the Ocean Color Instrument (OCI) at the sub-percent level. While the instrument suite and measurement requirements are currently being determined, the PACE SDT report provided details on imager options and spectral specifications. The options for a threshold instrument included a hyperspectral imager from 350-800 nm, two near-infrared (NIR) channels, and three short wave infrared (SWIR) channels at 1240, 1640, and 2130 nm. Other instrument options include a variation of the threshold instrument with 3 additional spectral channels at 940, 1378, and 2250 nm and the inclusion of a spectral polarimeter. In this work, we present cloud retrieval information content studies of optical thickness, droplet effective radius, and thermodynamic phase to quantify the potential for continuing the low cloud climate data record established by the MOderate Resolution and Imaging Spectroradiometer (MODIS) and Visible Infrared Imaging Radiometer Suite (VIIRS) missions with the PACE OCI instrument (i.e., non-polarized cloud reflectances and in the absence of midwave and longwave infrared channels). The information content analysis is performed using the GEneralized Nonlinear Retrieval Analysis (GENRA) methodology and the Collection 6 simulated cloud reflectance data for the common MODIS/VIIRS algorithm (MODAWG) for Cloud Mask, Cloud-Top, and Optical Properties. We show that using both channels near 2 microns improves the probability of cloud phase discrimination with shortwave-only cloud reflectance retrievals. Ongoing work will extend the information content analysis, currently performed for dark ocean surfaces, to different land surface types.

Medicare Advantage: options for standardizing benefits and information to improve consumer choice.

PubMed

O'Brien, Ellen; Hoadley, Jack

2008-04-01

The Medicare Advantage (MA) program offers beneficiaries a choice of private health plans as alternatives to the traditional fee-for-service Medicare program. MA plans potentially provide additional value, but as plan choices have proliferated, consumers contemplating their options have had difficulty understanding how they differ. Through "standardization" more consistent types of information and a limited number of dimensions along which plans vary--MA plans could reduce complexity and improve beneficiaries' ability to make informed choices. Such standardization steps would offer more meaningful variation in the health coverage options available to beneficiaries, Medicare officials and their community partners would find it far easier to educate beneficiaries about their health plan choices, and beneficiaries would better understand what they were buying. Standardization might also strengthen the ability of the market-based Medicare Advantage program to incorporate beneficiary preferences.

Integration options for high energy efficiency and improved economics in a wood-to-ethanol process.

PubMed

Sassner, Per; Zacchi, Guido

2008-04-15

There is currently a steady increase in the use of wood-based fuels for heat and power production in Sweden. A major proportion of these fuels could serve as feedstock for ethanol production. In this study various options for the utilization of the solid residue formed during ethanol production from spruce, such as the production of pellets, electricity and heat for district heating, were compared in terms of overall energy efficiency and production cost. The effects of changes in the process performance, such as variations in the ethanol yield and/or the energy demand, were also studied. The process was based on SO2-catalysed steam pretreatment, which was followed by simultaneous saccharification and fermentation. A model including all the major process steps was implemented in the commercial flow-sheeting program Aspen Plus, the model input was based on data recently obtained on lab scale or in a process development unit. For the five base case scenarios presented in the paper the overall energy efficiency ranged from 53 to 92%, based on the lower heating values, and a minimum ethanol selling price from 3.87 to 4.73 Swedish kronor per litre (0.41-0.50 EUR/L); however, ethanol production was performed in essentially the same way in each base case scenario. (Highly realistic) improvements in the ethanol yield and reductions in the energy demand resulted in significantly lower production costs for all scenarios. Although ethanol was shown to be the main product, i.e. yielding the major part of the income, the co-product revenue had a considerable effect on the process economics and the importance of good utilization of the entire feedstock was clearly shown. With the assumed prices of the co-products, utilization of the excess solid residue for heat and power production was highly economically favourable. The study also showed that improvements in the ethanol yield and reductions in the energy demand resulted in significant production cost reductions almost independently of each other.

78 FR 77365 - Federal Employees' Group Life Insurance Program: Options B and C

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... 3206-AM96 Federal Employees' Group Life Insurance Program: Options B and C AGENCY: U.S. Office of... proposing to amend the Federal Employees' Group Life Insurance (FEGLI) regulations to provide an election... into law. This law, the Federal Employees Life Insurance Improvement Act, changed many parts of the...

77 FR 75243 - Self-Regulatory Organizations; Options Clearing Corporation; Order Approving Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... modeling and risk management procedures (``Risk Management Proposal'') \\9\\ is approved by the Commission.... The enhancements are part of OCC's ongoing efforts to test and improve its risk management operations... Index Options,\\12\\ and only subject to the filing and approval of the Risk Management Proposal, as...

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

ERIC Educational Resources Information Center

Hansen, Kenneth H.

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

Improving Career Exploration Using Psychometric Technology.

ERIC Educational Resources Information Center

Wegner, Kenneth W.

In most interest inventories, a single stimulus item is presented and the respondent indicates a preference in terms of degree of like, dislike, or indifference. This approach provides normative scales with scores that may be compared with various group distributions. The forced choice of options adds to the score on the scale for option selected…

75 FR 57313 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-62902; File No. SR-CBOE-2010-081] Self... Options Executed in Open Outcry or in the Automated Improvement Mechanism September 14, 2010. Pursuant to... notice to solicit comments on the proposed rule change from interested persons. I. Self-Regulatory...

76 FR 40948 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-64817; File No. SR-CBOE-2011-059] Self... Customer Orders in SPY Options Executed in Open Outcry or in the Automated Improvement Mechanism July 6...)(2). I. Self-Regulatory Organization's Statement of the Terms of Substance of the Proposed Rule...

75 FR 76770 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated: Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-09

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-63422; File No. SR-CBOE-2010-105] Self... Orders in SPDR Options Executed in Open Outcry or in the Automated Improvement Mechanism December 3, 2010... notice to solicit comments on the proposed rule change from interested persons. I. Self-Regulatory...

Towards cost-effective reliability through visualization of the reliability option space

NASA Technical Reports Server (NTRS)

Feather, Martin S.

2004-01-01

In planning a complex system's development there can be many options to improve its reliability. Typically their sum total cost exceeds the budget available, so it is necessary to select judiciously from among them. Reliability models can be employed to calculate the cost and reliability implications of a candidate selection.

Enhanced Decision-Making: The Use of a Videotape Decision-Aid for Patients with Prostate Cancer.

ERIC Educational Resources Information Center

Schapira, Marilyn M.; Meade, Cathy; Nattinger, Ann B.

1997-01-01

The development of a videotape for patients considering treatment options for clinically localized prostate cancer is described. The effectiveness of videotape in improving short-term recall of treatment options and outcomes was assessed quantitatively; qualitative analysis was used to assess the likelihood of patient's active participation in the…