Performance Analysis of Blind Subspace-Based Signature Estimation Algorithms for DS-CDMA Systems with Unknown Correlated Noise

NASA Astrophysics Data System (ADS)

Zarifi, Keyvan; Gershman, Alex B.

2006-12-01

We analyze the performance of two popular blind subspace-based signature waveform estimation techniques proposed by Wang and Poor and Buzzi and Poor for direct-sequence code division multiple-access (DS-CDMA) systems with unknown correlated noise. Using the first-order perturbation theory, analytical expressions for the mean-square error (MSE) of these algorithms are derived. We also obtain simple high SNR approximations of the MSE expressions which explicitly clarify how the performance of these techniques depends on the environmental parameters and how it is related to that of the conventional techniques that are based on the standard white noise assumption. Numerical examples further verify the consistency of the obtained analytical results with simulation results.

Non-compliance to the continuous ambulatory peritoneal dialysis procedure increases the risk of peritonitis.

PubMed

Mawar, Shashi; Gupta, Sanjay; Mahajan, Sandeep

2012-08-01

Peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) is the leading cause of technique failure. Information on the impact of non-compliance in performing CAPD exchange on peritonitis is limited. We aimed to find the prevalence of non-compliance to the CAPD procedure and its influence on the incidence of peritonitis. This observational study included 30 adult patients undergoing CAPD. The CAPD exchange procedure was observed at home and assessed as per the structured checklist and categorized into poor, average and good compliance. The compliance was correlated with the episodes of peritonitis in previous 1 year. The patients' mean age was 52 ± 13 years and the mean duration of CAPD was 2.1 ± 0.9 years. Only 16.5% of patients were good performers, while 67% were average performers, and 16.5% were poor performers. The technique skill was similar across all the steps of the procedure. The most common improperly performed steps were: not putting on a face mask in 68%, not flushing the tubing system in 60%, and not washing hands in 24%. Poor adherence to procedure was independent of age, gender, education and duration of dialysis. Ten episodes of peritonitis occurred in 5 patients over 1-year period. Peritonitis occurred in 60% of poor performers, whereas fully compliant patients had no peritonitis. Also 40% of the poorly compliant patients had multiple episodes of peritonitis. Poor compliance in performing the CAPD procedure is a modifiable risk factor for peritonitis. Adherence to recommended aseptic technique is the cornerstone of peritonitis prevention.

Real-time enhanced vision system

NASA Astrophysics Data System (ADS)

Hines, Glenn D.; Rahman, Zia-ur; Jobson, Daniel J.; Woodell, Glenn A.; Harrah, Steven D.

2005-05-01

Flying in poor visibility conditions, such as rain, snow, fog or haze, is inherently dangerous. However these conditions can occur at nearly any location, so inevitably pilots must successfully navigate through them. At NASA Langley Research Center (LaRC), under support of the Aviation Safety and Security Program Office and the Systems Engineering Directorate, we are developing an Enhanced Vision System (EVS) that combines image enhancement and synthetic vision elements to assist pilots flying through adverse weather conditions. This system uses a combination of forward-looking infrared and visible sensors for data acquisition. A core function of the system is to enhance and fuse the sensor data in order to increase the information content and quality of the captured imagery. These operations must be performed in real-time for the pilot to use while flying. For image enhancement, we are using the LaRC patented Retinex algorithm since it performs exceptionally well for improving low-contrast range imagery typically seen during poor visibility poor visibility conditions. In general, real-time operation of the Retinex requires specialized hardware. To date, we have successfully implemented a single-sensor real-time version of the Retinex on several different Digital Signal Processor (DSP) platforms. In this paper we give an overview of the EVS and its performance requirements for real-time enhancement and fusion and we discuss our current real-time Retinex implementations on DSPs.

LAPAROSCOPIC SALPINGECTOMY IN TWO CAPTIVE LEOPARDS (PANTHERA PARDUS) USING A SINGLE PORTAL ACCESS SYSTEM.

PubMed

Hartman, Marthinus J; Monnet, Eric; Kirberger, Robert M; Schoeman, Johan P

2015-12-01

Laparoscopic salpingectomy was performed in two adult leopards (Panthera pardus) using a single portal access system, with a multicannulated single-incision laparoscopic surgery port, without any complications. The poorly developed ovarian bursa provided easy access to the uterine tube for salpingectomy. Laparoscopic salpingectomy can be safely performed in the leopard using a single portal access system.

Coaches' Voices Bring 6 Lessons to Light

ERIC Educational Resources Information Center

Brady, Cheryl H.

2007-01-01

In 1996, the Kansas City (Kan.) Public Schools, a largely poor, urban system, was facing a crisis. Talk at local and state levels was about closing a number of poor-performing schools. The author discusses how the district took matters in hand to make significant changes. Partnering with the local National Education Association leadership,…

Impaired Patient-Reported Outcomes Predict Poor School Functioning and Daytime Sleepiness: The PROMIS Pediatric Asthma Study.

PubMed

Jones, Conor M; DeWalt, Darren A; Huang, I-Chan

Poor asthma control in children is related to impaired patient-reported outcomes (PROs; eg, fatigue, depressive symptoms, anxiety), but less well studied is the effect of PROs on children's school performance and sleep outcomes. In this study we investigated whether the consistency status of PROs over time affected school functioning and daytime sleepiness in children with asthma. Of the 238 children with asthma enrolled in the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Study, 169 children who provided survey data for all 4 time points were used in the analysis. The child's PROs, school functioning, and daytime sleepiness were measured 4 times within a 15-month period. PRO domains included asthma impact, pain interference, fatigue, depressive symptoms, anxiety, and mobility. Each child was classified as having poor/fair versus good PROs per meaningful cut points. The consistency status of each domain was classified as consistently poor/fair if poor/fair status was present for at least 3 time points; otherwise, the status was classified as consistently good. Seemingly unrelated regression was performed to test if consistently poor/fair PROs predicted impaired school functioning and daytime sleepiness at the fourth time point. Consistently poor/fair in all PRO domains was significantly associated with impaired school functioning and excessive daytime sleepiness (Ps < .01) after controlling for the influence of the child's age, sex, and race/ethnicity. Children with asthma with consistently poor/fair PROs are at risk of poor school functioning and daytime sleepiness. Developing child-friendly PRO assessment systems to track PROs can inform potential problems in the school setting. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Hard metal exposures. Part 1: Observed performance of three local exhaust ventilation systems.

PubMed

Guffey, S E; Simcox, N; Booth, D W; Hibbard, R; Stebbins, A

2000-04-01

Not every ventilation system performs as intended; much can be learned when they do not. The purpose of this study was to compare observed initial performance to expected levels for three saw-reconditioning shop ventilation systems and to characterize the changes in performance of the systems over a one-year period. These three local exhaust ventilation systems were intended to control worker exposures to cobalt, cadmium, and chromium during wet grinding, dry grinding, and welding/brazing activities. Prior to installation the authors provided some design guidance based on Industrial Ventilation, a Manual of Recommended Practice. However, the authors had limited influence on the actual installation and operation and no line authority for the systems. In apparent efforts to cut costs and to respond to other perceived needs, the installed systems deviated from the specifications used in pressure calculations in many important aspects, including adding branch ducts, use of flexible ducts, the choice of fans, and the construction of some hoods. After installation of the three systems, ventilation measurements were taken to determine if the systems met design specifications, and worker exposures were measured to determine effectiveness. The results of the latter will be published as a companion article. The deviations from design and maintenance failures may have adversely affected performance. From the beginning to the end of the study period the distribution of air flow never matched the design specifications for the systems. The observed air flows measured within the first month of installation did not match the predicated design air flows for any of the systems, probably because of the differences between the design and the installed system. Over the first year of operation, hood air flow variability was high due to inadequate cleaning of the sticky process materials which rapidly accumulated in the branch ducts. Poor distribution of air flows among branch ducts frequently produced individual hood air flows that were far below specified design levels even when the total air flow through that system was more than adequate. To experienced practitioners, it is not surprising that deviations from design recommendations and poor maintenance would be associated with poor system performance. Although commonplace, such experiences have not been documented in peer-reviewed publications to date. This publication is a first step in providing that documentation.

Goats Don't Wear Coats: An Examination of Semantic Interference in Rhyming Assessments of Reading Readiness for English Language Learners

ERIC Educational Resources Information Center

Moreira, Sylvia; Hamilton, Maryellen

2006-01-01

Rhyming tests have historically been used in the education system to assess reading readiness. English language learners (ELLs) have consistently scored poorly on these assessment tools. The current article examines a possible reason for this poor performance by ELLs. Specifically, the authors examined the relationship between semantic…

Children's catching performance when the demands on the postural system is altered.

PubMed

Angelakopoulos, Georgios T; Tsorbatzoudis, Haralambos; Grouios, George

2014-07-01

In many dynamic interceptive actions performers need to integrate activity of manual and postural subsystems for successful performance. Groups of different skill level (poor and good catchers), (mean age = 9.1 and 9.4 respectively) were required to perform one-handed catches under different postural constraints: standing; standing in contact with a postural support aid by their side (PSAS) or to the left of their trunk (PSAF); Tandem; and sitting (control). Results revealed that, for poor catchers, the number of successful catches increased and grasp errors decreased significantly when sitting and with both postural aids in comparison with standing alone and Tandem conditions. Kinematic analyses showed that the postural aid devices reduced head sway in the anterior-posterior direction, while the PSAF reduced lateral head sway. The poor catchers' performance benefited from an enlarged support surface, and reduction of lateral sway. Good catchers performed successfully under all task constraints, signifying the existence of a functional relationship between postural and grasping subsystems during performance. The results are discussed in the frame of Bernstein's (1967) and Newell's (1986) theory.

Processing Solvent Dependent Morphology of Diketopyrrolopyrrole (DPP) based Low Band Gap Polymer and PCBM Blends

NASA Astrophysics Data System (ADS)

Ferdous, Sunzida; Liu, Feng; Russell, Thomas

2013-03-01

Solution processing of polymer semiconductors is widely used for fabrication of low cost organic solar cells. Recently, mixed solvent systems or additive based systems for fabricating polymer solar cells have proven to be beneficial for obtaining high performance devices with multi-length scale morphologies. To control the morphology during the processing step, one needs to understand the effect of solvent as it evaporates to form the final thin film structure. In this study, we used diketopyrrolopyrrole (DPP) based low band gap polymer and phenyl-C71-butyric acid methyl ester (PCBM) blend in a series of mixed solvent systems consisting of a good solvent for both of the active material components, as well as different solvents that are good solvents for PCBM, but poor solvents for the polymer. Different evaporation times of the poor solvents during the drying process, and different solubility of the polymer in these poor solvents as well as their interaction with the substrate play an important role in the final morphology. In-situ GIWAXS studies were performed to observe the evolution of the structure as the solvent evaporates. The final morphologies of the thin film devices were also characterized by AFM, TEM, and various x-ray scattering techniques to correlate the morphology with the obtained device performances.

A Review of On-Site Wastewater Treatment Systems in Western Australia from 1997 to 2011

PubMed Central

Gunady, Maria; Shishkina, Natalia; Tan, Henry; Rodriguez, Clemencia

2015-01-01

On-site wastewater treatment systems (OWTS) are widely used in Western Australia (WA) to treat and dispose of household wastewater in areas where centralized sewerage systems are unavailable. Septic tanks, aerobic treatment units (ATUs), and composting toilets with greywater systems are among the most well established and commonly used OWTS. However, there are concerns that some OWTS installed in WA are either performing below expected standards or failing. Poorly performing OWTS are often attributed to inadequate installation, inadequate maintenance, poor public awareness, insufficient local authority resources, ongoing wastewater management issues, or inadequate adoption of standards, procedures, and guidelines. This paper is to review the installations and failures of OWTS in WA. Recommendations to the Department of Health Western Australia (DOHWA) and Local Government (LG) in regard to management strategies and institutional arrangements of OWTS are also highlighted. PMID:25960745

An Expert System for the Development of Efficient Parallel Code

NASA Technical Reports Server (NTRS)

Jost, Gabriele; Chun, Robert; Jin, Hao-Qiang; Labarta, Jesus; Gimenez, Judit

2004-01-01

We have built the prototype of an expert system to assist the user in the development of efficient parallel code. The system was integrated into the parallel programming environment that is currently being developed at NASA Ames. The expert system interfaces to tools for automatic parallelization and performance analysis. It uses static program structure information and performance data in order to automatically determine causes of poor performance and to make suggestions for improvements. In this paper we give an overview of our programming environment, describe the prototype implementation of our expert system, and demonstrate its usefulness with several case studies.

Solar-energy-system performance evaluation, October 1980-August 1981

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

Wetzel, P.E.

The solar site is an Animal Quarantine Center in Upton, New York, using 2484 ft/sup 2/ of flat-plate collectors and 5300 gallons of solar hot water storage located outside and above ground. The system was designed to provide 20% of the annual heating load and 100% of the annual domestic hot water load. The solar system actually provided 5% of the total system load. Many control and mechanical malfunctions contributed to the poor performance. (MHR)

The effects of long-term 20 mg/L carbon dioxide exposure on the health and performance of Atlantic salmon Salmo salar post-smolts in water recirculation aquaculture systems

USDA-ARS?s Scientific Manuscript database

Previous research and experience has linked elevated dissolved carbon dioxide (CO2) to reduced growth performance, poor feed conversion, and a variety of health issues in farm-raised fish, including Atlantic salmon Salmo salar. Supplemental control measures in water recirculation aquaculture systems...

COMPUTER TOOLS FOR SANITARY SEWER SYSTEM CAPACITY ANALYSIS AND PLANNING

EPA Science Inventory

Rainfall-derived infiltration and inflow (RDII) into sanitary sewer systems has long been recognized as a major source of operating problems, causing poor performance of many sewer systems. RDII is the main cause of SSOs to customer basements, streets, or nearby streams and can a...

Development of Plant Control Diagnosis Technology and Increasing Its Applications

NASA Astrophysics Data System (ADS)

Kugemoto, Hidekazu; Yoshimura, Satoshi; Hashizume, Satoru; Kageyama, Takashi; Yamamoto, Toru

A plant control diagnosis technology was developed to improve the performance of plant-wide control and maintain high productivity of plants. The control performance diagnosis system containing this technology picks out the poor performance loop, analyzes the cause, and outputs the result on the Web page. Meanwhile, the PID tuning tool is used to tune extracted loops from the control performance diagnosis system. It has an advantage of tuning safely without process changes. These systems are powerful tools to do Kaizen (continuous improvement efforts) step by step, coordinating with the operator. This paper describes a practical technique regarding the diagnosis system and its industrial applications.

Improving Teaching Effectiveness: Merit Pay vs. Organizational Culture.

ERIC Educational Resources Information Center

Bushardt, Stephen C.; Fowler, Aubrey R.

1987-01-01

Identifies four conditions which cause merit pay systems to fail to increase teacher performance: lack of skills, the poor timing of rewards, an inability to measure performance; and competing reinforcers. Explains why organizational culture is a more effective mediator of rewards. (SD)

An Analysis of Operating Room Performance Metrics at Reynolds Army Community Hospital

DTIC Science & Technology

2009-06-28

and Disorders of the Male Reproductive System Diseases and Disorders of the Blood, Blood Forming Organs, Immunological Myeloproliferative Diseases and...Disorders, Poorly Differentiated Neoplasm Infectious and Parasitic Diseases, Systemic or Unspecified Sites Injuries, Poisonings and Toxic Effects

Inequality, Segregation and Poor Performance: The Education System in Northern Ireland

ERIC Educational Resources Information Center

Borooah, Vani K.; Knox, Colin

2017-01-01

Northern Ireland is now a post-conflict society but one of the legacies of the "troubles" is an education system which is defined by religious affiliation/identity. A parallel system of schools continues to exist where Catholics largely attend "maintained" schools and Protestants "controlled" or state schools. While…

Performance Appraisal in an Academic Library: A Case Study.

ERIC Educational Resources Information Center

George, Verna E.

Well-designed performance appraisals should provide employees with feedback concerning their performance, serve as a basis for modifying behavior toward more effective work habits, and provide managers with data which they can use to judge future job assignments and compensation. Poorly-designed ones, used as short-term control systems, can create…

Assembling nanoparticle coatings to improve the drug delivery performance of lipid based colloids

NASA Astrophysics Data System (ADS)

Simovic, Spomenka; Barnes, Timothy J.; Tan, Angel; Prestidge, Clive A.

2012-02-01

Lipid based colloids (e.g. emulsions and liposomes) are widely used as drug delivery systems, but often suffer from physical instabilities and non-ideal drug encapsulation and delivery performance. We review the application of engineered nanoparticle layers at the interface of lipid colloids to improve their performance as drug delivery systems. In addition we focus on the creation of novel hybrid nanomaterials from nanoparticle-lipid colloid assemblies and their drug delivery applications. Specifically, nanoparticle layers can be engineered to enhance the physical stability of submicron lipid emulsions and liposomes, satbilise encapsulated active ingredients against chemical degradation, control molecular transport and improve the dermal and oral delivery characteristics, i.e. increase absorption, bioavailability and facilitate targeted delivery. It is feasible that hybrid nanomaterials composed of nanoparticles and colloidal lipids are effective encapsulation and delivery systems for both poorly soluble drugs and biological drugs and may form the basis for the next generation of medicines. Additional pre-clinical research including specific animal model studies are required to advance the peptide/protein delivery systems, whereas the silica lipid hybrid systems have now entered human clinical trials for poorly soluble drugs.

Unsatisfactory Performance: How California's K-12 Education System Protects Mediocrity and How Teacher Quality Can Be Improved.

ERIC Educational Resources Information Center

Dawson, Thomas C.; Billingsley, K. Lloyd

This study examines the quality of California's K-12 education, discussing how the system protects mediocrity and how to improve educational quality in the state. It explains that what most ails the teaching force is that excellent teachers are not rewarded for superior work, and failing teachers are rarely held accountable for poor performance.…

Poor Performance Among Trainees in a Dutch Postgraduate GP Training Program.

PubMed

Vermeulen, Margit I; Kuyvenhoven, Marijke M; de Groot, Esther; Zuithoff, Nicolaas Pa; Pieters, Honore M; van der Graaf, Yolanda; Damoiseaux, Roger Amj

2016-06-01

Poor performance among trainees is an important issue, for patient safety and economic reasons. While early identification might enhance remediation measures, we explored the frequency, nature, and risk factors of poor performance in a Dutch postgraduate general practitioner (GP) training program. All trainees who started the GP training between 2005 and 2007 were included. Multivariate logistic regression analysis was applied to examine associations between individual characteristics; early assessments of competencies and knowledge, training process characteristics (eg, illness, maternal leave), and the outcome poor performance; sub-analyses were performed for each year. A total of 215 trainees started the 3-year GP program, and 49 (22.8%) exhibited poor performance (in one or more years). In the first and second years, problem areas among poor performers were equally distributed across the roles of "medical expert," "communicator," and "professional." In the third year, shortcomings in "professionalism" were the most common problem. Increasing age was a risk factor for poor performance as were insufficient scores in communication and knowledge. Poor performance in the previous year was a risk factor for poor performance in the second and third years; OR=4.20 (CI=1.31--13.47) and OR=5.40 (CI=1.58--18.47), respectively. Poor performance is prevalent but primarily occurring within a single training year. This finding suggests that trainees are capable of solving trainee problems. Increasing age, insufficient assessment scores early in the training, and poor performance in a previous year constitute risk factors for poor performance.

Ada issues in implementing ART-Ada

NASA Technical Reports Server (NTRS)

Lee, S. Daniel

1990-01-01

Due to the Ada mandate of a number of government agencies, interest in deploying expert systems such as Ada has increased. Recently, several Ada-based expert system tools have been developed. According to a recent benchmark report, these tools do not perform as well as similar tools written in C. While poorly implemented Ada compilers contribute to the poor benchmark result, some fundamental problems of the Ada language itself have been uncovered. Here, the authors describe Ada language issues encountered during the deployment of ART-Ada, an expert system tool for Ada deployment. ART-Ada is being used to implement several prototype expert systems for the Space Station Freedom and the U.S. Air Force.

Artificial Intelligence In Computational Fluid Dynamics

NASA Technical Reports Server (NTRS)

Vogel, Alison Andrews

1991-01-01

Paper compares four first-generation artificial-intelligence (Al) software systems for computational fluid dynamics. Includes: Expert Cooling Fan Design System (EXFAN), PAN AIR Knowledge System (PAKS), grid-adaptation program MITOSIS, and Expert Zonal Grid Generation (EZGrid). Focuses on knowledge-based ("expert") software systems. Analyzes intended tasks, kinds of knowledge possessed, magnitude of effort required to codify knowledge, how quickly constructed, performances, and return on investment. On basis of comparison, concludes Al most successful when applied to well-formulated problems solved by classifying or selecting preenumerated solutions. In contrast, application of Al to poorly understood or poorly formulated problems generally results in long development time and large investment of effort, with no guarantee of success.

From many deaths to some few cases of drug-resistant tuberculosis: travelling with the systems quality improvement model in Lacs Health District, Togo

PubMed Central

Afanvi, Kossivi Agbelenko

2015-01-01

The ultimate goal of every tuberculosis (TB) treatment program is a high treatment success rate. Treatment success is extremely important because, when the rate is high, it significantly contributes to declining numbers of new cases by reducing the number and period of infectious cases, TB morbidity and mortality, and prevents the emergence of resistant strains. Our aim was to decrease TB mortality by increasing pulmonary TB patients’ treatment success rate to at least 85 % in Lacs Health District by end of July 2014. A systems and dialogic analysis of the public health system related to TB patients’ treatment revealed that it was not performing well; we found weak coverage and quality of TB services, a poorly-functioning TB health information system, poor-performing health workforce, poor availability of HIV tests and antiretroviral for TB patients, and low degree of patients’ participation in their care. We redesigned the system to correct those weaknesses. The effectiveness of these changes was monitored using plan, do, study, act (PDSA) cycles. We increased TB patient success rate from 80% to 95% between February 2012 and July 2014.The mortality rate dropped from 13% to 3% and the failure to follow-up rate dropped from 3% to 2%. In conclusion, district health systems performance depends on factors such as the closeness of services to population; skilled workforce; the ability to collect and analyze data and use information for action; population empowerment, and good management and improvement capabilities of management team especially the public health director. High TB patients’ success rate depends also on the availability of antiretroviral drugs. It is highly important that every district health management team member develops improvement capabilities. PMID:26734412

The dysfunctional consequences of a performance measurement system: the case of the Iranian national hospital grading programme.

PubMed

Aryankhesal, Aidin; Sheldon, Trevor A; Mannion, Russell; Mahdipour, Saeade

2015-07-01

Performance measurement systems are increasingly used to reward and improve provider performance. However, such initiatives may also inadvertently induce a range of unintended and dysfunctional side-effects. This study explores the unintended and adverse consequences induced by the Iranian national hospital grading programme, which incorporates financial incentives for meeting nationally defined standards. We interviewed key informants across four key groups with a legitimate interest in healthcare performance: four purposively selected hospitals; four health insurance organizations; the Iranian hospital accreditation body; and one grading agency. The transcribed interviews and field notes were analysed thematically, and subsequently, member checking was conducted. Seven dysfunctional consequences were identified: misrepresentation of data by hospitals; increased anxiety and stress among hospital employees; tunnel vision; financial pressures on poorly graded hospitals; incentives to purchase unnecessary equipment; erosion of public trust; and restricting access to hospital services by patients. These were caused by the way the grading system was implemented: poor standards of audit; the way in which the audit process was conducted; and the timing of audits. The pay for performance element of the grading system and the focus on structural aspects in the standards made improvement in grading particularly difficult for those hospitals that had been assessed as under-performing. Although the Iranian hospital grading system has resulted in a significant increase in the adoption of national standards, it has nevertheless induced a range of perverse outcomes. To mitigate these requires further refinement and recalibration of the system. © The Author(s) 2015.

Black-white disparity in physical performance among older women with newly diagnosed non-metastatic breast cancer: Exploring the role of inflammation and physical activity.

PubMed

Owusu, Cynthia; Schluchter, Mark; Koroukian, Siran M; Schmitz, Kathryn H; Berger, Nathan A

2018-04-23

To examine racial differences in physical performance among older women with newly diagnosed non-metastatic breast cancer and identify clinical, behavioral and biological factors that might contribute to such disparities. This is a cross-sectional study of women aged ≥65 years with newly diagnosed stage I-III breast cancer recruited from ambulatory oncology clinics at an academic center, between September 2010 and August 2015. Participants completed a Comprehensive Geriatric Assessment and laboratory testing for biomarkers of inflammation [interleukin-6 (IL6)] prior to receiving systemic treatment for cancer. The primary outcome was poor physical performance, defined as scoring ≤7 on the Short Physical Performance Battery, Yes or No. Logistic regression analyses were undertaken. Among 135 women with mean age of 74.8 years (SD = 6.9), 31% were African-American (AA), and 33% had poor physical performance. Controlling for age, education, comorbidities and geriatric syndromes, participants with poor physical performance were more likely to be AA [versus (vs.) Non-Hispanic Whites (NHW)], odds ratio (OR) = 3.10, 95% confidence interval (CI) = 1.18-8.15. Controlling further for physical activity (PA) attenuated the racial disparity in physical performance (OR = 2.50, CI = 0.91-6.84). Lastly, controlling for IL6 further diminished the racial disparity in physical performance (OR = 1.93, CI = 0.67-5.56). In adjusted models, PA and IL6 explained 29% and 38%, respectively, of the racial disparity in poor physical performance. Among older women with newly diagnosed non-metastatic breast cancer, poor physical performance was prevalent and AA were disproportionately affected. Less engagement in physical activity and subclinical inflammation partly contributed to this disparity. Copyright © 2018 Elsevier Inc. All rights reserved.

Paediatric cerebrovascular CT angiography-towards better image quality.

PubMed

Thust, Stefanie C; Chong, Wui Khean Kling; Gunny, Roxana; Mazumder, Asif; Poitelea, Marius; Welsh, Anna; Ederies, Ash; Mankad, Kshitij

2014-12-01

Paediatric cerebrovascular CT angiography (CTA) can be challenging to perform due to variable cardiovascular physiology between different age groups and the risk of movement artefact. This analysis aimed to determine what proportion of CTA at our institution was of diagnostic quality and identify technical factors which could be improved. a retrospective analysis of 20 cases was performed at a national paediatric neurovascular centre assessing image quality with a subjective scoring system and Hounsfield Unit (HU) measurements. Demographic data, contrast dose, flow rate and triggering times were recorded for each patient. Using a qualitative scoring system, 75% of studies were found to be of diagnostic quality (n=9 'good', n=6 'satisfactory') and 25% (n=5) were 'poor'. Those judged subjectively to be poor had arterial contrast density measured at less than 250 HU. Increased arterial opacification was achieved for cases performed with an increased flow rate (2.5-4 mL/s) and higher intravenous contrast dose (2 mL/kg). Triggering was found to be well timed in nine cases, early in four cases and late in seven cases. Of the scans triggered early, 75% were poor. Of the scans triggered late, less (29%) were poor. High flow rates (>2.5 mL/s) were a key factor for achieving high quality paediatric cerebrovascular CTA imaging. However, appropriate triggering by starting the scan immediately on contrast opacification of the monitoring vessel plays an important role and could maintain image quality when flow rates were lower. Early triggering appeared more detrimental than late.

Model Error Budgets

NASA Technical Reports Server (NTRS)

Briggs, Hugh C.

2008-01-01

An error budget is a commonly used tool in design of complex aerospace systems. It represents system performance requirements in terms of allowable errors and flows these down through a hierarchical structure to lower assemblies and components. The requirements may simply be 'allocated' based upon heuristics or experience, or they may be designed through use of physics-based models. This paper presents a basis for developing an error budget for models of the system, as opposed to the system itself. The need for model error budgets arises when system models are a principle design agent as is increasingly more common for poorly testable high performance space systems.

National Assessment and the Opportunity to Learn in Educational Reform

ERIC Educational Resources Information Center

Snyder, Conrad Wesley, Jr.; Mereku, Kofi D.; Amedahe, Francis K.; Etsey, Kofui; Adu, John

2013-01-01

Over two decades, national assessments in Ghana have revealed generally poor performances across curriculum-based tests for primary school (Grades 1-6). Various reform agendas have been applied to the education system, sometimes with isolated success, but the overall performances remained stable and low. Surveying teacher mentors in schools…

Loran digital phase-locked loop and RF front-end system error analysis

NASA Technical Reports Server (NTRS)

Mccall, D. L.

1979-01-01

An analysis of the system performance of the digital phase locked loops (DPLL) and RF front end that are implemented in the MINI-L4 Loran receiver is presented. Three of the four experiments deal with the performance of the digital phase locked loops. The other experiment deals with the RF front end and DPLL system error which arise in the front end due to poor signal to noise ratios. The ability of the DPLLs to track the offsets is studied.

Mirror Me: Imitative Responses in Adults with Autism

ERIC Educational Resources Information Center

Schunke, Odette; Schöttle, Daniel; Vettorazzi, Eik; Brandt, Valerie; Kahl, Ursula; Bäumer, Tobias; Ganos, Christos; David, Nicole; Peiker, Ina; Engel, Andreas K; Brass, Marcel; Münchau, Alexander

2016-01-01

Dysfunctions of the human mirror neuron system have been postulated to underlie some deficits in autism spectrum disorders including poor imitative performance and impaired social skills. Using three reaction time experiments addressing mirror neuron system functions under simple and complex conditions, we examined 20 adult autism spectrum…

Cholinergic control over attention in rats prone to attribute incentive salience to reward cues

PubMed Central

Paolone, Giovanna; Angelakos, Christopher C.; Meyer, Paul J.; Robinson, Terry E.; Sarter, Martin

2013-01-01

Some rats (sign-trackers, ST) are especially prone to attribute incentive salience to reward cues, relative to others (goal-trackers, GT). Thus, reward cues are more likely to promote maladaptive reward-seeking behavior in ST than GT. Here, we asked whether ST and GT differ on another trait that can contribute to poor restraint over behavior evoked by reward cues. We report that, relative to GT, ST have poor control over attentional performance, due in part to insufficient cholinergic stimulation of cortical circuitry. We found that, relative to GT, ST showed poor performance on a sustained attention task (SAT). Furthermore, their performance fluctuated rapidly between periods of good to near-chance performance. This finding was reproduced using a separate cohort of rats. As demonstrated earlier, performance on the SAT was associated with increases in extracellular levels of cortical acetylcholine (ACh); however, SAT performance-associated increases in ACh levels were significantly attenuated in ST relative to GT. Consistent with the view that the modulatory effects of ACh involves stimulation of α4β2* nicotinic acetylcholine receptors (nAChRs), systemic administration of the partial nAChR agonist ABT-089 improved SAT performance in ST and abolished the difference between SAT-associated ACh levels in ST and GT. Neither the nonselective nAChR agonist nicotine nor the psychostimulant amphetamine improved SAT performance. These findings suggest that individuals who have a propensity to attribute high incentive salience to reward cues also exhibit relatively poor attentional control. A combination of these traits may render individuals especially vulnerable to disorders such as obesity and addiction. PMID:23658172

Forever Alone? Testing Single Eccentric Planetary Systems for Multiple Companions

NASA Astrophysics Data System (ADS)

Wittenmyer, Robert A.; Wang, Songhu; Horner, Jonathan; Tinney, C. G.; Butler, R. P.; Jones, H. R. A.; O'Toole, S. J.; Bailey, J.; Carter, B. D.; Salter, G. S.; Wright, D.; Zhou, Ji-Lin

2013-09-01

Determining the orbital eccentricity of an extrasolar planet is critically important for understanding the system's dynamical environment and history. However, eccentricity is often poorly determined or entirely mischaracterized due to poor observational sampling, low signal-to-noise, and/or degeneracies with other planetary signals. Some systems previously thought to contain a single, moderate-eccentricity planet have been shown, after further monitoring, to host two planets on nearly circular orbits. We investigate published apparent single-planet systems to see if the available data can be better fit by two lower-eccentricity planets. We identify nine promising candidate systems and perform detailed dynamical tests to confirm the stability of the potential new multiple-planet systems. Finally, we compare the expected orbits of the single- and double-planet scenarios to better inform future observations of these interesting systems.

Selecting HVAC Systems for Schools To Balance the Needs for Indoor Air Quality, Energy Conservation and Maintenance. Technical Bulletin.

ERIC Educational Resources Information Center

Wheeler, Arthur E.; Kunz, Walter S., Jr.

Although poor air quality in a school can have multiple causes, the heating, ventilating, and air-conditioning (HVAC) system plays a major role. Suggestions that architects, facilities managers, school board members, and administrators can use in selecting HVAC systems are discussed. Focus is on the performance criteria for classroom systems, and…

From approach to inhibition: the influence of power on responses to poor performers.

PubMed

Ferguson, Amanda J; Ormiston, Margaret E; Moon, Henry

2010-03-01

This article examines how relative differences in power affect responses to poor performers in organizations. We predicted that higher power individuals would engage in approach-related behaviors, whereas lower power individuals would be inhibited when responding to poor performers. Results from a scenario study and a field study generally supported this prediction, indicating that power was positively related to training or confronting a poor performer and negatively related to compensating for or rejecting a poor performer. A second scenario study investigated the effect of the interaction of power and emotion on individual responses to poor performers. Results showed that the type of emotion expressed moderated the effect of power on inhibition-related responses. We discuss implications for managing poor performers with relative power differences. 2010 APA, all rights reserved

Comparative performances of staging systems for early hepatocellular carcinoma.

PubMed

Nathan, Hari; Mentha, Gilles; Marques, Hugo P; Capussotti, Lorenzo; Majno, Pietro; Aldrighetti, Luca; Pulitano, Carlo; Rubbia-Brandt, Laura; Russolillo, Nadia; Philosophe, Benjamin; Barroso, Eduardo; Ferrero, Alessandro; Schulick, Richard D; Choti, Michael A; Pawlik, Timothy M

2009-08-01

Several staging systems for patients with hepatocellular carcinoma (HCC) have been proposed, but studies of their prognostic accuracy have yielded conflicting conclusions. Stratifying patients with early HCC is of particular interest because these patients may derive the greatest benefit from intervention, yet no studies have evaluated the comparative performances of staging systems in patients with early HCC. A retrospective cohort study was performed using data on 379 patients who underwent liver resection or liver transplantation for HCC at six major hepatobiliary centres in the USA and Europe. The staging systems evaluated were: the Okuda staging system, the International Hepato-Pancreato-Biliary Association (IHPBA) staging system, the Cancer of the Liver Italian Programme (CLIP) score, the Barcelona Clinic Liver Cancer (BCLC) staging system, the Japanese Integrated Staging (JIS) score and the American Joint Committee on Cancer/International Union Against Cancer (AJCC/UICC) staging system, 6th edition. A recently proposed early HCC prognostic score was also evaluated. The discriminative abilities of the staging systems were evaluated using Cox proportional hazards models and the bootstrap-corrected concordance index (c). Overall survival of the cohort was 74% at 3 years and 52% at 5 years, with a median survival of 62 months. Most systems demonstrated poor discriminatory ability (P > 0.05 on Cox proportional hazards analysis, c approximately 0.5). However, the AJCC/UICC system clearly stratified patients (P < 0.001, c = 0.59), albeit only into two groups. The early HCC prognostic score also clearly stratified patients (P < 0.001, c = 0.60) and identified three distinct prognostic groups. The early HCC prognostic score is superior to the AJCC/UICC staging system (6th edition) for predicting the survival of patients with early HCC after liver resection or liver transplantation. Other major HCC staging systems perform poorly in patients with early HCC.

Kinect-Based Virtual Game for the Elderly that Detects Incorrect Body Postures in Real Time

PubMed Central

Saenz-de-Urturi, Zelai; Garcia-Zapirain Soto, Begonya

2016-01-01

Poor posture can result in loss of physical function, which is necessary to preserving independence in later life. Its decline is often the determining factor for loss of independence in the elderly. To avoid this, a system to correct poor posture in the elderly, designed for Kinect-based indoor applications, is proposed in this paper. Due to the importance of maintaining a healthy life style in senior citizens, the system has been integrated into a game which focuses on their physical stimulation. The game encourages users to perform physical activities while the posture correction system helps them to adopt proper posture. The system captures limb node data received from the Kinect sensor in order to detect posture variations in real time. The DTW algorithm compares the original posture with the current one to detect any deviation from the original correct position. The system was tested and achieved a successful detection percentage of 95.20%. Experimental tests performed in a nursing home with different users show the effectiveness of the proposed solution. PMID:27196903

High-intensity focused ultrasound ablation assisted using color Doppler imaging for the treatment of hepatocellular carcinomas.

PubMed

Fukuda, Hiroyuki; Numata, Kazushi; Nozaki, Akito; Kondo, Masaaki; Morimoto, Manabu; Maeda, Shin; Tanaka, Katsuaki; Ohto, Masao; Ito, Ryu; Ishibashi, Yoshiharu; Oshima, Noriyoshi; Ito, Ayao; Zhu, Hui; Wang, Zhi-Biao

2013-12-01

We evaluated the usefulness of color Doppler flow imaging to compensate for the inadequate resolution of the ultrasound (US) monitoring during high-intensity focused ultrasound (HIFU) for the treatment of hepatocellular carcinoma (HCC). US-guided HIFU ablation assisted using color Doppler flow imaging was performed in 11 patients with small HCC (<3 lesions, <3 cm in diameter). The HIFU system (Chongqing Haifu Tech) was used under US guidance. Color Doppler sonographic studies were performed using an HIFU 6150S US imaging unit system and a 2.7-MHz electronic convex probe. The color Doppler images were used because of the influence of multi-reflections and the emergence of hyperecho. In 1 of the 11 patients, multi-reflections were responsible for the poor visualization of the tumor. In 10 cases, the tumor was poorly visualized because of the emergence of a hyperecho. In these cases, the ability to identify the original tumor location on the monitor by referencing the color Doppler images of the portal vein and the hepatic vein was very useful. HIFU treatments were successfully performed in all 11 patients with the assistance of color Doppler imaging. Color Doppler imaging is useful for the treatment of HCC using HIFU, compensating for the occasionally poor visualization provided by B-mode conventional US imaging.

The Use of Magnetoencephalography in Evaluating Human Performance

DTIC Science & Technology

1991-06-01

determines the head cartesian coordinate system, and calculates the locations of the dipole sets in this reference frame. This system is based on an optical ...differences in brain activity are found between imagers and nonimagers , the brain areas which seem to be involved will be localized. 25 3. The poor

The Transfer of Abstract Principles Governing Complex Adaptive Systems

ERIC Educational Resources Information Center

Goldstone, Robert L.; Sakamoto, Yasuaki

2003-01-01

Four experiments explored participants' understanding of the abstract principles governing computer simulations of complex adaptive systems. Experiments 1, 2, and 3 showed better transfer of abstract principles across simulations that were relatively dissimilar, and that this effect was due to participants who performed relatively poorly on the…

Assessment and Develop the Saudi's Contractors Classification System

ERIC Educational Resources Information Center

Almutairi, Saud

2017-01-01

Research has shown that construction projects in Saudi Arabia have had a perceived poor performance for the past three decades, from 1970-2016. The Saudi construction industry relies on a Contractor Classification System (CCS) to determine contractors' capabilities, and prevent underperformance. Through this study, a survey was conducted among…

How well do contoured superior midshaft clavicle plates fit the clavicle? A cadaveric study.

PubMed

Malhas, Amar M; Skarparis, Yiannis G; Sripada, Sankar; Soames, Roger W; Jariwala, Arpit C

2016-06-01

Given the degree of variation in clavicular morphology, 4 clavicle plating systems were examined for their congruity as superior, midshaft, anatomic clavicle (SMAC) plates in a cadaveric study. SMAC plates from 4 manufacturers were applied to 79 dry right human clavicles. Two systems offered multiple (4) variations of plates (MP), 1 offered two variations (TP), and 1 had a single plate (SP). Two examiners applied and clamped the best-fitting plate from each system onto each of the 79 clavicles and then graded them: 1, poor fit; 2, good fit; and 3, anatomic fit. Each examiner repeated the process to assess intraobserver and interobserver reliability. The scores were averaged to produce a final score for each system for each clavicle. The MP systems scored the highest (32%-37% anatomic, 54%-63% good, 5%-8% poor), followed by the TP system (30% anatomic, 53% good, 17% poor), and finally the SP system (9% anatomic, 59% good, 32% poor). Of note, clavicular length significantly correlated with a higher degree of conformity in all plating systems (Spearman rank correlation P < .05 for each system). In clavicles longer than 150 mm, the MP and TP systems performed identically, with the SP system close behind. Contouring of the plate is needed in 73% of cases overall. Plating systems with multiple plate shape variations are more advantageous when dealing with smaller-sized clavicles, typically in females. However, when dealing with larger clavicles, there was no real difference. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Visualization Co-Processing of a CFD Simulation

NASA Technical Reports Server (NTRS)

Vaziri, Arsi

1999-01-01

OVERFLOW, a widely used CFD simulation code, is combined with a visualization system, pV3, to experiment with an environment for simulation/visualization co-processing on a SGI Origin 2000 computer(O2K) system. The shared memory version of the solver is used with the O2K 'pfa' preprocessor invoked to automatically discover parallelism in the source code. No other explicit parallelism is enabled. In order to study the scaling and performance of the visualization co-processing system, sample runs are made with different processor groups in the range of 1 to 254 processors. The data exchange between the visualization system and the simulation system is rapid enough for user interactivity when the problem size is small. This shared memory version of OVERFLOW, with minimal parallelization, does not scale well to an increasing number of available processors. The visualization task takes about 18 to 30% of the total processing time and does not appear to be a major contributor to the poor scaling. Improper load balancing and inter-processor communication overhead are contributors to this poor performance. Work is in progress which is aimed at obtaining improved parallel performance of the solver and removing the limitations of serial data transfer to pV3 by examining various parallelization/communication strategies, including the use of the explicit message passing.

36 CFR 1210.14 - Special award conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... award conditions. If an applicant or recipient has a history of poor performance, is not financially stable, has a management system that does not meet the standards prescribed in this part, has not...

Cognitive and academic functioning of juvenile detainees: implications for correctional populations and public health.

PubMed

Lansing, Amy E; Washburn, Jason J; Abram, Karen M; Thomas, Ursula C; Welty, Leah J; Teplin, Linda A

2014-01-01

Cognitive functioning affects health. This study assessed cognitive functioning among participants in the Northwestern Juvenile Project, a stratified random sample of 1,829 newly detained juveniles (10 to 18 years old) from Cook County, Illinois. The study examined receptive vocabulary, oral reading, arithmetic computation skills, and general intellectual abilities. The sample exhibited impaired overall intellectual functioning and deficits in all areas. Males performed more poorly than females. More than three quarters of males showed below average overall intellectual functioning, and 9 in 10 had below average receptive vocabulary skills. Hispanic and African American males performed more poorly than non-Hispanic White males. The multiple systems that serve delinquent youth--correctional, health, legal, and rehabilitative--must collaborate to tailor needed services to the cognitive level of youth in the juvenile justice system.

Cognitive and academic functioning of juvenile detainees: Implications for correctional populations and public health

PubMed Central

Lansing, Amy E.; Washburn, Jason J.; Abram, Karen M.; Thomas, Ursula C.; Welty, Leah J.; Teplin, Linda A.

2014-01-01

Cognitive functioning affects health. This study assessed cognitive functioning among participants in the Northwestern Juvenile Project, a stratified random sample of 1,829 newly detained juveniles (10-18 years old) from Cook County, Illinois. We examined receptive vocabulary, oral reading, arithmetic computation skills, and general intellectual abilities. Our sample exhibited impaired overall intellectual functioning and deficits in all areas. Males performed more poorly than females overall. More than three-quarters of males showed below average overall intellectual functioning, and nine in ten males had below average receptive vocabulary skills. Hispanic and African American males performed more poorly than non-Hispanic white males; The multiple systems that serve delinquent youth—correctional, health, legal, and rehabilitative—must collaborate to tailor needed services to the cognitive level of youth in the juvenile justice system. PMID:24352405

Imitation and action understanding in autistic spectrum disorders: how valid is the hypothesis of a deficit in the mirror neuron system?

PubMed

Hamilton, Antonia F de C; Brindley, Rachel M; Frith, Uta

2007-04-09

The motor mirror neuron system supports imitation and goal understanding in typical adults. Recently, it has been proposed that a deficit in this mirror neuron system might contribute to poor imitation performance in children with autistic spectrum disorders (ASD) and might be a cause of poor social abilities in these children. We aimed to test this hypothesis by examining the performance of 25 children with ASD and 31 typical children of the same verbal mental age on four action representation tasks and a theory of mind battery. Both typical and autistic children had the same tendency to imitate an adult's goals, to imitate in a mirror fashion and to imitate grasps in a motor planning task. Children with ASD showed superior performance on a gesture recognition task. These imitation and gesture recognition tasks all rely on the mirror neuron system in typical adults, but performance was not impaired in children with ASD. In contrast, the ASD group were impaired on the theory of mind tasks. These results provide clear evidence against a general imitation impairment and a global mirror neuron system deficit in children with autism. We suggest this data can best be understood in terms of multiple brain systems for different types of imitation and action understanding, and that the ability to understand and imitate the goals of hand actions is intact in children with ASD.

Implementation and flight-test of a multi-mode rotorcraft flight-control system for single-pilot use in poor visibility

NASA Technical Reports Server (NTRS)

Hindson, William S.

1987-01-01

A flight investigation was conducted to evaluate a multi-mode flight control system designed according to the most recent recommendations for handling qualities criteria for new military helicopters. The modes and capabilities that were included in the system are those considered necessary to permit divided-attention (single-pilot) lowspeed and hover operations near the ground in poor visibility conditions. Design features included mode-selection and mode-blending logic, the use of an automatic position-hold mode that employed precision measurements of aircraft position, and a hover display which permitted manually-controlled hover flight tasks in simulated instrument conditions. Pilot evaluations of the system were conducted using a multi-segment evaluation task. Pilot comments concerning the use of the system are provided, and flight-test data are presented to show system performance.

E-health systems for management of MDR-TB in resource-poor environments: a decade of experience and recommendations for future work.

PubMed

Fraser, Hamish S F; Habib, Ali; Goodrich, Mark; Thomas, David; Blaya, Joaquin A; Fils-Aime, Joseph Reginald; Jazayeri, Darius; Seaton, Michael; Khan, Aamir J; Choi, Sharon S; Kerrison, Foster; Falzon, Dennis; Becerra, Mercedes C

2013-01-01

Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring. Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments. We describe here the experience with implementing these systems and evaluating many aspects of their performance, and review other systems for MDR-TB management. We recommend a new approach to information systems to address the barriers to scale up MDR-TB treatment, particularly access to the appropriate drugs and lab data. We propose moving away from fragmented, vertical systems to focus on common platforms, addressing all stages of TB care, support for open data standards and interoperability, care for a wide range of diseases including HIV, integration with mHealth applications, and ability to function in resource-poor environments.

Teaching 5- and 6-Year-Olds to Count: Knowledge of South African Educators

ERIC Educational Resources Information Center

Feza, Nosisi N.

2016-01-01

Mathematics learning and teaching continues to be a challenge in the South African education system. This challenge is observed in the poor performance of students in national and international assessments. Research suggests that teachers' content knowledge and knowledge of teaching mathematics contribute significantly to students' performance. In…

Debriefing Can Reduce Misperceptions of Feedback: The Case of Renewable Resource Management

ERIC Educational Resources Information Center

Qudrat-Ullah, Hassan

2007-01-01

According to the hypothesis of misperception of feedback, people's poor performance in renewable resource management tasks can be attributed to their general tendency to systematically misperceive the dynamics of bioeconomic systems. The thesis of this article is that dynamic decision performance can be improved by helping individuals develop more…

Evaluation of Passive Vents in New Construction Multifamily Buildings

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

Sean Maxwell; Berger, David; Zuluaga, Marc

Exhaust ventilation and corresponding outdoor air strategies are being implemented in high performance, new construction, multifamily buildings to meet program or code requirements for improved indoor air quality, but a lack of clear design guidance is resulting in poor performance of these systems despite the best intentions of the programs or standards.

Prevention of and dealing with poor performance: an interview study about how professional associations aim to support healthcare professionals.

PubMed

Weenink, Jan-Willem; Kool, Rudolf B; Hesselink, Gijs; Bartels, Ronald H; Westert, Gert P

2017-10-01

To explore how professional associations of nine healthcare professions aim to support professionals to prevent and deal with poor performance. Qualitative interview study. The Netherlands. Representatives of professional associations for dentists, general practitioners, medical specialists, midwives, nurses, pharmacists, physiotherapists, psychologists and psychotherapists. During nine face-to-face semi-structured interviews we asked how associations aim to support professionals in prevention of and dealing with poor performance. Following the first interview, we monitored new initiatives in support over a 2.5-year period, after which we conducted a second interview. Interviews were analysed using thematic analysis. Available policy and support regarding poor performance. Three themes emerged from our data (i.e. elaborating on professional performance, performance insight and dealing with poor performance) for which we identified a total of 10 categories of support. Support concerned professional codes, guidelines and codes of conduct, quality registers, individual performance assessment, peer consultation, practice evaluation, helpdesk and expert counselling, a protocol for dealing with poor performance, a place for support and to report poor performance, and internal disciplinary procedures. This study provides an overview of support given to nine healthcare professions by their associations regarding poor performance, and identifies gaps that associations could follow up on, such as clarifying what to do when confronted with a poorly performing colleague, supporting professionals that poorly perform, and developing methods for individual performance assessment to gain performance insight. A next step would be to evaluate the use and effect of different types of support. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Effects of Automation Types on Air Traffic Controller Situation Awareness and Performance

NASA Technical Reports Server (NTRS)

Sethumadhavan, A.

2009-01-01

The Joint Planning and Development Office has proposed the introduction of automated systems to help air traffic controllers handle the increasing volume of air traffic in the next two decades (JPDO, 2007). Because fully automated systems leave operators out of the decision-making loop (e.g., Billings, 1991), it is important to determine the right level and type of automation that will keep air traffic controllers in the loop. This study examined the differences in the situation awareness (SA) and collision detection performance of individuals when they worked with information acquisition, information analysis, decision and action selection and action implementation automation to control air traffic (Parasuraman, Sheridan, & Wickens, 2000). When the automation was unreliable, the time taken to detect an upcoming collision was significantly longer for all the automation types compared with the information acquisition automation. This poor performance following automation failure was mediated by SA, with lower SA yielding poor performance. Thus, the costs associated with automation failure are greater when automation is applied to higher order stages of information processing. Results have practical implications for automation design and development of SA training programs.

Robust Adaptive Control Using a Filtering Action

DTIC Science & Technology

2009-09-01

research performed on this class of control systems , sensitivity to external disturbances and modeling errors together with poor transient response...dissertation, we address the problems of designing a class of Adaptive Control systems which yield fast adaptation, thus good transient response, and...unable to stabilize the system . Although this approach requires more knowledge about the system in order to control it, it is still attractive in cases

Correlations between cerebral glucose metabolism and neuropsychological test performance in nonalcoholic cirrhotics.

PubMed

Lockwood, Alan H; Weissenborn, Karin; Bokemeyer, Martin; Tietge, U; Burchert, Wolfgang

2002-03-01

Many cirrhotics have abnormal neuropsychological test scores. To define the anatomical-physiological basis for encephalopathy in nonalcoholic cirrhotics, we performed resting-state fluorodeoxyglucose positron emission tomographic scans and administered a neuropsychological test battery to 18 patients and 10 controls. Statistical parametric mapping correlated changes in regional glucose metabolism with performance on the individual tests and a composite battery score. In patients without overt encephalopathy, poor performance correlated with reductions in metabolism in the anterior cingulate. In all patients, poor performance on the battery was positively correlated (p < 0.001) with glucose metabolism in bifrontal and biparietal regions of the cerebral cortex and negatively correlated with metabolism in hippocampal, lingual, and fusiform gyri and the posterior putamen. Similar patterns of abnormal metabolism were found when comparing the patients to 10 controls. Metabolic abnormalities in the anterior attention system and association cortices mediating executive and integrative function form the pathophysiological basis for mild hepatic encephalopathy.

Comparison of ground-coupled solar-heat-pump systems to conventional systems for residential heating, cooling and water heating

NASA Astrophysics Data System (ADS)

Choi, M. K.; Morehouse, J. H.; Hughes, P. J.

1981-07-01

An analysis is performed of ground-coupled stand-alone and series configured solar-assisted liquid-to-air heat pump systems for residences. The year-round thermal performance of these systems for space heating, space cooling, and water heating is determined by simulation and compared against non-ground-coupled solar heat pump systems as well as conventional heating and cooling systems in three geographic locations: Washington, DC; Fort Worth, Texas; and Madison, Wisconsin. The results indicate that without tax credits a combined solar/ground-coupled heat pump system for space heating and cooling is not cost competitive with conventional systems. Its thermal performance is considerably better than non-ground-coupled solar heat pumps in Fort Worth. Though the ground-coupled stand-alone heat pump provides 51 percent of the heating and cooling load with non-purchased energy in Fort Worth, its thermal performance in Washington and Madison is poor.

5 CFR 9701.408 - Developing performance and addressing poor performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Developing performance and addressing poor performance. (a) Subject to budgetary and other organizational... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Developing performance and addressing poor performance. 9701.408 Section 9701.408 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY...

An Expert Assistant for Computer Aided Parallelization

NASA Technical Reports Server (NTRS)

Jost, Gabriele; Chun, Robert; Jin, Haoqiang; Labarta, Jesus; Gimenez, Judit

2004-01-01

The prototype implementation of an expert system was developed to assist the user in the computer aided parallelization process. The system interfaces to tools for automatic parallelization and performance analysis. By fusing static program structure information and dynamic performance analysis data the expert system can help the user to filter, correlate, and interpret the data gathered by the existing tools. Sections of the code that show poor performance and require further attention are rapidly identified and suggestions for improvements are presented to the user. In this paper we describe the components of the expert system and discuss its interface to the existing tools. We present a case study to demonstrate the successful use in full scale scientific applications.

Evaluation of FSO System Availability in Haze Condition

NASA Astrophysics Data System (ADS)

Anis, A. A.; Rashidi, C. B. M.; Aljunid, S. A.; Rahman, A. K.

2018-03-01

In this paper, we proposed the evaluation of FSO system availability in haze condition. The atmospheric attenuation by weather conditions in the atmosphere as the most challenging problem of FSO system as the system performance is severely degraded and causing the signal optic to be transmitted poorly. The effects of haze condition on the performance of FSO system is stressed out and focused in this paper. From the evaluation of the analysis, designs of FSO system are proposed to obtain a system with improved link performance in haze conditions. The scattering coefficient and the atmospheric attenuation are determined using Beer’s Lambert equation. From the research, the link performance of the system is greatly improved using Design 2 with minimum BER of 10-127127 and maximu m Q Factor of 23.98. The FSO system using Design 2 has better performance compared to Design 1 in haze condition as the optical signals could penetrate the dense haze better without losing much optical power during the transmission to the scattering.

Eddy covariance measurements with a new fast-response, enclosed-path analyzer: Spectral characteristics and cross-system comparisons

Treesearch

K. Novick; J. Walker; W.S. Chan; A. Schmidt; C. Sobek; J.M. Vose

2013-01-01

A new class of enclosed path gas analyzers suitable for eddy covariance applications combines the advantages of traditional closed-path systems (small density corrections, good performance in poor weather) and open-path systems (good spectral response, low power requirements), and permits estimates of instantaneous gas mixing ratio. Here, the extent to which these...

Control issues of microgravity vibration isolation

NASA Technical Reports Server (NTRS)

Knospe, Carl R.; Hampton, Richard D.

1991-01-01

Active vibration isolation systems contemplated for microgravity space experiments may be designed to reach given performance requirements in a variety of ways. An analogy to passive isolation systems proves to be illustrative but lacks the flexibility as a design tool of a control systems approach and may lead to poor design. Control theory as applied to vibration isolation is reviewed and passive analogies discussed.

Septic arthritis associated with systemic sepsis.

PubMed

Jung, Sung-Weon; Kim, Dong-Hee; Shin, Sung-Jin; Kang, Byoung-Youl; Eho, Yil-Ju; Yang, Seong-Wook

2018-01-01

Septic arthritis presents with good joint function, but sometimes leads to poor outcomes. Concurrent systemic sepsis has been regarded as the poor outcome, and the exact cause remains unclear. This paper was performed to identify factors associated with concurrent systemic sepsis and to research results to predict poor outcomes in patients with septic arthritis. Laboratory and medical data were reviewed for 137 adults with acute septic arthritis who underwent open or arthroscopic surgical debridement at our institution between January 2005 and December 2014. The patients were divided according to whether they had septic arthritis alone (Group A) or in combination with systemic sepsis (Group B). Systemic sepsis was defined as two more systemic inflammatory signs in response to an infectious process. Patient characteristics, laboratory findings, synovial fluid findings and cultures, and surgical results were compared between two groups. Of the 137 patients, 41 (29.9%) had initial systemic sepsis at the diagnosis of septic arthritis. Independent t test revealed that duration of prodromal symptom (p = 0.012), serum neutrophil percent (p = 0.008), C-reactive protein (p = 0.001), Charlson comorbidity index (p = 0.001), positive culture in synovial fluid (p = 0.001), and methicillin-sensitive Staphylococcus aureus (MSSA) isolate in synovial fluid (p = 0.001) had significant correlations with the group B. Repeated debridement was performed for those who had recurrence of infection, and this procedure was more often in group B (23 versus 21 joints, 23.9 versus 51.2%, p = 0.012). Progression of arthritis occurred more often in group B (16 versus 17 joints, 16.7 versus 41.5%, p = 0.001). Septic arthritis combined with systemic sepsis was related to duration of prodromal symptom, serum neutrophil percent, C-reactive protein, Charlson comorbidity index, positive culture in synovial fluid, and a MSSA isolate in synovial fluid. Concurrent systemic sepsis led to poor outcomes in patients with septic arthritis in terms of recurrence of infection and progression of arthritis. III Case control study.

Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings.

PubMed

Van Rie, A; Fitzgerald, D; Kabuya, G; Van Deun, A; Tabala, M; Jarret, N; Behets, F; Bahati, E

2008-03-01

Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories.

A STUDY OF LONGITUDINAL PATTERNS OF FAILURE AMONG HIGH SCHOOL DROP-OUTS AND POORLY PERFORMING GRADUATES.

ERIC Educational Resources Information Center

STOLLER, DAVID S.

THE RELATIONSHIP BETWEEN PATTERNS OF POOR PERFORMANCE AND SIGNIFICANT DISTINGUISHING FACTORS WHICH MIGHT IDENTIFY DROPOUTS IS EXPLORED. DATA WERE OBTAINED ON 270 STUDENTS (FROM A PARENT POPULATION OF 2,500) WHO WERE POOR PERFORMERS (POOR PERFORMANCE BEING DEFINED AS THREE "D'S" OR "F'S" IN HIGH SCHOOL). THE VAST MAJORITY OF…

Eddy covariance measurements in complex terrain with a new fast response, closed-path analyzer: spectral characteristics and cross-system comparisons

EPA Science Inventory

In recent years, a new class of enclosed, closed-path gas analyzers suitable for eddy covariance applications has come to market, designed to combine the advantages of traditional closed-path systems (small density corrections, good performance in poor weather) and open-path syst...

Thermal and economic assessment of ground-coupled storage for residential solar heat pump systems

NASA Astrophysics Data System (ADS)

Choi, M. K.; Morehouse, J. H.

1980-11-01

This study performed an analysis of ground-coupled stand-alone and series configured solar-assisted liquid-to-air heat pump systems for residences. The year-round thermal performance of these systems for space heating, space cooling, and water heating were determined by simulation and compared against non-ground-coupled solar heat pump systems as well as conventional heating and cooling systems in three geographic locations: Washington, D.C., Fort Worth, Tex., and Madison, Wis. The results indicate that without tax credits a combined solar/ground-coupled heat pump system for space heating and cooling is not cost competitive with conventional systems. Its thermal performance is considerably better than non-ground-coupled solar heat pumps in Forth Worth. Though the ground-coupled stand-alone heat pump provides 51% of the heating and cooling load with non-purchased energy in Forth Worth, its thermal performance in Washington and Madison is poor.

Evaluation of central nervous system in patients with glycogen storage disease type 1a.

PubMed

Aydemir, Yusuf; Gürakan, Figen; Saltık Temizel, İnci Nur; Demir, Hülya; Oğuz, Kader Karlı; Yalnızoğlu, Dilek; Topçu, Meral; Özen, Hasan; Yüce, Aysel

2016-01-01

We aimed to evaluate structure and functions of central nervous system (CNS) in children with glycogen storage disease (GSD) type 1a. Neurological examination, psychometric tests, electroencephalography (EEG), magnetic resonance imaging (MRI), visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) were performed. The results were compared between patients with good and poor metabolic control and healthy children. Twenty-three patients with GSD type 1a were studied. Twelve patients were in poor metabolic control group and 11 patients in good metabolic control group. Five patients had intellectual disability, 10 had EEG abnormalities, seven had abnormal VEP and two had abnormal BAEP results. MRI was abnormal in five patients. There was significant correlation between the number of hypoglycemic attacks and MRI abnormalities. Central nervous system may be affected in GSD type 1a even in patients with normal neurologic examination. Accumulation of abnormal results in patients with poor metabolic control supports the importance of metabolic control in GSD type 1a.

Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

PubMed Central

Berman, P.

2000-01-01

Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision of services to improve performance. To do this wisely, much better information on ambulatory care organization is needed, as well as more experience with diverse approaches to improve performance. PMID:10916916

Is there enough research output of EU projects available to assess and improve health system performance? An attempt to understand and categorise the output of EU projects conducted between 2002 and 2012.

PubMed

Zander, Britta; Busse, Reinhard

2017-02-22

Adequate performance assessment benefits from the use of disaggregated data to allow a proper evaluation of health systems. Since routinely collected data are usually not disaggregated enough to allow stratified analyses of healthcare needs, utilisation, cost and quality across different sectors, international research projects could fill this gap by exploring means to data collection or even providing individual-level data. The aim of this paper is therefore to (1) study the availability and accessibility of relevant European-funded health projects, and (2) to analyse their contents and methodologies. The European Commission Public Health Projects Database and CORDIS were searched for eligible projects, which were then analysed by information openly available online. Overall, only a few of the 39 identified projects produced data useful for proper performance assessment, due to, for example, lacking available or accessible data, or poor linkage of health status to costs and patient experiences. Other problems were insufficient databases to identify projects and poor communication of project contents and results. A new approach is necessary to improve accessibility to and coverage of data on outcomes, quality and costs of health systems enabling decision-makers and health professionals to properly assess performance.

Performance of a normalized energy metric without jammer state information for an FH/MFSK system in worst case partial band jamming

NASA Technical Reports Server (NTRS)

Lee, P. J.

1985-01-01

For a frequency-hopped noncoherent MFSK communication system without jammer state information (JSI) in a worst case partial band jamming environment, it is well known that the use of a conventional unquantized metric results in very poor performance. In this paper, a 'normalized' unquantized energy metric is suggested for such a system. It is shown that with this metric, one can save 2-3 dB in required signal energy over the system with hard decision metric without JSI for the same desired performance. When this very robust metric is compared to the conventional unquantized energy metric with JSI, the loss in required signal energy is shown to be small. Thus, the use of this normalized metric provides performance comparable to systems for which JSI is known. Cutoff rate and bit error rate with dual-k coding are used for the performance measures.

The economic survival of long stay institutions for impoverished aged people.

PubMed

Creutzberg, Marion; Gonçalves, Lúcia Hisako Takase; Sobottka, Emil Albert

2007-01-01

Identify structural couplings of Retirement Institutions for the Aged (RIA) with the economic system, in order to maintain those institutions that shelter the poor aged in the Brazilian context. Qualitative, exploratory-descriptive study. The data collection was carried out through interviews with seven leading people and eight aged people, analysis of communication of 52 non-profit Brazilian RIAs, both public and private. The content analysis was performed based on the Niklas Luhmann's Systems Theory. It was verified that in face of the aged scarce resources, a considerable share of the maintenance costs are supported by the institutions themselves, whose search for resources is done by leaders, team, the aged and communities. The excessive involvement of these institutions in the elaboration of programs for searching funds can harm the performance of their essential function which is to care for the poor aged.

Ridge Regression Signal Processing

NASA Technical Reports Server (NTRS)

Kuhl, Mark R.

1990-01-01

The introduction of the Global Positioning System (GPS) into the National Airspace System (NAS) necessitates the development of Receiver Autonomous Integrity Monitoring (RAIM) techniques. In order to guarantee a certain level of integrity, a thorough understanding of modern estimation techniques applied to navigational problems is required. The extended Kalman filter (EKF) is derived and analyzed under poor geometry conditions. It was found that the performance of the EKF is difficult to predict, since the EKF is designed for a Gaussian environment. A novel approach is implemented which incorporates ridge regression to explain the behavior of an EKF in the presence of dynamics under poor geometry conditions. The basic principles of ridge regression theory are presented, followed by the derivation of a linearized recursive ridge estimator. Computer simulations are performed to confirm the underlying theory and to provide a comparative analysis of the EKF and the recursive ridge estimator.

Teachers' Perspectives on School Climate at a Low-Performing School

ERIC Educational Resources Information Center

Carson, Paul Kit

2012-01-01

A number of research studies have indicated that issues with school climate may be a source of the low academic and social success of students in the public school system. A poor school climate is often associated with low-performing schools; a positive school climate can increase student achievement and other indicators of school success such as…

Organizational Failure in an NHS Hospital Trust: A Qualitative Study.

PubMed

Ravaghi, Hamid; Mannion, Russell; Sajadi, Haniye Sadat

2015-01-01

The objective was to explore the key factors associated with organizational failure in an NHS Hospital Trust. This case study adopted a qualitative design. Fifty-seven semistructured interviews and document analyses were conducted as well. Data were analyzed using a framework analysis method. A range of symptoms of organizational performance failure was identified. These relate to a financial deficit, lack of good external relationships, inability to meet core targets, a lack of clear management systems, and low staff morale. These markers had not been taken seriously by the previous senior management team. Symptoms of failure were the reflection of presence of secondary and primary causes of failure. Poor managerial leadership, poor financial control and performance management, lack of open culture, distraction by 2 large projects, and the lack of clinician engagement were perceived as internal causes of failure and the high level of policy changes within the NHS as the key external cause. The level of deprivation in the area was also thought to have had a negative impact on performance. The findings reinforce and expand on those of recent studies across the public sector. Tracking an organization's performance and early diagnosis of performance problems, focusing on performance management systems, and taking into account contextual factors are issues that should be considered.

Real-time Enhanced Vision System

NASA Technical Reports Server (NTRS)

Hines, Glenn D.; Rahman, Zia-Ur; Jobson, Daniel J.; Woodell, Glenn A.; Harrah, Steven D.

2005-01-01

Flying in poor visibility conditions, such as rain, snow, fog or haze, is inherently dangerous. However these conditions can occur at nearly any location, so inevitably pilots must successfully navigate through them. At NASA Langley Research Center (LaRC), under support of the Aviation Safety and Security Program Office and the Systems Engineering Directorate, we are developing an Enhanced Vision System (EVS) that combines image enhancement and synthetic vision elements to assist pilots flying through adverse weather conditions. This system uses a combination of forward-looking infrared and visible sensors for data acquisition. A core function of the system is to enhance and fuse the sensor data in order to increase the information content and quality of the captured imagery. These operations must be performed in real-time for the pilot to use while flying. For image enhancement, we are using the LaRC patented Retinex algorithm since it performs exceptionally well for improving low-contrast range imagery typically seen during poor visibility conditions. In general, real-time operation of the Retinex requires specialized hardware. To date, we have successfully implemented a single-sensor real-time version of the Retinex on several different Digital Signal Processor (DSP) platforms. In this paper we give an overview of the EVS and its performance requirements for real-time enhancement and fusion and we discuss our current real-time Retinex implementations on DSPs.

Improvements of the offshore earthquake locations in the Earthquake Early Warning System

NASA Astrophysics Data System (ADS)

Chen, Ta-Yi; Hsu, Hsin-Chih

2017-04-01

Since 2014 the Earthworm Based Earthquake Alarm Reporting (eBEAR) system has been operated and been used to issue warnings to schools. In 2015 the system started to provide warnings to the public in Taiwan via television and the cell phone. Online performance of the eBEAR system indicated that the average reporting times afforded by the system are approximately 15 and 28 s for inland and offshore earthquakes, respectively. The eBEAR system in average can provide more warning time than the current EEW system (3.2 s and 5.5 s for inland and offshore earthquakes, respectively). However, offshore earthquakes were usually located poorly because only P-wave arrivals were used in the eBEAR system. Additionally, in the early stage of the earthquake early warning system, only fewer stations are available. The poor station coverage may be a reason to answer why offshore earthquakes are difficult to locate accurately. In the Geiger's inversion procedure of earthquake location, we need to put an initial hypocenter and origin time into the location program. For the initial hypocenter, we defined some test locations on the offshore area instead of using the average of locations from triggered stations. We performed 20 programs concurrently running the Geiger's method with different pre-defined initial position to locate earthquakes. We assume that if the program with the pre-defined initial position is close to the true earthquake location, during the iteration procedure of the Geiger's method the processing time of this program should be less than others. The results show that using pre-defined locations for trial-hypocenter in the inversion procedure is able to improve the accurate of offshore earthquakes. Especially for EEW system, in the initial stage of the EEW system, only use 3 or 5 stations to locate earthquakes may lead to bad results because of poor station coverage. In this study, the pre-defined trial-locations provide a feasible way to improve the estimations of earthquake locations in EEW system.

Field testing and evaluation of a demonstration timber bridge.

DOT National Transportation Integrated Search

2012-02-01

Asphalt wearing surfaces are commonly used on timber bridges with transverse glued-laminated deck panel systems to help protect the timber components. However, poor performance of these asphalt wearing surfaces in the past has resulted in repeated re...

Clinical value of the VMI supplemental tests: a modified replication study.

PubMed

Avi-Itzhak, Tamara; Obler, Doris Richard

2008-10-01

To carry out a modified replication of the study performed by Kulp and Sortor evaluating the clinical value of the information provided by Beery's visual-motor supplemental tests of Visual Perception (VP) and Motor Coordination (MC) in normally developed children. The objectives were to (a) estimate the correlations among the three tests scores; (b) assess the predictive power of the VP and MC scores in explaining the variance in Visual-Motor Integration (VMI) scores; and (c) examine whether poor performance on the VMI is related to poor performance on VP or MC. METHODS.: A convenience sample of 71 children ages 4 and 5 years (M = 4.62 +/- 0.43) participated in the study. The supplemental tests significantly (F = 9.59; dF = 2; p < or = 0. 001) explained 22% of the variance in VMI performance. Only VP was significantly related to VMI (beta = 0.39; T = 3.49) accounting for the total amount of explained variance. Using the study population norms, 11 children (16% of total sample) did poorly on the VMI; of those 11, 73% did poorly on the VP, and none did poorly on the MC. None of these 11 did poorly on both the VP and MC. Nine percent of total sample who did poorly on the VP performed within the norm on the VMI. Thirteen percent who performed poorly on the MC performed within the norm on the VMI. Using the VMI published norms, 14 children (20% of total sample) who did poorly on the VP performed within the norm on the VMI. Forty-eight percent who did poorly on MC performed within the norm on the VMI. Findings supported Kulp and Sortor's conclusions that each area should be individually evaluated during visual-perceptual assessment of children regardless of performance on the VMI.

A systematic FPGA acceleration design for applications based on convolutional neural networks

NASA Astrophysics Data System (ADS)

Dong, Hao; Jiang, Li; Li, Tianjian; Liang, Xiaoyao

2018-04-01

Most FPGA accelerators for convolutional neural network are designed to optimize the inner acceleration and are ignored of the optimization for the data path between the inner accelerator and the outer system. This could lead to poor performance in applications like real time video object detection. We propose a brand new systematic FPFA acceleration design to solve this problem. This design takes the data path optimization between the inner accelerator and the outer system into consideration and optimizes the data path using techniques like hardware format transformation, frame compression. It also takes fixed-point, new pipeline technique to optimize the inner accelerator. All these make the final system's performance very good, reaching about 10 times the performance comparing with the original system.

Developing and Planning a Texas Based Homeschool Curriculum

ERIC Educational Resources Information Center

Terry, Bobby K.

2011-01-01

Texas has some of the lowest SAT scores in the nation. They are ranked 36th nationwide in graduation rates and teacher salaries rank at number 33. The public school system in Texas has problems with overcrowding, violence, and poor performance on standardized testing. Currently 300,000 families have opted out of the public school system in order…

Applying Cognitive Load Theory to the Redesign of a Conventional Database Systems Course

ERIC Educational Resources Information Center

Mason, Raina; Seton, Carolyn; Cooper, Graham

2016-01-01

Cognitive load theory (CLT) was used to redesign a Database Systems course for Information Technology students. The redesign was intended to address poor student performance and low satisfaction, and to provide a more relevant foundation in database design and use for subsequent studies and industry. The original course followed the conventional…

Measuring Health System Strengthening: Application of the Balanced Scorecard Approach to Rank the Baseline Performance of Three Rural Districts in Zambia

PubMed Central

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

Introduction There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. Methodology The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Results Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff −0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). Conclusion The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could be valuable in monitoring and evaluation of health systems. PMID:23555590

Measuring health system strengthening: application of the balanced scorecard approach to rank the baseline performance of three rural districts in Zambia.

PubMed

Mutale, Wilbroad; Godfrey-Fausset, Peter; Mwanamwenge, Margaret Tembo; Kasese, Nkatya; Chintu, Namwinga; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-01-01

There is growing interest in health system performance and recently WHO launched a report on health systems strengthening emphasising the need for close monitoring using system-wide approaches. One recent method is the balanced scorecard system. There is limited application of this method in middle- and low-income countries. This paper applies the concept of balanced scorecard to describe the baseline status of three intervention districts in Zambia. The Better Health Outcome through Mentoring and Assessment (BHOMA) project is a randomised step-wedged community intervention that aims to strengthen the health system in three districts in the Republic of Zambia. To assess the baseline status of the participating districts we used a modified balanced scorecard approach following the domains highlighted in the MOH 2011 Strategic Plan. Differences in performance were noted by district and residence. Finance and service delivery domains performed poorly in all study districts. The proportion of the health workers receiving training in the past 12 months was lowest in Kafue (58%) and highest in Luangwa district (77%). Under service capacity, basic equipment and laboratory capacity scores showed major variation, with Kafue and Luangwa having lower scores when compared to Chongwe. The finance domain showed that Kafue and Chongwe had lower scores (44% and 47% respectively). Regression model showed that children's clinical observation scores were negatively correlated with drug availability (coeff -0.40, p = 0.02). Adult clinical observation scores were positively association with adult service satisfaction score (coeff 0.82, p = 0.04) and service readiness (coeff 0.54, p = 0.03). The study applied the balanced scorecard to describe the baseline status of 42 health facilities in three districts of Zambia. Differences in performance were noted by district and residence in most domains with finance and service delivery performing poorly in all study districts. This tool could be valuable in monitoring and evaluation of health systems.

Adoption and sustained use of cleaner cooking fuels in rural India: a case control study protocol to understand household, network, and organizational drivers.

PubMed

Kumar, Praveen; Dhand, Amar; Tabak, Rachel G; Brownson, Ross C; Yadama, Gautam N

2017-01-01

Implementing efficient stoves and clean fuels in low and middle-income countries are critical for improving health of poor women and children and improve the environment. Cleaner biomass stoves, however, perform poorly against the World Health Organization's indoor air quality guidelines. This has shifted the focus to systematic dissemination and implementation of cleaner cooking systems such as liquefied petroleum gas (LPG) among poor communities. Even when there is some uptake of LPG by poor communities, its sustained use has been low. Concurrent use of LPG with traditional biomass cookstoves compromises reductions in household air pollution and limits health and environmental dividends. Therefore understanding key drivers of adoption and sustained implementation of clean fuels among the poor is critical. There is a significant gap, however, in the research to understand determinants and sustained exclusive use of clean fuels in rural poor communities. Using a case control study design, this study will explore the impact of affordability, accessibility, and awareness on adoption and sustained use of LPG among rural poor communities of India. The study uses a multistage random sampling to collect primary data from 510 households. Case group or LPG adopters constitute 255 households while control group or non-LPG adopters constitute the remaining 255 households. The study will deploy sophisticated stove use monitoring sensors in each of the stoves in 100 case group households to monitor stove use and stacking behavior (using clean and traditional systems of cooking) of participants for 12 months. Moreover, this will be the first study to explore the impact of personal social networks striated by gender on LPG adoption. This study is guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) implementation science evaluation framework. Lessons from this study will feed into a larger discussion on developing a pro-poor strategy to foster uptake and sustained use of cleaner cooking systems such as LPG. Understanding the determinants of adoption and sustained use of cleaner cooking systems through the RE-AIM framework will expand our insights on implementation of cleaner cooking systems among poor communities and will advance implementation science in the clean cooking sector. A thorough study of such implementation strategies is crucial to realize multiple UN Sustainable Development Goals on global health, climate change, and energy security.

Design and implementation of streaming media server cluster based on FFMpeg.

PubMed

Zhao, Hong; Zhou, Chun-long; Jin, Bao-zhao

2015-01-01

Poor performance and network congestion are commonly observed in the streaming media single server system. This paper proposes a scheme to construct a streaming media server cluster system based on FFMpeg. In this scheme, different users are distributed to different servers according to their locations and the balance among servers is maintained by the dynamic load-balancing algorithm based on active feedback. Furthermore, a service redirection algorithm is proposed to improve the transmission efficiency of streaming media data. The experiment results show that the server cluster system has significantly alleviated the network congestion and improved the performance in comparison with the single server system.

Design and Implementation of Streaming Media Server Cluster Based on FFMpeg

PubMed Central

Zhao, Hong; Zhou, Chun-long; Jin, Bao-zhao

2015-01-01

Poor performance and network congestion are commonly observed in the streaming media single server system. This paper proposes a scheme to construct a streaming media server cluster system based on FFMpeg. In this scheme, different users are distributed to different servers according to their locations and the balance among servers is maintained by the dynamic load-balancing algorithm based on active feedback. Furthermore, a service redirection algorithm is proposed to improve the transmission efficiency of streaming media data. The experiment results show that the server cluster system has significantly alleviated the network congestion and improved the performance in comparison with the single server system. PMID:25734187

Effects of rain and fog on the Shuttle Ku-band microwave scanning beam landing system range and accuracy performance

NASA Technical Reports Server (NTRS)

Butler, D.

1981-01-01

The microwave Scanning Beam Landing System's (MSBLS) performance in fog and rain was studied. The fog and rain effects on the Shuttle Ku-band system were determined. Specifically, microwave attenuation, beam distortion, and coordinate errors resulting from operation of the MSBLS in poor weather conditions were evaluated. The main physical processes giving rise to microwave attenuation were found to be absorption and scattering by water droplets. The general theory of scattering and absorption used is discussed and a listing of applicable computer programs is provided.

Multi-Objective Reinforcement Learning-based Deep Neural Networks for Cognitive Space Communications

NASA Technical Reports Server (NTRS)

Ferreria, Paulo; Paffenroth, Randy; Wyglinski, Alexander M.; Hackett, Timothy; Bilen, Sven; Reinhart, Richard; Mortensen, Dale

2017-01-01

Future communication subsystems of space exploration missions can potentially benefit from software-defined radios (SDRs) controlled by machine learning algorithms. In this paper, we propose a novel hybrid radio resource allocation management control algorithm that integrates multi-objective reinforcement learning and deep artificial neural networks. The objective is to efficiently manage communications system resources by monitoring performance functions with common dependent variables that result in conflicting goals. The uncertainty in the performance of thousands of different possible combinations of radio parameters makes the trade-off between exploration and exploitation in reinforcement learning (RL) much more challenging for future critical space-based missions. Thus, the system should spend as little time as possible on exploring actions, and whenever it explores an action, it should perform at acceptable levels most of the time. The proposed approach enables on-line learning by interactions with the environment and restricts poor resource allocation performance through virtual environment exploration. Improvements in the multiobjective performance can be achieved via transmitter parameter adaptation on a packet-basis, with poorly predicted performance promptly resulting in rejected decisions. Simulations presented in this work considered the DVB-S2 standard adaptive transmitter parameters and additional ones expected to be present in future adaptive radio systems. Performance results are provided by analysis of the proposed hybrid algorithm when operating across a satellite communication channel from Earth to GEO orbit during clear sky conditions. The proposed approach constitutes part of the core cognitive engine proof-of-concept to be delivered to the NASA Glenn Research Center SCaN Testbed located onboard the International Space Station.

Multi-Objective Reinforcement Learning-Based Deep Neural Networks for Cognitive Space Communications

NASA Technical Reports Server (NTRS)

Ferreria, Paulo Victor R.; Paffenroth, Randy; Wyglinski, Alexander M.; Hackett, Timothy M.; Bilen, Sven G.; Reinhart, Richard C.; Mortensen, Dale J.

2017-01-01

Future communication subsystems of space exploration missions can potentially benefit from software-defined radios (SDRs) controlled by machine learning algorithms. In this paper, we propose a novel hybrid radio resource allocation management control algorithm that integrates multi-objective reinforcement learning and deep artificial neural networks. The objective is to efficiently manage communications system resources by monitoring performance functions with common dependent variables that result in conflicting goals. The uncertainty in the performance of thousands of different possible combinations of radio parameters makes the trade-off between exploration and exploitation in reinforcement learning (RL) much more challenging for future critical space-based missions. Thus, the system should spend as little time as possible on exploring actions, and whenever it explores an action, it should perform at acceptable levels most of the time. The proposed approach enables on-line learning by interactions with the environment and restricts poor resource allocation performance through virtual environment exploration. Improvements in the multiobjective performance can be achieved via transmitter parameter adaptation on a packet-basis, with poorly predicted performance promptly resulting in rejected decisions. Simulations presented in this work considered the DVB-S2 standard adaptive transmitter parameters and additional ones expected to be present in future adaptive radio systems. Performance results are provided by analysis of the proposed hybrid algorithm when operating across a satellite communication channel from Earth to GEO orbit during clear sky conditions. The proposed approach constitutes part of the core cognitive engine proof-of-concept to be delivered to the NASA Glenn Research Center SCaN Testbed located onboard the International Space Station.

An adaptive cryptographic accelerator for network storage security on dynamically reconfigurable platform

NASA Astrophysics Data System (ADS)

Tang, Li; Liu, Jing-Ning; Feng, Dan; Tong, Wei

2008-12-01

Existing security solutions in network storage environment perform poorly because cryptographic operations (encryption and decryption) implemented in software can dramatically reduce system performance. In this paper we propose a cryptographic hardware accelerator on dynamically reconfigurable platform for the security of high performance network storage system. We employ a dynamic reconfigurable platform based on a FPGA to implement a PowerPCbased embedded system, which executes cryptographic algorithms. To reduce the reconfiguration latency, we apply prefetch scheduling. Moreover, the processing elements could be dynamically configured to support different cryptographic algorithms according to the request received by the accelerator. In the experiment, we have implemented AES (Rijndael) and 3DES cryptographic algorithms in the reconfigurable accelerator. Our proposed reconfigurable cryptographic accelerator could dramatically increase the performance comparing with the traditional software-based network storage systems.

Preparation and Pharmacokinetics Evaluation of Solid Self-Microemulsifying Drug Delivery System (S-SMEDDS) of Osthole.

PubMed

Sun, Chaojie; Gui, Yun; Hu, Rongfeng; Chen, Jiayi; Wang, Bin; Guo, Yuxing; Lu, Wenjie; Nie, Xiangjiang; Shen, Qiang; Gao, Song; Fang, Wenyou

2018-05-29

The study was performed aiming to enhance the solubility and oral bioavailability of poorly water-soluble drug osthole by formulating solid self-microemulsifying drug delivery system (S-SMEDDS) via spherical crystallization technique. Firstly, the liquid self-microemulsifying drug delivery system (L-SMEDDS) of osthole was formulated with castor oil, Cremophor RH40, and 1,2-propylene glycol after screening various lipids and emulsifiers. The type and amount of polymeric materials, good solvents, bridging agents, and poor solvents in S-SMEDDS formulations were further determined by single-factor study. The optimal formulation contained 1:2 of ethyl cellulose (EC) and Eudragit S100, which served as matrix forming and enteric coating polymers respectively. Anhydrous ethanol and dichloromethane with a ratio of 5:3 are required to perform as good solvent and bridging agent, respectively, with the addition of 0.08% SDS aqueous solution as poor solvent. The optimized osthole S-SMEDDS had a high yield (83.91 ± 3.31%) and encapsulation efficiency (78.39 ± 2.25%). Secondly, osthole L-SMEDDS was solidified to osthole S-SMEDDS with no significant changes in terms of morphology, particle size, and zeta potential. In vitro release study demonstrated a sustained release of the drug from osthole S-SMEDDS. Moreover, in vivo pharmacokinetic study showed that the T max and mean residence time (MRT (0-t) ) of osthole were significantly prolonged and further confirmed that osthole S-SMEDDS exhibited sustained release effect in rabbits. Comparing with osthole aqueous suspension and L-SMEDDS, osthole S-SMEDDS increased bioavailability by 205 and 152%, respectively. The results suggested that S-SMEDDS was an effective oral solid dosage form, which can improve the solubility and oral bioavailability of poorly water-soluble drug osthole.

Face Recognition for Access Control Systems Combining Image-Difference Features Based on a Probabilistic Model

NASA Astrophysics Data System (ADS)

Miwa, Shotaro; Kage, Hiroshi; Hirai, Takashi; Sumi, Kazuhiko

We propose a probabilistic face recognition algorithm for Access Control System(ACS)s. Comparing with existing ACSs using low cost IC-cards, face recognition has advantages in usability and security that it doesn't require people to hold cards over scanners and doesn't accept imposters with authorized cards. Therefore face recognition attracts more interests in security markets than IC-cards. But in security markets where low cost ACSs exist, price competition is important, and there is a limitation on the quality of available cameras and image control. Therefore ACSs using face recognition are required to handle much lower quality images, such as defocused and poor gain-controlled images than high security systems, such as immigration control. To tackle with such image quality problems we developed a face recognition algorithm based on a probabilistic model which combines a variety of image-difference features trained by Real AdaBoost with their prior probability distributions. It enables to evaluate and utilize only reliable features among trained ones during each authentication, and achieve high recognition performance rates. The field evaluation using a pseudo Access Control System installed in our office shows that the proposed system achieves a constant high recognition performance rate independent on face image qualities, that is about four times lower EER (Equal Error Rate) under a variety of image conditions than one without any prior probability distributions. On the other hand using image difference features without any prior probabilities are sensitive to image qualities. We also evaluated PCA, and it has worse, but constant performance rates because of its general optimization on overall data. Comparing with PCA, Real AdaBoost without any prior distribution performs twice better under good image conditions, but degrades to a performance as good as PCA under poor image conditions.

Speech Perception Deficits in Mandarin-Speaking School-Aged Children with Poor Reading Comprehension

PubMed Central

Liu, Huei-Mei; Tsao, Feng-Ming

2017-01-01

Previous studies have shown that children learning alphabetic writing systems who have language impairment or dyslexia exhibit speech perception deficits. However, whether such deficits exist in children learning logographic writing systems who have poor reading comprehension remains uncertain. To further explore this issue, the present study examined speech perception deficits in Mandarin-speaking children with poor reading comprehension. Two self-designed tasks, consonant categorical perception task and lexical tone discrimination task were used to compare speech perception performance in children (n = 31, age range = 7;4–10;2) with poor reading comprehension and an age-matched typically developing group (n = 31, age range = 7;7–9;10). Results showed that the children with poor reading comprehension were less accurate in consonant and lexical tone discrimination tasks and perceived speech contrasts less categorically than the matched group. The correlations between speech perception skills (i.e., consonant and lexical tone discrimination sensitivities and slope of consonant identification curve) and individuals’ oral language and reading comprehension were stronger than the correlations between speech perception ability and word recognition ability. In conclusion, the results revealed that Mandarin-speaking children with poor reading comprehension exhibit less-categorized speech perception, suggesting that imprecise speech perception, especially lexical tone perception, is essential to account for reading learning difficulties in Mandarin-speaking children. PMID:29312031

[Excessive Daytime Sleepiness, Poor Quality Sleep, and Low Academic Performance in Medical Students].

PubMed

Machado-Duque, Manuel Enrique; Echeverri Chabur, Jorge Enrique; Machado-Alba, Jorge Enrique

2015-01-01

Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population. A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed. The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis. A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Special-effect edit detection using VideoTrails: a comparison with existing techniques

NASA Astrophysics Data System (ADS)

Kobla, Vikrant; DeMenthon, Daniel; Doermann, David S.

1998-12-01

Video segmentation plays an integral role in many multimedia applications, such as digital libraries, content management systems, and various other video browsing, indexing, and retrieval systems. Many algorithms for segmentation of video have appeared within the past few years. Most of these algorithms perform well on cuts, but yield poor performance on gradual transitions or special effects edits. A complete video segmentation system must also achieve good performance on special effect edit detection. In this paper, we discuss the performance of our Video Trails-based algorithms, with other existing special effect edit-detection algorithms within the literature. Results from experiments testing for the ability to detect edits from TV programs, ranging from commercials to news magazine programs, including diverse special effect edits, which we have introduced.

Neuropsychological Functioning in Survivors of Childhood Leukemia.

ERIC Educational Resources Information Center

Reeb, Roger N.; Regan, Judith M.

1998-01-01

Examined neuropsychological functioning of survivors of acute lymphoblastic leukemia who underwent central-nervous-system prophylactic treatment. Findings replicated past research in showing survivors perform poorly on visual-motor integration tasks and develop a Nonverbal Learning Disability. Findings offer recommendations for future research and…

32 CFR 776.77 - Related investigations and actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... omissions by covered attorneys may constitute professional misconduct, criminal misconduct, poor performance... to appropriate civil authority. (c) Poor performance of duty is properly addressed by the covered USG... criminal conduct or poor performance of duty involving covered attorneys. When, however, investigations...

A novel system for automated propofol sedation: hybrid sedation system (HSS).

PubMed

Zaouter, Cedrick; Taddei, Riccardo; Wehbe, Mohamad; Arbeid, Erik; Cyr, Shantale; Giunta, Francesco; Hemmerling, Thomas M

2017-04-01

Closed-loop systems for propofol have been demonstrated to be safe and reliable for general anesthesia. However, no study has been conducted using a closed-loop system specifically designed for sedation in patients under spinal anesthesia. We developed an automatic anesthesia sedation system that allows for closed-loop delivery of propofol for sedation integrating a decision support system, called the hybrid sedation system (HSS). The objective of this study is to compare this system with standard practice. One hundred fifty patients were enrolled and randomly assigned to two groups: HSS-Group (N = 75), in which propofol was administered using a closed-loop system; Control Group (N = 75), in which propofol was delivered manually. The clinical performance of the propofol sedation control is defined as efficacy to maintain bispectral index (BIS) near 65. The clinical control was called 'Excellent', 'Good', 'Poor' and 'Inadequate' with BIS values within 10 %, from 11 to 20 %, 21 to 30 %, or greater than 30 % of the BIS target of 65, respectively. The controller performance was evaluated using Varvel's parameters. Data are presented as mean ± standard deviation, groups were compared using t test or Chi square test, P < 0.05. Clinical performance of sedation showed 'Excellent' control in the HSS-group for a significantly longer period of time (49 vs. 26 % in the control group, P < 0.0001). 'Poor' and 'Inadequate' sedation was significantly shorter in the HSS Group compared to the Control Group (11 and 10 % vs. 20 and 18 %, respectively, P < 0.0001). The novel, closed-loop system for propofol sedation showed better maintenance of the target BIS value compared to manual administration.

A BEME (Best Evidence in Medical Education) systematic review of the use of workplace-based assessment in identifying and remediating poor performance among postgraduate medical trainees.

PubMed

Barrett, Aileen; Galvin, Rose; Steinert, Yvonne; Scherpbier, Albert; O'Shaughnessy, Ann; Horgan, Mary; Horsley, Tanya

2015-05-08

Workplace-based assessments were designed to facilitate observation and structure feedback on the performance of trainees in real-time clinical settings and scenarios. Research in workplace-based assessments has primarily centred on understanding psychometric qualities and performance improvement impacts of trainees generally. An area that is far less understood is the use of workplace-based assessments for trainees who may not be performing at expected or desired standards, referred to within the literature as trainees 'in difficulty' or 'underperforming'. In healthcare systems that increasingly depend on service provided by junior doctors, early detection (and remediation) of poor performance is essential. However, barriers to successful implementation of workplace-based assessments (WBAs) in this context include a misunderstanding of the use and purpose of these formative assessment tools. This review aims to explore the impact - or effectiveness - of workplace-based assessment on the identification of poor performance and to determine those conditions that support and enable detection, i.e. whether by routine or targeted use where poor performance is suspected. The review also aims to explore what effect (if any) the use of WBA may have on remediation or on changing clinical practice. The personal impact of the detection of poor performance on trainees and/or trainers may also be explored. Using BEME (Best Evidence in Medical Education) Collaboration review guidelines, nine databases will be searched for English-language records. Studies examining interventions for workplace-based assessment either routinely or in relation to poor performance will be included. Independent agreement (kappa .80) will be achieved using a randomly selected set of records prior to commencement of screening and data extraction using a BEME coding sheet modified as applicable (Buckley et al., Med Teach 31:282-98, 2009) as this has been used in previous WBA systematic reviews (Miller and Archer, BMJ doi:10.1136/bmj.c5064, 2010) allowing for more rigorous comparisons with the published literature. Educational outcomes will be evaluated using Kirkpatrick's framework of educational outcomes using Barr's adaptations (Barr et al., Evaluations of interprofessional education; a United Kingdom review of health and social care, 2000) for medical education research. Our study will contribute to an ongoing international debate regarding the applicability of workplace-based assessments as a meaningful formative assessment approach within the context of postgraduate medical education. The review has been registered by the BEME Collaboration www.bemecollaboration.org .

Quality Lies in the Eyes of the Beholder: A Mismatch between Student Evaluation and Peer Observation of Teaching

ERIC Educational Resources Information Center

Hassan, Salochana; Wium, Wouter

2014-01-01

The study described in this article was prompted by the poor performance of students in an "at risk subject" in a science faculty at a university in South Africa. Teacher performance could contribute to poor performance among students, therefore the performance of one of the science teachers whose students were performing poorly was…

The Evergreen Effect: Washington's Poor Evaluation System Revealed. Charts You Can Trust

ERIC Educational Resources Information Center

Aldeman, Chad

2013-01-01

When the state of Washington identified the bottom 5 percent of its lowest-performing schools in 2011, five of the 19 schools in Pasco School District made the list. All elementary schools, they had failed to meet academic performance goals every year since the state began measuring schools against them in 2006. Over a three-year period, only 30…

Tracking Vaccination Teams During Polio Campaigns in Northern Nigeria by Use of Geographic Information System Technology: 2013-2015.

PubMed

Touray, Kebba; Mkanda, Pascal; Tegegn, Sisay G; Nsubuga, Peter; Erbeto, Tesfaye B; Banda, Richard; Etsano, Andrew; Shuaib, Faisal; Vaz, Rui G

2016-05-01

Nigeria is among the 3 countries in which polio remains endemic. The country made significant efforts to reduce polio transmission but remains challenged by poor-quality campaigns and poor team performance in some areas. This article demonstrates the application of geographic information system technology to track vaccination teams to monitor settlement coverage, reduce the number of missed settlements, and improve team performance. In each local government area where tracking was conducted, global positioning system-enabled Android phones were given to each team on a daily basis and were used to record team tracks. These tracks were uploaded to a dashboard to show the level of coverage and identify areas missed by the teams. From 2012 to June 2015, tracking covered 119 immunization days. A total of 1149 tracking activities were conducted. Of these, 681 (59%) were implemented in Kano state. There was an improvement in the geographic coverage of settlements and an overall reduction in the number of missed settlements. The tracking of vaccination teams provided significant feedback during polio campaigns and enabled supervisors to evaluate performance of vaccination teams. The reports supported other polio program activities, such as review of microplans and the deployment of other interventions, for increasing population immunity in northern Nigeria. © 2016 World Health Organization; licensee Oxford Journals.

The Display of Visual Information in Mission Command Systems: Implications for Cognitive Performance in the Command Post of the Future

DTIC Science & Technology

2013-08-01

position unless so designated by other authorized documents. Citation of manufacturer’s or trade names does not constitute an official endorsement or...the presence of large volumes of time critical information. CPOF was designed to support the Army transformation to network-enabled operations. The...Cognitive Performance The visual display of information is vital to cognitive performance. For example, the poor visual design of the radar display

Optimization of the Implementation of Managed Aquifer Recharge - Effects of Aquifer Heterogeneity

NASA Astrophysics Data System (ADS)

Maliva, Robert; Missimer, Thomas; Kneppers, Angeline

2010-05-01

Managed aquifer recharge (MAR) has become a key component of integrated water resources management, especially in water scarce regions. MAR can serve the dual role of increasing the supply of available water and improving the quality of recharged water through natural attenuation processes. The performance of MAR systems is highly dependent upon site-specific hydrogeological conditions. Aquifer heterogeneity, such as the presence of high-permeability preferential flow zones and dual or even the so-called triple-porosity conditions, has been responsible for the under performance or failure of some MAR systems. Aquifer heterogeneity can result in much more rapid and unpredictable movement and mixing of recharged water and the bypassing of natural attenuation processes. A critical element of MAR projects is a detailed aquifer characterization and the development of groundwater flow and solute transport models at the appropriate spatial and temporal scales that accurately simulate local heterogeneous flow systems. Geochemical modeling based on high-quality, site-specific mineralogical and water chemistry data can also be used to predict the potential for adverse water-rock interactions such as the leaching of arsenic and trace metals into recharged water. Hydrogeological conditions that could lead to poor system performance should be identified early in the project development before the investment is made to construct a full-scale system. Hydrogeological conditions that have lead to poor MAR system performance are typically identifiable at the exploratory well stage of projects. Early detection of adverse hydrogeological conditions provides an opportunity to either abandon a likely under-performing project, select an alternative site with more favorable conditions, or modify the system design to be more compatible with local hydrogeology. Advanced borehole geophysical techniques and workflow software can allow for enhanced aquifer characterization and thus allow for more successful MAR implementation as a tool for improved water resources management.

Linking Logistics and Operations: A Case Study of World War II Air Power

DTIC Science & Technology

1991-01-01

Weapon System Evaluation Group, 1951, p. 30). The logistic innovation greatly extended the time that combat ships could remain on station and...presented. This Note was produced under the Project AIR FORCE Resource Management and System Acquisition Program in the project "Combat Support C3 Needs...maintenance workload data suggest either unacceptable system performance or excessive costs. The predictive power of these models is so poor as to

Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

PubMed Central

Bevan, Gwyn; Hamblin, Richard

2009-01-01

Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

SQL is Dead; Long-live SQL: Relational Database Technology in Science Contexts

NASA Astrophysics Data System (ADS)

Howe, B.; Halperin, D.

2014-12-01

Relational databases are often perceived as a poor fit in science contexts: Rigid schemas, poor support for complex analytics, unpredictable performance, significant maintenance and tuning requirements --- these idiosyncrasies often make databases unattractive in science contexts characterized by heterogeneous data sources, complex analysis tasks, rapidly changing requirements, and limited IT budgets. In this talk, I'll argue that although the value proposition of typical relational database systems are weak in science, the core ideas that power relational databases have become incredibly prolific in open source science software, and are emerging as a universal abstraction for both big data and small data. In addition, I'll talk about two open source systems we are building to "jailbreak" the core technology of relational databases and adapt them for use in science. The first is SQLShare, a Database-as-a-Service system supporting collaborative data analysis and exchange by reducing database use to an Upload-Query-Share workflow with no installation, schema design, or configuration required. The second is Myria, a service that supports much larger scale data, complex analytics, and supports multiple back end systems. Finally, I'll describe some of the ways our collaborators in oceanography, astronomy, biology, fisheries science, and more are using these systems to replace script-based workflows for reasons of performance, flexibility, and convenience.

Effluent quality from 200 on-site sewage systems: design values for guidelines.

PubMed

Charles, K J; Ashbolt, N J; Roser, D J; McGuinness, R; Deere, D A

2005-01-01

The quality of effluent from an on-site sewage treatment system is a critical factor in designing the disposal area and, hence, ensuring the sustained performance of the system. Contaminant concentrations in effluent are typically specified in regulatory guidelines or standards; however, the accuracy of these guideline values are brought into question due to the poor performance of septic tanks and the high failure rates of disposal systems reported here and elsewhere. Results from studies of septic tank effluent quality indicated that the effluent is of poorer quality than currently suggested by guidelines. Aerated wastewater treatment systems were found to perform to accreditation guidelines; however, insufficient nutrient data is presently available to assess nutrient loads. It is proposed that the 80th percentile of system performance be adopted as the design value for sizing effluent disposal areas to minimise failure associated with overloading. For septic tanks this equates to 660 mg L(-1) SS, 330 mg L(-1) BOD, 250 mg L(-1) TN and 36 mg L(-1) TP.

[Operation directions by comparing financial ratio of 22 provincial hospitals].

PubMed

Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C

1996-12-01

Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a hospital with more confidence, flexibility and readiness for internal improvement always demonstrates greater business efficiency.

Combining surface reanalysis and remote sensing data for monitoring evapotranspiration

USGS Publications Warehouse

Marshall, M.; Tu, K.; Funk, C.; Michaelsen, J.; Williams, Pat; Williams, C.; Ardö, J.; Marie, B.; Cappelaere, B.; Grandcourt, A.; Nickless, A.; Noubellon, Y.; Scholes, R.; Kutsch, W.

2012-01-01

Climate change is expected to have the greatest impact on the world's poor. In the Sahel, a climatically sensitive region where rain-fed agriculture is the primary livelihood, expected decreases in water supply will increase food insecurity. Studies on climate change and the intensification of the water cycle in sub-Saharan Africa are few. This is due in part to poor calibration of modeled actual evapotranspiration (AET), a key input in continental-scale hydrologic models. In this study, a model driven by dynamic canopy AET was combined with the Global Land Data Assimilation System realization of the NOAH Land Surface Model (GNOAH) wet canopy and soil AET for monitoring purposes in sub-Saharan Africa. The performance of the hybrid model was compared against AET from the GNOAH model and dynamic model using eight eddy flux towers representing major biomes of sub-Saharan Africa. The greatest improvements in model performance are at humid sites with dense vegetation, while performance at semi-arid sites is poor, but better than individual models. The reduction in errors using the hybrid model can be attributed to the integration of a dynamic vegetation component with land surface model estimates, improved model parameterization, and reduction of multiplicative effects of uncertain data.

5 CFR 362.207 - Withdrawal and readmission.

Code of Federal Regulations, 2010 CFR

2010-01-01

... withdraws from the Program for reasons that are not related to misconduct, poor performance, or suitability... misconduct, poor performance, or suitability, as determined by the agency, he/she will not be readmitted to... are not related to misconduct, poor performance, or suitability, he/she may petition the employing...

Discovering system requirements

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

Bahill, A.T.; Bentz, B.; Dean, F.F.

1996-07-01

Cost and schedule overruns are often caused by poor requirements that are produced by people who do not understand the requirements process. This report provides a high-level overview of the system requirements process, explaining types, sources, and characteristics of good requirements. System requirements, however, are seldom stated by the customer. Therefore, this report shows ways to help you work with your customer to discover the system requirements. It also explains terminology commonly used in the requirements development field, such as verification, validation, technical performance measures, and the various design reviews.

Interference control in working memory: comparing groups of children with atypical development.

PubMed

Palladino, Paola; Ferrari, Marcella

2013-01-01

The study aimed to test whether working memory deficits in children at risk of Learning Disabilities (LD) and/or attention deficit/hyperactivity disorder (ADHD) can be attributed to deficits in interference control, thereby implicating prefrontal systems. Two groups of children known for showing poor working memory (i.e., children with poor comprehension and children with ADHD) were compared to a group of children with specific reading decoding problems (i.e., having severe problems in phonological rather than working memory) and to a control group. All children were tested with a verbal working memory task. Interference control of irrelevant items was examined by a lexical decision task presented immediately after the final recall in about half the trials, selected at random. The interference control measure was therefore directly related to working memory performance. Results confirmed deficient working memory performance in poor comprehenders and children at risk of ADHD + LD. More interestingly, this working memory deficit was associated with greater activation of irrelevant information than in the control group. Poor decoders showed more efficient interference control, in contrast to poor comprehenders and ADHD + LD children. These results indicated that interfering items were still highly accessible to working memory in children who fail the working memory task. In turn, these findings strengthen and clarify the role of interference control, one of the most critical prefrontal functions, in working memory.

Forgotten forests--issues and prospects in biome mapping using Seasonally Dry Tropical Forests as a case study.

PubMed

Särkinen, Tiina; Iganci, João R V; Linares-Palomino, Reynaldo; Simon, Marcelo F; Prado, Darién E

2011-11-24

South America is one of the most species diverse continents in the world. Within South America diversity is not distributed evenly at both local and continental scales and this has led to the recognition of various areas with unique species assemblages. Several schemes currently exist which divide the continental-level diversity into large species assemblages referred to as biomes. Here we review five currently available biome maps for South America, including the WWF Ecoregions, the Americas basemap, the Land Cover Map of South America, Morrone's Biogeographic regions of Latin America, and the Ecological Systems Map. The comparison is performed through a case study on the Seasonally Dry Tropical Forest (SDTF) biome using herbarium data of habitat specialist species. Current biome maps of South America perform poorly in depicting SDTF distribution. The poor performance of the maps can be attributed to two main factors: (1) poor spatial resolution, and (2) poor biome delimitation. Poor spatial resolution strongly limits the use of some of the maps in GIS applications, especially for areas with heterogeneous landscape such as the Andes. Whilst the Land Cover Map did not suffer from poor spatial resolution, it showed poor delimitation of biomes. The results highlight that delimiting structurally heterogeneous vegetation is difficult based on remote sensed data alone. A new refined working map of South American SDTF biome is proposed, derived using the Biome Distribution Modelling (BDM) approach where georeferenced herbarium data is used in conjunction with bioclimatic data. Georeferenced specimen data play potentially an important role in biome mapping. Our study shows that herbarium data could be used as a way of ground-truthing biome maps in silico. The results also illustrate that herbarium data can be used to model vegetation maps through predictive modelling. The BDM approach is a promising new method in biome mapping, and could be particularly useful for mapping poorly known, fragmented, or degraded vegetation. We wish to highlight that biome delimitation is not an exact science, and that transparency is needed on how biomes are used as study units in macroevolutionary and ecological research.

Forgotten forests - issues and prospects in biome mapping using Seasonally Dry Tropical Forests as a case study

PubMed Central

2011-01-01

Background South America is one of the most species diverse continents in the world. Within South America diversity is not distributed evenly at both local and continental scales and this has led to the recognition of various areas with unique species assemblages. Several schemes currently exist which divide the continental-level diversity into large species assemblages referred to as biomes. Here we review five currently available biome maps for South America, including the WWF Ecoregions, the Americas basemap, the Land Cover Map of South America, Morrone's Biogeographic regions of Latin America, and the Ecological Systems Map. The comparison is performed through a case study on the Seasonally Dry Tropical Forest (SDTF) biome using herbarium data of habitat specialist species. Results Current biome maps of South America perform poorly in depicting SDTF distribution. The poor performance of the maps can be attributed to two main factors: (1) poor spatial resolution, and (2) poor biome delimitation. Poor spatial resolution strongly limits the use of some of the maps in GIS applications, especially for areas with heterogeneous landscape such as the Andes. Whilst the Land Cover Map did not suffer from poor spatial resolution, it showed poor delimitation of biomes. The results highlight that delimiting structurally heterogeneous vegetation is difficult based on remote sensed data alone. A new refined working map of South American SDTF biome is proposed, derived using the Biome Distribution Modelling (BDM) approach where georeferenced herbarium data is used in conjunction with bioclimatic data. Conclusions Georeferenced specimen data play potentially an important role in biome mapping. Our study shows that herbarium data could be used as a way of ground-truthing biome maps in silico. The results also illustrate that herbarium data can be used to model vegetation maps through predictive modelling. The BDM approach is a promising new method in biome mapping, and could be particularly useful for mapping poorly known, fragmented, or degraded vegetation. We wish to highlight that biome delimitation is not an exact science, and that transparency is needed on how biomes are used as study units in macroevolutionary and ecological research. PMID:22115315

Medical record keeping and system performance in orthopaedic trauma patients.

PubMed

Cosic, Filip; Kimmel, Lara; Edwards, Elton

2016-01-01

Objective The medical record is critical for documentation and communication between healthcare professionals. The aim of the present study was to evaluate important aspects of the orthopaedic medical record and system performance to determine whether any deficiencies exist in these areas. Methods Review of 200 medical records of surgically treated traumatic lower limb injury patients was undertaken. The operative report, discharge summary and first and second outpatient reviews were evaluated. Results In all cases, an operative report was completed by a senior surgeon. Weight-bearing status was adequately documented in 91% of reports. Discharge summaries were completed for 82.5% of admissions, with 87.3% of these having instructions reflective of those in the operative report. Of first and second outpatient reviews, 69% and 73%, respectively, occurred within 1 week of the requested time. Previously documented management plans were changed in 30% of reviews. At 6-months post-operatively, 42% of patients had been reviewed by a member of their operating team. Discussion Orthopaedic medical record documentation remains an area for improvement. In addition, hospital out-patient systems perform suboptimally and may affect patient outcomes. What is known about the topic? Medical records are an essential tool in modern medical practice. Despite the importance of comprehensive documentation in the medical record, numerous examples of poor documentation have been demonstrated, including substandard documentation during consultant ward rounds by junior doctors leading to a breakdown in healthcare professional communication and potential patient mismanagement. Further inadequacies of medical record documentation have been demonstrated in surgical discharge notes, with complete and correct documentation reported to be as low as 65%. What does this paper add? Standards of patient care should be constantly monitored and deficiencies identified in order to implement a remedy and close the quality loop. The present study has highlighted that the standard of orthopaedic trauma medical record keeping at an Australian Level 1 trauma centre is below what is expected and several key areas of documentation require improvement. This paper further evaluates the system performance of the out-patient system, an area where, to the authors knowledge, there is no previous work published. The findings show that the performance was below what is expected for surgical review, with many patients failing to be reviewed by their operating surgeon. What are the implications for practitioners? The present study shows that there is a poor level of documentation and a standard of out-patient review below what is expected. The implications of these findings will be to highlight current deficiencies to practitioners and promote change in current practice to improve the quality of medical record documentation among medical staff. Further, the findings of poor system performance will promote change in the current system of delivering out-patient care to patients.

A Test of the California Wildlife-Habitat Relationship System for Breeding Birds in Valley-Foothill Riparian Habitat

Treesearch

Stephen A. Laymon

1989-01-01

The California Wildlife-Habitat Relationship (WHR) system was tested for birds breeding in the Valley-Foothill Riparian habitat along California's Sacramento and South Fork Kern rivers. The model performed poorly with 33 pct and 21 pct correct predictions respectively at the two locations. Changes to the model for 60 species on the Sacramento River and 66 species...

Managing Your Team's Weakest Link.

PubMed

Hills, Laura

2015-01-01

Do you have a poor-performing employee on your medical practice team? If so, you're not alone. Unfortunately, this is a problem that many medical practice managers face. This article describes the best strategies for managing your team's weakest link. It explores common yet very difficult circumstances that cause low employee performance and that test the patience, heart, and skills of a practice manager. It guides readers through a process of self-discovery to determine whether their negative biases or grudges may be causing employees to perform poorly. It suggests several possible other reasons for weak employee performance, including problems with the job, practice, leadership, communication, and fit between the employee and the job. This article also suggests the best strategy for communicating concerns about performance to the weakest-link employee. It offers guidance to practice managers about protecting their time and energy when handling a poor performer. It provides a simple formula for calculating the cost of a low-performing employee, 10 possible personal reasons for the employee's poor work performance, specific questions to ask to uncover the reasons for poor performance, and an eight-rule strategy for confronting poor performance effectively. Finally, this article offers practice managers a practical strategy for handling resistance from their weakest link, illustrated with a sample dialogue.

a Method for the Positioning and Orientation of Rail-Bound Vehicles in Gnss-Free Environments

NASA Astrophysics Data System (ADS)

Hung, R.; King, B. A.; Chen, W.

2016-06-01

Mobile Mapping System (MMS) are increasingly applied for spatial data collection to support different fields because of their efficiencies and the levels of detail they can provide. The Position and Orientation System (POS), which is conventionally employed for locating and orienting MMS, allows direct georeferencing of spatial data in real-time. Since the performance of a POS depends on both the Inertial Navigation System (INS) and the Global Navigation Satellite System (GNSS), poor GNSS conditions, such as in long tunnels and underground, introduce the necessity for post-processing. In above-ground railways, mobile mapping technology is employed with high performance sensors for finite usage, which has considerable potential for enhancing railway safety and management in real-time. In contrast, underground railways present a challenge for a conventional POS thus alternative configurations are necessary to maintain data accuracy and alleviate the need for post-processing. This paper introduces a method of rail-bound navigation to replace the role of GNSS for railway applications. The proposed method integrates INS and track alignment data for environment-independent navigation and reduces the demand of post-processing. The principle of rail-bound navigation is presented and its performance is verified by an experiment using a consumer-grade Inertial Measurement Unit (IMU) and a small-scale railway model. The method produced a substantial improvement in position and orientation for a poorly initialised system in centimetre positional accuracy. The potential improvements indicated by, and limitations of rail-bound navigation are also considered for further development in existing railway systems.

Merit Pay Misfires

ERIC Educational Resources Information Center

Ramirez, Al

2011-01-01

Critics argue that the uniform salary schedule is unfair because it promotes mediocrity by rewarding poor performers while failing to recognize outstanding achievement on the job. Advocates for merit pay systems for preK-12 education also contend that the uniform salary schedule ignores the basic purpose of education--student learning. Although…

Irregular Applications: Architectures & Algorithms

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

Feo, John T.; Villa, Oreste; Tumeo, Antonino

Irregular applications are characterized by irregular data structures, control and communication patterns. Novel irregular high performance applications which deal with large data sets and require have recently appeared. Unfortunately, current high performance systems and software infrastructures executes irregular algorithms poorly. Only coordinated efforts by end user, area specialists and computer scientists that consider both the architecture and the software stack may be able to provide solutions to the challenges of modern irregular applications.

Iron nutrition and premenopausal women: effects of poor iron status on physical and neuropsychological performance.

PubMed

McClung, James P; Murray-Kolb, Laura E

2013-01-01

Iron is a nutritionally essential trace element that functions through incorporation into proteins and enzymes, many of which contribute to physical and neuropsychological performance. Poor iron status, including iron deficiency (ID; diminished iron stores) and iron deficiency anemia (IDA; poor iron stores and diminished hemoglobin), affects billions of people worldwide. This review focuses on physical and neuropsychological outcomes associated with ID and IDA in premenopausal women, as the prevalence of ID and IDA is often greater in premenopausal women than other population demographics. Recent studies addressing the physiological effects of poor iron status on physical performance, including work productivity, voluntary activity, and athletic performance, are addressed. Similarly, the effects of iron status on neurological performance, including cognition, affect, and behavior, are summarized. Nutritional countermeasures for the prevention of poor iron status and the restoration of decrements in performance outcomes are described.

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

Attitude determination using an adaptive multiple model filtering Scheme

NASA Technical Reports Server (NTRS)

Lam, Quang; Ray, Surendra N.

1995-01-01

Attitude determination has been considered as a permanent topic of active research and perhaps remaining as a forever-lasting interest for spacecraft system designers. Its role is to provide a reference for controls such as pointing the directional antennas or solar panels, stabilizing the spacecraft or maneuvering the spacecraft to a new orbit. Least Square Estimation (LSE) technique was utilized to provide attitude determination for the Nimbus 6 and G. Despite its poor performance (estimation accuracy consideration), LSE was considered as an effective and practical approach to meet the urgent need and requirement back in the 70's. One reason for this poor performance associated with the LSE scheme is the lack of dynamic filtering or 'compensation'. In other words, the scheme is based totally on the measurements and no attempts were made to model the dynamic equations of motion of the spacecraft. We propose an adaptive filtering approach which employs a bank of Kalman filters to perform robust attitude estimation. The proposed approach, whose architecture is depicted, is essentially based on the latest proof on the interactive multiple model design framework to handle the unknown of the system noise characteristics or statistics. The concept fundamentally employs a bank of Kalman filter or submodel, instead of using fixed values for the system noise statistics for each submodel (per operating condition) as the traditional multiple model approach does, we use an on-line dynamic system noise identifier to 'identify' the system noise level (statistics) and update the filter noise statistics using 'live' information from the sensor model. The advanced noise identifier, whose architecture is also shown, is implemented using an advanced system identifier. To insure the robust performance for the proposed advanced system identifier, it is also further reinforced by a learning system which is implemented (in the outer loop) using neural networks to identify other unknown quantities such as spacecraft dynamics parameters, gyro biases, dynamic disturbances, or environment variations.

Attitude determination using an adaptive multiple model filtering Scheme

NASA Astrophysics Data System (ADS)

Lam, Quang; Ray, Surendra N.

1995-05-01

Attitude determination has been considered as a permanent topic of active research and perhaps remaining as a forever-lasting interest for spacecraft system designers. Its role is to provide a reference for controls such as pointing the directional antennas or solar panels, stabilizing the spacecraft or maneuvering the spacecraft to a new orbit. Least Square Estimation (LSE) technique was utilized to provide attitude determination for the Nimbus 6 and G. Despite its poor performance (estimation accuracy consideration), LSE was considered as an effective and practical approach to meet the urgent need and requirement back in the 70's. One reason for this poor performance associated with the LSE scheme is the lack of dynamic filtering or 'compensation'. In other words, the scheme is based totally on the measurements and no attempts were made to model the dynamic equations of motion of the spacecraft. We propose an adaptive filtering approach which employs a bank of Kalman filters to perform robust attitude estimation. The proposed approach, whose architecture is depicted, is essentially based on the latest proof on the interactive multiple model design framework to handle the unknown of the system noise characteristics or statistics. The concept fundamentally employs a bank of Kalman filter or submodel, instead of using fixed values for the system noise statistics for each submodel (per operating condition) as the traditional multiple model approach does, we use an on-line dynamic system noise identifier to 'identify' the system noise level (statistics) and update the filter noise statistics using 'live' information from the sensor model. The advanced noise identifier, whose architecture is also shown, is implemented using an advanced system identifier. To insure the robust performance for the proposed advanced system identifier, it is also further reinforced by a learning system which is implemented (in the outer loop) using neural networks to identify other unknown quantities such as spacecraft dynamics parameters, gyro biases, dynamic disturbances, or environment variations.

Visualizing request-flow comparison to aid performance diagnosis in distributed systems.

PubMed

Sambasivan, Raja R; Shafer, Ilari; Mazurek, Michelle L; Ganger, Gregory R

2013-12-01

Distributed systems are complex to develop and administer, and performance problem diagnosis is particularly challenging. When performance degrades, the problem might be in any of the system's many components or could be a result of poor interactions among them. Recent research efforts have created tools that automatically localize the problem to a small number of potential culprits, but research is needed to understand what visualization techniques work best for helping distributed systems developers understand and explore their results. This paper compares the relative merits of three well-known visualization approaches (side-by-side, diff, and animation) in the context of presenting the results of one proven automated localization technique called request-flow comparison. Via a 26-person user study, which included real distributed systems developers, we identify the unique benefits that each approach provides for different problem types and usage modes.

Kunduz ANA Garrison: Army Corps of Engineers Released DynCorp of All Contractual Obligations despite Poor Performance and Structural Failures

DTIC Science & Technology

2012-10-01

20  FIGURES Figure 1 - Kunduz PRT March 2012 with Elevated Building Pad and Positive Drainage System ...Figure 1 - Kunduz PRT March 2012 with Elevated Building Pad and Positive Drainage System Source: SIGAR photo March 25, 2012. ACTIONS TAKEN BY...garrison compound and including a storm drainage system . USACE-TAN also commented that its engineers were unaware of the soil subsidence problem until the

Method of wavefront tilt correction for optical heterodyne detection systems under strong turbulence

NASA Astrophysics Data System (ADS)

Xiang, Jing-song; Tian, Xin; Pan, Le-chun

2014-07-01

Atmospheric turbulence decreases the heterodyne mixing efficiency of the optical heterodyne detection systems. Wavefront tilt correction is often used to improve the optical heterodyne mixing efficiency. But the performance of traditional centroid tracking tilt correction is poor under strong turbulence conditions. In this paper, a tilt correction method which tracking the peak value of laser spot on focal plane is proposed. Simulation results show that, under strong turbulence conditions, the performance of peak value tracking tilt correction is distinctly better than that of traditional centroid tracking tilt correction method, and the phenomenon of large antenna's performance inferior to small antenna's performance which may be occurred in centroid tracking tilt correction method can also be avoid in peak value tracking tilt correction method.

The extraction of motion-onset VEP BCI features based on deep learning and compressed sensing.

PubMed

Ma, Teng; Li, Hui; Yang, Hao; Lv, Xulin; Li, Peiyang; Liu, Tiejun; Yao, Dezhong; Xu, Peng

2017-01-01

Motion-onset visual evoked potentials (mVEP) can provide a softer stimulus with reduced fatigue, and it has potential applications for brain computer interface(BCI)systems. However, the mVEP waveform is seriously masked in the strong background EEG activities, and an effective approach is needed to extract the corresponding mVEP features to perform task recognition for BCI control. In the current study, we combine deep learning with compressed sensing to mine discriminative mVEP information to improve the mVEP BCI performance. The deep learning and compressed sensing approach can generate the multi-modality features which can effectively improve the BCI performance with approximately 3.5% accuracy incensement over all 11 subjects and is more effective for those subjects with relatively poor performance when using the conventional features. Compared with the conventional amplitude-based mVEP feature extraction approach, the deep learning and compressed sensing approach has a higher classification accuracy and is more effective for subjects with relatively poor performance. According to the results, the deep learning and compressed sensing approach is more effective for extracting the mVEP feature to construct the corresponding BCI system, and the proposed feature extraction framework is easy to extend to other types of BCIs, such as motor imagery (MI), steady-state visual evoked potential (SSVEP)and P300. Copyright © 2016 Elsevier B.V. All rights reserved.

PPO and HMO performance factors: insurance company evaluation criteria.

PubMed

Rodin, B E

1993-01-01

A venture into managed care should be done only following the proper amount of due diligence. The goal should be to select the most effective managed care organization with the flexibility to meet long-term needs and the mission to work on an ongoing basis to improve service and managed care performance. Unfortunately, all too often purchasers do not demand critical information from managed care service providers. As a result, poor quality organizations have prospered and delivered less than satisfactory results. In fact, it is not unusual that savings from discounts are more than offset by increased use of health care services because of poor utilization management. It is important to be aware that use of the appropriate selection methods and monitoring performance on an ongoing basis are best done by dedicated professionals. They are also resource intensive and require a sophisticated systems capability. Since resources and systems involve significant investment, the most appropriate course for purchasers is to play the role of educated consumers. Detailed documentation should be demanded from all potential service providers to ensure that due diligence and ongoing management are in fact performed. The health care management staff at ITT Hartford is often told by managed care vendors that few other purchasers perform thorough review. It is imperative that managed care be scrutinized at least as closely as any important business venture.

Understanding words, understanding numbers: an exploration of the mathematical profiles of poor comprehenders.

PubMed

Pimperton, Hannah; Nation, Kate

2010-06-01

Poor comprehenders are children who show significant deficits in their reading comprehension performance, despite average, or above-average word reading ability. To date, there have been no in-depth studies of the mathematical performance profiles of such children. This study aimed to explore the mathematical profiles of poor comprehenders. Given that language impairment is associated with difficulties with mathematics, and that poor comprehenders tend to have oral language weaknesses, we hypothesized that poor comprehenders would show relative weaknesses in aspects of mathematical performance. From a sample of 109 children aged 7-8 years, we selected 14 poor comprehenders and 14 controls with age-appropriate reading comprehension ability. The groups were matched on non-verbal ability, multiple measures of reading accuracy, and chronological age. We compared the performance of the group of poor comprehenders with that of the matched controls on two standardized measures of mathematical ability, one measuring procedural arithmetic prowess and the other tapping higher-level mathematical reasoning. Although there were no group differences in performance on the arithmetic measure, the poor comprehenders showed significantly lower scores than the controls on the mathematical reasoning task. The poor comprehenders exhibited impaired verbal ability relative to controls, with these differences in verbal ability associated with the group differences found on the test of mathematical reasoning. Poor comprehenders' deficits are not limited to the domain of literacy; their underlying profile of impairments also seems to selectively impact on certain components of mathematical ability.

An audit of level two and level three checks of anaesthesia delivery systems performed at three hospitals in South Australia.

PubMed

Sweeney, N; Owen, H; Fronsko, R; Hurlow, E

2012-11-01

Anaesthetists may subject patients to unnecessary risk by not checking anaesthetic equipment thoroughly before use. Numerous adverse events have been associated with failure to check equipment. The Australian and New Zealand College of Anaesthetists and anaesthetic delivery system manufactures have made recommendations on how anaesthetic equipment should be maintained and checked before use and for the training required for staff who use such equipment. These recommendations are made to minimise the risk to patients undergoing anaesthesia. This prospective audit investigated the adherence of anaesthetic practitioners to a selection of those recommendations. Covert observations of anaesthetic practitioners were made while they were checking their designated anaesthetic machine, either at the beginning of a day's list or between cases. Structured interviews with staff who check the anaesthetic machine were carried out to determine the training they had received. The results indicated poor compliance with recommendations: significantly, the backup oxygen cylinders' pressure/contents were not checked in 45% of observations; the emergency ventilation device was not checked in 67% of observations; the breathing circuit was not tested between patients in 79% of observations; no documentation of the checks performed was done in any cases; and no assessment or accreditation of the staff who performed these checks was performed. It was concluded that the poor compliance was a system failing and that patient safety might be increased with training and accrediting staff responsible for checking equipment, documenting the checks performed, and the formulation and use of a checklist.

Comparing federal and state healthcare provider performance in villages targeted by the conditional cash transfer programme of Mexico.

PubMed

Bustamante, Arturo Vargas

2011-10-01

This study investigates household out-of-pocket healthcare expenditures (OPH) and preventive care utilization (PHU) to compare federal and state healthcare provider performance in villages targeted by conditional cash transfer (CCT) programmes in poor rural areas of Mexico. Lower OPH and higher PHU are indicative of better performance in the study setting. Log-linear and probit regression models were used to compare outcomes in households from treatment and control villages reached by federal and state healthcare providers. In treatment villages, eligible households receive cash grants from the CCT programme. In control villages, eligible households do not receive cash grants from the CCT programme at the time of the survey. Families who live in treatment villages reported lower OPH (-52.5% for federal and -46.2% for state clinics) and higher PHU (21% for federal and 20% for state clinics) regardless of clinic setting. As the reduction in OPH is higher in areas reached by the federal clinics, it implies better performance from this healthcare delivery system. Additionally, federal clinic outcomes were also more homogeneous because OPH are not significantly different between treatment and control villages. Alternative measures such as drug and physician expenditures, diabetes and hypertension tests and nutritional-supplement receipt confirmed these findings. Mexico has two healthcare delivery systems that cater to identical rural populations. The better-funded and more centralized federal system is more effective at providing health care in poor rural villages of Mexico regardless of CCT participation. State clinics in villages targeted by the CCT programme, however, perform significantly better. © 2011 Blackwell Publishing Ltd.

Mental Imagery and Visual Working Memory

PubMed Central

Keogh, Rebecca; Pearson, Joel

2011-01-01

Visual working memory provides an essential link between past and future events. Despite recent efforts, capacity limits, their genesis and the underlying neural structures of visual working memory remain unclear. Here we show that performance in visual working memory - but not iconic visual memory - can be predicted by the strength of mental imagery as assessed with binocular rivalry in a given individual. In addition, for individuals with strong imagery, modulating the background luminance diminished performance on visual working memory and imagery tasks, but not working memory for number strings. This suggests that luminance signals were disrupting sensory-based imagery mechanisms and not a general working memory system. Individuals with poor imagery still performed above chance in the visual working memory task, but their performance was not affected by the background luminance, suggesting a dichotomy in strategies for visual working memory: individuals with strong mental imagery rely on sensory-based imagery to support mnemonic performance, while those with poor imagery rely on different strategies. These findings could help reconcile current controversy regarding the mechanism and location of visual mnemonic storage. PMID:22195024

Mental imagery and visual working memory.

PubMed

Keogh, Rebecca; Pearson, Joel

2011-01-01

Visual working memory provides an essential link between past and future events. Despite recent efforts, capacity limits, their genesis and the underlying neural structures of visual working memory remain unclear. Here we show that performance in visual working memory--but not iconic visual memory--can be predicted by the strength of mental imagery as assessed with binocular rivalry in a given individual. In addition, for individuals with strong imagery, modulating the background luminance diminished performance on visual working memory and imagery tasks, but not working memory for number strings. This suggests that luminance signals were disrupting sensory-based imagery mechanisms and not a general working memory system. Individuals with poor imagery still performed above chance in the visual working memory task, but their performance was not affected by the background luminance, suggesting a dichotomy in strategies for visual working memory: individuals with strong mental imagery rely on sensory-based imagery to support mnemonic performance, while those with poor imagery rely on different strategies. These findings could help reconcile current controversy regarding the mechanism and location of visual mnemonic storage.

Management by consent in human-machine systems: when and why it breaks down.

PubMed

Olson, W A; Sarter, N B

2001-01-01

This study examined the effects of conflict type, time pressure, and display design on operators' ability to make informed decisions about proposed machine goals and actions in a management-by-consent context. A group of 30 B757 pilots were asked to fly eight descent scenarios while responding to a series of air traffic control clearances. Each scenario presented pilots with a different conflict that arose from either incompatible goals contained in the clearance or inappropriate implementation of the clearance by automated flight deck systems. Pilots were often unable to detect these conflicts, especially under time pressure, and thus failed to disallow or intervene with proposed machine actions. Detection performance was particularly poor for conflicts related to clearance implementation. These conflicts were most likely to be missed when automated systems did more than the pilot expected of them. Performance and verbal protocol data indicate that the observed difficulties can be explained by a combination of poor system feedback and pilots' difficulties with generating expectations of future system behavior. Our results are discussed in terms of their implications for the choice and implementation of automation management strategies in general and, more specifically, with respect to risks involved in envisioned forms of digital air-ground communication in the future aviation system. Actual or potential applications of this research include the design of future data link systems and procedures, as well as the design of future automated systems in any domain that rely on operator consent as a mechanism for human-machine coordination.

Disentangling Linguistic Modality Effects in Semantic Processing

ERIC Educational Resources Information Center

Moita, Mara; Nunes, Maria Vânia

2017-01-01

Sensory systems are essential for perceiving and conceptualizing our semantic knowledge about the world and the way we interact with it. Despite studies reporting neural changes to compensate for the absence of a given sensory modality, studies focusing on the assessment of semantic processing reveal poor performances by deaf individuals when…

2 CFR 215.14 - Special award conditions.

Code of Federal Regulations, 2010 CFR

2010-01-01

....14 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET CIRCULARS AND GUIDANCE Reserved UNIFORM.... If an applicant or recipient: has a history of poor performance, is not financially stable, has a management system that does not meet the standards prescribed in this part, has not conformed to the terms...

Market Tested Business Education: Corporate Sector Perceptions of Saudi Graduates Competencies

ERIC Educational Resources Information Center

Iqbal, Adnan; Zenchenkov, Mikhail

2014-01-01

University-industry collaboration patterns in more advanced economies have greatly impacted expectations for higher educational systems in developing countries. In Saudi Arabia, generally poor innovation performance of domestic industry has been perceived as a constraint in global competitiveness. The purpose of this study was to determine if…

Inhibition in Dot Comparison Tasks

ERIC Educational Resources Information Center

Clayton, Sarah; Gilmore, Camilla

2015-01-01

Dot comparison tasks are commonly used to index an individual's Approximate Number System (ANS) acuity, but the cognitive processes involved in completing these tasks are poorly understood. Here, we investigated how factors including numerosity ratio, set size and visual cues influence task performance. Forty-four children aged 7-9 years completed…

10 CFR 600.114 - Special award conditions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... recipient has a history of poor performance, is not financially stable, has a management system that does... previous award, or is not otherwise responsible, DOE may impose additional requirements as needed, without... subaward. In any such case, the recipient must notify DOE in writing within 15 days of the subaward. DOE...

7 CFR 3015.4 - Special restrictive terms.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... (a) Occasionally an awarding agency, or a recipient awarding a subgrant, may find that a particular recipient: (1) Is financially unstable, (2) Has a history of poor performance, or (3) Has a management system that does not meet the standards in this part. In these cases the awarding agency may impose...

7 CFR 3015.4 - Special restrictive terms.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... (a) Occasionally an awarding agency, or a recipient awarding a subgrant, may find that a particular recipient: (1) Is financially unstable, (2) Has a history of poor performance, or (3) Has a management system that does not meet the standards in this part. In these cases the awarding agency may impose...

10 CFR 600.114 - Special award conditions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... recipient has a history of poor performance, is not financially stable, has a management system that does... previous award, or is not otherwise responsible, DOE may impose additional requirements as needed, without... subaward. In any such case, the recipient must notify DOE in writing within 15 days of the subaward. DOE...

10 CFR 600.114 - Special award conditions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... recipient has a history of poor performance, is not financially stable, has a management system that does... previous award, or is not otherwise responsible, DOE may impose additional requirements as needed, without... subaward. In any such case, the recipient must notify DOE in writing within 15 days of the subaward. DOE...

7 CFR 3015.4 - Special restrictive terms.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (a) Occasionally an awarding agency, or a recipient awarding a subgrant, may find that a particular recipient: (1) Is financially unstable, (2) Has a history of poor performance, or (3) Has a management system that does not meet the standards in this part. In these cases the awarding agency may impose...

7 CFR 3015.4 - Special restrictive terms.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... (a) Occasionally an awarding agency, or a recipient awarding a subgrant, may find that a particular recipient: (1) Is financially unstable, (2) Has a history of poor performance, or (3) Has a management system that does not meet the standards in this part. In these cases the awarding agency may impose...

CREDENTIALISM AND THE EDUCATION SYSTEM.

ERIC Educational Resources Information Center

MILLER, S.M.

EXISTING SOCIAL AND OCCUPATIONAL STRUCTURES SHOULD BE REMADE SO THAT CREDENTIALISM DOES NOT ARBITARILY BAR NEGROES AND THE POOR FROM ECONOMIC WELL-BEING AND SOCIAL MOBILITY. GRADUATION FROM A SCHOOL SIMPLY IMPLIES THAT ONE HAS FIT INTO THE PROPER EDUCATIONAL STRAITS AND DOES NOT NECESSARILY SIGNAL QUALITY PERFORMANCE. CREDENTIALISM AND ITS…

NCLB--Year for Change

ERIC Educational Resources Information Center

Odland, Jerry

2007-01-01

Much debate continues about whether the 2001 No Child Left Behind Act (NCLB) has actually improved the academic achievement level of poorly performing students or only created yet another layer of government oversight to an already heavily burdened public school system. Drafted in 2001 and signed into law in January 2002, NCLB provided the…

A comparative study of spray-dried and freeze-dried hydrocortisone/polyvinyl pyrrolidone solid dispersions.

PubMed

Dontireddy, Rakesh; Crean, Abina M

2011-10-01

Poor water solubility of new chemical entities (NCEs) is one of the major challenges the pharmaceutical industry currently faces. The purpose of this study was to investigate the feasibility of freeze-drying as an alternative technique to spray-drying to produce solid dispersions of poorly water-soluble drugs. Also investigated was the use of aqueous solvent mixtures in place of pure solvent for the production of solid dispersions. Aqueous solvent systems would reduce the environmental impact of pure organic solvent systems. Spray-dried and freeze-dried hydrocortisone/polyvinyl pyrrolidone solid dispersions exhibited differences in dissolution behavior. Freeze-dried dispersions exhibited faster dissolution rates than the corresponding spray-dried dispersions. Spray-dried systems prepared using both solvent systems (20% v/v and 96% v/v ethanol) displayed similar dissolution performance despite displaying differences in glass transition temperatures (T(g)) and surface areas. All dispersions showed drug/polymer interactions indicated by positive deviations in T(g) from the predicted values calculated using the Couchman-Karasz equation. Fourier transform infrared (FTIR) spectroscopic results confirmed the conversion of crystalline drug to the amorphous in the dispersions. Stability studies were preformed at 40°C and 75% relative humidity to investigate the physical stability of prepared dispersions. Recrystallization was observed after a month and the resultant dispersions were tested for their dissolution performance to compare with the dissolution performance of the dispersions prior to the stability study. The dissolution rate of the freeze-dried dispersions remained higher than both spray-dried dispersions after storage.

An adaptive optics imaging system designed for clinical use.

PubMed

Zhang, Jie; Yang, Qiang; Saito, Kenichi; Nozato, Koji; Williams, David R; Rossi, Ethan A

2015-06-01

Here we demonstrate a new imaging system that addresses several major problems limiting the clinical utility of conventional adaptive optics scanning light ophthalmoscopy (AOSLO), including its small field of view (FOV), reliance on patient fixation for targeting imaging, and substantial post-processing time. We previously showed an efficient image based eye tracking method for real-time optical stabilization and image registration in AOSLO. However, in patients with poor fixation, eye motion causes the FOV to drift substantially, causing this approach to fail. We solve that problem here by tracking eye motion at multiple spatial scales simultaneously by optically and electronically integrating a wide FOV SLO (WFSLO) with an AOSLO. This multi-scale approach, implemented with fast tip/tilt mirrors, has a large stabilization range of ± 5.6°. Our method consists of three stages implemented in parallel: 1) coarse optical stabilization driven by a WFSLO image, 2) fine optical stabilization driven by an AOSLO image, and 3) sub-pixel digital registration of the AOSLO image. We evaluated system performance in normal eyes and diseased eyes with poor fixation. Residual image motion with incremental compensation after each stage was: 1) ~2-3 arc minutes, (arcmin) 2) ~0.5-0.8 arcmin and, 3) ~0.05-0.07 arcmin, for normal eyes. Performance in eyes with poor fixation was: 1) ~3-5 arcmin, 2) ~0.7-1.1 arcmin and 3) ~0.07-0.14 arcmin. We demonstrate that this system is capable of reducing image motion by a factor of ~400, on average. This new optical design provides additional benefits for clinical imaging, including a steering subsystem for AOSLO that can be guided by the WFSLO to target specific regions of interest such as retinal pathology and real-time averaging of registered images to eliminate image post-processing.

Magnetic Sensors with Picotesla Magnetic Field Sensitivity at Room Temperature

DTIC Science & Technology

2008-06-01

such small fields require cryogenic cooling such as SQUID sensors, require sophisticated detection systems such as atomic magnetometers and fluxgate ... magnetometers , or have large size and poor low frequency performance such as coil systems. [3-7] The minimum detectable field (the field noise times...Kingdon, "Development of a Combined EMI/ Magnetometer Sensor for UXO Detection," Proc. Symposium on the Applications of Geophysics to Environmental and

N Reasons Why Production-Rules are Insufficient Models for Expert System Knowledge Representation Schemes

DTIC Science & Technology

1991-02-01

3 2.2 Hybrid Rule/Fact Schemas .............................................................. 3 3 THE LIMITATIONS OF RULE BASED KNOWLEDGE...or hybrid rule/fact schemas. 2 UNCLASSIFIED .WA UNCLASSIFIED ERL-0520-RR 2.1 Propositional Logic The simplest form of production-rules are based upon...requirements which may lead to poor system performance. 2.2 Hybrid Rule/Fact Schemas Hybrid rule/fact relationships (also known as Predicate Calculus ) have

Real-time Enhancement, Registration, and Fusion for an Enhanced Vision System

NASA Technical Reports Server (NTRS)

Hines, Glenn D.; Rahman, Zia-ur; Jobson, Daniel J.; Woodell, Glenn A.

2006-01-01

Over the last few years NASA Langley Research Center (LaRC) has been developing an Enhanced Vision System (EVS) to aid pilots while flying in poor visibility conditions. The EVS captures imagery using two infrared video cameras. The cameras are placed in an enclosure that is mounted and flown forward-looking underneath the NASA LaRC ARIES 757 aircraft. The data streams from the cameras are processed in real-time and displayed on monitors on-board the aircraft. With proper processing the camera system can provide better-than-human-observed imagery particularly during poor visibility conditions. However, to obtain this goal requires several different stages of processing including enhancement, registration, and fusion, and specialized processing hardware for real-time performance. We are using a real-time implementation of the Retinex algorithm for image enhancement, affine transformations for registration, and weighted sums to perform fusion. All of the algorithms are executed on a single TI DM642 digital signal processor (DSP) clocked at 720 MHz. The image processing components were added to the EVS system, tested, and demonstrated during flight tests in August and September of 2005. In this paper we briefly discuss the EVS image processing hardware and algorithms. We then discuss implementation issues and show examples of the results obtained during flight tests.

Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment

PubMed Central

Samal, Janmejaya

2016-01-01

Introduction A competent health system is of paramount importance in delivering the desired health services in a particular community. Aim The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India. Materials and Methods A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area. Results There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district. Conclusion Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services. PMID:27656464

Health System Competency for Maternal Health Services in Balasore District and Jaleswar Block, Balasore, Odisha, India: An Assessment.

PubMed

Dehury, Ranjit Kumar; Samal, Janmejaya

2016-08-01

A competent health system is of paramount importance in delivering the desired health services in a particular community. The broad objective of this study was to assess the health system competency for the maternal health services in Balasore District and Jaleswar block of Balasore district, Odisha, India. A mixed method approach was adopted in order to understand the health system competency for maternal health services in the study area. There was poor accessibility through road, poor electricity connection and piped water for the health care centers in the district. Even, existing Primary Health Centres (PHCs) lack ECG and X-Ray machines for proper diagnostic services which jeopardize the catering of health services. Community Health Centres (CHC) lack basic diagnostic and ambulance services making the tribal pockets inaccessible. The tribal dominated Jaleswar block shows poor performance in terms of total registered Antenatal Checkups (ANC) (only 77%). A gradual decrease in the rate of ANC, from first to fourthcheckup, was observed in the district. Lack of public health infrastructure in general and non-compliance to Indian Public Health Standards (IPHS) in particular, affect the health of tribal women resulting in lack of interest in availing the institutional delivery services and other pertinent maternal health services.

Paediatric cerebrovascular CT angiography—towards better image quality

PubMed Central

Thust, Stefanie C.; Chong, Wui Khean Kling; Gunny, Roxana; Mazumder, Asif; Poitelea, Marius; Welsh, Anna; Ederies, Ash

2014-01-01

Background Paediatric cerebrovascular CT angiography (CTA) can be challenging to perform due to variable cardiovascular physiology between different age groups and the risk of movement artefact. This analysis aimed to determine what proportion of CTA at our institution was of diagnostic quality and identify technical factors which could be improved. Materials and methods a retrospective analysis of 20 cases was performed at a national paediatric neurovascular centre assessing image quality with a subjective scoring system and Hounsfield Unit (HU) measurements. Demographic data, contrast dose, flow rate and triggering times were recorded for each patient. Results Using a qualitative scoring system, 75% of studies were found to be of diagnostic quality (n=9 ‘good’, n=6 ‘satisfactory’) and 25% (n=5) were ‘poor’. Those judged subjectively to be poor had arterial contrast density measured at less than 250 HU. Increased arterial opacification was achieved for cases performed with an increased flow rate (2.5-4 mL/s) and higher intravenous contrast dose (2 mL/kg). Triggering was found to be well timed in nine cases, early in four cases and late in seven cases. Of the scans triggered early, 75% were poor. Of the scans triggered late, less (29%) were poor. Conclusions High flow rates (>2.5 mL/s) were a key factor for achieving high quality paediatric cerebrovascular CTA imaging. However, appropriate triggering by starting the scan immediately on contrast opacification of the monitoring vessel plays an important role and could maintain image quality when flow rates were lower. Early triggering appeared more detrimental than late. PMID:25525579

The relationship between corporate environmental performance and environmental disclosure: an empirical study in China.

PubMed

Meng, X H; Zeng, S X; Shi, Jonathan J; Qi, G Y; Zhang, Z B

2014-12-01

Based on a content analysis of 533 Chinese listed companies, this study examines how corporate environmental performance affects not only the level of detail of a company's environmental disclosures, but also what information is disclosed. The results show that (1) both poor and good performers have more disclosure than the median (i.e., "mixed") performers, which provides empirical evidence to support a nonlinear relationship between corporate environmental performance and environmental disclosure; (2) poor performers disclose more soft information on environmental performance than good performers, and good performers disclose more solid information; and (3) although poor performers increase disclosure after being exposed as environmental violators, they avoid disclosing negative environmental information, such as the violation and the associated penalties. This study provides additional evidence for a nonlinear relationship between environmental performance and disclosure in emerging markets, and suggests environmental disclosure may not be a valid signal to differentiate good performers from poor performers in contemporary China. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Developmental programming: the concept, large animal models, and the key role of uteroplacental vascular development.

PubMed

Reynolds, L P; Borowicz, P P; Caton, J S; Vonnahme, K A; Luther, J S; Hammer, C J; Maddock Carlin, K R; Grazul-Bilska, A T; Redmer, D A

2010-04-01

Developmental programming refers to the programming of various bodily systems and processes by a stressor of the maternal system during pregnancy or during the neonatal period. Such stressors include nutritional stress, multiple pregnancy (i.e., increased numbers of fetuses in the gravid uterus), environmental stress (e.g., high environmental temperature, high altitude, prenatal steroid exposure), gynecological immaturity, and maternal or fetal genotype. Programming refers to impaired function of numerous bodily systems or processes, leading to poor growth, altered body composition, metabolic dysfunction, and poor productivity (e.g., poor growth, reproductive dysfunction) of the offspring throughout their lifespan and even across generations. A key component of developmental programming seems to be placental dysfunction, leading to altered fetal growth and development. We discuss various large animal models of developmental programming and how they have and will continue to contribute to our understanding of the mechanisms underlying altered placental function and developmental programming, and, further, how large animal models also will be critical to the identification and application of therapeutic strategies that will alleviate the negative consequences of developmental programming to improve offspring performance in livestock production and human medicine.

From nanoemulsions to self-nanoemulsions, with recent advances in self-nanoemulsifying drug delivery systems (SNEDDS).

PubMed

Rehman, Fiza Ur; Shah, Kifayat Ullah; Shah, Shefaat Ullah; Khan, Ikram Ullah; Khan, Gul Majid; Khan, Amjad

2017-11-01

Lipid-based drug delivery systems (LBDDS) are the most promising technique to formulate the poorly water soluble drugs. Nanotechnology strongly influences the therapeutic performance of hydrophobic drugs and has become an essential approach in drug delivery research. Self-nanoemulsifying drug delivery systems (SNEDDS) are a vital strategy that combines benefits of LBDDS and nanotechnology. SNEDDS are now preferred to improve the formulation of drugs with poor aqueous solubility. Areas covered: The review in its first part shortly describes the LBDDS, nanoemulsions and clarifies the ambiguity between nanoemulsions and microemulsions. In the second part, the review discusses SNEDDS and elaborates on the current developments and modifications in this area without discussing their associated preparation techniques and excipient properties. Expert opinion: SNEDDS have exhibit the potential to increase the bioavailability of poorly water soluble drugs. The stability of SNEDDS is further increased by solidification. Controlled release and supersaturation can be achieved, and are associated with increased patient compliance and improved drug loads, respectively. Presence of biodegradable ingredients and ease of large-scale manufacturing combined with a lot of 'drug-targeting opportunities' give SNEDDS a clear distinction and prominence over other solubility enhancement techniques.

Determining team cognition from delay analysis using cross recurrence plot.

PubMed

Hajari, Nasim; Cheng, Irene; Bin Zheng; Basu, Anup

2016-08-01

Team cognition is an important factor in evaluating and determining team performance. Forming a team with good shared cognition is even more crucial for laparoscopic surgery applications. In this study, we analyzed the eye tracking data of two surgeons during a laparoscopic simulation operation, then performed Cross Recurrence Analysis (CRA) on the recorded data to study the delay behaviour for good performer and poor performer teams. Dual eye tracking data for twenty two dyad teams were recorded during a laparoscopic task and then the teams were divided into good performer and poor performer teams based on the task times. Eventually we studied the delay between two team members for good and poor performer teams. The results indicated that the good performer teams show a smaller delay comparing to poor performer teams. This study is compatible with gaze overlap analysis between team members and therefore it is a good evidence of shared cognition between team members.

Determination of properties of PVE lubricants with HFC refrigerants[PolyVinylEther

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

Kaneko, Masato; Sakanoue, Shuichi; Tazaki, Toshihiro

1999-07-01

Polyalkyleneglycol (PAG) and polyol ester (POE) have been developed as refrigeration lubricants, used with HFC134a. PAG is used for automotive air conditioning systems and POE is used for domestic reciprocating refrigerators and for A/C systems. Although PAG exhibits good lubricity performance, it is difficult to use for domestic reciprocating refrigerators due to its low dielectric property. POE is difficult to use for automotive A/C systems, due to hydrolysis and poor lubricity performance. Polyvinylether (PVE) can be used in place of PAG and POE with HFC refrigerants. PVE is used for A/C systems as well as refrigerator and freezer applications. PVEmore » is an ideal lubricant for use with HFCs.« less

A corpus of full-text journal articles is a robust evaluation tool for revealing differences in performance of biomedical natural language processing tools

PubMed Central

2012-01-01

Background We introduce the linguistic annotation of a corpus of 97 full-text biomedical publications, known as the Colorado Richly Annotated Full Text (CRAFT) corpus. We further assess the performance of existing tools for performing sentence splitting, tokenization, syntactic parsing, and named entity recognition on this corpus. Results Many biomedical natural language processing systems demonstrated large differences between their previously published results and their performance on the CRAFT corpus when tested with the publicly available models or rule sets. Trainable systems differed widely with respect to their ability to build high-performing models based on this data. Conclusions The finding that some systems were able to train high-performing models based on this corpus is additional evidence, beyond high inter-annotator agreement, that the quality of the CRAFT corpus is high. The overall poor performance of various systems indicates that considerable work needs to be done to enable natural language processing systems to work well when the input is full-text journal articles. The CRAFT corpus provides a valuable resource to the biomedical natural language processing community for evaluation and training of new models for biomedical full text publications. PMID:22901054

Applied estimation for hybrid dynamical systems using perceptional information

NASA Astrophysics Data System (ADS)

Plotnik, Aaron M.

This dissertation uses the motivating example of robotic tracking of mobile deep ocean animals to present innovations in robotic perception and estimation for hybrid dynamical systems. An approach to estimation for hybrid systems is presented that utilizes uncertain perceptional information about the system's mode to improve tracking of its mode and continuous states. This results in significant improvements in situations where previously reported methods of estimation for hybrid systems perform poorly due to poor distinguishability of the modes. The specific application that motivates this research is an automatic underwater robotic observation system that follows and films individual deep ocean animals. A first version of such a system has been developed jointly by the Stanford Aerospace Robotics Laboratory and Monterey Bay Aquarium Research Institute (MBARI). This robotic observation system is successfully fielded on MBARI's ROVs, but agile specimens often evade the system. When a human ROV pilot performs this task, one advantage that he has over the robotic observation system in these situations is the ability to use visual perceptional information about the target, immediately recognizing any changes in the specimen's behavior mode. With the approach of the human pilot in mind, a new version of the robotic observation system is proposed which is extended to (a) derive perceptional information (visual cues) about the behavior mode of the tracked specimen, and (b) merge this dissimilar, discrete and uncertain information with more traditional continuous noisy sensor data by extending existing algorithms for hybrid estimation. These performance enhancements are enabled by integrating techniques in hybrid estimation, computer vision and machine learning. First, real-time computer vision and classification algorithms extract a visual observation of the target's behavior mode. Existing hybrid estimation algorithms are extended to admit this uncertain but discrete observation, complementing the information available from more traditional sensors. State tracking is achieved using a new form of Rao-Blackwellized particle filter called the mode-observed Gaussian Particle Filter. Performance is demonstrated using data from simulation and data collected on actual specimens in the ocean. The framework for estimation using both traditional and perceptional information is easily extensible to other stochastic hybrid systems with mode-related perceptional observations available.

Factors Affecting the Delivery, Access, and Use of Interventions to Prevent Malaria in Pregnancy in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

PubMed Central

Hill, Jenny; Hoyt, Jenna; van Eijk, Anna Maria; D'Mello-Guyett, Lauren; ter Kuile, Feiko O.; Steketee, Rick; Smith, Helen; Webster, Jayne

2013-01-01

Background Malaria in pregnancy has important consequences for mother and baby. Coverage with the World Health Organization–recommended prevention strategy for pregnant women in sub-Saharan Africa of intermittent preventive treatment in pregnancy (IPTp) and insecticide-treated nets (ITNs) is low. We conducted a systematic review to explore factors affecting delivery, access, and use of IPTp and ITNs among healthcare providers and women. Methods and Results We searched the Malaria in Pregnancy Library and Global Health Database from 1 January 1990 to 23 April 2013, without language restriction. Data extraction was performed by two investigators independently, and data was appraised for quality and content. Data on barriers and facilitators, and the effect of interventions, were explored using content analysis and narrative synthesis. We conducted a meta-analysis of determinants of IPTp and ITN uptake using random effects models, and performed subgroup analysis to evaluate consistency across interventions and study populations, countries, and enrolment sites. We did not perform a meta-ethnography of qualitative data. Ninety-eight articles were included, of which 20 were intervention studies. Key barriers to the provision of IPTp and ITNs were unclear policy and guidance on IPTp; general healthcare system issues, such as stockouts and user fees; health facility issues stemming from poor organisation, leading to poor quality of care; poor healthcare provider performance, including confusion over the timing of each IPTp dose; and women's poor antenatal attendance, affecting IPTp uptake. Key determinants of IPTp coverage were education, knowledge about malaria/IPTp, socio-economic status, parity, and number and timing of antenatal clinic visits. Key determinants of ITN coverage were employment status, education, knowledge about malaria/ITNs, age, and marital status. Predictors showed regional variations. Conclusions Delivery of ITNs through antenatal clinics presents fewer problems than delivery of IPTp. Many obstacles to IPTp delivery are relatively simple barriers that could be resolved in the short term. Other barriers are more entrenched within the overall healthcare system or socio-economic/cultural contexts, and will require medium- to long-term strategies. Please see later in the article for the Editors' Summary PMID:23935459

Medial olivocochlear function in children with poor speech-in-noise performance and language disorder.

PubMed

Rocha-Muniz, Caroline Nunes; Mamede Carvallo, Renata Mota; Schochat, Eliane

2017-05-01

Contralateral masking of transient-evoked otoacoustic emissions is a phenomenon that suggests an inhibitory effect of the olivocochlear efferent auditory pathway. Many studies have been inconclusive in demonstrating a clear connection between this system and a behavioral speech-in-noise listening skill. The purpose of this study was to investigate the activation of a medial olivocochlear (MOC) efferent in children with poor speech-in-noise (PSIN) performance and children with language impairment and PSIN (SLI + PSIN). Transient evoked otoacoustic emissions (TEOAEs) with and without contralateral white noise were tested in 52 children (between 6 and 12 years). These children were arranged in three groups: typical development (TD) (n = 25), PSIN (n = 14) and SLI + PSI (n = 13). PSIN and SLI + PSI groups presented reduced otoacoustic emission suppression in comparison with the TD group. Our finding suggests differences in MOC function among children with typical development and children with poor SIN and language problems. Copyright © 2017 Elsevier B.V. All rights reserved.

Optimized iterative decoding method for TPC coded CPM

NASA Astrophysics Data System (ADS)

Ma, Yanmin; Lai, Penghui; Wang, Shilian; Xie, Shunqin; Zhang, Wei

2018-05-01

Turbo Product Code (TPC) coded Continuous Phase Modulation (CPM) system (TPC-CPM) has been widely used in aeronautical telemetry and satellite communication. This paper mainly investigates the improvement and optimization on the TPC-CPM system. We first add the interleaver and deinterleaver to the TPC-CPM system, and then establish an iterative system to iteratively decode. However, the improved system has a poor convergence ability. To overcome this issue, we use the Extrinsic Information Transfer (EXIT) analysis to find the optimal factors for the system. The experiments show our method is efficient to improve the convergence performance.

Real-time Enhancement, Registration, and Fusion for a Multi-Sensor Enhanced Vision System

NASA Technical Reports Server (NTRS)

Hines, Glenn D.; Rahman, Zia-ur; Jobson, Daniel J.; Woodell, Glenn A.

2006-01-01

Over the last few years NASA Langley Research Center (LaRC) has been developing an Enhanced Vision System (EVS) to aid pilots while flying in poor visibility conditions. The EVS captures imagery using two infrared video cameras. The cameras are placed in an enclosure that is mounted and flown forward-looking underneath the NASA LaRC ARIES 757 aircraft. The data streams from the cameras are processed in real-time and displayed on monitors on-board the aircraft. With proper processing the camera system can provide better-than- human-observed imagery particularly during poor visibility conditions. However, to obtain this goal requires several different stages of processing including enhancement, registration, and fusion, and specialized processing hardware for real-time performance. We are using a real-time implementation of the Retinex algorithm for image enhancement, affine transformations for registration, and weighted sums to perform fusion. All of the algorithms are executed on a single TI DM642 digital signal processor (DSP) clocked at 720 MHz. The image processing components were added to the EVS system, tested, and demonstrated during flight tests in August and September of 2005. In this paper we briefly discuss the EVS image processing hardware and algorithms. We then discuss implementation issues and show examples of the results obtained during flight tests. Keywords: enhanced vision system, image enhancement, retinex, digital signal processing, sensor fusion

Association of tic disorders with poor academic performance in central Spain: a population-based study.

PubMed

Cubo, Esther; Trejo, José; Ausín, Vanesa; Sáez, Sara; Delgado, Vanesa; Macarrón, Jesus; Cordero, José; Louis, Elan D; Kompoliti, Katie; Benito-León, Julián

2013-07-01

To analyze the association between tic disorders and poor academic performance in school-aged children. This was a cross-sectional, observational study conducted in a randomly selected sample of mainstream school-aged children (aged 6-16 years). The sampling frame included different types of schools and educational levels. Children with poor academic performance (eg, repeating a grade, special needs), and tic disorders (defined based on Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria) were identified. Children with and without tics and children with and without poor academic performance were compared in terms of clinical features (ie, medical history and neurologic and psychiatric comorbidities), school, and environmental characteristics. Logistic regression analyses were performed using school performance (dependent variable) and tic disorders (independent variable), after adjusting for confounding variables. The study cohort comprised 1867 children (mean age, 10.9 + 2.9 years; 1007 males [53.9%]). Tics were present in 162 children (8.6%), and poor academic performance was noted in 223 (11.9%). Overall poor academic performance was associated with age (OR, 1.71; P < .0001), television viewing (OR, 5.33; P = .04), attention deficit hyperactivity disorder (OR, 1.38; P < .0001), and family history of school dysfunction (OR, 2.43; P = .02) and was negatively associated with higher IQ score (OR, 0.90; P < .0001) and tic disorders (OR, 0.29; P = .01). After adjusting for other covariates, the presence of tic disorders was not associated with poor academic performance in our cohort. Early academic support and modification of environmental characteristics are needed for children at higher risk for school dysfunction, to enhance academic performance. Copyright © 2013 Mosby, Inc. All rights reserved.

A driver-adaptive stability control strategy for sport utility vehicles

NASA Astrophysics Data System (ADS)

Zhu, Shenjin; He, Yuping

2017-08-01

Conventional vehicle stability control (VSC) systems are designed for average drivers. For a driver with a good driving skill, the VSC systems may be redundant; for a driver with a poor driving skill, the VSC intervention may be inadequate. To increase safety of sport utility vehicles (SUVs), this paper proposes a novel driver-adaptive VSC (DAVSC) strategy based on scaling the target yaw rate commanded by the driver. The DAVSC system is adaptive to drivers' driving skills. More control effort would be exerted for drivers with poor driving skills, and vice versa. A sliding mode control (SMC)-based differential braking (DB) controller is designed using a three degrees of freedom (DOF) yaw-plane model. An eight DOF nonlinear yaw-roll model is used to simulate the SUV dynamics. Two driver models, namely longitudinal and lateral, are used to 'drive' the virtual SUV. By integrating the virtual SUV, the DB controller, and the driver models, the performance of the DAVSC system is investigated. The simulations demonstrate the effectiveness of the DAVSC strategy.

Floating lipid beads for the improvement of bioavailability of poorly soluble basic drugs: in-vitro optimization and in-vivo performance in humans.

PubMed

Abouelatta, Samar M; Aboelwafa, Ahmed A; Khalil, Rawia M; ElGazayerly, Omaima N

2015-01-01

The challenge in developing oral drug delivery systems of poorly soluble basic drugs is primarily due to their pH dependent solubility. Cinnarizine (CNZ), a model for a poorly soluble basic drug, has pH dependent solubility; where it dissolves readily at low pH in the stomach and exhibits a very low solubility at pH values greater than 4. It is also characterized by a short half life of 3-6h, which requires frequent daily administration resulting in poor patient compliance. In an attempt to solve these problems, extended release floating lipid beads were formulated. A 2(4) full factorial design was utilized for optimization of the effects of various independent variables; lipid:drug ratio, % Pluronic F-127, % Sterotex, and Gelucire 43/01:Gelucire 50/13 ratio, on the loading efficiency and release of CNZ from the lipid beads. In-vivo pharmacokinetic study of the optimized CNZ-lipid beads compared to Stugeron® (reference standard) was performed in healthy human volunteers. A promising approach for enhancing the bioavailability of the poorly soluble basic drug, CNZ, utilizing novel and simple floating lipid beads was successfully developed. Zero order release profile of CNZ was achieved for 12h. Mean AUC0-24 and AUC0-∞ of the optimized CNZ-loaded lipid beads were 4.23 and 6.04 times that of Stugeron® tablets respectively. Copyright © 2014 Elsevier B.V. All rights reserved.

A Comparison of a Brain-Based Adaptive System and a Manual Adaptable System for Invoking Automation

NASA Technical Reports Server (NTRS)

Bailey, Nathan R.; Scerbo, Mark W.; Freeman, Frederick G.; Mikulka, Peter J.; Scott, Lorissa A.

2004-01-01

Two experiments are presented that examine alternative methods for invoking automation. In each experiment, participants were asked to perform simultaneously a monitoring task and a resource management task as well as a tracking task that changed between automatic and manual modes. The monitoring task required participants to detect failures of an automated system to correct aberrant conditions under either high or low system reliability. Performance on each task was assessed as well as situation awareness and subjective workload. In the first experiment, half of the participants worked with a brain-based system that used their EEG signals to switch the tracking task between automatic and manual modes. The remaining participants were yoked to participants from the adaptive condition and received the same schedule of mode switches, but their EEG had no effect on the automation. Within each group, half of the participants were assigned to either the low or high reliability monitoring task. In addition, within each combination of automation invocation and system reliability, participants were separated into high and low complacency potential groups. The results revealed no significant effects of automation invocation on the performance measures; however, the high complacency individuals demonstrated better situation awareness when working with the adaptive automation system. The second experiment was the same as the first with one important exception. Automation was invoked manually. Thus, half of the participants pressed a button to invoke automation for 10 s. The remaining participants were yoked to participants from the adaptable condition and received the same schedule of mode switches, but they had no control over the automation. The results showed that participants who could invoke automation performed more poorly on the resource management task and reported higher levels of subjective workload. Further, those who invoked automation more frequently performed more poorly on the tracking task and reported higher levels of subjective workload. and the adaptable condition in the second experiment revealed only one significant difference: the subjective workload was higher in the adaptable condition. Overall, the results show that a brain-based, adaptive automation system may facilitate situation awareness for those individuals who are more complacent toward automation. By contrast, requiring operators to invoke automation manually may have some detrimental impact on performance but does appear to increases subjective workload relative to an adaptive system.

Poor Performance in Mathematics: Is There a Basis for a Self-Worth Explanation for Women?

ERIC Educational Resources Information Center

Thompson, Ted; Dinnel, Dale L.

2007-01-01

The self-worth theory of achievement motivation holds that in situations in which poor performance is likely to reveal low ability, certain students (known as self-worth protective students) intentionally withdraw effort in order to avoid the negative implications of poor performance in terms of damage to self-worth. In this study, evidence of…

Who Are the Low-Performing Students? PISA in Focus. No. 60

ERIC Educational Resources Information Center

OECD Publishing, 2016

2016-01-01

Far too many students around the world are trapped in a vicious cycle of poor performance and demotivation that leads only to more bad marks and further disengagement from school. Students who perform poorly at age 15 face a high risk of dropping out of school altogether. By the time they become young adults, poor proficiency in numeracy and…

A comparison of the performance of digital mammography systems.

PubMed

Monnin, P; Gutierrez, D; Bulling, S; Guntern, D; Verdun, F R

2007-03-01

An objective analysis of image quality parameters was performed for six digital mammography systems. The presampled modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE) for the systems were determined at different doses, for 28 kVp with a Mo/Mo or W/Al target/filter combination and 2 mm of additional aluminium filtration. The flat-panel units have higher MTF and DQE in the mid to high frequency range than standard CR systems. The highest DQE, over the whole dose range, is for the slit-scanning direct photon counting system. Dual-side read CR can overcome the inherent x-ray absorption and signal collection limitations of standard CR mammography, improving the low-frequency DQE by 40%, to the same level as full-field systems, but it does not improve the poor spatial resolution of phosphor.

Towards Automated Nanomanipulation under Scanning Electron Microscopy

NASA Astrophysics Data System (ADS)

Ye, Xutao

Robotic Nanomaterial Manipulation inside scanning electron microscopes (SEM) is useful for prototyping functional devices and characterizing one-dimensional nanomaterial's properties. Conventionally, manipulation of nanowires has been performed via teleoperation, which is time-consuming and highly skill-dependent. Manual manipulation also has the limitation of low success rates and poor reproducibility. This research focuses on a robotic system capable of automated pick-place of single nanowires. Through SEM visual detection and vision-based motion control, the system transferred individual silicon nanowires from their growth substrate to a microelectromechanical systems (MEMS) device that characterized the nanowires' electromechanical properties. The performances of the nanorobotic pick-up and placement procedures were quantified by experiments. The system demonstrated automated nanowire pick-up and placement with high reliability. A software system for a load-lock-compatible nanomanipulation system is also designed and developed in this research.

Abernethy malformation with portal vein aneurysm in a child.

PubMed

Chandrashekhara, Sheragaru H; Bhalla, Ashu Seith; Gupta, Arun Kumar; Vikash, C S; Kabra, Susheel Kumar

2011-01-01

Abernethy malformation is an extremely rare anomaly of the splanchnic venous system. We describe multidetector computed tomography findings of an incidentally detected Abernethy malformation with portal vein aneurysm in a two-and-half-year old child. The computed tomography scan was performed for the evaluation of respiratory distress, poor growth, and loss of appetite.

Statistical Techniques for Efficient Indexing and Retrieval of Document Images

ERIC Educational Resources Information Center

Bhardwaj, Anurag

2010-01-01

We have developed statistical techniques to improve the performance of document image search systems where the intermediate step of OCR based transcription is not used. Previous research in this area has largely focused on challenges pertaining to generation of small lexicons for processing handwritten documents and enhancement of poor quality…

Exploring Sources of Variation in Romanian Science Achievement

ERIC Educational Resources Information Center

Istrate, Olimpius; Noveanu, Gabriela; Smith, Thomas M.

2006-01-01

The shift from a centrally-controlled to a market-oriented economy in the early 1990s put pressure on the Romanian education system to reform both the curriculum and methods of instruction employed in primary and secondary education. At least part of the pressure to implement educational reforms came from the relatively poor performance of…

Teamwork and Literacy: Learning from a Skills-Poor Position.

ERIC Educational Resources Information Center

Hart-Landsberg, Sylvia; Reder, Stephen

A study examined the roles of literacy and teamwork in an automotive parts manufacturing company that was restructuring to implement a "high-performance" model of team organization, worker responsibility for quality control, and a pay-for-knowledge compensation system. The study focused on the formal and informal educational practices from which…

Interdisciplinary Curriculum: A Fusion of Reform Ideas.

ERIC Educational Resources Information Center

Grady, Joan Butterworth

Problems such as poor test performance and low student motivation require that those in the educational system seriously consider restructuring the way they teach. For many years, content has been taught in periods of isolated time units; however, this Carnegie unit is an anachronism that needs to be eliminated. The alternative to the Carnegie…

Statement of the Independent Review Panel of the National Assessment of Chapter 1.

ERIC Educational Resources Information Center

Department of Education, Washington, DC.

The Independent Review Panel of the National Assessment of Chapter 1 recommends fundamental changes to the program, while endorsing its continuing vital role in meeting the special educational needs of poor and disadvantaged students. The program's focus on low-level basic skills, funding systems that discourage highest-level performance, money…

Coupling Effect between Equilibrium Field and Heating Field and Modification of the Power Supply System on SUNIST Spherical Tokamak

NASA Astrophysics Data System (ADS)

He, Yexi; Li, Xiaoyan; Gao, Zhe

2005-02-01

Strong inductive coupling between the heating field and equilibrium field is confirmed to be responsible for the poor plasma equilibrium in initial discharges on the SUNIST spherical tokamak. A modification project for the power supply system of equilibrium field coils is successfully performed to increase the duration time of plasma current flattop from much less than 1ms to about 2 ms.

Biomarkers, lactate, and clinical scores as outcome predictors in systemic poisons exposures.

PubMed

Lionte, C; Sorodoc, V; Tuchilus, C; Cimpoiesu, D; Jaba, E

2017-07-01

Acute exposure to systemic poisons represents an important challenge in clinical toxicology. We aimed to analyze the potential role of cardiac biomarkers, routine laboratory tests, and clinical scores as morbidity and in-hospital mortality predictors in patients intoxicated with various systemic poisons. We conducted a prospective study on adults acutely exposed to systemic poisons. We determined the PSS, Glasgow Coma Scale (GCS), and we performed electrocardiogram, laboratory tests, lactate and cardiac biomarkers (which were reassessed 4 h, respectively 6 h later). Of 120 patients included, 45% developed complications, 19.2% had a poor outcome, and 5% died. Multivariate logistic regression sustained lactate (odds ratio (OR) 1.58; confidence interval (CI) 95%: 0.97-2.59; p 0.066), MB isoenzyme of creatine kinase (6h-CKMB; OR 1.08; CI 95%: 1.02-1.16; p 0.018) as predictors for a poor outcome. A GCS < 10 (OR 0.113; CI 95%: 0.019-0.658; p 0.015) and 4h-lactate (OR 4.87; CI 95%: 0.79-29.82; p 0.087) predicted mortality after systemic poisons exposure. Receiver operating characteristic analysis showed that brain natriuretic peptide (area under the curve (AUC), 0.96; CI 95%: 0.92-0.99; p < 0.001), lactate (AUC, 0.91; CI 95%: 0.85-0.97; p < 0.001), and 6h-CKMB have good discriminatory capacity for predicting a poor outcome. In conclusion, these biomarkers, lactate, and GCS can be used to predict morbidity and mortality after systemic poisons exposure.

Association between overweight/obesity and academic performance in South Korean adolescents.

PubMed

Kim, Jong-Hyuck; So, Wi-Young

2013-12-01

The purpose of this study was to examine the relationship between academic performance and obesity/overweight among South Korean adolescents. Our data set included 72,399 adolescents in grades 7-12 who had participated in the 5th Korea Youth Risk Behaviour Web-based Survey (KYRBWS-V) in 2009. We assessed the association between academic performance and body mass index (BMI), using multivariate logistic regression analysis after adjusting for covariates such as age, parents' education level, economic status, mental stress experienced, sleep duration, frequency of muscle-strengthening exercises, smoking and drinking behaviour, and vigorous and moderate physical activity (PA). For boys, being overweight (compared with being of normal weight) had a significantly greater odds of poor academic performance (OR=1.182, 95% Cl 1.052-1.329, p=0.005). Obese boys had 1.182 (1.048-1.332, p=0.006), 1.461 (1.294-1.648, p<0.001), and 1.443(1.256-1.657, p<0.001) greater odds of having average, poor, and very poor performance, respectively. In the analysis for girls, overweight girls had 1.314 (1.124-1.536, p<0.001) and 1.296 (1.084-1.548, p=0.004) greater odds of having poor and very poor academic performance, respectively. Finally, obese girls had 1.374 (1.098-1.718, p=0.005), 1.672 (1.339-2.089, p<0.001), and 1.887 (1.478-2.409, p<0.001) greater odds of having average, poor, or very poor academic performance, respectively. Thus, overweight/obesity was negatively associated with academic performance in both boys and girls. The results of this study indicate that adolescents would benefit from weight management to prevent obesity and, possibly, improve academic performance.

A Note on Rocket Performance Comparison Through Impulse and Thrust Coefficients

NASA Astrophysics Data System (ADS)

Taylor, N. V.

Comparison of rocket motor systems is important when generating data to be used in making design decisions. In order to present meaningful comparisons, non-dimensional numbers related to performance are beneficial, as they remove effects of scale. Traditionally thrust coefficients and C* have been used to quantify the aerodynamic and chemical performance of a system respectively. However, it is argued here that in fact the thrust coefficient does not fully account for aerodynamic performance, as the impact of non-uniform flow at the throat is not accounted for. This discharge coefficient is usually allocated to the chemical efficiency through a correction to C*. However, this causes a coupling between chemical and aerodynamic efficiencies which may lead to poor design decisions. Through the use of a specific impulse coefficient, this risk is avoided, and furthermore comparison of unconventional nozzles becomes more straightforward. It is admitted, however, that this has no actual impact on real motor performance, being more in the way of a tidier `accounting' system.

Development of Performance Dashboards in Healthcare Sector: Key Practical Issues.

PubMed

Ghazisaeidi, Marjan; Safdari, Reza; Torabi, Mashallah; Mirzaee, Mahboobeh; Farzi, Jebraeil; Goodini, Azadeh

2015-10-01

Static nature of performance reporting systems in health care sector has resulted in inconsistent, incomparable, time consuming, and static performance reports that are not able to transparently reflect a round picture of performance and effectively support healthcare managers' decision makings. So, the healthcare sector needs interactive performance management tools such as performance dashboards to measure, monitor, and manage performance more effectively. The aim of this article was to identify key issues that need to be addressed for developing high-quality performance dashboards in healthcare sector. A literature review was established to search electronic research databases, e-journals collections, and printed journals, books, dissertations, and theses for relevant articles. The search strategy interchangeably used the terms of "dashboard", "performance measurement system", and "executive information system" with the term of "design" combined with operator "AND". Search results (n=250) were adjusted for duplications, screened based on their abstract relevancy and full-text availability (n=147) and then assessed for eligibility (n=40). Eligible articles were included if they had explicitly focused on dashboards, performance measurement systems or executive information systems design. Finally, 28 relevant articles included in the study. Creating high-quality performance dashboards requires addressing both performance measurement and executive information systems design issues. Covering these two fields, identified contents were categorized to four main domains: KPIs development, Data Sources and data generation, Integration of dashboards to source systems, and Information presentation issues. This study implies the main steps to develop dashboards for the purpose of performance management. Performance dashboards developed on performance measurement and executive information systems principles and supported by proper back-end infrastructure will result in creation of dynamic reports that help healthcare managers to consistently measure the performance, continuously detect outliers, deeply analyze causes of poor performance, and effectively plan for the future.

Novel solutions to low-frequency problems with geometrically designed beam-waveguide systems

NASA Technical Reports Server (NTRS)

Imbriale, W. A.; Esquivel, M. S.; Manshadi, F.

1995-01-01

The poor low-frequency performance of geometrically designed beam-waveguide (BWG) antennas is shown to be caused by the diffraction phase centers being far from the geometrical optics mirror focus, resulting in substantial spillover and defocusing loss. Two novel solutions are proposed: (1) reposition the mirrors to focus low frequencies and redesign the high frequencies to utilize the new mirror positions, and (2) redesign the input feed system to provide an optimum solution for the low frequency. A novel use of the conjugate phase-matching technique is utilized to design the optimum low-frequency feed system, and the new feed system has been implemented in the JPL research and development BWG as part of a dual S-/X-band (2.3 GHz/8.45 GHz) feed system. The new S-band feed system is shown to perform significantly better than the original geometrically designed system.

Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScope(TM)) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study.

PubMed

Wu, Yan-Guang; Lazzaroni-Tealdi, Emanuela; Wang, Qi; Zhang, Lin; Barad, David H; Kushnir, Vitaly A; Darmon, Sarah K; Albertini, David F; Gleicher, Norbert

2016-08-24

Previously manual human embryology in many in vitro fertilization (IVF) centers is rapidly being replaced by closed embryo incubation systems with time-lapse imaging. Whether such systems perform comparably to manual embryology in different IVF patient populations has, however, never before been investigated. We, therefore, prospectively compared embryo quality following closed system culture with time-lapse photography (EmbryoScope™) and standard embryology. We performed a two-part prospectively randomized study in IVF (clinical trial # NCT92256309). Part A involved 31 infertile poor prognosis patients prospectively randomized to EmbryoScope™ and standard embryology. Part B involved embryos from 17 egg donor-recipient cycles resulting in large egg/embryo numbers, thus permitting prospectively alternative embryo assignments to EmbryoScope™ and standard embryology. We then compared pregnancy rates and embryo quality on day-3 after fertilization and embryologist time utilized per processed embryo. Part A revealed in poor prognosis patients no differences in day-3 embryo scores, implantation and clinical pregnancy rates between EmbryoScope™ and standard embryology. The EmbryoScope™, however, more than doubled embryology staff time (P < 0.0001). In Part B, embryos grown in the EmbyoScope™ demonstrated significantly poorer day-3 quality (depending on embryo parameter between P = 0.005 and P = 0.01). Suspicion that conical culture dishes of the EmbryoScope™ (EmbryoSlide™) may be the cause was disproven when standard culture dishes demonstrated no outcome difference in standard incubation. Though due to small patient numbers preliminary, this study raises concerns about the mostly uncontrolled introduction of closed incubation systems with time lapse imaging into routine clinical embryology. Appropriately designed and powered prospectively randomized studies appear urgently needed in well-defined patient populations before the uncontrolled utilization of these instruments further expands. NCT02246309 Registered September 18, 2014.

Prognostic value of long noncoding RNA MALAT1 in digestive system malignancies.

PubMed

Zhai, Hui; Li, Xiao-Mei; Maimaiti, Ailifeire; Chen, Qing-Jie; Liao, Wu; Lai, Hong-Mei; Liu, Fen; Yang, Yi-Ning

2015-01-01

MALAT1, a newly discovered long noncoding RNA (lncRNA), has been reported to be highly expressed in many types of cancers. This meta-analysis summarizes its potential prognostic value in digestive system malignancies. A quantitative meta-analysis was performed through a systematic search in PubMed, Cochrane Library, Web of Science and Chinese National Knowledge Infrastructure (CNKI) for eligible papers on the prognostic impact of MALAT1 in digestive system malignancies from inception to Apr. 25, 2015. Pooled hazard ratios (HRs) with 95% confidence interval (95% CI) were calculated to summarize the effect. Five studies were included in the study, with a total of 527 patients. A significant association was observed between MALAT1 abundance and poor overall survival (OS) of patients with digestive system malignancies, with pooled hazard ratio (HR) of 7.68 (95% confidence interval [CI]: 4.32-13.66, P<0.001). Meta sensitivity analysis suggested the reliability of our findings. No publication bias was observed. MALAT1 abundance may serve as a novel predictive factor for poor prognosis in patients with digestive system malignancies.

Prospector: A web-based tool for rapid acquisition of gold standard data for pathology research and image analysis

PubMed Central

Wright, Alexander I.; Magee, Derek R.; Quirke, Philip; Treanor, Darren E.

2015-01-01

Background: Obtaining ground truth for pathological images is essential for various experiments, especially for training and testing image analysis algorithms. However, obtaining pathologist input is often difficult, time consuming and expensive. This leads to algorithms being over-fitted to small datasets, and inappropriate validation, which causes poor performance on real world data. There is a great need to gather data from pathologists in a simple and efficient manner, in order to maximise the amount of data obtained. Methods: We present a lightweight, web-based HTML5 system for administering and participating in data collection experiments. The system is designed for rapid input with minimal effort, and can be accessed from anywhere in the world with a reliable internet connection. Results: We present two case studies that use the system to assess how limitations on fields of view affect pathologist agreement, and to what extent poorly stained slides affect judgement. In both cases, the system collects pathologist scores at a rate of less than two seconds per image. Conclusions: The system has multiple potential applications in pathology and other domains. PMID:26110089

Prospector: A web-based tool for rapid acquisition of gold standard data for pathology research and image analysis.

PubMed

Wright, Alexander I; Magee, Derek R; Quirke, Philip; Treanor, Darren E

2015-01-01

Obtaining ground truth for pathological images is essential for various experiments, especially for training and testing image analysis algorithms. However, obtaining pathologist input is often difficult, time consuming and expensive. This leads to algorithms being over-fitted to small datasets, and inappropriate validation, which causes poor performance on real world data. There is a great need to gather data from pathologists in a simple and efficient manner, in order to maximise the amount of data obtained. We present a lightweight, web-based HTML5 system for administering and participating in data collection experiments. The system is designed for rapid input with minimal effort, and can be accessed from anywhere in the world with a reliable internet connection. We present two case studies that use the system to assess how limitations on fields of view affect pathologist agreement, and to what extent poorly stained slides affect judgement. In both cases, the system collects pathologist scores at a rate of less than two seconds per image. The system has multiple potential applications in pathology and other domains.

Prognostic value of long noncoding RNA MALAT1 in digestive system malignancies

PubMed Central

Zhai, Hui; Li, Xiao-Mei; Maimaiti, Ailifeire; Chen, Qing-Jie; Liao, Wu; Lai, Hong-Mei; Liu, Fen; Yang, Yi-Ning

2015-01-01

Background: MALAT1, a newly discovered long noncoding RNA (lncRNA), has been reported to be highly expressed in many types of cancers. This meta-analysis summarizes its potential prognostic value in digestive system malignancies. Methods: A quantitative meta-analysis was performed through a systematic search in PubMed, Cochrane Library, Web of Science and Chinese National Knowledge Infrastructure (CNKI) for eligible papers on the prognostic impact of MALAT1 in digestive system malignancies from inception to Apr. 25, 2015. Pooled hazard ratios (HRs) with 95% confidence interval (95% CI) were calculated to summarize the effect. Results: Five studies were included in the study, with a total of 527 patients. A significant association was observed between MALAT1 abundance and poor overall survival (OS) of patients with digestive system malignancies, with pooled hazard ratio (HR) of 7.68 (95% confidence interval [CI]: 4.32-13.66, P<0.001). Meta sensitivity analysis suggested the reliability of our findings. No publication bias was observed. Conclusions: MALAT1 abundance may serve as a novel predictive factor for poor prognosis in patients with digestive system malignancies. PMID:26770406

Field Performance of Inverter-Driven Heat Pumps in Cold Climates

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

Williamson, James; Aldrich, Robb

2015-08-01

CARB observed a wide range of operating efficiencies and outputs from site to site. Maximum capacities were found to be generally in line with manufacturer's claims as outdoor temperatures fell to -10°F. The reasons for the wide range in heating performance likely include: low indoor air flow rates, poor placement of outdoor units, relatively high return air temperatures, thermostat set back, integration with existing heating systems, and occupants limiting indoor fan speed. Even with lower efficiencies than published in other studies, most of the heat pumps here still provide heat at lower cost than oil, propane, or certainly electric resistancemore » systems.« less

Lower-limb kinematics of single-leg squat performance in young adults.

PubMed

Horan, Sean A; Watson, Steven L; Carty, Christopher P; Sartori, Massimo; Weeks, Benjamin K

2014-01-01

To determine the kinematic parameters that characterize good and poor single-leg squat (SLS) performance. A total of 22 healthy young adults free from musculoskeletal impairment were recruited for testing. For each SLS, both two-dimensional video and three-dimensional motion analysis data were collected. Pelvis, hip, and knee angles were calculated using a reliable and validated lower-limb (LL) biomechanical model. Two-dimensional video clips of SLSs were blindly assessed in random order by eight musculoskeletal physiotherapists using a 10-point ordinal scale. To facilitate between-group comparisons, SLS performances were stratified by tertiles corresponding to poor, intermediate, and good SLS performance. Mean ratings of SLS performance assessed by physiotherapists were 8.3 (SD 0.5), 6.8 (SD 0.7), and 4.0 (SD 0.8) for good, intermediate, and poor squats, respectively. Three-dimensional analysis revealed that people whose SLS performance was assessed as poor exhibited increased hip adduction, reduced knee flexion, and increased medio-lateral displacement of the knee joint centre compared to those whose SLS performance was assessed as good (p≤0.05). Overall, poor SLS performance is characterized by inadequate knee flexion and excessive frontal plane motion of the knee and hip. Future investigations of SLS performance should consider standardizing knee flexion angle to illuminate other influential kinematic parameters.

Doctors' stress responses and poor communication performance in simulated bad-news consultations.

PubMed

Brown, Rhonda; Dunn, Stewart; Byrnes, Karen; Morris, Richard; Heinrich, Paul; Shaw, Joanne

2009-11-01

No studies have previously evaluated factors associated with high stress levels and poor communication performance in breaking bad news (BBN) consultations. This study determined factors that were most strongly related to doctors' stress responses and poor communication performance during a simulated BBN task. In 2007, the authors recruited 24 doctors comprising 12 novices (i.e., interns/residents with 1-3 years' experience) and 12 experts (i.e., registrars, medical/radiation oncologists, or cancer surgeons, with more than 4 years' experience). Doctors participated in simulated BBN consultations and a number of control tasks. Five-minute-epoch heart rate (HR), HR variability, and communication performance were assessed in all participants. Subjects also completed a short questionnaire asking about their prior experience BBN, perceived stress, psychological distress (i.e., anxiety, depression), fatigue, and burnout. High stress responses were related to inexperience with BBN, fatigue, and giving bad versus good news. Poor communication performance in the consultation was related to high burnout and fatigue scores. These results suggest that BBN was a stressful experience for doctors even in a simulated encounter, especially for those who were inexperienced and/or fatigued. Poor communication performance was related to burnout and fatigue, but not inexperience with BBN. These results likely indicate that burnout and fatigue contributed to stress and poor work performance in some doctors during the simulated BBN task.

[Attrition and poor performance in general practice training: age, competence and knowledge play a role].

PubMed

Vermeulen, Margit I; Kuyvenhoven, Marijke M; Zuithoff, N P A Peter; van der Graaf, Yolanda; Pieters, H M Ron

2011-01-01

To investigate which determinants are related to poor performance and forced attrition in the first year residency in general practice (GP). Observational retrospective cohort study. We collected data relating to personal characteristics such as age, sex and clinical experience from residents who started the GP training in Utrecht, the Netherlands, in the period March 2005-August 2007. We also collected competence scores from the domains 'medical expertise', 'doctor-patient communication' and 'professionalism', as well as scores on a national GP knowledge test. The outcome measures were 'poor performance' and 'forced attrition'. Multivariate logistic regression was used to analyse correlations between personal characteristics, competence scores on the 3 domains and knowledge scores in the first trimester on the one hand and poor performance or forced attrition on the other. 215 residents started the GP training. In the first trimester a quarter of the residents had an insufficient score in 1 or more of the domains. Competence scores were mutually correlated, but did not correlate with the knowledge score. 18 residents showed poor performance and 3 were forced to stop their training. Poor performance and forced attrition were correlated with age (adjusted odds ratio (OR): 1.1; 95% CI: 1.0-1.3), insufficient knowledge (adjusted OR: 8.9; 3.0-26.3) and medical expertise (adjusted OR: 2.1; 1.1-4.0) at the beginning of the training. Age, insufficient knowledge of general practice, and insufficient competence in the domain of 'medical expertise' at the beginning of the training are risk factors for poor performance by residents and attrition from their GP training.

Performance Metrics for Monitoring Parallel Program Executions

NASA Technical Reports Server (NTRS)

Sarukkai, Sekkar R.; Gotwais, Jacob K.; Yan, Jerry; Lum, Henry, Jr. (Technical Monitor)

1994-01-01

Existing tools for debugging performance of parallel programs either provide graphical representations of program execution or profiles of program executions. However, for performance debugging tools to be useful, such information has to be augmented with information that highlights the cause of poor program performance. Identifying the cause of poor performance necessitates the need for not only determining the significance of various performance problems on the execution time of the program, but also needs to consider the effect of interprocessor communications of individual source level data structures. In this paper, we present a suite of normalized indices which provide a convenient mechanism for focusing on a region of code with poor performance and highlights the cause of the problem in terms of processors, procedures and data structure interactions. All the indices are generated from trace files augmented with data structure information.. Further, we show with the help of examples from the NAS benchmark suite that the indices help in detecting potential cause of poor performance, based on augmented execution traces obtained by monitoring the program.

Evaluation of Mental Workload among ICU Ward's Nurses.

PubMed

Mohammadi, Mohsen; Mazloumi, Adel; Kazemi, Zeinab; Zeraati, Hojat

2015-01-01

High level of workload has been identified among stressors of nurses in intensive care units (ICUs). The present study investigated nursing workload and identified its influencing perfor-mance obstacles in ICUs. This cross-sectional study was conducted, in 2013, on 81 nurses working in ICUs in Imam Khomeini Hospital in Tehran, Iran. NASA-TLX was applied for assessment of workload. Moreover, ICUs Performance Obstacles Questionnaire was used to identify performance obstacles associated with ICU nursing. Physical demand (mean=84.17) was perceived as the most important dimensions of workload by nurses. The most critical performance obstacles affecting workload included: difficulty in finding a place to sit down, hectic workplace, disorganized workplace, poor-conditioned equipment, waiting for using a piece of equipment, spending much time seeking for supplies in the central stock, poor quality of medical materials, delay in getting medications, unpredicted problems, disorganized central stock, outpatient surgery, spending much time dealing with family needs, late, inadequate, and useless help from nurse assistants, and ineffective morning rounds (P-value<0.05). Various performance obstacles are correlated with nurses' workload, affirms the significance of nursing work system characteristics. Interventions are recommended based on the results of this study in the work settings of nurses in ICUs.

Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis.

PubMed

Lee, Nuri; Kim, Ji-Eun; Gu, Ja-Yoon; Yoo, Hyun Ju; Kim, Inho; Yoon, Sung-Soo; Park, Seonyang; Han, Kyou-Sup; Kim, Hyun Kyung

2016-01-01

Disseminated intravascular coagulation (DIC) is characterized by consumption of coagulation factors and anticoagulants. Thrombin generation assay (TGA) gives useful information about global hemostatic status. We developed a new TGA system that anticoagulant addition can deplete thrombin generation in plasma, which may reflect defective anticoagulant system in DIC. TGAs were measured on the calibrated automated thrombogram with and without thrombomodulin or protein Z in 152 patients who were suspected of having DIC, yielding four parameters including lag time, endogenous thrombin potential, peak thrombin and time-to-peak in each experiment. Nonsurvivors showed significantly prolonged lag time and time-to-peak in TGA-protein Z system, which was performed with added protein Z. In multivariate Cox regression analysis, lag time and time-to-peak in TGA system were significant independent prognostic factors. In TGA-protein Z system, lag time and time-to-peak were revealed as independent prognostic factors of DIC. Protein Z addition could potentiate its anticoagulant effect in DIC with poor prognosis, suggesting the presence of defective protein Z system. The prolonged lag time and time-to-peak in both TGA and TGA-protein Z systems are expected to be used as independent prognostic factors of DIC.

Supporting large scale applications on networks of workstations

NASA Technical Reports Server (NTRS)

Cooper, Robert; Birman, Kenneth P.

1989-01-01

Distributed applications on networks of workstations are an increasingly common way to satisfy computing needs. However, existing mechanisms for distributed programming exhibit poor performance and reliability as application size increases. Extension of the ISIS distributed programming system to support large scale distributed applications by providing hierarchical process groups is discussed. Incorporation of hierarchy in the program structure and exploitation of this to limit the communication and storage required in any one component of the distributed system is examined.

Increased risk of mortality in systemic sclerosis-associated digital ulcers: a systematic review and meta-analysis.

PubMed

Meunier, Pauline; Dequidt, Laure; Barnetche, Thomas; Lazaro, Estibaliz; Duffau, Pierre; Richez, Christophe; Couzi, Lionel; Truchetet, Marie-Elise; Seneschal, Julien

2018-06-10

Survival can be threatened in certain forms of systemic sclerosis (SSc) so clear prognostic factors are needed. The aim of this meta-analysis was to assess the association between the presence of digital ulcers (DUs) and mortality in SSc. We performed a systematic review and meta-analysis in the Pubmed and Scopus databases from the earliest records to May 2017. Two research strategies were performed: « systemic sclerosis » and « digital ulcers » (strategy A); « systemic sclerosis » and « mortality » (strategy B). The primary outcome was the mortality associated with the presence of DUs in patients with SSc. The literature search identified 1473 citations. Fifty-nine studies were examined for full text. Ten articles were included for the meta-analysis. SSc patients with DUs had an increased pooled mortality risk: RR = 1.53 (IC 95%: [1.23-1.90]). This meta-analysis revealed a higher mortality in SSc patients with associated DUs. Having DUs may be a predictive factor of developing organ involvement such as pulmonary or cardiovascular events that could be associated with poor survival. It suggests that early screening of DUs in SSc patients is important to identify patients most at risk of poor survival. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Determinants of performance failure in the nursing home industry☆

PubMed Central

Zinn, Jacqueline; Mor, Vincent; Feng, Zhanlian; Intrator, Orna

2013-01-01

This study investigates the determinants of performance failure in U.S. nursing homes. The sample consisted of 91,168 surveys from 10,901 facilities included in the Online Survey Certification and Reporting system from 1996 to 2005. Failed performance was defined as termination from the Medicare and Medicaid programs. Determinants of performance failure were identified as core structural change (ownership change), peripheral change (related diversification), prior financial and quality of care performance, size and environmental shock (Medicaid case mix reimbursement and prospective payment system introduction). Additional control variables that could contribute to the likelihood of performance failure were included in a cross-sectional time series generalized estimating equation logistic regression model. Our results support the contention, derived from structural inertia theory, that where in an organization’s structure change occurs determines whether it is adaptive or disruptive. In addition, while poor prior financial and quality performance and the introduction of case mix reimbursement increases the risk of failure, larger size is protective, decreasing the likelihood of performance failure. PMID:19128865

Determinants of performance failure in the nursing home industry.

PubMed

Zinn, Jacqueline; Mor, Vincent; Feng, Zhanlian; Intrator, Orna

2009-03-01

This study investigates the determinants of performance failure in U.S. nursing homes. The sample consisted of 91,168 surveys from 10,901 facilities included in the Online Survey Certification and Reporting system from 1996 to 2005. Failed performance was defined as termination from the Medicare and Medicaid programs. Determinants of performance failure were identified as core structural change (ownership change), peripheral change (related diversification), prior financial and quality of care performance, size and environmental shock (Medicaid case mix reimbursement and prospective payment system introduction). Additional control variables that could contribute to the likelihood of performance failure were included in a cross-sectional time series generalized estimating equation logistic regression model. Our results support the contention, derived from structural inertia theory, that where in an organization's structure change occurs determines whether it is adaptive or disruptive. In addition, while poor prior financial and quality performance and the introduction of case mix reimbursement increases the risk of failure, larger size is protective, decreasing the likelihood of performance failure.

Designing an IMAC system using TeraNet

NASA Astrophysics Data System (ADS)

Mun, In K.; Hilal, S. K.; Andrews, M. C.; Gidron, Rafael

1992-07-01

Even though considerable progresses have been made with communication technology, one of the more difficult problems facing in installing a comprehensive clinically effective Image Management and Communication (IMAC) system for a hospital is the communication problem. Most existing systems are based on Ethernet or Token-ring net. Some of the newer systems are being installed using FDDL. All these systems have inherent problems like communication speed, control of bandwidth usage, or/and poor performance under heavy traffic. In order to overcome these difficulties, we are designing a complete IMAC system based on a novel network known as TeraNet, being developed at Center for Telecommunication Research, Columbia University.

Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance

PubMed Central

Pleasant, Andrew

2014-01-01

The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583

Twin Screw Extruder Production of MTTP Decoy Flares SERDP WP-1240

DTIC Science & Technology

2005-12-01

5 3. Carnauba Wax ( wax from palm tree exudate, a common ingredient in high quality car polish) Hazards of the remaining formulations were...1. Microsere 5866, a microcrystalline wax derived from refining petroleum 2. Elvax 250, poly(ethylene-co-vinyl acetate) (hot glue ingredient...5866 Poor performance when 1-gm sample ignited Elvax 250 Poor performance when 1-gm sample ignited Carnuba Wax Poor performance when 1-gm sample

Novel Nanostructured Solid Materials for Modulating Oral Drug Delivery from Solid-State Lipid-Based Drug Delivery Systems.

PubMed

Dening, Tahnee J; Rao, Shasha; Thomas, Nicky; Prestidge, Clive A

2016-01-01

Lipid-based drug delivery systems (LBDDS) have gained significant attention in recent times, owing to their ability to overcome the challenges limiting the oral delivery of poorly water-soluble drugs. Despite the successful commercialization of several LBDDS products over the years, a large discrepancy exists between the number of poorly water-soluble drugs displaying suboptimal in vivo performances and the application of LBDDS to mitigate their various delivery challenges. Conventional LBDDS, including lipid solutions and suspensions, emulsions, and self-emulsifying formulations, suffer from various drawbacks limiting their widespread use and commercialization. Accordingly, solid-state LBDDS, fabricated by adsorbing LBDDS onto a chemically inert solid carrier material, have attracted substantial interest as a viable means of stabilizing LBDDS whilst eliminating some of the various limitations. This review describes the impact of solid carrier choice on LBDDS performance and highlights the importance of appropriate solid carrier material selection when designing hybrid solid-state LBDDS. Specifically, emphasis is placed on discussing the ability of the specific solid carrier to modulate drug release, control lipase action and lipid digestion, and enhance biopharmaceutical performance above the original liquid-state LBDDS. To encourage the interested reader to consider their solid carrier choice on a higher level, various novel materials with the potential for future use as solid carriers for LBDDS are described. This review is highly significant in guiding future research directions in the solid-state LBDDS field and fostering the translation of these delivery systems to the pharmaceutical marketplace.

Charter Schools and the Corporate Makeover of Public Education: What's at Stake?

ERIC Educational Resources Information Center

Fabricant, Michael; Fine, Michelle

2012-01-01

This book will reset the discourse on charter schooling by systematically exploring the gap between the promise and the performance of charter schools. The authors do not defend the public school system, which for decades has failed primarily poor children of color. Instead, they use empirical evidence to determine whether charter schooling offers…

K-12 Education in Germany: Curriculum and PISA 2015

ERIC Educational Resources Information Center

Atmacasoy, Abdullah

2017-01-01

Against the backdrop of PISA 2015 results, the aim of this study is to review basic structures of German education system by exploring curriculum development process, key features of each educational level and teacher education in order to grasp how Germany has amended her poor performance after PISA 2000 and persistently improved the quality of…

Abernethy malformation with portal vein aneurysm in a child

PubMed Central

Chandrashekhara, Sheragaru H.; Bhalla, Ashu Seith; Gupta, Arun Kumar; Vikash, C. S.; Kabra, Susheel Kumar

2011-01-01

Abernethy malformation is an extremely rare anomaly of the splanchnic venous system. We describe multidetector computed tomography findings of an incidentally detected Abernethy malformation with portal vein aneurysm in a two-and-half-year old child. The computed tomography scan was performed for the evaluation of respiratory distress, poor growth, and loss of appetite. PMID:21430844

Using Truncated Lectures, Conceptual Exercises, and Manipulatives to Improve Learning in the Neuroanatomy Classroom

ERIC Educational Resources Information Center

Krontiris-Litowitz, Johanna

2008-01-01

Functional Neuroanatomy is a course designed to help students learn the function and anatomy of the human nervous system. Historically, students have had difficulty with the spinal tract curricular unit and frequently resorted to memorization to "learn" the material. They performed poorly on exams and failed to demonstrate competence in the…

Development of self-control in children aged 3 to 9 years: Perspective from a dual-systems model

PubMed Central

Tao, Ting; Wang, Ligang; Fan, Chunlei; Gao, Wenbin

2014-01-01

The current study tested a set of interrelated theoretical propositions based on a dual-systems model of self-control. Data were collected from 2135 children aged 3 to 9 years. The results suggest that (a) there was positive growth in good self-control, whereas poor control remained relatively stable; and (b) girls performed better than boys on tests of good self-control. The results are discussed in terms of their implications for a dual-systems model of self-control theory and future empirical work. PMID:25501669

Change blindness and visual memory: visual representations get rich and act poor.

PubMed

Varakin, D Alexander; Levin, Daniel T

2006-02-01

Change blindness is often taken as evidence that visual representations are impoverished, while successful recognition of specific objects is taken as evidence that they are richly detailed. In the current experiments, participants performed cover tasks that required each object in a display to be attended. Change detection trials were unexpectedly introduced and surprise recognition tests were given for nonchanging displays. For both change detection and recognition, participants had to distinguish objects from the same basic-level category, making it likely that specific visual information had to be used for successful performance. Although recognition was above chance, incidental change detection usually remained at floor. These results help reconcile demonstrations of poor change detection with demonstrations of good memory because they suggest that the capability to store visual information in memory is not reflected by the visual system's tendency to utilize these representations for purposes of detecting unexpected changes.

CMS keeps raising the stakes on quality improvement.

PubMed

2014-10-01

A significant portion of the Centers for Medicare & Medicaid Services (CMS) 2015 Inpatient Prospective Payment System final rule focuses on quality and raises the percentage of the Medicare base payment hospitals can lose if they perform poorly. Case managers must be involved with patients from the minute they come in the door, through the hospital stay, and after discharge, experts say. Reimbursement is affected by risk-adjustment, which means case managers must make sure the documentation is as complete and specific as possible to show the full picture of the patient's severity of illness as well as any conditions that were present on admission. As the readmission reduction program expands to add new diagnoses and the penalties for poor performance increase, case managers must change their focus from discharge planning to transition planning that takes into account what resources patients need after discharge, experts say.

Poor performances of EuroSCORE and CARE score for prediction of perioperative mortality in octogenarians undergoing aortic valve replacement for aortic stenosis.

PubMed

Chhor, Vibol; Merceron, Sybille; Ricome, Sylvie; Baron, Gabriel; Daoud, Omar; Dilly, Marie-Pierre; Aubier, Benjamin; Provenchere, Sophie; Philip, Ivan

2010-08-01

Although results of cardiac surgery are improving, octogenarians have a higher procedure-related mortality and more complications with increased length of stay in ICU. Consequently, careful evaluation of perioperative risk seems necessary. The aims of our study were to assess and compare the performances of EuroSCORE and CARE score in the prediction of perioperative mortality among octogenarians undergoing aortic valve replacement for aortic stenosis and to compare these predictive performances with those obtained in younger patients. This retrospective study included all consecutive patients undergoing cardiac surgery in our institution between November 2005 and December 2007. For each patient, risk assessment for mortality was performed using logistic EuroSCORE, additive EuroSCORE and CARE score. The main outcome measure was early postoperative mortality. Predictive performances of these scores were assessed by calibration and discrimination using goodness-of-fit test and area under the receiver operating characteristic curve, respectively. During this 2-year period, we studied 2117 patients, among whom 134/211 octogenarians and 335/1906 nonoctogenarians underwent an aortic valve replacement for aortic stenosis. When considering patients with aortic stenosis, discrimination was poor in octogenarians and the difference from nonoctogenarians was significant for each score (0.58, 0.59 and 0.56 vs. 0.82, 0.81 and 0.77 for additive EuroSCORE, logistic EuroSCORE and CARE score in octogenarians and nonoctogenarians, respectively, P < 0.05). Moreover, in the whole cohort, logistic EuroSCORE significantly overestimated mortality among octogenarians. Predictive performances of these scores are poor in octogenarians undergoing cardiac surgery, especially aortic valve replacement. Risk assessment and therapeutic decisions in octogenarians should not be made with these scoring systems alone.

Overexpression of MutSα Complex Proteins Predicts Poor Prognosis in Oral Squamous Cell Carcinoma.

PubMed

Wagner, Vivian Petersen; Webber, Liana Preto; Salvadori, Gabriela; Meurer, Luise; Fonseca, Felipe Paiva; Castilho, Rogério Moraes; Squarize, Cristiane Helena; Vargas, Pablo Agustin; Martins, Manoela Domingues

2016-05-01

The DNA mismatch repair (MMR) system is responsible for the detection and correction of errors created during DNA replication, thereby avoiding the incorporation of mutations in dividing cells. The prognostic value of alterations in MMR system has not previously been analyzed in oral squamous cell carcinoma (OSCC).The study comprised 115 cases of OSCC diagnosed between 1996 and 2010. The specimens collected were constructed into tissue microarray blocks. Immunohistochemical staining for MutSα complex proteins hMSH2 and hMSH6 was performed. The slides were subsequently scanned into high-resolution images, and nuclear staining of hMSH2 and hMSH6 was analyzed using the Nuclear V9 algorithm. Univariable and multivariable Cox proportional hazard regression models were performed to evaluate the prognostic value of hMSH2 and hMSH6 in OSCC.All cases in the present cohort were positive for hMSH2 and hMSH6 and a direct correlation was found between the expression of the proteins (P < 0.05). The mean number of positive cells for hMSH2 and hMSH6 was 64.44 ± 15.21 and 31.46 ± 22.38, respectively. These values were used as cutoff points to determine high protein expression. Cases with high expression of both proteins simultaneously were classified as having high MutSα complex expression. In the multivariable analysis, high expression of the MutSα complex was an independent prognostic factor for poor overall survival (hazard ratio: 2.75, P = 0.02).This study provides a first insight of the prognostic value of alterations in MMR system in OSCC. We found that MutSα complex may constitute a molecular marker for the poor prognosis of OSCC.

Evidence that communication impairment in schizophrenia is associated with generalized poor task performance.

PubMed

Merrill, Anne M; Karcher, Nicole R; Cicero, David C; Becker, Theresa M; Docherty, Anna R; Kerns, John G

2017-03-01

People with schizophrenia exhibit wide-ranging cognitive deficits, including slower processing speed and decreased cognitive control. Disorganized speech symptoms, such as communication impairment, have been associated with poor cognitive control task performance (e.g., goal maintenance and working memory). Whether communication impairment is associated with poorer performance on a broader range of non-cognitive control measures is unclear. In the current study, people with schizophrenia (n =51) and non-psychiatric controls (n =26) completed speech interviews allowing for reliable quantitative assessment of communication impairment. Participants also completed multiple goal maintenance and working memory tasks. In addition, we also examined (a) simple measures of processing speed involving highly automatic prepotent responses and (b) a non-cognitive control measure of general task performance. Schizophrenia communication impairment was significantly associated with poor performance in all cognitive domains, with the largest association found with processing speed (r s =-0.52). Further, communication impairment was also associated with the non-cognitive control measure of poor general task performance (r s =-0.43). In contrast, alogia, a negative speech symptom, and positive symptoms were less if at all related to cognitive task performance. Overall, this study suggests that communication impairment in schizophrenia may be associated with relatively generalized poor cognitive task performance. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Effects of gastric pH on oral drug absorption: In vitro assessment using a dissolution/permeation system reflecting the gastric dissolution process.

PubMed

Kataoka, Makoto; Fukahori, Miho; Ikemura, Atsumi; Kubota, Ayaka; Higashino, Haruki; Sakuma, Shinji; Yamashita, Shinji

2016-04-01

The aim of the present study was to evaluate the effects of gastric pH on the oral absorption of poorly water-soluble drugs using an in vitro system. A dissolution/permeation system (D/P system) equipped with a Caco-2 cell monolayer was used as the in vitro system to evaluate oral drug absorption, while a small vessel filled with simulated gastric fluid (SGF) was used to reflect the gastric dissolution phase. After applying drugs in their solid forms to SGF, SGF solution containing a 1/100 clinical dose of each drug was mixed with the apical solution of the D/P system, which was changed to fasted state-simulated intestinal fluid. Dissolved and permeated amounts on applied amount of drugs were then monitored for 2h. Similar experiments were performed using the same drugs, but without the gastric phase. Oral absorption with or without the gastric phase was predicted in humans based on the amount of the drug that permeated in the D/P system, assuming that the system without the gastric phase reflected human absorption with an elevated gastric pH. The dissolved amounts of basic drugs with poor water solubility, namely albendazole, dipyridamole, and ketoconazole, in the apical solution and their permeation across a Caco-2 cell monolayer were significantly enhanced when the gastric dissolution process was reflected due to the physicochemical properties of basic drugs. These amounts resulted in the prediction of higher oral absorption with normal gastric pH than with high gastric pH. On the other hand, when diclofenac sodium, the salt form of an acidic drug, was applied to the D/P system with the gastric phase, its dissolved and permeated amounts were significantly lower than those without the gastric phase. However, the oral absorption of diclofenac was predicted to be complete (96-98%) irrespective of gastric pH because the permeated amounts of diclofenac under both conditions were sufficiently high to achieve complete absorption. These estimations of the effects of gastric pH on the oral absorption of poorly water-soluble drugs were consistent with observations in humans. In conclusion, the D/P system with the gastric phase may be a useful tool for better predicting the oral absorption of poorly water-soluble basic drugs. In addition, the effects of gastric pH on the oral absorption of poorly water-soluble drugs may be evaluated by the D/P system with and without the gastric phase. Copyright © 2016 Elsevier B.V. All rights reserved.

20 CFR 658.604 - Assessment and evaluation of program performance data.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., whether overall or relative to a particular program activity, indicate poor program performance does not... that a State agency's performance is poor that the data may raise a presumption (prima facie case) that... performance data. 658.604 Section 658.604 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION...

Enhanced performance of macrophage-encapsulated nanoparticle albumin-bound-paclitaxel in hypo-perfused cancer lesions

NASA Astrophysics Data System (ADS)

Leonard, Fransisca; Curtis, Louis T.; Yesantharao, Pooja; Tanei, Tomonori; Alexander, Jenolyn F.; Wu, Min; Lowengrub, John; Liu, Xuewu; Ferrari, Mauro; Yokoi, Kenji; Frieboes, Hermann B.; Godin, Biana

2016-06-01

Hypovascularization in tumors such as liver metastases originating from breast and other organs correlates with poor chemotherapeutic response and higher mortality. Poor prognosis is linked to impaired transport of both low- and high-molecular weight drugs into the lesions and to high washout rate. Nanoparticle albumin-bound-paclitaxel (nAb-PTX) has demonstrated benefits in clinical trials when compared to paclitaxel and docetaxel. However, its therapeutic efficacy for breast cancer liver metastasis is disappointing. As macrophages are the most abundant cells in the liver tumor microenvironment, we design a multistage system employing macrophages to deliver drugs into hypovascularized metastatic lesions, and perform in vitro, in vivo, and in silico evaluation. The system encapsulates nAb-PTX into nanoporous biocompatible and biodegradable multistage vectors (MSV), thus promoting nAb-PTX retention in macrophages. We develop a 3D in vitro model to simulate clinically observed hypo-perfused tumor lesions surrounded by macrophages. This model enables evaluation of nAb-PTX and MSV-nab PTX efficacy as a function of transport barriers. Addition of macrophages to this system significantly increases MSV-nAb-PTX efficacy, revealing the role of macrophages in drug transport. In the in vivo model, a significant increase in macrophage number, as compared to unaffected liver, is observed in mice, confirming the in vitro findings. Further, a mathematical model linking drug release and retention from macrophages is implemented to project MSV-nAb-PTX efficacy in a clinical setting. Based on macrophage presence detected via liver tumor imaging and biopsy, the proposed experimental/computational approach could enable prediction of MSV-nab PTX performance to treat metastatic cancer in the liver.Hypovascularization in tumors such as liver metastases originating from breast and other organs correlates with poor chemotherapeutic response and higher mortality. Poor prognosis is linked to impaired transport of both low- and high-molecular weight drugs into the lesions and to high washout rate. Nanoparticle albumin-bound-paclitaxel (nAb-PTX) has demonstrated benefits in clinical trials when compared to paclitaxel and docetaxel. However, its therapeutic efficacy for breast cancer liver metastasis is disappointing. As macrophages are the most abundant cells in the liver tumor microenvironment, we design a multistage system employing macrophages to deliver drugs into hypovascularized metastatic lesions, and perform in vitro, in vivo, and in silico evaluation. The system encapsulates nAb-PTX into nanoporous biocompatible and biodegradable multistage vectors (MSV), thus promoting nAb-PTX retention in macrophages. We develop a 3D in vitro model to simulate clinically observed hypo-perfused tumor lesions surrounded by macrophages. This model enables evaluation of nAb-PTX and MSV-nab PTX efficacy as a function of transport barriers. Addition of macrophages to this system significantly increases MSV-nAb-PTX efficacy, revealing the role of macrophages in drug transport. In the in vivo model, a significant increase in macrophage number, as compared to unaffected liver, is observed in mice, confirming the in vitro findings. Further, a mathematical model linking drug release and retention from macrophages is implemented to project MSV-nAb-PTX efficacy in a clinical setting. Based on macrophage presence detected via liver tumor imaging and biopsy, the proposed experimental/computational approach could enable prediction of MSV-nab PTX performance to treat metastatic cancer in the liver. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr07796f

Poor Executive Functions among Children with Moderate-into-Severe Asthma: Evidence from WCST Performance.

PubMed

Taha, Haitham

2017-01-01

Executive functions (EFs) measures of 27 asthmatic children, with general learning difficulties, were tested by using the Wisconsin card sorting test (WCST), and were compared to the performances of 30 non-asthmatic children with general learning difficulties. The results revealed that the asthmatic group has poor performance through all the WCST psychometric parameters and especially the perseverative errors one. The results were discussed in light of the postulation that poor EFs could be associated with the learning difficulties of asthmatic children. Neurophysiological framework has been suggested to explain the etiology of poor EFs among children with moderate into severe asthma.

Microbial Contamination of Drinking Water and Human Health from Community Water Systems.

PubMed

Ashbolt, Nicholas J

2015-03-01

A relatively short list of reference viral, bacterial and protozoan pathogens appears adequate to assess microbial risks and inform a system-based management of drinking waters. Nonetheless, there are data gaps, e.g. human enteric viruses resulting in endemic infection levels if poorly performing disinfection and/or distribution systems are used, and the risks from fungi. Where disinfection is the only treatment and/or filtration is poor, cryptosporidiosis is the most likely enteric disease to be identified during waterborne outbreaks, but generally non-human-infectious genotypes are present in the absence of human or calf fecal contamination. Enteric bacteria may dominate risks during major fecal contamination events that are ineffectively managed. Reliance on culture-based methods exaggerates treatment efficacy and reduces our ability to identify pathogens/indicators; however, next-generation sequencing and polymerase chain reaction approaches are on the cusp of changing that. Overall, water-based Legionella and non-tuberculous mycobacteria probably dominate health burden at exposure points following the various societal uses of drinking water.

Systems genetics identifies a convergent gene network for cognition and neurodevelopmental disease.

PubMed

Johnson, Michael R; Shkura, Kirill; Langley, Sarah R; Delahaye-Duriez, Andree; Srivastava, Prashant; Hill, W David; Rackham, Owen J L; Davies, Gail; Harris, Sarah E; Moreno-Moral, Aida; Rotival, Maxime; Speed, Doug; Petrovski, Slavé; Katz, Anaïs; Hayward, Caroline; Porteous, David J; Smith, Blair H; Padmanabhan, Sandosh; Hocking, Lynne J; Starr, John M; Liewald, David C; Visconti, Alessia; Falchi, Mario; Bottolo, Leonardo; Rossetti, Tiziana; Danis, Bénédicte; Mazzuferi, Manuela; Foerch, Patrik; Grote, Alexander; Helmstaedter, Christoph; Becker, Albert J; Kaminski, Rafal M; Deary, Ian J; Petretto, Enrico

2016-02-01

Genetic determinants of cognition are poorly characterized, and their relationship to genes that confer risk for neurodevelopmental disease is unclear. Here we performed a systems-level analysis of genome-wide gene expression data to infer gene-regulatory networks conserved across species and brain regions. Two of these networks, M1 and M3, showed replicable enrichment for common genetic variants underlying healthy human cognitive abilities, including memory. Using exome sequence data from 6,871 trios, we found that M3 genes were also enriched for mutations ascertained from patients with neurodevelopmental disease generally, and intellectual disability and epileptic encephalopathy in particular. M3 consists of 150 genes whose expression is tightly developmentally regulated, but which are collectively poorly annotated for known functional pathways. These results illustrate how systems-level analyses can reveal previously unappreciated relationships between neurodevelopmental disease-associated genes in the developed human brain, and provide empirical support for a convergent gene-regulatory network influencing cognition and neurodevelopmental disease.

Common Characteristics of Good and Poorly Performing PCC Pavements

DOT National Transportation Integrated Search

1998-01-01

This report documents the analysis and findings of a study to identify the site conditions and design/construction features of concrete pavements (JPCP, JRCP, CRCP) that lead to good performance and those that lead to poor performance. Data from Long...

Common Characteristics of Good and Poorly Performing AC Pavements

DOT National Transportation Integrated Search

1999-12-01

This report documents the analysis and findings of a study to identify the site conditions and design/construction features of : flexible pavements that lead to good performance and those that lead to poor performance. Data from the Long Term Pavemen...

Correlation between stressors and academic performance in second year medical students.

PubMed

Nuallaong, Winitra

2011-12-01

The present study aimed to find which type of stressors correlating to academic performance in second year medical students. One-hundred and eighty three second year medical students of Thammasat University participated in a three-week cross-sectional study. The self-report questionnaire consisted of Thai stress test, stress factors and examination grades referring academic performance were applied in the present study. Females felt stress more than males in severe, high, and medium level of stress. There was no low level of stress and no correlation between stress level and the entrance programs. Academic performance found relating to 1) fear of doing a mistake, 2) feeling of competition or comparison, 3) unilateral headache, 4) worrying, and 5) poor concentration. Students with poor concentration had significantly decreasing grade in the second year (p < 0.01). Interestingly, worrying, feeling of competition or comparison, and fear of doing a mistake correlated to increasing grade in some terms (p < 0.05). Specifically to poor concentration, there were medium linear association with fatigue, poor memory, feeling confused, feeling sad, feeling angry or irritable, changing appetite, and headache from stress (p < 0.01). Poor concentration was the only stressor significantly correlated with poorer academic performance. Poor concentration also correlated with physical, cognitive, and financial problems. The recommendation is to keep watching those issues in order to early detect problem about academic performance.

Health, safety and environmental unit performance assessment model under uncertainty (case study: steel industry).

PubMed

Shamaii, Azin; Omidvari, Manouchehr; Lotfi, Farhad Hosseinzadeh

2017-01-01

Performance assessment is a critical objective of management systems. As a result of the non-deterministic and qualitative nature of performance indicators, assessments are likely to be influenced by evaluators' personal judgments. Furthermore, in developing countries, performance assessments by the Health, Safety and Environment (HSE) department are based solely on the number of accidents. A questionnaire is used to conduct the study in one of the largest steel production companies in Iran. With respect to health, safety, and environment, the results revealed that control of disease, fire hazards, and air pollution are of paramount importance, with coefficients of 0.057, 0.062, and 0.054, respectively. Furthermore, health and environment indicators were found to be the most common causes of poor performance. Finally, it was shown that HSE management systems can affect the majority of performance safety indicators in the short run, whereas health and environment indicators require longer periods of time. The objective of this study is to present an HSE-MS unit performance assessment model in steel industries. Moreover, we seek to answer the following question: what are the factors that affect HSE unit system in the steel industry? Also, for each factor, the extent of impact on the performance of the HSE management system in the organization is determined.

Data-driven battery product development: Turn battery performance into a competitive advantage.

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

Sholklapper, Tal

Poor battery performance is a primary source of user dissatisfaction across a broad range of applications, and is a key bottleneck hindering the growth of mobile technology, wearables, electric vehicles, and grid energy storage. Engineering battery systems is difficult, requiring extensive testing for vendor selection, BMS programming, and application-specific lifetime testing. This work also generates huge quantities of data. This presentation will explain how to leverage this data to help ship quality products faster using fewer resources while ensuring safety and reliability in the field, ultimately turning battery performance into a competitive advantage.

Differences in dichogamy and herkogamy contribute to higher selfing in contrasting environments in the annual Blackstonia perfoliata (Gentianaceae)

PubMed Central

Brys, Rein; Geens, Bram; Beeckman, Tom; Jacquemyn, Hans

2013-01-01

Background and Aims The establishment of plant populations in novel environments may generate pronounced shifts in floral traits and plant mating systems, particularly when pollinators are scarce. In this study, floral morphology and mating system functioning are compared between recently established and older populations of the annual plant Blackstonia perfoliata that occur in different pollinator environments. Methods Hand-pollination and emasculation experiments were conducted to assess the extent of pollinator-mediated pollen deposition and pollen limitation, and the contribution of autonomous selfing to total seed production. Detailed measurements of key floral traits were performed to compare the flower morphology and mating system functioning between plants from both pollination environments. Key Results Pollinator-mediated pollen deposition was about twice as low in the recently colonized and pollinator-poor environment compared with the old and pollinator-rich sites, but total seed set was little affected by any type of pollen limitation. The contribution of autonomous selfing to total seed production was higher in the pollinator-poor sites than in the pollinator-rich sites (index of reproductive assurance = 0·56 and 0·17, respectively), and seed production was only poorly affected by selfing, whereas in the pollinator-rich populations selfing reduced total reproductive output by about 40 % compared with outcross pollination. Plants originating from pollinator-poor environments produced smaller flowers that showed significantly lower levels of dichogamy (i.e. protogyny) and herkogamy. These reductions resulted in a 2-fold higher capacity for autonomous selfing under pollinator-free conditions (index of autonomous selfing = 0·81 and 0·41 in plants originating from the pollinator-poor and pollinator-rich environment, respectively). Conclusions The results illustrate that plant populations colonizing novel environments can differ markedly in floral morphology and mating system functioning. Due to a temporal shift in the male phase, the breeding system of B. perfoliata shifted from delayed selfing under pollinator-rich conditions towards competing selfing in recently established populations, providing greater reproductive assurance when pollinators and/or reproductive partners are limited. PMID:23408833

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

Kubicek, Gregory J., E-mail: kubicek-gregory@cooperhealth.edu; Turtz, Alan; Xue, Jinyu

Purpose: Patients with poor performance status (PS), usually defined as a Karnofsky Performance Status of 60 or less, were not eligible for randomized stereotactic radiosurgery (SRS) studies, and many guidelines suggest that whole-brain radiation therapy (WBRT) is the most appropriate treatment for poor PS patients. Methods and Materials: In this retrospective review of our SRS database, we identified 36 patients with PS of 60 or less treated with SRS for central nervous system (CNS) metastatic disease. PS, as defined by the Karnofsky Performance Status, was 60 (27 patients), 50 (8 patients), or 40 (1 patient). The median number of CNSmore » lesions treated was 3. Results: Median overall survival (OS) was 7.2 months (range, 0.73-25.6 months). Fifteen patients (41%) were alive at 6 months, and 6 patients (16.6%) were alive at 1 year. There was no difference in OS in patients who underwent previous WBRT. There were no local failures or cases of radiation toxicity. Distant CNS failures were seen in 9 patients (25%). Conclusions: Our patients with poor PS had reasonable median OS and relatively low distant CNS failure rates. Patients in this patient population may be ideal candidates for SRS compared with WBRT given the low incidence of distant failure over their remaining lives and the favorable logistics of single-fraction treatment for these patients with debility and their caregivers.« less

Atmospheric turbulence and sensor system effects on biometric algorithm performance

NASA Astrophysics Data System (ADS)

Espinola, Richard L.; Leonard, Kevin R.; Byrd, Kenneth A.; Potvin, Guy

2015-05-01

Biometric technologies composed of electro-optical/infrared (EO/IR) sensor systems and advanced matching algorithms are being used in various force protection/security and tactical surveillance applications. To date, most of these sensor systems have been widely used in controlled conditions with varying success (e.g., short range, uniform illumination, cooperative subjects). However the limiting conditions of such systems have yet to be fully studied for long range applications and degraded imaging environments. Biometric technologies used for long range applications will invariably suffer from the effects of atmospheric turbulence degradation. Atmospheric turbulence causes blur, distortion and intensity fluctuations that can severely degrade image quality of electro-optic and thermal imaging systems and, for the case of biometrics technology, translate to poor matching algorithm performance. In this paper, we evaluate the effects of atmospheric turbulence and sensor resolution on biometric matching algorithm performance. We use a subset of the Facial Recognition Technology (FERET) database and a commercial algorithm to analyze facial recognition performance on turbulence degraded facial images. The goal of this work is to understand the feasibility of long-range facial recognition in degraded imaging conditions, and the utility of camera parameter trade studies to enable the design of the next generation biometrics sensor systems.

Does poor school performance cause later psychosocial problems among children in foster care? Evidence from national longitudinal registry data.

PubMed

Forsman, Hilma; Brännström, Lars; Vinnerljung, Bo; Hjern, Anders

2016-07-01

Research has shown that children in foster care are a high-risk group for adverse economic, social and health related outcomes in young adulthood. Children's poor school performance has been identified as a major risk factor for these poor later life outcomes. Aiming to support the design of effective intervention strategies, this study examines the hypothesized causal effect of foster children's poor school performance on subsequent psychosocial problems, here conceptualized as economic hardship, illicit drug use, and mental health problems, in young adulthood. Using the potential outcomes approach, longitudinal register data on more than 7500 Swedish foster children born 1973-1978 were analyzed by means of doubly robust treatment-effect estimators. The results show that poor school performance has a negative impact on later psychosocial problems net of observed background attributes and potential selection on unobservables, suggesting that the estimated effects allow for causal interpretations. Promotion of school performance may thus be a viable intervention path for policymakers and practitioners interested in improving foster children's overall life chances. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship between Poor Sleep and Daytime Cognitive Performance in Young Adults with Autism

ERIC Educational Resources Information Center

Limoges, Elyse; Bolduc, Christianne; Berthiaume, Claude; Mottron, Laurent; Godbout, Roger

2013-01-01

Poor sleep is a common feature in autism even though patients themselves do not necessarily complain. The impact of poor sleep on daytime cognitive functioning in autism is not well-known and we therefore investigated whether sleep in autism correlates with daytime cognitive performance. A battery of non-verbal tasks was administered, in the…

CAUSES OF POOR SEALANT PERFORMANCE IN SOIL-GAS- RESISTANT FOUNDATIONS

EPA Science Inventory

The paper discusses causes of poor sealant performance in soil-gas-resistant foundations. ealants for radon-resistant foundation construction must seal the gap between concrete sections. odern sealants have such low permeability that seal performance depends only on the permeabil...

Poor school performance.

PubMed

Karande, Sunil; Kulkarni, Madhuri

2005-11-01

Education is one of the most important aspects of human resource development. Poor school performance not only results in the child having a low self-esteem, but also causes significant stress to the parents. There are many reasons for children to under perform at school, such as, medical problems, below average intelligence, specific learning disability, attention deficit hyperactivity disorder, emotional problems, poor socio-cultural home environment, psychiatric disorders and even environmental causes. The information provided by the parents, classroom teacher and school counselor about the child's academic difficulties guides the pediatrician to form an initial diagnosis. However, a multidisciplinary evaluation by an ophthalmologist, otolaryngologist, counselor, clinical psychologist, special educator, and child psychiatrist is usually necessary before making the final diagnosis. It is important to find the reason(s) for a child's poor school performance and come up with a treatment plan early so that the child can perform up to full potential.

Anatomy of a system accident: the crash of Avianca Flight 052.

PubMed

Helmreich, R L

1994-01-01

On January 25, 1990, Avianca Flight 052 crashed after running out of fuel following a missed approach to New York's John F. Kennedy Airport. Weather was poor on the East Coast of the United States that day, and the flight had experienced several holding patterns enroute from Medellín, Colombia, to New York. The accident is analyzed in terms of Helmreich and Foushee's (1993) model of crew performance and Reason's (1990) model of latent pathogens in system operations.

Anatomy of a system accident: The crash of Avianca Flight 052

NASA Technical Reports Server (NTRS)

Helmreich, Robert L.

1994-01-01

On January 25, 1990, Avianca Flight 052 crashed after running out of fuel following a missed approach to New York's John F. Kennedy Airport. Weather was poor on the East Coast of the United States that day, and the flight had experienced several holding patterns enroute from Medellin, Colombia, to New York. The accident is analyzed in terms of Helmreich and Foushee's (1993) model of crew performance and Reason's (1990) model of latent pathogens in system operations.

Promoting Airmen with the Potential to Lead: A Study of the Air Force Master Sergeant Promotion System

DTIC Science & Technology

2014-01-01

than men. A common rule of thumb for measuring the existence of adverse impact is the four-fifths rule, which says that adverse impact is...a test. Similarly, another respondent commented that the current system “ says if you hang in there long enough, then you can get promoted, and I...Consequently, we did not review assessment methods found to be poor predictors of performance (e.g., handwriting analysis known as graphology

Is vertical integration adding value to health systems?

PubMed

Weil, T P

2000-04-01

Vertical integration is a concept used by health systems when attempting to achieve economies of scale, greater coordination of services, and improved market penetration. This article focuses on the actual outcomes of utilizing vertical integration in the health field and then compares these findings with those reported in other industries. This analysis concludes that this organizational model does not work particularly well in the health industry, as illustrated by health alliances' poor fiscal performance when they acquire physician practices or when they start their own HMO plans.

NASA Marshall Space Flight Center Improves Cooling System Performance: Best Management Practice Case Study #10: Cooling Towers (Fact Sheet)

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

Not Available

National Aeronautics and Space Administration's (NASA) Marshall Space Flight Center (MSFC) has a longstanding sustainability program that revolves around energy and water efficiency as well as environmental protection. MSFC identified a problematic cooling loop with six separate compressor heat exchangers and a history of poor efficiency. The facility engineering team at MSFC partnered with Flozone Services, Incorporated to implement a comprehensive water treatment platform to improve the overall efficiency of the system.

Land mobile satellite propagation results

NASA Technical Reports Server (NTRS)

Nicholas, David C.

1988-01-01

During the Fall of 1987 a land mobile satellite demonstration using the MARECS B2 satellite at 26 degrees W was performed. While all the data have not been digested, some observations are in order. First, the system worked remarkably well for the margins indicated. Second, when the system worked poorly, the experimenters could almost always identify terrain or other obstacles causing blockage. Third, the forward link seems relatively more reliable than the return link, and occasional return link problems occured which have not been entirely explained.

Development of polyisocyanurate pour foam formulation for space shuttle external tank thermal protection system

NASA Technical Reports Server (NTRS)

Harvey, James A.; Butler, John M.; Chartoff, Richard P.

1988-01-01

Four commercially available polyisocyanurate polyurethane spray-foam insulation formulations are used to coat the external tank of the space shuttle. There are several problems associated with these formulations. For example, some do not perform well as pourable closeout/repair systems. Some do not perform well at cryogenic temperatures (poor adhesion to aluminum at liquid nitrogen temperatures). Their thermal stability at elevated temperatures is not adequate. A major defect in all the systems is the lack of detailed chemical information. The formulations are simply supplied to NASA and Martin Marietta, the primary contractor, as components; Part A (isocyanate) and Part B (poly(s) and additives). Because of the lack of chemical information the performance behavior data for the current system, NASA sought the development of a non-proprietary room temperature curable foam insulation. Requirements for the developed system were that it should exhibit equal or better thermal stability both at elevated and cryogenic temperatures with better adhesion to aluminum as compared to the current system. Several formulations were developed that met these requirements, i.e., thermal stability, good pourability, and good bonding to aluminum.

Comparison of adaptive critic-based and classical wide-area controllers for power systems.

PubMed

Ray, Swakshar; Venayagamoorthy, Ganesh Kumar; Chaudhuri, Balarko; Majumder, Rajat

2008-08-01

An adaptive critic design (ACD)-based damping controller is developed for a thyristor-controlled series capacitor (TCSC) installed in a power system with multiple poorly damped interarea modes. The performance of this ACD computational intelligence-based method is compared with two classical techniques, which are observer-based state-feedback (SF) control and linear matrix inequality LMI-H(infinity) robust control. Remote measurements are used as feedback signals to the wide-area damping controller for modulating the compensation of the TCSC. The classical methods use a linearized model of the system whereas the ACD method is purely measurement-based, leading to a nonlinear controller with fixed parameters. A comparative analysis of the controllers' performances is carried out under different disturbance scenarios. The ACD-based design has shown promising performance with very little knowledge of the system compared to classical model-based controllers. This paper also discusses the advantages and disadvantages of ACDs, SF, and LMI-H(infinity).

Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health.

PubMed

Alshamsan, Riyadh; Lee, John Tayu; Rana, Sangeeta; Areabi, Hasan; Millett, Christopher

2017-09-01

Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage.

Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health

PubMed Central

Alshamsan, Riyadh; Lee, John Tayu; Rana, Sangeeta; Areabi, Hasan; Millett, Christopher

2017-01-01

Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal health coverage. Design Cross-sectional analysis from the World Health Organization Study on global AGEing and adult health, collected between 2007 and 2010. Setting Six middle-income countries: China, Ghana, India, Mexico, Russia and South Africa. Participants Nationally representative sample of adults aged 50 years and older. Main outcome measures We present achievement against key indicators of health system performance across effectiveness, cost, access, patient-centredness and equity domains. Results We found areas of poor performance in prevention and management of chronic conditions, such as hypertension control and cancer screening coverage. We also found that cost remains a barrier to healthcare access in spite of insurance schemes. Finally, we found evidence of disparities across many indicators, particularly in the effectiveness and patient centredness domains. Conclusions These findings identify important focus areas for action and shared learning as these countries move towards achieving universal health coverage. PMID:28895493

Mental state attribution in schizophrenia: what distinguishes patients with "poor" from patients with "fair" mentalising skills?

PubMed

Brüne, M; Schaub, D

2012-07-01

Although many patients with schizophrenia are impaired in mental states attribution abilities, a significant number perform within normal or near-normal ranges in mental state attribution tasks. No studies have analysed cognitive or behavioural differences between patients with - to some extent - preserved mental state attribution skills and those with poor mentalising abilities. To examine characteristics of "poor" and "fair" mentalisers, 58 patients with schizophrenia performed a mental state attribution task, a test of general intelligence, and two executive functioning tests. "Poor" and "fair" mentalising skills were defined according to a median-split procedure; the median score in the patient group was also within two standard deviations of the control group. In addition, patients' social behavioural skills and psychopathological profiles were rated. Patients performing within normal or near normal ranges on the mental state attribution task had fewer social behavioural abnormalities than patients with poor mentalising abilities (even when controlled for intelligence), but did not differ in executive functioning. Fair mental state performers showed less disorganisation and excitement symptoms than poor performers. The degree of disorganisation mediated the influence of mental state attribution on social behavioural skills. Schizophrenia patients with (partially) preserved mentalising skills have fewer behavioural problems in the social domain than patients with poor mentalising abilities. Conceptual disorganisation mediates the prediction of social behavioural skills through mentalising skills, suggesting that disorganised patients may require special attention regarding social-cognitive skills training. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

A Temporal Locality-Aware Page-Mapped Flash Translation Layer

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

Kim, Youngjae; Gupta, Aayush; Urgaonkar, Bhuvan

2013-01-01

The poor performance of random writes has been a cause of major concern which needs to be addressed to better utilize the potential of flash in enterprise-scale environments. We examine one of the important causes of this poor performance: the design of the flash translation layer (FTL) which performs the virtual-to-physical address translations and hides the erase-before-write characteristics of flash. We propose a complete paradigm shift in the design of the core FTL engine from the existing techniques with our Demand-Based Flash Translation Layer (DFTL) which selectively caches page- level address mappings. Our experimental evaluation using FlashSim with realistic enterprise-scalemore » workloads endorses the utility of DFTL in enterprise-scale storage systems by demonstrating: 1) improved performance, 2) reduced garbage collection overhead and 3) better overload behavior compared with hybrid FTL schemes which are the most popular implementation methods. For example, a predominantly random-write dominant I/O trace from an OLTP application running at a large financial institution shows a 78% improvement in average response time (due to a 3-fold reduction in operations of the garbage collector), compared with the hybrid FTL scheme. Even for the well-known read-dominant TPC-H benchmark, for which DFTL introduces additional overheads, we improve system response time by 56%. Moreover, interestingly, when write-back cache on DFTL-based SSD is enabled, DFTL even outperforms the page-based FTL scheme, improving their response time by 72% in Financial trace.« less

Sensitivity to gaze-contingent contrast increments in naturalistic movies: An exploratory report and model comparison

PubMed Central

Wallis, Thomas S. A.; Dorr, Michael; Bex, Peter J.

2015-01-01

Sensitivity to luminance contrast is a prerequisite for all but the simplest visual systems. To examine contrast increment detection performance in a way that approximates the natural environmental input of the human visual system, we presented contrast increments gaze-contingently within naturalistic video freely viewed by observers. A band-limited contrast increment was applied to a local region of the video relative to the observer's current gaze point, and the observer made a forced-choice response to the location of the target (≈25,000 trials across five observers). We present exploratory analyses showing that performance improved as a function of the magnitude of the increment and depended on the direction of eye movements relative to the target location, the timing of eye movements relative to target presentation, and the spatiotemporal image structure at the target location. Contrast discrimination performance can be modeled by assuming that the underlying contrast response is an accelerating nonlinearity (arising from a nonlinear transducer or gain control). We implemented one such model and examined the posterior over model parameters, estimated using Markov-chain Monte Carlo methods. The parameters were poorly constrained by our data; parameters constrained using strong priors taken from previous research showed poor cross-validated prediction performance. Atheoretical logistic regression models were better constrained and provided similar prediction performance to the nonlinear transducer model. Finally, we explored the properties of an extended logistic regression that incorporates both eye movement and image content features. Models of contrast transduction may be better constrained by incorporating data from both artificial and natural contrast perception settings. PMID:26057546

An adaptive optics imaging system designed for clinical use

PubMed Central

Zhang, Jie; Yang, Qiang; Saito, Kenichi; Nozato, Koji; Williams, David R.; Rossi, Ethan A.

2015-01-01

Here we demonstrate a new imaging system that addresses several major problems limiting the clinical utility of conventional adaptive optics scanning light ophthalmoscopy (AOSLO), including its small field of view (FOV), reliance on patient fixation for targeting imaging, and substantial post-processing time. We previously showed an efficient image based eye tracking method for real-time optical stabilization and image registration in AOSLO. However, in patients with poor fixation, eye motion causes the FOV to drift substantially, causing this approach to fail. We solve that problem here by tracking eye motion at multiple spatial scales simultaneously by optically and electronically integrating a wide FOV SLO (WFSLO) with an AOSLO. This multi-scale approach, implemented with fast tip/tilt mirrors, has a large stabilization range of ± 5.6°. Our method consists of three stages implemented in parallel: 1) coarse optical stabilization driven by a WFSLO image, 2) fine optical stabilization driven by an AOSLO image, and 3) sub-pixel digital registration of the AOSLO image. We evaluated system performance in normal eyes and diseased eyes with poor fixation. Residual image motion with incremental compensation after each stage was: 1) ~2–3 arc minutes, (arcmin) 2) ~0.5–0.8 arcmin and, 3) ~0.05–0.07 arcmin, for normal eyes. Performance in eyes with poor fixation was: 1) ~3–5 arcmin, 2) ~0.7–1.1 arcmin and 3) ~0.07–0.14 arcmin. We demonstrate that this system is capable of reducing image motion by a factor of ~400, on average. This new optical design provides additional benefits for clinical imaging, including a steering subsystem for AOSLO that can be guided by the WFSLO to target specific regions of interest such as retinal pathology and real-time averaging of registered images to eliminate image post-processing. PMID:26114033

Efficiency indices and indicators of poor performance among emerging small-scale pig farmers in the Limpopo Province, South Africa.

PubMed

Mokoele, Japhta M; Spencer, B Tom; van Leengoed, Leo A M G; Fasina, Folorunso O

2014-11-12

Limpopo is a very important area for pig production in terms of animal populations and contributions to transboundary animal disease spread. Emerging small-scale pig farmers (ESSPF) are being encouraged to establish operations and spread in South Africa; however, for these farmers to perform optimally, they need to understand the basics of animal agriculture and contribute to enhancing biosecurity and efficient production systems. In the present study, the limitations to efficient production amongst ESSPF were evaluated and some improvements were suggested. It was found that the ESSPF are dominated by males and include a large percentage of older persons. A total of 26.54% of these farmers have post-matriculation qualifications. Undefined and indigenous breeds still dominate their animal genetics. The animal health technicians are the preferred channels by which farmers report diseases to the authorities (52.47%) and only one out of five (20.37%) will preferably report a disease situation direct to a veterinarian. These farmers do not vaccinate their stock, and knowledge of biosecurity is poor. Antimicrobials, especially tetracyclines, are abused. Animals that are slaughtered within the community or sold at local sale points, pension pay stations and auction markets are likely candidates for disease spread. It is recommended that the younger generations are retained and incentivised in animal agriculture. Improved training on management, health, biosecurity and better market access must be provided for the ESSPF, whilst efforts should made to consolidate these farmers into small cooperatives. The current government agricultural support system will need to be reworked to benefit the resource-poor farmers. Collaborative efforts in disease reporting and management among veterinarians, animal health technicians and extension officers will become necessary. Finally, the creation of a progressive quality grading system for ESSPF should be planned by the industry and this should be attached to a reward system that will encourage these farmers to target good farming practice.

Effect of exposure to good vs poor medical trainee performance on attending physician ratings of subsequent performances.

PubMed

Yeates, Peter; O'Neill, Paul; Mann, Karen; Eva, Kevin W

2012-12-05

Competency-based models of education require assessments to be based on individuals' capacity to perform, yet the nature of human judgment may fundamentally limit the extent to which such assessment is accurately possible. To determine whether recent observations of the Mini Clinical Evaluation Exercise (Mini-CEX) performance of postgraduate year 1 physicians influence raters' scores of subsequent performances, consistent with either anchoring bias (scores biased similar to previous experience) or contrast bias (scores biased away from previous experience). Internet-based randomized, blinded experiment using videos of Mini-CEX assessments of postgraduate year 1 trainees interviewing new internal medicine patients. Participants were 41 attending physicians from England and Wales experienced with the Mini-CEX, with 20 watching and scoring 3 good trainee performances and 21 watching and scoring 3 poor performances. All then watched and scored the same 3 borderline video performances. The study was completed between July and November 2011. The primary outcome was scores assigned to the borderline videos, using a 6-point Likert scale (anchors included: 1, well below expectations; 3, borderline; 6, well above expectations). Associations were tested in a multivariable analysis that included participants' sex, years of practice, and the stringency index (within-group z score of initial 3 ratings). The mean rating scores assigned by physicians who viewed borderline video performances following exposure to good performances was 2.7 (95% CI, 2.4-3.0) vs 3.4 (95% CI, 3.1-3.7) following exposure to poor performances (difference of 0.67 [95% CI, 0.28-1.07]; P = .001). Borderline videos were categorized as consistent with failing scores in 33 of 60 assessments (55%) in those exposed to good performances and in 15 of 63 assessments (24%) in those exposed to poor performances (P < .001). They were categorized as consistent with passing scores in 5 of 60 assessments (8.3%) in those exposed to good performances compared with 25 of 63 assessments (39.5%) in those exposed to poor performances (P < .001). Sex and years of attending practice were not associated with scores. The priming condition (good vs poor performances) and the stringency index jointly accounted for 45% of the observed variation in raters' scores for the borderline videos (P < .001). In an experimental setting, attending physicians exposed to videos of good medical trainee performances rated subsequent borderline performances lower than those who had been exposed to poor performances, consistent with a contrast bias.

Capital projects: Economic and financial analyses of nine capital projects in Egypt. Technical report

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

Hanrahan, M.; Walker, J.

1994-03-01

Over the period 1977-92, the US Agency for International Development (A.I.D.) funded nine capital projects in Egypt, which collectively increased electric power generation, introduced a modern telephone system in Cairo and Alexandria, and rehabilitated a water and sewer system that served 23 million people. This study presents detailed ex post facto analyses of the projects` economic and financial internal rates of return. The methodology, assumptions, and data are examined and described. Results indicate a mixed performance, with generally low to medium financial and economic rates of return. In large measure, the poor performance was due to the Egyptian Government`s poormore » economic policies.« less

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening.

PubMed

Windisch, Ricarda; Waiswa, Peter; Neuhann, Florian; Scheibe, Florian; de Savigny, Don

2011-08-01

Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in disease-specific interventions. The multiplicity and complexity of existing challenges require a long-term and systems perspective essentially in contrast to the current short term and program-specific nature of external assistance.

Using an in vitro system for maintaining Varroa destructor mites on Apis mellifera hosts: Studies of mite longevity and feeding behavior

USDA-ARS?s Scientific Manuscript database

Varroa destructor mites (Vd) are ectoparasites of Apis mellifera honey bees, and the damage they inflict on hosts is a likely causative factor of recent poor honey bee colony performance. Much research has produced an arsenal of control agents against Vd, which have become resistant to many chemical...

Stumbling at the First Step: Efficiency Implications of Poor Performance in the Foundational First Five Years

ERIC Educational Resources Information Center

Crouch, Luis; Merseth, Katherine A.

2017-01-01

This paper highlights patterns in school enrollment indicators that affect the efficiency and effectiveness of education systems in a set of low-income countries: those that have expanded access quickly in the last decade or two, but have not yet absorbed that expansion efficiently. Although the patterns in these indicators are observable in the…

Poor and Rich: Student Economic Stratification and Academic Performance in a Public Research University System

ERIC Educational Resources Information Center

Douglass, John; Thomson, Gregg

2012-01-01

One sees various efforts in developed as well as in developing economies to seek a greater participation of lower-income students in their nation's leading universities. Once lower-income students do enroll in a highly selective institution, what happens to them? How well do they do academically when compared to their more wealthy counterparts?…

Exogenous Variables and Value-Added Assessments: A Fatal Flaw

ERIC Educational Resources Information Center

Berliner, David C.

2014-01-01

Background: There has been rapid growth in value-added assessment of teachers to meet the widely supported policy goal of identifying the most effective and the most ineffective teachers in a school system. The former group is to be rewarded while the latter group is to be helped or fired for their poor performance. But, value-added approaches to…

Do Charter Schools Ruin Local Public Schools in Poor Neighborhoods? Evidence from New York City. Working Paper #02-14

ERIC Educational Resources Information Center

Cordes, Sarah

2014-01-01

Charter schools and school choice are popular reforms believed to improve student performance largely through market competition, increased innovation, or some combination of the two mechanisms. Opponents of school choice argue that such reforms sap needed funds and resources from the traditional public school system. Despite this claim, there has…

A Proposed Habitat Management Plan for Yellow-Billed Cuckoos in California

Treesearch

Stephen A. Laymon; Mary D. Halterman

1989-01-01

The California Wildlife-Habitat Relationship (WHR) system was tested for birds breeding in the Valley-Foothill Riparian habitat along California's Sacramento and South Fork Kern rivers. The model performed poorly with 33 pct and 21 pct correct predictions respectively at the two locations. Changes to the model for 60 species on the Sacramento River and 66 species...

Earlier School Start Times as a Risk Factor for Poor School Performance: An Examination of Public Elementary Schools in the Commonwealth of Kentucky

ERIC Educational Resources Information Center

Keller, Peggy S.; Smith, Olivia A.; Gilbert, Lauren R.; Bi, Shuang; Haak, Eric A.; Buckhalt, Joseph A.

2015-01-01

Adequate sleep is essential for child learning. However, school systems may inadvertently be promoting sleep deprivation through early school start times. The current study examines the potential implications of early school start times for standardized test scores in public elementary schools in Kentucky. Associations between early school start…

Poor Gait Performance and Prediction of Dementia: Results From a Meta-Analysis.

PubMed

Beauchet, Olivier; Annweiler, Cédric; Callisaya, Michele L; De Cock, Anne-Marie; Helbostad, Jorunn L; Kressig, Reto W; Srikanth, Velandai; Steinmetz, Jean-Paul; Blumen, Helena M; Verghese, Joe; Allali, Gilles

2016-06-01

Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. An English and French Medline search was conducted in June 2015, with no limit of date, using the medical subject headings terms "Gait" OR "Gait Disorders, Neurologic" OR "Gait Apraxia" OR "Gait Ataxia" AND "Dementia" OR "Frontotemporal Dementia" OR "Dementia, Multi-Infarct" OR "Dementia, Vascular" OR "Alzheimer Disease" OR "Lewy Body Disease" OR "Frontotemporal Dementia With Motor Neuron Disease" (Supplementary Concept). Poor gait performance was defined by standardized tests of walking, and dementia was diagnosed according to international consensus criteria. Four etiologies of dementia were identified: any dementia, Alzheimer disease (AD), vascular dementia (VaD), and non-AD (ie, pooling VaD, mixed dementias, and other dementias). Fixed effects meta-analyses were performed on the estimates in order to generate summary values. Of the 796 identified abstracts, 12 (1.5%) were included in this systematic review and meta-analysis. Poor gait performance predicted dementia [pooled hazard ratio (HR) combined with relative risk and odds ratio = 1.53 with P < .001 for any dementia, pooled HR = 1.79 with P < .001 for VaD, HR = 1.89 with P value < .001 for non-AD]. Findings were weaker for predicting AD (HR = 1.03 with P value = .004). This meta-analysis provides evidence that poor gait performance predicts dementia. This association depends on the type of dementia; poor gait performance is a stronger predictor of non-AD dementias than AD. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Human performance modeling for system of systems analytics: combat performance-shaping factors.

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

Lawton, Craig R.; Miller, Dwight Peter

The US military has identified Human Performance Modeling (HPM) as a significant requirement and challenge of future systems modeling and analysis initiatives. To support this goal, Sandia National Laboratories (SNL) has undertaken a program of HPM as an integral augmentation to its system-of-system (SoS) analytics capabilities. The previous effort, reported in SAND2005-6569, evaluated the effects of soldier cognitive fatigue on SoS performance. The current effort began with a very broad survey of any performance-shaping factors (PSFs) that also might affect soldiers performance in combat situations. The work included consideration of three different approaches to cognition modeling and how appropriate theymore » would be for application to SoS analytics. This bulk of this report categorizes 47 PSFs into three groups (internal, external, and task-related) and provides brief descriptions of how each affects combat performance, according to the literature. The PSFs were then assembled into a matrix with 22 representative military tasks and assigned one of four levels of estimated negative impact on task performance, based on the literature. Blank versions of the matrix were then sent to two ex-military subject-matter experts to be filled out based on their personal experiences. Data analysis was performed to identify the consensus most influential PSFs. Results indicate that combat-related injury, cognitive fatigue, inadequate training, physical fatigue, thirst, stress, poor perceptual processing, and presence of chemical agents are among the PSFs with the most negative impact on combat performance.« less

Risk factors of poor functional results at 1-year after pseudocontinent perineal colostomy for ultralow rectal adenocarcinoma.

PubMed

Souadka, Amine; Majbar, Mohammed Anass; Bougutab, Abdeslam; El Othmany, Azzedine; Jalil, Abdelouahed; Ahyoud, Fatema Zahra; El Malki, Hadj Omar; Souadka, Abdelilah

2013-10-01

Pseudocontinent perineal colostomy is one of the techniques that helps recover the body image of patients undergoing abdominoperineal resection. This technique is rarely used internationally given its unknown functional results. The study aimed to evaluate 1-year functional outcomes of perineal pseudocontinent colostomy and to determine the risk factors for "poor" functional results. This study is a retrospective interventional case series. This study was conducted at a tertiary care university hospital and oncological center in Morocco. From January 1993 to December 2007, 149 patients underwent pseudocontinent perineal colostomy after abdominoperineal resection for low rectal adenocarcinoma. Pseudocontinent perineal colostomy was performed with the use of the Schmidt technique after abdominoperineal resection. One-year functional results were assessed according to the Kirwan classification system. Functional results were considered "poor" when the Kirwan score was C, D, or E. Univariable and multivariable analyses were used to evaluate the impact of age, sex, type of surgery, irrigation frequency, palpable muscular ring, concomitant chemoradiotherapy, stage, and perineal complications on functional results. One hundred forty-six patients were analyzed. According to the Kirwan system, the scores showed that 100 (68.5%) patients had "good" continence results (stage A-B) and 46 (31.5%) patients had altered functional results (stage C-D-E). With the exception of pelvic recurrences, no conversions from a perineal colostomy to an abdominal colostomy were performed for dissatisfactory functional results. In multivariate analysis, the only independent predictive factors of poor functional results were the occurrence of perineal complications (OR, 3.923; 95% CI, 1.461-10.35; p = 0.007) and extended resection (OR, 3.03; 95% CI, 1.183-7.750; p = 0.021) LIMITATION OF THE STUDY:: This study is an observational retrospective study on selected patients (mainly a young population). This study showed that perineal complications and extended resection are associated with poor functional results after pseudocontinent perineal colostomy. These data can help clinicians to better inform patients about the outcomes of this technique and to assist them in choosing the right reconstruction technique after abdominoperineal resection.

Cutter Connectivity Bandwidth Study

NASA Astrophysics Data System (ADS)

2002-10-01

The goal of this study was to determine how much bandwidth is required for cutters to meet emerging data transfer requirements. The Cutter Connectivity Business Solutions Team with guidance front the Commandant's 5 Innovation Council sponsored this study. Today, many Coast Guard administrative and business functions are being conducted via electronic means. Although our larger cutters can establish part-time connectivity using commercial satellite communications (SATCOM) while underway, there are numerous complaints regarding poor application performance. Additionally, smaller cutters do not have any standard means of underway connectivity. The R&D study shows the most important factor affecting web performance and enterprise applications onboard cutters was latency. Latency describes the time it takes the signal to reach the satellite and come back down through space. The latency due to use of higher orbit satellites is causing poor application performance and inefficient use of expensive SATCOM links. To improve performance, the CC must, (1) reduce latency by using alternate communications links such as low-earth orbit satellites, (2) tailor applications to the SATCOM link and/or (3) optimize protocols used for data communication to minimize time required by present applications to establish communications between the user and the host systems.

Investigating data entry task performance on a laptop under the impact of vibration: the effect of color.

PubMed

Mallick, Zulquernain

2007-01-01

The last 20 years have seen a tremendous growth in mobile computing and wireless communications and services. An experimental study was conducted to explore the effect of text/background color on a laptop computing system along with variable environmental vibration on operators' data entry task performance in moving automobiles. The operators' performance was measured in terms of the number of characters entered per minute without spaces (NCEPMWS) on a laptop computing system. The subjects were divided into 3 categories, namely, Novices, Intermediates and Experts. Findings suggest a re-evaluation of existing laptop designs taking ergonomics into consideration. It appears that proper selection of text/background color on the laptop coupled with controlled vehicular speed could result in a better quality of interaction between human and laptops and it could also resolve the problem of poor data entry task performance.

Comparison of a brain-based adaptive system and a manual adaptable system for invoking automation.

PubMed

Bailey, Nathan R; Scerbo, Mark W; Freeman, Frederick G; Mikulka, Peter J; Scott, Lorissa A

2006-01-01

Two experiments are presented examining adaptive and adaptable methods for invoking automation. Empirical investigations of adaptive automation have focused on methods used to invoke automation or on automation-related performance implications. However, no research has addressed whether performance benefits associated with brain-based systems exceed those in which users have control over task allocations. Participants performed monitoring and resource management tasks as well as a tracking task that shifted between automatic and manual modes. In the first experiment, participants worked with an adaptive system that used their electroencephalographic signals to switch the tracking task between automatic and manual modes. Participants were also divided between high- and low-reliability conditions for the system-monitoring task as well as high- and low-complacency potential. For the second experiment, participants operated an adaptable system that gave them manual control over task allocations. Results indicated increased situation awareness (SA) of gauge instrument settings for individuals high in complacency potential using the adaptive system. In addition, participants who had control over automation performed more poorly on the resource management task and reported higher levels of workload. A comparison between systems also revealed enhanced SA of gauge instrument settings and decreased workload in the adaptive condition. The present results suggest that brain-based adaptive automation systems may enhance perceptual level SA while reducing mental workload relative to systems requiring user-initiated control. Potential applications include automated systems for which operator monitoring performance and high-workload conditions are of concern.

Reproduction and lactational performance of cattle in a smallholder dairy system in Zimbabwe.

PubMed

Masama, E; Kusina, N T; Sibanda, S; Majoni, C

2003-04-01

A study was conducted in two adjacent locations. Nharira (communal) and Lancashire (small-scale commercial) farming areas in Zimbabwe to characterize the breeds and evaluate the reproductive and lactation performance of dairy cattle under smallholder management. The types of cows identified were Friesian, Jersey and Red Dane, and an indigenous Sanga breed called the Mashona and its crossbreds. Both sectors used more exotic and crossbred cows than indigenous cows. The mean monthly weights of the dairy cows were higher in Lancashire than in Nharira and the calving intervals were longer in Nharira than in Lancashire. The mean age at first calving was higher and the mean total lactation yields were greater in Nharira than in Lancashire, but the mean 305-day lactation yields were not significantly different. The mean lactation lengths were longer for the cows from Nharira. It was concluded that the reproductive and lactation performances were low. The calving intervals were extended, probably owing to suboptimal nutrition and heat stress, particularly during the dry season, and to poor management practices, such as delayed mating due to the poor availability of bulls.

Alkyl polyglucoside vs. ethoxylated surfactant-based microemulsions as vehicles for two poorly water-soluble drugs: physicochemical characterization and in vivo skin performance.

PubMed

Pajić, Nataša Z Bubić; Todosijević, Marija N; Vuleta, Gordana M; Cekić, Nebojša D; Dobričić, Vladimir D; Vučen, Sonja R; Čalija, Bojan R; Lukić, Milica Ž; Ilić, Tanja M; Savić, Snežana D

2017-12-20

Two types of biocompatible surfactants were evaluated for their capability to formulate skin-friendly/non-irritant microemulsions as vehicles for two poorly water-soluble model drugs differing in properties and concentrations: alkyl polyglucosides (decyl glucoside and caprylyl/capryl glucoside) and ethoxylated surfactants (glycereth-7-caprylate/ caprate and polysorbate 80). Phase behavior, structural inversion and microemulsion solubilization potential for sertaconazole nitrate and adapalene were found to be highly dependent on the surfactants structure and HLB value. Performed characterization (polarized light microscopy, pH, electrical conductivity, rheological, FTIR and DSC measurements) indicated a formulation containing glycereth- 7-caprylate/caprate as suitable for incorporation of both drugs, whereas alkyl polyglucoside-based systems did not exhibit satisfying solubilization capacity for sertaconazole nitrate. Further, monitored parameters were strongly affected by sertaconazole nitrate incorporation, while they remained almost unchanged in adapalene-loaded vehicles. In addition, results of the in vivo skin performance study supported acceptable tolerability for all investigated formulations, suggesting selected microemulsions as promising carriers worth exploring further for effective skin delivery of model drugs.

Research on Captive Broodstock Programs for Pacific Salmon, 2001-2002 Annual Report.

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

Berejikian, Barry A.; Tezak, E.P.; Endicott, Rick

In the 2000 Federal Columbia River Power System (FCRPS) Biological Opinion, NMFS identified six populations of steelhead and several salmon populations that had dropped to critically low levels and continue to decline. Following thorough risk-benefit analyses, captive propagation programs for some or all of the steelhead (Oncorhynchus mykiss) populations may be required to reduce the risk of extinction, and more programs may be required in the future. Thus, captive propagation programs designed to maintain or rebuild steelhead populations require intensive and rigorous scientific evaluation, much like the other objectives of BPA Project 1993-056-00 currently underway for chinook (O. tshawytscha) andmore » sockeye salmon (O. nerka). Pacific salmon reared to the adult stage in captivity exhibit poor reproductive performance when released to spawn naturally. Poor fin quality and swimming performance, incomplete development of secondary sex characteristics, changes in maturation timing, and other factors may contribute to reduced spawning success. Improving natural reproductive performance is critical for the success of captive broodstock programs in which adult-release is a primary reintroduction strategy for maintaining ESA-listed populations.« less

Faculty Evaluations Correlate Poorly with Medical Student Examination Performance in a Fourth-Year Emergency Medicine Clerkship.

PubMed

Dubosh, Nicole M; Fisher, Jonathan; Lewis, Jason; Ullman, Edward A

2017-06-01

Clerkship directors routinely evaluate medical students using multiple modalities, including faculty assessment of clinical performance and written examinations. Both forms of evaluation often play a prominent role in final clerkship grade. The degree to which these modalities correlate in an emergency medicine (EM) clerkship is unclear. We sought to correlate faculty clinical evaluations with medical student performance on a written, standardized EM examination of medical knowledge. This is a retrospective study of fourth-year medical students in a 4-week EM elective at one academic medical center. EM faculty performed end of shift evaluations of students via a blinded online system using a 5-point Likert scale for 8 domains: data acquisition, data interpretation, medical knowledge base, professionalism, patient care and communication, initiative/reliability/dependability, procedural skills, and overall evaluation. All students completed the National EM M4 Examination in EM. Means, medians, and standard deviations for end of shift evaluation scores were calculated, and correlations with examination scores were assessed using a Spearman's rank correlation coefficient. Thirty-nine medical students with 224 discrete faculty evaluations were included. The median number of evaluations completed per student was 6. The mean score (±SD) on the examination was 78.6% ± 6.1%. The examination score correlated poorly with faculty evaluations across all 8 domains (ρ 0.074-0.316). Faculty evaluations of medical students across multiple domains of competency correlate poorly with written examination performance during an EM clerkship. Educators need to consider the limitations of examination score in assessing students' ability to provide quality patient clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

Potential role of maternal lineage in the thoroughbred breeding strategy.

PubMed

Lin, Xiang; Zhou, Shi; Wen, Li; Davie, Allan; Yao, Xinkui; Liu, Wujun; Zhang, Yong

2015-05-05

Many studies have focused on identifying the genes or single nucleotide polymorphisms associated with the athletic ability of thoroughbreds, but few have considered differences in maternal and paternal heritability of athletic ability. Herein, we report on our association study of career race performances of 675 Australian thoroughbreds with their pedigrees. Racing performance data (prize money per start) were collected from the Bloodhound database. The performance of all horses was categorised as either poor or elite athletic achievement. Then, 675 foals were divided by their parents' performance (elite or poor) into four groups: (1) elite dams and elite sires; (2) elite dams and poor sires; (3) poor dams and elite sires; and (4) poor dams and poor sires. The performance of foals was then compared between the four groups. The results show that the heritability of race performance between dams and foals (r = 0.141, P < 0.001) is much higher than that between sires and foals (r = 0.035, P = 0.366), and that this difference is statistically significant (P < 0.05). We also examined the effect of the child-bearing age of dams and sires on the ratio of elite foals. We found a strong correlation between the number of elite foals and dams' child-bearing age (r = -0.105, P < 0.001), with the ratio of elite offspring reaching a high level between a child-bearing age of 8 and 11 years (χ2 = 14.31, d.f. = 1, P < 0.001). These findings suggest that the maternal line may play an important role in the selective breeding of athletic performance in thoroughbreds.

Perceptions of good medical practice in the NHS: a survey of senior health professionals.

PubMed

Hutchinson, A; Williams, M; Meadows, K; Barbour, R S; Jones, R

1999-12-01

To categorize senior health professionals' experience with poor medical practice in hospitals and in general practice, to describe perceptions which senior NHS staff have of good medical practice, and to describe how problems of poor medical practice are currently managed. A postal questionnaire survey. The questionnaire sought perceptions of good medical practice, asked participants to characterise deviations from good practice, and to describe experience with managing poor performance at the time of the introduction of the General Medical Council (GMC) performance procedures. A range of NHS settings in the UK: hospital trusts, health authorities/boards, local medical committees, community health councils. Senior health professionals involved in the management of medical professional performance. Perceptions of what constitutes good medical practice. Most respondents considered that persistent problems related to clinical practice (diagnosis, management, and outcome and prescribing) would require local management and, possibly, referral to the GMC performance procedures. Informal mechanisms, including informal discussion, education, training, and work shifting, were the most usual means of handling a doctor whose performance was poor. Many took a less serious view of deficiencies in performance on manner and attitude and communication, although consultation skills rather than technical skills comprised the greatest number of complaints about doctors. Senior NHS professionals seem reluctant to consider persistently poor consultation skills in the same critical light as they do persistently poor technical practice. These attitudes may need to change with the implementation of clinical governance and updated guidance from the GMC on what constitutes good medical practice.

Born Small for Gestational Age and Poor School Performance - How Small Is Too Small?

PubMed

Lindström, Linda; Wikström, Anna-Karin; Bergman, Eva; Lundgren, Maria

2017-01-01

To assess the relationship between severity of small for gestational age (SGA) and the risk of poor school performance, and to investigate whether adult stature modifies this risk. 1,088,980 Swedish children born at term between 1973 and 1988 were categorized into severe SGA (less than -3 standard deviations (SD) of expected birth weight), moderate SGA (-2.01 to -3 SD), mild SGA (-1.01 to -2 SD), and appropriate for gestational age (-1 to 0.99 SD). The risk of poor school performance at the time of graduation from compulsory school (grades <10th percentile) was calculated using unconditional logistic regression models and adjusted for socio-economic factors. In a sub-analysis, we stratified boys by adult stature, and adjusted for maternal but not paternal height. All SGA groups were significantly associated with an increased risk of poor school performance, with adjusted odds ratios and 95% confidence intervals ranging from 1.85 (1.65-2.07) for severe SGA to 1.25 (1.22-1.28) for mild SGA. In the sub-analysis, all birth weight groups were associated with an increased risk of poor school performance among boys with short stature compared to those with non-short stature. Mild SGA is associated with a significantly increased risk of poor school performance, and the risk increases with severity of SGA. Further, this risk diminishes after adequate catch-up growth. © 2017 S. Karger AG, Basel.

Conducting effective performance appraisals.

PubMed

2001-01-01

According to experts, performance appraisals rate just below firing someone as the least favorite thing managers do. Many factors contribute to this view--one is that current systems do a poor job of evaluating performance and in fact often impede both evaluation and performance. When used as part of an ongoing supportive process of goal setting and feedback, performance appraisals can enhance performance and morale. One alternative to traditional employee evaluation methods is full-circle or 360-degree feedback. Contained in this issue are practical suggestions for preparing employees for performance appraisals which, when followed daily, encourage employees to put their best feet forward as part of their regular routine. Also included is a template specific to assessing the performance of clinical laboratory technologists . Additionally, numerous resources are provided to help you refine appraisal systems to fit your needs. Full-circle feedback is proving to be a boon to managers. It relieves them from being the exclusive "heavies" in evaluating performance, integrates appraisal input from several sources, and incorporates increasing employee skills, competencies, and satisfaction, thus improving productivity of people and processes. And aren't integration and continuous improvement what the laboratory is all about?

Tracking Vaccination Teams During Polio Campaigns in Northern Nigeria by Use of Geographic Information System Technology: 2013–2015

PubMed Central

Touray, Kebba; Mkanda, Pascal; Tegegn, Sisay G.; Nsubuga, Peter; Erbeto, Tesfaye B.; Banda, Richard; Etsano, Andrew; Shuaib, Faisal; Vaz, Rui G.

2016-01-01

Introduction. Nigeria is among the 3 countries in which polio remains endemic. The country made significant efforts to reduce polio transmission but remains challenged by poor-quality campaigns and poor team performance in some areas. This article demonstrates the application of geographic information system technology to track vaccination teams to monitor settlement coverage, reduce the number of missed settlements, and improve team performance. Methods. In each local government area where tracking was conducted, global positioning system–enabled Android phones were given to each team on a daily basis and were used to record team tracks. These tracks were uploaded to a dashboard to show the level of coverage and identify areas missed by the teams. Results. From 2012 to June 2015, tracking covered 119 immunization days. A total of 1149 tracking activities were conducted. Of these, 681 (59%) were implemented in Kano state. There was an improvement in the geographic coverage of settlements and an overall reduction in the number of missed settlements. Conclusions. The tracking of vaccination teams provided significant feedback during polio campaigns and enabled supervisors to evaluate performance of vaccination teams. The reports supported other polio program activities, such as review of microplans and the deployment of other interventions, for increasing population immunity in northern Nigeria. PMID:26609004

An Evaluation of the Performance Diagnostic Checklist-Human Services to Assess an Employee Performance Problem in a Center-Based Autism Treatment Facility

ERIC Educational Resources Information Center

Ditzian, Kyle; Wilder, David A.; King, Allison; Tanz, Jeanine

2015-01-01

The Performance Diagnostic Checklist-Human Services (PDC-HS) is an informant-based tool designed to assess the environmental variables that contribute to poor employee performance in human services settings. We administered the PDC-HS to 3 supervisors to assess the variables that contributed to poor performance by 4 staff members when securing…

Standard & Poor's "Return on Resources" Measure of School Performance. Issue Brief. Volume 1, Issue 1

ERIC Educational Resources Information Center

Reeder, Brian

2004-01-01

Standard & Poors (S&P) uses a measure they call a Performance Cost Index (PCI) as their measure of a school or district?s ?Return on Resources?. The Performance Cost Index is defined as the average cost per measured ?unit? of student performance. In its simplest form, the Performance Cost Index is calculated as per student expenditures divided by…

Tabletop Molecular Communication: Text Messages through Chemical Signals

PubMed Central

Farsad, Nariman; Guo, Weisi; Eckford, Andrew W.

2013-01-01

In this work, we describe the first modular, and programmable platform capable of transmitting a text message using chemical signalling – a method also known as molecular communication. This form of communication is attractive for applications where conventional wireless systems perform poorly, from nanotechnology to urban health monitoring. Using examples, we demonstrate the use of our platform as a testbed for molecular communication, and illustrate the features of these communication systems using experiments. By providing a simple and inexpensive means of performing experiments, our system fills an important gap in the molecular communication literature, where much current work is done in simulation with simplified system models. A key finding in this paper is that these systems are often nonlinear in practice, whereas current simulations and analysis often assume that the system is linear. However, as we show in this work, despite the nonlinearity, reliable communication is still possible. Furthermore, this work motivates future studies on more realistic modelling, analysis, and design of theoretical models and algorithms for these systems. PMID:24367571

Proteomic analysis of serum and sputum analytes distinguishes controlled and poorly controlled asthmatics.

PubMed

Kasaian, M T; Lee, J; Brennan, A; Danto, S I; Black, K E; Fitz, L; Dixon, A E

2018-04-17

A major goal of asthma therapy is to achieve disease control, with maintenance of lung function, reduced need for rescue medication, and prevention of exacerbation. Despite current standard of care, up to 70% of patients with asthma remain poorly controlled. Analysis of serum and sputum biomarkers could offer insights into parameters associated with poor asthma control. To identify signatures as determinants of asthma disease control, we performed proteomics using Olink proximity extension analysis. Up to 3 longitudinal serum samples were collected from 23 controlled and 25 poorly controlled asthmatics. Nine of the controlled and 8 of the poorly controlled subjects also provided 2 longitudinal sputum samples. The study included an additional cohort of 9 subjects whose serum was collected within 48 hours of asthma exacerbation. Two separate pre-defined Proseek Multiplex panels (INF and CVDIII) were run to quantify 181 separate protein analytes in serum and sputum. Panels consisting of 9 markers in serum (CCL19, CCL25, CDCP1, CCL11, FGF21, FGF23, Flt3L, IL-10Rβ, IL-6) and 16 markers in sputum (tPA, KLK6, RETN, ADA, MMP9, Chit1, GRN, PGLYRP1, MPO, HGF, PRTN3, DNER, PI3, Chi3L1, AZU1, and OPG) distinguished controlled and poorly controlled asthmatics. The sputum analytes were consistent with a pattern of neutrophil activation associated with poor asthma control. The serum analyte profile of the exacerbation cohort resembled that of the controlled group rather than that of the poorly controlled asthmatics, possibly reflecting a therapeutic response to systemic corticosteroids. Proteomic profiles in serum and sputum distinguished controlled and poorly controlled asthmatics, and were maintained over time. Findings support a link between sputum neutrophil markers and loss of asthma control. © 2018 John Wiley & Sons Ltd.

20 CFR 632.23 - Termination and corrective action of a CAP and/or Master Plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... substantiates serious management, fiscal and/or performance problems, information from the Inspector General or gained through incident reports of poor performance, serious administrative problems and/or inability to... termination: (1) Poor performance and inability to meet Federal standards related to such debt collection...

Health-care process improvement decisions: a systems perspective.

PubMed

Walley, Paul; Silvester, Kate; Mountford, Shaun

2006-01-01

The paper seeks to investigate decision-making processes within hospital improvement activity, to understand how performance measurement systems influence decisions and potentially lead to unsuccessful or unsustainable process changes. A longitudinal study over a 33-month period investigates key events, decisions and outcomes at one medium-sized hospital in the UK. Process improvement events are monitored using process control methods and by direct observation. The authors took a systems perspective of the health-care processes, ensuring that the impacts of decisions across the health-care supply chain were appropriately interpreted. The research uncovers the ways in which measurement systems disguise failed decisions and encourage managers to take a low-risk approach of "symptomatic relief" when trying to improve performance metrics. This prevents many managers from trying higher risk, sustainable process improvement changes. The behaviour of the health-care system is not understood by many managers and this leads to poor analysis of problem situations. Measurement using time-series methodologies, such as statistical process control are vital for a better understanding of the systems impact of changes. Senior managers must also be aware of the behavioural influence of similar performance measurement systems that discourage sustainable improvement. There is a risk that such experiences will tarnish the reputation of performance management as a discipline. Recommends process control measures as a way of creating an organization memory of how decisions affect performance--something that is currently lacking.

Rituximab is associated with improved survival in Burkitt lymphoma: a retrospective analysis from two US academic medical centers.

PubMed

Wildes, Tanya M; Farrington, Laura; Yeung, Cecilia; Harrington, Alexandra M; Foyil, Kelley V; Liu, Jingxia; Kreisel, Friederike; Bartlett, Nancy L; Fenske, Timothy S

2014-02-01

Burkitt lymphoma (BL) is a rare, highly aggressive B-cell malignancy treated most successfully with brief-duration, high-intensity chemotherapeutic regimens. The benefit of the addition of rituximab to these regimens remains uncertain. We sought to examine the effectiveness of chemotherapy with and without rituximab in patients with BL. This study is a retrospective cohort study of all adult patients with BL diagnosed and treated with modern, dose-intense chemotherapeutic regimens from 1998-2008 at two tertiary care institutions. All cases were confirmed by application of WHO 2008 criteria by hematopathologists. Medical records were reviewed for patient-, disease-, and treatment- related factors as well as treatment response and survival. Factors associated with survival were analyzed using Cox proportional hazards modeling. A total of 35 patients were analyzed: 18 patients received rituximab with chemotherapy (R-chemo) and 17 received chemotherapy (chemo) alone. The median age was 42 (range 20-74 years); 57% were male; 71% had Ann Arbor Stage IV disease; 33% had central nervous system involvement; 78% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. R-chemo was associated with significantly longer overall survival (OS) than chemo alone (5-year OS 70% and 29%, respectively, p = 0.040). On multivariate regression analysis, poor performance status and central nervous system involvement were associated with poorer survival. The addition of rituximab to chemotherapy was associated with improved OS in patients with Burkitt lymphoma. Poor performance status and central nervous system involvement were prognostically significant on multivariate analysis.

Not self-focused attention but negative beliefs affect poor social performance in social anxiety: an investigation of pathways in the social anxiety-social rejection relationship.

PubMed

Voncken, Marisol J; Dijk, Corine; de Jong, Peter J; Roelofs, Jeffrey

2010-10-01

Patients with social anxiety disorder (SAD) not only fear negative evaluation but are indeed less likeable than people without SAD. Previous research shows social performance to mediate this social anxiety-social rejection relationship. This study studied two pathways hypothesized to lead to poor social performance in social anxiety: increased self-focused attention and negative beliefs. State social anxiety was experimentally manipulated in high and low-blushing-fearful individuals by letting half of the participants believe that they blushed intensely during a 5 min getting-acquainted interaction with two confederates. Participants rated their state social anxiety, self-focused attention, and level of negative beliefs. Two confederates and two video-observers rated subsequently likeability (i.e., social rejection) and social performance of the participants. In both groups, the social anxiety-social rejection relationship was present. Although state social anxiety was related to heightened self-focused attention and negative beliefs, only negative beliefs were associated with relatively poor social performance. In contrast to current SAD models, self-focused attention did not play a key-role in poor social performance but seemed to function as a by-product of state social anxiety. Beliefs of being negatively evaluated seem to elicit changes in behavioral repertoire resulting in a poor social performance and subsequent rejection. Copyright 2010 Elsevier Ltd. All rights reserved.

Sleep problems are associated with poor outcomes in remedial teaching programmes: a preliminary study.

PubMed

Blunden, Sarah L; Chervin, Ron D

2008-05-01

Problematic behaviour and deficient academic performance have been reported in children with sleep problems, but whether sleep problems are common among children presenting with primary behavioural and performance concerns in remedial programmes is not well studied. We studied this possibility in 80 Australian school children aged 6-15 years and then compared 15 of these children from mainstream schools to 15 demographically matched children in specialist behavioural programmes for problematic behaviour and academic difficulties. Parents completed the Child Behaviour Checklist and the Sleep Disorders Scale for Children. Questionnaires assessed behaviour, academic performance and symptoms of diverse sleep disorders, expressed as T-scores (mean (SD) = 50 (10)). Teachers rated students' academic performance (A, B, C, D, E). When compared with the 15 controls, the 15 index children had significantly more sleep problems, in addition to parental concerns about school performance. In the total sample (n = 80), poor sleep including symptoms of daytime sleepiness, parasomnias, behavioural sleep problems and combined sleep problems was associated with poor academic performance and daytime behavioural issues. This preliminary study suggests that children in remedial school programmes may have poor sleep compared with those in mainstream schools. Sleep problems were associated with problematic behaviour and poor academic performance. If sleep disturbances worsen daytime behaviour, then diagnosis and treatment of underlying sleep disorders could offer a novel therapeutic opportunity.

Educational attainment in poor comprehenders

PubMed Central

Ricketts, Jessie; Sperring, Rachael; Nation, Kate

2014-01-01

To date, only one study has investigated educational attainment in poor (reading) comprehenders, providing evidence of poor performance on national UK school tests at age 11 years relative to peers (Cain and Oakhill, 2006). In the present study, we adopted a longitudinal approach, tracking attainment on such tests from 11 years to the end of compulsory schooling in the UK (age 16 years). We aimed to investigate the proposal that educational weaknesses (defined as poor performance on national assessments) might become more pronounced over time, as the curriculum places increasing demands on reading comprehension. Participants comprised 15 poor comprehenders and 15 controls; groups were matched for chronological age, nonverbal reasoning ability and decoding skill. Children were identified at age 9 years using standardized measures of nonverbal reasoning, decoding and reading comprehension. These measures, along with a measure of oral vocabulary knowledge, were repeated at age 11 years. Data on educational attainment were collected from all participants (n = 30) at age 11 and from a subgroup (n = 21) at 16 years. Compared to controls, educational attainment in poor comprehenders was lower at ages 11 and 16 years, an effect that was significant at 11 years. When poor comprehenders were compared to national performance levels, they showed significantly lower performance at both time points. Low educational attainment was not evident for all poor comprehenders. Nonetheless, our findings point to a link between reading comprehension difficulties in mid to late childhood and poor educational outcomes at ages 11 and 16 years. At these ages, pupils in the UK are making key transitions: they move from primary to secondary schools at 11, and out of compulsory schooling at 16. PMID:24904464

Association between Self-Reported Academic Performance and Risky Sexual Behavior among Ugandan University Students- A Cross Sectional Study

PubMed Central

Mehra, Devika; Kyagaba, Emmanuel; Östergren, Per-Olof; Agardh, Anette

2014-01-01

Little is known about the association between self-reported academic performance and risky sexual behaviors and if this differs by gender, among university students. Academic performance can create psychological pressure in young students. Poor academic performance might thus potentially contribute to risky sexual behavior among university students. The aim of this study was to investigate the association between self-reported academic performance and risky sexual behaviors, and whether gender affects this relationship among Ugandan university students. In 2010, 1,954 students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda (72% response rate). Multivariate logistic regression analysis was used for the analysis. 1,179 (60.3%) students in our study sample reported having debuted sexually. Of these 440 (42.2%) used condoms inconsistently with new sexual partners, and 344 (33.6%) had had multiple sexual partners. We found a statistically significant association between poor academic performance and inconsistent condom use with a new sex partner and this association remained significant even after adjusting for all the potential confounders. There was no such association detected regarding multiple sexual partners. We also found that gender modified the effect of poor academic performance on inconsistent condom use. Females, who were poor academic performers, were found to be at a higher risk of inconsistent condom use than their male counterparts. Interventions should be designed to provide extra support to poor academic performers, which may improve their performance and self-esteem, which in turn might reduce their risky sexual behaviors. PMID:24999121

Association between self-reported academic performance and risky sexual behavior among Ugandan university students- a cross sectional study.

PubMed

Mehra, Devika; Kyagaba, Emmanuel; Ostergren, Per-Olof; Agardh, Anette

2014-04-16

Little is known about the association between self-reported academic performance and risky sexual behaviors and if this differs by gender, among university students. Academic performance can create psychological pressure in young students. Poor academic performance might thus potentially contribute to risky sexual behavior among university students. The aim of this study was to investigate the association between self-reported academic performance and risky sexual behaviors, and whether gender affects this relationship among Ugandan university students. In 2010, 1,954 students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda (72% response rate). Multivariate logistic regression analysis was used for the analysis. 1,179 (60.3%) students in our study sample reported having debuted sexually. Of these 440 (42.2%) used condoms inconsistently with new sexual partners, and 344 (33.6%) had had multiple sexual partners. We found a statistically significant association between poor academic performance and inconsistent condom use with a new sex partner and this association remained significant even after adjusting for all the potential confounders. There was no such association detected regarding multiple sexual partners. We also found that gender modified the effect of poor academic performance on inconsistent condom use. Females, who were poor academic performers, were found to be at a higher risk of inconsistent condom use than their male counterparts. Interventions should be designed to provide extra support to poor academic performers, which may improve their performance and self-esteem, which in turn might reduce their risky sexual behaviors.

Stabilization and delivery approaches for protein and peptide pharmaceuticals: an extensive review of patents.

PubMed

Swain, Suryakanta; Mondal, Debanik; Beg, Sarwar; Patra, Chinam Niranjan; Dinda, Subas Chandra; Sruti, Jammula; Rao, Muddana Eswara Bhanoji

2013-04-01

Proteins and peptides are the building blocks of human body and act as the arsenal to combat against the invading pathogenic organisms for treatment and management of diseases. Majority of such biomacromolecules are synthesized by the human body itself. However, entry of disease causing pathogens causes misleading in the synthesis of desired proteins for antibody formation. In such alarming situations, the delivery of requisite protein and peptide from external source helps in augmenting the body's immunity. The major drawbacks underlying poor biopharmaceutical performance of high molecular weight protein and peptide drugs are due to poor oral absorption, formulation stability, degradation in the gastric milieu, susceptible to presystemic metabolism. Numerous literature recounts the application of myriad drug delivery strategies for the effective delivery of protein and peptides viz. parentral, oral, transdermal, nasal, pulmonary, rectal, buccal and ocular drug delivery systems. There are many reviews on various delivery strategies for protein and peptide pharmaceuticals, but the present review article provides a bird's eye view on various novel drug delivery systems used for enhanced delivery of protein and peptide pharmaceuticals in the light of patent literature. Apart from this, the present manuscript endeavor provides idea on possible causes and major degradation pathways responsible for poor stability of protein and peptide drugs along with recent market instances on them utilizing novel drug delivery systems.

Cognitive control components and speech symptoms in people with schizophrenia.

PubMed

Becker, Theresa M; Cicero, David C; Cowan, Nelson; Kerns, John G

2012-03-30

Previous schizophrenia research suggests poor cognitive control is associated with schizophrenia speech symptoms. However, cognitive control is a broad construct. Two important cognitive control components are poor goal maintenance and poor verbal working memory storage. In the current research, people with schizophrenia (n=45) performed three cognitive tasks that varied in their goal maintenance and verbal working memory storage demands. Speech symptoms were assessed using clinical rating scales, ratings of disorganized speech from typed transcripts, and self-reported disorganization. Overall, alogia was associated with both goal maintenance and verbal working memory tasks. Objectively rated disorganized speech was associated with poor goal maintenance and with a task that included both goal maintenance and verbal working memory storage demands. In contrast, self-reported disorganization was unrelated to either amount of objectively rated disorganized speech or to cognitive control task performance, instead being associated with negative mood symptoms. Overall, our results suggest that alogia is associated with both poor goal maintenance and poor verbal working memory storage and that disorganized speech is associated with poor goal maintenance. In addition, patients' own assessment of their disorganization is related to negative mood, but perhaps not to objective disorganized speech or to cognitive control task performance. Published by Elsevier Ireland Ltd.

Encoding of speech sounds at auditory brainstem level in good and poor hearing aid performers.

PubMed

Shetty, Hemanth Narayan; Puttabasappa, Manjula

Hearing aids are prescribed to alleviate loss of audibility. It has been reported that about 31% of hearing aid users reject their own hearing aid because of annoyance towards background noise. The reason for dissatisfaction can be located anywhere from the hearing aid microphone till the integrity of neurons along the auditory pathway. To measure spectra from the output of hearing aid at the ear canal level and frequency following response recorded at the auditory brainstem from individuals with hearing impairment. A total of sixty participants having moderate sensorineural hearing impairment with age range from 15 to 65 years were involved. Each participant was classified as either Good or Poor Hearing aid Performers based on acceptable noise level measure. Stimuli /da/ and /si/ were presented through loudspeaker at 65dB SPL. At the ear canal, the spectra were measured in the unaided and aided conditions. At auditory brainstem, frequency following response were recorded to the same stimuli from the participants. Spectrum measured in each condition at ear canal was same in good hearing aid performers and poor hearing aid performers. At brainstem level, better F 0 encoding; F 0 and F 1 energies were significantly higher in good hearing aid performers than in poor hearing aid performers. Though the hearing aid spectra were almost same between good hearing aid performers and poor hearing aid performers, subtle physiological variations exist at the auditory brainstem. The result of the present study suggests that neural encoding of speech sound at the brainstem level might be mediated distinctly in good hearing aid performers from that of poor hearing aid performers. Thus, it can be inferred that subtle physiological changes are evident at the auditory brainstem in a person who is willing to accept noise from those who are not willing to accept noise. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review

PubMed Central

Miller, Rosalind; Goodman, Catherine

2016-01-01

In low- and middle-income countries (LMIC) in Asia, pharmacies are often patients’ first point of contact with the health care system and their preferred channel for purchasing medicines. Unfortunately, pharmacy practice in these settings has been characterized by deficient knowledge and inappropriate treatment. This paper systematically reviews both the performance of all types of pharmacies and drug stores across Asia’s LMIC, and the determinants of poor practice, in order to reflect on how this could best be addressed. Poor pharmacy practice in Asia appears to have persisted over the past 30 years. We identify a set of inadequacies that occur at key moments throughout the pharmacy encounter, including: insufficient history taking; lack of referral of patients who require medical attention; illegal sale of a wide range of prescription only medicines without a prescription; sale of medicines that are either clinically inappropriate and/or in doses that are outside of the therapeutic range; sale of incomplete courses of antibiotics; and limited provision of information and counselling. In terms of determinants of poor practice, first knowledge was found to be necessary but not sufficient to ensure correct management of patients presenting at the pharmacy. This is evidenced by large discrepancies between stated and actual practice; little difference in the treatment behaviour of less and more qualified personnel and the failure of training programmes to improve practice to a satisfactory level. Second, we identified a number of profit maximizing strategies employed by pharmacy staff that can be linked to poor practices. Finally, whilst the research is relatively sparse, the regulatory environment appears to play an important role in shaping behaviour. Future efforts to improve the situation may yield more success than historical attempts, which have tended to concentrate on education, if they address the profit incentives faced by pharmacy personnel and the regulatory system. PMID:26962123

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review.

PubMed

Miller, Rosalind; Goodman, Catherine

2016-03-08

In low- and middle-income countries (LMIC) in Asia, pharmacies are often patients' first point of contact with the health care system and their preferred channel for purchasing medicines. Unfortunately, pharmacy practice in these settings has been characterized by deficient knowledge and inappropriate treatment. This paper systematically reviews both the performance of all types of pharmacies and drug stores across Asia's LMIC, and the determinants of poor practice, in order to reflect on how this could best be addressed. Poor pharmacy practice in Asia appears to have persisted over the past 30 years. We identify a set of inadequacies that occur at key moments throughout the pharmacy encounter, including: insufficient history taking; lack of referral of patients who require medical attention; illegal sale of a wide range of prescription only medicines without a prescription; sale of medicines that are either clinically inappropriate and/or in doses that are outside of the therapeutic range; sale of incomplete courses of antibiotics; and limited provision of information and counselling. In terms of determinants of poor practice, first knowledge was found to be necessary but not sufficient to ensure correct management of patients presenting at the pharmacy. This is evidenced by large discrepancies between stated and actual practice; little difference in the treatment behaviour of less and more qualified personnel and the failure of training programmes to improve practice to a satisfactory level. Second, we identified a number of profit maximizing strategies employed by pharmacy staff that can be linked to poor practices. Finally, whilst the research is relatively sparse, the regulatory environment appears to play an important role in shaping behaviour. Future efforts to improve the situation may yield more success than historical attempts, which have tended to concentrate on education, if they address the profit incentives faced by pharmacy personnel and the regulatory system. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Understanding human resource management practices in Botswana's public health sector.

PubMed

Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

2016-11-21

Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

Effectiveness of an Expert System for Astronaut Assistance on a Sleep Experiment

NASA Technical Reports Server (NTRS)

Heher, Dennis; Callini, Gianluca; Essig, Susanne M.; Young, Laurence R.; Koga, Dennis (Technical Monitor)

1998-01-01

Principal Investigator-in-a-Box ([PI]) is an expert system designed to train and assist astronauts with the performance of an experiment outside their field of expertise, particularly when contact with the Principal Investigators on the ground is limited or impossible. In the current case, [PI] was designed to assist with the calibration and troubleshooting procedures of the Neurolab Sleep and Respiration Experiment during the pre-sleep period of no ground contact. It displays physiological signals in real time during the pre-sleep instrumentation period, and alerts the astronauts when a poor signal quality is detected. Results of the first study indicated a beneficial effect of [PI] and training in reducing anomaly detection time and the number of undetected anomalies. For the in-flight performance, excluding the saturated signals, the expert system had an 84.2% detection accuracy, and the questionnaires filled out by the astronauts showed positive crew reactions to the expert system.

Meeting the challenge in performance management: the diffusion and implementation of the balanced scorecard in Chinese hospitals.

PubMed

Gao, Tian; Gurd, Bruce

2015-03-01

The bonus system used in Chinese hospitals has been criticized for eroding doctors' professional ethics and aggravating patient expense. This research article focuses on one system to improve hospital performance, the balanced scorecard (BSC). We use three data sources to examine the diffusion and implementation of the BSC in China: a questionnaire survey in Shandong Province, a print-media indicators and content analysis of the published BSC papers and semi-structured interviews with managers of Chinese hospitals that use the BSC. The research evidence shows that bonus systems are important, partially because of the poor pay of hospital professionals, and the BSC is perceived as providing a fair system to award such bonuses. This helps explain the relative endurance of the BSC in Chinese hospitals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Using risk adjustment approaches in child welfare performance measurement: Applications and insights from health and mental health settings

PubMed Central

Raghavan, Ramesh

2014-01-01

Federal policymaking in the last decade has dramatically expanded performance measurement within child welfare systems, and states are currently being fiscally penalized for poor performance on defined outcomes. However, in contrast to performance measurement in health settings, current policy holds child welfare systems solely responsible for meeting outcomes, largely without taking into account the effects of factors at the level of the child, and his or her social ecology, that might undermine the performance of child welfare agencies. Appropriate measurement of performance is predicated upon the ability to disentangle individual, as opposed to organizational, determinants of outcomes, which is the goal of risk adjustment methodologies. This review briefly conceptualizes and examines risk adjustment approaches in health and child welfare, suggests approaches to expanding its use to appropriately measure the performance of child welfare agencies, and highlights research gaps that diminish the appropriate use of risk adjustment approaches – and which consequently suggest the need for caution – in policymaking around performance measurement of child welfare agencies. PMID:25253917

Thermal environmental case study of an existing underfloor air distribution (UFAD) system in a high-rise building in the tropics

NASA Astrophysics Data System (ADS)

Ya, Y. H.; Poh, K. S.

2015-09-01

The performance of an existing underfloor air distribution (UFAD) system in a renowned high-rise office tower in Malaysia was studied to identify the root cause issues behind the poor indoor air quality. Occupants are the best thermal sensor. The building was detected with the sick building syndrome (SBS) that causes runny noses, flu-like symptoms, irritated skin, and etc. Long period of exposure to indoor air pollutants may increase the occupant's health risk. The parameters such as the space temperature, relative humidity, air movement, air change, fresh air flow rate, chilled water supply and return are evaluated at three stories that consist of five open offices. A full traverse study was carried out at one of the fresh air duct. A simplified duct flow measurement method using pitot-tubes was developed. The results showed that the diffusers were not effective in creating the swirl effect to the space. Internal heat gain from human and office electrical equipment were not drawn out effectively. Besides, relative humidity has exceeded the recommended level. These issues were caused by the poor maintenance of the building. The energy efficiency strategy of the UFAD system comes from the higher supply air temperature. It may leads to insufficient cooling load for the latent heat gained under improper system performance. Special care and considerations in design, construction and maintenance are needed to ensure the indoor air quality to be maintained. Several improvements were recommended to tackle the existing indoor air quality issues. Solar system was studied as one of the innovative method for retrofitting.

Effectiveness of prehospital trauma triage systems in selecting severely injured patients: Is comparative analysis possible?

PubMed

van Rein, Eveline A J; van der Sluijs, Rogier; Houwert, R Marijn; Gunning, Amy C; Lichtveld, Rob A; Leenen, Luke P H; van Heijl, Mark

2018-01-27

In an optimal trauma system, prehospital trauma triage ensures transport of the right patient to the right hospital. Incorrect triage results in undertriage and overtriage. The aim of this systematic review is to evaluate and compare prehospital trauma triage system quality worldwide and determine effectiveness in terms of undertriage and overtriage for trauma patients. A systematic search of Pubmed/MEDLINE, Embase, and Cochrane Library databases was performed, using "trauma", "trauma center," or "trauma system", combined with "triage", "undertriage," or "overtriage", as search terms. All studies describing ground transport and actual destination hospital of patients with and without severe injuries, using prehospital triage, published before November 2017, were eligible for inclusion. To assess the quality of these studies, a critical appraisal tool was developed. A total of 33 articles were included. The percentage of undertriage ranged from 1% to 68%; overtriage from 5% to 99%. Older age and increased geographical distance were associated with undertriage. Mortality was lower for severely injured patients transferred to a higher-level trauma center. The majority of the included studies were of poor methodological quality. The studies of good quality showed poor performance of the triage protocol, but additional value of EMS provider judgment in the identification of severely injured patients. In most of the evaluated trauma systems, a substantial part of the severely injured patients is not transported to the appropriate level trauma center. Future research should come up with new innovative ways to improve the quality of prehospital triage in trauma patients. Copyright © 2018. Published by Elsevier Inc.

High performance gel imaging with a commercial single lens reflex camera

NASA Astrophysics Data System (ADS)

Slobodan, J.; Corbett, R.; Wye, N.; Schein, J. E.; Marra, M. A.; Coope, R. J. N.

2011-03-01

A high performance gel imaging system was constructed using a digital single lens reflex camera with epi-illumination to image 19 × 23 cm agarose gels with up to 10,000 DNA bands each. It was found to give equivalent performance to a laser scanner in this high throughput DNA fingerprinting application using the fluorophore SYBR Green®. The specificity and sensitivity of the imager and scanner were within 1% using the same band identification software. Low and high cost color filters were also compared and it was found that with care, good results could be obtained with inexpensive dyed acrylic filters in combination with more costly dielectric interference filters, but that very poor combinations were also possible. Methods for determining resolution, dynamic range, and optical efficiency for imagers are also proposed to facilitate comparison between systems.

A scalable healthcare information system based on a service-oriented architecture.

PubMed

Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

2011-06-01

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

A Longitudinal Examination of the Persistence of Late Emerging Reading Disabilities.

PubMed

Etmanskie, Jill M; Partanen, Marita; Siegel, Linda S

2016-01-01

There are some children who encounter unexpected reading difficulties in the fourth grade. This phenomenon has been described as late emerging reading disabilities (LERD). Using Grade 4 as a starting point, this study examined the reading development of 964 children between kindergarten and Grade 7. The results showed that 72.0% of children had typical reading performance in Grade 4, whereas there was 0.7% with poor word reading, 12.6% with poor reading comprehension, 2.5% with poor word reading and comprehension, and 12.2% with borderline performance. We also showed that there were similar proportions of children who had early versus late emerging reading difficulties; however, most of the late emerging poor readers recovered by Grade 7. Furthermore, our study showed that poor comprehenders showed poorer performance than typical readers on word reading, pseudoword decoding, and spelling between Grade 1 and Grade 7 and poorer performance on a working memory task in kindergarten. Overall, this study showed that most children recover from late emerging reading problems and that working memory may be an early indicator for reading comprehension difficulties. © Hammill Institute on Disabilities 2014.

The right strategy and perseverance can make an IDS profitable.

PubMed

Coddington, D C; Moore, K D

2001-12-01

Results of a recent study of 11 leading integrated delivery systems (IDSs) belie the common perception that IDSs are incapable of turning a profit. The study determined that the primary factors driving the poor financial performance of IDSs are organizational complexity, payment reductions mandated by the Balanced Budget Act of 1997, and a general lack of foresight regarding financial problems when embarking on an integration strategy. By implementing a wide range of initiatives to stem losses and improve financial performance, several of the case-study IDSs have accomplished dramatic financial turnarounds over the past three years, and all have achieved consistently stronger financial performance.

Error reduction by combining strapdown inertial measurement units in a baseball stitch

NASA Astrophysics Data System (ADS)

Tracy, Leah

A poor musical performance is rarely due to an inferior instrument. When a device is under performing, the temptation is to find a better device or a new technology to achieve performance objectives; however, another solution may be improving how existing technology is used through a better understanding of device characteristics, i.e., learning to play the instrument better. This thesis explores improving position and attitude estimates of inertial navigation systems (INS) through an understanding of inertial sensor errors, manipulating inertial measurement units (IMUs) to reduce that error and multisensor fusion of multiple IMUs to reduce error in a GPS denied environment.

Social inequality in dynamic balance performance in an early old age Spanish population: the role of health and lifestyle associated factors.

PubMed

Rodríguez López, Santiago; Nilsson, Charlotte; Lund, Rikke; Montero, Pilar; Fernández-Ballesteros, Rocío; Avlund, Kirsten

2012-01-01

This study investigates the association between socioeconomic status (SES) and dynamic balance performance and whether lifestyle factors explained any possible associations. A total of 448 nondisabled individuals, age-range 54-75 years and enrolled in the Active Aging Longitudinal Study of Spain in 2006, constituted the study population. Baseline data of this cross-sectional study were obtained by personal interviews and objective measures of balance performance. The present study shows an educational gradient in poor dynamic balance, where individuals with no formal education had higher risk of poor balance, also after adjustment for age, gender, obesity and physical activity. In addition, obesity and sedentary physical activity were related to poor dynamic balance. The findings suggest an independent effect of both SES and behavioral factors on poor balance performance in the older Spanish population. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Phasic dopamine release in the rat nucleus accumbens predicts approach and avoidance performance

PubMed Central

Gentry, Ronny N.; Lee, Brian; Roesch, Matthew R.

2016-01-01

Dopamine (DA) is critical for reward processing, but significantly less is known about its role in punishment avoidance. Using a combined approach-avoidance task, we measured phasic DA release in the nucleus accumbens (NAc) of rats during presentation of cues that predicted reward, punishment or neutral outcomes and investigated individual differences based on avoidance performance. Here we show that DA release within a single microenvironment is higher for reward and avoidance cues compared with neutral cues and positively correlated with poor avoidance behaviour. We found that DA release delineates trial-type during sessions with good avoidance but is non-selective during poor avoidance, with high release correlating with poor performance. These data demonstrate that phasic DA is released during cued approach and avoidance within the same microenvironment and abnormal processing of value signals is correlated with poor performance. PMID:27786172

An ANOVA Analysis of Education Inequities Using Participation and Representation in Education Systems

ERIC Educational Resources Information Center

Carter, Bruce J.

2017-01-01

A problem recognized in the United States is that a K-12 public education in urban communities is more likely to support existing patterns of inequality than to serve as a pathway to opportunity. The specific focus of this research was on the poor academic performance in U.S. K-12 urban communities. Using Benet's polarities of democracy theory as…

Milking performance evaluation and factors affecting milking claw vacuum levels with flow simulator.

PubMed

Enokidani, Masafumi; Kawai, Kazuhiro; Shinozuka, Yasunori; Watanabe, Aiko

2017-08-01

Milking performance of milking machines that matches the production capability of dairy cows is important in reducing the risk of mastitis, particularly in high-producing cows. This study used a simulated milking device to examine the milking performance of the milking system of 73 dairy farms and to analyze the factors affecting claw vacuum. Mean claw vacuum and range of fluctuation of claw vacuum (claw vacuum range) were measured at three different flow rates: 5.7, 7.6 and 8.7 kg/min. At the highest flow rate, only 16 farms (21.9%) met both standards of mean claw vacuum ≥35 kPa and claw vacuum range ≤ 7 kPa, showing that milking systems currently have poor milking performance. The factors affecting mean claw vacuum were claw type, milk-meter and vacuum shut-off device; the factor affecting claw vacuum range was claw type. Examination of the milking performance of the milking system using a simulated milking device allows an examination of the performance that can cope with high producing cows, indicating the possibility of reducing the risk of mastitis caused by inappropriate claw vacuum. © 2016 Japanese Society of Animal Science.

Measure Guideline: Passive Vents

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

Berger, David; Neri, Robin

2016-02-05

This document addresses the use of passive vents as a source of outdoor air in multifamily buildings. The challenges associated with implementing passive vents and the factors affecting performance are outlined. A comprehensive design methodology and quantified performance metrics are provided. Two hypothetical design examples are provided to illustrate the process. This document is intended to be useful to designers, decision-makers, and contractors implementing passive ventilation strategies. It is also intended to be a resource for those responsible for setting high-performance building program requirements, especially pertaining to ventilation and outdoor air. To ensure good indoor air quality, a dedicated sourcemore » of outdoor air is an integral part of high-performance buildings. Presently, there is a lack of guidance pertaining to the design and installation of passive vents, resulting in poor system performance. This report details the criteria necessary for designing, constructing, and testing passive vent systems to enable them to provide consistent and reliable levels of ventilation air from outdoors.« less

Perception of Overweight Is Associated with Poor Academic Performance in US Adolescents

ERIC Educational Resources Information Center

Florin, Todd A.; Shults, Justine; Stettler, Nicolas

2011-01-01

Background: To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement. Methods: We performed a cross-sectional study of 14-17-year-olds (N = 11,012) from the nationally representative…

Deterioration in Teachers' Performance: Causes and Some Remedies

ERIC Educational Resources Information Center

Yariv, Eliezer

2011-01-01

Why do teachers become poor performers? In semi-structured interviews, forty elementary school principals in Israel described the personal story of one poor-performing staff member. Half of the problematic teachers were veteran teachers who faced a marked internal and external shift in mid-career. The seeds of their problems were probably planted…

Predicting functional capacity in patients with a systemic right ventricle: subjective patient self-assessment is better than B-type natriuretic peptide levels and right ventricular systolic function.

PubMed

Book, Wendy; McConnell, Michael; Oster, Matthew; Lyle, Teresa; Kogon, Brian

2013-01-01

Many adults with transposition of the great arteries have an anatomic right ventricle functioning as the systemic ventricle and are known to develop congestive heart failure, premature cardiac death, and need for cardiac transplantation. Predictors of poor clinical outcome and functional status in patients with left ventricular failure do not always apply to these patients. We aimed to identify predictors of poor functional status in those patients with a systemic right ventricle. We performed a prospective study of 51 adults with transposition of the great arteries and systemic right ventricles. Demographic, clinical, laboratory, and imaging data were collected, and patients completed a Minnesota Living with Heart Failure Questionnaire (MLHFQ). Comparisons were made between those patients with d-type transposition of the great arteries (dTGA) who have undergone prior atrial switch and those with congenitally corrected transposition (ccTGA). A correlation analysis was performed to identify predictors of poor functional status, as determined by a 6-minute walk distance test. Median age was 30 years (range 19-65). Median B-type natriuretic peptide was 48 pg/mL (range 16-406). There were 27 patients (53%) with moderate-severe right ventricular dysfunction and 10 (20%) with moderate-severe tricuspid valve regurgitation. The median MLHFQ score was 9 (range 0-78) and 6-minute walk test was 510 m (range 231-703). Forty-one patients had a diagnosis of dTGA atrial switch and 11 patients had ccTGA. Patients with ccTGA were significantly older (40 vs. 28 years, P =.004) and had more tricuspid valve regurgitation (P =.02). Despite this, their MLHFQ scores were significantly lower (2.5 vs. 17, P =.04) and they walked further (635 vs. 504 m, P =.02). Predictors of a short 6-minute walk distance included short stature (P =.009) and dTGA (P =.002). The patient's self-assessment of poor health, as measured by an increased New York Heart Association class (P =.003) and a decreased MLHFQ score (P >.0001) also correlated. B-type natriuretic peptide levels, right ventricular dysfunction, severity of tricuspid valve regurgitation, need for pacemaker, and clinical signs of heart failure did not correlate with exercise tolerance. Traditional parameters used to predict outcomes in patients with left ventricular failure are not predictive in patients with a systemic right ventricle. Instead, patient's self-assessment of functional status did correlate with objective functional status. © 2013 Wiley Periodicals, Inc.

Exercising upper respiratory videoendoscopic evaluation of 100 nonracing performance horses with abnormal respiratory noise and/or poor performance.

PubMed

Davidson, E J; Martin, B B; Boston, R C; Parente, E J

2011-01-01

Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airway endoscopy. Relationships between horse demographics, resting endoscopic findings, treadmill intensity and implementation of head and neck flexion during exercise with exercising endoscopic findings were examined. Dynamic upper airway obstructions were observed in 72% of examinations. Head and neck flexion was necessary to obtain a diagnosis in 21 horses. Pharyngeal wall collapse was the most prevalent upper airway abnormality, observed in 31% of the examinations. Complex abnormalities were noted in 27% of the examinations. Resting laryngeal dysfunction was significantly associated with dynamic arytenoid collapse and the odds of detecting intermittent dorsal displacement of the soft palate (DDSP) during exercise in horses with resting DDSP was only 7.7%. Exercising endoscopic observations were different from the resting observations in 54% of examinations. Dynamic upper airway obstructions were common in nonracing performance horses with respiratory noise and/or poor performance. Resting endoscopy was only helpful in determining exercising abnormalities with recurrent laryngeal neuropathy. This study emphasises the importance of exercising endoscopic evaluation in nonracing performance horses with abnormal respiratory noise and/or poor performance for accurate assessment of dynamic upper airway function. © 2010 EVJ Ltd.

Improving operational land surface model canopy evapotranspiration in Africa using a direct remote sensing approach

NASA Astrophysics Data System (ADS)

Marshall, M.; Tu, K.; Funk, C.; Michaelsen, J.; Williams, P.; Williams, C.; Ardö, J.; Boucher, M.; Cappelaere, B.; de Grandcourt, A.; Nickless, A.; Nouvellon, Y.; Scholes, R.; Kutsch, W.

2013-03-01

Climate change is expected to have the greatest impact on the world's economically poor. In the Sahel, a climatically sensitive region where rain-fed agriculture is the primary livelihood, expected decreases in water supply will increase food insecurity. Studies on climate change and the intensification of the water cycle in sub-Saharan Africa are few. This is due in part to poor calibration of modeled evapotranspiration (ET), a key input in continental-scale hydrologic models. In this study, a remote sensing model of transpiration (the primary component of ET), driven by a time series of vegetation indices, was used to substitute transpiration from the Global Land Data Assimilation System realization of the National Centers for Environmental Prediction, Oregon State University, Air Force, and Hydrology Research Laboratory at National Weather Service Land Surface Model (GNOAH) to improve total ET model estimates for monitoring purposes in sub-Saharan Africa. The performance of the hybrid model was compared against GNOAH ET and the remote sensing method using eight eddy flux towers representing major biomes of sub-Saharan Africa. The greatest improvements in model performance were at humid sites with dense vegetation, while performance at semi-arid sites was poor, but better than the models before hybridization. The reduction in errors using the hybrid model can be attributed to the integration of a simple canopy scheme that depends primarily on low bias surface climate reanalysis data and is driven primarily by a time series of vegetation indices.

Li-Ion Cells Employing Electrolytes With Methyl Propionate and Ethyl Butyrate Co-Solvents

NASA Technical Reports Server (NTRS)

Smart, Marshall C.; Bugga, Ratnakumar V.

2011-01-01

Future NASA missions aimed at exploring Mars and the outer planets require rechargeable batteries that can operate at low temperatures to satisfy the requirements of such applications as landers, rovers, and penetrators. A number of terrestrial applications, such as hybrid electric vehicles (HEVs) and electric vehicles (EVs) also require energy storage devices that can operate over a wide temperature range (i.e., -40 to +70 C), while still providing high power capability and long life. Currently, the state-of-the-art lithium-ion system has been demonstrated to operate over a wide range of temperatures (-30 to +40 C); however, the rate capability at the lower temperatures is very poor. These limitations at very low temperatures are due to poor electrolyte conductivity, poor lithium intercalation kinetics over the electrode surface layers, and poor ionic diffusion in the electrode bulk. Two wide-operating-temperature-range electrolytes have been developed based on advances involving lithium hexafluorophosphate-based solutions in carbonate and carbonate + ester solvent blends, which have been further optimized in the context of the technology and targeted applications. The approaches employed include further optimization of electrolytes containing methyl propionate (MP) and ethyl butyrate (EB), which are effective co-solvents, to widen the operating temperature range beyond the baseline systems. Attention was focused on further optimizing ester-based electrolyte formulations that have exhibited the best performance at temperatures ranging from -60 to +60 C, with an emphasis upon improving the rate capability at -20 to -40 C. This was accomplished by increasing electrolyte salt concentration to 1.20M and increasing the ester content to 60 percent by volume to increase the ionic conductivity at low temperatures. Two JPL-developed electrolytes 1.20M LiPF6 in EC+EMC+MP (20:20:60 v/v %) and 1.20M LiPF6 in EC+EMC+EB (20:20:60 v/v %) operate effectively over a wide temperature range in MCMB-LiNiCoAlO2 and Li4Ti5O12-LiNi-CoAlO2 prototype cells. These electrolytes have enabled high rate performance at low temperature (i.e., up to 2.0C rates at -50 C and 5.0C rates at -40 C), and good cycling performance over a wide temperature range (i.e., from -40 to +70 C). Current efforts are focused upon improving the high temperature resilience of the methyl propionatebased system through the use of electrolyte additives, which are envisioned to improve the nature of the solid electrolyte interphase (SEI) layers.

Performance and cost of energy transport and storage systems for dish applications using reversible chemical reactions

NASA Technical Reports Server (NTRS)

Schredder, J. M.; Fujita, T.

1984-01-01

The use of reversible chemical reactions for energy transport and storage for parabolic dish networks is considered. Performance and cost characteristics are estimated for systems using three reactions (sulfur-trioxide decomposition, steam reforming of methane, and carbon-dioxide reforming of methane). Systems are considered with and without storage, and in several energy-delivery configurations that give different profiles of energy delivered versus temperature. Cost estimates are derived assuming the use of metal components and of advanced ceramics. (The latter reduces the costs by three- to five-fold). The process that led to the selection of the three reactions is described, and the effects of varying temperatures, pressures, and heat exchanger sizes are addressed. A state-of-the-art survey was performed as part of this study. As a result of this survey, it appears that formidable technical risks exist for any attempt to implement the systems analyzed in this study, especially in the area of reactor design and performance. The behavior of all components and complete systems under thermal energy transients is very poorly understood. This study indicates that thermochemical storage systems that store reactants as liquids have efficiencies below 60%, which is in agreement with the findings of earlier investigators.

Designing healthcare information technology to catalyse change in clinical care.

PubMed

Lester, William T; Zai, Adrian H; Grant, Richard W; Chueh, Henry C

2008-01-01

The gap between best practice and actual patient care continues to be a pervasive problem in our healthcare system. Efforts to improve on this knowledge-performance gap have included computerised disease management programs designed to improve guideline adherence. However, current computerised reminder and decision support interventions directed at changing physician behaviour have had only a limited and variable effect on clinical outcomes. Further, immediate pay-for-performance financial pressures on institutions have created an environment where disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their real-world effectiveness. The authors present a review of disease management as well as a conceptual framework to guide the development of more effective health information technology (HIT) tools for translating clinical information into clinical action.

Reconsidering the logic of World Federation of Neurosurgical Societies grading in patients with severe subarachnoid hemorrhage.

PubMed

Fung, Christian; Inglin, Fabienne; Murek, Michael; Balmer, Mathias; Abu-Isa, Janine; Z'Graggen, Werner J; Ozdoba, Christoph; Gralla, Jan; Jakob, Stephan M; Takala, Jukka; Beck, Jürgen; Raabe, Andreas

2016-02-01

Current data show a favorable outcome in up to 50% of patients with World Federation of Neurosurgical Societies (WFNS) Grade V subarachnoid hemorrhage (SAH) and a rather poor prediction of worst cases. Thus, the usefulness of the current WFNS grading system for identifying the worst scenarios for clinical studies and for making treatment decisions is limited. One reason for this lack of differentiation is the use of "negative" or "silent" diagnostic signs as part of the WFNS Grade V definition. The authors therefore reevaluated the WFNS scale by using "positive" clinical signs and the logic of the Glasgow Coma Scale as a progressive herniation score. The authors performed a retrospective analysis of 182 patients with SAH who had poor grades on the WFNS scale. Patients were graded according to the original WFNS scale and additionally according to a modified classification, the WFNS herniation (hWFNS) scale (Grade IV, no clinical signs of herniation; Grade V, clinical signs of herniation). The prediction of poor outcome was compared between these two grading systems. The positive predictive values of Grade V for poor outcome were 74.3% (OR 3.79, 95% CI 1.94-7.54) for WFNS Grade V and 85.7% (OR 8.27, 95% CI 3.78-19.47) for hWFNS Grade V. With respect to mortality, the positive predictive values were 68.3% (OR 3.9, 95% CI 2.01-7.69) for WFNS Grade V and 77.9% (OR 6.22, 95% CI 3.07-13.14) for hWFNS Grade V. Limiting WFNS Grade V to the positive clinical signs of the Glasgow Coma Scale such as flexion, extension, and pupillary abnormalities instead of including "no motor response" increases the prediction of mortality and poor outcome in patients with severe SAH.

Toward the modelling of safety violations in healthcare systems.

PubMed

Catchpole, Ken

2013-09-01

When frontline staff do not adhere to policies, protocols, or checklists, managers often regard these violations as indicating poor practice or even negligence. More often than not, however, these policy and protocol violations reflect the efforts of well intentioned professionals to carry out their work efficiently in the face of systems poorly designed to meet the diverse demands of patient care. Thus, non-compliance with institutional policies and protocols often signals a systems problem, rather than a people problem, and can be influenced among other things by training, competing goals, context, process, location, case complexity, individual beliefs, the direct or indirect influence of others, job pressure, flexibility, rule definition, and clinician-centred design. Three candidates are considered for developing a model of safety behaviour and decision making. The dynamic safety model helps to understand the relationship between systems designs and human performance. The theory of planned behaviour suggests that intention is a function of attitudes, social norms and perceived behavioural control. The naturalistic decision making paradigm posits that decisions are based on a wider view of multiple patients, expertise, systems complexity, behavioural intention, individual beliefs and current understanding of the system. Understanding and predicting behavioural safety decisions could help us to encourage compliance to current processes and to design better interventions.

Better efficacy for the osmotic release oral system methylphenidate among poor adherents to immediate-release methylphenidate in the three ADHD subtypes.

PubMed

Chou, Wen-Jiun; Chou, Miao-Chun; Tzang, Ruu-Fen; Hsu, Ya-Chen; Gau, Susan Shur-Fen; Chen, Shin-Jaw; Wu, Yu-Yu; Huang, Ya-Fen; Liang, Hsin-Yi; Cheng, Helen

2009-04-01

To determine factors for switching to osmotic release oral system methylphenidate (OROS-MPH) among poor adherents to immediate-release methylphenidate (IR-MPH); and to compare the efficacy of OROS-MPH on the three attention-deficit/hyperactivity disorder (ADHD) subtypes in a multi-site prospective observational study in Taiwan. The sample included 240 children with ADHD, aged 6-16 years, who were poor adherents to IR-MPH, 137 of whom were switched to OROS-MPH. The child psychiatrists diagnosed the Diagnostic Statistical Manual of Mental Disorders (4th edition) ADHD subtypes and assessed the medical history, adherence, side-effects, global ADHD severity, and family/school effectiveness. Parents reported their child's behavioral symptoms. The determinants for an OROS-MPH switch were higher dosage, shorter treatment and thrice-daily administration of IR-MPH, and more severe inattention symptoms. Hyperactivity and oppositional symptoms were greater in the ADHD combined and hyperactive-impulsive subtypes than the inattentive subtype. Switching to OROS-MPH significantly improved behavioral symptoms and family/school measures, and this was most evident in the ADHD-combined group, followed by the ADHD-inattentive group. Inattention influenced not only academic performance, but also overall classroom behaviors and the parent-child relationship, with the latter two also influenced by oppositional symptoms. This study suggests better efficacy for the OROS-MPH among poor adherents to IR-MPH; however, its effectiveness varied across the three ADHD subtypes (ClinicalTrials.gov number NCT00460720).

Responsiveness of the health insurance and private systems in Alexandria, Egypt.

PubMed

Mosallam, Rasha A; Aly, Mahmoud M; Moharram, Ahmed M

2013-04-01

Responsiveness to patients is a key indicator for measuring the health system performance with respect to nonhealth aspects. This study aimed to compare responsiveness of the Health Insurance Organization (HIO) with the private healthcare system and also to assess the importance of the different responsiveness domains according to the study population's perspective. Patients attending both inpatient and outpatient settings of both organizations were interviewed (200 outpatients and 200 inpatients from each selected hospital) using the WHO questionnaire. The questionnaire elicits the ratings of the respondents on their experiences with the healthcare system over the past 12 months in terms of responsiveness domains, respondents' inability to access medical care because of financial barriers, and their ranking of the relative importance of responsiveness domains. Almost twice the number of HIO participants reported poor responsiveness compared with the private organization participants (27.8 vs. 56.8%, respectively). The outpatient setting scored much favorably compared with the inpatient setting at the HIO (52.3% of respondents reported poor responsiveness in the outpatient setting compared with 76.3% in the inpatient setting); however, they were comparable in the private setting. Communication, prompt attention, and dignity were the domains most frequently rated as the most important (36.0, 32.0, and 14.7%, respectively). The type of organization (HIO vs. private organization) and setting of care (inpatient vs. outpatient) were significant predictors of responsiveness score (P<0.001). The overall rating of the patients on responsiveness of the HIO system is low, especially when compared with the private sector. The results emphasize the importance of establishment of systems for monitoring the performance of the providers and discontinuation of the services for the nonperformers.

Bayesian paradox in homeland security and homeland defense

NASA Astrophysics Data System (ADS)

Jannson, Tomasz; Forrester, Thomas; Wang, Wenjian

2011-06-01

In this paper we discuss a rather surprising result of Bayesian inference analysis: performance of a broad variety of sensors depends not only on a sensor system itself, but also on CONOPS parameters in such a way that even an excellent sensor system can perform poorly if absolute probabilities of a threat (target) are lower than a false alarm probability. This result, which we call Bayesian paradox, holds not only for binary sensors as discussed in the lead author's previous papers, but also for a more general class of multi-target sensors, discussed also in this paper. Examples include: ATR (automatic target recognition), luggage X-ray inspection for explosives, medical diagnostics, car engine diagnostics, judicial decisions, and many other issues.

RGB LED with smart control in the backlight and lighting

NASA Astrophysics Data System (ADS)

Ku, Johnson C. S.; Lee, C. J.

2008-02-01

To improve the LED (Light Emitting Diode) efficacy is the major consideration when the backlight and lighting system are implemented. An important source of poor efficacy come from the chip process or heat dissipation. White LED used blue chip with phosphor is the current solution and inadequate for the tunable color temperature system. The use of RGB (Red, Green and Blue) LED with smart control is presented in this study. The resulting coupled optical and thermal shows the better performance when it is synthesized in conjunction with a degree of color mixing technology.

A medical oncologist's approach to immunotherapy for advanced renal tumors: is nephrectomy indicated?

PubMed

Cooney, Matthew M; Remick, Scot C; Vogelzang, Nicholas J

2004-02-01

Metastatic renal cell carcinoma is highly resistant to systemic therapy. Although interleukin-2 and interferon remain the most active agents for this disease, long-term survival rates remain poor. Two phase 3 trials, European Organization Research and Treatment of Cancer 30947 and Southwest Oncology Group 8949, have demonstrated a survival benefit of nephrectomy followed by interferon versus interferon alone in patients having an excellent performance status (PS 0 and 1). Removal of the primary tumor followed by interferon is not recommended for patients with a moderate or poor PS (PS 2-4). Even with this aggressive approach, most patients eventually will die from their kidney cancer; therefore, every patient with metastatic disease should be considered for enrollment into clinical trials.

Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex

PubMed Central

Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2015-01-01

Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy. PMID:26184226

Intensity Variation Normalization for Finger Vein Recognition Using Guided Filter Based Singe Scale Retinex.

PubMed

Xie, Shan Juan; Lu, Yu; Yoon, Sook; Yang, Jucheng; Park, Dong Sun

2015-07-14

Finger vein recognition has been considered one of the most promising biometrics for personal authentication. However, the capacities and percentages of finger tissues (e.g., bone, muscle, ligament, water, fat, etc.) vary person by person. This usually causes poor quality of finger vein images, therefore degrading the performance of finger vein recognition systems (FVRSs). In this paper, the intrinsic factors of finger tissue causing poor quality of finger vein images are analyzed, and an intensity variation (IV) normalization method using guided filter based single scale retinex (GFSSR) is proposed for finger vein image enhancement. The experimental results on two public datasets demonstrate the effectiveness of the proposed method in enhancing the image quality and finger vein recognition accuracy.

Contralateral Associated Movements Correlate with Poorer Inhibitory Control, Attention and Visual Perception in Preschool Children.

PubMed

Kakebeeke, Tanja H; Messerli-Bürgy, Nadine; Meyer, Andrea H; Zysset, Annina E; Stülb, Kerstin; Leeger-Aschmann, Claudia S; Schmutz, Einat A; Arhab, Amar; Puder, Jardena J; Kriemler, Susi; Munsch, Simone; Jenni, Oskar G

2017-10-01

Contralateral associated movements (CAMs) frequently occur in complex motor tasks. We investigated whether and to what extent CAMs are associated with inhibitory control among preschool children in the Swiss Preschoolers' Health Study. Participants were 476 healthy, typically developing children (mean age = 3.88 years; 251 boys) evaluated on two consecutive afternoons. The children performed the Zurich Neuromotor Assessment, the statue subtest of the Neuropsychological Assessment for Children (NEPSY), and cognitive tests of the Intelligence and Development Scales-Preschool (IDS-P). CAMs were associated with poor inhibitory control on the statue test and poor selective attention and visual perception on the IDS-P. We attributed these findings to preschoolers' general immaturity of the central nervous system.

PRIVATE SECTOR IN HEALTH CARE DELIVERY: A REALITY AND A CHALLENGE IN PAKISTAN.

PubMed

Shaikh, Babar Tasneem

2015-01-01

Under performance of the public sector health care system in Pakistan has created a room for private sector to grow and become popular in health service delivery, despite its questionable quality, high cost and dubious ethics of medical practice. Private sector is no doubt a reality; and is functioning to plug many weaknesses and gaps in health care delivery to the poor people of Pakistan. Yet, it is largely unregulated and unchecked due to the absence of writ of the state. In spite of its inherent trait of profit making, the private sector has played a significant and innovative role both in preventive and curative service provision. Private sector has demonstrated great deal of responsiveness, hence creating a relation of trust with the consumers of health in Pakistan, majority of who spend out of their pocket to buy 'health'. There is definitely a potential to engage and involve private and non-state entities in the health care system building their capacities and instituting regulatory frameworks, to protect the poor's access to health care system.

The importance of understanding: Model space moderates goal specificity effects.

PubMed

Kistner, Saskia; Burns, Bruce D; Vollmeyer, Regina; Kortenkamp, Ulrich

2016-01-01

The three-space theory of problem solving predicts that the quality of a learner's model and the goal specificity of a task interact on knowledge acquisition. In Experiment 1 participants used a computer simulation of a lever system to learn about torques. They either had to test hypotheses (nonspecific goal), or to produce given values for variables (specific goal). In the good- but not in the poor-model condition they saw torque depicted as an area. Results revealed the predicted interaction. A nonspecific goal only resulted in better learning when a good model of torques was provided. In Experiment 2 participants learned to manipulate the inputs of a system to control its outputs. A nonspecific goal to explore the system helped performance when compared to a specific goal to reach certain values when participants were given a good model, but not when given a poor model that suggested the wrong hypothesis space. Our findings support the three-space theory. They emphasize the importance of understanding for problem solving and stress the need to study underlying processes.

Identifying poor performance among doctors in NHS organizations.

PubMed

Locke, Rachel; Scallan, Samantha; Leach, Camilla; Rickenbach, Mark

2013-10-01

To account for the means by which poor performance among career doctors is identified by National Health Service organizations, whether the tools are considered effective and how these processes may be strengthened in the light of revalidation and the requirement for doctors to demonstrate their fitness to practice. This study sought to look beyond the 'doctor as individual'; as well as considering the typical approaches to managing the practice of an individual, the systems within which the doctor is working were reviewed, as these are also relevant to standards of performance. A qualitative review was undertaken consisting of a literature review of current practice, a policy review of current documentation from 15 trusts in one deanery locality, and 14 semi-structured interviews with respondents with an overview of processes in use. The framework for the analysis of the data considered tools at three levels: individual, team and organizational. Tools are, in the main, reactive--with an individual focus. They rely on colleagues and others to speak out, so their effectiveness is hindered by a reluctance to do so. Tools can lack an evidence base for their use, and there is limited linking of data across contexts and tools. There is more work to be done in evaluating current tools and developing stronger processes. Linkage between data sources needs to be improved and proactive tools at the organizational level need further development to help with the early identification of performance issues. This would also assist in balancing a wider systems approach with a current over emphasis on individual doctors. © 2012 John Wiley & Sons Ltd.

Fuzzy adaptive integration scheme for low-cost SINS/GPS navigation system

NASA Astrophysics Data System (ADS)

Nourmohammadi, Hossein; Keighobadi, Jafar

2018-01-01

Due to weak stand-alone accuracy as well as poor run-to-run stability of micro-electro mechanical system (MEMS)-based inertial sensors, special approaches are required to integrate low-cost strap-down inertial navigation system (SINS) with global positioning system (GPS), particularly in long-term applications. This paper aims to enhance long-term performance of conventional SINS/GPS navigation systems using a fuzzy adaptive integration scheme. The main concept behind the proposed adaptive integration is the good performance of attitude-heading reference system (AHRS) in low-accelerated motions and its degradation in maneuvered or accelerated motions. Depending on vehicle maneuvers, gravity-based attitude angles can be intelligently utilized to improve orientation estimation in the SINS. Knowledge-based fuzzy inference system is developed for decision-making between the AHRS and the SINS according to vehicle maneuvering conditions. Inertial measurements are the main input data of the fuzzy system to determine the maneuvering level during the vehicle motions. Accordingly, appropriate weighting coefficients are produced to combine the SINS/GPS and the AHRS, efficiently. The assessment of the proposed integrated navigation system is conducted via real data in airborne tests.

An accurate computational method for an order parameter with a Markov state model constructed using a manifold-learning technique

NASA Astrophysics Data System (ADS)

Ito, Reika; Yoshidome, Takashi

2018-01-01

Markov state models (MSMs) are a powerful approach for analyzing the long-time behaviors of protein motion using molecular dynamics simulation data. However, their quantitative performance with respect to the physical quantities is poor. We believe that this poor performance is caused by the failure to appropriately classify protein conformations into states when constructing MSMs. Herein, we show that the quantitative performance of an order parameter is improved when a manifold-learning technique is employed for the classification in the MSM. The MSM construction using the K-center method, which has been previously used for classification, has a poor quantitative performance.

Masticatory performance is not associated with diet quality in Class II orthognathic surgery patients.

PubMed

Shinkai, R S; Hatch, J P; Sakai, S; Mobley, C C; Rugh, J D

2001-01-01

This study evaluated the association between masticatory function, diet, and digestive system problems in 59 Class II patients 5 years after bilateral sagittal split osteotomy. Dietary intake data were recorded in 4-day diet diaries and analyzed for overall diet quality (Healthy Eating Index) and selected dietary components. Masticatory function was assessed through measurements of masticatory performance, maximum bilateral bite force, and chewing time and number of chewing strokes until the subject felt that the bolus was ready to swallow. Self-reported frequency of digestive system problems was recorded with a 7-point Likert scale questionnaire. Masticatory function was not associated with diet quality or gastrointestinal problems. There was a weak association between intake of foods that require chewing (eg, fiber, protein, meat, and vegetables) and masticatory variables. Fourteen subjects (24%) had a poor diet and 45 subjects (76%) had a diet that needed improvement according to the Healthy Eating Index. Self-reported constipation was the only digestive system problem that was significantly associated with masticatory performance.

Embedded measures of performance validity using verbal fluency tests in a clinical sample.

PubMed

Sugarman, Michael A; Axelrod, Bradley N

2015-01-01

The objective of this study was to determine to what extent verbal fluency measures can be used as performance validity indicators during neuropsychological evaluation. Participants were clinically referred for neuropsychological evaluation in an urban-based Veteran's Affairs hospital. Participants were placed into 2 groups based on their objectively evaluated effort on performance validity tests (PVTs). Individuals who exhibited credible performance (n = 431) failed 0 PVTs, and those with poor effort (n = 192) failed 2 or more PVTs. All participants completed the Controlled Oral Word Association Test (COWAT) and Animals verbal fluency measures. We evaluated how well verbal fluency scores could discriminate between the 2 groups. Raw scores and T scores for Animals discriminated between the credible performance and poor-effort groups with 90% specificity and greater than 40% sensitivity. COWAT scores had lower sensitivity for detecting poor effort. A combination of FAS and Animals scores into logistic regression models yielded acceptable group classification, with 90% specificity and greater than 44% sensitivity. Verbal fluency measures can yield adequate detection of poor effort during neuropsychological evaluation. We provide suggested cut points and logistic regression models for predicting the probability of poor effort in our clinical setting and offer suggested cutoff scores to optimize sensitivity and specificity.

Management for non-variceal upper gastrointestinal bleeding in elderly patients: the experience of a tertiary university hospital

PubMed Central

Kurumi, Hiroki; Takeda, Yohei; Yashima, Kazuo; Isomoto, Hajime

2017-01-01

Background Peptic ulcer bleeding (PUB) is the main cause of non-variceal upper gastrointestinal bleeding (UGIB). Endoscopic treatment and acid suppression with proton-pump inhibitors (PPIs) are most important in the management of PUB and these treatments have reduced mortality. However, elderly patients sometimes have a poor prognostic outcome due to severe comorbidities. Methods A retrospective study was performed on 504 cases with acute non-variceal UGIB who were examined in our hospital, in order to reveal the risk factor of a poor outcome in elderly patients. Results Two hundred and thirty-four cases needed hemostasis; 11 cases had unsuccessful endoscopic treatments; 31 cases had re-bleeding after endoscopic hemostasis. Forty-three cases died within 30 days after the initial urgent endoscopy, but only seven cases died from bleeding. Elderly patients aged over 65 years had more severe comorbidities, and were prescribed non-steroidal anti-inflammatory drugs (NSAIDs), antiplatelet agents and/or anticoagulation agents, more frequently, compared with non-elderly patients. The significant risk factor of needing hemostatic therapy was the taking of two or more NSAIDs, antiplatelet agents and/or anticoagulation agents. The most important risk of a poor outcome in elderly patients was various kinds of severe comorbidities. And so, it is important to predict such an outcome in these cases. AIMS65 is a simple and relatively useful scoring system that predicts the risk of a poor outcome in UGIB. High-score patients via AIMS65 were associated with a high mortality rate because of death from comorbidities. Conclusions The elderly patients in whom were prescribed two or more NSAIDs, antiplatelet agents and/or anticoagulation agents, should have UGIB prevented using a PPI. The most significant risk of a poor outcome in elderly patients was severe comorbidities. We recommend that elderly patients with UGIB should be estimated as having a poor outcome as soon as possible via the risk scoring system AIMS65. PMID:28616396

Management for non-variceal upper gastrointestinal bleeding in elderly patients: the experience of a tertiary university hospital.

PubMed

Kawaguchi, Koichiro; Kurumi, Hiroki; Takeda, Yohei; Yashima, Kazuo; Isomoto, Hajime

2017-04-01

Peptic ulcer bleeding (PUB) is the main cause of non-variceal upper gastrointestinal bleeding (UGIB). Endoscopic treatment and acid suppression with proton-pump inhibitors (PPIs) are most important in the management of PUB and these treatments have reduced mortality. However, elderly patients sometimes have a poor prognostic outcome due to severe comorbidities. A retrospective study was performed on 504 cases with acute non-variceal UGIB who were examined in our hospital, in order to reveal the risk factor of a poor outcome in elderly patients. Two hundred and thirty-four cases needed hemostasis; 11 cases had unsuccessful endoscopic treatments; 31 cases had re-bleeding after endoscopic hemostasis. Forty-three cases died within 30 days after the initial urgent endoscopy, but only seven cases died from bleeding. Elderly patients aged over 65 years had more severe comorbidities, and were prescribed non-steroidal anti-inflammatory drugs (NSAIDs), antiplatelet agents and/or anticoagulation agents, more frequently, compared with non-elderly patients. The significant risk factor of needing hemostatic therapy was the taking of two or more NSAIDs, antiplatelet agents and/or anticoagulation agents. The most important risk of a poor outcome in elderly patients was various kinds of severe comorbidities. And so, it is important to predict such an outcome in these cases. AIMS65 is a simple and relatively useful scoring system that predicts the risk of a poor outcome in UGIB. High-score patients via AIMS65 were associated with a high mortality rate because of death from comorbidities. The elderly patients in whom were prescribed two or more NSAIDs, antiplatelet agents and/or anticoagulation agents, should have UGIB prevented using a PPI. The most significant risk of a poor outcome in elderly patients was severe comorbidities. We recommend that elderly patients with UGIB should be estimated as having a poor outcome as soon as possible via the risk scoring system AIMS65.

Optimal input selection for neural machine interfaces predicting multiple non-explicit outputs.

PubMed

Krepkovich, Eileen T; Perreault, Eric J

2008-01-01

This study implemented a novel algorithm that optimally selects inputs for neural machine interface (NMI) devices intended to control multiple outputs and evaluated its performance on systems lacking explicit output. NMIs often incorporate signals from multiple physiological sources and provide predictions for multidimensional control, leading to multiple-input multiple-output systems. Further, NMIs often are used with subjects who have motor disabilities and thus lack explicit motor outputs. Our algorithm was tested on simulated multiple-input multiple-output systems and on electromyogram and kinematic data collected from healthy subjects performing arm reaches. Effects of output noise in simulated systems indicated that the algorithm could be useful for systems with poor estimates of the output states, as is true for systems lacking explicit motor output. To test efficacy on physiological data, selection was performed using inputs from one subject and outputs from a different subject. Selection was effective for these cases, again indicating that this algorithm will be useful for predictions where there is no motor output, as often is the case for disabled subjects. Further, prediction results generalized for different movement types not used for estimation. These results demonstrate the efficacy of this algorithm for the development of neural machine interfaces.

Development of polyisocyanurate pour foam formulation for space shuttle external tank thermal protection system. Final technical report, March 1986-October 1987

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

Harvey, J.A.; Butler, J.M.; Chartoff, R.P.

1988-08-01

Four commercially available polyisocyanurate polyurethane spray-foam insulation formulations are used to coat the external tank of the space shuttle. There are several problems associated with these formulations. For example, some do not perform well as pourable closeout/repair systems. Some do not perform well at cryogenic temperatures (poor adhesion to aluminum at liquid nitrogen temperatures). Their thermal stability at elevated temperatures is not adequate. A major defect in all the systems is the lack of detailed chemical information. The formulations are simply supplied to NASA and Martin Marietta, the primary contractor, as components; Part A (isocyanate) and Part B (poly(s) andmore » additives). Because of the lack of chemical information the performance behavior data for the current system, NASA sought the development of a non-proprietary room temperature curable foam insulation. Requirements for the developed system were that it should exhibit equal or better thermal stability both at elevated and cryogenic temperatures with better adhesion to aluminum as compared to the current system. Several formulations were developed that met these requirements, i.e., thermal stability, good pourability, and good bonding to aluminum.« less

Getting off on the Wrong Foot: Longitudinal Effects of Hispanic Students' Stability Attributions Following Poor Initial Test Performance

ERIC Educational Resources Information Center

Cox, Cody B.; Yang, Yan

2012-01-01

Though studies have established that following poor performance, attributions to stable causes affect the performance of minority students, few studies have explored the impact of stability attributions over time. This study explored attributions following initial failure among a predominantly Hispanic student population. We measured students'…

Performance of Seven Seed Sources of Blue Spruce in Central North Dakota

Treesearch

David H. Dawson; Paul O. Rudolf

1966-01-01

Blue spruce (Picea pungens Engelm.) has been planted quite extensively in North Dakota shelterbelts and farmstead windbreaks. Generally survival and growth have been promising, but there is considerable variation in performance of individual trees or plantations. Poorly adapted seed sources have been suspected as one cause for poor performance. There should be...

A distributed approach for optimizing cascaded classifier topologies in real-time stream mining systems.

PubMed

Foo, Brian; van der Schaar, Mihaela

2010-11-01

In this paper, we discuss distributed optimization techniques for configuring classifiers in a real-time, informationally-distributed stream mining system. Due to the large volume of streaming data, stream mining systems must often cope with overload, which can lead to poor performance and intolerable processing delay for real-time applications. Furthermore, optimizing over an entire system of classifiers is a difficult task since changing the filtering process at one classifier can impact both the feature values of data arriving at classifiers further downstream and thus, the classification performance achieved by an ensemble of classifiers, as well as the end-to-end processing delay. To address this problem, this paper makes three main contributions: 1) Based on classification and queuing theoretic models, we propose a utility metric that captures both the performance and the delay of a binary filtering classifier system. 2) We introduce a low-complexity framework for estimating the system utility by observing, estimating, and/or exchanging parameters between the inter-related classifiers deployed across the system. 3) We provide distributed algorithms to reconfigure the system, and analyze the algorithms based on their convergence properties, optimality, information exchange overhead, and rate of adaptation to non-stationary data sources. We provide results using different video classifier systems.

Elevated serum alpha-fetoprotein in poorly differentiated adenocarcinoma with neuroendocrine differentiation of the ascending colon: a case report.

PubMed

Lin, Hung-Hsin; Chang, Chia-Chu; Yang, Shung-Haur; Chang, Shih-Ching; Chen, Wei-Shone; Liang, Wen-Yih; Lin, Jen-Kou; Jiang, Jeng-Kai

2016-03-15

Colorectal cancer (CRC) is the most common form of cancer and the third leading cause of death in Taiwan. Serum alpha-fetoprotein (AFP) has been extensively used as a biomarker for hepatocellular carcinoma (HCC) and yolk sac tumors. This case report presents a 90-year-old woman with right abdominal pain and poor appetite for 1 week. The computed tomography (CT) showed wall thickening in the proximal ascending colon with ruptured appendicitis. Preoperative serum AFP was high. There was no definite liver metastasis or other abnormal findings in the hepatobiliary systems. After initial empirical antibiotic treatment, we performed laparoscopic right hemicolectomy. The pathological assessment was poorly differentiated adenocarcinoma with neuroendocrine differentiation in the ascending colon. The tumor cells did not produce AFP. Amazingly, the follow-up serum AFP level 1 month after the surgery declined to normal range. The patient had an uneventful course after the surgery and was free of recurrence or metastasis within 5 months of follow-up. AFP may be a useful tumor marker in poorly differentiated colorectal cancer with neuroendocrine component patients and a prediction of early treatment response.

Rotor systems research aircraft risk-reduction shake test

NASA Technical Reports Server (NTRS)

Wellman, J. Brent

1990-01-01

A shake test and an extensive analysis of results were performed to evaluate the possibility of and the method for dynamically calibrating the Rotor Systems Research Aircraft (RSRA). The RSRA airframe was subjected to known vibratory loads in several degrees of freedom and the responses of many aircraft transducers were recorded. Analysis of the transducer responses using the technique of dynamic force determination showed that the RSRA, when used as a dynamic measurement system, could predict, a posteriori, an excitation force in a single axis to an accuracy of about 5 percent and sometimes better. As the analysis was broadened to include multiple degrees of freedom for the excitation force, the predictive ability of the measurement system degraded to about 20 percent, with the error occasionally reaching 100 percent. The poor performance of the measurement system is explained by the nonlinear response of the RSRA to vibratory forces and the inadequacy of the particular method used in accounting for this nonlinearity.

Orthographic Processing and Visual Sequential Memory in Unexpectedly Poor Spellers

ERIC Educational Resources Information Center

Holmes, Virginia M.; Malone, Aisling M.; Redenbach, Holly

2008-01-01

Does unexpectedly poor spelling in adults result from inferior visual sequential memory? In one experiment, unexpectedly poor spellers performed significantly worse than better spellers in the immediate reproduction of sequences of visual symbols, but in a second experiment, the effect was not replicated. Poor spellers were also no worse at the…

The mirror neuron system: a neural substrate for methods in stroke rehabilitation.

PubMed

Garrison, Kathleen A; Winstein, Carolee J; Aziz-Zadeh, Lisa

2010-06-01

Mirror neurons found in the premotor and parietal cortex respond not only during action execution, but also during observation of actions being performed by others. Thus, the motor system may be activated without overt movement. Rehabilitation of motor function after stroke is often challenging due to severity of impairment and poor to absent voluntary movement ability. Methods in stroke rehabilitation based on the mirror neuron system--action observation, motor imagery, and imitation--take advantage of this opportunity to rebuild motor function despite impairments, as an alternative or complement to physical therapy. Here the authors review research into each condition of practice, and discuss the relevance of the mirror neuron system to stroke recovery.

Addressing inequity in health and health care in Mexico.

PubMed

Barraza-Lloréns, Mariana; Bertozzi, Stefano; González-Pier, Eduardo; Gutiérrez, Juan Pablo

2002-01-01

Despite the fact that life expectancy at birth in Mexico has improved from forty-two years in 1940 to seventy-three in 2000, major inequalities persist in health and access to health care. The Mexican health care system has evolved into a series of disjointed subsystems that are incapable of delivering universal health insurance. Without greatly restructuring the way health care is financed, performance with respect to equity will remain poor. This paper presents the inequities of the system and describes how the current system contributes to the status quo rather than redressing the situation. After tracing the origins of the present system, we discuss policy initiatives for moving toward universal health insurance.

In use performance of catalytic converters on properly maintained high mileage vehicles

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

Sabourin, M.A.; Larson, R.E.; Donahue, K.S.

1986-01-01

A test program to evaluate the performance of catalytic converters from fifty-six 1981 and 1982 model year high mileage properly maintained in-use vehicles (from 21 engine families) was performed by the Certification Division of the Office of Mobile Sources (EPA). The program is called the Catalyst Change Program. All program vehicles were screened for proper maintenance and for mileages that ranged from 35,000 to 60,000 miles. Among vehicles belonging to 21 high sales volume and high technology engine and emission control system designs tested, poor catalyst performance was determined to be a significant contributor to emissions failure of properly-maintained vehiclesmore » at or near their warranted useful life mileage.« less

Development of Performance Dashboards in Healthcare Sector: Key Practical Issues

PubMed Central

Ghazisaeidi, Marjan; Safdari, Reza; Torabi, Mashallah; Mirzaee, Mahboobeh; Farzi, Jebraeil; Goodini, Azadeh

2015-01-01

Background: Static nature of performance reporting systems in health care sector has resulted in inconsistent, incomparable, time consuming, and static performance reports that are not able to transparently reflect a round picture of performance and effectively support healthcare managers’ decision makings. So, the healthcare sector needs interactive performance management tools such as performance dashboards to measure, monitor, and manage performance more effectively. The aim of this article was to identify key issues that need to be addressed for developing high-quality performance dashboards in healthcare sector. Methods: A literature review was established to search electronic research databases, e-journals collections, and printed journals, books, dissertations, and theses for relevant articles. The search strategy interchangeably used the terms of “dashboard”, “performance measurement system”, and “executive information system” with the term of “design” combined with operator “AND”. Search results (n=250) were adjusted for duplications, screened based on their abstract relevancy and full-text availability (n=147) and then assessed for eligibility (n=40). Eligible articles were included if they had explicitly focused on dashboards, performance measurement systems or executive information systems design. Finally, 28 relevant articles included in the study. Results: Creating high-quality performance dashboards requires addressing both performance measurement and executive information systems design issues. Covering these two fields, identified contents were categorized to four main domains: KPIs development, Data Sources and data generation, Integration of dashboards to source systems, and Information presentation issues. Conclusion: This study implies the main steps to develop dashboards for the purpose of performance management. Performance dashboards developed on performance measurement and executive information systems principles and supported by proper back-end infrastructure will result in creation of dynamic reports that help healthcare managers to consistently measure the performance, continuously detect outliers, deeply analyze causes of poor performance, and effectively plan for the future. PMID:26635442

An Experiment in the Ruralization of Education: IPAR and the Cameroonian Reform. Experiments and Innovations in Education No. 8.

ERIC Educational Resources Information Center

Lallez, Raymond

The problem of primary education has existed for some time in both the western and eastern regions of the United Republic of Cameroon in Africa. It was generally accepted that the main reason for the poor performance of the education system was the insufficient training of the vast majority of primary school teachers. From the beginning, ENIR…

National Security Personnel System: Successfully Designed for Failure

DTIC Science & Technology

2009-01-28

the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government . U.S. Army War College, Carlisle Barracks...Department of Defense, or the U.S. Government . U.S. Army War College CARLISLE BARRACKS, PENNSYLVANIA 17013 ABSTRACT AUTHOR: Theresa M. Murray TITLE...Instead, the CSRA raised concerns about poor job performance, protection of federal employees who ‘blew the whistle’ on government misconduct and

Controlled poorly soluble drug release from solid self-microemulsifying formulations with high viscosity hydroxypropylmethylcellulose.

PubMed

Yi, Tao; Wan, Jiangling; Xu, Huibi; Yang, Xiangliang

2008-08-07

The objective of this work was the development of a controlled release system based on self-microemulsifying mixture aimed for oral delivery of poorly water-soluble drugs. HPMC-based particle formulations were prepared by spray drying containing a model drug (nimodipine) of low water solubility and hydroxypropylmethylcellulose (HPMC) of high viscosity. One type of formulations contained nimodipine mixed with HPMC and the other type of formulations contained HPMC and nimodipine dissolved in a self-microemulsifying system (SMES) consisting of ethyl oleate, Cremophor RH 40 and Labrasol. Based on investigation by transmission electron microscopy (TEM), scanning electron microscopy (SEM), differential scanning calorimetry (DSC) and X-ray powder diffraction, differences were found in the particle structure between both types of formulations. In vitro release was performed and characterized by the power law. Nimodipine release from both types of formulations showed a controlled release profile and the two power law parameters, n and K, correlated to the viscosity of HPMC. The parameters were also influenced by the presence of SMES. For the controlled release solid SMES, oil droplets containing dissolved nimodipine diffused out of HPMC matrices following exposure to aqueous media. Thus, it is possible to control the in vitro release of poorly soluble drugs from solid oral dosage forms containing SMES.

Pluronic-Functionalized Silica-Lipid Hybrid Microparticles: Improving the Oral Delivery of Poorly Water-Soluble Weak Bases.

PubMed

Rao, Shasha; Richter, Katharina; Nguyen, Tri-Hung; Boyd, Ben J; Porter, Christopher J H; Tan, Angel; Prestidge, Clive A

2015-12-07

A Pluronic-functionalized silica-lipid hybrid (Plu-SLH) microparticle system for the oral delivery of poorly water-soluble, weak base drugs is reported for the first time. A highly effective Plu-SLH microparticle system was composed of Labrasol as the lipid phase, Pluronic F127 as the polymeric precipitation inhibitor (PPI), and silica nanoparticles as the solid carrier. For the model drug cinnarizine (CIN), the Plu-SLH delivery system was shown to offer significant biopharmaceutical advantages in comparison with unformulated drug and drug in the silica-lipid hybrid (SLH) system. In vitro two-phase dissolution studies illustrated significantly reduced pH provoked CIN precipitation and an 8- to 14-fold improvement in the extent of dissolution in intestinal conditions. In addition, under simulated intestinal digesting conditions, the Plu-SLH provided approximately three times more drug solubilization than the SLH. Oral administration in rats resulted in superior bioavailability for Plu-SLH microparticles, i.e., 1.6- and 2.1-fold greater than the SLH and the unformulated CIN, respectively. A physical mixture of Pluronic and SLH (Plu&SLH), having the same composition as Plu-SLH, was also evaluated, but showed no significant increase in CIN absorption when compared to unmodified CIN or SLH. This work represents the first study where different methods of incorporating PPI to formulate solid-state lipid-based formulations were compared for the impact on the biopharmaceutical performance. The data suggest that the novel physicochemical properties and structure of the fabricated Plu-SLH microparticle delivery system play an important role in facilitating the synergistic advantage of Labrasol and Pluronic F127 in preventing drug precipitation, and the Plu-SLH provides efficient oral delivery of poorly water-soluble weak bases.

Diblock Terpolymers Are Tunable and pH Responsive Vehicles To Increase Hydrophobic Drug Solubility for Oral Administration.

PubMed

Tale, Swapnil; Purchel, Anatolii A; Dalsin, Molly C; Reineke, Theresa M

2017-11-06

Synthetic polymers offer tunable platforms to create new oral drug delivery vehicles (excipients) to increase solubility, supersaturation maintenance, and bioavailability of poorly aqueous soluble pharmaceutical candidates. Five well-defined diblock terpolymers were synthesized via reversible addition-fragmentation chain transfer polymerization (RAFT) and consist of a first block of either poly(ethylene-alt-propylene) (PEP), poly(N-isopropylacrylamide) (PNIPAm), or poly(N,N-diethylaminoethyl methacrylate) (PDEAEMA) and a second hydrophilic block consisting of a gradient copolymer of N,N-dimethylacrylamide (DMA) and 2-methacrylamidotrehalose (MAT). This family of diblock terpolymers offers hydrophobic, hydrophilic, or H-bonding functionalities to serve as noncovalent sites of drug binding. Drug-polymer spray dried dispersions (SDDs) were created with a model drug, probucol, and characterized by differential scanning calorimetry (DSC). These studies revealed that probucol crystallinity decreased with increasing H-bonding sites available in the polymer. The PNIPAm-b-P(DMA-grad-MAT) systems revealed the best performance at pH 6.5, where immediate probucol release and effective maintenance of 100% supersaturation was found, which is important for facilitating drug solubility in more neutral conditions (intestinal environment). However, the PDEAEMA-b-P(DMA-grad-MAT) system revealed poor probucol dissolution at pH 6.5 and 5.1. Alternatively, at an acidic pH of 3.1, a rapid and high dissolution profile and effective supersaturation maintenance of up to 90% of the drug was found, which could be useful for triggering drug release in acidic environments (stomach). The PEP-b-P(DMA-grad-MAT) system showed poor performance (only ∼20% of drug solubility at pH 6.5), which was attributed to the low solubility of the polymers in the dissolution media. This work demonstrates the utility of diblock terpolymers as a potential new excipient platform to optimize design parameters for triggered release and solubilizing hydrophobic drug candidates for oral delivery.

Evaluation of Mental Workload among ICU Ward's Nurses

PubMed Central

Mohammadi, Mohsen; Mazloumi, Adel; Kazemi, Zeinab; Zeraati, Hojat

2015-01-01

Background: High level of workload has been identified among stressors of nurses in intensive care units (ICUs). The present study investigated nursing workload and identified its influencing perfor­mance obstacles in ICUs. Methods: This cross-sectional study was conducted, in 2013, on 81 nurses working in ICUs in Imam Khomeini Hospital in Tehran, Iran. NASA-TLX was applied for assessment of workload. Moreover, ICUs Performance Obstacles Questionnaire was used to identify performance obstacles associated with ICU nursing. Results: Physical demand (mean=84.17) was perceived as the most important dimensions of workload by nurses. The most critical performance obstacles affecting workload included: difficulty in finding a place to sit down, hectic workplace, disorganized workplace, poor-conditioned equipment, waiting for using a piece of equipment, spending much time seeking for supplies in the central stock, poor quality of medical materials, delay in getting medications, unpredicted problems, disorganized central stock, outpatient surgery, spending much time dealing with family needs, late, inadequate, and useless help from nurse assistants, and ineffective morning rounds (P-value<0.05). Conclusion: Various performance obstacles are correlated with nurses' workload, affirms the significance of nursing work system characteristics. Interventions are recommended based on the results of this study in the work settings of nurses in ICUs. PMID:26933647

Designing Security-Hardened Microkernels For Field Devices

NASA Astrophysics Data System (ADS)

Hieb, Jeffrey; Graham, James

Distributed control systems (DCSs) play an essential role in the operation of critical infrastructures. Perimeter field devices are important DCS components that measure physical process parameters and perform control actions. Modern field devices are vulnerable to cyber attacks due to their increased adoption of commodity technologies and that fact that control networks are no longer isolated. This paper describes an approach for creating security-hardened field devices using operating system microkernels that isolate vital field device operations from untrusted network-accessible applications. The approach, which is influenced by the MILS and Nizza architectures, is implemented in a prototype field device. Whereas, previous microkernel-based implementations have been plagued by poor inter-process communication (IPC) performance, the prototype exhibits an average IPC overhead for protected device calls of 64.59 μs. The overall performance of field devices is influenced by several factors; nevertheless, the observed IPC overhead is low enough to encourage the continued development of the prototype.

A novel x-ray imaging system and its imaging performance

NASA Astrophysics Data System (ADS)

Yu, Chunyu; Chang, Benkang; Wang, Shiyun; Zhang, Junju; Yao, Xiao

2006-09-01

Since x-ray was discovered and applied to the imaging technology, the x-ray imaging techniques have experienced several improvements, from film-screen, x-ray image intensifier, CR to DR. To store and transmit the image information conveniently, the digital imaging is necessary for the imaging techniques in medicine and biology. Usually as the intensifying screen technique as for concerned, to get the digital image signals, the CCD was lens coupled directly to the screen, but which suffers from a loss of x-ray signal and resulted in the poor x-ray image perfonnance. Therefore, to improve the image performance, we joined the brightness intensifier, which, was named the Low Light Level (LLL) image intensifier in military affairs, between the intensifying screen and the CCD and designed the novel x-ray imaging system. This design method improved the image performance of the whole system thus decreased the x-ray dose. Comparison between two systems with and without the brightness intensifier was given in detail in this paper. Moreover, the main noise source of the image produced by the novel system was analyzed, and in this paper, the original images produced by the novel x-ray imaging system and the processed images were given respectively. It was clear that the image performance was satisfied and the x-ray imaging system can be used in security checking and many other nondestructive checking fields.

Accurate Monitoring and Fault Detection in Wind Measuring Devices through Wireless Sensor Networks

PubMed Central

Khan, Komal Saifullah; Tariq, Muhammad

2014-01-01

Many wind energy projects report poor performance as low as 60% of the predicted performance. The reason for this is poor resource assessment and the use of new untested technologies and systems in remote locations. Predictions about the potential of an area for wind energy projects (through simulated models) may vary from the actual potential of the area. Hence, introducing accurate site assessment techniques will lead to accurate predictions of energy production from a particular area. We solve this problem by installing a Wireless Sensor Network (WSN) to periodically analyze the data from anemometers installed in that area. After comparative analysis of the acquired data, the anemometers transmit their readings through a WSN to the sink node for analysis. The sink node uses an iterative algorithm which sequentially detects any faulty anemometer and passes the details of the fault to the central system or main station. We apply the proposed technique in simulation as well as in practical implementation and study its accuracy by comparing the simulation results with experimental results to analyze the variation in the results obtained from both simulation model and implemented model. Simulation results show that the algorithm indicates faulty anemometers with high accuracy and low false alarm rate when as many as 25% of the anemometers become faulty. Experimental analysis shows that anemometers incorporating this solution are better assessed and performance level of implemented projects is increased above 86% of the simulated models. PMID:25421739

A phase 1, randomized, controlled dose-escalation study of EP-1300 polyepitope DNA vaccine against Plasmodium falciparum malaria administered via electroporation.

PubMed

Spearman, Paul; Mulligan, Mark; Anderson, Evan J; Shane, Andi L; Stephens, Kathy; Gibson, Theda; Hartwell, Brooke; Hannaman, Drew; Watson, Nora L; Singh, Karnail

2016-11-04

Plasmodium falciparum malaria is one of the leading infectious causes of childhood mortality in Africa. EP-1300 is a polyepitope plasmid DNA vaccine expressing 38 cytotoxic T cell epitopes and 16 helper T cell epitopes derived from P. falciparum antigens expressed predominantly in the liver phase of the parasite's life cycle. We performed a phase 1 randomized, placebo-controlled, dose escalation clinical trial of the EP-1300 DNA vaccine administered via electroporation using the TriGrid Delivery System device (Ichor Medical Systems). Although the delivery of the EP-1300 DNA vaccine via electroporation was safe, tolerability was less than that usually observed with standard needle and syringe intramuscular administration. This was primarily due to acute local discomfort at the administration site during electroporation. Despite the use of electroporation, the vaccine was poorly immunogenic. The reasons for the poor immunogenicity of this polyepitope DNA vaccine remain uncertain. ClinicalTrials.gov NCT01169077. Copyright © 2016 Elsevier Ltd. All rights reserved.

Why Rural Community Day Secondary Schools Students' Performance in Physical Science Examinations Is Poor in Lilongwe Rural West Education District in Malawi

ERIC Educational Resources Information Center

Mlangeni, Angstone Noel J. Thembachako; Chiotha, Sosten Staphael

2015-01-01

A study was conducted to investigate factors that affect students' poor performance in physical science examinations at Malawi School Certificate of Education and Junior Certificate of Education levels in Community day secondary schools (CDSS) in Lilongwe Rural West Education District in Malawi. Students' performance was collected from schools'…

Is Self-Worth Protection Best Regarded as Intentional Self-Handicapping Behaviour or an Outcome of Choking under Pressure?

ERIC Educational Resources Information Center

Thompson, Ted; Dinnel, Dale L.

2007-01-01

Self-worth protective students characteristically perform poorly when they anticipate that poor performance is likely to reveal low ability, yet perform well in situations that involve little threat to self-worth. The present study sought a further understanding of this variable pattern of achievement, assessing two possibilities: (1) that the…

CameraHRV: robust measurement of heart rate variability using a camera

NASA Astrophysics Data System (ADS)

Pai, Amruta; Veeraraghavan, Ashok; Sabharwal, Ashutosh

2018-02-01

The inter-beat-interval (time period of the cardiac cycle) changes slightly for every heartbeat; this variation is measured as Heart Rate Variability (HRV). HRV is presumed to occur due to interactions between the parasym- pathetic and sympathetic nervous system. Therefore, it is sometimes used as an indicator of the stress level of an individual. HRV also reveals some clinical information about cardiac health. Currently, HRV is accurately measured using contact devices such as a pulse oximeter. However, recent research in the field of non-contact imaging Photoplethysmography (iPPG) has made vital sign measurements using just the video recording of any exposed skin (such as a person's face) possible. The current signal processing methods for extracting HRV using peak detection perform well for contact-based systems but have poor performance for the iPPG signals. The main reason for this poor performance is the fact that current methods are sensitive to large noise sources which are often present in iPPG data. Further, current methods are not robust to motion artifacts that are common in iPPG systems. We developed a new algorithm, CameraHRV, for robustly extracting HRV even in low SNR such as is common with iPPG recordings. CameraHRV combined spatial combination and frequency demodulation to obtain HRV from the instantaneous frequency of the iPPG signal. CameraHRV outperforms other current methods of HRV estimation. Ground truth data was obtained from FDA-approved pulse oximeter for validation purposes. CameraHRV on iPPG data showed an error of 6 milliseconds for low motion and varying skin tone scenarios. The improvement in error was 14%. In case of high motion scenarios like reading, watching and talking, the error was 10 milliseconds.

Advancing land surface model development with satellite-based Earth observations

NASA Astrophysics Data System (ADS)

Orth, Rene; Dutra, Emanuel; Trigo, Isabel F.; Balsamo, Gianpaolo

2017-04-01

The land surface forms an essential part of the climate system. It interacts with the atmosphere through the exchange of water and energy and hence influences weather and climate, as well as their predictability. Correspondingly, the land surface model (LSM) is an essential part of any weather forecasting system. LSMs rely on partly poorly constrained parameters, due to sparse land surface observations. With the use of newly available land surface temperature observations, we show in this study that novel satellite-derived datasets help to improve LSM configuration, and hence can contribute to improved weather predictability. We use the Hydrology Tiled ECMWF Scheme of Surface Exchanges over Land (HTESSEL) and validate it comprehensively against an array of Earth observation reference datasets, including the new land surface temperature product. This reveals satisfactory model performance in terms of hydrology, but poor performance in terms of land surface temperature. This is due to inconsistencies of process representations in the model as identified from an analysis of perturbed parameter simulations. We show that HTESSEL can be more robustly calibrated with multiple instead of single reference datasets as this mitigates the impact of the structural inconsistencies. Finally, performing coupled global weather forecasts we find that a more robust calibration of HTESSEL also contributes to improved weather forecast skills. In summary, new satellite-based Earth observations are shown to enhance the multi-dataset calibration of LSMs, thereby improving the representation of insufficiently captured processes, advancing weather predictability and understanding of climate system feedbacks. Orth, R., E. Dutra, I. F. Trigo, and G. Balsamo (2016): Advancing land surface model development with satellite-based Earth observations. Hydrol. Earth Syst. Sci. Discuss., doi:10.5194/hess-2016-628

Toward the establishment of standardized in vitro tests for lipid-based formulations, part 1: method parameterization and comparison of in vitro digestion profiles across a range of representative formulations.

PubMed

Williams, Hywel D; Sassene, Philip; Kleberg, Karen; Bakala-N'Goma, Jean-Claude; Calderone, Marilyn; Jannin, Vincent; Igonin, Annabel; Partheil, Anette; Marchaud, Delphine; Jule, Eduardo; Vertommen, Jan; Maio, Mario; Blundell, Ross; Benameur, Hassan; Carrière, Frédéric; Müllertz, Anette; Porter, Christopher J H; Pouton, Colin W

2012-09-01

The Lipid Formulation Classification System Consortium is an industry-academia collaboration, established to develop standardized in vitro methods for the assessment of lipid-based formulations (LBFs). In this first publication, baseline conditions for the conduct of digestion tests are suggested and a series of eight model LBFs are described to probe test performance across different formulation types. Digestion experiments were performed in vitro using a pH-stat apparatus and danazol employed as a model poorly water-soluble drug. LBF digestion (rate and extent) and drug solubilization patterns on digestion were examined. To evaluate cross-site reproducibility, experiments were conducted at two sites and highly consistent results were obtained. In a further refinement, bench-top centrifugation was explored as a higher throughput approach to separation of the products of digestion (and compared with ultracentrifugation), and conditions under which this method was acceptable were defined. Drug solubilization was highly dependent on LBF composition, but poorly correlated with simple performance indicators such as dispersion efficiency, confirming the utility of the digestion model as a means of formulation differentiation. Copyright © 2012 Wiley Periodicals, Inc.

Upper Limb Coordination in Individuals With Stroke: Poorly Defined and Poorly Quantified.

PubMed

Tomita, Yosuke; Rodrigues, Marcos R M; Levin, Mindy F

2017-01-01

The identification of deficits in interjoint coordination is important in order to better focus upper limb rehabilitative treatment after stroke. The majority of standardized clinical measures characterize endpoint performance, such as accuracy, speed, and smoothness, based on the assumption that endpoint performance reflects interjoint coordination, without measuring the underlying temporal and spatial sequences of joint recruitment directly. However, this assumption is questioned since improvements of endpoint performance can be achieved through different degrees of restitution or compensation of upper limb motor impairments based on the available kinematic redundancy of the system. Confusion about adequate measurement may stem from a lack a definition of interjoint coordination during reaching. We suggest an operational definition of interjoint coordination during reaching as a goal-oriented process in which joint degrees of freedom are organized in both spatial and temporal domains such that the endpoint reaches a desired location in a context-dependent manner. In this point-of-view article, we consider how current approaches to laboratory and clinical measures of coordination comply with our definition. We propose future study directions and specific research strategies to develop clinical measures of interjoint coordination with better construct and content validity than those currently in use.

The innovation value chain.

PubMed

Hansen, Morten T; Birkinshaw, Julian

2007-06-01

The challenges of coming up with fresh ideas and realizing profits from them are different for every company. One firm may excel at finding good ideas but may have weak systems for bringing them to market. Another organization may have a terrific process for funding and rolling out new products and services but a shortage of concepts to develop. In this article, Hansen and Birkinshaw caution executives against using the latest and greatest innovation approaches and tools without understanding the unique deficiencies in their companies' innovation systems. They offer a framework for evaluating innovation performance: the innovation value chain. It comprises the three main phases of innovation (idea generation, conversion, and diffusion) as well as the critical activities performed during those phases (looking for ideas inside your unit; looking for them in other units; looking for them externally; selecting ideas; funding them; and promoting and spreading ideas companywide). Using this framework, managers get an end-to-end view of their innovation efforts. They can pinpoint their weakest links and tailor innovation best practices appropriately to strengthen those links. Companies typically succumb to one of three broad "weakest-link" scenarios. They are idea poor, conversion poor, or diffusion poor. The article looks at the ways smart companies - including Intuit, P&G, Sara Lee, Shell, and Siemens- modify the best innovation practices and apply them to address those organizations' individual needs and flaws. The authors warn that adopting the chain-based view of innovation requires new measures of what can be delivered by each link in the chain. The approach also entails new roles for employees "external scouts" and "internal evangelists," for example. Indeed, in their search for new hires, companies should seek out those candidates who can help address particular weaknesses in the innovation value chain.

High Performance of Supercapacitor from PEDOT:PSS Electrode and Redox Iodide Ion Electrolyte

PubMed Central

Gao, Xing; Zu, Lei; Cai, Xiaomin; Li, Ce; Lian, Huiqin; Liu, Yang; Wang, Xiaodong; Cui, Xiuguo

2018-01-01

Insufficient energy density and poor cyclic stability is still challenge for conductive polymer-based supercapacitor. Herein, high performance electrochemical system has been assembled by combining poly (3,4-ethylenedioxythiophene) (PEDOT):poly (styrene sulfonate) (PSS) redox electrode and potassium iodide redox electrolyte, which provide the maximum specific capacity of 51.3 mAh/g and the retention of specific capacity of 87.6% after 3000 cycles due to the synergic effect through a simultaneous redox reaction both in electrode and electrolyte, as well as the catalytic activity for reduction of triiodide of the PEDOT:PSS. PMID:29772662

Can a poverty-reducing and progressive tax and transfer system hurt the poor?

PubMed

Higgins, Sean; Lustig, Nora

2016-09-01

To analyze anti-poverty policies in tandem with the taxes used to pay for them, comparisons of poverty before and after taxes and transfers are often used. We show that these comparisons, as well as measures of horizontal equity and progressivity, can fail to capture an important aspect: that a substantial proportion of the poor are made poorer (or non-poor made poor) by the tax and transfer system. We illustrate with data from seventeen developing countries: in fifteen, the fiscal system is poverty-reducing and progressive, but in ten of these at least one-quarter of the poor pay more in taxes than they receive in transfers. We call this fiscal impoverishment, and axiomatically derive a measure of its extent. An analogous measure of fiscal gains of the poor is also derived, and we show that changes in the poverty gap can be decomposed into our axiomatic measures of fiscal impoverishment and gains.

Prognostic risk stratification derived from individual patient level data for men with advanced penile squamous cell carcinoma receiving first-line systemic therapy.

PubMed

Pond, Gregory R; Di Lorenzo, Giuseppe; Necchi, Andrea; Eigl, Bernhard J; Kolinsky, Michael P; Chacko, Raju T; Dorff, Tanya B; Harshman, Lauren C; Milowsky, Matthew I; Lee, Richard J; Galsky, Matthew D; Federico, Piera; Bolger, Graeme; DeShazo, Mollie; Mehta, Amitkumar; Goyal, Jatinder; Sonpavde, Guru

2014-05-01

Prognostic factors in men with penile squamous cell carcinoma (PSCC) receiving systemic therapy are unknown. A prognostic classification system in this disease may facilitate interpretation of outcomes and guide rational drug development. We performed a retrospective analysis to identify prognostic factors in men with PSCC receiving first-line systemic therapy for advanced disease. Individual patient level data were obtained from 13 institutions to study prognostic factors in the context of first-line systemic therapy for advanced PSCC. Cox proportional hazards regression analysis was conducted to examine the prognostic effect of these candidate factors on progression-free survival (PFS) and overall survival (OS): age, stage, hemoglobin, neutrophil count, lymphocyte count, albumin, site of metastasis (visceral or nonvisceral), smoking, circumcision, regimen, ECOG performance status (PS), lymphovascular invasion, precancerous lesion, and surgery following chemotherapy. The effect of different treatments was then evaluated adjusting for factors in the prognostic model. The study included 140 eligible men. Mean age across all men was 57.0 years. Among them, 8.6%, 21.4%, and 70.0% of patients had stage 2, 3, and 4 diseases, respectively; 40.7% had ECOG PS ≥ 1, 47.4% had visceral metastases, and 73.6% received cisplatin-based chemotherapy. The multivariate model of poor prognostic factors included visceral metastases (P<0.001) and ECOG PS ≥ 1 (P<0.001) for both PFS and OS. A risk stratification model constructed with 0, 1, and both poor prognostic factors was internally validated and demonstrated moderate discriminatory ability (c-statistic of 0.657 and 0.677 for OS and PFS, respectively). The median OS for the entire population was 9 months. Median OS was not reached, 8, and 7 months for those with 0, 1, and both risk factors, respectively. Cisplatin-based regimens were associated with better OS (P = 0.017) but not PFS (P = 0.37) compared with noncisplatin-based regimens after adjusting for the 2 prognostic factors. In men with advanced PSCC receiving first-line systemic therapy, visceral metastases and ECOG PS ≥ 1 were poor prognostic factors. A prognostic model including these factors exhibited moderate discriminatory ability for outcomes and warrants external validation. Patients receiving cisplatin-based regimens exhibited better outcomes compared with noncisplatin-based regimens after adjusting for prognostic factors. © 2013 Published by Elsevier Inc.

Can crystal engineering be as beneficial as micronisation and overcome its pitfalls?: A case study with cilostazol.

PubMed

Sai Gouthami, Kodukula; Kumar, Dinesh; Thipparaboina, Rajesh; Chavan, Rahul B; Shastri, Nalini R

2015-08-01

Improvement in dissolution of the drugs having poor solubility is a challenge in pharmaceutical industry. Micronization is one technique, employed for dissolution enhancement of cilostazol, a BCS class II drug. However, the obtained micronized drug possesses poor flowability. The aim of this study was to improve the dissolution rate and flow properties of cilostazol by crystal engineering, using habit modification method and compare with micronized cilostazol bulk drug. Simulation studies were performed to predict the effect of solvents on cilostazol crystal habit. Cilostazol crystals with different habits were prepared by solvent:anti-solvent crystallization technique. SEM, FTIR, DSC, TGA and PXRD were used for solid state characterization. The results revealed that cilostazol re-crystallized from methanol-hexane system were hexagonal and ethanol-hexane system gave rods. Cilostazol engineered habits showed increased dissolution rate than unprocessed drug but similar dissolution rate when compared to micronized cilostazol. Micronized cilostazol showed a dissolution efficiency of 75.58% where as cilostazol recrystallized from methanol-hexane and ethanol-hexane systems resulted in a dissolution efficiency of 72.63% and 68.63%, respectively. In addition, crystal engineering resulted in improved flow properties of re-crystallized habits when compared to micronized form of the drug. In conclusion, crystal engineering by habit modification show potential for dissolution enhancement with an added advantage of improved flow properties over micronization technique, for poorly soluble drugs like cilostazol. Copyright © 2015 Elsevier B.V. All rights reserved.

GPU-Accelerated Forward and Back-Projections with Spatially Varying Kernels for 3D DIRECT TOF PET Reconstruction.

PubMed

Ha, S; Matej, S; Ispiryan, M; Mueller, K

2013-02-01

We describe a GPU-accelerated framework that efficiently models spatially (shift) variant system response kernels and performs forward- and back-projection operations with these kernels for the DIRECT (Direct Image Reconstruction for TOF) iterative reconstruction approach. Inherent challenges arise from the poor memory cache performance at non-axis aligned TOF directions. Focusing on the GPU memory access patterns, we utilize different kinds of GPU memory according to these patterns in order to maximize the memory cache performance. We also exploit the GPU instruction-level parallelism to efficiently hide long latencies from the memory operations. Our experiments indicate that our GPU implementation of the projection operators has slightly faster or approximately comparable time performance than FFT-based approaches using state-of-the-art FFTW routines. However, most importantly, our GPU framework can also efficiently handle any generic system response kernels, such as spatially symmetric and shift-variant as well as spatially asymmetric and shift-variant, both of which an FFT-based approach cannot cope with.

GPU-Accelerated Forward and Back-Projections With Spatially Varying Kernels for 3D DIRECT TOF PET Reconstruction

NASA Astrophysics Data System (ADS)

Ha, S.; Matej, S.; Ispiryan, M.; Mueller, K.

2013-02-01

We describe a GPU-accelerated framework that efficiently models spatially (shift) variant system response kernels and performs forward- and back-projection operations with these kernels for the DIRECT (Direct Image Reconstruction for TOF) iterative reconstruction approach. Inherent challenges arise from the poor memory cache performance at non-axis aligned TOF directions. Focusing on the GPU memory access patterns, we utilize different kinds of GPU memory according to these patterns in order to maximize the memory cache performance. We also exploit the GPU instruction-level parallelism to efficiently hide long latencies from the memory operations. Our experiments indicate that our GPU implementation of the projection operators has slightly faster or approximately comparable time performance than FFT-based approaches using state-of-the-art FFTW routines. However, most importantly, our GPU framework can also efficiently handle any generic system response kernels, such as spatially symmetric and shift-variant as well as spatially asymmetric and shift-variant, both of which an FFT-based approach cannot cope with.

Scaling up antiretroviral therapy in Uganda: using supply chain management to appraise health systems strengthening

PubMed Central

2011-01-01

Background Strengthened national health systems are necessary for effective and sustained expansion of antiretroviral therapy (ART). ART and its supply chain management in Uganda are largely based on parallel and externally supported efforts. The question arises whether systems are being strengthened to sustain access to ART. This study applies systems thinking to assess supply chain management, the role of external support and whether investments create the needed synergies to strengthen health systems. Methods This study uses the WHO health systems framework and examines the issues of governance, financing, information, human resources and service delivery in relation to supply chain management of medicines and the technologies. It looks at links and causal chains between supply chain management for ART and the national supply system for essential drugs. It combines data from the literature and key informant interviews with observations at health service delivery level in a study district. Results Current drug supply chain management in Uganda is characterized by parallel processes and information systems that result in poor quality and inefficiencies. Less than expected health system performance, stock outs and other shortages affect ART and primary care in general. Poor performance of supply chain management is amplified by weak conditions at all levels of the health system, including the areas of financing, governance, human resources and information. Governance issues include the lack to follow up initial policy intentions and a focus on narrow, short-term approaches. Conclusion The opportunity and need to use ART investments for an essential supply chain management and strengthened health system has not been exploited. By applying a systems perspective this work indicates the seriousness of missing system prerequisites. The findings suggest that root causes and capacities across the system have to be addressed synergistically to enable systems that can match and accommodate investments in disease-specific interventions. The multiplicity and complexity of existing challenges require a long-term and systems perspective essentially in contrast to the current short term and program-specific nature of external assistance. PMID:21806826

Poor decision-making by chronic marijuana users is associated with decreased functional responsiveness to negative consequences.

PubMed

Wesley, Michael J; Hanlon, Colleen A; Porrino, Linda J

2011-01-30

Chronic marijuana users (MJ Users) perform poorly on the Iowa Gambling Task (IGT), a complex decision-making task in which monetary wins and losses guide strategy development. This functional magnetic resonance imaging (MRI) study sought to determine if the poor performance of MJ Users was related to differences in brain activity while evaluating wins and losses during the strategy development phase of the IGT. MJ Users (16) and Controls (16) performed a modified IGT in an MRI scanner. Performance was tracked and functional activity in response to early wins and losses was examined. While the MJ Users continued to perform poorly at the end of the task, there was no difference in group performance during the initial strategy development phase. During this phase, before the emergence of behavioral differences, Controls exhibited significantly greater activity in response to losses in the anterior cingulate cortex, medial frontal cortex, precuneus, superior parietal lobe, occipital lobe and cerebellum as compared to MJ Users. Furthermore, in Controls, but not MJ Users, the functional response to losses in the anterior cingulate cortex, ventral medial prefrontal cortex and rostral prefrontal cortex positively correlated with performance over time. These data suggest MJ Users are less sensitive to negative feedback during strategy development. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Statistical Exposé of a Multiple-Compartment Anaerobic Reactor Treating Domestic Wastewater.

PubMed

Pfluger, Andrew R; Hahn, Martha J; Hering, Amanda S; Munakata-Marr, Junko; Figueroa, Linda

2018-06-01

  Mainstream anaerobic treatment of domestic wastewater is a promising energy-generating treatment strategy; however, such reactors operated in colder regions are not well characterized. Performance data from a pilot-scale, multiple-compartment anaerobic reactor taken over 786 days were subjected to comprehensive statistical analyses. Results suggest that chemical oxygen demand (COD) was a poor proxy for organics in anaerobic systems as oxygen demand from dissolved inorganic material, dissolved methane, and colloidal material influence dissolved and particulate COD measurements. Additionally, univariate and functional boxplots were useful in visualizing variability in contaminant concentrations and identifying statistical outliers. Further, significantly different dissolved organic removal and methane production was observed between operational years, suggesting that anaerobic reactor systems may not achieve steady-state performance within one year. Last, modeling multiple-compartment reactor systems will require data collected over at least two years to capture seasonal variations of the major anaerobic microbial functions occurring within each reactor compartment.

Impact of familiar and unfamiliar settings on cooking task assessments in frail older adults with poor and preserved executive functions.

PubMed

Provencher, Véronique; Demers, Louise; Gagnon, Lise; Gélinas, Isabelle

2012-05-01

Hospitalized frail older patients are usually assessed for their ability to perform some daily living activities in a clinical setting prior to discharge. However, assessments that take place in this unfamiliar environment might not be as representative of their functional performance as assessments at home. This may be related to a decline in some cognitive components, such as executive functions (EF), which enable one to cope with new environments. This study thus aims to compare cooking task performance in familiar and unfamiliar settings in a population of frail older adults with poor and preserved EF. Thirty-seven frail older adults were assigned to one of two groups: poor EF or preserved EF. Participants performed two cooking tasks in familiar and unfamiliar settings, using a counterbalanced design. Their performance was assessed with a reliable tool based on observation of motor and process skills (Assessment of Motor and Process Skills). Thirty-three participants were retained for analysis. They demonstrated significantly better motor skills (F = 5.536; p = 0.025) and process skills (F = 8.149; p = 0.008) in the familiar setting. The difference between settings was particularly marked for process skills in participants with poor EF (F = 16.920; p < 0.001). This study suggests that a home setting may be preferable for a more accurate assessment of cooking task performance in frail older adults, especially those with poor EF. These findings highlight the risk of underestimating frail older adults' performance when assessed in an unfamiliar setting (e.g. hospital), which could lead to inefficient allocation of home care services.

Performance of Cleared Blood Glucose Monitors.

PubMed

Klonoff, David C; Prahalad, Priya

2015-07-01

Cleared blood glucose monitor (BGM) systems do not always perform as accurately for users as they did to become cleared. We performed a literature review of recent publications between 2010 and 2014 that present data about the frequency of inaccurate performance using ISO 15197 2003 and ISO 15197 2013 as target standards. We performed an additional literature review of publications that present data about the clinical and economic risks of inaccurate BGMs for making treatment decisions or calibrating continuous glucose monitors (CGMs). We found 11 publications describing performance of 98 unique BGM systems. 53 of these 98 (54%) systems met ISO 15197 2003 and 31 of the 98 (32%) tested systems met ISO 15197 2013 analytical accuracy standards in all studies in which they were evaluated. Of the tested systems, 33 were identified by us as FDA-cleared. Among these FDA-cleared BGM systems, 24 out of 32 (75%) met ISO 15197 2003 and 15 out of 31 (48.3%) met ISO 15197 2013 in all studies in which they were evaluated. Among the non-FDA-cleared BGM systems, 29 of 65 (45%) met ISO 15197 2003 and 15 out of 65 (23%) met ISO 15197 2013 in all studies in which they were evaluated. It is more likely that an FDA-cleared BGM system, compared to a non-FDA-cleared BGM system, will perform according to ISO 15197 2003 (χ(2) = 6.2, df = 3, P = 0.04) and ISO 15197 2013 (χ(2) = 11.4, df = 3, P = 0.003). We identified 7 articles about clinical risks and 3 articles about economic risks of inaccurate BGMs. We conclude that a significant proportion of cleared BGMs do not perform at the level for which they were cleared or according to international standards of accuracy. Such poor performance leads to adverse clinical and economic consequences. © 2015 Diabetes Technology Society.

Evaluation of Passive Vents in New Construction Multifamily Buildings

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

Maxwell, Sean; Berger, David; Zuluaga, Marc

Exhaust ventilation and corresponding outdoor air strategies are being implemented in high-performance new construction multifamily buildings to meet program or code requirements for improved indoor air quality, but a lack of clear design guidance is resulting in poor performance of these systems despite the best intentions of the programs or standards. CARB's 2014 'Evaluation of Ventilation Strategies in New Construction Multifamily Buildings' consistently demonstrated that commonly used outdoor air strategies are not performing as expected. Of the four strategies evaluated in 2014, the exhaust ventilation system that relied on outdoor air from a pressurized corridor was ruled out as amore » potential best practice due to its conflict with meeting requirements within most fire codes. Outdoor air that is ducted directly to the apartments was a strategy determined to have the highest likelihood of success, but with higher first costs and operating costs. Outdoor air through space conditioning systems was also determined to have good performance potential, with proper design and execution. The fourth strategy, passive systems, was identified as the least expensive option for providing outdoor air directly to apartments, with respect to both first costs and operating costs. However, little is known about how they actually perform in real-world conditions or how to implement them effectively. Based on the lack of data available on the performance of these low-cost systems and their frequent use in the high-performance building programs that require a provision for outdoor air, this research project sought to further evaluate the performance of passive vents.« less

Building America Case Study: Evaluation of Passive Vents in New-Construction Multifamily Buildings, New York, New York

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

Exhaust ventilation and corresponding outdoor air strategies are being implemented in high-performance new construction multifamily buildings to meet program or code requirements for improved indoor air quality, but a lack of clear design guidance is resulting in poor performance of these systems despite the best intentions of the programs or standards. CARB's 2014 'Evaluation of Ventilation Strategies in New Construction Multifamily Buildings' consistently demonstrated that commonly used outdoor air strategies are not performing as expected. Of the four strategies evaluated in 2014, the exhaust ventilation system that relied on outdoor air from a pressurized corridor was ruled out as amore » potential best practice due to its conflict with meeting requirements within most fire codes. Outdoor air that is ducted directly to the apartments was a strategy determined to have the highest likelihood of success, but with higher first costs and operating costs. Outdoor air through space conditioning systems was also determined to have good performance potential, with proper design and execution. The fourth strategy, passive systems, was identified as the least expensive option for providing outdoor air directly to apartments, with respect to both first costs and operating costs. However, little is known about how they actually perform in real-world conditions or how to implement them effectively. Based on the lack of data available on the performance of these low-cost systems and their frequent use in the high-performance building programs that require a provision for outdoor air, this research project sought to further evaluate the performance of passive vents.« less

Frequency of and risk factors for poor cognitive performance in hemodialysis patients

USDA-ARS?s Scientific Manuscript database

There are few detailed data on cognition in patients undergoing dialysis. We evaluated the frequency of and risk factors for poor cognitive performance using detailed neurocognitive testing. In this cross-sectional cohort study, 314 hemodialysis patients from 6 Boston-area hemodialysis units underwe...

Confronting Poor Performance.

ERIC Educational Resources Information Center

Dennis, Bruce L.

Responsible and effective administrative leadership requires confronting those members of the teaching staff who are a negative influence on the institution. Importantly, the absence of expressed appreciation for good work can have a devastating impact on a principal's image if he or she suddenly begins to confront poor performances. Actually, the…

Bringing a Time-Depth Perspective to Collective Animal Behaviour.

PubMed

Biro, Dora; Sasaki, Takao; Portugal, Steven J

2016-07-01

The field of collective animal behaviour examines how relatively simple, local interactions between individuals in groups combine to produce global-level outcomes. Existing mathematical models and empirical work have identified candidate mechanisms for numerous collective phenomena but have typically focused on one-off or short-term performance. We argue that feedback between collective performance and learning - giving the former the capacity to become an adaptive, and potentially cumulative, process - is a currently poorly explored but crucial mechanism in understanding collective systems. We synthesise material ranging from swarm intelligence in social insects through collective movements in vertebrates to collective decision making in animal and human groups, to propose avenues for future research to identify the potential for changes in these systems to accumulate over time. Copyright © 2016 Elsevier Ltd. All rights reserved.

Utilizing feedback in adaptive SAR ATR systems

NASA Astrophysics Data System (ADS)

Horsfield, Owen; Blacknell, David

2009-05-01

Existing SAR ATR systems are usually trained off-line with samples of target imagery or CAD models, prior to conducting a mission. If the training data is not representative of mission conditions, then poor performance may result. In addition, it is difficult to acquire suitable training data for the many target types of interest. The Adaptive SAR ATR Problem Set (AdaptSAPS) program provides a MATLAB framework and image database for developing systems that adapt to mission conditions, meaning less reliance on accurate training data. A key function of an adaptive system is the ability to utilise truth feedback to improve performance, and it is this feature which AdaptSAPS is intended to exploit. This paper presents a new method for SAR ATR that does not use training data, based on supervised learning. This is achieved by using feature-based classification, and several new shadow features have been developed for this purpose. These features allow discrimination of vehicles from clutter, and classification of vehicles into two classes: targets, comprising military combat types, and non-targets, comprising bulldozers and trucks. The performance of the system is assessed using three baseline missions provided with AdaptSAPS, as well as three additional missions. All performance metrics indicate a distinct learning trend over the course of a mission, with most third and fourth quartile performance levels exceeding 85% correct classification. It has been demonstrated that these performance levels can be maintained even when truth feedback rates are reduced by up to 55% over the course of a mission.

Maternal Health Situation in Bihar and Madhya Pradesh: A Comparative Analysis of State Fact Sheets of National Family Health Survey (NFHS)-3 and 4.

PubMed

Dehury, Ranjit Kumar; Samal, Janmejaya

2016-09-01

Maternal health constitutes the health of women during pregnancy, childbirth and the postpartum period. Bihar and Madhya Pradesh (MP) constitute the Empowered Action Group (EAG) states under National Rural Health Mission (NRHM) and are consistently having poor maternal health indicators. The main objective of this study was to assess the maternal health situation of Bihar and MP based on National Family Health Survey (NFHS-3) and 4 fact sheets. The study adopted a narrative description in which the NFHS fact sheets (NFHS-3 & 4) of both these states were obtained from appropriate sources and compared for various maternal health indicators. Albeit progress has been observed from NFHS-3 to NFHS-4 however, the progress is very dismal compared with the progress of other similar Indian states. Relatively MP has shown better progress compared to Bihar. Poor performance is being observed in all the three levels of maternal health; pregnancy {Ante-Natal Care (ANC), Tetanus toxoid (TT) and Iron and Folic Acid (IFA)}, child birth (Institutional delivery by Skilled Birth Attendant (SBA), Caesarean Section (CS) and post partum care (hospital stay and Janani Suraksha Yojna (JSY). The poor performance of both these states in all these indicators requires multipronged approach strong political will, health system strengthening, community mobilization and awareness. Given the status of maternal health in India and more especially in states BIMARU (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh) and EAG states (Empowered action group), improvement in the performance of maternal health related activities is highly necessary.

Does adding clinical data to administrative data improve agreement among hospital quality measures?

PubMed

Hanchate, Amresh D; Stolzmann, Kelly L; Rosen, Amy K; Fink, Aaron S; Shwartz, Michael; Ash, Arlene S; Abdulkerim, Hassen; Pugh, Mary Jo V; Shokeen, Priti; Borzecki, Ann

2017-09-01

Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA). For patients admitted for acute myocardial infarction (AMI), heart failure (HF) and pneumonia we examined changes in hospital performance on 30-d mortality and 30-d readmission rates as a result of adding clinical data to administrative data. We evaluated whether this enhancement yielded improved measures of hospital quality, based on concordance with other hospital quality indicators. For 30-d mortality, data enhancement improved model performance, and significantly changed hospital performance profiles; for 30-d readmission, the impact was modest. Concordance between enhanced measures of both outcomes, and with other hospital quality measures - including Joint Commission process measures, VA Surgical Quality Improvement Program (VASQIP) mortality and morbidity, and case volume - remained poor. Adding laboratory tests and vital signs to measure hospital performance on mortality and readmission did not improve the poor rates of agreement across hospital quality indicators in the VA. Efforts to improve risk adjustment models should continue; however, evidence of validation should precede their use as reliable measures of quality. Published by Elsevier Inc.

Effects of nicergoline on age-related decrements in radial maze performance and acetylcholine levels.

PubMed

McArthur, R A; Carfagna, N; Banfi, L; Cavanus, S; Cervini, M A; Fariello, R; Post, C

1997-01-01

The effects of chronic oral administration of nicergoline (5.0 mg/kg; bid) on locomotor activity, eight-arm radial maze performance plus striatal, cortical, and hippocampal acetylcholine (ACh) levels were examined in young and aged Wistar rats. Chronic nicergoline administration did not modify either the locomotor activity or radial maze learning in young rats. Young rats learned the radial maze procedure rapidly and improved their performance throughout the successive training sessions. Radial maze performance in young rats was characterised by very few arm reentries. Aged rats were hypoactive and did not explore or enter the radial maze arms, and consequently performed poorly in the radial maze throughout the training sessions. Nicergoline treatment did not significantly modify locomotor activity in aged rats. Aged rats treated with nicergoline also performed poorly initially but improved with repeated training in the radial maze. This improvement was associated with an increasing number of arms being entered and very few arm reentries. Reduced acetylcholine (ACh) levels were also associated with age. Aged rats had significantly reduced levels of ACh in the straitum and cortex, but not the hippocampus as compared to young rats. Nicergoline treatment did not change ACh levels in young rats, but substantially restored the reduced ACh levels in aged rats. These results indicate that nicergoline is an effective cognitive enhancer in a learning model of age-related deficits and that these results may be related to changes in the cholinergic system.

Design of Grid Portal System Based on RIA

NASA Astrophysics Data System (ADS)

Cao, Caifeng; Luo, Jianguo; Qiu, Zhixin

Grid portal is an important branch of grid research. In order to solve the weak expressive force, the poor interaction, the low operating efficiency and other insufficiencies of the first and second generation of grid portal system, RIA technology was introduced to it. A new portal architecture was designed based on RIA and Web service. The concrete realizing scheme of portal system was presented by using Adobe Flex/Flash technology, which formed a new design pattern. In system architecture, the design pattern has B/S and C/S superiorities, balances server and its client side, optimizes the system performance, realizes platform irrelevance. In system function, the design pattern realizes grid service call, provides client interface with rich user experience, integrates local resources by using FABridge, LCDS, Flash player and some other components.

Reducing failures of working memory with performance feedback.

PubMed

Adam, Kirsten C S; Vogel, Edward K

2016-10-01

Fluctuations in attentional control can lead to failures of working memory (WM), in which the subject is no better than chance at reporting items from a recent display. In three experiments, we used a whole-report measure of visual WM to examine the impact of feedback on the rate of failures. In each experiment, subjects remembered an array of colored items across a blank delay, and then reported the identity of items using a whole-report procedure. In Experiment 1, we gave subjects simple feedback about the number of items they correctly identified at the end of each trial. In Experiment 2, we gave subjects additional information about the cumulative number of items correctly identified within each block. Finally, in Experiment 3, we gave subjects weighted feedback in which poor trials resulted in lost points and consistent successful performance received "streak" points. Surprisingly, simple feedback (Exp. 1) was ineffective at improving average performance or decreasing the rate of poor-performance trials. Simple cumulative feedback (Exp. 2) modestly decreased poor-performance trials (by 7 %). Weighted feedback produced the greatest benefits, decreasing the frequency of poor-performance trials by 28 % relative to baseline performance. This set of results demonstrates the usefulness of whole-report WM measures for investigating the effects of feedback on WM performance. Further, we showed that only a feedback structure that specifically discouraged lapses using negative feedback led to large reductions in WM failures.

Performance and Maqasid al-Shari'ah's Pentagon-Shaped Ethical Measurement.

PubMed

Bedoui, Houssem Eddine; Mansour, Walid

2015-06-01

Business performance is traditionally viewed from the one-dimensional financial angle. This paper develops a new approach that links performance to the ethical vision of Islam based on maqasid al-shari'ah (i.e., the objectives of Islamic law). The approach involves a Pentagon-shaped performance scheme structure via five pillars, namely wealth, posterity, intellect, faith, and human self. Such a scheme ensures that any firm or organization can ethically contribute to the promotion of human welfare, prevent corruption, and enhance social and economic stability and not merely maximize its own performance in terms of its financial return. A quantitative measure of ethical performance is developed. It surprisingly shows that a firm or organization following only the financial aspect at the expense of the others performs poorly. This paper discusses further the practical instances of the quantitative measurement of the ethical aspects of the system taken at an aggregate level.

77 FR 9876 - Proposed Modification of VOR Federal Airways V-10, V-12, and V-508 in the Vicinity of Olathe, KS

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-21

... (OJC) VOR/DME navigation aid located on the Johnson County Executive Airport, Olathe, KS, due to poor performance of the navigation aid. The OJC VOR/DME performs poorly due to suburban encroachment into the...

12 CFR 367.6 - Causes for exclusion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... default; or (2) The termination of such contract(s) for poor performance; or (3) A violation of the terms of a contract that would have resulted in a default or termination of the contract for poor... lack of integrity, or conspiracy to do the same; (l) The contractor's performance under previous...

Principals' Perceptions of Barriers to Dismissal of Poor-Performing Teachers

ERIC Educational Resources Information Center

Dandoy, Jason R.

2012-01-01

The purpose of this study is to determine which factors influence items that school principals consider "barriers" to dismissal of "incompetent" or "poor performing" teachers. This study determines if specific characteristics of schools, principals, or a combination of the two can predict the specific barriers cited…

Poorly Performing Physicians: Does the Script Concordance Test Detect Bad Clinical Reasoning?

ERIC Educational Resources Information Center

Goulet, Francois; Jacques, Andre; Gagnon, Robert; Charlin, Bernard; Shabah, Abdo

2010-01-01

Introduction: Evaluation of poorly performing physicians is a worldwide concern for licensing bodies. The College des Medecins du Quebec currently assesses the clinical competence of physicians previously identified with potential clinical competence difficulties through a day-long procedure called the Structured Oral Interview (SOI). Two peer…

Principals' Informal Methods for Appraising Poor-Performing Teachers

ERIC Educational Resources Information Center

Yariv, Eliezer

2009-01-01

Teacher appraisal is never an easy task, especially of teachers experiencing difficulties and failures. Nevertheless it is a requirement for good management, in our schools no less than our corporations. Forty elementary school principals in Israel described the informal methods they use to appraise teachers who are performing poorly. Most…

Improvement of the Quality, Health Promoting and Performance Enhancement Attributes of Combat Rations

DTIC Science & Technology

2014-10-03

characterized nutraceutical nanodelivery systems which can meet the Army’s needs. Thecommon problem of these dietary flavonoids is their poor water...efficacy evaluation. Tangeretin (4’,5,6,7,8-pentamethoxyflavone) belongs to a sub-group of flavonoid called polymethoxyflavone and is majorly gathered...staining intensity was multiplied to give the immunoreactive score (IRS). Clinical chemistry At the end of 11 weeks, blood samples were collected from

The Relationship of Job Performance to Physical Fitness and Its Application to U. S. Navy Submariners

DTIC Science & Technology

1981-09-29

stressful conditions. Limitation of physical activity, desynchronization of circadian rhythms, adverse work -rest cycles, lack of privacy, and altered...Physical Fitness Aboard Submarines 11 6.2 Disease and Coronary Artery Disease Risk Factors in Submarines 12 6.3 Fatigue, Work -Rest Cycles, and...1974). Stress and disease appear to be related, since organ systems function poorly during periods of stress . Therefore, stress has been viewed as

Summary Report - Inspections of DoD Facilities and Military Housing and Audits of Base Operations and Support Services Contracts

DTIC Science & Technology

2016-10-14

not holding contractors accountable for poor performance while constructing and maintaining facilities. These systemic problems resulted in...portfolio was about $880 billion at the end of FY 2015. Between 2003 and 2008, 18 U.S. military and contractor personnel electrocution fatalities...maintenance of DoD facilities. For instance, Report No. DODIG-2013-099 stated that installations “lacked qualified Government or contractor electricians

Wavefront control of large optical systems

NASA Technical Reports Server (NTRS)

Meinel, Aden B.; Meinel, Marjorie P.; Breckinridge, J. B.

1990-01-01

Several levels of wavefront control are necessary for the optimum performance of very large telescopes, especially segmented ones like the Large Deployable Reflector. In general, the major contributors to wavefront error are the segments of the large primary mirror. Wavefront control at the largest optical surface may not be the optimum choice because of the mass and inaccessibility of the elements of this surface that require upgrading. The concept of two-stage optics was developed to permit a poor wavefront from the large optics to be upgraded by means of a wavefront corrector at a small exit pupil of the system.

Methods to characterize charging effects

NASA Astrophysics Data System (ADS)

Slots, H.

1984-08-01

Methods to characterize charging in insulating material under high voltage dc stress, leading to electrical breakdown, are reviewed. The behavior of the charges can be studied by ac loss angle measurements after application or removal of dc bias. Measurements were performed on oil-paper and oil-Mylar systems. The poor reproducibility of the measurements makes it impossible to draw more than qualitative conclusions about the charging effects. With an ultrasound pressure wave the electric field distribution in a material can be determined. An alternative derivation for the transient response of a system which elucidates the influence of several parameters in a simple way is given.

The French Health Care System; What can We Learn?

PubMed

El Taguri, A; Nasef, A

2008-12-01

All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. (Specific, Measurable, Achievable, Realistic, Time specific) objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services. The French Health Care System (FHCS) ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System.

Measurement system analysis of viscometers used for drilling mud characterization

NASA Astrophysics Data System (ADS)

Mat-Shayuti, M. S.; Adzhar, S. N.

2017-07-01

Viscometers in the Faculty of Chemical Engineering, University Teknologi MARA, are subject to heavy utilization from the members of the faculty. Due to doubts surrounding their result integrity and maintenance management, Measurement System Analysis was executed. 5 samples of drilling muds with varied barite content from 5 - 25 weight% were prepared and their rheological properties determined in 3 trials by 3 operators using the viscometers. Gage Linearity and Bias Study were performed using Minitab software and the result shows high biases in the range of 19.2% to 38.7%, with non-linear trend along the span of measurements. Gage Repeatability & Reproducibility (Nested) analysis later produces Percent Repeatability & Reproducibility more than 7.7% and Percent Tolerance above 30%. Lastly, good and marginal Distinct Categories output are seen among the results. Despite acceptable performance of the measurement system in Distinct Categories, the poor results in accuracy, linearity, and Percent Repeatability & Reproducibility render the gage generally not capable. Improvement to the measurement system is imminent.

Reproductive performances of dairy cows in smallholder production system in Selalle, Central Ethiopia.

PubMed

Lobago, F; Bekana, M; Gustafsson, H; Kindahl, H

2006-05-01

A study was conducted to assess the reproductive performance and factors that influence reproductive efficiency of cows in smallholder dairy farms in Selalle, Central Ethiopia. Three hundred dairy farms (average herd size = 8) were visited and data on reproductive, breeding and management histories were collected and analysed. The overall geometric means for calving to conception interval (n=382) and duration after last calving (n=422) were 187 and 201 days in pregnant and non-pregnant cows, respectively. The least-squares mean calving to conception interval was higher (p < 0.05) in mixed crop-livestock production (MCLP) than in small urban dairy production (SUDP) systems and was lower (p < 0.01) in non-suckling than in suckling cows. District significantly influenced (p < 0.01) the least-squares mean duration after last calving and, among the districts, non-pregnant cows in Wuchale-Jida had the highest values, whereas cows in Sululta and Mulo had the lowest values. The overall average number of services per conception (+/-SD) and the first service conception rate were 1.6 +/- 1.0 (n=382) and 56% (n=456), respectively. The prevalences of abortion, dystocia (assisted parturition), retained fetal membrane, vulval discharge/endometritis and pre-weaning calf mortality were 1.4%, 1.3%, 5.4%, 2.8% and 17.4%, respectively. The present estimates of extended calving to conception interval and duration after last calving indicate poor reproductive performances of cows in Selalle smallholder dairy farms. The pre-weaning calf mortality rate is highly significant. Accordingly, a further detailed investigation is necessary to identify and quantify the specific reproductive disorders and associated interacting factors attributing to such poor performance and to determine the causes and predisposing factors behind such high calf mortality.

Concurrent validation of Xsens MVN measurement of lower limb joint angular kinematics.

PubMed

Zhang, Jun-Tian; Novak, Alison C; Brouwer, Brenda; Li, Qingguo

2013-08-01

This study aims to validate a commercially available inertial sensor based motion capture system, Xsens MVN BIOMECH using its native protocols, against a camera-based motion capture system for the measurement of joint angular kinematics. Performance was evaluated by comparing waveform similarity using range of motion, mean error and a new formulation of the coefficient of multiple correlation (CMC). Three dimensional joint angles of the lower limbs were determined for ten healthy subjects while they performed three daily activities: level walking, stair ascent, and stair descent. Under all three walking conditions, the Xsens system most accurately determined the flexion/extension joint angle (CMC > 0.96) for all joints. The joint angle measurements associated with the other two joint axes had lower correlation including complex CMC values. The poor correlation in the other two joint axes is most likely due to differences in the anatomical frame definition of limb segments used by the Xsens and Optotrak systems. Implementation of a protocol to align these two systems is necessary when comparing joint angle waveforms measured by the Xsens and other motion capture systems.

Building America Case Study: Design Guidance for Passive Vents in New Construction Multifamily Buildings, New York, New York

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

2016-02-01

This document addresses the use of passive vents as a source of outdoor air in multifamily buildings. The challenges associated with implementing passive vents and the factors affecting performance are outlined. A comprehensive design methodology and quantified performance metrics are provided. Two hypothetical design examples are provided to illustrate the process. This document is intended to be useful to designers, decision-makers, and contractors implementing passive ventilation strategies. It is also intended to be a resource for those responsible for setting high-performance building program requirements, especially pertaining to ventilation and outdoor air. To ensure good indoor air quality, a dedicated sourcemore » of outdoor air is an integral part of high-performance buildings. Presently, there is a lack of guidance pertaining to the design and installation of passive vents, resulting in poor system performance. This report details the criteria necessary for designing, constructing, and testing passive vent systems to enable them to provide consistent and reliable levels of ventilation air from outdoors.« less

Clinical utility of the Conners' Continuous Performance Test-II to detect poor effort in U.S. military personnel following traumatic brain injury.

PubMed

Lange, Rael T; Iverson, Grant L; Brickell, Tracey A; Staver, Tara; Pancholi, Sonal; Bhagwat, Aditya; French, Louis M

2013-06-01

The purpose of this study is to examine the clinical utility of the Conners' Continuous Performance Test (CPT-II) as an embedded marker of poor effort in military personnel undergoing neuropsychological evaluations following traumatic brain injury. Participants were 158 U.S. military service members divided into 3 groups on the basis of brain injury severity and performance (pass/fail) on 2 symptom validity tests: Mild Traumatic Brain Injury (MTBI)-Pass (n = 87), MTBI-Fail (n = 42), and severe traumatic brain injury (STBI)-Pass (n = 29). The MTBI-Fail group performed worse on the majority of CPT-II measures compared with both the MTBI-Pass and STBI-Pass groups. When comparing the MTBI-Fail group and MTBI-Pass groups, the most accurate measure for identifying poor effort was the Commission T score. When selected measures were combined (i.e., Omissions, Commissions, and Perseverations), there was a very small increase in sensitivity (from .26 to .29). When comparing the MTBI-Fail group and STBI-Pass groups, the most accurate measure for identifying poor effort was the Omission and Commissions T score. When selected measures were combined, sensitivity again increased (from .24 to .45). Overall, these results suggest that individual CPT-II measures can be useful for identifying people who are suspected of providing poor effort from those who have provided adequate effort. However, due to low sensitivity and modest negative predictive power values, this measure cannot be used in isolation to detect poor effort, and is largely useful as a test to "rule in," not "rule out" poor effort. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Adrenoleukodystrophy

MedlinePlus

... 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, ...

Medical adherence to acne therapy: a systematic review.

PubMed

Snyder, Stephanie; Crandell, Ian; Davis, Scott A; Feldman, Steven R

2014-04-01

Poor adherence of acne patients to treatment may equate to poor clinical efficacy, increased healthcare costs, and unnecessary treatments. Authors have investigated risk factors for poor medical adherence and how to improve this difficult problem in the context of acne. This systematic review aims to describe what methods have been used to measure adherence, what is known about acne patients' adherence to treatment, and the factors affecting adherence. A MEDLINE search was performed for randomized controlled trials published between 1978 and June 2013, focusing on patient adherence to prescribed acne medications. A test for equality of proportions was performed on studies of similar design to collectively analyze adherence to oral versus topical medication. The self-reported adherence data collected from these clinical trials were then compared with adherence data from a pharmacy database study. Studies varied in modalities of data collection, but the majority utilized subjective methods. Topical therapies were more often studied than oral. The overall oral adherence rate, as calculated by a test of equality of proportions, was 76.3%, while the overall topical adherence rate was 75.8% (p=0.927). The occurrence of side effects and young age were cited as the top reasons for poor adherence, followed by forgetfulness. The MEDLINE search resulted in a limited sample of adherence studies. In addition, there is currently no standardized or fully validated method of measurement, allowing for variability in what was considered 'adherent'. Lastly, data collected via subjective methods cannot guarantee reliable results. Overall, the values reflected a population adherent to both topical and oral medications, with no significant difference in adherence between the two. However, the methodologies used by many of the studies were weak, and the findings are not consistent with results of more objective measures of adherence. The leading factors that contribute to poor adherence may be reduced with enhanced patient consultation, reminder systems, and education.

49 CFR 240.309 - Railroad oversight responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... reported train accidents attributed to poor safety performance by locomotive engineers; (3) The number and... and analysis concerning the administration of its program for responding to detected instances of poor... analysis shall involve: (1) The number and nature of the instances of detected poor safety conduct...

Analytical review based on statistics on good and poor financial performance of LPD in Bangli regency.

NASA Astrophysics Data System (ADS)

Yasa, I. B. A.; Parnata, I. K.; Susilawati, N. L. N. A. S.

2018-01-01

This study aims to apply analytical review model to analyze the influence of GCG, accounting conservatism, financial distress models and company size on good and poor financial performance of LPD in Bangli Regency. Ordinal regression analysis is used to perform analytical review, so that obtained the influence and relationship between variables to be considered further audit. Respondents in this study were LPDs in Bangli Regency, which amounted to 159 LPDs of that number 100 LPDs were determined as randomly selected samples. The test results found GCG and company size have a significant effect on both the good and poor financial performance, while the conservatism and financial distress model has no significant effect. The influence of the four variables on the overall financial performance of 58.8%, while the remaining 41.2% influenced by other variables. Size, FDM and accounting conservatism are variables, which are further recommended to be audited.

Oral and Written Expression in Children With Reading Comprehension Difficulties.

PubMed

Carretti, Barbara; Motta, Eleonora; Re, Anna Maria

2016-01-01

Several studies have highlighted that children with reading comprehension difficulties also have problems in tasks that involve telling a story, in writing or verbally. The main differences identified regard poor comprehenders' lower level of coherence in their productions by comparison with good comprehenders. Only one study has compared poor and good comprehenders' performance in both modalities (oral and written), however, to see whether these modalities differently influence poor comprehenders' performance. We qualitatively and quantitatively compared the performance of good and poor comprehenders in oral and written narrative tasks with the aim of shedding light on this issue. Regression analyses were also used to explore the role of working memory and vocabulary in explaining individual differences. Our results showed that the two groups produced narratives of comparable length, with similar percentages of spelling mistakes, whereas they differed in terms of the quality of their narratives, regardless of the modality. These differences were qualified by analyzing the children's use of connective devices, and poor comprehenders were found to use a higher proportion of additive devices than good comprehenders. Regression analyses showed that working memory (particularly the intrusion errors measure) explained a modest part of the qualitative differences in narrative production. Implications for our theoretical understanding of poor comprehenders' profiles and education are discussed. © Hammill Institute on Disabilities 2014.

Effect of ethnicity on performance in a final objective structured clinical examination: qualitative and quantitative study

PubMed Central

Wass, Val; Roberts, Celia; Hoogenboom, Ron; Jones, Roger; Van der Vleuten, Cees

2003-01-01

Objective To assess the effect of ethnicity on student performance in stations assessing communication skills within an objective structured clinical examination. Design Quantitative and qualitative study. Setting A final UK clinical examination consisting of a two day objective structured clinical examination with 22 stations. Participants 82 students from ethnic minorities and 97 white students. Main outcome measures Mean scores for stations (quantitative) and observations made using discourse analysis on selected communication stations (qualitative). Results Mean performance of students from ethnic minorities was significantly lower than that of white students for stations assessing communication skills on days 1 (67.0% (SD 6.8%) and 72.3% (7.6%); P=0.001) and 2 (65.2% (6.6%) and 69.5% (6.3%); P=0.003). No examples of overt discrimination were found in 309 video recordings. Transcriptions showed subtle differences in communication styles in some students from ethnic minorities who performed poorly. Examiners' assumptions about what is good communication may have contributed to differences in grading. Conclusions There was no evidence of explicit discrimination between students from ethnic minorities and white students in the objective structured clinical examination. A small group of male students from ethnic minorities used particularly poorly rated communicative styles, and some subtle problems in assessing communication skills may have introduced bias. Tests need to reflect issues of diversity to ensure that students from ethnic minorities are not disadvantaged. What is already known on this topicUK medical schools are concerned that students from ethnic minorities may perform less well than white students in examinationsIt is important to understand whether our examination system disadvantages themWhat this study addsMean performance of students from ethnic minorities was significantly lower than that of white students in a final year objective structured clinical examinationTwo possible reasons for the difference were poor communicative performance of a small group of male students from ethnic minorities and examiners' use of a textbook patient centred notion of good communicationIssues of diversity in test construction and implementation must be addressed to ensure that students from ethnic minorities are not disadvantaged PMID:12689978

Performance-based self-esteem and burnout in a cross-sectional study of medical students.

PubMed

Dahlin, M; Joneborg, N; Runeson, B

2007-02-01

To examine levels of burnout among medical students and test the hypothesis that high performance-based self-esteem is associated with burnout. Further to study associations between burnout and self-rated health. Cross-sectional survey, of medical students at 1st, 3rd and 6th year of medical school, N = 342, 59.1% women. Burnout was monitored by the Oldenburg Burnout Inventory (OLBI), comprising Exhaustion and Disengagement dimensions. Performance-based self-esteem (PBSE) was assessed by the PBSE-scale (PBSS) and self-rated health by SRH-5. The response rate was 90.4%. Females were more exhausted than males and sixth year students were most disengaged. High performance-based self-esteem was present in 41.7% of the respondents and poor health in 10.7%. Performance-based self-esteem had significant and moderate correlations with both burnout dimensions. Logistic regression showed a positive association between poor health and Exhaustion. Exhaustion among medical students was significantly associated with poor health, and deserves attention from teachers. Performance-based self-esteem was higher than in other populations and associated with both burnout dimensions, but not with poor health. Further research on study environment and burnout is needed, and the reasons for female students' higher exhaustion levels should be further investigated.

Disturbance Accommodating Adaptive Control with Application to Wind Turbines

NASA Technical Reports Server (NTRS)

Frost, Susan

2012-01-01

Adaptive control techniques are well suited to applications that have unknown modeling parameters and poorly known operating conditions. Many physical systems experience external disturbances that are persistent or continually recurring. Flexible structures and systems with compliance between components often form a class of systems that fail to meet standard requirements for adaptive control. For these classes of systems, a residual mode filter can restore the ability of the adaptive controller to perform in a stable manner. New theory will be presented that enables adaptive control with accommodation of persistent disturbances using residual mode filters. After a short introduction to some of the control challenges of large utility-scale wind turbines, this theory will be applied to a high-fidelity simulation of a wind turbine.

Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: A proof of concept study.

PubMed

van Duren, B H; Sugand, K; Wescott, R; Carrington, R; Hart, A

2018-05-01

Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of femur fractures can result in poor mobilisation, chronic pain, and increased cut-out rate requiring revision surgery. A realistic, affordable, and portable fluoroscopic simulation system can improve performance metrics in trainees, including the tip-apex distance (the only clinically validated outcome), and improve outcomes. We developed a digital fluoroscopic imaging simulator using orthogonal cameras to track coloured markers attached to the guide-wire which created a virtual overlay on fluoroscopic images of the hip. To test the accuracy with which the augmented reality system could track a guide-wire, a standard workshop femur was used to calibrate the system with a positional marker fixed to indicate the apex; this allowed for comparison between guide-wire tip-apex distance (TAD) calculated by the system to be compared to that physically measured. Tests were undertaken to determine: (1) how well the apex could be targeted; (2) the accuracy of the calculated TAD. (3) The number of iterations through the algorithm giving the optimal accuracy-time relationship. The calculated TAD was found to have an average root mean square error of 4.2 mm. The accuracy of the algorithm was shown to increase with the number of iterations up to 20 beyond which the error asymptotically converged to an error of 2 mm. This work demonstrates a novel augmented reality simulation of guide-wire insertion in DHS surgery. To our knowledge this has not been previously achieved. In contrast to virtual reality, augmented reality is able to simulate fluoroscopy while allowing the trainee to interact with real instrumentation and performing the procedure on workshop bone models. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Understanding Preclerkship Medical Students' Poor Performance in Prescription Writing.

PubMed

James, Henry; Al Khaja, Khalid A J; Tayem, Yasin I; Veeramuthu, Sindhan; Sequeira, Reginald P

2016-05-01

This study aimed to explore reasons for poor performance in prescription writing stations of the objective structured practical examination (OSPE) and absenteeism in prescription writing sessions among preclerkship medical students at the Arabian Gulf University (AGU) in Manama, Bahrain. This descriptive study was carried out between September 2014 and June 2015 among 157 preclerkship medical students at AGU. Data were collected using focus group discussions and a questionnaire with closed- and open-ended items. All 157 students participated in the study (response rate: 100.0%). The most frequently cited reasons for poor performance in OSPE stations were an inability to select the correct drugs (79.6%), treatment duration (69.4%), drug quantity (69.4%) and drug formulation (68.2%). Additionally, students reported inadequate time for completing the stations (68.8%). During focus group discussions, students reported other reasons for poor performance, including examination stress and the difficulty of the stations. Absenteeism was attributed to the length of each session (55.4%), lack of interest (50.3%), reliance on peers for information (48.4%) and optional attendance policies (47.1%). Repetitive material, large group sessions, unmet student expectations and the proximity of the sessions to summative examinations were also indicated to contribute to absenteeism according to open-ended responses or focus group discussions. This study suggests that AGU medical students perform poorly in prescription writing OSPE stations because of inadequate clinical pharmacology knowledge. Participation in prescription writing sessions needs to be enhanced by addressing the concerns identified in this study. Strategies to improve attendance and performance should take into account the learner-teacher relationship.

The association of snoring and risk of obstructive sleep apnea with poor academic performance among university students.

PubMed

Khassawneh, Basheer Y; Alkhatib, Loiy L; Ibnian, Ali M; Khader, Yousef S

2018-04-20

Subjects with obstructive sleep apnea (OSA) have neurocognitive dysfunction. The aim of this study was to estimate the prevalence of symptoms and risk of OSA among university students and the association with academic performance. A cross-sectional study was conducted at Jordan University of Science and Technology. Students from faculties of engineering, medicine, nursing, pharmacy, and dentistry were asked to participate in this study. The Berlin Sleep Questionnaire was used to report symptoms and risk of OSA. Below average cumulative scores were considered poor academic performance. A total of 777 students (51% female; mean age, 20 years) completed the study questionnaire. According to the study definition, 42 students (5.4%) had high risk for OSA. Snoring was reported by 11% and daytime sleepiness and fatigue by 30%. Compared to female students, male students had more snoring (14.6 vs. 7.6%, p = 0.002) and higher risk for OSA (6.5 vs. 1.6%, p = 0.001). Both self-reported snoring and being at high risk for OSA were associated with poor academic performance (27.9 vs. 11.6% and 23.1 vs. 9.2%, respectively; p < 0.02). After adjusting for confounding factors, the odds ratio of having poor academic performance in students at high risk for OSA was 2.4 (CI 1.11-5.2, p = 0.027). Snoring and OSA were uncommon among university students. However, both were more common among male students and were associated with poor academic performance.

Elevated serum cytokines correlated with altered behavior, serum cortisol rhythm, and dampened 24-hour rest-activity patterns in patients with metastatic colorectal cancer.

PubMed

Rich, Tyvin; Innominato, Pasquale F; Boerner, Julie; Mormont, M Christine; Iacobelli, Stefano; Baron, Benoit; Jasmin, Claude; Lévi, Francis

2005-03-01

Incapacitating symptom burden in cancer patients contributes to poor quality of life (QOL) and can influence treatment outcomes because of poor tolerance to therapy. In this study, the role of circulating cytokines in the production symptoms in cancer patients is evaluated. Eighty patients with metastatic colorectal cancer with either normal (group I, n = 40) or dampened (group II, n = 40) 24-hour rest/activity patterns measured by actigraphy were identified. Actigraphy patterns were correlated with QOL indices, serum cortisol obtained at 8:00 a.m. and 4:00 p.m. and with serum levels of transforming growth factor-alpha, tumor necrosis factor-alpha, and interleukin 6 (IL-6) obtained at 8:00 a.m. and analyzed in duplicate by ELISA. Cytokine levels and survival were also correlated. Group II patients had significantly higher pre treatment levels of all three cytokines, displayed significantly poorer emotional and social functioning, had higher fatigue, more appetite loss, and poorer performance status compared with group I patients. Transforming growth factor-alpha (TGF-alpha) and IL-6 were significantly increased in the patients with WHO performance status >1 and in those with appetite loss. Fatigue was significantly associated with elevated TGF-alpha only. IL-6 was increased in those patients with extensive liver involvement and multiple organ replacement, and it was significantly correlated with dampened cortisol rhythm. In a multivariate analysis, IL-6 was correlated with poor treatment outcome. Significant correlations were found between serum levels of TGF-alpha and IL-6, circadian patterns in wrist activity and serum cortisol and tumor-related symptoms in patients with metastatic colorectal cancer. These data support the hypothesis that some cancer patient's symptoms of fatigue, poor QOL, and treatment outcome are related to tumor or host generated cytokines and could reflect cytokine effects on the circadian timing system. This interplay between cytokine signaling pathways, the hypothalamic-pituitary-adrenal axis, the autonomic nervous system, and efferent pathways of the suprachiasmatic nucleus that control circadian physiology, opens the way to new rational interventions for symptom management in cancer patients.

Promotion bureau warehouse system design. Case study in University of AA

NASA Astrophysics Data System (ADS)

Parwati, N.; Qibtiyah, M.

2017-12-01

The warehouse becomes one of the important parts in an industry. By having a good warehousing system, an industry can improve the effectiveness of its performance, so that profits for the company can continue to increase. Meanwhile, if it has a poorly organized warehouse system, it is feared there will be a decrease in the level of effectiveness of the industry itself. In this research, the object was warehousing system in promotion bureau of University AA. To improve the effectiveness of warehousing system, warehouse layout design is done by specifying categories of goods based on the flow of goods in and out of warehouse with ABC analysis method. In addition, the design of information systems to assist in controlling the system to support all the demand for every burreau and department in the university.

The Influence of Closing Poor Performing Primary Schools on the Educational Attainment of Students

ERIC Educational Resources Information Center

De Witte, Kristof; Van Klaveren, Chris

2014-01-01

This paper examines whether the closure of poor performing primary schools improved students' educational attainment. It is believed that school closure affects children's educational outcomes positively because children switch to better primary schools. At the same time, school closure creates a social disturbance such that educational outcomes…

Faculty Response to Department Leadership: Strategies for Creating More Supportive Academic Work Environments

ERIC Educational Resources Information Center

Miller, Michael T.; Murry, John W., Jr.

2015-01-01

Having a strong, positive departmental chair is critical to enhancing and assuring faculty performance and student learning. Poor leadership, however, can result in increased faculty turn over, poor teaching and research performance, and even the discouragement of students from enrolling. The current study explored response strategies by faculty…

Instructor Responses to Poor Student Communication Performance: An Attributional Interpretation.

ERIC Educational Resources Information Center

Fiechtner, Susan Brown; Krayer, Karl J.

A study was conducted (1) to investigate factors that influence an instructor's choice of behavior when confronted with incidents of students' poor communication performance, and (2) to demonstrate how attribution theory can be used as a vehicle for describing and understanding the causes of instructor reactions or behaviors. The study sought to…

Group III-arsenide-nitride long wavelength laser diodes

NASA Astrophysics Data System (ADS)

Coldren, Christopher W.

Semiconductor laser diodes transmitting data over silica optical fiber form the backbone of modern day communications systems, enabling terabit per second data transmission over hundreds to thousands of kilometers of distance. The wavelength of emission of the transmission semiconductor laser diode is a critical parameter that determines the performance of the communications system. In high performance fiber optic communications systems, lasers emitting at 1300nm and 1550nm are used because of the low loss and distortion properties of the fiber in these spectral windows. The available lasers today that operate in these fiber optic transmission windows suffer from high cost and poor performance under the typical environmental conditions and require costly and unreliable cooling systems. This dissertation presents work that demonstrates that it is possible to make lasers devices with 1300nm laser emission that are compatible with low cost and operation under extreme operating conditions. The key enabling technology developed is a novel semiconductor material based structure. A group III-Arsenide-Nitride quantum well structure was developed that can be grown expitaxially on GaAs substrates. The properties of this group III-Arsenide-Nitride structure allowed high performance edge emitting and vertical cavity surface emitting lasers to be fabricated which exhibited low threshold currents and low sensitivity to operating temperature.

A novel method for measuring health care system performance: experience from QIDS in the Philippines.

PubMed

Solon, Orville; Woo, Kimberly; Quimbo, Stella A; Shimkhada, Riti; Florentino, Jhiedon; Peabody, John W

2009-05-01

Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q was developed, implemented in hospitals in the Philippines and how it compares with typical measures. Q consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q. Q was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2(1/2) years. We found Q to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled USD2133 or USD305 per assessment per site. Q appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings.

A novel method for measuring health care system performance: experience from QIDS in the Philippines

PubMed Central

Solon, Orville; Woo, Kimberly; Quimbo, Stella A; Shimkhada, Riti; Florentino, Jhiedon; Peabody, John W

2009-01-01

Objectives Measuring and monitoring health system performance is important albeit controversial. Technical, logistic and financial challenges are formidable. We introduced a system of measurement, which we call Q*, to measure the quality of hospital clinical performance across a range of facilities. This paper describes how Q* was developed, implemented in hospitals in the Philippines and how it compares with typical measures. Methods Q* consists of measures of clinical performance, patient satisfaction and volume of physician services. We evaluate Q* using experimental data from the Quality Improvement Demonstration Study (QIDS), a randomized policy experiment. We determined its responsiveness over time and to changes in structural measures such as staffing and supplies. We also examined the operational costs of implementing Q*. Results Q* was sustainable, minimally disruptive and readily grafted into existing routines in 30 hospitals in 10 provinces semi-annually for a period of 2½ years. We found Q* to be more responsive to immediate impacts of policy change than standard structural measures. The operational costs totalled US$2133 or US$305 per assessment per site. Conclusion Q* appears to be an achievable assessment tool that is a comprehensive and responsive measure of system level quality at a limited cost in resource-poor settings. PMID:19224955

Lapatinib nano-delivery systems: a promising future for breast cancer treatment.

PubMed

Bonde, Gunjan Vasant; Yadav, Sarita Kumari; Chauhan, Sheetal; Mittal, Pooja; Ajmal, Gufran; Thokala, Sathish; Mishra, Brahmeshwar

2018-05-01

Breast cancer stands the second prominent cause of death among women. For its efficient treatment, Lapatinib (LAPA) was developed as a selective tyrosine kinase inhibitor of receptors, overexpressed by breast cancer cells. Various explored delivery strategies for LAPA indicated its controlled release with enhanced aqueous solubility, improved bioavailability, decreased plasma protein binding, reduced dose and toxicity to the other organs with maximized clinical efficacy, compared to its marketed tablet formulation. Areas covered: This comprehensive review deals with the survey, performed through different electronic databases, regarding various challenges and their solutions attained by fabricating delivery systems like nanoparticles, micelle, nanocapsules, nanochannels, and liposomes. It also covers the synthesis of novel LAPA-conjugates for diagnostic purpose. Expert opinion: Unfortunately, clinical use of LAPA is restricted because of its extensive albumin binding capacity, poor oral bioavailability, and poor aqueous solubility. LAPA is marketed as the oral tablet only. Therefore, it becomes imperative to formulate alternate efficient multiparticulate or nano-delivery systems for administration through non-oral routes, for active/passive targeting, and to scale-up by pharmaceutical scientists followed by their clinical trials by clinical experts. LAPA combinations with capecitabine and letrozole should also be tried for breast cancer treatment.

Low NOx combustion and SCR flow field optimization in a low volatile coal fired boiler.

PubMed

Liu, Xing; Tan, Houzhang; Wang, Yibin; Yang, Fuxin; Mikulčić, Hrvoje; Vujanović, Milan; Duić, Neven

2018-08-15

Low NO x burner redesign and deep air staging have been carried out to optimize the poor ignition and reduce the NO x emissions in a low volatile coal fired 330 MW e boiler. Residual swirling flow in the tangentially-fired furnace caused flue gas velocity deviations at furnace exit, leading to flow field unevenness in the SCR (selective catalytic reduction) system and poor denitrification efficiency. Numerical simulations on the velocity field in the SCR system were carried out to determine the optimal flow deflector arrangement to improve flow field uniformity of SCR system. Full-scale experiment was performed to investigate the effect of low NO x combustion and SCR flow field optimization. Compared with the results before the optimization, the NO x emissions at furnace exit decreased from 550 to 650 mg/Nm³ to 330-430 mg/Nm³. The sample standard deviation of the NO x emissions at the outlet section of SCR decreased from 34.8 mg/Nm³ to 7.8 mg/Nm³. The consumption of liquid ammonia reduced from 150 to 200 kg/h to 100-150 kg/h after optimization. Copyright © 2018. Published by Elsevier Ltd.

Organizational analysis of maternal mortality reduction programs in Madagascar.

PubMed

Harimanana, Aina; Barennes, Hubert; Reinharz, Daniel

2011-01-01

Little is known about the organizational factors involved in policy creation and programs implementation aimed at reducing maternal mortality in Madagascar. A qualitative case study was performed to investigate organizational factors influencing the health system's capacity to elaborate and implement maternal mortality reduction programs. Semi-structured interviews were conducted with 53 participants. A conceptual framework based on Gamson's coalition theory and Hinings and Greenwood's archetypes concept was used. Three major conclusions emerge: the Ministry of Health is a poor leader in the development of national strategies, due to its dependency on external financial resources and expertise, and because of poor transmission of key information from the field; at a meso level (regions and districts), the capacity to adapt programs is highly dependent on the collaboration with NGOs; at the micro level, there are few incentives provided to field workers to participate in a collective effort and little attempt to exploit complementarities between scare resources. The Madagascar health system should consider the need for improvement in data analysis capacity, and implementing behavior-changing tools suitable for stimulating providers who work inside and outside the health care system, to participate to a coordinated collective effort. Copyright © 2010 John Wiley & Sons, Ltd.

Recommendations for level-determined sampling in wells

NASA Astrophysics Data System (ADS)

Lerner, David N.; Teutsch, Georg

1995-10-01

Level-determined samples of groundwater are increasingly important for hydrogeological studies. The techniques for collecting them range from the use of purpose drilled wells, sometimes with sophisticated dedicated multi-level samplers in them, to a variety of methods used in open wells. Open, often existing, wells are frequently used on cost grounds, but there are risks of obtaining poor and unrepresentative samples. Alternative approaches to level-determined sampling incorporate seven concepts: depth sampling; packer systems; individual wells; dedicated multi-level systems; separation pumping; baffle systems; multi-port sock samplers. These are outlined and evaluated in terms of the environment to be sampled, and the features and performance of the methods. Recommendations are offered to match methods to sampling problems.

Frequentist and Bayesian Orbital Parameter Estimaton from Radial Velocity Data Using RVLIN, BOOTTRAN, and RUN DMC

NASA Astrophysics Data System (ADS)

Nelson, Benjamin Earl; Wright, Jason Thomas; Wang, Sharon

2015-08-01

For this hack session, we will present three tools used in analyses of radial velocity exoplanet systems. RVLIN is a set of IDL routines used to quickly fit an arbitrary number of Keplerian curves to radial velocity data to find adequate parameter point estimates. BOOTTRAN is an IDL-based extension of RVLIN to provide orbital parameter uncertainties using bootstrap based on a Keplerian model. RUN DMC is a highly parallelized Markov chain Monte Carlo algorithm that employs an n-body model, primarily used for dynamically complex or poorly constrained exoplanet systems. We will compare the performance of these tools and their applications to various exoplanet systems.

The Concert system - Compiler and runtime technology for efficient concurrent object-oriented programming

NASA Technical Reports Server (NTRS)

Chien, Andrew A.; Karamcheti, Vijay; Plevyak, John; Sahrawat, Deepak

1993-01-01

Concurrent object-oriented languages, particularly fine-grained approaches, reduce the difficulty of large scale concurrent programming by providing modularity through encapsulation while exposing large degrees of concurrency. Despite these programmability advantages, such languages have historically suffered from poor efficiency. This paper describes the Concert project whose goal is to develop portable, efficient implementations of fine-grained concurrent object-oriented languages. Our approach incorporates aggressive program analysis and program transformation with careful information management at every stage from the compiler to the runtime system. The paper discusses the basic elements of the Concert approach along with a description of the potential payoffs. Initial performance results and specific plans for system development are also detailed.

Automatic visual monitoring of welding procedure in stainless steel kegs

NASA Astrophysics Data System (ADS)

Leo, Marco; Del Coco, Marco; Carcagnì, Pierluigi; Spagnolo, Paolo; Mazzeo, Pier Luigi; Distante, Cosimo; Zecca, Raffaele

2018-05-01

In this paper a system for automatic visual monitoring of welding process, in dry stainless steel kegs for food storage, is proposed. In the considered manufacturing process the upper and lower skirts are welded to the vessel by means of Tungsten Inert Gas (TIG) welding. During the process several problems can arise: 1) residuals on the bottom 2) darker weld 3) excessive/poor penetration and 4) outgrowths. The proposed system deals with all the four aforementioned problems and its inspection performances have been evaluated by using a large set of kegs demonstrating both the reliability in terms of defect detection and the suitability to be introduced in the manufacturing system in terms of computational costs.

Robust Parallel Motion Estimation and Mapping with Stereo Cameras in Underground Infrastructure

NASA Astrophysics Data System (ADS)

Liu, Chun; Li, Zhengning; Zhou, Yuan

2016-06-01

Presently, we developed a novel robust motion estimation method for localization and mapping in underground infrastructure using a pre-calibrated rigid stereo camera rig. Localization and mapping in underground infrastructure is important to safety. Yet it's also nontrivial since most underground infrastructures have poor lighting condition and featureless structure. Overcoming these difficulties, we discovered that parallel system is more efficient than the EKF-based SLAM approach since parallel system divides motion estimation and 3D mapping tasks into separate threads, eliminating data-association problem which is quite an issue in SLAM. Moreover, the motion estimation thread takes the advantage of state-of-art robust visual odometry algorithm which is highly functional under low illumination and provides accurate pose information. We designed and built an unmanned vehicle and used the vehicle to collect a dataset in an underground garage. The parallel system was evaluated by the actual dataset. Motion estimation results indicated a relative position error of 0.3%, and 3D mapping results showed a mean position error of 13cm. Off-line process reduced position error to 2cm. Performance evaluation by actual dataset showed that our system is capable of robust motion estimation and accurate 3D mapping in poor illumination and featureless underground environment.

Preparation and in vitro/in vivo characterization of porous sublingual tablets containing ternary kneaded solid system of vinpocetine with î-cyclodextrin and hydroxy Acid.

PubMed

Aburahma, Mona H; El-Laithy, Hanan M; Hamza, Yassin El-Said

2010-01-01

The demand for sublingual tablets has been growing during the previous decades especially for drugs with extensive hepatic first-pass metabolism. Vinpocetine, a widely used neurotropic agent, has low oral bioavailability due to its poor aqueous solubility and marked first-pass metabolism. Accordingly, the aim of this work was to develop tablets for the sublingual delivery of vinpocetine. Initially, the feasibility of improving vinpocetineâs poor aqueous solubility by preparing kneaded solid systems of the drug with Î-Cyclodextrin and hydroxy acids (citric acid and tartaric acid) was assessed. The solid system with improved solubility and dissolution properties was incorporated into porous tablets that rapidly disintegrate permitting fast release of vinpocetine into the sublingual cavity. The pores were induced into these tablets by directly compressing the tabletsâ excipients with a sublimable material, either camphor or menthol, which was eventually sublimated leaving pores. The obtained results demonstrated that the tablets prepared using camphor attained sufficient mechanical strength for practical use together with rapid disintegration and dissolution. In vivo absorption study performed in rabbits indicated that the sublingual administration of the proposed porous tablets containing vinpocetine solid system with Î-Cyclodextrin and tartaric acid could be useful for therapeutic application.

Preparation and In Vitro/In Vivo Characterization of Porous Sublingual Tablets Containing Ternary Kneaded Solid System of Vinpocetine with β-Cyclodextrin and Hydroxy Acid

PubMed Central

Aburahma, Mona H.; El-Laithy, Hanan M.; Hamza, Yassin El-Said

2010-01-01

The demand for sublingual tablets has been growing during the previous decades especially for drugs with extensive hepatic first-pass metabolism. Vinpocetine, a widely used neurotropic agent, has low oral bioavailability due to its poor aqueous solubility and marked first-pass metabolism. Accordingly, the aim of this work was to develop tablets for the sublingual delivery of vinpocetine. Initially, the feasibility of improving vinpocetine’s poor aqueous solubility by preparing kneaded solid systems of the drug with β-Cyclodextrin and hydroxy acids (citric acid and tartaric acid) was assessed. The solid system with improved solubility and dissolution properties was incorporated into porous tablets that rapidly disintegrate permitting fast release of vinpocetine into the sublingual cavity. The pores were induced into these tablets by directly compressing the tablets’ excipients with a sublimable material, either camphor or menthol, which was eventually sublimated leaving pores. The obtained results demonstrated that the tablets prepared using camphor attained sufficient mechanical strength for practical use together with rapid disintegration and dissolution. In vivo absorption study performed in rabbits indicated that the sublingual administration of the proposed porous tablets containing vinpocetine solid system with β-Cyclodextrin and tartaric acid could be useful for therapeutic application. PMID:21179352

Health services analysis as a tool for evidence-based policy decisions: the case of the Ministry of Health and Social Security in Mexico.

PubMed

Kroeger, Axel; Hernandez, Juan Manuel

2003-12-01

To describe the strengths and weaknesses of two Mexican health care providers for poor populations [Ministry of Health (MoH) and Social Security (SS)] in order to facilitate policy decisions about the future of the two systems. In four Mexican states we conducted (i) a household interview survey in 10 724 households; (ii) a user satisfaction survey in 1319 households; (iii) a satisfaction survey of 236 health workers; (iv) in-depth interviews with 190 health workers; (v) 188 focus-group discussions with different population groups; (vi) a document analysis. Both systems serve populations with similar characteristics of poverty. The availability of resources was better in the MoH system; SS care was better concerning process indicators (family planning, antenatal care; in-service delivery of drugs, staff productivity, user satisfaction and staff motivation), efficiency and effectiveness (reduction of morbidity and mortality). Possible explanatory factors for the better performance of the SS system were strong supervision, regular communication, joint data analysis and annual population surveys. Better service organization makes a difference regarding efficiency and effectiveness. Policy-makers, deciding on which kind of health services are best for the poor, should take into account health services' analyses.

Is More Better? - Night Vision Enhancement System's Pedestrian Warning Modes and Older Drivers.

PubMed

Brown, Timothy; He, Yefei; Roe, Cheryl; Schnell, Thomas

2010-01-01

Pedestrian fatalities as a result of vehicle collisions are much more likely to happen at night than during day time. Poor visibility due to darkness is believed to be one of the causes for the higher vehicle collision rate at night. Existing studies have shown that night vision enhancement systems (NVES) may improve recognition distance, but may increase drivers' workload. The use of automatic warnings (AW) may help minimize workload, improve performance, and increase safety. In this study, we used a driving simulator to examine performance differences of a NVES with six different configurations of warning cues, including: visual, auditory, tactile, auditory and visual, tactile and visual, and no warning. Older drivers between the ages of 65 and 74 participated in the study. An analysis based on the distance to pedestrian threat at the onset of braking response revealed that tactile and auditory warnings performed the best, while visual warnings performed the worst. When tactile or auditory warnings were presented in combination with visual warning, their effectiveness decreased. This result demonstrated that, contrary to general sense regarding warning systems, multi-modal warnings involving visual cues degraded the effectiveness of NVES for older drivers.

Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach.

PubMed

Phillips, Charles D; Hawes, Catherine; Lieberman, Trudy; Koren, Mary Jane

2007-06-25

Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents. As a result, the authors doubt the ability of many nursing home performance systems to truly help consumers differentiate among homes providing different levels of quality. We also argue that, for consumers, performance measurement models are better at identifying problem facilities than potentially good homes. In response to these concerns we present a proposal for a less ambitious approach to nursing home performance measurement than previously used. We believe consumers can make better informed choice using a simpler system designed to pinpoint poor-quality nursing homes, rather than one designed to rank hundreds of facilities based on differences in quality-of-care indicators that are of questionable importance. The suggested performance model is based on five principles used in the development of the Consumers Union 2006 Nursing Home Quality Monitor. We can best serve policy-makers and consumers by eschewing nursing home reporting systems that present information about all the facilities in a city, a state, or the nation on a website or in a report. We argue for greater modesty in our efforts and a focus on identifying only the potentially poorest or best homes. In the end, however, it is important to remember that information from any performance measurement website or report is no substitute for multiple visits to a home at different times of the day to personally assess quality.

A framework for assessing the performance of health systems.

PubMed Central

Murray, C. J.; Frenk, J.

2000-01-01

Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges. PMID:10916909

A framework for assessing the performance of health systems.

PubMed

Murray, C J; Frenk, J

2000-01-01

Health systems vary widely in performance, and countries with similar levels of income, education and health expenditure differ in their ability to attain key health goals. This paper proposes a framework to advance the understanding of health system performance. A first step is to define the boundaries of the health system, based on the concept of health action. Health action is defined as any set of activities whose primary intent is to improve or maintain health. Within these boundaries, the concept of performance is centred around three fundamental goals: improving health, enhancing responsiveness to the expectations of the population, and assuring fairness of financial contribution. Improving health means both increasing the average health status and reducing health inequalities. Responsiveness includes two major components: (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider). Fairness of financial contribution means that every household pays a fair share of the total health bill for a country (which may mean that very poor households pay nothing at all). This implies that everyone is protected from financial risks due to health care. The measurement of performance relates goal attainment to the resources available. Variation in performance is a function of the way in which the health system organizes four key functions: stewardship (a broader concept than regulation); financing (including revenue collection, fund pooling and purchasing); service provision (for personal and non-personal health services); and resource generation (including personnel, facilities and knowledge). By investigating these four functions and how they combine, it is possible not only to understand the proximate determinants of health system performance, but also to contemplate major policy challenges.

Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia.

PubMed

Bardosono, Saptawati; Sastroamidjojo, Soemilah; Lukito, Widjaja

2007-01-01

There is empirical evidence at the national level that suggests the 1999 Indonesian economic crisis impact was very heterogeneous both between urban and rural areas and across regions. A cross sectional study of the nutritional status of children and its determinants was performed in urban poor areas of Jakarta, and rural areas of Banggai in Central Sulawesi, and Alor-Rote in East Nusa Tenggara. Two-stage cluster sampling was used to obtain 1078 households with under-five children in the urban poor area of Jakarta, and 262 and 631 households with under-five children each for the rural areas of Banggai and Alor-Rote, respectively. Data collection for both studies was performed from January 1999 to June 2001. The study shows that wasting affected more children in the urban poor areas of Jakarta than in the other study areas. On the other hand, stunting and anemia were significantly more severe among children 6-59 months of age in the rural area of Alor-Rote compared to the other study areas. The high prevalence of infectious diseases was significantly related to the higher prevalence of wasting in the study areas of Jakarta and Banggai, and also significantly related to the higher prevalence of stunting and anemia in the study area of Alor-Rote. To avert this kind of health impact of a economic downturn, there is a need to improve the nutritional and health status of under-five children and their mothers through the existing health care system, provide basic health services and improve the capacity of health staff across Indonesia as part of the decentralization process.

Framework for Architecture Trade Study Using MBSE and Performance Simulation

NASA Technical Reports Server (NTRS)

Ryan, Jessica; Sarkani, Shahram; Mazzuchim, Thomas

2012-01-01

Increasing complexity in modern systems as well as cost and schedule constraints require a new paradigm of system engineering to fulfill stakeholder needs. Challenges facing efficient trade studies include poor tool interoperability, lack of simulation coordination (design parameters) and requirements flowdown. A recent trend toward Model Based System Engineering (MBSE) includes flexible architecture definition, program documentation, requirements traceability and system engineering reuse. As a new domain MBSE still lacks governing standards and commonly accepted frameworks. This paper proposes a framework for efficient architecture definition using MBSE in conjunction with Domain Specific simulation to evaluate trade studies. A general framework is provided followed with a specific example including a method for designing a trade study, defining candidate architectures, planning simulations to fulfill requirements and finally a weighted decision analysis to optimize system objectives.

Poland.

PubMed

1987-09-01

In 1986, Poland's population was 37.5 million and the annual population growth rate was 0.8%. The infant mortality rate was 19.3/1000 and life expectancy stood at 71.6 years. Of the labor force of 17.5 million, 30% were engaged in agriculture, 44% were in industry and commerce, 8% were government employees, and 11% were employed in services. Poland is a communist state. The economy is based on the Soviet model of state ownership of most of the country's productive assets, although the private sector predominates in agriculture. The rights of private farmers are now protected through a 1983 amendment to the constitution. Poland's economy has performed poorly in comparison with other Eastern European economies. The economic growth rate is 5% and inflation averages 20%. Per capita income is US$2000. Industries were centralized following World War II, and this systemic rigidity is considered to have contributed to the economy's poor performance. Another important factor has been low reliance of foreign trade, meaning that Poland's industries have failed to develop competitiveness. The government has committed itself to a so-called second-stage of economic reform, but to date there have been few concrete accomplishments.

Identifying a key physical factor sensitive to the performance of Madden-Julian oscillation simulation in climate models

NASA Astrophysics Data System (ADS)

Kim, Go-Un; Seo, Kyong-Hwan

2018-01-01

A key physical factor in regulating the performance of Madden-Julian oscillation (MJO) simulation is examined by using 26 climate model simulations from the World Meteorological Organization's Working Group for Numerical Experimentation/Global Energy and Water Cycle Experiment Atmospheric System Study (WGNE and MJO-Task Force/GASS) global model comparison project. For this, intraseasonal moisture budget equation is analyzed and a simple, efficient physical quantity is developed. The result shows that MJO skill is most sensitive to vertically integrated intraseasonal zonal wind convergence (ZC). In particular, a specific threshold value of the strength of the ZC can be used as distinguishing between good and poor models. An additional finding is that good models exhibit the correct simultaneous convection and large-scale circulation phase relationship. In poor models, however, the peak circulation response appears 3 days after peak rainfall, suggesting unfavorable coupling between convection and circulation. For an improving simulation of the MJO in climate models, we propose that this delay of circulation in response to convection needs to be corrected in the cumulus parameterization scheme.

Object form discontinuity facilitates displacement discrimination across saccades.

PubMed

Demeyer, Maarten; De Graef, Peter; Wagemans, Johan; Verfaillie, Karl

2010-06-01

Stimulus displacements coinciding with a saccadic eye movement are poorly detected by human observers. In recent years, converging evidence has shown that this phenomenon does not result from poor transsaccadic retention of presaccadic stimulus position information, but from the visual system's efforts to spatially align presaccadic and postsaccadic perception on the basis of visual landmarks. It is known that this process can be disrupted, and transsaccadic displacement detection performance can be improved, by briefly blanking the stimulus display during and immediately after the saccade. In the present study, we investigated whether this improvement could also follow from a discontinuity in the task-irrelevant form of the displaced stimulus. We observed this to be the case: Subjects more accurately identified the direction of intrasaccadic displacements when the displaced stimulus simultaneously changed form, compared to conditions without a form change. However, larger improvements were still observed under blanking conditions. In a second experiment, we show that facilitation induced by form changes and blanks can combine. We conclude that a strong assumption of visual stability underlies the suppression of transsaccadic change detection performance, the rejection of which generalizes from stimulus form to stimulus position.

Air-liquid interface exposure to aerosols of poorly soluble nanomaterials induces different biological activation levels compared to exposure to suspensions.

PubMed

Loret, Thomas; Peyret, Emmanuel; Dubreuil, Marielle; Aguerre-Chariol, Olivier; Bressot, Christophe; le Bihan, Olivier; Amodeo, Tanguy; Trouiller, Bénédicte; Braun, Anne; Egles, Christophe; Lacroix, Ghislaine

2016-11-03

Recently, much progress has been made to develop more physiologic in vitro models of the respiratory system and improve in vitro simulation of particle exposure through inhalation. Nevertheless, the field of nanotoxicology still suffers from a lack of relevant in vitro models and exposure methods to predict accurately the effects observed in vivo, especially after respiratory exposure. In this context, the aim of our study was to evaluate if exposing pulmonary cells at the air-liquid interface to aerosols of inhalable and poorly soluble nanomaterials generates different toxicity patterns and/or biological activation levels compared to classic submerged exposures to suspensions. Three nano-TiO 2 and one nano-CeO 2 were used. An exposure system was set up using VitroCell® devices to expose pulmonary cells at the air-liquid interface to aerosols. A549 alveolar cells in monocultures or in co-cultures with THP-1 macrophages were exposed to aerosols in inserts or to suspensions in inserts and in plates. Submerged exposures in inserts were performed, using similar culture conditions and exposure kinetics to the air-liquid interface, to provide accurate comparisons between the methods. Exposure in plates using classical culture and exposure conditions was performed to provide comparable results with classical submerged exposure studies. The biological activity of the cells (inflammation, cell viability, oxidative stress) was assessed at 24 h and comparisons of the nanomaterial toxicities between exposure methods were performed. Deposited doses of nanomaterials achieved using our aerosol exposure system were sufficient to observe adverse effects. Co-cultures were more sensitive than monocultures and biological responses were usually observed at lower doses at the air-liquid interface than in submerged conditions. Nevertheless, the general ranking of the nanomaterials according to their toxicity was similar across the different exposure methods used. We showed that exposure of cells at the air-liquid interface represents a valid and sensitive method to assess the toxicity of several poorly soluble nanomaterials. We underlined the importance of the cellular model used and offer the possibility to deal with low deposition doses by using more sensitive and physiologic cellular models. This brings perspectives towards the use of relevant in vitro methods of exposure to assess nanomaterial toxicity.

A simple strategy to reduce stereotype threat for orthopedic residents.

PubMed

Gomez, Everlyne; Wright, James G

2014-04-01

Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR.

Self-rated imagery and encoding strategies in visual memory.

PubMed

Berger, G H; Gaunitz, S C

1979-02-01

The value of self-rated vividness of imagery in predicting performance was investigated, taking into account the mnemonic strategies utilized among subjects performing a visual-memory task. Subjects classified as 'good' or 'poor' imagers, according to their scores in the Vividness of Visual Imagery Questionnaire (VVIQ; Marks, 1972), were to detect as rapidly as possible differences between pairs of similar pictures presented consecutively. No coding instructions were given and the mnemonic strategies used were analysed by studying subjective reports and objective performance measurements. The results indicated that the subjects utilized two main strategies--a detail or an image strategy. The detail strategy was the more efficient. In accordance with a previous study (Berger & Gaunitz, 1977), it was found that the VVIQ did not discriminate between performance by 'good' and 'poor' imagers. However, among subjects who used the image strategy, 'good' imagers performed more rapidly than 'poor' imagers. Self-rated imagery may then have some value in predicting performance among individuals shown to have utilized an image strategy.

Use of Circadian Lighting System to improve night shift alertness and performance of NRC Headquarters Operations Officers

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

Baker, T.L.; Morisseau, D.; Murphy, N.M.

1995-04-01

The Nuclear Regulatory Commission`s (NRC) Headquarters Operations Officers (HOOs) receive and respond to events reported in the nuclear industry on a 24-hour basis. The HOOs have reported reduced alertness on the night shift, leading to a potential deterioration in their on-shift cognitive performance during the early morning hours. For some HOOs, maladaptation to the night shift was also reported to be the principal cause of: (a) reduced alertness during the commute to and from work, (b) poor sleep quality, and (c) personal lifestyle problems. ShiftWork Systems, Inc. (SWS) designed and installed a Circadian Lighting System (CLS) at both the Bethesdamore » and Rockville HOO stations with the goal of facilitating the HOOs physiological adjustment to their night shift schedules. The data indicate the following findings: less subjective fatigue on night shifts; improved night shift alertness and mental performance; higher HOO confidence in their ability to assess event reports; longer, deeper and more restorative day sleep after night duty shifts; swifter adaptation to night work; and a safer commute, particularly for those with extensive drives.« less

The association between reading abilities and visual-spatial attention in Hong Kong Chinese children.

PubMed

Liu, Sisi; Liu, Duo; Pan, Zhihui; Xu, Zhengye

2018-03-25

A growing body of research suggests that visual-spatial attention is important for reading achievement. However, few studies have been conducted in non-alphabetic orthographies. This study extended the current research to reading development in Chinese, a logographic writing system known for its visual complexity. Eighty Hong Kong Chinese children were selected and divided into poor reader and typical reader groups, based on their performance on the measures of reading fluency, Chinese character reading, and reading comprehension. The poor and typical readers were matched on age and nonverbal intelligence. A Posner's spatial cueing task was adopted to measure the exogenous and endogenous orienting of visual-spatial attention. Although the typical readers showed the cueing effect in the central cue condition (i.e., responses to targets following valid cues were faster than those to targets following invalid cues), the poor readers did not respond differently in valid and invalid conditions, suggesting an impairment of the endogenous orienting of attention. The two groups, however, showed a similar cueing effect in the peripheral cue condition, indicating intact exogenous orienting in the poor readers. These findings generally supported a link between the orienting of covert attention and Chinese reading, providing evidence for the attentional-deficit theory of dyslexia. Copyright © 2018 John Wiley & Sons, Ltd.

Impact of hygiene of housing conditions on performance and health of two pig genetic lines divergent for residual feed intake.

PubMed

Chatelet, A; Gondret, F; Merlot, E; Gilbert, H; Friggens, N C; Le Floc'h, N

2018-02-01

Pigs selected for high performance may be more at risk of developing diseases. This study aimed to assess the health and performance of two pig lines divergently selected for residual feed intake (RFI) (low RFI (LRFI) v. high RFI (HRFI)) and housed in two contrasted hygiene conditions (poor v. good) using a 2×2 factorial design (n=40/group). The challenge period (Period 1), started on week zero (W0) when 12-week-old pigs were transferred to good or poor housing conditions. At week 6 (W6), half of the pigs in each group were slaughtered. During a recovery period (Period 2) from W6 to W13 to W14, the remaining pigs (n=20/group) were transferred in good hygiene conditions before being slaughtered. Blood was collected every three (Period 1) or 2 weeks (Period 2) to assess blood indicators of immune and inflammatory responses. Pulmonary lesions at slaughter and performance traits were evaluated. At W6, pneumonia prevalence was greater for pigs housed in poor than in good conditions (51% v. 8%, respectively, P<0.001). Irrespective of hygiene conditions, lung lesion scores were lower for LRFI pigs than for HRFI pigs (P=0.03). At W3, LRFI in poor conditions had the highest number of blood granulocytes (hygiene×line, P=0.03) and at W6, HRFI pigs in poor conditions had the greatest plasma haptoglobin concentrations (hygiene×line, P=0.02). During Period 1, growth rate and growth-to-feed ratio were less affected by poor hygiene in LRFI pigs than in HRFI pigs (hygiene×line, P=0.001 and P=0.02, respectively). Low residual feed intake pigs in poor conditions ate more than the other groups (hygiene×line, P=0.002). Irrespective of the line, fasting plasma glucose concentrations were higher in poor conditions, whereas fasting free fatty acids concentrations were lower than in good conditions. At the end of Period 2, pneumonia prevalence was similar for both housing conditions (39% v. 38%, respectively). During Period 2, plasma protein concentrations were greater for pigs previously housed in poor than in good conditions during Period 1. Immune traits, gain-to-feed ratio, BW gain and feed consumption did not differ during Period 2. Nevertheless, at W12, BW of HRFI previously housed in poor conditions was 13.4 kg lower than BW of HRFI pigs (P<0.001) previously housed in good conditions. In conclusion, health of the most feed efficient LRFI pigs was less impaired by poor hygiene conditions. This line was able to preserve its health, growth performance and its feed ingestion to a greater extent than the less efficient HRFI line.

Combining approaches to on-line handwriting information retrieval

NASA Astrophysics Data System (ADS)

Peña Saldarriaga, Sebastián; Viard-Gaudin, Christian; Morin, Emmanuel

2010-01-01

In this work, we propose to combine two quite different approaches for retrieving handwritten documents. Our hypothesis is that different retrieval algorithms should retrieve different sets of documents for the same query. Therefore, significant improvements in retrieval performances can be expected. The first approach is based on information retrieval techniques carried out on the noisy texts obtained through handwriting recognition, while the second approach is recognition-free using a word spotting algorithm. Results shows that for texts having a word error rate (WER) lower than 23%, the performances obtained with the combined system are close to the performances obtained on clean digital texts. In addition, for poorly recognized texts (WER > 52%), an improvement of nearly 17% can be observed with respect to the best available baseline method.

The cost of poor quality: an opportunity of enormous proportions.

PubMed

Hughes, J M

1998-01-01

In all organizations, the state of finance is routinely reported in sublime detail for study and action. And yet, anywhere from 20 to 50 percent of the monies involved in that report are never identified as unnecessary and nonproductive. These monies, referred to as the Cost of Waste (COW), are the result of actions that have been taken or must be taken because quality is not served--inappropriate actions are being performed or appropriate actions are not being performed right the first time, every time. Proactively determining, reporting, and monitoring the COW brings a degree of objectivity to the quality management process and provides a powerful internal driver for performance improvement. A 10 step Cost of Waste system is proposed.

Consequences of self-handicapping: effects on coping, academic performance, and adjustment.

PubMed

Zuckerman, M; Kieffer, S C; Knee, C R

1998-06-01

Self-handicappers erect impediments to performance to protect their self-esteem. The impediments may interfere with the ability to do well and, as such, may result in poor adjustment. Using a longitudinal design, the present studies examined prospective effects of self-handicapping on coping, academic performance, and several adjustment-related variables (e.g., self-esteem). It was found that, compared to low self-handicappers, high self-handicappers reported higher usage of coping strategies implying withdrawal and negative focus. High self-handicappers performed less well academically, an effect that was mediated in part by poor study habits. Finally, high self-handicapping resulted in poorer adjustment over time, and poorer adjustment resulted in higher self-handicapping over time. These relations are consistent with the idea of a vicious cycle in which self-handicapping and poor adjustment reinforce one another.

The oral microbiome and human health.

PubMed

Yamashita, Yoshihisa; Takeshita, Toru

2017-01-01

In this brief review, we discuss our previous research on the relationship between the bacterial composition of salivary microbiota and periodontal disease. Analysis using a terminal restriction fragment length polymorphism method and an international comparison suggest that the predominance of the genera Prevotella and Veillonella in the salivary microbiota is attributable to periodontal disease conditions, and that the predominance of the genus Neisseria indicates healthy periodontal conditions. Furthermore, we recently used next-generation sequencing technology to perform a detailed large-scale analysis of the salivary microbiota. An important finding of that study was that high bacterial richness in the salivary microbiota was significantly associated with poor oral health, as indicated by decayed teeth, periodontitis, and poor oral hygiene. Another important result was that relative abundance of predominant bacteria in saliva was significantly associated with oral health-related conditions. Of the two different cohabiting groups of bacteria found in the salivary microbiota, a greater relative abundance of group I bacteria, which include Prevotella and Veillonella species, was associated with poor oral health, high body mass index, and old age. These findings suggest that the salivary microbiota reflects oral and systemic conditions.

Robotic ICSI (intracytoplasmic sperm injection).

PubMed

Lu, Zhe; Zhang, Xuping; Leung, Clement; Esfandiari, Navid; Casper, Robert F; Sun, Yu

2011-07-01

This paper is the first report of robotic intracytoplasmic sperm injection (ICSI). ICSI is a clinical procedure performed worldwide in fertility clinics, requiring pick-up of a single sperm and insertion of it into an oocyte (i.e., egg cell). Since its invention 20 years ago, ICSI has been conducted manually by a handful of highly skilled embryologists; however, success rates vary significantly among clinics due to poor reproducibility and inconsistency across operators. We leverage our work in robotic cell injection to realize robotic ICSI and aim ultimately, to standardize how clinical ICSI is performed. This paper presents some of the technical aspects of our robotic ICSI system, including a cell holding device, motion control, and computer vision algorithms. The system performs visual tracking of single sperm, robotic immobilization of sperm, aspiration of sperm with picoliter volume, and insertion of sperm into an oocyte with a high degree of reproducibility. The system requires minimal human involvement (requiring only a few computer mouse clicks), and is human operator skill independent. Using the hamster oocyte-human sperm model in preliminary trials, the robotic system demonstrated a high success rate of 90.0% and survival rate of 90.7% (n=120). © 2011 IEEE

The limits of low-temperature performance of Li-ion cells

NASA Technical Reports Server (NTRS)

Huang, C.; Sakamoto, J.; Wolfenstine, J.; Surampudi, S.

2000-01-01

The results of electrode and electrolyte studies reveal that the poor low-temperature (<-30 degrees C) performance of Li-ion cells is mainly caused by the carbon electrodes and not the organic electrolytes and solid electrolyte interphase, as previously suggested. It is suggested that the main causes for the poor performance in the carbon electrodes are (i) the low value and concentration depedence of the Li diffusivity and (ii) limited Li capacity.

Computational solvent system screening for the separation of tocopherols with centrifugal partition chromatography using deep eutectic solvent-based biphasic systems.

PubMed

Bezold, Franziska; Weinberger, Maria E; Minceva, Mirjana

2017-03-31

Tocopherols are a class of molecules with vitamin E activity. Among those, α-tocopherol is the most important vitamin E source in the human diet. The purification of tocopherols involving biphasic liquid systems can be challenging since these vitamins are poorly soluble in water. Deep eutectic solvents (DES) can be used to form water-free biphasic systems and have already proven applicable for centrifugal partition chromatography separations. In this work, a computational solvent system screening was performed using the predictive thermodynamic model COSMO-RS. Liquid-liquid equilibria of solvent systems composed of alkanes, alcohols and DES, as well as partition coefficients of α-tocopherol, β-tocopherol, γ-tocopherol, and σ-tocopherol in these biphasic solvent systems were calculated. From the results the best suited biphasic solvent system, namely heptane/ethanol/choline chloride-1,4-butanediol, was chosen and a batch injection of a tocopherol mixture, mainly consisting of α- and γ-tocopherol, was performed using a centrifugal partition chromatography set up (SCPE 250-BIO). A separation factor of 1.74 was achieved for α- and γ-tocopherol. Copyright © 2017 Elsevier B.V. All rights reserved.

Integration of membrane distillation into traditional salt farming method: Process development and modelling

NASA Astrophysics Data System (ADS)

Hizam, S.; Bilad, M. R.; Putra, Z. A.

2017-10-01

Farmers still practice the traditional salt farming in many regions, particularly in Indonesia. This archaic method not only produces low yield and poor salt quality, it is also laborious. Furthermore, the farming locations typically have poor access to fresh water and are far away from electricity grid, which restrict upgrade to a more advanced technology for salt production. This paper proposes a new concept of salt harvesting method that improves the salt yield and at the same time facilitates recovery of fresh water from seawater. The new concept integrates solar powered membrane distillation (MD) and photovoltaic cells to drive the pumping. We performed basic solar still experiments to quantify the heat flux received by a pond. The data were used as insight for designing the proposed concept, particularly on operational strategy and the most effective way to integrate MD. After the conceptual design had been developed, we formulated mass and energy balance to estimate the performance of the proposed concept. Based on our data and design, it is expected that the system would improve the yield and quality of the salt production, maximizing fresh water harvesting, and eventually provides economical gain for salt farmers hence improving their quality of life. The key performance can only be measured via experiment using gain output ratio as performance indicator, which will be done in a future study.

Economic Assessment and Budgetary Impact of a Telemedicine Procedure and Spirometry Quality Control in the Primary Care Setting.

PubMed

Marina, Nuria; Bayón, Juan Carlos; López de Santa María, Elena; Gutiérrez, Asunción; Inchausti, Marta; Bustamante, Victor; Gáldiz, Juan B

2016-01-01

To evaluate the economic impact of a telemedicine procedure designed to improve the quality of lung function testing (LFT) in primary care in a public healthcare system, compared with the standard method. The economic impact of 9,039 LFTs performed in 51 health centers (2010-2013) using telespirometry (TS) compared to standard spirometry (SS) was studied. TS costs more per unit than SS (€47.80 vs. €39.70) (2013), but the quality of the TS procedure is superior (84% good quality, compared to 61% using the standard procedure). Total cost of TS was €431,974 (compared with €358,306€ for SS), generating an economic impact of €73,668 (2013). The increase in cost for good quality LFT performed using TS was €34,030 (2010) and €144,295 (2013), while the costs of poor quality tests fell by €15,525 (2010) and 70,627€ (2013). The cost-effectiveness analysis concludes that TS is 23% more expensive and 46% more effective. Healthcare costs consequently fall as the number of LFTs performed by TS rises. Avoiding poor quality, invalid LFTs generates savings that compensate for the increased costs of performing LFTs with TS, making it a cost-effective method. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Improving Learner Handovers in Medical Education.

PubMed

Warm, Eric J; Englander, Robert; Pereira, Anne; Barach, Paul

2017-07-01

Multiple studies have demonstrated that the information included in the Medical Student Performance Evaluation fails to reliably predict medical students' future performance. This faulty transfer of information can lead to harm when poorly prepared students fail out of residency or, worse, are shuttled through the medical education system without an honest accounting of their performance. Such poor learner handovers likely arise from two root causes: (1) the absence of agreed-on outcomes of training and/or accepted assessments of those outcomes, and (2) the lack of standardized ways to communicate the results of those assessments. To improve the current learner handover situation, an authentic, shared mental model of competency is needed; high-quality tools to assess that competency must be developed and tested; and transparent, reliable, and safe ways to communicate this information must be created.To achieve these goals, the authors propose using a learner handover process modeled after a patient handover process. The CLASS model includes a description of the learner's Competency attainment, a summary of the Learner's performance, an Action list and statement of Situational awareness, and Synthesis by the receiving program. This model also includes coaching oriented towards improvement along the continuum of education and care. Just as studies have evaluated patient handover models using metrics that matter most to patients, studies must evaluate this learner handover model using metrics that matter most to providers, patients, and learners.

Language Profiles of Poor Comprehenders in English and French

ERIC Educational Resources Information Center

D'Angelo, Nadia; Chen, Xi

2017-01-01

This study explored components of language comprehension (vocabulary, grammar, and higher-level language) skills for poor comprehenders in French immersion. We identified three groups of bilingual comprehenders (poor, average, and good) based on English reading performance and compared their language comprehension skills in English L1 and French…

A Prognostic Modeling Approach for Predicting Recurring Maintenance for Shipboard Propulsion Systems

DTIC Science & Technology

2001-06-01

CIT CDT 1 CIP CDP η γ 1γ T T adb (1) Compressor fouling has also been shown to increase vibration , (Ozgur et al (2000) and Tsalavoutas et al) but... vibration increases and secondly is the poor reliability with which performance degradation severity may be assessed. In lieu of these practical...Industrial Gas Turbines” International Gas Turbine and Aeroengine Congress and Exposition, Belgium, June 1990 4. Kurtz, Rainer, Brun, Klaus, and

Decision Making by School Administrators in the United States and South Africa Using Two Different Standards: The Best Interest of the Child and the Right of Parents to Make Decisions for Their Children

ERIC Educational Resources Information Center

Mawdsley, Ralph D.; Visser, P. J. Hans; Permuth, Steven B.

2006-01-01

The opportunity for and expectation of parents' involvement in the education of their children is a staple of the American educational system. The absence of parent participation in their children's education has been decried by educators as a contributing factor to a range of problems in schools, from poor academic performance to disciplinary…

Describing the Elephant: Framing a Discussion on Command and Control

DTIC Science & Technology

2014-08-01

Joint Communications System; and other governing doctrine. The prevalence of C2 in our joint doctrine reflects the centrality of performing C2 well...and the tragedy of doing it poorly (e.g., Operation Eagle Claw during the Iran hostage crisis ; the 1994 Blackhawk shoot-down in Operation Northern...from C2 in the air. By means of its mobility, airborne C2 offers range, reach, and adaptabil- ity—coupled with unique communications and surveillance

Allogeneic stem cell transplantation in children with acute lymphoblastic leukemia after isolated central nervous system relapse: our experiences and review of the literature.

PubMed

Yoshihara, T; Morimoto, A; Kuroda, H; Imamura, T; Ishida, H; Tsunamoto, K; Naya, M; Hibi, S; Todo, S; Imashuku, S

2006-01-01

The prognosis of patients with acute lymphoblastic leukemia (ALL) and central nervous system (CNS) relapse has historically been very poor. Although chemo-radiotherapy has improved outcomes, some patients still have a poor prognosis after CNS relapse. Therefore, allogeneic hematopoietic stem cell transplantation (allo-SCT) has recently become an option for treatment of CNS leukemia; however, information, particularly on the long-term outcome of transplant recipients, is limited. We performed allo-SCT in eight pediatric patients with ALL (n=7) or T-cell type non-Hodgkin's lymphoma (n=1), who had isolated CNS relapse. All patients survived for a median of 70.5 (range, 13-153) months after SCT. Sequelae developed late in some patients: mental retardation (IQ=47) in one patient, severe alopecia in two patients, limited chronic graft-versus-host-disease in three patients, and amenorrhea and/or hypothyroidism in three patients. Except for a pre-school child with post transplant CNS relapse, six out of seven patients show normal school/social performance. Our results clearly indicate a high cure rate of isolated CNS relapse by allo-SCT in pediatric lymphoid malignancies; however, there needs to be further studies to determine which are the appropriate candidates for transplantation and what is the best transplant regimen to achieve high cure rate and maintain good quality of life.

Atmospheric Research at BNL

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

Peter Daum

2008-10-06

Brookhaven researcher Peter Daum discusses an international field experiment designed to make observations of critical components of the climate system of the southeastern Pacific. Because elements of this system are poorly understood and poorly represent

Atmospheric Research at BNL

ScienceCinema

Peter Daum

2017-12-09

Brookhaven researcher Peter Daum discusses an international field experiment designed to make observations of critical components of the climate system of the southeastern Pacific. Because elements of this system are poorly understood and poorly represent

A balanced scorecard for health services in Afghanistan.

PubMed

Peters, David H; Noor, Ayan Ahmed; Singh, Lakhwinder P; Kakar, Faizullah K; Hansen, Peter M; Burnham, Gilbert

2007-02-01

The Ministry of Public Health (MOPH) in Afghanistan has developed a balanced scorecard (BSC) to regularly monitor the progress of its strategy to deliver a basic package of health services. Although frequently used in other health-care settings, this represents the first time that the BSC has been employed in a developing country. The BSC was designed via a collaborative process focusing on translating the vision and mission of the MOPH into 29 core indicators and benchmarks representing six different domains of health services, together with two composite measures of performance. In the absence of a routine health information system, the 2004 BSC for Afghanistan was derived from a stratified random sample of 617 health facilities, 5719 observations of patient-provider interactions, and interviews with 5597 patients, 1553 health workers, and 13,843 households. Nationally, health services were found to be reaching more of the poor than the less-poor population, and providing for more women than men, both key concerns of the government. However, serious deficiencies were found in five domains, and particularly in counselling patients, providing delivery care during childbirth, monitoring tuberculosis treatment, placing staff and equipment, and establishing functional village health councils. The BSC also identified wide variations in performance across provinces; no province performed better than the others across all domains. The innovative adaptation of the BSC in Afghanistan has provided a useful tool to summarize the multidimensional nature of health-services performance, and is enabling managers to benchmark performance and identify strengths and weaknesses in the Afghan context.

Low-impact falls: demands on a system of trauma management, prediction of outcome, and influence of comorbidities.

PubMed

Kennedy, R L; Grant, P T; Blackwell, D

2001-10-01

Falls from a low height are an extremely common source of injury, the severity of which is often underestimated. As a result, low fall patients are usually not transferred to Level I trauma centers. There are surprisingly few systematic data relating to the demands made on systems of trauma care by patients with low falls. This study addresses this issue using information from a comprehensive national trauma database. The performance of TRISS methodology, and the factors associated with prolonged hospital stay, in low fall patients is also examined. The study included 31,419 patients. Patients with low falls (< 2 m) were compared with those suffering high falls (> or = 2 m), motor vehicle crashes, assault, sports injuries, and a group with unclassified injuries. Probability of survival was estimated using TRISS, and its performance in different types of injury was assessed using measures of discrimination and calibration. The influence of coexistent medical conditions on mortality and length of stay was investigated using logistic regression. Low falls accounted for 45.5% of all admissions, and 43.9% of the total bed days. The low fall group was older (mean age, 61.6 years), and predominantly female (62.5%) in contrast to the other groups (both p < 0.001). There were fewer severely injured patients than in all of the other groups except sports injuries. The area under the receiver operating characteristic curve for TRISS applied to low falls (0.874) was less than that for high falls (0.969), motor vehicle crashes (0.973), assaults (0.960), sports (1.000), and unclassified injuries (0.965). Also, the calibration of the TRISS model was poor for patients with low falls. A logistic regression model derived from a training set of 5,000 patients gave slightly improved discrimination and markedly improved calibration when compared with TRISS. Although there was a strong relationship between the number of coexistent medical conditions and the risk of dying after a low fall, including data on comorbidities in a predictive model did not improve performance. Prolonged stay (defined as greater than the 90th centile, 23 days) was more likely in women (p < 0.005), or with advanced age (p < 0.001) or low initial calculated probability of survival (p < 0.001). Cardiovascular and central nervous system diseases and diabetes were associated with longer hospital stay (all p < 0.001). A logistic regression model using TRISS variables and comorbidity data gave poor prediction of prolonged stay. There was considerable variation in the length of stay between institutions. Patients with low falls make considerable demands on a system of trauma care. TRISS methodology performs less well in this group than with other types of injury. Chronic medical conditions are associated with increased mortality and more prolonged stay after a low fall. Between-institutional variation in length of stay was considerable and this, along with the poor performance of predictive models derived from routinely collected clinical data, make it unlikely that length of stay could be used as a measure of institutional performance. More robust audit measures for patients with low falls are required.

Long noncoding RNA CCAT2 can predict metastasis and poor prognosis: A meta-analysis.

PubMed

Fan, Yang-Hua; Fang, Hua; Ji, Chen-Xing; Xie, Huan; Xiao, Bing; Zhu, Xin-Gen

2017-03-01

It has been reported that Colon cancer-associated transcript 2 (CCAT2) is dysregulated in various cancers. We performed this meta-analysis to clarify its promising functions as a prognosis marker in malignant tumors. Electronic databases, including PubMed, Medline, OVID, Cochrane Library, and Web of Science, were searched from inception to October 20, 2016. The hazard ratio (HR) and 95% confidence interval (CI) were calculated to explore the relationship between CCAT2 expression and survival, which were extracted from the eligible studies. The odds ratio (OR) was calculated to assess the association between CCAT2 expression and pathological parameters using RevMan5.3 software. Six original studies were included in this meta-analysis including 725 cancer patients. The pooled HR suggested that high CCAT2 expression was significantly correlated with overall survival (OS) (HR=2.30, 95% CI: 1.62-3.25, p<0.00001) in cancer patients. Subgroup analysis revealed a significant association between CCAT2 and OS in urogenital system (HR=1.70, 95% CI: 1.27-2.26, p<0.003) and non-urogenital system cancer patients (HR=3.18, 95% CI: 2.09-4.83, p<0.0001). A significant association was observed between high CCAT2 expression and poor progression-free survival (PFS) in cancer patients (pooled HR=2.76, 95% CI: 1.74-4.37). CCAT2 expression was significantly related to lymph node metastasis (LNM) (OR=4.33, 95% CI 2.03-9.22), distant metastasis (DM) (OR=11.66, 95% CI: 5.36-25.37) and tumor stage (OR=2.58, 95% CI 1.86-3.57). This meta-analysis demonstrated that high CCAT2 expression significantly predicts poor OS, poor PFS, LNM, DM and tumor stage, suggesting that high CCAT2 expression may serve as a novel biomarker for poor prognosis and metastasis in cancers. Copyright © 2017 Elsevier B.V. All rights reserved.

Health data in Ontario: taking stock and moving ahead.

PubMed

Iron, Karey

2006-01-01

Ontario has been a leader in performance-reporting in clinical areas such as surgery, cardiac care and drug use in the elderly. Data used to report on these areas are readily available for performance evaluation and are of reasonable quality. But other key areas like managing chronic disease and preventive care cannot be fully evaluated because relevant data are either unavailable or of poor quality. A focus on timely access to good quality demographic and vital statistics data would enhance our ability to evaluate components of the Ontario health system. New comprehensive primary care, laboratory services and drug prescriptions data sources are also necessary for health-system evaluation and planning. In the short term, a dedicated, centralized agency with legislative authority is proposed to move Ontario's health information agenda forward in a holistic, strategic and timely manner.

[Determining social factors related to pesticide poisoning among rice farmers in Colombia].

PubMed

Varona, Marcela E; Díaz, Sonia M; Briceño, Leonardo; Sánchez-Infante, Clara I; Torres, Carlos H; Palma, Ruth M; Groot, Helena; Idrovo, Alvaro J

2016-08-01

Objective Large quantities of pesticides are used in rice crops. The aim of this study is to characterize how farmers are exposed to pesticides and subsequent poisoning. Materials and Methods A multilevel (individual and community) multi-method study, which included ethnographic and survey methods, as well as measurement of pesticides in water and human samples, was performed. Results The production process is described and the main risk factors are presented. Pesticides are considered the greatest danger at work and at their homes. Workers have poor working conditions and are not protected by the system of occupational risks. Azinphos-methyl, endosulfan, β-BHC, bromophos-methyl, bromophos-ethyl and 2,4- DDT were found in water samples. The survey included 381 workers with mild (12.86 %), moderate (67.98 %) and severe (5.51 %) poisonings respectively. Severe cases presented lower levels of education, lower levels of health care access to the contributory regimen of the Colombian social security system and higher incidence of cardiovascular disease, diabetes, herpes or other viral infections. Conclusion There are precarious working conditions that favor exposure to pesticides correlated to the exclusion of farmers from the occupational risk system, to poverty and to poor education. It is urgent to include these workers to the system of occupational risk system and to improve their living conditions, thus reducing unsafe practices when handling pesticides.

Singing proficiency in the majority: normality and "phenotypes" of poor singing.

PubMed

Dalla Bella, Simone; Berkowska, Magdalena

2009-07-01

Recent evidence indicates that the majority of occasional singers can carry a tune. For example, when asked to sing a well-known song (e.g., "Happy Birthday"), nonmusicians performing at a slow tempo are as proficient as professional singers. Yet, some occasional singers are poor singers, mostly in the pitch domain, and sometimes despite not having impoverished perception. Poor singing is not a monolithic deficit, but is likely to be characterized by a diversity of singing "phenotypes." Here we systematically examined singing proficiency in a group of occasional singers, with the goal of characterizing the different patterns of poor singing. Participants sang three well-known melodies (e.g., "Jingle Bells") at a natural tempo and at a slow tempo, as indicated by a metronome. For each rendition, we computed objective measures of pitch and time accuracy with an acoustical method. The results confirmed previous observations that the majority of occasional singers can sing in tune and in time. Moreover, singing at a slow tempo after the target melody to be imitated was presented with a metronome improved pitch and time accuracy. In general, poor singers were mostly impaired on the pitch dimension, although various patterns of impairment emerged. Pitch accuracy or time accuracy could be selectively impaired; moreover, absolute measures of singing proficiency (pitch or tempo transposition) dissociated from relative measures of proficiency (pitch intervals, relative duration). These patterns of dissociations point to a multicomponent system underlying proficient singing that fractionates as a result of a developmental anomaly.

Contextual Factors Related to Math Anxiety in Second-Grade Children

ERIC Educational Resources Information Center

Jameson, Molly M.

2014-01-01

As the United States falls farther behind other countries in standardized math assessments, the author seeks to understand why U.S. students perform so poorly. One of the possible explanations to U.S. students' poor math performance may be math anxiety. However, math anxiety in elementary school children is a neglected area in the research. The…

The Effects of Knowledge of Criterion Task on Comprehension and Recall in Normally Achieving and Learning Disabled Children.

ERIC Educational Resources Information Center

Wong, Bernice Y. L.; And Others

1982-01-01

A study investigated the hypothesis that poor comprehension or recall of task demands, rather than a putative lack of goal directedness, is a possible source of learning-disabled children's poor performance of experimental tasks. Clear instructions substantially facilitated performance by both normally achieving and learning disabled children of…

Using a Computerised Graphics Package to Achieve a Technology-Oriented Classroom

ERIC Educational Resources Information Center

Aladejana, Francisca; Idowu, Lanre

2009-01-01

The present situation in Nigeria involves students of fine arts, a practical-oriented subject, being exposed to poor methods of teaching with consequent poor performances. This study examined the extent to which the use of a computerised graphics package could make the classroom technology-oriented and affect the performance of learners. This is…

The Effect of Script on Poor Readers' Sensitivity to Dynamic Visual Stimuli

ERIC Educational Resources Information Center

Kim, Jeesun; Davis, Chris; Burnham, Denis; Luksaneeyanawin, Sudaporn

2004-01-01

The current research examined performance of good and poor readers of Thai on two tasks that assess sensitivity to dynamic visual displays. Readers of Thai, a complex alphabetic script that nonetheless has a regular orthography, were chosen in order to contrast patterns of performance with readers of Korean Hangul (a similarly regular language but…