Estimating sensitivity and specificity for technology assessment based on observer studies.

PubMed

Nishikawa, Robert M; Pesce, Lorenzo L

2013-07-01

The goal of this study was to determine the accuracy and precision of using scores from a receiver operating characteristic rating scale to estimate sensitivity and specificity. We used data collected in a previous study that measured the improvements in radiologists' ability to classify mammographic microcalcification clusters as benign or malignant with and without the use of a computer-aided diagnosis scheme. Sensitivity and specificity were estimated from the rating data from a question that directly asked the radiologists their biopsy recommendations, which was used as the "truth," because it is the actual recall decision, thus it is their subjective truth. By thresholding the rating data, sensitivity and specificity were estimated for different threshold values. Because of interreader and intrareader variability, estimated sensitivity and specificity values for individual readers could be as much as 100% in error when using rating data compared to using the biopsy recommendation data. When pooled together, the estimates using thresholding the rating data were in good agreement with sensitivity and specificity estimated from the recommendation data. However, the statistical power of the rating data estimates was lower. By simply asking the observer his or her explicit recommendation (eg, biopsy or no biopsy), sensitivity and specificity can be measured directly, giving a more accurate description of empirical variability and the power of the study can be maximized. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Toward interactive context-aware affective educational recommendations in computer-assisted language learning

NASA Astrophysics Data System (ADS)

Santos, Olga C.; Saneiro, Mar; Boticario, Jesus G.; Rodriguez-Sanchez, M. C.

2016-01-01

This work explores the benefits of supporting learners affectively in a context-aware learning situation. This features a new challenge in related literature in terms of providing affective educational recommendations that take advantage of ambient intelligence and are delivered through actuators available in the environment, thus going beyond previous approaches which provided computer-based recommendation that present some text or tell aloud the learner what to do. To address this open issue, we have applied TORMES elicitation methodology, which has been used to investigate the potential of ambient intelligence for making more interactive recommendations in an emotionally challenging scenario (i.e. preparing for the oral examination of a second language learning course). Arduino open source electronics prototyping platform is used both to sense changes in the learners' affective state and to deliver the recommendation in a more interactive way through different complementary sensory communication channels (sight, hearing, touch) to cope with a universal design. An Ambient Intelligence Context-aware Affective Recommender Platform (AICARP) has been built to support the whole experience, which represents a progress in the state of the art. In particular, we have come up with what is most likely the first interactive context-aware affective educational recommendation. The value of this contribution lies in discussing methodological and practical issues involved.

Adolescent and Young Adult Cancer Survivors' Valuation of Post-Treatment Recommended Care.

PubMed

Kaul, Sapna; Smits-Seemann, Rochelle R; Zamora, Eduardo R; Spraker-Perlman, Holly; Boyle, Kevin J; Kirchhoff, Anne C

2017-03-01

Examine whether survivors of adolescent and young adult (AYA) cancer value recommended post-treatment care using focus groups and a willingness to pay (WTP) survey. WTP, a measure of value, indicates the dollar amount individuals are willing to pay to use a service. Participants were recruited through the Utah Cancer Registry. N = 28 survivors diagnosed with cancer at ages 15-39 and currently aged ≥18 participated in focus groups, and N = 4 in phone interviews (participation rate = 50%). All participants responded to a demographic survey and WTP questions based on one-time and monthly payments for annual visits. Focus group participants responded to an open-ended question on the value of follow-up care. Interval regressions identified factors associated with WTP. Qualitative analysis summarized themes for the open-ended question. Focus group participants reported valuing follow-up care as it brings peace of mind and helps them manage their health. Yet, 38% reported not having a cancer-related visit in the previous year. Only 27% and 43% of survivors agreed to pay any one-time and monthly payments, respectively. The monthly payment mean WTP was $41 (95% confidence interval [CI]: 31-84), equating to $494 annually, which is greater than the mean WTP for one-time payment ($362, 95% CI: 293-432, p < 0.001), suggesting that survivors may prefer monthly payments. Several factors, including being female and in better health, predicted higher WTP. Many AYA cancer survivors report not visiting their doctors annually for post-treatment care despite verbally valuing care. Models that demonstrate high quality and distribute costs over time should be evaluated to encourage survivors to receive recommended care.

Assessment of natural radioactivity in various commercial tiles used for building purposes in Nigeria.

PubMed

Joel, E S; Maxwell, O; Adewoyin, O O; Ehi-Eromosele, C O; Embong, Z; Oyawoye, F

2018-01-01

In this study, we evaluated the activity concentration of natural radionuclides ( 226 Ra, 232 Th and 40 K) for fifteen (15) different brands of tile samples used for building purposes in Nigeria. The tile samples were analyzed using High purity Germanium gamma detector. The mean activity concentrations of 226 Ra, 232 Th, and 40 K were observed to be 61.1 ± 5.5 Bq/kg, 70.2 ± 6.08 Bq/kg and 514.7 ± 59.8 Bq/kg respectively. Various hazard indices such as absorbed dose rate, external and internal hazard index, annual effective dose rate, Gamma activity Index (Iγ) and Alpha Index (Iα) were calculated. The obtained results showed that the mean radium equivalent activity (Raeq), the absorbed dose rate (D), external and internal hazard index, the annual effective dose (AEDR) equivalent, Gamma activity Index (Iγ) and Alpha Index (Iα) were: 204.42 Bq/kg, 177.61 nGyh -1 , 0.55, 0.77, 0.96 mSvyr -1 , 0.74 and 0.32 respectively. The average value of radium equivalent obtained in this study is less than that of the recommended value of 370 Bq/kg but the average values of the other radiological hazards for some samples are found to be slightly above international recommended values except H ex , H in and AEDE which are within the international reference value of unity. The measured concentrations of these radioactive materials were correlated with other previous result obtained from similar tile materials used in other countries and found to be in good agreement with the international standard, however, the tiles are recommended for decoration purposes in Nigeria.

Single measure and gated screening approaches for identifying students at-risk for academic problems: Implications for sensitivity and specificity.

PubMed

Van Norman, Ethan R; Nelson, Peter M; Klingbeil, David A

2017-09-01

Educators need recommendations to improve screening practices without limiting students' instructional opportunities. Repurposing previous years' state test scores has shown promise in identifying at-risk students within multitiered systems of support. However, researchers have not directly compared the diagnostic accuracy of previous years' state test scores with data collected during fall screening periods to identify at-risk students. In addition, the benefit of using previous state test scores in conjunction with data from a separate measure to identify at-risk students has not been explored. The diagnostic accuracy of 3 types of screening approaches were tested to predict proficiency on end-of-year high-stakes assessments: state test data obtained during the previous year, data from a different measure administered in the fall, and both measures combined (i.e., a gated model). Extant reading and math data (N = 2,996) from 10 schools in the Midwest were analyzed. When used alone, both measures yielded similar sensitivity and specificity values. The gated model yielded superior specificity values compared with using either measure alone, at the expense of sensitivity. Implications, limitations, and ideas for future research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Polarizabilities and hyperpolarizabilities for the atoms Al, Si, P, S, Cl, and Ar: Coupled cluster calculations.

PubMed

Lupinetti, Concetta; Thakkar, Ajit J

2005-01-22

Accurate static dipole polarizabilities and hyperpolarizabilities are calculated for the ground states of the Al, Si, P, S, Cl, and Ar atoms. The finite-field computations use energies obtained with various ab initio methods including Moller-Plesset perturbation theory and the coupled cluster approach. Excellent agreement with experiment is found for argon. The experimental alpha for Al is likely to be in error. Only limited comparisons are possible for the other atoms because hyperpolarizabilities have not been reported previously for most of these atoms. Our recommended values of the mean dipole polarizability (in the order Al-Ar) are alpha/e(2)a(0) (2)E(h) (-1)=57.74, 37.17, 24.93, 19.37, 14.57, and 11.085 with an error estimate of +/-0.5%. The recommended values of the mean second dipole hyperpolarizability (in the order Al-Ar) are gamma/e(4)a(0) (4)E(h) (-3)=2.02 x 10(5), 4.31 x 10(4), 1.14 x 10(4), 6.51 x 10(3), 2.73 x 10(3), and 1.18 x 10(3) with an error estimate of +/-2%. Our recommended polarizability anisotropy values are Deltaalpha/e(2)a(0) (2)E(h) (-1)=-25.60, 8.41, -3.63, and 1.71 for Al, Si, S, and Cl respectively, with an error estimate of +/-1%. The recommended hyperpolarizability anisotropies are Deltagamma/e(4)a(0) (4)E(h) (-3)=-3.88 x 10(5), 4.16 x 10(4), -7.00 x 10(3), and 1.65 x 10(3) for Al, Si, S, and Cl, respectively, with an error estimate of +/-4%. (c) 2005 American Institute of Physics.

The AME2016 atomic mass evaluation (I). Evaluation of input data; and adjustment procedures

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

Huang, W. J.; Audi, G.; Wang, Meng

This paper is the first of two articles (Part I and Part II) that presents the results of the new atomic mass evaluation, Ame2016. It includes complete information on the experimental input data (also including unused and rejected ones), as well as details on the evaluation procedures used to derive the tables of recommended values given in the second part. This article describes the evaluation philosophy and procedures that were implemented in the selection of specific nuclear reaction, decay and mass-spectrometric results. These input values were entered in the least-squares adjustment for determining the best values for the atomic massesmore » and their uncertainties. Details of the calculation and particularities of the Ame are then described. All accepted and rejected data, including outweighted ones, are presented in a tabular format and compared with the adjusted values obtained using the least-squares fit analysis. Differences with the previous Ame2012 evaluation are discussed and specific information is presented for several cases that may be of interest to Ame users. The second Ame2016 article gives a table with the recommended values of atomic masses, as well as tables and graphs of derived quantities, along with the list of references used in both the Ame2016 and the Nubase2016 evaluations (the first paper in this issue). Amdc: http://amdc.impcas.ac.cn/« less

Mental Health and Mental Disorder Recommendation Programs

PubMed Central

Ruchiwit, Manyat

2017-01-01

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and target groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Mental Health and Mental Disorder Recommendation Programs

PubMed Central

Ruchiwit, Manyat

2017-01-01

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environ-ment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors. Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs. Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future. Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and tar-get groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Prescribing and formulating neonatal intravenous feeding solutions by microcomputer.

PubMed Central

MacMahon, P

1984-01-01

This paper describes a computer programme for a low cost microcomputer designed to assist in the task of administering total parenteral nutrition to neonates: no knowledge of computers is necessary to operate the system. The programme displays recommended values for each of the total parenteral nutrition constituents that must be prescribed, based on detailed analysis of all the pertinent variables. The recommended values may be rejected but they do provide a useful prompt, especially for the more junior doctors. The programme includes a number of safeguards that protect against entering potentially dangerous values. As soon as the operator has completed the procedure of entering total parenteral nutrition requirements the calculations necessary to formulate a solution containing these are automatically performed. The print out contains this data plus instructions on the infusion rate and an analysis of the formulation's calorific content. This system makes it easier to vary the quantity of individual total parenteral nutrition constituents and time has been saved which was previously wasted performing laborious calculations. One of the most important contributions has been the virtual elimination of errors in the complex task of prescribing and formulating total parenteral nutrition for sick neonates. PMID:6430246

Incidence of isolated nodal failure in non-small cell lung cancer patients included in a prospective study of the value of PET-CT.

PubMed

Kolodziejczyk, Milena; Bujko, Krzysztof; Michalski, Wojciech; Kepka, Lucyna

2012-07-01

Elective nodal irradiation (ENI) is not recommended in PET-CT-based radiotherapy for NSCLC despite a low level of evidence to support such guidelines. The aim of this investigation is to find out whether omitting ENI is safe. Sixty-seven patients treated within a frame of a previously published prospective trial of the value of PET-CT were included in the analysis. Seventeen (25%) patients received ENI due to higher initial nodal involvement and in the remaining 50 patients (75%) with N0-N1 or single N2 disease ENI was omitted. Isolated nodal failure (INF) was recorded if relapse occurred in the initially uninvolved regional lymph node without previous or simultaneous local recurrence regardless of the status of distant metastases. With a median follow-up of 32 months, the estimated 3-year overall survival was 42%, local progression-free interval was 55%, and distant metastases-free interval was 62%. Three patients developed INF; all had ENI omitted from treatment, giving a final result of three INFs in 50 (6%) patients treated without ENI. In this group of patients, the 3-year cause-specific cumulative incidence of INF was 6.4% (95% confidence interval: 0-17%). The omission of ENI appears to be not as safe as suggested by current recommendations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Plasma osmolality reference values in African grey parrots (Psittacus erithacus erithacus), Hispaniolan Amazon parrots (Amazona ventralis), and red-fronted macaws (Ara rubrogenys).

PubMed

Beaufrère, Hugues; Acierno, Mark; Mitchell, Mark; Guzman, David Sanchez-Migallon; Bryant, Heather; Tully, Thomas N

2011-06-01

Birds are routinely presented to veterinarians for dehydration. Success with these cases ultimately depends on providing replacement fluids and re-establishing fluid homeostasis. Few studies have been done to determine reference ranges for plasma osmolality in birds. The goals of this study were to determine reference values for plasma osmolality in 3 species of parrots and to provide recommendations on fluid selection for replacement therapy in these species. Blood samples were collected from 21 adult Hispaniolan Amazon parrots (Amazona ventralis), 21 Congo African grey parrots (Psittacus erithacus erithacus), and 9 red-fronted macaws (Ara rubrogenys), and were placed into lithium heparin containers. Plasma osmolality was measured in duplicate with a freezing point depression osmometer. Summary statistics were computed from the average values. Reference ranges, calculated by using the robust method, were 288-324, 308-345, and 223-369 mOsm/kg in African grey parrots, Hispaniolan Amazon parrots, and red-fronted macaws, respectively. The mean +/- SD values were 306 +/- 7, 327 +/- 7, and 304 +/- 18 mOsm/kg in African grey parrots, Hispaniolan Amazon parrots, and red-fronted macaws, respectively. Comparisons with osmolality values in mammals and values previously reported for psittacine bird species suggest that plasma osmolality is slightly higher in parrots than in mammals, species-specific differences exist, and differences between reported values occur. Overall, fluids with an osmolarity close to 300-320 mOsm/L, such as Normosol-R, Plasmalyte-R, Plasmalyte-A, and NaCl 0.9%, can be recommended in parrots for fluid replacement therapy when isotonic fluids are required.

Reference values of thirty-one frequently used laboratory markers for 75-year-old males and females

PubMed Central

Ryden, Ingvar; Lind, Lars

2012-01-01

Background We have previously reported reference values for common clinical chemistry tests in healthy 70-year-old males and females. We have now repeated this study 5 years later to establish reference values also at the age of 75. It is important to have adequate reference values for elderly patients as biological markers may change over time, and adequate reference values are essential for correct clinical decisions. Methods We have investigated 31 frequently used laboratory markers in 75-year-old males (n = 354) and females (n = 373) without diabetes. The 2.5 and 97.5 percentiles for these markers were calculated according to the recommendations of the International Federation of Clinical Chemistry. Results Reference values are reported for 75-year-old males and females for 31 frequently used laboratory markers. Conclusion There were minor differences between reference intervals calculated with and without individuals with cardiovascular diseases. Several of the reference intervals differed from Scandinavian reference intervals based on younger individuals (Nordic Reference Interval Project). PMID:22300333

Consensus recommendations for the management of hyperglycaemia in critically ill patients in the Indian setting.

PubMed

Mukherjee, J J; Chatterjee, P S; Saikia, M; Muruganathan, A; Das, Ashok Kumar

2014-07-01

Hyperglycaemia occurs frequently in critically-ill patients. Not only does it occur among patients with pre-existing diabetes mellitus but elevated blood glucose values during an acute illness can also be seen in previously glucose-tolerant individuals (stress hyperglycaemia). Numerous observational studies have shown an increase in morbidity and mortality in critically ill patients with hyperglycaemia. Interestingly, outcomes in individuals with stress hyperglycaemia are worse than that in critically ill hyperglycaemic patients with pre-existing diabetes. Proper management of hyperglycaemia has been shown to result in improved clinical outcomes. Critically ill patients with hyperglycaemia should primarily be managed with intravenous insulin infusion to allow dynamic adjustment of treatment to suit the rapid changes in blood glucose values in these patients. Currently, there are in existence a fair number of published protocols to administer intensive intravenous insulin therapy that range from the relatively simple to the fairly complex. Different management strategies have been proposed depending upon whether the critically ill hyperglycaemic patient is stationed in the emergency department, the medical intensive care unit (ICU), the surgical ICU or the coronary care unit. Moreover, the ideal target blood glucose value to maintain in this group of patients remains controversial. Keeping these issues in mind, a group of leading experts in the fields of diabetes and critical care extensively reviewed the literature and framed recommendations with special attention to clinical practice in India. The aim was to formulate recommendations which are based on sound evidence and yet are simple and easy to understand and implement across the ICU throughout the country. In the current recommendations, intensive intravenous insulin therapy has been suggested as the preferred mode of managing hyperglycaemia in patients admitted to critical care settings. The current recommendations suggest using a simple and similar protocol for managing hyperglycaemia in critically-ill patients irrespective of their location among the various critical care units in a hospital. Recommendations have also been made for transition from intravenous to subcutaneous administration of insulin when the patient is transferred out of the critical care setting. It is hoped that the current recommendations shall form the basis for the management of hyperglycaemia in critically ill patients across the country.

[LDL cholesterol lowering therapy: no target value but personalised treatment].

PubMed

Simoons, Maarten L; Deckers, Jaap W

2015-01-01

We previously recommended that LDL cholesterol lowering therapy be based on the risk for (recurrent) coronary events, rather than on arbitrary targets for serum LDL cholesterol concentration. We also recommended refraining from therapy with ezetimibe until its efficacy in preventing cardiovascular events had been documented. At the American Heart Association scientific sessions 2014 the results of the IMPROVE-IT study were reported. In this large, randomised trial, a modest benefit of the combination of simvastatin plus ezetimibe over simvastatin alone was reported after 7 years of treatment. The efficacy of such combination therapy was similar to the efficacy of high-dose statin therapy, while the combination therapy is much more expensive. Comparing the efficacy and costs of different preventive therapies, we recommend first prescribing aspirin and a moderate dose of statin, secondly an ACE inhibitor. A high-dose statin should be considered in high-risk patients. The combination of simvastatin and ezetimibe should be prescribed only in high-risk patients (e.g. diabetics after myocardial infarction) who do not tolerate high-dose statins.

Frequency of Candidiasis and Colonization of Candida albicans in Relation to Oral Contraceptive Pills.

PubMed

Aminzadeh, Atousa; Sabeti Sanat, Ali; Nik Akhtar, Saeed

2016-10-01

Candidiasis, the infection caused by Candida albicans , is one of the most common infections of the oral cavity in humans. Candidiasis causes irritation and is known for its carcinogenic effects. Thus, it is important to recognize the predisposing factors for this opportunistic infection. Several previous studies have demonstrated an increased frequency of vaginal candidiasis in relation to oral contraceptive consumption. Only a few studies on the relation between oral contraceptives and oral candidiasis have been previously conducted. This study aims to evaluate the possible relation between oral contraceptive pills and oral candidiasis. This analytic, case-control study included 40 non-pregnant women divided into two groups: 20 who used oral contraceptive pills and 20 who did not. The groups were matched according to age, oral health, and past and present medical history. Samples were collected from the tongue's dorsum using a cotton swab and inoculated on CHROMagar culture plates. The frequency of positive cultures and the number of Candida colonies were compared between the two groups using independent t-tests and Mann-Whitney statistical tests with SPSS18 software. The frequency of positive cultures of Candida albicans was higher (P value = 0.03) for the case group. Also, the number of C. albicans and C. krusei was significantly higher for the case group compared to the control group (P value = 0.04, P value = 0.03). The results of the present study demonstrate that oral contraceptives containing estradiol can lead to Candida colonization in the oral cavity. It is recommended that further studies comparing the influence of oral contraceptives on Candida's adherence to the epithelium is highly recommended.

CODATA recommended values of the fundamental constants

NASA Astrophysics Data System (ADS)

Mohr, Peter J.; Taylor, Barry N.

2000-11-01

A review is given of the latest Committee on Data for Science and Technology (CODATA) adjustment of the values of the fundamental constants. The new set of constants, referred to as the 1998 values, replaces the values recommended for international use by CODATA in 1986. The values of the constants, and particularly the Rydberg constant, are of relevance to the calculation of precise atomic spectra. The standard uncertainty (estimated standard deviation) of the new recommended value of the Rydberg constant, which is based on precision frequency metrology and a detailed analysis of the theory, is approximately 1/160 times the uncertainty of the 1986 value. The new set of recommended values as well as a searchable bibliographic database that gives citations to the relevant literature is available on the World Wide Web at physics.nist.gov/constants and physics.nist.gov/constantsbib, respectively. .

2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines.

PubMed

Ferraris, Victor A; Brown, Jeremiah R; Despotis, George J; Hammon, John W; Reece, T Brett; Saha, Sibu P; Song, Howard K; Clough, Ellen R; Shore-Lesserson, Linda J; Goodnough, Lawrence T; Mazer, C David; Shander, Aryeh; Stafford-Smith, Mark; Waters, Jonathan; Baker, Robert A; Dickinson, Timothy A; FitzGerald, Daniel J; Likosky, Donald S; Shann, Kenneth G

2011-03-01

Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time. The Society of Thoracic Surgeons recommends review and possible update of previously published guidelines at least every three years. This summary is an update of the blood conservation guideline published in 2007. The search methods used in the current version differ compared to the previously published guideline. Literature searches were conducted using standardized MeSH terms from the National Library of Medicine PUBMED database list of search terms. The following terms comprised the standard baseline search terms for all topics and were connected with the logical 'OR' connector--Extracorporeal circulation (MeSH number E04.292), cardiovascular surgical procedures (MeSH number E04.100), and vascular diseases (MeSH number C14.907). Use of these broad search terms allowed specific topics to be added to the search with the logical 'AND' connector. In this 2011 guideline update, areas of major revision include: 1) management of dual anti-platelet therapy before operation, 2) use of drugs that augment red blood cell volume or limit blood loss, 3) use of blood derivatives including fresh frozen plasma, Factor XIII, leukoreduced red blood cells, platelet plasmapheresis, recombinant Factor VII, antithrombin III, and Factor IX concentrates, 4) changes in management of blood salvage, 5) use of minimally invasive procedures to limit perioperative bleeding and blood transfusion, 6) recommendations for blood conservation related to extracorporeal membrane oxygenation and cardiopulmonary perfusion, 7) use of topical hemostatic agents, and 8) new insights into the value of team interventions in blood management. Much has changed since the previously published 2007 STS blood management guidelines and this document contains new and revised recommendations. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Glycaemic index and glycaemic load values of commonly consumed foods in the United Arab Emirates.

PubMed

Al Dhaheri, Ayesha S; Henry, C Jeyakumar K; Mohamad, Maysm N; Ohuma, Eric O; Ismail, Leila Cheikh; Al Meqbaali, Fatima T; Jarrar, Amjad H

2017-04-01

Glycaemic index (GI) and glycaemic load (GL) values of some commonly consumed foods in the United Arab Emirates were determined with an aim of adding these values to the existing international table of GI and GL values. In all, eighteen test foods categorised into breads (n 5), entrée dishes (n 3), main dishes (n 5) and sweet dishes (n 5) were tested. For each test food, at least fifteen healthy participants consumed 25 or 50 g available carbohydrate portions of a reference food (glucose), which was tested three times, and a test food after an overnight fast, was tested once, on separate occasions. Capillary blood samples were obtained by finger-prick and blood glucose was measured using clinical chemistry analyser. A fasting blood sample was obtained at baseline and before consumption of test foods. Additional blood samples were obtained at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI value of each test food was calculated as the percentage of the incremental area under the blood glucose curve (IAUC) for the test food of each participant divided by the average IAUC for the reference food of the same participant. The GI values of tested foods ranged from low (55 or less) to high (70 or more). The GI values of various breads and rice-containing dishes were comparable with previously published values. This study provides GI and GL values of previously untested traditional Emirati foods which could provide a useful guide on dietary recommendations for the Emirati population.

Mining the preferences of patients for ubiquitous clinic recommendation.

PubMed

Chen, Tin-Chih Toly; Chiu, Min-Chi

2018-03-06

A challenge facing all ubiquitous clinic recommendation systems is that patients often have difficulty articulating their requirements. To overcome this problem, a ubiquitous clinic recommendation mechanism was designed in this study by mining the clinic preferences of patients. Their preferences were defined using the weights in the ubiquitous clinic recommendation mechanism. An integer nonlinear programming problem was solved to tune the values of the weights on a rolling basis. In addition, since it may take a long time to adjust the values of weights to their asymptotic values, the back propagation network (BPN)-response surface method (RSM) method is applied to estimate the asymptotic values of weights. The proposed methodology was tested in a regional study. Experimental results indicated that the ubiquitous clinic recommendation system outperformed several existing methods in improving the successful recommendation rate.

The AME2016 atomic mass evaluation (I). Evaluation of input data; and adjustment procedures

NASA Astrophysics Data System (ADS)

Huang, W. J.; Audi, G.; Wang, Meng; Kondev, F. G.; Naimi, S.; Xu, Xing

2017-03-01

This paper is the first of two articles (Part I and Part II) that presents the results of the new atomic mass evaluation, AME2016. It includes complete information on the experimental input data (also including unused and rejected ones), as well as details on the evaluation procedures used to derive the tables of recommended values given in the second part. This article describes the evaluation philosophy and procedures that were implemented in the selection of specific nuclear reaction, decay and mass-spectrometric results. These input values were entered in the least-squares adjustment for determining the best values for the atomic masses and their uncertainties. Details of the calculation and particularities of the AME are then described. All accepted and rejected data, including outweighted ones, are presented in a tabular format and compared with the adjusted values obtained using the least-squares fit analysis. Differences with the previous AME2012 evaluation are discussed and specific information is presented for several cases that may be of interest to AME users. The second AME2016 article gives a table with the recommended values of atomic masses, as well as tables and graphs of derived quantities, along with the list of references used in both the AME2016 and the NUBASE2016 evaluations (the first paper in this issue). AMDC: http://amdc.impcas.ac.cn/ Contents The AME2016 atomic mass evaluation (I). Evaluation of input data; and adjustment proceduresAcrobat PDF (1.2 MB) Table I. Input data compared with adjusted valuesAcrobat PDF (1.3 MB)

Impact of a public cholesterol screening program.

PubMed

Fischer, P M; Guinan, K H; Burke, J J; Karp, W B; Richards, J W

1990-12-01

The National Cholesterol Education Program (NCEP) has endorsed physician case finding as the primary method to detect individuals with elevated cholesterol levels. Despite this recommendation, promotional and for-profit public screening programs have flourished. We surveyed participants of a mall-based cholesterol screening program 1 year after their screening. Sixty-four percent of those screened had not previously known their cholesterol levels. Those who were newly screened were less likely to benefit from this testing than the general public, since they were older (mean age, 55.3 years), more likely to be female (67.4%), and nonsmokers (88%). Screenees had excellent recall of their cholesterol level (mean absolute reporting error, 0.24 mmol/L [9 mg/dL]) and a good understanding of cholesterol as a coronary heart disease risk. Those with elevated cholesterol levels reported high distress from screening but no reduction in overall psychosocial well-being and an actual decrease in absenteeism. Only 53.7% of all who were advised to seek follow-up because of an elevated screening value had done so within the year following the screening program. However, of those with values greater than 6.2 mmol/L (240 mg/dL), 68% had sought follow-up. Many of those who participate in public screening programs have been previously tested, fall into low-benefit groups, or fail to comply with recommended follow-up. We therefore conclude that cholesterol screening programs of the type now commonly offered are unlikely to contribute greatly to the national efforts to further reduce coronary heart disease.

Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

PubMed Central

Tiwari, Tejpratap; Moro, Pedro; Messonnier, Nancy E.; Reingold, Arthur; Sawyer, Mark; Clark, Thomas A.

2018-01-01

Summary This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of tetanus, diphtheria, and pertussis in the United States. As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations and replaces all previously published reports and policy notes; it is intended for use by clinicians and public health providers as a resource. ACIP recommends routine vaccination for tetanus, diphtheria, and pertussis. Infants and young children are recommended to receive a 5-dose series of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccines, with one adolescent booster dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. Adults who have never received Tdap also are recommended to receive a booster dose of Tdap. Women are recommended to receive a dose of Tdap during each pregnancy, which should be administered from 27 through 36 weeks’ gestation, regardless of previous receipt of Tdap. After receipt of Tdap, adolescents and adults are recommended to receive a booster tetanus and diphtheria toxoids (Td) vaccine every 10 years to assure ongoing protection against tetanus and diphtheria. PMID:29702631

[Blood pressure targets : The lower the better does not suit all].

PubMed

Hoffmann, U

2018-04-01

The systolic blood pressure intervention trial (SPRINT) published in 2015 has opened up new discussions on whether a lower blood pressure target as recommended by the current guidelines would be better for some patient groups. To review patient groups in which lower blood pressure targets would not be better. The results of SPRINT, its post-hoc and subgroup analyses, other studies and newer studies, as well as metaanalyses on the topic of blood pressure targets are reviewed and discussed. Studies with patients excluded from the SPRINT study were also analysed. The current international guidelines and recommendations of the Deutsche Hochdruckliga e. V. DHL® are included. Blood pressure monitoring methods differed considerably in the previously published studies. The low blood pressure value in SPRINT was mainly achieved due to the unusual method of blood pressure monitoring used and, as such, cannot be compared with blood pressure values in other studies. Based on current evidence, "the lower the better" should not be recommended in the following patient groups: older patients, in particular infirm older patients, patients with diabetes, patients without coronary heart disease or with low cardiovascular risk. When determining a blood pressure target, the method of blood pressure monitoring should be defined. A lower blood pressure target has been shown to be better in some well defined patient groups. However, adverse events due to antihypertensive medications should always be taken into account. Given the multiple exclusion criteria in trials and the results of many studies, "new" lower blood pressure targets could not be recommended in a large population of patients.

Standardization of haematology critical results management in adults: an International Council for Standardization in Haematology, ICSH, survey and recommendations.

PubMed

Keng, T B; De La Salle, B; Bourner, G; Merino, A; Han, J-Y; Kawai, Y; Peng, M T; McCafferty, R

2016-10-01

These recommendations are intended to develop a consensus in the previously published papers as to which parameters and what values should be considered critical. A practical guide on the standardization of critical results management in haematology laboratories would be beneficial as part of good laboratory and clinical practice and for use by laboratory-accrediting agencies. A working group with members from Europe, America, Australasia and Asia was formed by International Council for Standardization in Haematology. A pattern of practice survey of 21 questions was distributed in 2014, and the data were collected electronically by Survey Monkey. The mode, or most commonly occurring value, was selected as the threshold for the upper and lower alert limits for critical results reporting. A total of 666 laboratories submitted data to this study and, of these, 499 submitted complete responses. Full blood count critical results alert thresholds, morphology findings that trigger critical result notification, critical results alert list, notification process and maintenance of critical results management protocol are described. This international survey provided a snapshot of the current practice worldwide and has identified the existence of considerable heterogeneity of critical results management. The recommendations in this study represent a consensus of good laboratory practice. They are intended to encourage the implementation of a standardized critical results management protocol in the laboratory. © 2016 John Wiley & Sons Ltd.

Making our offices universally accessible: guidelines for physicians

PubMed Central

Jones, K E; Tamari, I E

1997-01-01

OBJECTIVE: To develop recommendations for office-based physicians who wish to make their offices accessible to all patients. OPTIONS: Include taking steps to make offices more accessible, or not; offices may be accessible to varying degrees. OUTCOMES: Outcomes of accessibility involve patient-care, economic, ethical and legal issues. Stakeholders in these outcomes include patients, physicians, government and society. EVIDENCE: Data were obtained from a series of searches of MEDLINE, CINAHL and Healthstar (previously Health) databases for articles on disability and family medicine, primary (health) care and family practice, and on access and offices, and health services accessibility, and from a telephone survey of 50 stakeholders. VALUES: A high value was placed on services to persons with disabilities and on stakeholder input. Universal accessibility was valued as an overall goal; improved accessibility was also highly valued. BENEFITS, HARMS AND COSTS: Benefits to patients include improved access to care as guaranteed by the Canada Health Act and in keeping with provincial Human Rights Codes. Benefits to physicians include contact with a broader patient population and freedom from fear of litigation. Costs of improved accessibility vary depending on individual circumstances and on whether an office is being built or renovated; some improvement costs are minimal. RECOMMENDATIONS: All physicians should take measures to improve practice accessibility. Improved access should be considered in each of the following areas: transportation and entrance to the facility, entrance to the office, waiting rooms, rest rooms, examination rooms, general building features and other features. VALIDATION: No similar guidelines exist. To assess the content validity of these guidelines, the authors had a draft document reviewed by 18 stakeholders. All specific recommendations met the minimum criterion of adherence to current legislation, including national and provincial building codes. The specific recommendations are endorsed by the Canadian Paraplegic Association (national and Ontario offices), the DisAbled Women's Network (Ontario) and the Centre for Independent Living (Toronto). SPONSORS: Development of these guidelines was supported in part by the Department of Family and Community Medicine, Toronto Hospital, Toronto, Ont. PMID:9068570

Sensor Acquisition for Water Utilities: Survey, Down Selection Process, and Technology List

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

Alai, M; Glascoe, L; Love, A

2005-06-29

The early detection of the biological and chemical contamination of water distribution systems is a necessary capability for securing the nation's water supply. Current and emerging early-detection technology capabilities and shortcomings need to be identified and assessed to provide government agencies and water utilities with an improved methodology for assessing the value of installing these technologies. The Department of Homeland Security (DHS) has tasked a multi-laboratory team to evaluate current and future needs to protect the nation's water distribution infrastructure by supporting an objective evaluation of current and new technologies. The LLNL deliverable from this Operational Technology Demonstration (OTD) wasmore » to assist the development of a technology acquisition process for a water distribution early warning system. The technology survey includes a review of previous sensor surveys and current test programs and a compiled database of relevant technologies. In the survey paper we discuss previous efforts by governmental agencies, research organizations, and private companies. We provide a survey of previous sensor studies with regard to the use of Early Warning Systems (EWS) that includes earlier surveys, testing programs, and response studies. The list of sensor technologies was ultimately developed to assist in the recommendation of candidate technologies for laboratory and field testing. A set of recommendations for future sensor selection efforts has been appended to this document, as has a down selection example for a hypothetical water utility.« less

Baveno VI Recommendation on Avoidance of Screening Endoscopy in Cirrhotic Patients: Are We There Yet?

PubMed Central

Silva, Mário Jorge; Bernardes, Carlos; Pinto, João; Loureiro, Rafaela; Duarte, Pedro; Mendes, Milena; Calinas, Filipe

2017-01-01

Introduction Recent studies assessed the predictive value of liver transient elastography, combined or not with platelet count, for the presence of esophageal varices in patients with liver cirrhosis, and multiple cutoffs have been proposed. The Baveno VI consensus states that patients with compensated advanced chronic liver disease, liver stiffness <20 kPa, and a platelet count >150,000 have a very low risk of having varices requiring treatment and can avoid screening endoscopy. We aimed to validate this recommendation in a cohort of cirrhotic patients. Methods Retrospective analysis of all patients evaluated at the Gastroenterology Department (Centro Hospitalar de Lisboa Central) between September 2009 and October 2015 with a liver stiffness (FibroScan®) compatible with liver cirrhosis as well as upper endoscopy and blood tests within 12 months from elastography. Patients on propranolol ≥80 mg/day or carvedilol ≥12.5 mg/day, as well as those with previous variceal bleeding, variceal endoscopic treatments, or cirrhosis decompensations were excluded. We validated the new Baveno VI recommendation and explored alternative cutoffs. Results Ninety-seven patients were analyzed, 76.3% (74/97) male, mean age 54.3 ± 11.2 years. Most patients (55.7%) had no varices and 14.4% had varices requiring treatment. Most patients (78.4%) had cirrhosis related to chronic hepatitis C. If the new Baveno VI recommendation had been applied to this cohort, upper endoscopy would have been avoided in 11.3% (11/97) of patients, none of them with esophageal varices requiring treatment: specificity 100%, sensitivity 13.3%, positive predictive value 100%, and negative predictive value 16.3% for absence of varices requiring treatment. If screening endoscopy had been avoided in those patients with liver stiffness <30 kPa and platelet count ≥120,000, endoscopy would have been avoided in 27.8% (27/97) of patients, none of whom with esophageal varices requiring treatment: specificity 100%, sensitivity 32.5%, positive predictive value 100%, and negative predictive value 20% for absence of varices requiring treatment. Conclusions The new Baveno VI criteria identified compensated cirrhotic patients without varices requiring treatment in whom screening endoscopy could have been avoided safely. Further studies are needed to confirm these findings and potentially explore more ambitious but still safe cutoffs for those criteria. PMID:28848787

Modified Cut-Off Value of the Urine Protein-To-Creatinine Ratio Is Helpful for Identifying Patients at High Risk for Chronic Kidney Disease: Validation of the Revised Japanese Guideline.

PubMed

Yamamoto, Hiroyuki; Yamamoto, Kyoko; Yoshida, Katsumi; Shindoh, Chiyohiko; Takeda, Kyoko; Monden, Masami; Izumo, Hiroko; Niinuma, Hiroyuki; Nishi, Yutaro; Niwa, Koichiro; Komatsu, Yasuhiro

2015-11-01

Chronic kidney disease (CKD) is a global public health issue, and strategies for its early detection and intervention are imperative. The latest Japanese CKD guideline recommends that patients without diabetes should be classified using the urine protein-to-creatinine ratio (PCR) instead of the urine albumin-to-creatinine ratio (ACR); however, no validation studies are available. This study aimed to validate the PCR-based CKD risk classification compared with the ACR-based classification and to explore more accurate classification methods. We analyzed two previously reported datasets that included diabetic and/or cardiovascular patients who were classified into early CKD stages. In total, 860 patients (131 diabetic patients and 729 cardiovascular patients, including 193 diabetic patients) were enrolled. We assessed the CKD risk classification of each patient according to the estimated glomerular filtration rate and the ACR-based or PCR-based classification. The use of the cut-off value recommended in the current guideline (PCR 0.15 g/g creatinine) resulted in risk misclassification rates of 26.0% and 16.6% for the two datasets. The misclassification was primarily caused by underestimation. Moderate to substantial agreement between each classification was achieved: Cohen's kappa, 0.56 (95% confidence interval, 0.45-0.69) and 0.72 (0.67-0.76) in each dataset, respectively. To improve the accuracy, we tested various candidate PCR cut-off values, showing that a PCR cut-off value of 0.08-0.10 g/g creatinine resulted in improvement in the misclassification rates and kappa values. Modification of the PCR cut-off value would improve its efficacy to identify high-risk populations who will benefit from early intervention.

Sport Activity for Health!! The Effects of Karate Participants' Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention.

PubMed

Chang, Ying-Chih; Yeh, Tsu-Ming; Pai, Fan-Yun; Huang, Tai-Peng

2018-05-10

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research.

Sport Activity for Health!! The Effects of Karate Participants’ Involvement, Perceived Value, and Leisure Benefits on Recommendation Intention

PubMed Central

Chang, Ying-Chih; Pai, Fan-Yun; Huang, Tai-Peng

2018-01-01

This study intends to discuss the effects of participants’ involvement, perceived value, and leisure benefits on recommendation intention in the sport of karate. The questionnaires were collected online by karate clubs on Facebook and included 369 valid participants. The research findings show that karate participants from different places of residence do not display significant differences in involvement, perceived value, leisure benefits, and recommendation intention. Furthermore, “attraction” in the involvement category reveals the highest mean, “paid spirit and energy being worthy” in perceived value appears as the highest mean, and “physiological benefits” in leisure benefits shows the highest mean. The Pearson correlation analysis result presents significant strong positive correlations between involvement, perceived value, leisure benefits, and recommendation intention. Finally, multiple regression analysis reveals that leisure benefits, except “physiological benefits”, show notably positive effects on recommendation intention. According to the research results, suggestions are proposed for the reference of karate teaching business managers, participants, and future research. PMID:29748459

Status of linear boundary-layer stability and the e to the nth method, with emphasis on swept-wing applications

NASA Technical Reports Server (NTRS)

Hefner, J. N.; Bushnell, D. M.

1980-01-01

The-state-of-the-art for the application of linear stability theory and the e to the nth power method for transition prediction and laminar flow control design are summarized, with analyses of previously published low disturbance, swept wing data presented. For any set of transition data with similar stream distrubance levels and spectra, the e to the nth power method for estimating the beginning of transition works reasonably well; however, the value of n can vary significantly, depending upon variations in disturbance field or receptivity. Where disturbance levels are high, the values of n are appreciably below the usual average value of 9 to 10 obtained for relatively low disturbance levels. It is recommended that the design of laminar flow control systems be based on conservative estimates of n and that, in considering the values of n obtained from different analytical approaches or investigations, the designer explore the various assumptions which entered into the analyses.

Determination of Phosphorus and Potassium in Commercial Inorganic Fertilizers by Inductively Coupled Plasma-Optical Emission Spectrometry: Single-Laboratory Validation, First Action 2015.18.

PubMed

Thiex, Nancy J

2016-07-01

A previously validated method for the determination of both citrate-EDTA-soluble P and K and acid-soluble P and K in commercial inorganic fertilizers by inductively coupled plasma-optical emission spectrometry was submitted to the expert review panel (ERP) for fertilizers for consideration of First Action Official Method(SM) status. The ERP evaluated the single-laboratory validation results and recommended the method for First Action Official Method status and provided recommendations for achieving Final Action. Validation materials ranging from 4.4 to 52.4% P2O5 (1.7-22.7% P) and 3-62% K2O (2.5-51.1% K) were used for the validation. Recoveries from validation materials for citrate-soluble P and K ranged from 99.3 to 124.9% P and from 98.4 to 100.7% K. Recoveries from validation materials for acid-soluble "total" P and K ranged from 95.53 to 99.40% P and from 98.36 to 107.28% K. Values of r for citrate-soluble P and K, expressed as RSD, ranged from 0.28 to 1.30% for P and from 0.41 to 1.52% for K. Values of r for total P and K, expressed as RSD, ranged from 0.71 to 1.13% for P and from 0.39 to 1.18% for K. Based on the validation data, the ERP recommended the method (with alternatives for the citrate-soluble and the acid-soluble extractions) for First Action Official Method status and provided recommendations for achieving Final Action status.

Phosphorus saturation and superficial fertilizer application as key parameters to assess the risk of diffuse phosphorus losses from agricultural soils in Brazil.

PubMed

Fischer, P; Pöthig, R; Gücker, B; Venohr, M

2018-07-15

In Brazil, a steady increase in phosphorus (P) fertilizer application and agricultural intensification has been reported for recent decades. The concomitant P accumulation in soils potentially threatens surface water bodies with eutrophication through diffuse P losses. Here, we demonstrated the applicability of a soil type-independent approach for estimating the degree of P saturation (DPS; a risk parameter of P loss) by a standard method of water-soluble phosphorus (WSP) for two major soil types (Oxisols, Entisols) of the São Francisco catchment in Brazil. Subsequently, soil Mehlich-1P (M1P) levels recommended by Brazilian agricultural institutions were transformed into DPS values. Recommended M1P values for optimal agronomic production corresponded to DPS values below critical thresholds of high risks of P losses (DPS=80%) for major crops of the catchment. Higher risks of reaching critical DPS values due to P accumulation were found for Entisols due to their total sorption capacities being only half those of Oxisols. For complementary information on soil mineralogy and its influence on P sorption and P binding forms, Fourier transformation infrared (FTIR) spectroscopic analyses were executed. FTIR analyses suggested the occurrence of the clay minerals palygorskite and sepiolite in some of the analyzed Entisols and the formation of crandallite as the soil specific P binding form in the investigated Oxisols. Palygorskite and sepiolite can enhance P solubility and hence the risk of P losses. In contrast, the reshaping of superphosphate grains into crandallite may explain the chemical processes leading to previously observed low dissolved P concentrations in surface runoff from Oxisols. To prevent high risk of P losses, we recommend avoiding superficial fertilizer application and establishing environmental thresholds for soil M1P based on DPS. These measures could help to prevent eutrophication of naturally oligotrophic surface waters, and subsequent adverse effects on biodiversity and ecosystem function. Copyright © 2018 Elsevier B.V. All rights reserved.

Average and recommended half-life values for two neutrino double beta decay: Upgrade-2013

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

Barabash, A. S.

2013-12-30

All existing positive results on two neutrino double beta decay in different nuclei were analyzed. Using the procedure recommended by the Particle Data Group, weighted average values for half-lives of {sup 48}Ca, {sup 76}Ge, {sup 82}Se, {sup 96}Zr, {sup 100}Mo, {sup 100}Mo−{sup 100}Ru (0{sub 1}{sup +}), {sup 116}Cd, {sup 130}Te, {sup 136}Xe, {sup 150}Nd, {sup 150}Nd−{sup 150}Sm (0{sub 1}{sup +}) and {sup 238}U were obtained. Existing geochemical data were analyzed and recommended values for half-lives of {sup 128}Te and {sup 130}Ba are proposed. I recommend the use of these results as the most currently reliable values for half-lives.

Report of the IAU Working Group on Cartographic Coordinates and Rotational Elements: 2015

NASA Astrophysics Data System (ADS)

Archinal, B. A.; Acton, C. H.; A'Hearn, M. F.; Conrad, A.; Consolmagno, G. J.; Duxbury, T.; Hestroffer, D.; Hilton, J. L.; Kirk, R. L.; Klioner, S. A.; McCarthy, D.; Meech, K.; Oberst, J.; Ping, J.; Seidelmann, P. K.; Tholen, D. J.; Thomas, P. C.; Williams, I. P.

2018-03-01

This report continues the practice where the IAU Working Group on Cartographic Coordinates and Rotational Elements revises recommendations regarding those topics for the planets, satellites, minor planets, and comets approximately every 3 years. The Working Group has now become a "functional working group" of the IAU, and its membership is open to anyone interested in participating. We describe the procedure for submitting questions about the recommendations given here or the application of these recommendations for creating a new or updated coordinate system for a given body. Regarding body orientation, the following bodies have been updated: Mercury, based on MESSENGER results; Mars, along with a refined longitude definition; Phobos; Deimos; (1) Ceres; (52) Europa; (243) Ida; (2867) Šteins; Neptune; (134340) Pluto and its satellite Charon; comets 9P/Tempel 1, 19P/Borrelly, 67P/Churyumov-Gerasimenko, and 103P/Hartley 2, noting that such information is valid only between specific epochs. The special challenges related to mapping 67P/Churyumov-Gerasimenko are also discussed. Approximate expressions for the Earth have been removed in order to avoid confusion, and the low precision series expression for the Moon's orientation has been removed. The previously online only recommended orientation model for (4) Vesta is repeated with an explanation of how it was updated. Regarding body shape, text has been included to explain the expected uses of such information, and the relevance of the cited uncertainty information. The size of the Sun has been updated, and notation added that the size and the ellipsoidal axes for the Earth and Jupiter have been recommended by an IAU Resolution. The distinction of a reference radius for a body (here, the Moon and Titan) is made between cartographic uses, and for orthoprojection and geophysical uses. The recommended radius for Mercury has been updated based on MESSENGER results. The recommended radius for Titan is returned to its previous value. Size information has been updated for 13 other Saturnian satellites and added for Aegaeon. The sizes of Pluto and Charon have been updated. Size information has been updated for (1) Ceres and given for (16) Psyche and (52) Europa. The size of (25143) Itokawa has been corrected. In addition, the discussion of terminology for the poles (hemispheres) of small bodies has been modified and a discussion on cardinal directions added. Although they continue to be used for planets and their satellites, it is assumed that the planetographic and planetocentric coordinate system definitions do not apply to small bodies. However, planetocentric and planetodetic latitudes and longitudes may be used on such bodies, following the right-hand rule. We repeat our previous recommendations that planning and efforts be made to make controlled cartographic products; newly recommend that common formulations should be used for orientation and size; continue to recommend that a community consensus be developed for the orientation models of Jupiter and Saturn; newly recommend that historical summaries of the coordinate systems for given bodies should be developed, and point out that for planets and satellites planetographic systems have generally been historically preferred over planetocentric systems, and that in cases when planetographic coordinates have been widely used in the past, there is no obvious advantage to switching to the use of planetocentric coordinates. The Working Group also requests community input on the question submitting process, posting of updates to the Working Group website, and on whether recommendations should be made regarding exoplanet coordinate systems.

Endotracheal suctioning in intubated newborns: an integrative literature review

PubMed Central

Gonçalves, Roberta Lins; Tsuzuki, Lucila Midori; Carvalho, Marcos Giovanni Santos

2015-01-01

Evidence-based practices search for the best available scientific evidence to support problem solving and decision making. Because of the complexity and amount of information related to health care, the results of methodologically sound scientific papers must be integrated by performing literature reviews. Although endotracheal suctioning is the most frequently performed invasive procedure in intubated newborns in neonatal intensive care units, few Brazilian studies of good methodological quality have examined this practice, and a national consensus or standardization of this technique is lacking. Therefore, the purpose of this study was to review secondary studies on the subject to establish recommendations for endotracheal suctioning in intubated newborns and promote the adoption of best-practice concepts when conducting this procedure. An integrative literature review was performed, and the recommendations of this study are to only perform endotracheal suctioning in newborns when there are signs of tracheal secretions and to avoid routinely performing the procedure. In addition, endotracheal suctioning should be conducted by at least two people, the suctioning time should be less than 15 seconds, the negative suction pressure should be below 100 mmHg, and hyperoxygenation should not be used on a routine basis. If indicated, oxygenation is recommended with an inspired oxygen fraction value that is 10 to 20% greater than the value of the previous fraction, and it should be performed 30 to 60 seconds before, during and 1 minute after the procedure. Saline instillation should not be performed routinely, and the standards for invasive procedures must be respected. PMID:26465249

How should unmatched otolaryngology applicants proceed?

PubMed

Schwan, Josianna; Abaza, Mona; Cabrera-Muffly, Cristina

2015-10-01

To determine the attitudes of otolaryngology residency program directors and chairpersons toward unmatched residency applicants, including whether a surgical internship or research year is preferred in considering repeat applicants. Cross-sectional survey. Approval was obtained from the Colorado Multiple Institution Review Board. A 12-question Web-based survey was sent to otolaryngology residency program directors and chairpersons three times over a 6-week period. Responses collected from respondents were anonymous, with no identifying characteristics. Forty-five percent of those contacted responded to the survey. The most commonly recommended course of action for an unmatched applicant was completion of a general surgery intern year (43%) or a year of research (31%). Program directors were more likely than chairpersons to recommend a year of research (P value 0.014). Ninety-seven percent of the respondents felt it was important or essential to obtain new letters of recommendation. Respondents ranked poor interview skills as the most common reason for applicants remaining unmatched (29%). Otolaryngology residency match is even more competitive for previously unmatched applicants. Unmatched applicants should be advised to proceed with either a research year or postgraduate year 1 general surgery year. Before applying again, applicants should obtain new letters of recommendation, and the importance of improving poor interviewing skills should be emphasized by advisors. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Antiretroviral treatment for HIV infection: Swedish recommendations 2016.

PubMed

Eriksen, Jaran; Albert, Jan; Blaxhult, Anders; Carlander, Christina; Flamholc, Leo; Gisslén, Magnus; Josephson, Filip; Karlström, Olof; Navér, Lars; Svedhem, Veronica; Yilmaz, Aylin; Sönnerborg, Anders

2017-01-01

The Swedish Medical Products Agency and the Swedish Reference Group for Antiviral Therapy (RAV) have jointly published recommendations for the treatment of HIV infection on seven previous occasions (2002, 2003, 2005, 2007, 2009, 2011 and 2014). In February 2016, an expert group under the guidance of RAV once more revised the guidelines. The most important updates in the present guidelines are as follows: Tenofovir alafenamide (TAF) has recently been registered. TAF has several advantages over tenofovir disoproxilfumarate (TDF) and is recommended instead of TDF in most cases. First-line treatment for previously untreated individuals includes dolutegravir, boosted darunavir or efavirenz with either abacavir/lamivudine or tenofovir (TDF/TAF)/emtricitabine. Pre-exposure prophylaxis (PrEP) is recommended for high-risk individuals. As in the case of the previous publication, recommendations are evidence-graded in accordance with the Oxford Centre for Evidence Based Medicine ( http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/ ) ( Table 1 ). This document does not cover treatment of opportunistic infections and tumours. [Table: see text].

Eyeglasses for Children - a Survey of Daily Practice.

PubMed

Hagander, C E; Traber, G; Landau, K; Jaggi, G P

2016-04-01

Glasses for children are recommended and prescribed by different groups of professionals. We set out to compare the prescription practices of ophthalmologists, orthoptists and optometrists/opticians in Switzerland. Online questionnaire on the prescription and recommendation of glasses in fictitious cases of children of different ages, refractive values and symptoms. The questionnaire was sent out to members of the Swiss Ophthalmological Society, Swiss Orthoptics and Schweizerischer Berufsverband für Augenoptik und Optometrie. 307 questionnaires were analysed. Optometrists/opticians recommended glasses with a significantly smaller cycloplegic refraction value (p < 0.005) than did orthoptists and ophthalmologists. In the example of a 14-year-old asymptomatic child, ophthalmologists recommended glasses at + 2.64 [Dpt], orthoptists at + 2.44 [Dpt] and optometrists/opticians at + 1.32 [Dpt]. Optometrists/opticians tended to recommend slightly higher correction values in glasses than did ophthalmologists and orthoptists. In Switzerland, optometrists/opticians recommend glasses with significantly smaller cycloplegic refraction values than do orthoptists and ophthalmologists, regardless of age or symptoms described in these fictitious cases. Georg Thieme Verlag KG Stuttgart · New York.

A Boltzmann constant determination based on Johnson noise thermometry

NASA Astrophysics Data System (ADS)

Flowers-Jacobs, N. E.; Pollarolo, A.; Coakley, K. J.; Fox, A. E.; Rogalla, H.; Tew, W. L.; Benz, S. P.

2017-10-01

A value for the Boltzmann constant was measured electronically using an improved version of the Johnson Noise Thermometry (JNT) system at the National Institute of Standards and Technology (NIST), USA. This system is different from prior ones, including those from the 2011 determination at NIST and both 2015 and 2017 determinations at the National Institute of Metrology (NIM), China. As in all three previous determinations, the main contribution to the combined uncertainty is the statistical uncertainty in the noise measurement, which is mitigated by accumulating and integrating many weeks of cross-correlated measured data. The second major uncertainty contribution also still results from variations in the frequency response of the ratio of the measured spectral noise of the two noise sources, the sense resistor at the triple-point of water and the superconducting quantum voltage noise source. In this paper, we briefly describe the major differences between our JNT system and previous systems, in particular the input circuit and approach we used to match the frequency responses of the two noise sources. After analyzing and integrating 50 d of accumulated data, we determined a value: k~=1.380 642 9(69)× {{10}-23} J K-1 with a relative standard uncertainty of 5.0× {{10}-6} and relative offset -4.05× {{10}-6} from the CODATA 2014 recommended value.

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

Parker, Kent E.; Golovich, Elizabeth C.; Wellman, Dawn M.

Iodine sorption onto seven resins and six carbon materials was evaluated using water from well 299-W19-36 on the Hanford Site. These materials were tested using a range of solution-to-solid ratios. The test results are as follows. The efficacy of the resin and granular activated carbon materials was less than predicted based on manufacturers’ performance data. It is hypothesized that this is due to the differences in speciation previously determined for Hanford groundwater. The sorption of iodine is affected by the iodine species in the source water. Iodine loading on resins using source water ranged from 1.47 to 1.70 µg/g withmore » the corresponding K d values from 189.9 to 227.0 mL/g. The sorption values when the iodine is converted to iodide ranged from 2.75 to 5.90 µg/g with the corresponding K d values from 536.3 to 2979.6 mL/g. It is recommended that methods to convert iodine to iodide be investigated in fiscal year (FY) 2015. The chemicals used to convert iodine to iodate adversely affected the sorption of iodine onto the carbon materials. Using as-received source water, loading and K d values ranged from 1.47 to 1.70 µg/g and 189.8 to 226.3 mL/g respectively. After treatment, loading and K d values could not be calculated because there was little change between the initial and final iodine concentration. It is recommended the cause of the decrease in iodine sorption be investigated in FY15. In direct support of CH2M HILL Plateau Remediation Company, Pacific Northwest National Laboratory has evaluated samples from within the 200W pump and treat bioreactors. As part of this analysis, pictures taken within the bioreactor reveal a precipitate that, based on physical properties and known aqueous chemistry, is hypothesized to be iron pyrite or chalcopyrite, which could affect iodine adsorption. It is recommended these materials be tested at different solution-to-solid ratios in FY15 to determine their effect on iodine sorption.« less

Experiences of clinical teaching for dental core trainees working in hospital.

PubMed

Mannion, C J; Brotherton, P

2014-07-11

There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching.

What scientists want from their research ethics committee.

PubMed

Keith-Spiegel, Patricia; Tabachnick, Barbara

2006-03-01

Whereas investigators have directed considerable criticism against Institutional Review Boards (IRBs), the desirable characteristics of IRBs have not previously been empirically determined. A sample of 886 experienced biomedical and social and behavioral scientists rated 45 descriptors of IRB actions and functions as to their importance. Predictions derived from organizational justice research findings in other work settings were generally borne out. Investigators place high value on the fairness and respectful consideration of their IRBs. Expected differences between biomedical and social behavioral researchers and other variables were unfounded. Recommendations are offered for educating IRBs to accord researchers greater respect and fair treatment.

Sensory irritating potency of some microbial volatile organic compounds (MVOCs) and a mixture of five MVOCs.

PubMed

Korpi, A; Kasanen, J P; Alarie, Y; Kosma, V M; Pasanen, A L

1999-01-01

The authors investigated the ability/potencies of 3 microbial volatile organic compounds and a mixture of 5 microbial volatile organic compounds to cause eye and upper respiratory tract irritation (i.e., sensory irritation), with an animal bioassay. The authors estimated potencies by determining the concentration capable of decreasing the respiratory frequency of mice by 50% (i.e., the RD50 value). The RD50 values for 1-octen-3-ol, 3-octanol, and 3-octanone were 182 mg/m3 (35 ppm), 1359 mg/m3 (256 ppm), and 17586 mg/m3 (3360 ppm), respectively. Recommended indoor air levels calculated from the individual RD50 values for 1-octen-3-ol, 3-octanol, and 3-octanone were 100, 1000, and 13000 microg/m3, respectively-values considerably higher than the reported measured indoor air levels for these compounds. The RD50 value for a mixture of 5 microbial volatile organic compounds was also determined and found to be 3.6 times lower than estimated from the fractional concentrations and the respective RD50s of the individual components. The data support the conclusion that a variety of microbial volatile organic compounds may have some synergistic effects for the sensory irritation response, which constrains the interpretation and application of recommended indoor air levels of individual microbial volatile organic compounds. The results also showed that if a particular component of a mixture was much more potent than the other components, it may dominate the sensory irritation effect. With respect to irritation symptoms reported in moldy houses, the results of this study indicate that the contribution of microbial volatile organic compounds to these symptoms seems less than previously supposed.

[Recommendations in neonatal resuscitation].

PubMed

2004-01-01

The recommendations for neonatal resuscitation are not always based on sufficient scientific evidence and thus expert consensus based on current research, knowledge, and experience are useful for formulating practical protocols that are easy to follow. The latest recommendations, in 2000, modified previously published recommendations and are included in the present text.

Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children

PubMed Central

Murad, Mohammad H.; Pringsheim, Tamara; Feinstein, Anthony; Chang, Anne B.; Newcombe, Peter A.; Rubin, Bruce K.; McGarvey, Lorcan P.; Weir, Kelly; Altman, Kenneth W.; Weinberger, Miles; Irwin, Richard S.; Adams, Todd M.; Altman, Kenneth W.; Barker, Alan F.; Birring, Surinder S.; Blackhall, Fiona; Bolser, Donald C.; Boulet, Louis-Philippe; Braman, Sidney S.; Brightling, Christopher; Callahan-Lyon, Priscilla; Canning, Brendan J.; Chang, Anne B.; Coeytaux, Remy; Cowley, Terrie; Davenport, Paul; Diekemper, Rebecca L.; Ebihara, Satoru; El Solh, Ali A.; Escalante, Patricio; Feinstein, Anthony; Field, Stephen K.; Fisher, Dina; French, Cynthia T.; Gibson, Peter; Gold, Philip; Gould, Michael K.; Grant, Cameron; Harding, Susan M.; Harnden, Anthony; Hill, Adam T.; Irwin, Richard S.; Kahrilas, Peter J.; Keogh, Karina A.; Lane, Andrew P.; Lim, Kaiser; Malesker, Mark A.; Mazzone, Peter; Mazzone, Stuart; McCrory, Douglas C.; McGarvey, Lorcan; Molasiotis, Alex; Murad, M. Hassan; Newcombe, Peter; Nguyen, Huong Q.; Oppenheimer, John; Prezant, David; Pringsheim, Tamara; Restrepo, Marcos I.; Rosen, Mark; Rubin, Bruce; Ryu, Jay H.; Smith, Jaclyn; Tarlo, Susan M.; Vertigan, Anne E.; Wang, Gang; Weinberger, Miles; Weir, Kelly; Wiener, Renda Soylemez

2015-01-01

BACKGROUND: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic. METHODS: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients’ values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology. RESULTS: The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate. CONCLUSIONS: Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality. PMID:25856777

Implications of lower risk thresholds for statin treatment in primary prevention: analysis of CPRD and simulation modelling of annual cholesterol monitoring.

PubMed

McFadden, Emily; Stevens, Richard; Glasziou, Paul; Perera, Rafael

2015-01-01

To estimate numbers affected by a recent change in UK guidelines for statin use in primary prevention of cardiovascular disease. We modelled cholesterol ratio over time using a sample of 45,151 men (≥40years) and 36,168 women (≥55years) in 2006, without statin treatment or previous cardiovascular disease, from the Clinical Practice Research Datalink. Using simulation methods, we estimated numbers indicated for new statin treatment, if cholesterol was measured annually and used in the QRISK2 CVD risk calculator, using the previous 20% and newly recommended 10% thresholds. We estimate that 58% of men and 55% of women would be indicated for treatment by five years and 71% of men and 73% of women by ten years using the 20% threshold. Using the proposed threshold of 10%, 84% of men and 90% of women would be indicated for treatment by 5years and 92% of men and 98% of women by ten years. The proposed change of risk threshold from 20% to 10% would result in the substantial majority of those recommended for cholesterol testing being indicated for statin treatment. Implications depend on the value of statins in those at low to medium risk, and whether there are harms. Copyright © 2014. Published by Elsevier Inc.

Ocular effects of exposure to triethylamine in the sand core cold box of a foundry.

PubMed Central

Reilly, M J; Rosenman, K D; Abrams, J H; Zhu, Z; Tseng, C; Hertzberg, V; Rice, C

1995-01-01

OBJECTIVES--To assess the acute and chronic ophthalmological effects of triethylamine exposure among foundry workers. METHODS--Ocular effects on people currently, previously, and never exposed to triethylamine in a foundry cold box were studied at two points in time. The initial phase included an ocular examination with a slit lamp to assess corneal health, a visual acuity test, and a questionnaire to assess vision symptoms. The follow up included measurements of corneal thickness with an ultrasonic pachymeter and the vision symptoms questionnaire before and after the shift and at the beginning and end of the week. Personal air measurements for triethylamine were also obtained during the follow up. RESULTS--The vision symptoms of blurriness, halos around lights, and blue hazy vision occurred more often in currently exposed workers than those previously or never exposed to triethylamine. Air concentrations of triethylamine ranged from < 0.33 mg/m3 to 20.3 mg/m3. Among currently exposed workers, symptoms were more common among those with exposure to > 10 mg/m3 of triethylamine (odds ratio (OR) = 3.0, 95% confidence interval (95% CI) 0.35-25.6). No differences in corneal thickness were found in currently or previously exposed workers and those never exposed. No increase in corneal thickness was found after v before the shift. CONCLUSION--Despite low concentrations of triethylamine and no corneal oedema, workers exposed to triethylamine reported vision symptoms. Possible explanations for these symptoms without corneal oedema are that triethylamine affects ciliary muscle function or that the corneal oedema was transient and not present when corneal thickness measurements were taken. No chronic effects were found in previously exposed workers. Further research is needed to elucidate the mechanism for the reported vision symptoms, which occurred below the current United States eight hour time weighted standard of 100 mg/m3 and the American Conference of Governmental Industrial Hygienists (ACGIH) recommended value at the time of our study of 40 mg/m3. We recommend that air concentrations be maintained to meet the current recommended ACGIH threshold of 4.1 mg/m3. PMID:7795757

75 FR 9205 - Science Advisory Board Staff Office Notification of a Public Meeting of a Workgroup of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-01

... on the Integrated Risk Information System (IRIS)'' (EPA/ 635/R-10/001). The SAB workgroup will assess the adequacy of EPA's implementation of the SAB previous recommendations regarding the cancer risk... previous recommendations for the revision of EPA's cancer risk assessment of inorganic arsenic. Background...

Reconnaissance geochemical survey of the Farah Garan-Kutam mineral belt, Kingdom of Saudi Arabia

USGS Publications Warehouse

Samater, R.M.; Johnson, P.R.; Bookstrom, A.A.

1991-01-01

In the present survey, geochemical anomalies locate all the sites of mineralization known from previous work. The survey is therefore technically a success. However, a large number of these anomalies probably result from contamination of the wadi systems by metal dispersed from ancient mine workings, and this particular survey, overall, may be of limited value as a guide to the discovery of hitherto unknown mineralization. Nevertheless, the survey outlines two areas that may mark extensions to known mineralization, and a number of other areas in which no mineralization is known. Based on a consideration of the character of the bedrock geology, the value of each reported analytical result in relation to the respective element thresholds, and the number of anomalous samples that cluster in any given area, four areas are recommended for high-priority follow-up sampling.

Upgraded Analytical Model of the Cylinder Test

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

Souers, P. Clark; Lauderbach, Lisa; Garza, Raul

2013-03-15

A Gurney-type equation was previously corrected for wall thinning and angle of tilt, and now we have added shock wave attenuation in the copper wall and air gap energy loss. Extensive calculations were undertaken to calibrate the two new energy loss mechanisms across all explosives. The corrected Gurney equation is recommended for cylinder use over the original 1943 form. The effect of these corrections is to add more energy to the adiabat values from a relative volume of 2 to 7, with low energy explosives having the largest correction. The data was pushed up to a relative volume of aboutmore » 15 and the JWL parameter ω was obtained directly. The total detonation energy density was locked to the v=7 adiabat energy density, so that the Cylinder test gives all necessary values needed to make a JWL.« less

Upgraded Analytical Model of the Cylinder Test

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

Souers, P. Clark; Lauderbach, Lisa; Garza, Raul

2013-03-15

A Gurney-type equation was previously corrected for wall thinning and angle of tilt, and now we have added shock wave attenuation in the copper wall and air gap energy loss. Extensive calculations were undertaken to calibrate the two new energy loss mechanisms across all explosives. The corrected Gurney equation is recommended for cylinder use over the original 1943 form. The effect of these corrections is to add more energy to the adiabat values from a relative volume of 2 to 7, with low energy explosives having the largest correction. The data was pushed up to a relative volume of aboutmore » 15 and the JWL parameter ω was obtained directly. Finally, the total detonation energy density was locked to the v = 7 adiabat energy density, so that the Cylinder test gives all necessary values needed to make a JWL.« less

Performance of buried pipe installation : tech summary.

DOT National Transportation Integrated Search

2010-05-01

Existing codes and recommendations often require standard/minimum values for the bedding, backfi ll, and fi ll cover geometric and : mechanical properties in the installation of buried pipes under transportation facilities. These recommended values a...

Comprehensive manual handling limits for lowering, pushing, pulling and carrying activities.

PubMed

Shoaf, C; Genaidy, A; Karwowski, W; Waters, T; Christensen, D

1997-11-01

The objective of this study was to develop a set of mathematical models for manual lowering, pushing, pulling and carrying activities that would result in establishing load capacity limits to protect the lower back against occupational low-back disorders. In order to establish safe guidelines, a three-stage process was used. First, psychophysical data was used to generate the models' discounting factors and recommended load capacities. Second, biomechanical analysis was used to refine the recommended load capacities. Third, physiological criteria were used to validate the models' discounting factors. Both task and personal factors were considered in the models' development. When compared to the results from prior psychophysical research for these activities, the developed load capacity values are lower than previously established limits. The results of this study allowed the authors to validate the hypothesis proposed and tested by Karwowski (1983) that states that the combination of physiological and biomechanical stresses should lead to the overall measure of task acceptability or the psychophysical stress. This study also found that some of the discounting factors for the task frequency parameters recommended in the prior psychophysical research should not be used as several of the high frequency factors violated physiological limits.

The influence of smoking and parity on serum markers for Down's syndrome screening.

PubMed

Tislarić, Dubravka; Brajenović-Milić, Bojana; Ristić, Smiljana; Latin, Visnja; Zuvić-Butorac, Marta; Bacić, Josip; Petek, Marijan; Kapović, Miljenko

2002-01-01

To evaluate the impact of smoking and number of previous births on maternal serum levels of alpha-fetoprotein and free beta-subunit of human chorionic gonadotropin (free beta-hCG). The study included 3,252 completed unaffected singleton pregnancies that proceeded beyond 37 weeks' gestation and resulted with a birth of healthy child. Smoking status of mothers and data concerning gravidity and parity were collected at the sampling date. Serum markers were measured between 13 and 22 gestational weeks, corrected for maternal weight, and converted to multiples of median (MoM) for unaffected pregnancy of the corresponding gestational age. Median MoM values for both markers were examined in relation to both: smoking habits and number of previous births. Smokers had significantly decreased free beta-hCG MoM values compared to nonsmokers (p < 0.001). The median levels showed a negative relationship with the number of previous births. The significance of a decreasing trend was proved, both in smokers (p < 0.001) and nonsmokers (p < 0.001). The median maternal serum alpha-fetoprotein MoM values did not show any significant dependence, neither with regard to smoking (p = 0.65) nor with regard to parity (p = 0.07). The recommendable adjustment of serum markers to smoking habits, especially concerning the free beta-hCG levels, would be worthwhile. The evidence of the coexisting influence of parity on serum levels of free beta-hCG, both in smokers and nonsmokers, should perhaps be a stimulus for reconsideration of which corrections the screening performance is dependent on. Copyright 2002 S. Karger AG, Basel

Recommended Values of Meteorological Factors to Be Considered in the Design of Aircraft Ice-Prevention Equipment

NASA Technical Reports Server (NTRS)

Jones, Alun R; Lewis, William

1949-01-01

Meteorological conditions conducive to aircraft icing are arranged in four classifications: three are associated with cloud structure and the fourth with freezing rain. The range of possible meteorological factors for each classification is discussed and specific values recommended for consideration in the design of ice-prevention equipment for aircraft are selected and tabulated. The values selected are based upon a study of the available observational data and theoretical considerations where observations are lacking. Recommendations for future research in the field are presented.

Nuclear Data Sheets for A=164

NASA Astrophysics Data System (ADS)

Singh, Balraj; Chen, Jun

2018-01-01

Experimental nuclear structure data for the known A=164 isobaric nuclides (Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, Hf, Ta, W, Re, Os, Ir) have been evaluated, and presented together with Adopted properties of level energies, and associated γ rays. The decay data for these nuclides have also been evaluated, providing Adopted values of γ and β radiations, and log ft values. No excited states are known in 164Eu, 164Tb, and 164Ir. Information for 164Gd, 164Re and 164Os is limited due to insufficient experimental data. For radioactive nuclides, decay schemes of 164Sm, 164Gd and 164Re are not known, and those of 164W, 164Tb, 164Lu, 164Hf, 164Ta and 164W are incomplete. The decay schemes of 164Ho and the two activities of 164Tm seem fairly complete. The decay scheme of 164Yb presents a major problem that the Q(ε) value of 887 keV 29 recommended in 2017Wa10 is in disagreement with the population of levels at 928, 952 and 1060 keV in the daughter nucleus. This decay scheme, which so far has been mainly reported in a secondary reference (1982AdZZ) needs further investigation. Also the masses of 164Yb and 164Tm need either new measurements or a re-evaluation to resolve discrepancy of about 220 keV in the Q value of 164Yb decay to 164Tm. The reactions and decays for which no new experimental information has become available since the 2001 update have undergone revisions to incorporate conversion coefficients from BrIcc code, and evaluated Q values from 2017Wa10, but the essential content of such datasets may have remained the same as in previous evaluations. In this respect the present work greatly benefited from all the previous NDS evaluations (2001Si27,1992Sh07, 1986Sh03,1974Bu30), but at the same time data presented herein supersede all the previous published evaluations.

Transfer of radiocarbon liquid releases from the AREVA La Hague spent fuel reprocessing plant in the English Channel.

PubMed

Fiévet, Bruno; Voiseux, Claire; Rozet, Marianne; Masson, Michel; Bailly du Bois, Pascal

2006-01-01

The recent risk assessment by the North-Cotentin Radioecology Group (, 1999) outlined that (14)C has become one of the major sources of the low dose to man through seafood consumption. It was recommended that more data should be collected about (14)C in the local marine environment. The present study aims to respond to this recommendation. The estimation of (14)C activity in marine species is based on concentration factor values. The values reported here ranged from 1x10(3) to 5x10(3)Bqkg(-1)ww/BqL(-1). A comparison was made between the observed and predicted values. The accuracy of (14)C activity calculations was estimated between underestimation by a factor of 2 and over-estimation by 50% (95% confidence interval). However, the use of the concentration factor parameter is based on the biological and seawater compartments being in steady state. This assumption may not be met at short distances from the point of release of discharges, where rapid changes in seawater concentration may be smoothed out in living organisms due to transfer kinetics. The data processing technique, previously published by Fiévet and Plet (2003. Estimating biological half-lives of radionuclides in marine compartments from environmental time-series measurements. Journal of Environmental Radioactivity 65, 91-107), was used to deal with (14)C transfer kinetics, and carbon half-lives between seawater and a few biological compartments were thus estimated.

Harmonization of the Bayer ADVIA Centaur and Abbott AxSYM automated B-type natriuretic peptide assay in patients on hemodialysis.

PubMed

Barak, Mira; Weinberger, Ronit; Marcusohn, Jerom; Froom, Paul

2005-01-01

There are two fully automated high-throughput clinical instruments for brain natriuretic peptide (BNP) assays, the Bayer ADVIA Centaur assay, and the Abbott AxSYM assay. Although both recommend a cut-off value of 100 pg/mL, we are unaware of previous studies that have compared the unadjusted results of the two methods, required for proper evaluation of patients undergoing this test on different platforms. From 43 hemodialysis patients, 80 paired samples were collected by venipuncture into plastic evacuated tubes containing EDTA. The Bayer assay yielded lower values than the Abbott assay, with linear regression of 0.53 x Abbott assay (95% confidence interval, 0.50-0.56) being forced through 0, demonstrating an r(2)-value of 0.954. Regression for the Abbott assay was 1.79 x Bayer assay (95% CI, 1.69-1.89). The cut-off values for abnormal BNP results analyzed on the Abbott system are not identical to those on the Bayer system, and this needs to be taken into account when comparing studies on the clinical utility of these systems.

A Methodological Review of US Budget-Impact Models for New Drugs.

PubMed

Mauskopf, Josephine; Earnshaw, Stephanie

2016-11-01

A budget-impact analysis is required by many jurisdictions when adding a new drug to the formulary. However, previous reviews have indicated that adherence to methodological guidelines is variable. In this methodological review, we assess the extent to which US budget-impact analyses for new drugs use recommended practices. We describe recommended practice for seven key elements in the design of a budget-impact analysis. Targeted literature searches for US studies reporting estimates of the budget impact of a new drug were performed and we prepared a summary of how each study addressed the seven key elements. The primary finding from this review is that recommended practice is not followed in many budget-impact analyses. For example, we found that growth in the treated population size and/or changes in disease-related costs expected during the model time horizon for more effective treatments was not included in several analyses for chronic conditions. In addition, all drug-related costs were not captured in the majority of the models. Finally, for most studies, one-way sensitivity and scenario analyses were very limited, and the ranges used in one-way sensitivity analyses were frequently arbitrary percentages rather than being data driven. The conclusions from our review are that changes in population size, disease severity mix, and/or disease-related costs should be properly accounted for to avoid over- or underestimating the budget impact. Since each budget holder might have different perspectives and different values for many of the input parameters, it is also critical for published budget-impact analyses to include extensive sensitivity and scenario analyses based on realistic input values.

Local heterogeneities in early batches of EBT2 film: a suggested solution.

PubMed

Kairn, T; Aland, T; Kenny, J

2010-08-07

To enhance the utility of radiochromic films for high-resolution dosimetry of small and modulated radiotherapy fields, we propose a means to negate the effects of heterogeneities in EBT2 (and other) films. The results of using our simple procedure for evaluating radiation dose in EBT2 film are compared with the results of using the manufacturer's recommended procedure as well as a procedure previously established for evaluating dose in older EBT film. It is shown that Newton's ring-like scanning artefacts can be avoided through the use of a plastic frame, to elevate the film above the scanner's surface. The effects of film heterogeneity can be minimized by evaluating net optical density, pixelwise, as the logarithm of the ratio of the red-channel pixel value in each pixel of each irradiated film to the red-channel pixel value in the same pixel in the same film prior to irradiation. The application of a blue-channel correction was found to result in increased noise. It is recommended that, when using EBT2 film for radiotherapy quality assurance, the films should be scanned before and after irradiation and analysed using the method proposed herein, without the use of the blue-channel correction, in order to produce dose images with minimal film heterogeneity effects.

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

Reporting numeric values of complete crowns. Part 1: Clinical preparation parameters.

PubMed

Tiu, Janine; Al-Amleh, Basil; Waddell, J Neil; Duncan, Warwick J

2015-07-01

An implemented objective measuring system for measuring clinical tooth preparations does not exist. The purpose of this study was to compare clinically achieved tooth preparations for ceramic crowns by general dentists with the recommended values in the literature with an objective measuring method. Two hundred thirty-six stone dies prepared for anterior and posterior complete ceramic crown restorations (IPS e.max Press; Ivoclar Vivadent) were collected from dental laboratories. The dies were scanned and analyzed using the coordinate geometry method. Cross-sectioned images were captured, and the average total occlusal convergence angle, margin width, and abutment height for each preparation was measured and presented with associated 95% confidence intervals. The average total occlusal convergence angles for each tooth type was above the recommended values reported in the literature. The average margin widths (0.40 to 0.83 mm) were below the minimum recommended values (1 to 1.5 mm). The tallest preparations were maxillary canines (5.25 mm), while the shortest preparations were mandibular molars (1.87 mm). Complete crown preparations produced in general practice do not achieve the recommended values found in the literature. However, these recommended values are not based on clinical trials, and the effects of observed shortfalls on the clinical longevity of these restorations are not predictable. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Worldwide end-of-life practice for patients in ICUs.

PubMed

Wong, Wai-Tat; Phua, Jason; Joynt, Gavin M

2018-04-01

Published data and practice recommendations on end-of-life (EOL) generally reflect Western practice frameworks. Understanding worldwide practices is important because improving economic conditions are promoting rapid expansion of intensive care services in many previously disadvantaged regions, and increasing migration has promoted a new cultural diversity previously predominantly unicultural societies. This review explores current knowledge of similarities and differences in EOL practice between regions and possible causes and implications of these differences. Recent observational and survey data shows a marked variability in the practice of withholding and withdrawing life sustaining therapy worldwide. Some evidence supports the view that culture, religion, and socioeconomic factors influence EOL practice, and individually or together account for differences observed. There are also likely to be commonly desired values and expectations for EOL practice, and recent attempts at establishing where worldwide consensus may lie have improved our understanding of shared values and practices. Awareness of differences, understanding their likely complex causes, and using this knowledge to inform individualized care at EOL is likely to improve the quality of care for patients. Further research should clarify the causes of EOL practice variability, monitor trends, and objectively evaluate the quality of EOL practice worldwide.

Evaluation of the 235 U resonance parameters to fit the standard recommended values

DOE PAGES

Leal, Luiz; Noguere, Gilles; Paradela, Carlos; ...

2017-09-13

A great deal of effort has been dedicated to the revision of the standard values in connection with the neutron interaction for some actinides. While standard data compilation are available for decades nuclear data evaluations included in existing nuclear data libraries (ENDF, JEFF, JENDL, etc.) do not follow the standard recommended values. Indeed, the majority of evaluations for major actinides do not conform to the standards whatsoever. In particular, for the n + 235U interaction the only value in agreement with the standard is the thermal fission cross section. We performed a resonance re-evaluation of the n + 235U interactionmore » in order to address the issues regarding standard values in the energy range from 10-5 eV to 2250 eV. Recently, 235U fission cross-section measurements have been performed at the CERN Neutron Time-o-Flight facility (TOF), known as n_TOF, in the energy range from 0.7 eV to 10 keV. The data were normalized according to the recommended standard of the fission integral in the energy range 7.8 eV to 11 eV. As a result, the n_TOF averaged fission cross sections above 100 eV are in good agreement with the standard recommended values. The n_TOF data were included in the 235U resonance analysis that was performed with the code SAMMY. In addition to the average standard values related to the fission cross section, standard thermal values for fission, capture, and elastic cross sections were also included in the evaluation. Our paper presents the procedure used for re-evaluating the 235U resonance parameters including the recommended standard values as well as new cross section measurements.« less

Evaluation of the 235 U resonance parameters to fit the standard recommended values

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

Leal, Luiz; Noguere, Gilles; Paradela, Carlos

A great deal of effort has been dedicated to the revision of the standard values in connection with the neutron interaction for some actinides. While standard data compilation are available for decades nuclear data evaluations included in existing nuclear data libraries (ENDF, JEFF, JENDL, etc.) do not follow the standard recommended values. Indeed, the majority of evaluations for major actinides do not conform to the standards whatsoever. In particular, for the n + 235U interaction the only value in agreement with the standard is the thermal fission cross section. We performed a resonance re-evaluation of the n + 235U interactionmore » in order to address the issues regarding standard values in the energy range from 10-5 eV to 2250 eV. Recently, 235U fission cross-section measurements have been performed at the CERN Neutron Time-o-Flight facility (TOF), known as n_TOF, in the energy range from 0.7 eV to 10 keV. The data were normalized according to the recommended standard of the fission integral in the energy range 7.8 eV to 11 eV. As a result, the n_TOF averaged fission cross sections above 100 eV are in good agreement with the standard recommended values. The n_TOF data were included in the 235U resonance analysis that was performed with the code SAMMY. In addition to the average standard values related to the fission cross section, standard thermal values for fission, capture, and elastic cross sections were also included in the evaluation. Our paper presents the procedure used for re-evaluating the 235U resonance parameters including the recommended standard values as well as new cross section measurements.« less

Evaluation of the 235U resonance parameters to fit the standard recommended values

NASA Astrophysics Data System (ADS)

Leal, Luiz; Noguere, Gilles; Paradela, Carlos; Durán, Ignacio; Tassan-Got, Laurent; Danon, Yaron; Jandel, Marian

2017-09-01

A great deal of effort has been dedicated to the revision of the standard values in connection with the neutron interaction for some actinides. While standard data compilation are available for decades nuclear data evaluations included in existing nuclear data libraries (ENDF, JEFF, JENDL, etc.) do not follow the standard recommended values. Indeed, the majority of evaluations for major actinides do not conform to the standards whatsoever. In particular, for the n + 235U interaction the only value in agreement with the standard is the thermal fission cross section. A resonance re-evaluation of the n + 235U interaction has been performed to address the issues regarding standard values in the energy range from 10-5 eV to 2250 eV. Recently, 235U fission cross-section measurements have been performed at the CERN Neutron Time-of-Flight facility (TOF), known as n_TOF, in the energy range from 0.7 eV to 10 keV. The data were normalized according to the recommended standard of the fission integral in the energy range 7.8 eV to 11 eV. As a result, the n_TOF averaged fission cross sections above 100 eV are in good agreement with the standard recommended values. The n_TOF data were included in the 235U resonance analysis that was performed with the code SAMMY. In addition to the average standard values related to the fission cross section, standard thermal values for fission, capture, and elastic cross sections were also included in the evaluation. This paper presents the procedure used for re-evaluating the 235U resonance parameters including the recommended standard values as well as new cross section measurements.

Update of NIST half-life results corrected for ionization chamber source-holder instability.

PubMed

Unterweger, M P; Fitzgerald, R

2014-05-01

As reported at the ICRM 2011, it was discovered that the source holder used for calibrations in the NIST 4πγ ionization chamber (IC) was not stable. This has affected a large number of half-life measurement results previously reported and used in compilations of nuclear data. Corrections have been made on all of the half-life data based on the assumption that the changes to the ionization chamber response were gradual. The corrections are energy dependent and therefore radionuclide specific. This presentation will review our results and present the recommended changes in half-life values and/or uncertainties. © 2013 Published by Elsevier Ltd.

Fast and Accurate Metadata Authoring Using Ontology-Based Recommendations.

PubMed

Martínez-Romero, Marcos; O'Connor, Martin J; Shankar, Ravi D; Panahiazar, Maryam; Willrett, Debra; Egyedi, Attila L; Gevaert, Olivier; Graybeal, John; Musen, Mark A

2017-01-01

In biomedicine, high-quality metadata are crucial for finding experimental datasets, for understanding how experiments were performed, and for reproducing those experiments. Despite the recent focus on metadata, the quality of metadata available in public repositories continues to be extremely poor. A key difficulty is that the typical metadata acquisition process is time-consuming and error prone, with weak or nonexistent support for linking metadata to ontologies. There is a pressing need for methods and tools to speed up the metadata acquisition process and to increase the quality of metadata that are entered. In this paper, we describe a methodology and set of associated tools that we developed to address this challenge. A core component of this approach is a value recommendation framework that uses analysis of previously entered metadata and ontology-based metadata specifications to help users rapidly and accurately enter their metadata. We performed an initial evaluation of this approach using metadata from a public metadata repository.

Fast and Accurate Metadata Authoring Using Ontology-Based Recommendations

PubMed Central

Martínez-Romero, Marcos; O’Connor, Martin J.; Shankar, Ravi D.; Panahiazar, Maryam; Willrett, Debra; Egyedi, Attila L.; Gevaert, Olivier; Graybeal, John; Musen, Mark A.

2017-01-01

In biomedicine, high-quality metadata are crucial for finding experimental datasets, for understanding how experiments were performed, and for reproducing those experiments. Despite the recent focus on metadata, the quality of metadata available in public repositories continues to be extremely poor. A key difficulty is that the typical metadata acquisition process is time-consuming and error prone, with weak or nonexistent support for linking metadata to ontologies. There is a pressing need for methods and tools to speed up the metadata acquisition process and to increase the quality of metadata that are entered. In this paper, we describe a methodology and set of associated tools that we developed to address this challenge. A core component of this approach is a value recommendation framework that uses analysis of previously entered metadata and ontology-based metadata specifications to help users rapidly and accurately enter their metadata. We performed an initial evaluation of this approach using metadata from a public metadata repository. PMID:29854196

Correlation between serological and immunofluorescence results in the investigation of brucellosis in veterinary surgeons.

PubMed Central

Henderson, R J; Hill, D M; Vickers, A A; Edwards, J M; Tillett, H

1976-01-01

Four serological tests and three immunofluorescence tests for IgG, IgM, and IgA were compared for value in the investigation of brucellosis in veterinary surgeons. No one serological test stood out over the others, and the immunofluorescence tests did not appear to have advantages over the serological tests. If a laboratory is limited in time and resources then the saline agglutination or the complement fixation test would be reasonably satisfactory. The 2-mercaptoethanol test and the antihuman globulin (Coombs' test) have no advantages over the other two and could be dropped. Immunofluorescence tests are not recommended for routine testing of brucellosis sera. The results and these recommendations apply to the 'vet' sera tested; it is reasonable to suppose that what applies to 'vet' sera will also apply to sera of those who work with or are in repeated contact with cattle and who will have had previous experience of brucella antigen, that is, dairy farmers, herdsmen, or slaughter house employees. PMID:765361

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.

PubMed

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Primary-care providers may contribute to the use of low-value cancer screening. We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers' attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Providers reported they would discuss cancer screening more often than they would recommend it ( P <0.001). More providers would discuss and recommend screening for CRC than prostate cancer ( P <0.001), for younger than older patients ( P <0.001), and when the patient requested it than when not ( P <0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. More work appears to be needed to help providers to discuss and recommend screening that aligns with value.

Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening

PubMed Central

Kistler, Christine E; Vu, Maihan; Sutkowi-Hemstreet, Anne; Gizlice, Ziya; Harris, Russell P; Brewer, Noel T; Lewis, Carmen L; Dolor, Rowena J; Barclay, Colleen; Sheridan, Stacey L

2018-01-01

Background Primary-care providers may contribute to the use of low-value cancer screening. Objective We sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. Patients and methods This was a cross sectional survey of 126 primary-care providers in 24 primary-care clinics in the US. Participants completed surveys with two hypothetical screening scenarios for prostate or colorectal cancer (CRC). Patients in the scenarios varied by age and screening-request status. For each scenario, providers indicated whether they would discuss and recommend screening. Providers also reported on their screening attitudes and the influence of other factors known to affect screening (short patient visits, worry about lawsuits, clinical reminders/performance measures, and screening guidelines). We examined associations between providers’ attitudes and their screening recommendations for hypothetical 90-year-olds (the lowest-value screening). Results Providers reported they would discuss cancer screening more often than they would recommend it (P<0.001). More providers would discuss and recommend screening for CRC than prostate cancer (P<0.001), for younger than older patients (P<0.001), and when the patient requested it than when not (P<0.001). For a 90-year-old patient, every point increase in cancer-specific screening attitude increased the likelihood of a screening recommendation (30% for prostate cancer and 30% for CRC). Discussion While most providers’ reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request. Conclusion More work appears to be needed to help providers to discuss and recommend screening that aligns with value. PMID:29844698

36 CFR 65.5 - Designation of National Historic Landmarks.

Code of Federal Regulations, 2011 CFR

2011-07-01

... instances by special studies. Nominations and recommendations made by the appropriate State officials...; solicit written comments and recommendations on the study report; provide information on the National... recommendations are advisory. (2) Studies submitted to the Advisory Board (or the Consulting Committee previously...

36 CFR 65.5 - Designation of National Historic Landmarks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... instances by special studies. Nominations and recommendations made by the appropriate State officials...; solicit written comments and recommendations on the study report; provide information on the National... recommendations are advisory. (2) Studies submitted to the Advisory Board (or the Consulting Committee previously...

Women's Values and Preferences for Thromboprophylaxis during Pregnancy: A Comparison of Direct-choice and Decision Analysis using Patient Specific Utilities

PubMed Central

Eckman, Mark H.; Alonso-Coello, Pablo; Guyatt, Gordon H.; Ebrahim, Shanil; Tikkinen, Kari A.O.; Lopes, Luciane Cruz; Neumann, Ignacio; McDonald, Sarah D.; Zhang, Yuqing; Zhou, Qi; Akl, Elie A.; Jacobsen, Ann Flem; Santamaría, Amparo; Annichino-Bizzacchi, Joyce Maria; Bitar, Wael; Sandset, Per Morten; Bates, Shannon M.

2016-01-01

Background Women with a history of venous thromboembolism (VTE) have an increased recurrence risk during pregnancy. Low molecular weight heparin (LMWH) reduces this risk, but is costly, burdensome, and may increase risk of bleeding. The decision to start thromboprophylaxis during pregnancy is sensitive to women's values and preferences. Our objective was to compare women's choices using a holistic approach in which they were presented all of the relevant information (direct-choice) versus a personalized decision analysis in which a mathematical model incorporated their preferences and VTE risk to make a treatment recommendation. Methods Multicenter, international study. Structured interviews were on women with a history of VTE who were pregnant, planning, or considering pregnancy. Women indicated their willingness to receive thromboprophylaxis based on scenarios using personalized estimates of VTE recurrence and bleeding risks. We also obtained women's values for health outcomes using a visual analog scale. We performed individualized decision analyses for each participant and compared model recommendations to decisions made when presented with the direct-choice exercise. Results Of the 123 women in the study, the decision model recommended LMWH for 51 women and recommended against LMWH for 72 women. 12% (6/51) of women for whom the decision model recommended thromboprophylaxis chose not to take LMWH; 72% (52/72) of women for whom the decision model recommended against thromboprophylaxis chose LMWH. Conclusions We observed a high degree of discordance between decisions in the direct-choice exercise and decision model recommendations. Although which approach best captures individuals’ true values remains uncertain, personalized decision support tools presenting results based on personalized risks and values may improve decision making. PMID:26033397

Women's values and preferences for thromboprophylaxis during pregnancy: a comparison of direct-choice and decision analysis using patient specific utilities.

PubMed

Eckman, Mark H; Alonso-Coello, Pablo; Guyatt, Gordon H; Ebrahim, Shanil; Tikkinen, Kari A O; Lopes, Luciane Cruz; Neumann, Ignacio; McDonald, Sarah D; Zhang, Yuqing; Zhou, Qi; Akl, Elie A; Jacobsen, Ann Flem; Santamaría, Amparo; Annichino-Bizzacchi, Joyce Maria; Bitar, Wael; Sandset, Per Morten; Bates, Shannon M

2015-08-01

Women with a history of venous thromboembolism (VTE) have an increased recurrence risk during pregnancy. Low molecular weight heparin (LMWH) reduces this risk, but is costly, burdensome, and may increase risk of bleeding. The decision to start thromboprophylaxis during pregnancy is sensitive to women's values and preferences. Our objective was to compare women's choices using a holistic approach in which they were presented all of the relevant information (direct-choice) versus a personalized decision analysis in which a mathematical model incorporated their preferences and VTE risk to make a treatment recommendation. Multicenter, international study. Structured interviews were on women with a history of VTE who were pregnant, planning, or considering pregnancy. Women indicated their willingness to receive thromboprophylaxis based on scenarios using personalized estimates of VTE recurrence and bleeding risks. We also obtained women's values for health outcomes using a visual analog scale. We performed individualized decision analyses for each participant and compared model recommendations to decisions made when presented with the direct-choice exercise. Of the 123 women in the study, the decision model recommended LMWH for 51 women and recommended against LMWH for 72 women. 12% (6/51) of women for whom the decision model recommended thromboprophylaxis chose not to take LMWH; 72% (52/72) of women for whom the decision model recommended against thromboprophylaxis chose LMWH. We observed a high degree of discordance between decisions in the direct-choice exercise and decision model recommendations. Although which approach best captures individuals' true values remains uncertain, personalized decision support tools presenting results based on personalized risks and values may improve decision making. Copyright © 2015 Elsevier Ltd. All rights reserved.

Comparison of Giardia lamblia and Giardia muris cyst inactivation by ozone.

PubMed

Finch, G R; Black, E K; Labatiuk, C W; Gyürék, L; Belosevic, M

1993-11-01

Inactivation of Giardia lamblia and Giardia muris cysts was compared by using an ozone demand-free 0.05 M phosphate buffer in bench-scale batch reactors at 22 degrees C. Ozone was added to each trial from a concentrated stock solution for contact times of 2 and 5 min. The viability of the control and treated cysts was evaluated by using the C3H/HeN mouse and Mongolian gerbil models for G. muris and G. lamblia, respectively. The resistance of G. lamblia to ozone was not significantly different from that of G. muris under the study conditions, contrary to previously reported data that suggested G. lamblia was significantly more sensitive to ozone than G. muris was. The simple Ct value for 2 log unit inactivation of G. lamblia was 2.4 times higher than the Ct value recommended by the Surface Water Treatment Rule.

An International Approach to Enhancing a National Guideline on Driving and Dementia.

PubMed

Rapoport, Mark J; Chee, Justin N; Carr, David B; Molnar, Frank; Naglie, Gary; Dow, Jamie; Marottoli, Richard; Mitchell, Sara; Tant, Mark; Herrmann, Nathan; Lanctôt, Krista L; Taylor, John-Paul; Donaghy, Paul C; Classen, Sherrilene; O'Neill, Desmond

2018-03-12

The purpose of this study was to update a national guideline on assessing drivers with dementia, addressing limitations of previous versions which included a lack of developmental rigor and stakeholder involvement. An international multidisciplinary team reviewed 104 different recommendations from 12 previous guidelines on assessing drivers with dementia in light of a recent review of the literature. Revised guideline recommendations were drafted by consensus. A preliminary draft was sent to specialist physician and occupational therapy groups for feedback, using an a priori definition of 90% agreement as consensus. The research team drafted 23 guideline recommendations, and responses were received from 145 stakeholders. No recommendation was endorsed by less than 80% of respondents, and 14 (61%) of the recommendations were endorsed by more than 90%.The recommendations are presented in the manuscript. The revised guideline incorporates the perspectives of consensus of an expert group as well as front-line clinicians who regularly assess drivers with dementia. The majority of the recommendations were based on evidence at the level of expert opinion, revealing gaps in the evidence and future directions for research.

Effect of blood sampling schedule and method of calculating the area under the curve on validity and precision of glycaemic index values.

PubMed

Wolever, Thomas M S

2004-02-01

To evaluate the suitability for glycaemic index (GI) calculations of using blood sampling schedules and methods of calculating area under the curve (AUC) different from those recommended, the GI values of five foods were determined by recommended methods (capillary blood glucose measured seven times over 2.0 h) in forty-seven normal subjects and different calculations performed on the same data set. The AUC was calculated in four ways: incremental AUC (iAUC; recommended method), iAUC above the minimum blood glucose value (AUCmin), net AUC (netAUC) and iAUC including area only before the glycaemic response curve cuts the baseline (AUCcut). In addition, iAUC was calculated using four different sets of less than seven blood samples. GI values were derived using each AUC calculation. The mean GI values of the foods varied significantly according to the method of calculating GI. The standard deviation of GI values calculating using iAUC (20.4), was lower than six of the seven other methods, and significantly less (P<0.05) than that using netAUC (24.0). To be a valid index of food glycaemic response independent of subject characteristics, GI values in subjects should not be related to their AUC after oral glucose. However, calculating GI using AUCmin or less than seven blood samples resulted in significant (P<0.05) relationships between GI and mean AUC. It is concluded that, in subjects without diabetes, the recommended blood sampling schedule and method of AUC calculation yields more valid and/or more precise GI values than the seven other methods tested here. The only method whose results agreed reasonably well with the recommended method (ie. within +/-5 %) was AUCcut.

History of the recommended atomic-weight values from 1882 to 1997: A comparision of differences from current values to the estimated uncertainties of earlier values.

USGS Publications Warehouse

Coplen, T.B.; Peiser, H.S.

1998-01-01

International commissions and national committees for atomic weights (mean relative atomic masses) have recommended regularly updated, best values for these atomic weights as applicable to terrestrial sources of the chemical elements. Presented here is a historically complete listing starting with the values in F. W. Clarke's 1882 recalculation, followed by the recommended values in the annual reports of the American Chemical Society's Atomic Weights Commission. From 1903, an International Commission published such reports and its values (scaled to an atomic weight of 16 for oxygen) are here used in preference to those of national committees of Britain, Germany, Spain, Switzerland, and the U.S.A. We have, however, made scaling adjustments from Ar(16O) to Ar(12C) where not negligible. From 1920, this International Commission constituted itself under the International Union of Pure and Applied Chemistry (IUPAC). Since then, IUPAC has published reports (mostly biennially) listing the recommended atomic weights, which are reproduced here. Since 1979, these values have been called the "standard atomic weights" and, since 1969, all values have been published, with their estimated uncertainties. Few of the earlier values were published with uncertainties. Nevertheless, we assessed such uncertainties on the basis of our understanding of the likely contemporary judgement of the values' reliability. While neglecting remaining uncertainties of 1997 values, we derive "differences" and a retrospective index of reliability of atomic-weight values in relation to assessments of uncertainties at the time of their publication. A striking improvement in reliability appears to have been achieved since the commissions have imposed upon themselves the rule of recording estimated uncertainties from all recognized sources of error.

PROTECTING HEALTH WITH SAME DAY WATER QUALITY MONITORING RESULTS FOR BATHING BEACHES

EPA Science Inventory

Current US Environmental Protection Agency guidelines recommend the use of cultural methods for E. coli and enterococci to monitor beach water quality. The guidelines recommend a single sample value or a geometric mean value from at least five samples. The single sample guideli...

Values in environmental research: Citizens' views of scientists who acknowledge values.

PubMed

Elliott, Kevin C; McCright, Aaron M; Allen, Summer; Dietz, Thomas

2017-01-01

Scientists who perform environmental research on policy-relevant topics face challenges when communicating about how values may have influenced their research. This study examines how citizens view scientists who publicly acknowledge values. Specifically, we investigate whether it matters: if citizens share or oppose a scientist's values, if a scientist's conclusions seem contrary to or consistent with the scientist's values, and if a scientist is assessing the state of the science or making a policy recommendation. We conducted two 3x2 factorial design online experiments. Experiment 1 featured a hypothetical scientist assessing the state of the science on the public-health effects of exposure to Bisphenol A (BPA), and Experiment 2 featured a scientist making a policy recommendation on use of BPA. We manipulated whether or not the scientist expressed values and whether the scientist's conclusion appeared contrary to or consistent with the scientist's values, and we accounted for whether or not subjects' values aligned with the scientist's values. We analyzed our data with ordinary least squares (OLS) regression techniques. Our results provide at least preliminary evidence that acknowledging values may reduce the perceived credibility of scientists within the general public, but this effect differs depending on whether scientists and citizens share values, whether scientists draw conclusions that run contrary to their values, and whether scientists make policy recommendations.

Use of recommended search strategies in systematic reviews and the impact of librarian involvement: a cross-sectional survey of recent authors.

PubMed

Koffel, Jonathan B

2015-01-01

Previous research looking at published systematic reviews has shown that their search strategies are often suboptimal and that librarian involvement, though recommended, is low. Confidence in the results, however, is limited due to poor reporting of search strategies the published articles. To more accurately measure the use of recommended search methods in systematic reviews, the levels of librarian involvement, and whether librarian involvement predicts the use of recommended methods. A survey was sent to all authors of English-language systematic reviews indexed in the Database of Abstracts of Reviews of Effects (DARE) from January 2012 through January 2014. The survey asked about their use of search methods recommended by the Institute of Medicine, Cochrane Collaboration, and the Agency for Healthcare Research and Quality and if and how a librarian was involved in the systematic review. Rates of use of recommended methods and librarian involvement were summarized. The impact of librarian involvement on use of recommended methods was examined using a multivariate logistic regression. 1560 authors completed the survey. Use of recommended search methods ranged widely from 98% for use of keywords to 9% for registration in PROSPERO and were generally higher than in previous studies. 51% of studies involved a librarian, but only 64% acknowledge their assistance. Librarian involvement was significantly associated with the use of 65% of recommended search methods after controlling for other potential predictors. Odds ratios ranged from 1.36 (95% CI 1.06 to 1.75) for including multiple languages to 3.07 (95% CI 2.06 to 4.58) for using controlled vocabulary. Use of recommended search strategies is higher than previously reported, but many methods are still under-utilized. Librarian involvement predicts the use of most methods, but their involvement is under-reported within the published article.

Use of Recommended Search Strategies in Systematic Reviews and the Impact of Librarian Involvement: A Cross-Sectional Survey of Recent Authors

PubMed Central

Koffel, Jonathan B.

2015-01-01

Background Previous research looking at published systematic reviews has shown that their search strategies are often suboptimal and that librarian involvement, though recommended, is low. Confidence in the results, however, is limited due to poor reporting of search strategies the published articles. Objectives To more accurately measure the use of recommended search methods in systematic reviews, the levels of librarian involvement, and whether librarian involvement predicts the use of recommended methods. Methods A survey was sent to all authors of English-language systematic reviews indexed in the Database of Abstracts of Reviews of Effects (DARE) from January 2012 through January 2014. The survey asked about their use of search methods recommended by the Institute of Medicine, Cochrane Collaboration, and the Agency for Healthcare Research and Quality and if and how a librarian was involved in the systematic review. Rates of use of recommended methods and librarian involvement were summarized. The impact of librarian involvement on use of recommended methods was examined using a multivariate logistic regression. Results 1560 authors completed the survey. Use of recommended search methods ranged widely from 98% for use of keywords to 9% for registration in PROSPERO and were generally higher than in previous studies. 51% of studies involved a librarian, but only 64% acknowledge their assistance. Librarian involvement was significantly associated with the use of 65% of recommended search methods after controlling for other potential predictors. Odds ratios ranged from 1.36 (95% CI 1.06 to 1.75) for including multiple languages to 3.07 (95% CI 2.06 to 4.58) for using controlled vocabulary. Conclusions Use of recommended search strategies is higher than previously reported, but many methods are still under-utilized. Librarian involvement predicts the use of most methods, but their involvement is under-reported within the published article. PMID:25938454

Shielding for High-Energy Electron Accelerator Installations. National Bureau of Standards Handbook 97.

ERIC Educational Resources Information Center

National Bureau of Standards (DOC), Washington, DC.

Recommendations for radiation shielding, protection, and measurement are presented. This handbook is an extension of previous recommendations for protection against radiation from--(1) high energy and power electron accelerators, (2) food processing equipment, and (3) general sterilization equipment. The new recommendations are concerned with…

Calculations of stopping powers of 100 eV-30 keV electrons in 31 elemental solids

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

Tanuma, S.; Powell, C. J.; Penn, D. R.

We present calculated electron stopping powers (SPs) for 31 elemental solids (Li, Be, glassy C, graphite, diamond, Na, Mg, K, Sc, Ti, V, Fe, Y, Zr, Nb, Mo, Ru, Rh, In, Sn, Cs, Gd, Tb, Dy, Hf, Ta, W, Re, Os, Ir, and Bi). These SPs were determined with an algorithm previously used for the calculation of electron inelastic mean free paths and from energy-loss functions (ELFs) derived from experimental optical data. The SP calculations were made for electron energies between 100 eV and 30 keV and supplement our earlier SP calculations for ten additional solids (Al, Si, Cr, Ni,more » Cu, Ge, Pd, Ag, Pt, and Au). Plots of SP versus atomic number for the group of 41 solids show clear trends. Multiple peaks and shoulders are seen that result from the contributions of valence-electron and various inner-shell excitations. Satisfactory agreement was found between the calculated SPs and values from the relativistic Bethe SP equation with recommended values of the mean excitation energy (MEE) for energies above 10 keV. We determined effective MEEs versus maximum excitation energy from the ELFs for each solid. Plots of effective MEE versus atomic number showed the relative contributions of valence-electron and different core-electron excitations to the MEE. For a maximum excitation energy of 30 keV, our effective MEEs agreed well for Be, graphite, Na, Al, and Si with recommended MEEs; a difference for Li was attributed to sample oxidation in the SP measurements for the recommended MEE. Substantially different effective MEEs were found for the three carbon allotropes (graphite, diamond, and glassy C)« less

Evaluation of Road Performance Based on International Roughness Index and Falling Weight Deflectometer

NASA Astrophysics Data System (ADS)

Hasanuddin; Setyawan, A.; Yulianto, B.

2018-03-01

Assessment to the performance of road pavement is deemed necessary to improve the management quality of road maintenance and rehabilitation. This research to evaluate the road base on functional and structural and recommendations handling done. Assessing the pavement performance is conducted with functional and structural evaluation. Functional evaluation of pavement is based on the value of IRI (International Roughness Index) which among others is derived from reading NAASRA for analysis and recommended road handling. Meanwhile, structural evaluation of pavement is done by analyzing deflection value based on FWD (Falling Weight Deflectometer) data resulting in SN (Structural Number) value. The analysis will result in SN eff (Structural Number Effective) and SN f (Structural Number Future) value obtained from comparing SN eff to SN f value that leads to SCI (Structural Condition Index) value. SCI value implies the possible recommendation for handling pavement. The study done to Simpang Tuan-Batas Kota Jambi road segment was based on functional analysis. The study indicated that the road segment split into 12 segments in which segment 1, 3, 5, 7, 9, and 11 were of regular maintenance, segment 2, 4, 8, 10, 12 belonged to periodic maintenance, and segment 6 was of rehabilitation. The structural analysis resulted in 8 segments consisting of segment 1 and 2 recommended for regular maintenance, segment 3, 4, 5, and 7 for functional overlay, and 6 and 8 were of structural overlay.

Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).

PubMed

Cornet, Edouard; Mullier, François; Despas, Noemie; Jacqmin, Hugues; Geara, Carole; Boubaya, Marouane; Chatelain, Bernard; Troussard, Xavier

2016-10-01

The French-Speaking Cellular Haematology Group (GFHC) recently published criteria for microscopic analysis of a blood smears when a hemogram is requested. In order to evaluate and improve these recommendations using an XN (Sysmex) analyzer, we assessed 31,836 samples categorized into two sub-groups of patients either receiving or not receiving care in the clinical hematology/oncology departments of two university hospitals. By combining the manufacturer's recommendations and the GFHC recommendations, 21.3% of samples had a positive review flag in phase 1 of our study (17,991 samples). In phase 2 (13,845 samples), increasing the immature granulocytes (IG) percentage from 5-10% as a review trigger threshold, and ignoring slides with isolated flags 'PLT HIGH' (thrombocytosis) or 'MCV LOW' (microcytosis) or 'Blast/Abn Lymph and Atypical Lymph' (blast cells/abnormal lymphocytes and atypical lymphocytes) (in the absence of abnormal cells on a previous blood smear within 72 h), enabled us to significantly reduce the number of slides reviewed from 21.3-15.0% (p < 0.0001), without loss of clinical value. This decrease occurred in both sub-groups (hematology 48.7-38.0%, non-hematology 18.3-11.7%, p < 0.0001). In conclusion, the application of the GFHC criteria adapted to XN analyzers has enabled us to optimize the hematology laboratory processes, and thus reduce the production costs and the turnaround time of hemogram results.

Factors influencing intentions to use social recommender systems: a social exchange perspective.

PubMed

Chang, Tsung-Sheng; Hsiao, Wei-Hung

2013-05-01

This study employs the perspective of social exchange theory and seeks to understand users' intentions to use social recommender systems (SRS) through three psychological factors: trust, shared values, and reputation. We use structural equation modeling to analyze 221 valid questionnaires. The results show that trust has a direct positive influence on the intention to use SRS, followed by shared values, whereas reputation has an indirect influence on SRS use. We further discuss specific recommendations concerning these factors for developing SRS.

The preanalytical optimization of blood cultures: a review and the clinical importance of benchmarking in 5 Belgian hospitals.

PubMed

Willems, Elise; Smismans, Annick; Cartuyvels, Reinoud; Coppens, Guy; Van Vaerenbergh, Kristien; Van den Abeele, Anne-Marie; Frans, Johan

2012-05-01

Bloodstream infections remain a major challenge in medicine. Optimal detection of pathogens is only possible if the quality of preanalytical factors is thoroughly controlled. Since the laboratory is responsible for this preanalytical phase, the quality control of critical factors should be integrated in its quality control program. The numerous recommendations regarding blood culture collection contain controversies. Only an unambiguous guideline permits standardization and interlaboratory quality control. We present an evidence-based concise guideline of critical preanalytical determinants for blood culture collection and summarize key performance indicators with their concomitant target values. In an attempt to benchmark, we compared the true-positive rate, contamination rate, and collected blood volume of blood culture bottles in 5 Belgian hospital laboratories. The true-positive blood culture rate fell within previously defined acceptation criteria by Baron et al. (2005) in all 5 hospitals, whereas the contamination rate exceeded the target value in 4 locations. Most unexpected, in each of the 5 laboratories, more than one third of the blood culture bottles were incorrectly filled, irrespective of the manufacturer of the blood culture vials. As a consequence of this shortcoming, one manufacturer recently developed an automatic blood volume monitoring system. In conclusion, clear recommendations for standardized blood culture collection combined with quality control of critical factors of the preanalytical phase are essential for diagnostic blood culture improvement. Copyright © 2012 Elsevier Inc. All rights reserved.

Development of the UTAUT2 model to measure the acceptance of medical laboratory portals by patients in Shiraz.

PubMed

Ravangard, Ramin; Kazemi, Zhila; Abbasali, Somaye Zaker; Sharifian, Roxana; Monem, Hossein

2017-02-01

One of the main stages for achieving the success is acceptance of technology by its users. Hence, identifying the effective factors in successful acceptance of information technology is necessary and vital. One such factor is usability. This study aimed to investigate the software usability in the "Unified Theory of Acceptance and Use of Technology 2 (UTAUT2)" model in patients' use of medical diagnosis laboratories' electronic portals in 2015. This cross-sectional study was carried out on 170 patients in 2015. A 27-item questionnaire adopted from previous research and the Usability Evaluation questionnaire were used for data collection. Data were analyzed using Structural Equation Modeling (SEM), with Partial Least Squares approach by SPSS 20.0 and Smart-PLS V3.0. The results showed that the construct of intention to use had significant associations with price value (t-value=2.77), hedonic motivation (t-value=4.46), habit (t-value=1.99) and usability (t-value=5.2), as well as the construct of usage behavior with usability (t-value=3.45) and intention to use (t-value=2.03). Considering the results of this study, the following recommendations can be made in order for the higher use of portals by the patients: informing patients about the advantages of using these portals, designing portals in a simple and understandable form, increasing the portals' attractiveness, etc.

Rest and exercise echocardiography for early detection of pulmonary hypertension.

PubMed

Kusunose, Kenya; Yamada, Hirotsugu

2016-03-01

Early detection of pulmonary hypertension (PH) is essential to ensure that patients receive timely and appropriate treatment for this progressive disease. Rest and exercise echocardiography has been used to screen patients in an attempt to identify early stage PH. However, current PH guidelines recommend against exercise tests because of the lack of evidence. We reviewed previous studies to discuss the current standpoint concerning rest and exercise echocardiography in PH. Around 20 exercise echocardiography studies were included to assess the cutoff value for exercise-induced pulmonary hypertension (EIPH). Approximately 40 exercise echocardiography studies were also included to evaluate the pulmonary artery pressure-flow relationship as assessed by the slope of the mean pulmonary artery pressure and cardiac output (ΔmPAP/ΔQ). There were several EIPH and ΔmPAP/ΔQ reference values in individuals with pulmonary vascular disease. We believed that assessing the ΔmPAP/ΔQ makes sense from a physiological standpoint, and the clinical value should be confirmed in future studies. Exercise echocardiography is an appealing alternative in PH. Further studies are needed to assess the prognostic value of the pulmonary artery pressure-flow relationship in high-risk subjects.

A nuclear data approach for the Hubble constant measurements

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

Pritychenko, B.

2015-06-09

An extraordinary number of Hubble constant measurements challenges physicists with selection of the best numerical value. The standard U.S. Nuclear Data Program (USNDP) codes and procedures have been applied to resolve this issue. The nuclear data approach has produced the most probable or recommended Hubble constant value of 67.00(770) (km/sec)/Mpc. This recommended value is based on the last 25 years of experimental research and includes contributions from different types of measurements. The present result implies (14.6±1.7) x 10 9 years as a rough estimate for the age of the Universe. The complete list of recommended results is given and possiblemore » implications are discussed.« less

Critically Evaluated Energy Levels, Spectral Lines, Transition Probabilities, and Intensities of Singly Ionized Vanadium (V II)

NASA Astrophysics Data System (ADS)

Saloman, Edward B.; Kramida, Alexander

2017-08-01

The energy levels, observed spectral lines, and transition probabilities of singly ionized vanadium, V II, have been compiled. The experimentally derived energy levels belong to the configurations 3d 4, 3d 3 ns (n = 4, 5, 6), 3d 3 np, and 3d 3 nd (n = 4, 5), 3d 34f, 3d 24s 2, and 3d 24s4p. Also included are values for some forbidden lines that may be of interest to the astrophysical community. Experimental Landé g-factors and leading percentages for the levels are included when available, as well as Ritz wavelengths calculated from the energy levels. Wavelengths and transition probabilities are reported for 3568 and 1896 transitions, respectively. From the list of observed wavelengths, 407 energy levels are determined. The observed intensities, normalized to a common scale, are provided. From the newly optimized energy levels, a revised value for the ionization energy is derived, 118,030(60) cm-1, corresponding to 14.634(7) eV. This is 130 cm-1 higher than the previously recommended value from Iglesias et al.

A Secure Trust Establishment Scheme for Wireless Sensor Networks

PubMed Central

Ishmanov, Farruh; Kim, Sung Won; Nam, Seung Yeob

2014-01-01

Trust establishment is an important tool to improve cooperation and enhance security in wireless sensor networks. The core of trust establishment is trust estimation. If a trust estimation method is not robust against attack and misbehavior, the trust values produced will be meaningless, and system performance will be degraded. We present a novel trust estimation method that is robust against on-off attacks and persistent malicious behavior. Moreover, in order to aggregate recommendations securely, we propose using a modified one-step M-estimator scheme. The novelty of the proposed scheme arises from combining past misbehavior with current status in a comprehensive way. Specifically, we introduce an aggregated misbehavior component in trust estimation, which assists in detecting an on-off attack and persistent malicious behavior. In order to determine the current status of the node, we employ previous trust values and current measured misbehavior components. These components are combined to obtain a robust trust value. Theoretical analyses and evaluation results show that our scheme performs better than other trust schemes in terms of detecting an on-off attack and persistent misbehavior. PMID:24451471

A comparison of food-based recommendations and nutrient values of three food guides: USDA's MyPyramid, NHLBI's Dietary Approaches to Stop Hypertension Eating Plan, and Harvard's Healthy Eating Pyramid.

PubMed

Reedy, Jill; Krebs-Smith, Susan M

2008-03-01

The purpose of this research was to compare food-based recommendations and nutrient values of three food guides: the US Department of Agriculture's MyPyramid; the National Heart, Lung, and Blood Institute's Dietary Approaches to Stop Hypertension Eating Plan, and Harvard University's Healthy Eating Pyramid. Estimates of nutrient values associated with following each of the food guides at the 2,000-calorie level were made using a composite approach. This approach calculates population-weighted nutrient composites for each food group and subgroup, assuming average choices within food groups. Nutrient estimates were compared to the Dietary Reference Intakes and other goals and limits. Recommendations were similar regarding almost all food groups for both the type and amount of foods. Primary differences were seen in the types of vegetables and protein sources recommended and the amount of dairy products and total oil recommended. Overall nutrient values were also similar for most nutrients, except vitamin A, vitamin E, and calcium. These food guides were derived from different types of nutrition research, yet they share consistent messages: eat more fruits, vegetables, legumes, and whole grains; eat less added sugar and saturated fat; and emphasize plant oils.

A long-recommended but seldom-used method of analysis for fall injuries found a unique pattern of risk factors in the youngest-old.

PubMed

Legrand, Helen; Pihlsgård, Mats; Nordell, Eva; Elmståhl, Sölve

2015-08-01

Few studies on fall risk factors use long-recommended methods for analysis of recurrent events. Previous falls are the biggest risk factor for future falls, but few fall studies focus on the youngest-old. This study's objective was to apply Cox regression for recurrent events to identify factors associated with injurious falls in the youngest-old. Participants were community-dwelling residents of southern Sweden (n = 1,133), aged 59-67 at baseline (median 61.2), from the youngest cohorts of the larger Good Aging in Skåne (GÅS) study. Exposure variable data were collected from baseline study visits and medical records. Injurious falls, defined as emergency, inpatient, or specialist visits associated with ICD-10 fall codes during the follow-up period (2001-2011), were gathered from national and regional registries. Analysis was conducted using time to event Cox Regression for recurrent events. A majority (77.1 %) of injurious falls caused serious injuries such as fractures and open wounds. Exposure to nervous system medications [hazard ratio (HR) 1.40, 95 % confidence interval (CI) 1.03-1.89], central nervous system disease (HR 1.79, CI 1.18-2.70), and previous injurious fall(s) (HR 2.00, CI 1.50-2.68) were associated with increased hazard of injurious fall. Regression for recurrent events is feasible with typical falls' study data. The association of certain exposures with increased hazard of injurious falls begins earlier than previously studied. Different patterns of risk factors by age can provide insight into the progression of frailty. Tailored fall prevention screening and intervention may be of value in populations younger than those traditionally screened.

Necrotizing fasciitis in a pediatric orthopedic population.

PubMed

Tancevski, Aleksandar; Bono, Kenneth; Willis, Leisel; Klingele, Kevin

2013-06-01

Few studies have analyzed necrotizing fasciitis in children, and all have relied on cases of necrotizing fasciitis in the abdomen, head, and neck region. The authors sought to correlate the preoperative values of several laboratory tests previously validated in the adult literature, such as the Laboratory Risk Indicator for Necrotizing Fasciitis, with surgically confirmed necrotizing fasciitis in children to provide clinical guidance for the preoperative laboratory workup of necrotizing fasciitis. A retrospective chart review was performed on consecutive patients younger than 18 years with a diagnosis of necrotizing fasciitis. A total of 13 patients with an average age of 7.9 years (range, 9 months-16 years) were included. Ten (76.9%) infections were found in the lower extremity and 3 (23.1%) in the upper extremity. Seven (53.8%) patients had ecchymosis on examination. All patients presented with an elevated white blood cell count. No amputations were performed, and no mortality occurred. All patients underwent surgery within 24 hours of presentation. Elevated temperature, white blood count, erythrocyte sedimentation rate, and C-reactive protein values are typically seen in pediatric patients with necrotizing fasciitis; however, no correlation existed between other the preoperative laboratory values with the previously described scoring systems, such as the Laboratory Risk Indicator for Necrotizing Fasciitis. Aggressive monitoring of signs and symptoms is suggested, even if a patient does not meet all conventional diagnostic criteria. The authors recommend prompt surgical debridement and early administration of antibiotics, which should include clindamycin. Copyright 2013, SLACK Incorporated.

Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update.

PubMed

Hanna, Nasser; Johnson, David; Temin, Sarah; Baker, Sherman; Brahmer, Julie; Ellis, Peter M; Giaccone, Giuseppe; Hesketh, Paul J; Jaiyesimi, Ishmael; Leighl, Natasha B; Riely, Gregory J; Schiller, Joan H; Schneider, Bryan J; Smith, Thomas J; Tashbar, Joan; Biermann, William A; Masters, Gregory

2017-10-20

Purpose Provide evidence-based recommendations updating the 2015 ASCO guideline on systemic therapy for patients with stage IV non-small-cell lung cancer (NSCLC). Methods The ASCO NSCLC Expert Panel made recommendations based on a systematic review of randomized controlled trials from February 2014 to December 2016 plus the Cancer Care Ontario Program in Evidence-Based Care's update of a previous ASCO search. Results This guideline update reflects changes in evidence since the previous guideline update. Fourteen randomized controlled trials provide the evidence base; earlier phase trials also informed recommendation development. Recommendations New or revised recommendations include the following. Regarding first-line treatment for patients with non-squamous cell carcinoma or squamous cell carcinoma (without positive markers, eg, EGFR/ALK /ROS1), if the patient has high programmed death ligand 1 (PD-L1) expression, pembrolizumab should be used alone; if the patient has low PD-L1 expression, clinicians should offer standard chemotherapy. All other clinical scenarios follow 2015 recommendations. Regarding second-line treatment in patients who received first-line chemotherapy, without prior immune checkpoint therapy, if NSCLC tumor is positive for PD-L1 expression, clinicians should use single-agent nivolumab, pembrolizumab, or atezolizumab; if tumor has negative or unknown PD-L1 expression, clinicians should use nivolumab or atezolizumab. All immune checkpoint therapy is recommended alone plus in the absence of contraindications. For patients who received a prior first-line immune checkpoint inhibitor, clinicians should offer standard chemotherapy. For patients who cannot receive immune checkpoint inhibitor after chemotherapy, docetaxel is recommended; in patients with nonsquamous NSCLC, pemetrexed is recommended. In patients with a sensitizing EGFR mutation, disease progression after first-line epidermal growth factor receptor tyrosine kinase inhibitor therapy, and T790M mutation, osimertinib is recommended; if NSCLC lacks the T790M mutation, then chemotherapy is recommended. Patients with ROS1 gene rearrangement without prior crizotinib may be offered crizotinib, or if they previously received crizotinib, they may be offered chemotherapy.

Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009.

PubMed

Wright, Jennifer Gordon; Quinn, Conrad P; Shadomy, Sean; Messonnier, Nancy

2010-07-23

These recommendations from the Advisory Committee on Immunization Practices (ACIP) update the previous recommendations for anthrax vaccine adsorbed (AVA) (CDC. Use of anthrax vaccine in the United States: Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2000;49:1-20; CDC. Use of anthrax vaccine in response to terrorism: supplemental recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2002;51:1024-6) and reflect the status of anthrax vaccine supplies in the United States. This statement 1) provides updated information on anthrax epidemiology; 2) summarizes the evidence regarding the effectiveness and efficacy, immunogenicity, and safety of AVA; 3) provides recommendations for pre-event and preexposure use of AVA; and 4) provides recommendations for postexposure use of AVA. In certain instances, recommendations that did not change were clarified. No new licensed anthrax vaccines are presented. Substantial changes to these recommendations include the following: 1) reducing the number of doses required to complete the pre-event and preexposure primary series from 6 doses to 5 doses, 2) recommending intramuscular rather than subcutaneous AVA administration for preexposure use, 3) recommending AVA as a component of postexposure prophylaxis in pregnant women exposed to aerosolized Bacillus anthracis spores, 4) providing guidance regarding preexposure vaccination of emergency and other responder organizations under the direction of an occupational health program, and 5) recommending 60 days of antimicrobial prophylaxis in conjunction with 3 doses of AVA for optimal protection of previously unvaccinated persons after exposure to aerosolized B. anthracis spores.

Values in environmental research: Citizens’ views of scientists who acknowledge values

PubMed Central

McCright, Aaron M.; Allen, Summer; Dietz, Thomas

2017-01-01

Scientists who perform environmental research on policy-relevant topics face challenges when communicating about how values may have influenced their research. This study examines how citizens view scientists who publicly acknowledge values. Specifically, we investigate whether it matters: if citizens share or oppose a scientist’s values, if a scientist’s conclusions seem contrary to or consistent with the scientist’s values, and if a scientist is assessing the state of the science or making a policy recommendation. We conducted two 3x2 factorial design online experiments. Experiment 1 featured a hypothetical scientist assessing the state of the science on the public-health effects of exposure to Bisphenol A (BPA), and Experiment 2 featured a scientist making a policy recommendation on use of BPA. We manipulated whether or not the scientist expressed values and whether the scientist’s conclusion appeared contrary to or consistent with the scientist’s values, and we accounted for whether or not subjects’ values aligned with the scientist’s values. We analyzed our data with ordinary least squares (OLS) regression techniques. Our results provide at least preliminary evidence that acknowledging values may reduce the perceived credibility of scientists within the general public, but this effect differs depending on whether scientists and citizens share values, whether scientists draw conclusions that run contrary to their values, and whether scientists make policy recommendations. PMID:29069087

Recommending Peers for Learning: Matching on Dissimilarity in Interpretations to Provoke Breakdown

ERIC Educational Resources Information Center

Rajagopal, Kamakshi; van Bruggen, Jan M.; Sloep, Peter B.

2017-01-01

People recommenders are a widespread feature of social networking sites and educational social learning platforms alike. However, when these systems are used to extend learners' Personal Learning Networks, they often fall short of providing recommendations of learning value to their users. This paper proposes a design of a people recommender based…

Public-Private Partnership: Joint recommendations to improve downloads of large Earth observation data

NASA Astrophysics Data System (ADS)

Ramachandran, R.; Murphy, K. J.; Baynes, K.; Lynnes, C.

2016-12-01

With the volume of Earth observation data expanding rapidly, cloud computing is quickly changing the way Earth observation data is processed, analyzed, and visualized. The cloud infrastructure provides the flexibility to scale up to large volumes of data and handle high velocity data streams efficiently. Having freely available Earth observation data collocated on a cloud infrastructure creates opportunities for innovation and value-added data re-use in ways unforeseen by the original data provider. These innovations spur new industries and applications and spawn new scientific pathways that were previously limited due to data volume and computational infrastructure issues. NASA, in collaboration with Amazon, Google, and Microsoft, have jointly developed a set of recommendations to enable efficient transfer of Earth observation data from existing data systems to a cloud computing infrastructure. The purpose of these recommendations is to provide guidelines against which all data providers can evaluate existing data systems and be used to improve any issues uncovered to enable efficient search, access, and use of large volumes of data. Additionally, these guidelines ensure that all cloud providers utilize a common methodology for bulk-downloading data from data providers thus preventing the data providers from building custom capabilities to meet the needs of individual cloud providers. The intent is to share these recommendations with other Federal agencies and organizations that serve Earth observation to enable efficient search, access, and use of large volumes of data. Additionally, the adoption of these recommendations will benefit data users interested in moving large volumes of data from data systems to any other location. These data users include the cloud providers, cloud users such as scientists, and other users working in a high performance computing environment who need to move large volumes of data.

Transparent Reporting of Data Quality in Distributed Data Networks

PubMed Central

Kahn, Michael G.; Brown, Jeffrey S.; Chun, Alein T.; Davidson, Bruce N.; Meeker, Daniella; Ryan, Patrick B.; Schilling, Lisa M.; Weiskopf, Nicole G.; Williams, Andrew E.; Zozus, Meredith Nahm

2015-01-01

Introduction: Poor data quality can be a serious threat to the validity and generalizability of clinical research findings. The growing availability of electronic administrative and clinical data is accompanied by a growing concern about the quality of these data for observational research and other analytic purposes. Currently, there are no widely accepted guidelines for reporting quality results that would enable investigators and consumers to independently determine if a data source is fit for use to support analytic inferences and reliable evidence generation. Model and Methods: We developed a conceptual model that captures the flow of data from data originator across successive data stewards and finally to the data consumer. This “data lifecycle” model illustrates how data quality issues can result in data being returned back to previous data custodians. We highlight the potential risks of poor data quality on clinical practice and research results. Because of the need to ensure transparent reporting of a data quality issues, we created a unifying data-quality reporting framework and a complementary set of 20 data-quality reporting recommendations for studies that use observational clinical and administrative data for secondary data analysis. We obtained stakeholder input on the perceived value of each recommendation by soliciting public comments via two face-to-face meetings of informatics and comparative-effectiveness investigators, through multiple public webinars targeted to the health services research community, and with an open access online wiki. Recommendations: Our recommendations propose reporting on both general and analysis-specific data quality features. The goals of these recommendations are to improve the reporting of data quality measures for studies that use observational clinical and administrative data, to ensure transparency and consistency in computing data quality measures, and to facilitate best practices and trust in the new clinical discoveries based on secondary use of observational data. PMID:25992385

Why do health technology assessment coverage recommendations for the same drugs differ across settings? Applying a mixed methods framework to systematically compare orphan drug decisions in four European countries.

PubMed

Nicod, Elena

2017-07-01

Health technology assessment (HTA) coverage recommendations differ across countries for the same drugs. Unlike previous studies, this study adopts a mixed methods research design to investigate, in a systematic manner, these differences. HTA recommendations for ten orphan drugs appraised in England (NICE), Scotland (SMC), Sweden (TLV) and France (HAS) (N = 35) were compared using a validated methodological framework that breaks down these complex decision processes into stages facilitating their understanding, analysis and comparison, namely: (1) the clinical/cost-effectiveness evidence, (2) its interpretation (e.g. part of the deliberative process) and (3) influence on the final decision. This allowed qualitative and quantitative identification of the criteria driving recommendations and highlighted cross-country differences. Six out of ten drugs received diverging HTA recommendations. Reasons for cross-country differences included heterogeneity in the evidence appraised, in the interpretation of the same evidence, and in the different ways of dealing with the same uncertainty. These may have been influenced by agency-specific evidentiary, risk and value preferences, or stakeholder input. "Other considerations" (e.g. severity, orphan status) and other decision modulators (e.g. patient access schemes, lower discount rates, restrictions, re-assessments) also rendered uncertainty and cost-effectiveness estimates more acceptable. The different HTA approaches (clinical versus cost-effectiveness) and ways identified of dealing with orphan drug particularities also had implications on the final decisions. This research contributes to better understanding the drivers of these complex decisions and why countries make different decisions. It also contributed to identifying those factors beyond the standard clinical and cost-effectiveness tools used in HTA, and their role in shaping these decisions.

A Pilot Study of Neonatologists' Decision-Making Roles in Delivery Room Resuscitation Counseling for Periviable Births.

PubMed

Tucker Edmonds, Brownsyne; McKenzie, Fatima; Panoch, Janet E; White, Douglas B; Barnato, Amber E

2016-07-01

Relatively little is known about neonatologists' roles in helping families navigate the difficult decision to attempt or withhold resuscitation for a neonate delivering at the threshold of viability. Therefore, we aimed to describe the "decision-making role" of neonatologists in simulated periviable counseling sessions. We conducted a qualitative content analysis of audio-recorded simulation encounters and post-encounter debriefing interviews collected as part of a single-center simulation study of neonatologists' resuscitation counseling practices in the face of ruptured membranes at 23 weeks gestation. We trained standardized patients to request a recommendation if the physician presented multiple treatment options. We coded each encounter for communication behaviors, applying an adapted, previously developed coding scheme to classify physicians into four decision-making roles (informative, facilitative, collaborative, or directive). We also coded post-simulation debriefing interviews for responses to the open-ended prompt: "During this encounter, what did you feel was your role in the management decision-making process?" Fifteen neonatologists (33% of the division) participated in the study; audio-recorded debriefing interviews were available for 13. We observed 9 (60%) take an informative role, providing medical information only; 2 (13%) take a facilitative role, additionally eliciting the patient's values; 3 (20%) take a collaborative role, additionally engaging the patient in deliberation and providing a recommendation; and 1 (7%) take a directive role, making a treatment decision independent of the patient. Almost all (10/13, 77%) of the neonatologists described their intended role as informative. Neonatologists did not routinely elicit preferences, engage in deliberation, or provide treatment recommendations-even in response to requests for recommendations. These findings suggest there may be a gap between policy recommendations calling for shared decision making and actual clinical practice.

Determination of the molar extinction coefficient for the ferric reducing/antioxidant power assay.

PubMed

Hayes, William A; Mills, Daniel S; Neville, Rachel F; Kiddie, Jenna; Collins, Lisa M

2011-09-15

The FRAP reagent contains 2,4,6-tris(2-pyridyl)-s-triazine, which forms a blue-violet complex ion in the presence of ferrous ions. Although the FRAP (ferric reducing/antioxidant power) assay is popular and has been in use for many years, the correct molar extinction coefficient of this complex ion under FRAP assay conditions has never been published, casting doubt on the validity of previous calibrations. A previously reported value of 19,800 is an underestimate. We determined that the molar extinction coefficient was 21,140. The value of the molar extinction coefficient was also shown to depend on the type of assay and was found to be 22,230 under iron assay conditions, in good agreement with published data. Redox titration indicated that the ferrous sulfate heptahydrate calibrator recommended by Benzie and Strain, the FRAP assay inventors, is prone to efflorescence and, therefore, is unreliable. Ferrous ammonium sulfate hexahydrate in dilute sulfuric acid was a more stable alternative. Few authors publish their calibration data, and this makes comparative analyses impossible. A critical examination of the limited number of examples of calibration data in the published literature reveals only that Benzie and Strain obtained a satisfactory calibration using their method. Copyright © 2011 Elsevier Inc. All rights reserved.

ELIMINATION OF THE CHARACTERIZATION OF DWPF POUR STREAM SAMPLE AND THE GLASS FABRICATION AND TESTING OF THE DWPF SLUDGE BATCH QUALIFICATION SAMPLE

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

Amoroso, J.; Peeler, D.; Edwards, T.

2012-05-11

A recommendation to eliminate all characterization of pour stream glass samples and the glass fabrication and Product Consistency Test (PCT) of the sludge batch qualification sample was made by a Six-Sigma team chartered to eliminate non-value-added activities for the Defense Waste Processing Facility (DWPF) sludge batch qualification program and is documented in the report SS-PIP-2006-00030. That recommendation was supported through a technical data review by the Savannah River National Laboratory (SRNL) and is documented in the memorandums SRNL-PSE-2007-00079 and SRNL-PSE-2007-00080. At the time of writing those memorandums, the DWPF was processing sludge-only waste but, has since transitioned to a coupledmore » operation (sludge and salt). The SRNL was recently tasked to perform a similar data review relevant to coupled operations and re-evaluate the previous recommendations. This report evaluates the validity of eliminating the characterization of pour stream glass samples and the glass fabrication and Product Consistency Test (PCT) of the sludge batch qualification samples based on sludge-only and coupled operations. The pour stream sample has confirmed the DWPF's ability to produce an acceptable waste form from Slurry Mix Evaporator (SME) blending and product composition/durability predictions for the previous sixteen years but, ultimately the pour stream analysis has added minimal value to the DWPF's waste qualification strategy. Similarly, the information gained from the glass fabrication and PCT of the sludge batch qualification sample was determined to add minimal value to the waste qualification strategy since that sample is routinely not representative of the waste composition ultimately processed at the DWPF due to blending and salt processing considerations. Moreover, the qualification process has repeatedly confirmed minimal differences in glass behavior from actual radioactive waste to glasses fabricated from simulants or batch chemicals. In contrast, the variability study has significantly added value to the DWPF's qualification strategy. The variability study has evolved to become the primary aspect of the DWPF's compliance strategy as it has been shown to be versatile and capable of adapting to the DWPF's various and diverse waste streams and blending strategies. The variability study, which aims to ensure durability requirements and the PCT and chemical composition correlations are valid for the compositional region to be processed at the DWPF, must continue to be performed. Due to the importance of the variability study and its place in the DWPF's qualification strategy, it will also be discussed in this report. An analysis of historical data and Production Records indicated that the recommendation of the Six Sigma team to eliminate all characterization of pour stream glass samples and the glass fabrication and PCT performed with the qualification glass does not compromise the DWPF's current compliance plan. Furthermore, the DWPF should continue to produce an acceptable waste form following the remaining elements of the Glass Product Control Program; regardless of a sludge-only or coupled operations strategy. If the DWPF does decide to eliminate the characterization of pour stream samples, pour stream samples should continue to be collected for archival reasons, which would allow testing to be performed should any issues arise or new repository test methods be developed.« less

Recommended Values of the Fundamental Physical Constants: A Status Report

PubMed Central

Taylor, Barry N.; Cohen, E. Richard

1990-01-01

We summarize the principal advances made in the fundamental physical constants field since the completion of the 1986 CODATA least-squares adjustment of the constants and discuss their implications for both the 1986 set of recommended values and the next least-squares adjustment. In general, the new results lead to values of the constants with uncertainties 5 to 7 times smaller than the uncertainties assigned the 1986 values. However, the changes in the values themselves are less than twice the 1986 assigned one-standard-deviation uncertainties and thus are not highly significant. Although much new data has become available since 1986, three new results dominate the analysis: a value of the Planck constant obtained from a realization of the watt; a value of the fine-structure constant obtained from the magnetic moment anomaly of the electron; and a value of the molar gas constant obtained from the speed of sound in argon. Because of their dominant role in determining the values and uncertainties of many of the constants, it is highly desirable that additional results of comparable uncertainty that corroborate these three data items be obtained before the next adjustment is carried out. Until then, the 1986 CODATA set of recommended values will remain the set of choice. PMID:28179787

Proliferation resistance assessment of various methods of spent nuclear fuel storage and disposal

NASA Astrophysics Data System (ADS)

Kollar, Lenka

Many countries are planning to build or already are building new nuclear power plants to match their growing energy needs. Since all nuclear power plants handle nuclear materials that could potentially be converted and used for nuclear weapons, they each present a nuclear proliferation risk. Spent nuclear fuel presents the largest build-up of nuclear material at a power plant. This is a proliferation risk because spent fuel contains plutonium that can be chemically separated and used for a nuclear weapon. The International Atomic Energy Agency (IAEA) safeguards spent fuel in all non-nuclear weapons states that are party to the Non-Proliferation Treaty. Various safeguards methods are in use at nuclear power plants and research is underway to develop safeguards methods for spent fuel in centralized storage or underground storage and disposal. Each method of spent fuel storage presents different proliferation risks due to the nature of the storage method and the safeguards techniques that are utilized. Previous proliferation resistance and proliferation risk assessments have mainly compared nuclear material through the whole fuel cycle and not specifically focused on spent fuel storage. This project evaluates the proliferation resistance of the three main types of spent fuel storage: spent fuel pool, dry cask storage, and geological repository. The proliferation resistance assessment methodology that is used in this project is adopted from previous work and altered to be applicable to spent fuel storage. The assessment methodology utilizes various intrinsic and extrinsic proliferation-resistant attributes for each spent fuel storage type. These attributes are used to calculate a total proliferation resistant (PR) value. The maximum PR value is 1.00 and a greater number means that the facility is more proliferation resistant. Current data for spent fuel storage in the United States and around the world was collected. The PR values obtained from this data are 0.49 for the spent fuel pool, 0.42 for dry cask storage, 0.36 for the operating geological repository, and 0.28 for the closed geological repository. Therefore, the spent fuel pool is currently the most proliferation resistant method for storing spent fuel. The extrinsic attributes, mainly involving safeguards measures, affect the total PR value the most. As a result, several recommendations are made to improve the proliferation resistance of spent fuel. These recommendations include employing more advanced safeguards measures, such as verification techniques and remote monitoring, for dry cask storage and the geological repository. Dry cask storage facilities should also be located at the plant and in a secure building to minimize the proliferation risk. Finally, the cost-benefit analysis of increased safeguards needs to be considered. Taking these recommendations into account, the PR values of dry cask storage and the closed geological would be significantly increased, to 0.57 and 0.51, respectively. As a result, with increased safeguards to the safeguards level of the spent fuel pool, dry cask storage would be the most proliferation resistant method to store spent fuel. Therefore, the IAEA should continue to develop remote monitoring and cask storage verification techniques in order to improve the proliferation resistance of spent fuel.

Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network.

PubMed

Hall Moran, Victoria; Lowe, Nicola; Crossland, Nicola; Berti, Cristiana; Cetin, Irene; Hermoso, Maria; Koletzko, Berthold; Dykes, Fiona

2010-10-01

There is considerable variation in reference values for micronutrient intake during lactation across Europe. The European Micronutrients Recommendations Aligned project aims to harmonize dietary recommendations throughout Europe. Recommended nutrient intakes during lactation are based on limited data and are often extrapolated from known secretion of the nutrient in milk with adjustments for bioavailability, so that differences between values can be partly ascribed to differences in methodological approaches and how these approaches were applied. Few studies have considered the impact of lactation on the mother's nutritional status. Rather, focus has been placed on the influence of maternal nutritional status on the composition of her breast milk. Most common nutritional deficits in breast milk are the result of maternal deficiencies of the water-soluble vitamins, thiamine, riboflavin and vitamins B6 and B12. Other than maternal vitamin A status, which to some extent is reflected in breast milk, concentrations of fat-soluble vitamins and most minerals in breast milk are less affected by maternal status. Factors relating to suboptimal maternal nutritional status during lactation include maternal age, diet and lifestyle factors and spacing of consecutive births. Recent research is providing new knowledge on the micronutrient requirements of lactating women. Identifying needs for research and improving understanding of the differences in values that have been derived by various committees and groups across Europe will enhance transparency and facilitate the application of dietary recommendations in policy-making decision and their translation into recommendations for lactating women. Given the wide variation in breastfeeding practices across Europe, making nutritional recommendations for lactating women is complex and challenging. Thus, it is crucial to first examine the cultural practices within and across European populations and to assess its relevance before making recommendations. © 2010 Blackwell Publishing Ltd.

AUI&GIV: Recommendation with Asymmetric User Influence and Global Importance Value.

PubMed

Zhao, Zhi-Lin; Wang, Chang-Dong; Lai, Jian-Huang

2016-01-01

The user-based collaborative filtering (CF) algorithm is one of the most popular approaches for making recommendation. Despite its success, the traditional user-based CF algorithm suffers one serious problem that it only measures the influence between two users based on their symmetric similarities calculated by their consumption histories. It means that, for a pair of users, the influences on each other are the same, which however may not be true. Intuitively, an expert may have an impact on a novice user but a novice user may not affect an expert at all. Besides, each user may possess a global importance factor that affects his/her influence to the remaining users. To this end, in this paper, we propose an asymmetric user influence model to measure the directed influence between two users and adopt the PageRank algorithm to calculate the global importance value of each user. And then the directed influence values and the global importance values are integrated to deduce the final influence values between two users. Finally, we use the final influence values to improve the performance of the traditional user-based CF algorithm. Extensive experiments have been conducted, the results of which have confirmed that both the asymmetric user influence model and global importance value play key roles in improving recommendation accuracy, and hence the proposed method significantly outperforms the existing recommendation algorithms, in particular the user-based CF algorithm on the datasets of high rating density.

AUI&GIV: Recommendation with Asymmetric User Influence and Global Importance Value

PubMed Central

Zhao, Zhi-Lin; Wang, Chang-Dong; Lai, Jian-Huang

2016-01-01

The user-based collaborative filtering (CF) algorithm is one of the most popular approaches for making recommendation. Despite its success, the traditional user-based CF algorithm suffers one serious problem that it only measures the influence between two users based on their symmetric similarities calculated by their consumption histories. It means that, for a pair of users, the influences on each other are the same, which however may not be true. Intuitively, an expert may have an impact on a novice user but a novice user may not affect an expert at all. Besides, each user may possess a global importance factor that affects his/her influence to the remaining users. To this end, in this paper, we propose an asymmetric user influence model to measure the directed influence between two users and adopt the PageRank algorithm to calculate the global importance value of each user. And then the directed influence values and the global importance values are integrated to deduce the final influence values between two users. Finally, we use the final influence values to improve the performance of the traditional user-based CF algorithm. Extensive experiments have been conducted, the results of which have confirmed that both the asymmetric user influence model and global importance value play key roles in improving recommendation accuracy, and hence the proposed method significantly outperforms the existing recommendation algorithms, in particular the user-based CF algorithm on the datasets of high rating density. PMID:26828803

[Reference values of proteins for the Venezuelan population].

PubMed

Guerra, Marisa; Hernández, María N; López, Michelle; Alfaro, María J

2013-12-01

This study presents the reference values for protein requirements. The consumption of the Venezuelan population was obtained according to the Food Consumption Monitoring Survey (ESCA) 2010-2012. The diet provided good quality proteins, combining animal and vegetable foods in an approximate ratio of 1:1. The reference values were calculated based on the safe levels of protein intake recommended by WHO/FAO/UN 2007, with an adjustment for protein supply depending on age, weight, and contribution to the caloric formula of proteins for light physical activity. The reference values for protein requirements recommended as safe levels of intake in g/kg/day are 1.14 to 1.80 for males and females less than one-year-old, from 1 to 3 years, 0.90 to 1.14; from 4 to 6 years old, 0.86 to 0.89; and from 7 to 10 years old, 0.91 to 0.92. For adolescents, the average is 0.88 and 1.07 for males and females, respectively. In adults from 20 to 59 years old, 0.83 for men and women is recommended, and for older adults, 1.00 for men and women. In pregnant women, additional consumptions are recommended according to gestation time. Adolescent pregnant women must consume additional 1.2 to 1.7 g/kg/day to normal requirement. In breastfeeding women, the values differ between the first six months postnatal period and after six months of breastfeeding. The reference values for protein in this update were lower than the values of the 2000 version.

The new World Health Organization recommendation on the 2-dose measles vaccine schedule and the way forward in African Region

PubMed Central

Biellik, Robin Julian; Davis, Robert

2017-01-01

The new W.H.O. recommendation, which drops the coverage criterion for adoption of the 2-dose measles vaccine schedule, makes some African countries eligible for the 2-dose schedule which were previously ineligible. We look at the implications of the new recommendation for Ethiopia and Nigeria, the two largest African countries which are eligible under the new recommendation. PMID:29296149

Advanced subsonic long-haul transport terminal area compatibility study. Volume 2: Research and technology recommendations

NASA Technical Reports Server (NTRS)

1974-01-01

The Terminal Area Compatibility (TAC) study is briefly summarized for background information. The most important research items for the areas of noise congestion, and emissions are identified. Other key research areas are also discussed. The 50 recommended research items are categorized by flight phase, technology, and compatibility benefits. The relationship of the TAC recommendations to the previous ATT recommendations is discussed. The bulk of the document contains the 50 recommended research items. For each item, the potential payoff, state of readiness, recommended action and estimated cost and schedule are given.

76 FR 53847 - New International Commission on Radiological Protection; Recommendations on the Annual Dose Limit...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... Radiological Protection; Recommendations on the Annual Dose Limit to the Lens of the Eye AGENCY: Nuclear... Protection (ICRP) recommendations for the limitation of annual dose to the lens of the eye. This significant... might be lower than previously considered. For the lens of the eye, the threshold in absorbed dose for...

Is there an association between study materials and scores on the American Board of Orthopaedic Surgeons Part 1 examination?

PubMed

Krueger, Chad A; Aden, James

2014-01-01

Previous studies have shown that certain orthopaedic in-training examination scores can be used to identify which residents may be at risk for failing the American Board of Orthopaedic Surgeons (ABOS) Part 1 examination. However, no studies have examined how study resources may affect residents' ABOS Part 1 scores. The goal of this study is to determine which review sources or review courses, if any, are associated with improved ABOS Part 1 scores. A survey was sent to 221 of the 865 examinees who took the ABOS Part 1 examination in 2012. The questions inquired the respondents how well they performed on previous orthopaedic in-training examinations and ABOS Part 1, along with the study sources they most commonly used, review courses they attended, and resources they would recommended if they were to retake ABOS Part 1 examination. Overall, 118 of the 221 (53%) survey recipients completed the survey. Six (5%) of the respondents failed ABOS Part 1 examination. Orthobullets and the American Academy of Orthopaedic Surgeons self-assessment examinations were recommended as the primary study source significantly more (p < 0.01) than most other resources, but there was no significant association between study source and passing ABOS Part 1 or scoring in a certain percentile on ABOS Part 1. Similarly, there were no associations between attending a review course and either passing or scoring in a certain percentile for ABOS Part 1. Half of the respondents who failed ABOS Part 1 attended multiple review courses. There does not appear to be an association between improved ABOS Part 1 scores and orthopedic study materials or review courses. Further research into the value of certain educational modalities should be conducted to determine the best ways to educate orthopedic residents and determine the value of some of these commonly used orthopedic review modalities. Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

[Assessment of dietary habits in students of the Medical University of Bialystok with differentiated nutritional status].

PubMed

Stefańiska, Ewa; Ostrowska, Lucyna; Sajewicz, Joanna

2011-01-01

The research was conducted into 360 students of Medical University in Bialystok with differentiated nutritional status. The study involved 251 female students (46 with underweight, 186 with normal weight, 19 with excessive body weight) and 69 male students (7 with underweight, 47 with normal weight, 15 with excessive body weight). The quantity analyze of daily food rations was conducted on the base of the previous day 24 h dietary recall method. The computer program Diet 2.0 designed in the Institute of Food and Nutrition in Warsaw was used for calculations. Energetic value and basic nutrients supply was estimated and also the average content of dietary fiber and cholesterol. The results of the conducted research indicate lack ofbalanced content ofessential nutrients in daily food rations of the tested students of both sexes, irrespective of nutritional status. Energy supply was far too low comparing to recommended standards. It was proved that carbohydrate and fat supply was definitely lower than recommended standards. The research also showed low consumption of dietary fiber in all investigated groups and high consumption of cholesterol in men.

Broad and Inconsistent Muscle Food Classification Is Problematic for Dietary Guidance in the U.S.

PubMed Central

O’Connor, Lauren E.; Campbell, Wayne W.; Woerner, Dale R.; Belk, Keith E.

2017-01-01

Dietary recommendations regarding consumption of muscle foods, such as red meat, processed meat, poultry or fish, largely rely on current dietary intake assessment methods. This narrative review summarizes how U.S. intake values for various types of muscle foods are grouped and estimated via methods that include: (1) food frequency questionnaires; (2) food disappearance data from the U.S. Department of Agriculture Economic Research Service; and (3) dietary recall information from the National Health and Nutrition Examination Survey data. These reported methods inconsistently classify muscle foods into groups, such as those previously listed, which creates discrepancies in estimated intakes. Researchers who classify muscle foods into these groups do not consistently considered nutrient content, in turn leading to implications of scientific conclusions and dietary recommendations. Consequentially, these factors demonstrate a need for a more universal muscle food classification system. Further specification to this system would improve accuracy and precision in which researchers can classify muscle foods in nutrition research. Future multidisciplinary collaboration is needed to develop a new classification system via systematic review protocol of current literature. PMID:28926963

Defense Waste Processing Facility Nitric- Glycolic Flowsheet Chemical Process Cell Chemistry: Part 2

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

Zamecnik, J.; Edwards, T.

The conversions of nitrite to nitrate, the destruction of glycolate, and the conversion of glycolate to formate and oxalate were modeled for the Nitric-Glycolic flowsheet using data from Chemical Process Cell (CPC) simulant runs conducted by Savannah River National Laboratory (SRNL) from 2011 to 2016. The goal of this work was to develop empirical correlation models to predict these values from measureable variables from the chemical process so that these quantities could be predicted a-priori from the sludge or simulant composition and measurable processing variables. The need for these predictions arises from the need to predict the REDuction/OXidation (REDOX) statemore » of the glass from the Defense Waste Processing Facility (DWPF) melter. This report summarizes the work on these correlations based on the aforementioned data. Previous work on these correlations was documented in a technical report covering data from 2011-2015. This current report supersedes this previous report. Further refinement of the models as additional data are collected is recommended.« less

Blood pressure targets in type 2 diabetes. Evidence against or in favour of an aggressive approach.

PubMed

Mancia, Giuseppe; Grassi, Guido

2018-03-01

When associated with high blood pressure, type 2 diabetes mellitus is characterised by a high risk of adverse cardiovascular (CV) and renal outcomes. However, both can be effectively reduced by antihypertensive treatment. Current guidelines on the treatment of hypertension emphasize the need to effectively treat high blood pressure in diabetic individuals, but their recommendations differ in terms of the optimal target blood pressure value to aim for in order to maximise CV and renal protection. In some guidelines the recommended target blood pressure values are <140/90 mmHg (systolic/diastolic), whereas in others, blood pressure values close or even less than 130/80 mmHg are recommended. This paper will discuss the evidence for and against a conservative or more aggressive blood pressure target for treated diabetic hypertensive individuals based on the evidence provided by randomised trials, trial meta-analyses and large observational studies. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90 mmHg, and that values approaching 130/80 mmHg should be recommended. However, evidence in favour of even lower systolic values, i.e. <130 mmHg, is limited and is definitively against a reduction to <120 mmHg.

SU-E-I-27: Establishing Target Exposure Index Values for Computed Radiography

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

Murphy, N; Tchou, P; Belcher, K

2014-06-01

Purpose: To develop a standard set of target exposure index (TEI) values to be applied to Agfa Computed Radiography (CR) readers in accordance with International Electrotechnical Committee 62494-1 (ed. 1.0). Methods: A large data cohort was collected from six USAF Medical Treatment Facilities that exclusively use Agfa CR Readers. Dose monitoring statistics were collected from each reader. The data was analyzed based on anatomic region, view, and processing speed class. The Agfa specific exposure metric, logarithmic mean (LGM), was converted to exposure index (EI) for each data set. The optimum TEI value was determined by minimizing the number of studiesmore » that fell outside the acceptable deviation index (DI) range of +/− 2 for phototimed techniques or a range of +/−3 for fixed techniques. An anthropomorphic radiographic phantom was used to corroborate the TEI recommendations. Images were acquired of several anatomic regions and views using standard techniques. The images were then evaluated by two radiologists as either acceptable or unacceptable. The acceptable image with the lowest exposure and EI value was compared to the recommended TEI values using a passing DI range. Results: Target EI values were determined for a comprehensive list of anatomic regions and views. Conclusion: Target EI values must be established on each CR unit in order to provide a positive feedback system for the technologist. This system will serve as a mechanism to prevent under or overexposures of patients. The TEI recommendations are a first attempt at a large scale process improvement with the goal of setting reasonable and standardized TEI values. The implementation and effectiveness of the recommended TEI values should be monitored and adjustments made as necessary.« less

Human rabies prevention--United States, 2008: recommendations of the Advisory Committee on Immunization Practices.

PubMed

Manning, Susan E; Rupprecht, Charles E; Fishbein, Daniel; Hanlon, Cathleen A; Lumlertdacha, Boonlert; Guerra, Marta; Meltzer, Martin I; Dhankhar, Praveen; Vaidya, Sagar A; Jenkins, Suzanne R; Sun, Benjamin; Hull, Harry F

2008-05-23

These recommendations of the Advisory Committee on Immunization Practices (ACIP) update the previous recommendations on human rabies prevention (CDC. Human rabies prevention--United States, 1999: recommendations of the Advisory Committee on Immunization Practices. MMWR 1999;48 [No. RR-1]) and reflect the status of rabies and antirabies biologics in the United States. This statement 1) provides updated information on human and animal rabies epidemiology; 2) summarizes the evidence regarding the effectiveness/efficacy, immunogenicity, and safety of rabies biologics; 3) presents new information on the cost-effectiveness of rabies postexposure prophylaxis; 4) presents recommendations for rabies postexposure and pre-exposure prophylaxis; and 5) presents information regarding treatment considerations for human rabies patients. These recommendations involve no substantial changes to the recommended approach for rabies postexposure or pre-exposure prophylaxis. ACIP recommends that prophylaxis for the prevention of rabies in humans exposed to rabies virus should include prompt and thorough wound cleansing followed by passive rabies immunization with human rabies immune globulin (HRIG) and vaccination with a cell culture rabies vaccine. For persons who have never been vaccinated against rabies, postexposure antirabies vaccination should always include administration of both passive antibody (HRIG) and vaccine (human diploid cell vaccine [HDCV] or purified chick embryo cell vaccine [PCECV]). Persons who have ever previously received complete vaccination regimens (pre-exposure or postexposure) with a cell culture vaccine or persons who have been vaccinated with other types of vaccines and have previously had a documented rabies virus neutralizing antibody titer should receive only 2 doses of vaccine: one on day 0 (as soon as the exposure is recognized and administration of vaccine can be arranged) and the second on day 3. HRIG is administered only once (i.e., at the beginning of antirabies prophylaxis) to previously unvaccinated persons to provide immediate, passive, rabies virus neutralizing antibody coverage until the patient responds to HDCV or PCECV by actively producing antibodies. A regimen of 5 1-mL doses of HDCV or PCECV should be administered intramuscularly to previously unvaccinated persons. The first dose of the 5-dose course should be administered as soon as possible after exposure (day 0). Additional doses should then be administered on days 3, 7, 14, and 28 after the first vaccination. Rabies pre-exposure vaccination should include three 1.0-mL injections of HDCV or PCECV administered intramuscularly (one injection per day on days 0, 7, and 21 or 28). Modifications were made to the language of the guidelines to clarify the recommendations and better specify the situations in which rabies post- and pre-exposure prophylaxis should be administered. No new rabies biologics are presented, and no changes were made to the vaccination schedules. However, rabies vaccine adsorbed (RVA, Bioport Corporation) is no longer available for rabies postexposure or pre-exposure prophylaxis, and intradermal pre-exposure prophylaxis is no longer recommended because it is not available in the United States.

Actual and potential use of population viability analyses in recovery of plant species listed under the US endangered species act.

PubMed

Zeigler, Sara L; Che-Castaldo, Judy P; Neel, Maile C

2013-12-01

Use of population viability analyses (PVAs) in endangered species recovery planning has been met with both support and criticism. Previous reviews promote use of PVA for setting scientifically based, measurable, and objective recovery criteria and recommend improvements to increase the framework's utility. However, others have questioned the value of PVA models for setting recovery criteria and assert that PVAs are more appropriate for understanding relative trade-offs between alternative management actions. We reviewed 258 final recovery plans for 642 plants listed under the U.S. Endangered Species Act to determine the number of plans that used or recommended PVA in recovery planning. We also reviewed 223 publications that describe plant PVAs to assess how these models were designed and whether those designs reflected previous recommendations for improvement of PVAs. Twenty-four percent of listed species had recovery plans that used or recommended PVA. In publications, the typical model was a matrix population model parameterized with ≤5 years of demographic data that did not consider stochasticity, genetics, density dependence, seed banks, vegetative reproduction, dormancy, threats, or management strategies. Population growth rates for different populations of the same species or for the same population at different points in time were often statistically different or varied by >10%. Therefore, PVAs parameterized with underlying vital rates that vary to this degree may not accurately predict recovery objectives across a species' entire distribution or over longer time scales. We assert that PVA, although an important tool as part of an adaptive-management program, can help to determine quantitative recovery criteria only if more long-term data sets that capture spatiotemporal variability in vital rates become available. Lacking this, there is a strong need for viable and comprehensive methods for determining quantitative, science-based recovery criteria for endangered species with minimal data availability. Uso Actual y Potencial del Análisis de Viabilidad Poblacional para la Recuperación de Especies de Plantas Enlistadas en el Acta de Especies En Peligro de E.U.A. © 2013 Society for Conservation Biology.

Paediatric reference interval and biological variation trends of thyrotropin (TSH) and free thyroxine (T4) in an Asian population.

PubMed

Loh, Tze Ping; Sethi, Sunil Kumar; Metz, Michael Patrick

2015-08-01

To describe the reference intervals and biological variation data for thyrotropin (TSH) and free thyroxine (FT4) in a mixed Asian population using an indirect sampling approach and to compare them with published reports. TSH and FT4 of children measured once or twice over a 7-year period (2008-2014) at primary-care and tertiary-care settings were extracted from the laboratory information system. After excluding outliers, age-related reference intervals were derived using the Lambda-Mu-Sigma (LMS) approach, while age-partitioned biological variation data were obtained according to recommendations by Fraser and Harris. Both TSH and FT4 were very high at birth and declined with age. Similarly within-individual and between-individual biological variations were higher for both TSH and FT4 at birth and also declined with age. Our data were broadly similar to previous studies. Significant heterogeneity in study population and methods prohibited direct numerical comparison between this and previously published studies. This study fills two important gaps in our knowledge of paediatric thyroid function by reporting the centile trends (and reference values) in a mixed Asian population, as well as providing age-partitioned biological variation data. The variation in published reference intervals highlights the difficulty in harmonising paediatric thyroid reference intervals or recommending universal clinical cut-offs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Development of Monte Carlo simulations to provide scanner-specific organ dose coefficients for contemporary CT

NASA Astrophysics Data System (ADS)

Jansen, Jan T. M.; Shrimpton, Paul C.

2016-07-01

The ImPACT (imaging performance assessment of CT scanners) CT patient dosimetry calculator is still used world-wide to estimate organ and effective doses (E) for computed tomography (CT) examinations, although the tool is based on Monte Carlo calculations reflecting practice in the early 1990’s. Subsequent developments in CT scanners, definitions of E, anthropomorphic phantoms, computers and radiation transport codes, have all fuelled an urgent need for updated organ dose conversion factors for contemporary CT. A new system for such simulations has been developed and satisfactorily tested. Benchmark comparisons of normalised organ doses presently derived for three old scanners (General Electric 9800, Philips Tomoscan LX and Siemens Somatom DRH) are within 5% of published values. Moreover, calculated normalised values of CT Dose Index for these scanners are in reasonable agreement (within measurement and computational uncertainties of  ±6% and  ±1%, respectively) with reported standard measurements. Organ dose coefficients calculated for a contemporary CT scanner (Siemens Somatom Sensation 16) demonstrate potential deviations by up to around 30% from the surrogate values presently assumed (through a scanner matching process) when using the ImPACT CT Dosimetry tool for newer scanners. Also, illustrative estimates of E for some typical examinations and a range of anthropomorphic phantoms demonstrate the significant differences (by some 10’s of percent) that can arise when changing from the previously adopted stylised mathematical phantom to the voxel phantoms presently recommended by the International Commission on Radiological Protection (ICRP), and when following the 2007 ICRP recommendations (updated from 1990) concerning tissue weighting factors. Further simulations with the validated dosimetry system will provide updated series of dose coefficients for a wide range of contemporary scanners.

[Association of indoor air quality with physical health of users in a newly built school building in a university].

PubMed

Mori, Mihoko; Hara, Kunio; Miyakita, Takashi; Ishitake, Tatsuya

2011-01-01

Several users of a newly built school building in a university (new building) complained about their deteriorating physical health. We measured the air quality in the new building, an old school building and atmosphere in September 2007 and February 2008. We also conducted a questionnaire survey of subjective symptoms of users in the new building in February 2008. The university administrator took some remedial actions to improve the indoor air quality after the first measurement. In September 2007, the concentrations of total volatile organic compounds (TVOCs) and 2-ethyl-1-hexanol in the new building were higher than those in the old building and atmosphere. Moreover, the concentrations of TVOCs exceeded the Japanese recommended guideline values. In February 2008, the concentrations of these substances in the new building were lower than the previous values. Out of the 177 users who were surveyed regarding subjective symptoms, 59 responded to the survey. In September 2007, 21 users felt that their physical health had deteriorated, while in February 2008, 12 users felt no deterioration. However, nine users still complained about the deterioration of their physical health. It was suggested that the improvement in the indoor air quality may be influenced by the decrease in room temperature. Even if the concentrations of VOCs are below the recommended guideline values, users with an enhanced sensitivity towards VOCs may lose their tolerance to low-level VOCs. Our findings suggested that a survey of the changes in the subjective symptoms of users should be conducted to evaluate the improvement in the indoor air quality of newly built buildings.

ISO/GUM UNCERTAINTIES AND CIAAW (UNCERTAINTY TREATMENT FOR RECOMMENDED ATOMIC WEIGHTS AND ISOTOPIC ABUNDANCES)

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

HOLDEN,N.E.

2007-07-23

The International Organization for Standardization (ISO) has published a Guide to the expression of Uncertainty in Measurement (GUM). The IUPAC Commission on Isotopic Abundance and Atomic Weight (CIAAW) began attaching uncertainty limits to their recommended values about forty years ago. CIAAW's method for determining and assigning uncertainties has evolved over time. We trace this evolution to their present method and their effort to incorporate the basic ISO/GUM procedures into evaluations of these uncertainties. We discuss some dilemma the CIAAW faces in their present method and whether it is consistent with the application of the ISO/GUM rules. We discuss the attemptmore » to incorporate variations in measured isotope ratios, due to natural fractionation, into the ISO/GUM system. We make some observations about the inconsistent treatment in the incorporation of natural variations into recommended data and uncertainties. A recommendation for expressing atomic weight values using a tabulated range of values for various chemical elements is discussed.« less

76 FR 36892 - Atlantic Highly Migratory Species; 2011 North and South Atlantic Swordfish Quotas

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-23

... Atlantic Tunas (ICCAT) recommendations 10-02 and 09-03 into the quota adjustments for the 2011 fishing year... adopted for North Atlantic Swordfish for one year. Recommendation 10-02 included a total TAC of 13,700 mt... year. Recommendation 10-02 maintains the U.S. previous years' quota allocation of 2,937.6 mt dw as well...

Agreement between FRAX scores calculated with and without bone mineral density in women with osteopenia in Turkey.

PubMed

Olmez Sarikaya, Nese; Kapar Yavasi, Secil; Tan, Gulten; Satiroglu, Servet; Yildiz, Arife Hilal; Oz, Bengi; Yoleri, Ozlem; Memis, Asuman

2014-12-01

This study aimed to analyze the agreement between FRAX scores calculated with and without femoral neck (FN) bone mineral density (BMD) and to investigate the resultant treatment recommendations in women with osteopenia. A cross-sectional review of postmenopausal women who were referred for DXA evaluation was conducted. One hundred twenty-nine postmenopausal women aged 40 years and older with osteopenia [FN T-score between -1 and (-2.5)] were recruited for the study. Absolute agreement between FRAX scores calculated with and without BMD was analyzed by intraclass correlation analysis (ICC). Thresholds recommended by National Osteoporosis Foundation were used for treatment recommendations. Correlation between demographic factors and the difference in BMD+ and BMD- FRAX scores was analyzed by Spearman correlation test. Agreement levels and treatment recommendations were also analyzed in 112/129 patients without previous fracture. Agreement between BMD+ and BMD- MO and hip FRAX scores was good (ICC 0.867) and fair to good (ICC 0.641), respectively. In patients without previous fracture, agreement between MO and hip fracture probabilities was good (ICC = 0.838 and ICC = 0.778, respectively). Treatment recommendations with respect to treatment threshold of ≥3 for hip fracture probabilities were identical in 120/129 (93 %) cases. Difference between BMD+ and BMD- fracture probabilities was correlated with age and FN BMD. In most cases, FRAX without BMD provided the same treatment recommendations as FRAX with BMD in postmenopausal women with osteopenia. Exclusion of patients with previous fracture yielded better agreement levels.

Mandatory trans fat labeling regulations and nationwide product reformulations to reduce trans fatty acid content in foods contributed to lowered concentrations of trans fat in Canadian women's breast milk samples collected in 2009-2011.

PubMed

Ratnayake, Wm Nimal; Swist, Eleonora; Zoka, Rana; Gagnon, Claude; Lillycrop, William; Pantazapoulos, Peter

2014-10-01

Recent efforts in Canada to reduce industrial trans fatty acids (TFAs) in foods include mandated inclusion of TFA content on food labels and recommendations by Health Canada that encourage the food industry to voluntarily limit TFA content in all vegetable oils and soft margarines and in all other prepackaged foods to <2% and <5% of total fat, respectively. To assess the impact of these efforts, we measured the concentration of TFAs in human breast milk samples. The TFA content in 639 breast milk samples collected in 2009, 2010, and 2011 from breastfeeding mothers in 10 major cities across Canada was analyzed by gas chromatography. The mean (±SD) TFA contents were 2.7 ± 0.9% (n = 153, range: 1.4-7.2%), 2.2 ± 0.7% (n = 309, range: 1.0-6.8%), and 1.9 ± 0.5% (n = 177, range: 0.9-3.4%) of total milk fat for samples collected in 2009, 2010, and 2011, respectively. These values are considerably lower than the value of 7.2 ± 3.0% (range: 0.1-17.2%) found previously for Canadian human milk in 1992. On the basis of a linear correlation between the percentage of TFAs in the diet and human milk fat established by Craig-Schmidt et al, and assuming that 30% of energy of a lactating mother's diet is derived from fat, we estimated from the TFA human milk fat data that TFA intake of Canadian breastfeeding mothers was 0.9%, 0.5%, and 0.3% of total energy in 2009, 2010, and 2011, respectively. These estimated values are lower than the WHO's maximum recommended intake of 1% of total energy for a healthy diet. The results suggest that the trans fat labeling regulations introduced in 2003 and recommendations by Health Canada in 2007 instructing the food manufacturers and restaurants to limit TFAs in foods have resulted in significant reductions in TFAs in the diets of Canadian breastfeeding mothers and their breast milk. © 2014 American Society for Nutrition.

Report of the IAU Working Group on cartographic coordinates and rotational elements: 2009

USGS Publications Warehouse

Archinal, B.A.; A'Hearn, M.F.; Bowell, E.; Conrad, A.; Consolmagno, G.J.; Courtin, R.; Fukushima, T.; Hestroffer, D.; Hilton, J.L.; Krasinsky, G.A.; Neumann, G.; Oberst, J.; Seidelmann, P.K.; Stooke, P.; Tholen, D.J.; Thomas, P.C.; Williams, I.P.

2010-01-01

Every three years the IAU Working Group on Cartographic Coordinates and Rotational Elements revises tables giving the directions of the poles of rotation and the prime meridians of the planets, satellites, minor planets, and comets. This report takes into account the IAU Working Group for Planetary System Nomenclature (WGPSN) and the IAU Committee on Small Body Nomenclature (CSBN) definition of dwarf planets, introduces improved values for the pole and rotation rate of Mercury, returns the rotation rate of Jupiter to a previous value, introduces improved values for the rotation of five satellites of Saturn, and adds the equatorial radius of the Sun for comparison. It also adds or updates size and shape information for the Earth, Mars’ satellites Deimos and Phobos, the four Galilean satellites of Jupiter, and 22 satellites of Saturn. Pole, rotation, and size information has been added for the asteroids (21) Lutetia, (511) Davida, and (2867) Šteins. Pole and rotation information has been added for (2) Pallas and (21) Lutetia. Pole and rotation and mean radius information has been added for (1) Ceres. Pole information has been updated for (4) Vesta. The high precision realization for the pole and rotation rate of the Moon is updated. Alternative orientation models for Mars, Jupiter, and Saturn are noted. The Working Group also reaffirms that once an observable feature at a defined longitude is chosen, a longitude definition origin should not change except under unusual circumstances. It is also noted that alternative coordinate systems may exist for various (e.g. dynamical) purposes, but specific cartographic coordinate system information continues to be recommended for each body. The Working Group elaborates on its purpose, and also announces its plans to occasionally provide limited updates to its recommendations via its website, in order to address community needs for some updates more often than every 3 years. Brief recommendations are also made to the general planetary community regarding the need for controlled products, and improved or consensus rotation models for Mars, Jupiter, and Saturn.

Report of the IAU Working Group on cartographic coordinates and rotational elements: 2009

USGS Publications Warehouse

Archinal, Brent A.; A’Hearn, Michael F.; Bowell, Edward; Conrad, Al; Consolmagno, Guy J.; Courtin, Regis; Fukushima, Toshio; Hestroffer, Daniel; Hilton, James L.; Krasinsky, Georgij A.; Neumann, Gregory; Oberst, Jurgen; Seidelmann, P. Kenneth; Stooke, Philip; Tholen, David J.; Thomas, Peter C.; Williams, Iwan P.

2010-01-01

Every three years the IAU Working Group on Cartographic Coordinates and Rotational Elements revises tables giving the directions of the poles of rotation and the prime meridians of the planets, satellites, minor planets, and comets. This report takes into account the IAU Working Group for Planetary System Nomenclature (WGPSN) and the IAU Committee on Small Body Nomenclature (CSBN) definition of dwarf planets, introduces improved values for the pole and rotation rate of Mercury, returns the rotation rate of Jupiter to a previous value, introduces improved values for the rotation of five satellites of Saturn, and adds the equatorial radius of the Sun for comparison. It also adds or updates size and shape information for the Earth, Mars’ satellites Deimos and Phobos, the four Galilean satellites of Jupiter, and 22 satellites of Saturn. Pole, rotation, and size information has been added for the asteroids (21) Lutetia, (511) Davida, and (2867) Šteins. Pole and rotation information has been added for (2) Pallas and (21) Lutetia. Pole and rotation and mean radius information has been added for (1) Ceres. Pole information has been updated for (4) Vesta. The high precision realization for the pole and rotation rate of the Moon is updated. Alternative orientation models for Mars, Jupiter, and Saturn are noted. The Working Group also reaffirms that once an observable feature at a defined longitude is chosen, a longitude definition origin should not change except under unusual circumstances. It is also noted that alternative coordinate systems may exist for various (e.g. dynamical) purposes, but specific cartographic coordinate system information continues to be recommended for each body. The Working Group elaborates on its purpose, and also announces its plans to occasionally provide limited updates to its recommendations via its website, in order to address community needs for some updates more often than every 3 years. Brief recommendations are also made to the general planetary community regarding the need for controlled products, and improved or consensus rotation models for Mars, Jupiter, and Saturn.

Some Interesting Applications of Probabilistic Techiques in Structural Dynamic Analysis of Rocket Engines

NASA Technical Reports Server (NTRS)

Brown, Andrew M.

2014-01-01

Numerical and Analytical methods developed to determine damage accumulation in specific engine components when speed variation included. Dither Life Ratio shown to be well over factor of 2 for specific example. Steady-State assumption shown to be accurate for most turbopump cases, allowing rapid calculation of DLR. If hot-fire speed data unknown, Monte Carlo method developed that uses speed statistics for similar engines. Application of techniques allow analyst to reduce both uncertainty and excess conservatism. High values of DLR could allow previously unacceptable part to pass HCF criteria without redesign. Given benefit and ease of implementation, recommend that any finite life turbomachine component analysis adopt these techniques. Probability Values calculated, compared, and evaluated for several industry-proposed methods for combining random and harmonic loads. Two new excel macros written to calculate combined load for any specific probability level. Closed form Curve fits generated for widely used 3(sigma) and 2(sigma) probability levels. For design of lightweight aerospace components, obtaining accurate, reproducible, statistically meaningful answer critical.

Opportunities for Promoting Physical Activity in Rural Communities by Understanding the Interests and Values of Community Members.

PubMed

Park, Thomas; Eyler, Amy A; Tabak, Rachel G; Valko, Cheryl; Brownson, Ross C

2017-01-01

Physical activity (PA) has well-established health benefits, but most Americans do not meet national guidelines. In southeastern Missouri, trails have been developed to increase rates of PA. Although this has had success, broad-scale interventions will be needed to improve rates further. In this study, we surveyed residents of southeastern Missouri to identify ways to improve rates of PA. We conducted a telephone survey in 2015 of adults ( n = 524) from eight rural Missouri towns that had walking trails, regarding their activities and interests. Forty percent of respondents reported both walking and meeting PA recommendations, 29% reported walking but not meeting PA recommendations, and the remainder did not walk or did not answer. Respondents who used the trails were significantly more likely to meet PA recommendations (odds ratio = 2.7; 95% confidence interval = 1.7, 4.5). Certain values and interests that may encourage PA or draw people to trails were common. The group that walked but did not meet PA recommendations would be the ideal group to target for intervention, which could focus on their reported values and interests (e.g., personal relationships, being outdoors). Use of walking trails was associated with meeting PA recommendations.

Drilling deeper into the core: an analysis of journal evaluation methodologies used to create the "Basic List of Veterinary Medical Serials," third edition.

PubMed

Ugaz, Ana G

2011-04-01

The paper analyzes the journal evaluation criteria used to create the third edition of a core list of veterinary serials to determine the impact of each criterion on the final composition of the list in order to assess the value of using multiple criteria in creating a core list. Three additional lists were generated from criteria that were previously combined to prepare the third edition of the "Basic List of Veterinary Medical Serials": a list based on journal recommendations from veterinary specialty organizations, another list based on journals selected by veterinary librarians, and a list based on both indexing coverage and scholarly rank. The top fifteen journals in each of the three lists were then compared to reveal potential biases. Subject representation on the full lists generated by each of these methods was also compared. The list based on journal recommendations from veterinary specialty organizations exhibited a focus on clinically relevant titles. The list based on veterinary librarian recommendations resulted in the broadest subject coverage. The list based on indexing and scholarly rank, while emphasizing research titles, produced the largest number of unique titles. A combination approach that includes objective evaluation measures and practical input, whether from librarians or discipline experts, can improve coverage and can result in a list that balances research-based with clinical practice journals.

Development of the UTAUT2 model to measure the acceptance of medical laboratory portals by patients in Shiraz

PubMed Central

Ravangard, Ramin; Kazemi, Zhila; Abbasali, Somaye Zaker; Sharifian, Roxana; Monem, Hossein

2017-01-01

Introduction One of the main stages for achieving the success is acceptance of technology by its users. Hence, identifying the effective factors in successful acceptance of information technology is necessary and vital. One such factor is usability. This study aimed to investigate the software usability in the “Unified Theory of Acceptance and Use of Technology 2 (UTAUT2)” model in patients’ use of medical diagnosis laboratories’ electronic portals in 2015. Methods This cross-sectional study was carried out on 170 patients in 2015. A 27-item questionnaire adopted from previous research and the Usability Evaluation questionnaire were used for data collection. Data were analyzed using Structural Equation Modeling (SEM), with Partial Least Squares approach by SPSS 20.0 and Smart-PLS V3.0. Results The results showed that the construct of intention to use had significant associations with price value (t-value=2.77), hedonic motivation (t-value=4.46), habit (t-value=1.99) and usability (t-value=5.2), as well as the construct of usage behavior with usability (t-value=3.45) and intention to use (t-value=2.03). Conclusion Considering the results of this study, the following recommendations can be made in order for the higher use of portals by the patients: informing patients about the advantages of using these portals, designing portals in a simple and understandable form, increasing the portals’ attractiveness, etc. PMID:28465819

Low LET radiolysis escape yields for reducing radicals and H2 in pressurized high temperature water

NASA Astrophysics Data System (ADS)

Sterniczuk, Marcin; Yakabuskie, Pamela A.; Wren, J. Clara; Jacob, Jasmine A.; Bartels, David M.

2016-04-01

Low Linear Energy Transfer (LET) radiolysis escape yields (G values) are reported for the sum (G(radH)+G(e-)aq) and for G(H2) in subcritical water up to 350 °C. The scavenger system 1-10 mM acetate/0.001 M hydroxide/0.00048 M N2O was used with simultaneous mass spectroscopic detection of H2 and N2 product. Temperature-dependent measurements were carried out with 2.5 MeV electrons from a van de Graaff accelerator, while room temperature calibration measurements were done with a 60Co gamma source. The concentrations and dose range were carefully chosen so that initial spur chemistry is not perturbed and the N2 product yield corresponds to those reducing radicals that escape recombination in pure water. In comparison with a recent review recommendation of Elliot and Bartels (AECL report 153-127160-450-001, 2009), the measured reducing radical yield is seven percent smaller at room temperature but in fairly good agreement above 150 °C. The H2 escape yield is in good agreement throughout the temperature range with several previous studies that used much larger radical scavenging rates. Previous analysis of earlier high temperature measurements of Gesc(radOH) is shown to be flawed, although the actual G values may be nearly correct. The methodology used in the present report greatly reduces the range of possible error and puts the high temperature escape yields for low-LET radiation on a much firmer quantitative foundation than was previously available.

Online irrigation service for fruit und vegetable crops at farmers site

NASA Astrophysics Data System (ADS)

Janssen, W.

2009-09-01

Online irrigation service for fruit und vegetable crops at farmers site by W. Janssen, German Weather Service, 63067 Offenbach Agrowetter irrigation advice is a product which calculates the present soil moisture as well as the soil moisture to be expected over the next 5 days for over 30 different crops. It's based on a water balance model and provides targeted recommendations for irrigation. Irrigation inputs according to the soil in order to avoid infiltration and, as a consequence thereof, the undesired movement of nitrate and plant protectants into the groundwater. This interactive 'online system' takes into account the user's individual circumstances such as crop and soil characteristics and the precipitation and irrigation amounts at the user's site. Each user may calculate up to 16 different enquiries simultaneously (different crops or different emergence dates). The user can calculate the individual soil moistures for his fields with a maximum effort of 5 minutes per week only. The sources of water are precipitation and irrigation whereas water losses occur due to evapotranspiration and infiltration of water into the ground. The evapotranspiration is calculated by multiplying a reference evapotranspiration (maximum evapotranspiration over grass) with the so-called crop coefficients (kc values) that have been developed by the Geisenheim Research Centre, Vegetable Crops Branch. Kc values depending on the crop and the individual plant development stage. The reference evapotranspiration is calculated from a base weather station user has chosen (out of around 500 weather stations) using Penman method based on daily values. After chosen a crop and soil type the user must manually enter the precipitation data measured at the site, the irrigation water inputs and the dates for a few phenological stages. Economical aspects can be considered by changing the values of soil moisture from which recommendations for irrigation start from optimal to necessary plant supply. Previous comparative measurements carried out by the Agricultural Administration of Baden-Württemberg relating to potatoes, onions, vine stocks, and strawberries agreed very well with the calculations.

Predictive value of Borrelia burgdorferi IgG antibody levels in patients referred to a tertiary Lyme centre.

PubMed

Zwerink, M; Zomer, T P; van Kooten, B; Blaauw, G; van Bemmel, T; van Hees, B C; Vermeeren, Y M; Landman, G W

2018-03-01

A two-step testing strategy is recommended in serological testing for Lyme borreliosis; positive and indeterminate enzyme-linked immunosorbent assay (ELISA) results are confirmed with immunoblots. Several ELISAs quantify the concentration of antibodies tested, however, no recommendation exists for an upper cut-off value at which an IgG ELISA is sufficient and the immunoblot can be omitted. The study objective was to determine at which IgG antibody level an immunoblot does not have any additional predictive value compared to ELISA results. Data of adult patients who visited a tertiary Lyme centre between 2008 and 2014 were analysed. Both an ELISA (Enzygnost Lyme link VlsE IgG) and immunoblot (recomLine blot Borrelia) were performed. Clinical data were extracted from the patient's digital medical record. Positive predictive values (PPVs) for either previous or active infection with Borrelia burgdorferi s.l. were calculated for different cut-off ELISA IgG antibody levels where the immunoblot was regarded as reference test. In total, 1454 patients were included. According to the two-step test strategy, 486 (33%), 69 (5%) and 899 (62%) patients had positive, indeterminate and negative Borrelia IgG serology, respectively. At IgG levels of 500 IU/ml and higher, all immunoblots were positive, resulting in a 100% PPV (95% CI: 97.0-100). At IgG levels of 200 IU/ml and higher, the PPV was 99.3% (95% CI: 97.4-99.8). In conclusion, at IgG levels of 200 IU/ml and higher, an ELISA was sufficient to detect antibodies to Borrelia burgdorferi s.l. At those IgG levels, a confirmatory immunoblot may be omitted in patients referred to a tertiary Lyme centre. Before these results can be implemented in routine diagnosis of Lyme borreliosis, confirmation of the results is necessary in other patient populations and using other quantitative ELISAs and immunoblots. Copyright © 2017 Elsevier GmbH. All rights reserved.

Long-term effects of user preference-oriented recommendation method on the evolution of online system

NASA Astrophysics Data System (ADS)

Shi, Xiaoyu; Shang, Ming-Sheng; Luo, Xin; Khushnood, Abbas; Li, Jian

2017-02-01

As the explosion growth of Internet economy, recommender system has become an important technology to solve the problem of information overload. However, recommenders are not one-size-fits-all, different recommenders have different virtues, making them be suitable for different users. In this paper, we propose a novel personalized recommender based on user preferences, which allows multiple recommenders to exist in E-commerce system simultaneously. We find that output of a recommender to each user is quite different when using different recommenders, the recommendation accuracy can be significantly improved if each user is assigned with his/her optimal personalized recommender. Furthermore, different from previous works focusing on short-term effects on recommender, we also evaluate the long-term effect of the proposed method by modeling the evolution of mutual feedback between user and online system. Finally, compared with single recommender running on the online system, the proposed method can improve the accuracy of recommendation significantly and get better trade-offs between short- and long-term performances of recommendation.

Skin Resistivity Value of Upper Trapezius Latent Trigger Points

PubMed Central

Skorupska, Elżbieta; Zawadziński, Jarosław

2015-01-01

Introduction. The skin resistivity (SkR) measurement is commonly recommended for acupoints measurement, but for trigger points (TrPs) only one study is available. The purpose of the study was to evaluate SkR for latent TrPs compared to non-TrPs and the surrounding tissue. Material and Methods. Forty-two healthy volunteers with unilateral latent upper trapezius TrPs (12 men, 30 women) aged 21–23 (mean age: 22.1 ± 0.6 y) participated in the study. Keithley electrometer 610B was used for measuring SkR (Ag/AgCl self-adhesive, disposable ground electrode: 30 mm diameter). SkR was measured for latent TrPs and compared to opposite non-TrPs sites and the surrounding tissue. Results. The SkR decrease of TrPs-positive sites as compared to TrPs-negative sites and the surrounding tissue was confirmed. However, no statistically significant difference in the SkR value occurred when all data were analyzed. The same was confirmed after gender division and for TrPs-positive subjects examined for referred pain and twitch response presence. Conclusion. SkR reactive changes at latent TrPs are possible but the results were not consistent with the previous study. Thus, caution in applying SkR to latent TrPs isolation is recommended and its clinical use should not be encouraged yet. Further studies, especially on active TrPs, are yet required. PMID:26180796

Longitudinal design considerations to optimize power to detect variances and covariances among rates of change: Simulation results based on actual longitudinal studies

PubMed Central

Rast, Philippe; Hofer, Scott M.

2014-01-01

We investigated the power to detect variances and covariances in rates of change in the context of existing longitudinal studies using linear bivariate growth curve models. Power was estimated by means of Monte Carlo simulations. Our findings show that typical longitudinal study designs have substantial power to detect both variances and covariances among rates of change in a variety of cognitive, physical functioning, and mental health outcomes. We performed simulations to investigate the interplay among number and spacing of occasions, total duration of the study, effect size, and error variance on power and required sample size. The relation between growth rate reliability (GRR) and effect size to the sample size required to detect power ≥ .80 was non-linear, with rapidly decreasing sample sizes needed as GRR increases. The results presented here stand in contrast to previous simulation results and recommendations (Hertzog, Lindenberger, Ghisletta, & von Oertzen, 2006; Hertzog, von Oertzen, Ghisletta, & Lindenberger, 2008; von Oertzen, Ghisletta, & Lindenberger, 2010), which are limited due to confounds between study length and number of waves, error variance with GCR, and parameter values which are largely out of bounds of actual study values. Power to detect change is generally low in the early phases (i.e. first years) of longitudinal studies but can substantially increase if the design is optimized. We recommend additional assessments, including embedded intensive measurement designs, to improve power in the early phases of long-term longitudinal studies. PMID:24219544

Recommended Immunization Schedules for Persons Aged 0 through 18 Years--United States, 2010. Morbidity and Mortality Weekly Report QuickGuide. Volume 58, Number 51 & 52

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2010

2010-01-01

The Advisory Committee on Immunization Practices (ACIP) annually publishes an immunization schedule for persons aged 0 through 18 years that summarizes recommendations for currently licensed vaccines for children aged 18 years and younger and includes recommendations in effect as of December 15, 2009. The changes to the previous schedule are…

Limitations of the evidence base used to set recommended nutrient intakes for infants and lactating women.

USDA-ARS?s Scientific Manuscript database

Reported values for the concentrations of micronutrients in human milk form the basis of the majority of micronutrient intake recommendations for infants and the additional maternal requirements for lactation. The infant recommendations may also be extrapolated to provide estimates for young childre...

Optimal breastfeeding durations for HIV-exposed infants: the impact of maternal ART use, infant mortality and replacement feeding risk.

PubMed

Mallampati, Divya; MacLean, Rachel L; Shapiro, Roger; Dabis, Francois; Engelsmann, Barbara; Freedberg, Kenneth A; Leroy, Valeriane; Lockman, Shahin; Walensky, Rochelle; Rollins, Nigel; Ciaranello, Andrea

2018-04-01

In 2010, the WHO recommended women living with HIV breastfeed for 12 months while taking antiretroviral therapy (ART) to balance breastfeeding benefits against HIV transmission risks. To inform the 2016 WHO guidelines, we updated prior research on the impact of breastfeeding duration on HIV-free infant survival (HFS) by incorporating maternal ART duration, infant/child mortality and mother-to-child transmission data. Using the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Infant model, we simulated the impact of breastfeeding duration on 24-month HFS among HIV-exposed, uninfected infants. We defined "optimal" breastfeeding durations as those maximizing 24-month HFS. We varied maternal ART duration, mortality rates among breastfed infants/children, and relative risk of mortality associated with replacement feeding ("RRRF"), modelled as a multiplier on all-cause mortality for replacement-fed infants/children (range: 1 [no additional risk] to 6). The base-case simulated RRRF = 3, median infant mortality, and 24-month maternal ART duration. In the base-case, HFS ranged from 83.1% (no breastfeeding) to 90.2% (12-months breastfeeding). Optimal breastfeeding durations increased with higher RRRF values and longer maternal ART durations, but did not change substantially with variation in infant mortality rates. Optimal breastfeeding durations often exceeded the previous WHO recommendation of 12 months. In settings with high RRRF and long maternal ART durations, HFS is maximized when mothers breastfeed longer than the previously-recommended 12 months. In settings with low RRRF or short maternal ART durations, shorter breastfeeding durations optimize HFS. If mothers are supported to use ART for longer periods of time, it is possible to reduce transmission risks and gain the benefits of longer breastfeeding durations. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

The GRADE approach for assessing new technologies as applied to apheresis devices in ulcerative colitis

PubMed Central

2010-01-01

Background In the last few years, a new non-pharmacological treatment, termed apheresis, has been developed to lessen the burden of ulcerative colitis (UC). Several methods can be used to establish treatment recommendations, but over the last decade an informal collaboration group of guideline developers, methodologists, and clinicians has developed a more sensible and transparent approach known as the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). GRADE has mainly been used in clinical practice guidelines and systematic reviews. The aim of the present study is to describe the use of this approach in the development of recommendations for a new health technology, and to analyse the strengths, weaknesses, opportunities, and threats found when doing so. Methods A systematic review of the use of apheresis for UC treatment was performed in June 2004 and updated in May 2008. Two related clinical questions were selected, the outcomes of interest defined, and the quality of the evidence assessed. Finally, the overall quality of each question was taken into account to formulate recommendations following the GRADE approach. To evaluate this experience, a SWOT (strengths, weaknesses, opportunities and threats) analysis was performed to enable a comparison with our previous experience with the SIGN (Scottish Intercollegiate Guidelines Network) method. Results Application of the GRADE approach allowed recommendations to be formulated and the method to be clarified and made more explicit and transparent. Two weak recommendations were proposed to answer to the formulated questions. Some challenges, such as the limited number of studies found for the new technology and the difficulties encountered when searching for the results for the selected outcomes, none of which are specific to GRADE, were identified. GRADE was considered to be a more time-consuming method, although it has the advantage of taking into account patient values when defining and grading the relevant outcomes, thereby avoiding any influence from literature precedents, which could be considered to be a strength of this method. Conclusions The GRADE approach could be appropriate for making the recommendation development process for Health Technology Assessment (HTA) reports more explicit, especially with regard to new technologies. PMID:20553616

Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study.

PubMed

Lancellotti, Patrizio; Galderisi, Maurizio; Edvardsen, Thor; Donal, Erwan; Goliasch, Georg; Cardim, Nuno; Magne, Julien; Laginha, Sara; Hagendorff, Andreas; Haland, Trine F; Aaberge, Lars; Martinez, Christophe; Rapacciuolo, Antonio; Santoro, Ciro; Ilardi, Federica; Postolache, Adriana; Dulgheru, Raluca; Mateescu, Anca D; Beladan, Carmen C; Deleanu, Dan; Marchetta, Stella; Auffret, Vincent; Schwammenthal, Ehud; Habib, Gilbert; Popescu, Bogdan A

2017-09-01

The present Euro-Filling report aimed at comparing the diagnostic accuracy of the 2009 and 2016 echocardiographic grading algorithms for predicting invasively measured left ventricular filling pressure (LVFP). A total of 159 patients who underwent simultaneous evaluation of echo estimates of LVFP and invasive measurements of LV end-diastolic pressure (LVEDP) were enrolled at nine EACVI centres. Thirty-nine (25%) patients had a reduced LV ejection fraction (<50%), 77 (64%) were in NYHA ≥ II, and 85 (53%) had coronary artery disease. Sixty-four (40%) patients had elevated LVEDP (≥15 mmHg). Taken individually, all echocardiographic Doppler estimates of LVFP (E/A, E/e', left atrial volume, tricuspid regurgitation jet velocity) were marginally correlated with LVEDP. By using the 2016 recommendations, 65% of patients with normal non-invasive estimate of LVFP had normal LVEDP, while 79% of those with elevated non-invasive LVFP had elevated invasive LVEDP. By using 2009 recommendations, 68% of the patients with normal non-invasive LVFP had normal LVEDP, while 55% of those with elevated non-invasive LVFP had elevated LVEDP. The 2016 recommendations (sensitivity 75%, specificity 74%, positive predictive value 39%, negative predictive value 93%, AUC 0.78) identified slightly better patients with elevated invasive LVEDP (≥ 15 mmHg) as compared with the 2009 recommendations (sensitivity 43%, specificity 75%, positive predictive value 49%, negative predictive value 71%, AUC 0.68). The present Euro-Filling study demonstrates that the new 2016 recommendations for assessing LVFP non-invasively are fairly reliable and clinically useful, as well as superior to the 2009 recommendations in estimating invasive LVEDP. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

High-Value Consults: A Curriculum to Promote Point-of-Care, Evidence-Based Recommendations.

PubMed

Nandiwada, Deepa Rani; Kohli, Amar; McNamara, Megan; Smith, Kenneth J; Zimmer, Shanta; McNeil, Melissa; Spagnoletti, Carla; Rubio, Doris; Berlacher, Kathryn

2017-10-01

In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches. The curriculum included an online module, an EBM teaching point template, EBM presentations on rounds, and "coach" feedback on notes. A total of 15 residents and 4 fellows on cardiology consults participated, and 87% (13 of 15) of residents on consults felt the curriculum was educationally valuable. A total of 80% (72 of 90) of residents on general medicine rotations responded to the survey, and 25 of 72 residents (35%) had a consult with the EBM template. General medicine teams felt the EBM teaching points affected clinical decision-making (48%, 12 of 25) and favored dissemination of the curriculum (90%, 72 of 80). Checklist-guided chart review showed a 22% improvement in evidence-based summaries behind recommendations (7 of 36 precurriculum to 70 of 146 charts postcurriculum, P  = .015). The HVC consult curriculum during a cardiology elective was perceived by residents to influence clinical decision-making and evidence-based recommendations, and was found to be educationally valuable on both parties in the consult process.

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices

PubMed Central

Vellozzi, Claudia; Reingold, Arthur; Harris, Aaron; Haber, Penina; Ward, John W.; Nelson, Noele P.

2018-01-01

Summary Hepatitis B virus (HBV) is transmitted via blood or sexual contact. Persons with chronic HBV infection are at increased risk for cirrhosis and liver cancer and require medical care. This report updates and summarizes previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) and CDC regarding the prevention of HBV infection in the United States. ACIP recommends testing all pregnant women for hepatitis B surface antigen (HBsAg), and testing HBsAg-positive pregnant women for hepatitis B virus deoxyribonucleic acid (HBV DNA); administration of HepB vaccine and hepatitis B immune globulin (HBIG) for infants born to HBV-infected women within 12 hours of birth, followed by completion of the vaccine series and postvaccination serologic testing; universal hepatitis B vaccination within 24 hours of birth, followed by completion of the vaccine series; and vaccination of children and adolescents aged <19 years who have not been vaccinated previously. ACIP recommends vaccination of adults at risk for HBV infection, including universal vaccination of adults in settings in which a high proportion have risk factors for HBV infection and vaccination of adults requesting protection from HBV without acknowledgment of a specific risk factor. These recommendations also provide CDC guidance for postexposure prophylaxis following occupational and other exposures. This report also briefly summarizes previously published American Association for the Study of Liver Diseasest guidelines for maternal antiviral therapy to reduce perinatal HBV transmission. PMID:29939980

Coastal Zone Ecosystem Services: from science to values and decision making; a case study.

PubMed

Luisetti, T; Turner, R K; Jickells, T; Andrews, J; Elliott, M; Schaafsma, M; Beaumont, N; Malcolm, S; Burdon, D; Adams, C; Watts, W

2014-09-15

This research is concerned with the following environmental research questions: socio-ecological system complexity, especially when valuing ecosystem services; ecosystems stock and services flow sustainability and valuation; the incorporation of scale issues when valuing ecosystem services; and the integration of knowledge from diverse disciplines for governance and decision making. In this case study, we focused on ecosystem services that can be jointly supplied but independently valued in economic terms: healthy climate (via carbon sequestration and storage), food (via fisheries production in nursery grounds), and nature recreation (nature watching and enjoyment). We also explored the issue of ecosystem stock and services flow, and we provide recommendations on how to value stock and flows of ecosystem services via accounting and economic values respectively. We considered broadly comparable estuarine systems located on the English North Sea coast: the Blackwater estuary and the Humber estuary. In the past, these two estuaries have undergone major land-claim. Managed realignment is a policy through which previously claimed intertidal habitats are recreated allowing the enhancement of the ecosystem services provided by saltmarshes. In this context, we investigated ecosystem service values, through biophysical estimates and welfare value estimates. Using an optimistic (extended conservation of coastal ecosystems) and a pessimistic (loss of coastal ecosystems because of, for example, European policy reversal) scenario, we find that context dependency, and hence value transfer possibilities, vary among ecosystem services and benefits. As a result, careful consideration in the use and application of value transfer, both in biophysical estimates and welfare value estimates, is advocated to supply reliable information for policy making. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

INTERNATIONAL REPORT: Practical realization of the definition of the metre, including recommended radiations of other optical frequency standards (2003)

NASA Astrophysics Data System (ADS)

Felder, R.

2005-08-01

In 2003, the International Committee for Weights and Measures (CIPM) recommended updated values of the frequency for certain optical frequency standards recommended for the practical realization of the definition of the metre. The text of this CIPM Recommendation and details of the updated radiations are given here. The complete updated set of recommended radiations, including frequencies, wavelengths, uncertainties and operating conditions where appropriate, is available on the BIPM website.

Intramolecular BSSE and dispersion affect the structure of a dipeptide conformer

NASA Astrophysics Data System (ADS)

Hameed, Rabia; Khan, Afsar; van Mourik, Tanja

2018-05-01

B3LYP and MP2 calculations with the commonly-used 6-31+G(d) basis set predict qualitatively different structures for the Tyr-Gly conformer book1, which is the most stable conformer identified in a previous study. The structures differ mainly in the ψtyr Ramachandran angle (138° in the B3LYP structure and 120° in the MP2 structure). The causes for the discrepant structures are attributed to missing dispersion in the B3LYP calculations and large intramolecular BSSE in the MP2 calculations. The correct ψtyr value is estimated to be 130°. The MP2/6-31+G(d) profile identified an additional conformer, not present on the B3LYP surface, with a ψtyr value of 96° and a more folded structure. This minimum is, however, likely an artefact of large intramolecular BSSE values. We recommend the use of basis sets of at least quadruple-zeta quality in density functional theory (DFT), DFTaugmented with an empirical dispersion term (DFT-D) and second-order Møller-Plesset perturbation theory (MP2 ) calculations in cases where intramolecular BSSE is expected to be large.

VizieR Online Data Catalog: Energy levels of ionized vanadium (V II) (Saloman+, 2017)

NASA Astrophysics Data System (ADS)

Saloman, E. B.; Kramida, A.

2017-09-01

The energy levels, observed spectral lines, and transition probabilities of singly ionized vanadium, V II, have been compiled. The experimentally derived energy levels belong to the configurations 3d4, 3d3ns (n=4,5,6), 3d3np, and 3d3nd (n=4,5), 3d34f, 3d24s2, and 3d24s4p. Also included are values for some forbidden lines that may be of interest to the astrophysical community. Experimental Lande g-factors and leading percentages for the levels are included when available, as well as Ritz wavelengths calculated from the energy levels. Wavelengths and transition probabilities are reported for 3568 and 1896 transitions, respectively. From the list of observed wavelengths, 407 energy levels are determined. The observed intensities, normalized to a common scale, are provided. From the newly optimized energy levels, a revised value for the ionization energy is derived, 118,030(60)cm-1, corresponding to 14.634(7)eV. This is 130cm-1 higher than the previously recommended value from Iglesias+ (1988, Publ. Inst. Opt. Madrid 47 1). (3 data files).

Generic NICA-Donnan model parameters for metal-ion binding by humic substances.

PubMed

Milne, Christopher J; Kinniburgh, David G; van Riemsdijk, Willem H; Tipping, Edward

2003-03-01

A total of 171 datasets of literature and experimental data for metal-ion binding by fulvic and humic acids have been digitized and re-analyzed using the NICA-Donnan model. Generic parameter values have been derived that can be used for modeling in the absence of specific metalion binding measurements. These values complement the previously derived generic descriptions of proton binding. For ions where the ranges of pH, concentration, and ionic strength conditions are well covered by the available data,the generic parameters successfully describe the metalion binding behavior across a very wide range of conditions and for different humic and fulvic acids. Where published data for other metal ions are too sparse to constrain the model well, generic parameters have been estimated by interpolating trends observable in the parameter values of the well-defined data. Recommended generic NICA-Donnan model parameters are provided for 23 metal ions (Al, Am, Ba, Ca, Cd, Cm, Co, CrIII, Cu, Dy, Eu, FeII, FeIII, Hg, Mg, Mn, Ni, Pb, Sr, Thv, UVIO2, VIIIO, and Zn) for both fulvic and humic acids. These parameters probably represent the best NICA-Donnan description of metal-ion binding that can be achieved using existing data.

Prophylaxis and treatment of HIV-1 infection in pregnancy: Swedish recommendations 2010.

PubMed

Navér, Lars; Albert, Jan; Belfrage, Erik; Flamholc, Leo; Gisslén, Magnus; Gyllensten, Katarina; Josephson, Filip; Karlström, Olof; Lindgren, Susanne; Pettersson, Karin; Svedhem, Veronica; Sönnerborg, Anders; Westling, Katarina; Yilmaz, Aylin; Swedish Reference Group for Antiviral Therapy

2011-07-01

Prophylaxis and treatment with antiretroviral drugs and the use of elective caesarean section have resulted in a very low mother-to-child transmission of human immunodeficiency virus (HIV) during recent years. The availability of new antiretroviral drugs, updated general treatment guidelines and increasing knowledge of the importance of drug resistance, have necessitated regular revisions of the "Prophylaxis and treatment of HIV-1 infection in pregnancy" recommendations. For these reasons, The Swedish Reference Group for Antiviral Therapy (RAV) updated the 2007 recommendations at an expert meeting that took place on 25 March 2010. The most important revisions from the previous recommendations are: (1) it is recommended that treatment during pregnancy starts at the latest at gestational week 14-18; (2) ongoing efficient treatment at confirmed pregnancy may, with a few exceptions, be continued; (3) lopinavir/r and atazanavir/r are equally recommended protease inhibitors; (4) if maternal HIV RNA is >50 copies/ml close to delivery, a planned caesarean section, intravenous zidovudine, oral nevirapine for the mother and post-exposure prophylaxis for the infant with 3 antiretroviral drugs are recommended; (5) for delivery at <34 gestational weeks, intravenous zidovudine and oral nevirapine for the mother and at 48-72 h for the infant is recommended, in addition to other prophylaxis; (6) intravenous zidovudine is not recommended when HIV RNA is <50 copies/ml and a caesarean section is performed; (7) it is recommended that prophylaxis for the infant is started within 4 h; (8) prophylactic zidovudine for the infant may be administered twice daily instead of 4 times a day, as was the case previously; and (9) the number of sampling occasions for the infant has been decreased.

Nutrient intake values (NIVs): a recommended terminology and framework for the derivation of values.

PubMed

King, Janet C; Vorster, Hester H; Tome, Daniel G

2007-03-01

Although most countries and regions around the world set recommended nutrient intake values for their populations, there is no standardized terminology or framework for establishing these standards. Different terms used for various components of a set of dietary standards are described in this paper and a common set of terminology is proposed. The recommended terminology suggests that the set of values be called nutrient intake values (NIVs) and that the set be composed of three different values. The average nutrient requirement (ANR) reflects the median requirement for a nutrient in a specific population. The individual nutrient level (INLx) is the recommended level of nutrient intake for all healthy people in the population, which is set at a certain level x above the mean requirement. For example, a value set at 2 standard deviations above the mean requirement would cover the needs of 98% of the population and would be INL98. The third component of the NIVs is an upper nutrient level (UNL), which is the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in a specified life-stage group. The proposed framework for deriving a set of NIVs is based on a statistical approach for determining the midpoint of a distribution of requirements for a set of nutrients in a population (the ANR), the standard deviation of the requirements, and an individual nutrient level that assures health at some point above the mean, e.g., 2 standard deviations. Ideally, a second set of distributions of risk of excessive intakes is used as the basis for a UNL.

Review of Seismic Hazard Issues Associated with Auburn Dam Project, Sierra Nevada Foothills, California

USGS Publications Warehouse

Schwartz, D.P.; Joyner, W.B.; Stein, R.S.; Brown, R.D.; McGarr, A.F.; Hickman, S.H.; Bakun, W.H.

1996-01-01

Summary -- The U.S. Geological Survey was requested by the U.S. Department of the Interior to review the design values and the issue of reservoir-induced seismicity for a concrete gravity dam near the site of the previously-proposed Auburn Dam in the western foothills of the Sierra Nevada, central California. The dam is being planned as a flood-control-only dam with the possibility of conversion to a permanent water-storage facility. As a basis for planning studies the U.S. Army Corps of Engineers is using the same design values approved by the Secretary of the Interior in 1979 for the original Auburn Dam. These values were a maximum displacement of 9 inches on a fault intersecting the dam foundation, a maximum earthquake at the site of magnitude 6.5, a peak horizontal acceleration of 0.64 g, and a peak vertical acceleration of 0.39 g. In light of geological and seismological investigations conducted in the western Sierran foothills since 1979 and advances in the understanding of how earthquakes are caused and how faults behave, we have developed the following conclusions and recommendations: Maximum Displacement. Neither the pre-1979 nor the recent observations of faults in the Sierran foothills precisely define the maximum displacement per event on a fault intersecting the dam foundation. Available field data and our current understanding of surface faulting indicate a range of values for the maximum displacement. This may require the consideration of a design value larger than 9 inches. We recommend reevaluation of the design displacement using current seismic hazard methods that incorporate uncertainty into the estimate of this design value. Maximum Earthquake Magnitude. There are no data to indicate that a significant change is necessary in the use of an M 6.5 maximum earthquake to estimate design ground motions at the dam site. However, there is a basis for estimating a range of maximum magnitudes using recent field information and new statistical fault relations. We recommend reevaluating the maximum earthquake magnitude using current seismic hazard methodology. Design Ground Motions. A large number of strong-motion records have been acquired and significant advances in understanding of ground motion have been achieved since the original evaluations. The design value for peak horizontal acceleration (0.64 g) is larger than the median of one recent study and smaller than the median value of another. The value for peak vertical acceleration (0.39 g) is somewhat smaller than median values of two recent studies. We recommend a reevaluation of the design ground motions that takes into account new ground motion data with particular attention to rock sites at small source distances. Reservoir-Induced Seismicity. The potential for reservoir-induced seismicity must be considered for the Auburn Darn project. A reservoir-induced earthquake is not expected to be larger than the maximum naturally occurring earthquake. However, the probability of an earthquake may be enhanced by reservoir impoundment. A flood-control-only project may involve a lower probability of significant induced seismicity than a multipurpose water-storage dam. There is a need to better understand and quantify the likelihood of this hazard. A methodology should be developed to quantify the potential for reservoir induced seismicity using seismicity data from the Sierran foothills, new worldwide observations of induced and triggered seismicity, and current understanding of the earthquake process. Reevaluation of Design Parameters. The reevaluation of the maximum displacement, maximum magnitude earthquake, and design ground motions can be made using available field observations from the Sierran foothills, updated statistical relations for faulting and ground motions, and current computational seismic hazard methodologies that incorporate uncertainty into the analysis. The reevaluation does not require significant new geological field studies.

AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON MENOPAUSE-2017 UPDATE.

PubMed

Cobin, Rhoda H; Goodman, Neil F

2017-07-01

EXECUTIVE SUMMARY This American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) Position Statement is designed to update the previous menopause clinical practice guidelines published in 2011 but does not replace them. The current document reviews new clinical trials published since then as well as new information regarding possible risks and benefits of therapies available for the treatment of menopausal symptoms. AACE reinforces the recommendations made in its previous guidelines and provides additional recommendations on the basis of new data. A summary regarding this position statement is listed below: New information available from randomized clinical trials and epidemiologic studies reported after 2011 was critically reviewed. No previous recommendations from the 2011 menopause clinical practice guidelines have been reversed or changed. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, selective estrogen-receptor modulators (SERMs), and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. Newer information enhances AACE's guidance for the use of hormone therapy in different subsets of women. Newer information helps to support the use of various types of estrogens, SERMs, and progesterone, as well as the route of delivery. Newer information supports the previous recommendation against the use of bioidentical hormones. The use of nonhormonal therapies for the symptomatic relief of menopausal symptoms is supported. New recommendations in this position statement include: 1. the use of menopausal hormone therapy in symptomatic postmenopausal women should be based on consideration of all risk factors for cardiovascular disease, age, and time from menopause. 2. the use of transdermal as compared with oral estrogen preparations may be considered less likely to produce thrombotic risk and perhaps the risk of stroke and coronary artery disease. 3. when the use of progesterone is necessary, micronized progesterone is considered the safer alternative. 4. in symptomatic menopausal women who are at significant risk from the use of hormone replacement therapy, the use of selective serotonin re-uptake inhibitors and possibly other nonhormonal agents may offer significant symptom relief. 5. AACE does not recommend use of bioidentical hormone therapy. 6. AACE fully supports the recommendations of the Comité de l'Évolution des Pratiques en Oncologie regarding the management of menopause in women with breast cancer. 7. HRT is not recommended for the prevention of diabetes. 8. In women with previously diagnosed diabetes, the use of HRT should be individualized, taking in to account age, metabolic, and cardiovascular risk factors. AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; BMI = body mass index; CAC = coronary artery calcification; CEE = conjugated equine estrogen; CEPO = Comité de l'Évolution des Pratiques en Oncologie; CAD = coronary artery disease; CIMT = carotid intima media thickness; CVD = cardiovascular disease; FDA = Food and Drug Administration; HDL = high-density lipoprotein; HRT = hormone replacement therapy; HT = hypertension; KEEPS = Kronos Early Estrogen Prevention Study; LDL = low-density lipoprotein; MBS = metabolic syndrome; MPA = medroxyprogesterone acetate; RR = relative risk; SERM = selective estrogen-receptor modulator; SSRI = selective serotonin re-uptake inhibitor; VTE = venous thrombo-embolism; WHI = Women's Health Initiative.

Environmental investigation for property transfer, Fort Holabird Crime Records Center. Environmental investigation and alternatives assessment. Final report

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

Finger, F.J.; Todd, Q.R.

An Environmental Investigation and Alternatives Assessment was conducted for the Crime Records Center at Fort Holabird in Baltimore, Maryland. Groundwater sampling, underground storage tank tightness testing, radon sampling, asbestos sampling, soil observations, and a review of previously collected data were used to develop remedial alternatives and recommendations. Removal and record keeping were recommended for asbestos. The recommendation for groundwater was no action.

Comparison of separations of fatty acids from fish products using a 30-m Supelcowax-10 and a 100-m SP-2560 column.

PubMed

Santercole, Viviana; Delmonte, Pierluigi; Kramer, John K G

2012-03-01

Commercial fish oils and foods containing fish may contain trans and/or isomerized fatty acids (FA) produced during processing or as part of prepared foods. The current American Oil Chemists' Society (AOCS) official method for marine oils (method Ce 1i-07) is based on separation by use of poly(ethylene glycol) (PEG) columns, for example Supelcowax-10 or equivalent, which do not resolve most unsaturated FA geometric isomers. Highly polar 100-m cyanopropyl siloxane (CPS) columns, for example SP-2560 and CP Sil 88 are recommended for separation of geometric FA isomers. Complementary separations were achieved by use of two different elution temperature programs with the same CPS column. This study is the first direct comparison of the separations achieved by use of 30-m Supelcowax-10 and 100-m SP-2560 columns for fatty acid methyl esters (FAME) prepared from the same fish oil and fish muscle sample. To simplify the identification of the FA in these fish samples, FA were fractionated on the basis of the number and type of double bonds by silver-ion solid-phase extraction (Ag⁺-SPE) before GC analysis. The results showed that a combination of the three GC separations was necessary to resolve and identify most of the unsaturated FA, FA isomers, and other components of fish products, for example phytanic and phytenic acids. Equivalent chain length (ECL) values of most FAME in fish were calculated from the separations achieved by use of both GC columns; the values obtained were shown to be consistent with previously reported values for the Supelcowax-10 column. ECL values were also calculated for the FA separated on the SP-2560 column. The calculated ECL values were equally valid under isothermal and temperature-programmed elution GC conditions, and were valuable for confirmation of the identity of several unsaturated FAME in the fish samples. When analyzing commercially prepared fish foods, deodorized marine oils, or foods fortified with marine oils it is strongly recommended that quantitative data acquired by use of PEG columns is complemented with data obtained from separations using highly polar CPS columns.

Forest experiences of fifth-grade Chicago public school students.

Treesearch

Laura J. Metro; John F. Dwyer; Erwin S. Dreschler

1981-01-01

Analyzes previous visits to a forest and the associated experiences, as well as the expectations of those who had not previously visited a forest. Recommends educational programs that focus on the urban forest.

Opportunities for Promoting Physical Activity in Rural Communities by Understanding the Interests and Values of Community Members

PubMed Central

Eyler, Amy A.; Valko, Cheryl

2017-01-01

Purpose Physical activity (PA) has well-established health benefits, but most Americans do not meet national guidelines. In southeastern Missouri, trails have been developed to increase rates of PA. Although this has had success, broad-scale interventions will be needed to improve rates further. In this study, we surveyed residents of southeastern Missouri to identify ways to improve rates of PA. Methods We conducted a telephone survey in 2015 of adults (n = 524) from eight rural Missouri towns that had walking trails, regarding their activities and interests. Findings Forty percent of respondents reported both walking and meeting PA recommendations, 29% reported walking but not meeting PA recommendations, and the remainder did not walk or did not answer. Respondents who used the trails were significantly more likely to meet PA recommendations (odds ratio = 2.7; 95% confidence interval = 1.7, 4.5). Certain values and interests that may encourage PA or draw people to trails were common. Conclusions The group that walked but did not meet PA recommendations would be the ideal group to target for intervention, which could focus on their reported values and interests (e.g., personal relationships, being outdoors). Use of walking trails was associated with meeting PA recommendations. PMID:28932248

An evaluation of the International Society for Animal Genetics recommended parentage and identification panel for the domestic pigeon (Columba livia domestica).

PubMed

de Groot, M; van Haeringen, W A

2017-08-01

In this study, the International Society for Animal Genetics (ISAG) recommended panel for the identification of the domestic pigeon (Columba livia domestica) is characterized based on commonly used statistical parameters. The marker panel is based on 16 short tandem repeat (STR) loci (PIGN15, PIGN10, PIGN57, PIGN26, CliμD16, CliμD19, PIGN12, CliμD17, CliμT17, PIGN04, CliμD01, CliμD11, CliμD35, CliμT02, CliμT13, CliμT43). The alleles of the 16 loci consist of a mixture of tri-, tetra-, penta- and hexameric repeat patterns. A sex determination marker was included in the multiplex for quality control. The repeat sequence of the PIGN markers was previously unpublished and therefore sequenced to reveal the sequence pattern. In total, 1421 pigeons were genotyped on 16 STR loci to generate allele frequency data for each locus. For all 16 markers combined, a PE1 (combined non-exclusion probability, first parent) of 0.9986 and PE2 (combined non-exclusion probability, second parent) of >0.9999 was observed. Comparing the alleged father and mother, a PE value of >0.9999 was observed. Two of the markers, CliμD19 and PIGN12, were found to have relatively high Hardy-Weinberg equilibrium and F(null) values. Therefore these markers may be considered to be replaced by other STRs. Another point of discussion may be to add a gender identification marker to the recommended ISAG panel. Not only can this serve as an extra identification marker, but this can also confirm the sex of a sample, because it is challenging to determine the sex based on phenotypical characteristics, especially for chicks. In conclusion, the set of 16 STR markers can be used in routine parentage verification and the identification of individuals. © 2017 Stichting International Foundation for Animal Genetics.

Control of PM2.5 in Guangzhou during the 16th Asian Games period: implication for hazy weather prevention.

PubMed

Tao, Jun; Zhang, Leiming; Zhang, Zhisheng; Huang, Ruijin; Wu, Yunfei; Zhang, Renjian; Cao, Junji; Zhang, Yuanhang

2015-03-01

To evaluate the effectiveness of the integrated control measures for reducing PM2.5 (aerosol particles with an aerodynamic diameter of less than 2.5 μm) and hazy weather, day- and night-time PM2.5 samples were collected at an urban site in Guangzhou during the 16th Asian Games period in November 2010. PM2.5 samples were subject to chemical analysis for major water-soluble ions, organic carbon (OC), element carbon (EC), and biomass burning tracers-anhydrosugar levoglucosan (LG). In addition, aerosol scattering coefficient (bsp) at dry condition and aerosol absorption coefficient (bap) and visibility at ambient condition were measured. The seven major control measures were effective for reducing PM2.5 mass concentration and improving visibility during the Asian Games period. All monitored air pollutants except PM2.5 satisfied the National Ambient Air Quality Standards (NAAQS). However, daily PM2.5 concentrations still exceeded the NAAQS on 47% of the days and hazy weather also occurred on 80% of the days during this period. One factor causing the high frequency of hazy weather occurrence was the increased relative humidity during the Asian Games period. To avoid hazy weather occurrence, new PM2.5 standard was recommended based on visibility calculations using three available aerosol hygroscopic curves previously obtained for this city. The recommended PM2.5 standard was 63 μgm(-3) under dry condition and lower than 42 μg m(-3) under humid condition (RH ≥ 70%). These recommended value s were much stricter than the NAAQS value of 75 μg m(-3). To reach the new standard, more rigorous control measures for coal industries should be established in the Pearl River Delta (PRD) region. Copyright © 2014 Elsevier B.V. All rights reserved.

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

Li, G; Nishino, T; Greene, T

Purpose: To determine the consistency of digital detector (DR) tests recommended by AAPM TG150 and tests provided by commercially available DirectView Total Quality Tool (TQT). Methods: The DR tests recommended by the TG150 Detector Subgroup[1] were performed on 4 new Carestream DRX-Revolution and one Carestream DRX1C retrofit of a GE AMX-4 that had been in service for three years. After detector calibration, flat-field images plus images of two bar patterns oriented parallel and perpendicular to the A-C axis, were acquired at conditions recommended by TG150. Raw images were harvested and then analyzed using a MATLAB software previously validated[2,3,4]. Data weremore » analyzed using ROIs of two different dimensions: 1) 128 x 128 ROIs matching the detector electronics; and 2) 256 x 256 ROIs, each including 4 adjacent smaller ROIs. TG150 metrics from 128 x 128 ROIs were compared to TQT metrics, which are also obtained from 128 x 128 ROIs[5]. Results: The results show that both TG150 and TQT measurements were consistent among these detectors. Differences between TG150 and TQT values appear systematic. Compared with 128 x 128 ROIs, noise and SNR non-uniformity were lower with 256 x 256 ROIs, although signal non-uniformity was similar, indicating detectors were appropriately calibrated for gain and offset. MTF of the retrofit unit remained essentially the same between 2012 and 2015, but was inferior to the new units. The older generator focal spot is smaller (0.75mm vs. 1.2mm), and the SID for acquisition is 182cm as well, so focal spot dimensions cannot explain the difference. The difference in MTF may be secondary to differences in generator X-ray spectrum or by unannounced changes in detector architecture. Further investigation is needed. Conclusion: The study shows that both TG150 and TQT tests are consistent. The numerical value of some metrics are dependent on ROI size.« less

Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian Paediatric Society.

PubMed Central

1996-01-01

OBJECTIVE: To assist physicians in providing guidance to parents regarding neonatal circumcision. OPTIONS: Whether to recommend the routine circumcision of newborn male infants. OUTCOMES: Costs and complications of neonatal circumcision, the incidence of urinary tract infections, sexually transmitted diseases and cancer of the penis in circumcised and uncircumcised males, and of cervical cancer in their partners, and the costs of treating these diseases. EVIDENCE: The literature on circumcision was reviewed by the Fetus and Newborn Committee of the Canadian Paediatric Society. During extensive discussion at meetings of the committee over a 24-month period, the strength of the evidence was carefully weighed and the perspective of the committee developed. VALUES: The literature was assessed to determine whether neonatal circumcision improves the health of boys and men and is a cost-effective approach to preventing penile problems and associated urinary tract conditions. Religious and personal values were not included in the assessment. BENEFITS, HARMS AND COSTS: The effect of neonatal circumcision on the incidence of urinary tract infection, sexually transmitted diseases, cancer of the penis, cervical cancer and penile problems; the complications of circumcision; and estimates of the costs of neonatal circumcision and of the treatment of later penile conditions, urinary tract infections and complications of circumcision. RECOMMENDATION: Circumcision of newborns should not be routinely performed. VALIDATION: This recommendation is in keeping with previous statements on neonatal circumcision by the Canadian Paediatric Society and the American Academy of Pediatrics. The statement was reviewed by the Infectious Disease Committee of the Canadian Paediatric Society. The Board of Directors of the Canadian Paediatric Society has reviewed its content and approved it for publication. SPONSOR: This is an official statement of the Canadian Paediatric Society. No external financial support has been received by the Canadian Paediatric Society, or its members, for any portion of the statement's preparation. PMID:8634956

The Clinical Validation of the Athlete Sleep Screening Questionnaire: an Instrument to Identify Athletes that Need Further Sleep Assessment.

PubMed

Bender, Amy M; Lawson, Doug; Werthner, Penny; Samuels, Charles H

2018-06-04

Previous research has established that general sleep screening questionnaires are not valid and reliable in an athlete population. The Athlete Sleep Screening Questionnaire (ASSQ) was developed to address this need. While the initial validation of the ASSQ has been established, the clinical validity of the ASSQ has yet to be determined. The main objective of the current study was to evaluate the clinical validity of the ASSQ. Canadian National Team athletes (N = 199; mean age 24.0 ± 4.2 years, 62% females; from 23 sports) completed the ASSQ. A subset of athletes (N = 46) were randomized to the clinical validation sub-study which required subjects to complete an ASSQ at times 2 and 3 and to have a clinical sleep interview by a sleep medicine physician (SMP) who rated each subjects' category of clinical sleep problem and provided recommendations to improve sleep. To assess clinical validity, the SMP category of clinical sleep problem was compared to the ASSQ. The internal consistency (Cronbach's alpha = 0.74) and test-retest reliability (r = 0.86) of the ASSQ were acceptable. The ASSQ demonstrated good agreement with the SMP (Cohen's kappa = 0.84) which yielded a diagnostic sensitivity of 81%, specificity of 93%, positive predictive value of 87%, and negative predictive value of 90%. There were 25.1% of athletes identified to have clinically relevant sleep disturbances that required further clinical sleep assessment. Sleep improved from time 1 at baseline to after the recommendations at time 3. Sleep screening athletes with the ASSQ provides a method of accurately determining which athletes would benefit from preventative measures and which athletes suffer from clinically significant sleep problems. The process of sleep screening athletes and providing recommendations improves sleep and offers a clinical intervention output that is simple and efficient for teams and athletes to implement.

Comparison of beverage consumption in adult populations from three different countries: do the international reference values allow establishing the adequacy of water and beverage intakes?

PubMed

Nissensohn, Mariela; Fuentes Lugo, Daniel; Serra-Majem, Lluis

2016-07-13

Recommendations of adequate total water intake (aTWI) have been proposed by the European Food Safety Agency (EFSA) and the Institute of Medicine (IOM)of the United States of America. However, there are differences in the approach used to support them: IOM recommendation is based on average intakes observed in NHANES III (Third National Health and Nutrition Examination Survey) and EFSA recommendation on a combination of observed intakes from 13 different European countries. Despite these recommendations of aTWI, the currently available scientifi c evidence is not sufficient to establish a cut-off value that would prevent disease, reduce the risk for chronic diseases or improve health status. To compare the average daily consumption of fluids (water and other beverages) in selective samples of population from Mexico, US and Spain, evaluating the quantity of fluid intake and understanding the contribution of each fluid type to the total fl uid intake. We also aim to determine if they reached adequate intake (AI) values, as defi ned by three different criteria: IOM, EFSA and water density. Three studies were compared: from Mexico, the National Health and Nutrition Survey conducted in 2012 (NHNS 2012); from US, the NHANES III 2005-2010 and from Spain the ANIBES study leaded in 2013. Different categories of beverages were used to establish the pattern of energy intake for each country. Only adult population was selected. TWI of each study was compared with EFSA and IOM AI recommendations, as well as applying the criterion of water density (mL/kcal). The American study obtained the higher value of total kcal/day from food and beverages (2,437 ± 13). Furthermore, the percentage of daily energy intake coming from beverages was, for American adults, 21%. Mexico was slightly behind with 19% and Spain ANIBES study registered only 12%. ANIBES showed signifi cantly low AI values for the overall population, but even more alarming in the case of males. Only 12% of men, in contrast with 21% of women, do satisfy the EFSA criterion. The IOM criterion reaches even less with higher recommended values for daily intake. In contrast, 60% of the American population reached the recommended intake of the IOM criterion. However, available data did not allow calculating the percentage reached by the EFSA criterion. Data from the Mexican study did not permit conducting comparisons with IOM or with EFSA. However, the water density criteria (mL/kcal) was higher than 1. There is a notable difference between all three populations in terms of TWI. Furthermore, within the same population, values of adequacy of TWI changed signifi cantly when they were assessed using different criteria. More scientifi c evidence is required for the production of better defined water intake recommendations in the future as well as more studies focusing on beverage consumption patterns in different settings.

Addressing Cancer Drug Costs and Value

Cancer.gov

The President’s Cancer Panel has released its latest report, Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The report recommends six actions to maximize the value and affordability of cancer drug treatment.

Human Genetic Engineering: A Survey of Student Value Stances

ERIC Educational Resources Information Center

Wilson, Sara McCormack; And Others

1975-01-01

Assesses the values of high school and college students relative to human genetic engineering and recommends that biology educators explore instructional strategies merging human genetic information with value clarification techniques. (LS)

Current Fault Management Trends in NASA's Planetary Spacecraft

NASA Technical Reports Server (NTRS)

Fesq, Lorraine M.

2009-01-01

The key product of this three-day workshop is a NASA White Paper that documents lessons learned from previous missions, recommended best practices, and future opportunities for investments in the fault management domain. This paper summarizes the findings and recommendations that are captured in the White Paper.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force.

PubMed

Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

2013-01-01

Economic evaluations of health interventions pose a particular challenge for reporting because substantial information must be conveyed to allow scrutiny of study findings. Despite a growth in published reports, existing reporting guidelines are not widely adopted. There is also a need to consolidate and update existing guidelines and promote their use in a user-friendly manner. A checklist is one way to help authors, editors, and peer reviewers use guidelines to improve reporting. The task force's overall goal was to provide recommendations to optimize the reporting of health economic evaluations. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines into one current, useful reporting guidance. The CHEERS Elaboration and Explanation Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force facilitates the use of the CHEERS statement by providing examples and explanations for each recommendation. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. Previously published checklists or guidance documents related to reporting economic evaluations were identified from a systematic review and subsequent survey of task force members. A list of possible items from these efforts was created. A two-round, modified Delphi Panel with representatives from academia, clinical practice, industry, and government, as well as the editorial community, was used to identify a minimum set of items important for reporting from the larger list. Out of 44 candidate items, 24 items and accompanying recommendations were developed, with some specific recommendations for single study-based and model-based economic evaluations. The final recommendations are subdivided into six main categories: 1) title and abstract, 2) introduction, 3) methods, 4) results, 5) discussion, and 6) other. The recommendations are contained in the CHEERS statement, a user-friendly 24-item checklist. The task force report provides explanation and elaboration, as well as an example for each recommendation. The ISPOR CHEERS statement is available online via Value in Health or the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices - CHEERS Task Force webpage (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope that the ISPOR CHEERS statement and the accompanying task force report guidance will lead to more consistent and transparent reporting, and ultimately, better health decisions. To facilitate wider dissemination and uptake of this guidance, we are copublishing the CHEERS statement across 10 health economics and medical journals. We encourage other journals and groups to consider endorsing the CHEERS statement. The author team plans to review the checklist for an update in 5 years. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Scientific guidelines for preservation of samples collected from Mars

NASA Technical Reports Server (NTRS)

Gooding, James L. (Editor)

1990-01-01

The maximum scientific value of Martian geologic and atmospheric samples is retained when the samples are preserved in the conditions that applied prior to their collection. Any sample degradation equates to loss of information. Based on detailed review of pertinent scientific literature, and advice from experts in planetary sample analysis, number values are recommended for key parameters in the environmental control of collected samples with respect to material contamination, temperature, head-space gas pressure, ionizing radiation, magnetic fields, and acceleration/shock. Parametric values recommended for the most sensitive geologic samples should also be adequate to preserve any biogenic compounds or exobiological relics.

The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators.

PubMed

2017-11-01

This proceedings report presents the outcomes from an international workshop supported by the European Society of Human Reproduction and Embryology (ESHRE) and Alpha Scientists in Reproductive Medicine, designed to establish consensus on definitions and recommended values for Indicators for the assisted reproductive technology (ART) laboratory. Minimum performance-level values ('competency') and aspirational ('benchmark') values were recommended for a total of 19 Indicators, including 12 Key Performance Indicators (KPIs), five Performance Indicators (PIs), and two Reference Indicators (RIs). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Leadership Development in Dental Education: Report on the ADEA Leadership Institute, 2000-14.

PubMed

Haden, N Karl; Ditmyer, Marcia M; Mobley, Connie; Rodriguez, Tobias; Brallier, Lynn Beck; Valachovic, Richard W

2016-04-01

The American Dental Education Association’s Leadership Institute (ADEA LI) is the association’s flagship development program for those aspiring to leadership in dental and higher education. As with previous studies of the ADEA LI, ADEA will use information from the survey described in this report to improve the ADEA LI curriculum and to guide other leadership development efforts. In 2014-15, ADEA distributed a 50-item online survey via email to all ADEA LI alumni from the classes of 2000 through 2014. The survey included selected-response questions, closed-ended questions, and open-response questions. The survey had an overall response rate of 47% (133/285); response rates to individual items varied. The mean age of the respondents when they participated in the Institute was 48.5 years. Men and women were almost equally represented among the respondents. Nearly half reported their ultimate career goal as department chair, associate dean, or assistant dean, while 20 (15.8%) indicated a goal of becoming dean and 15 (11.8%) aspired to administrative roles higher than dean. Areas the respondents recommended for improvement included more programming in budgeting and financial management, fundraising, and personnel management. Almost 100% of the respondents indicated they would recommend the ADEA LI to others. Overall, the survey respondents confirmed the value of the ADEA LI in their assessment of their fellowship and its subsequent application to their careers. Comparison of elements from this study to previous studies of ADEA LI alumni demonstrates the effectiveness of past changes made to the Institute and the creation of additional ADEA leadership initiatives.

Temperature dependence of the HNO3 UV absorption cross sections

NASA Technical Reports Server (NTRS)

Burkholder, James B.; Talukdar, Ranajit K.; Ravishankara, A. R.; Solomon, Susan

1993-01-01

The temperature dependence of the HNO3 absorption cross sections between 240 and 360 K over the wavelength range 195 to 350 nm has been measured using a diode array spectrometer. Absorption cross sections were determined using both (1) absolute pressure measurements at 298 K and (2) a dual absorption cell arrangement in which the absorption spectrum at various temperatures is measured relative to the room temperature absorption spectrum. The HNO3 absorption spectrum showed a temperature dependence which is weak at short wavelengths but stronger at longer wavelengths which are important for photolysis in the lower stratosphere. The 298 K absorption cross sections were found to be larger than the values currently recommended for atmospheric modeling (DeMore et al., 1992). Our absorption cross section data are critically compared with the previous measurements of both room temperature and temperature-dependent absorption cross sections. Temperature-dependent absorption cross sections of HNO3 are recommended for use in atmospheric modeling. These temperature dependent HNO3 absorption cross sections were used in a two-dimensional dynamical-photochemical model to demonstrate the effects of the revised absorption cross sections on loss rate of HNO3 and the abundance of NO2 in the stratosphere.

Hypopituitarism in Traumatic Brain Injury—A Critical Note

PubMed Central

Klose, Marianne; Feldt-Rasmussen, Ulla

2015-01-01

While hypopituitarism after traumatic brain injury (TBI) was previously considered rare, it is now thought to be a major cause of treatable morbidity among TBI survivors. Consequently, recommendations for assessment of pituitary function and replacement in TBI were recently introduced. Given the high incidence of TBI with more than 100 pr. 100,000 inhabitants, TBI would be by far the most common cause of hypopituitarism if the recently reported prevalence rates hold true. The disproportion between this proposed incidence and the occasional cases of post-TBI hypopituitarism in clinical practice justifies reflection as to whether hypopituitarism has been unrecognized in TBI patients or whether diagnostic testing designed for high risk populations such as patients with obvious pituitary pathology has overestimated the true risk and thereby the disease burden of hypopituitarism in TBI. The findings on mainly isolated deficiencies in TBI patients, and particularly isolated growth hormone (GH) deficiency, raise the question of the potential impact of methodological confounding, determined by variable test-retest reproducibility, appropriateness of cut-off values, importance of BMI stratified cut-offs, assay heterogeneity, pre-test probability of hypopituitarism and lack of proper individual laboratory controls as reference population. In this review, current recommendations are discussed in light of recent available evidence. PMID:26239687

Flight motor set 360L009 (STS-36). Volume 1: System overview

NASA Technical Reports Server (NTRS)

Garecht, Diane M.

1990-01-01

Flight Motor Set 360L009, as part of NASA Space Shuttle Mission STS-36, a Department of Defence mission, was launched after two launch attempts. One launch was scrubbed following the failure of a ground-based Range Safety computer and one was scrubbed due to cloud cover at the return to launch landing site. As with all previous redesigned solid rocket motor launches, overall motor performance was excellent. There were no debris concerns from either motor. All ballistic and mass property parameters that could be assessed, closely matched the predicted values and were well within the required contract item specification levels. All field joint heaters and igniter joint heaters performed without anomalies. Evaluation of the ground environment instrumentation measurements again verified thermal model analysis data and showed agreement with predicted environmental effects. No launch commit criteria violations occurred. Postflight inspection again verified nominal performance of the insulation, phenolics, metal parts, and seals. Postflight evaluation indicated that both nozzles performed as expected during flight. All combustion gas was contained by insulation in the field and case-to-nozzle joints. Recommendations were made concerning improved thermal modeling and measurements. The rationale for these recommendations and complete result details are presented.

An Analysis of NASA Technology Transfer. Degree awarded by Pennsylvania State Univ.

NASA Technical Reports Server (NTRS)

Bush, Lance B.

1996-01-01

A review of previous technology transfer metrics, recommendations, and measurements is presented within the paper. A quantitative and qualitative analysis of NASA's technology transfer efforts is performed. As a relative indicator, NASA's intellectual property performance is benchmarked against a database of over 100 universities. Successful technology transfer (commercial sales, production savings, etc.) cases were tracked backwards through their history to identify the key critical elements that lead to success. Results of this research indicate that although NASA's performance is not measured well by quantitative values (intellectual property stream data), it has a net positive impact on the private sector economy. Policy recommendations are made regarding technology transfer within the context of the documented technology transfer policies since the framing of the Constitution. In the second thrust of this study, researchers at NASA Langley Research Center were surveyed to determine their awareness of, attitude toward, and perception about technology transfer. Results indicate that although researchers believe technology transfer to be a mission of the Agency, they should not be held accountable or responsible for its performance. In addition, the researchers are not well educated about the mechanisms to perform, or policies regarding, technology transfer.

Recommendations from Friends Anytime and Anywhere: Toward a Model of Contextual Offer and Consumption Values

PubMed Central

Shen, Xiao-Liang; Wang, Nan

2013-01-01

Abstract The ubiquity and portability of mobile devices provide additional opportunities for information retrieval. People can easily access mobile applications anytime and anywhere when they need to acquire specific context-aware recommendations (contextual offer) from their friends. This study, thus, represents an initial attempt to understand users' acceptance of a mobile-based social reviews platform, where recommendations from friends can be obtained with mobile devices. Based on the consumption value theory, a theoretical model is proposed and empirically examined using survey data from 218 mobile users. The findings demonstrate that contextual offers based on users' profiles, access time, and geographic positions significantly predict their value perceptions (utilitarian, hedonic, and social), which, in turn, affect their intention to use a mobile social reviews platform. This study is also believed to provide some useful insights to both research and practice. PMID:23530548

Three proposals to increase Australia's organ supply.

PubMed

Isdale, William; Savulescu, Julian

2015-01-01

In 2008 the Australian Government introduced a national reform agenda to increase organ and tissue donation. Australia continues to perform poorly by international standards on measures of organ procurement, however. This paper outlines three proposals to improve donation rates and considers the empirical evidence available for each. A number of ethical objections frequently given to resist such proposals are also addressed. Firstly, it is recommended that Australia implement an 'opt-out' system of organ donation. Secondly, the existing veto rules should be changed to better protect the wishes of those who wish to donate. Finally, a numer of incentives should be offered to increase donation rates; these could include incentives of financial value, but also non-financial incentives such as prioritisation for the receipt of organs for previous donors.

Recommendations for the surgical treatment of endometriosis-part 1: ovarian endometrioma.

PubMed

Saridogan, Ertan; Becker, Christian M; Feki, Anis; Grimbizis, Grigoris F; Hummelshoj, Lone; Keckstein, Joerg; Nisolle, Michelle; Tanos, Vasilios; Ulrich, Uwe A; Vermeulen, Nathalie; De Wilde, Rudy Leon

2017-01-01

What does this document on the surgical treatment of endometriosis jointly prepared by the European Society for Gynaecological Endoscopy (ESGE), ESHRE, and the World Endometriosis Society (WES) provide? This document provides recommendations covering technical aspects of different methods of surgery for endometriomas in women of reproductive age. Endometriomas (ovarian endometriotic cysts) are a commonly diagnosed form of endometriosis, owing to the relative ease and accuracy of ultrasound diagnosis. They frequently present a clinical dilemma as to whether and how to treat them when found during imaging or incidentally during surgery. Previously published guidelines have provided recommendations based on the best available evidence, but without technical details on the management of endometriosis. A working group of ESGE, ESHRE and WES collaborated on writing recommendations on the practical aspects of endometrioma surgery. This document focused on endometrioma surgery. Further documents in this series will provide recommendations for surgery of deep and peritoneal endometriosis. The document presents general recommendations for surgery of endometrioma and specific recommendations for cystectomy, ablation by laser or by plasma energy, electrocoagulation and a combination of these techniques applied together or with an interval between them. Owing to the limited evidence available, recommendations are mostly based on clinical expertise. These recommendations complement previous guidelines on the management of endometriosis. The meetings of the working group were funded by ESGE, ESHRE and WES. CB declares to be a member of the independent data monitoring committee for a clinical study by ObsEva and receiving research grants from Bayer, Roche Diagnostics, MDNA Life Sciences and Volition. ES received honoraria for provision of training to healthcare professionals from Ethicon, Olympus and Gedeon Richter. The other authors declare that they have no conflict of interest.

Frequency and Determinants of a Short-Interval Follow-up Recommendation After an Abnormal Screening Mammogram.

PubMed

Pelletier, Eric; Daigle, Jean-Marc; Defay, Fannie; Major, Diane; Guertin, Marie-Hélène; Brisson, Jacques

2016-11-01

After imaging assessment of an abnormal screening mammogram, a follow-up examination 6 months later is recommended to some women. Our aim was to identify which characteristics of lesions, women, and physicians are associated to such short-interval follow-up recommendation in the Quebec Breast Cancer Screening Program. Between 1998 and 2008, 1,839,396 screening mammograms were performed and a total of 114,781 abnormal screens were assessed by imaging only. Multivariate analysis was done with multilevel Poisson regression models with robust variance and generalized linear mixed models. A short-interval follow-up was recommended in 26.7% of assessments with imaging only, representing 2.3% of all screens. Case-mix adjusted proportion of short-interval follow-up recommendations varied substantially across physicians (range: 4%-64%). Radiologists with high recall rates (≥15%) had a high proportion of short-interval follow-up recommendation (risk ratio: 1.82; 95% confidence interval: 1.35-2.45) compared to radiologists with low recall rates (<5%). The adjusted proportion of short-interval follow-up was high (22.8%) even when a previous mammogram was usually available. Short-interval follow-up recommendation at assessment is frequent in this Canadian screening program, even when a previous mammogram is available. Characteristics related to radiologists appear to be key determinants of short-interval follow-up recommendation, rather than characteristics of lesions or patient mix. Given that it can cause anxiety to women and adds pressure on the health system, it appears important to record and report short-interval follow-up and to identify ways to reduce its frequency. Short-interval follow-up recommendations should be considered when assessing the burden of mammography screening. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

SCIENTIFIC AND SOCIAL VALUE JUDGMENTS FOR ORPHAN DRUGS IN HEALTH TECHNOLOGY ASSESSMENT.

PubMed

Nicod, Elena; Kanavos, Panos

2016-01-01

We explore how broader aspects of a treatment's value and the impact of the condition on patients not captured by routine health technology assessment (HTA) methods using clinical and economic evidence, defined as "other considerations," may influence HTA processes in different settings. Countries included were England, Scotland, Sweden, and France. Data sources were the publicly available reports on HTA recommendations. Ten drugs with European Medicines Agency orphan designation and appraised in England were selected. Qualitative thematic analysis was used to systematically identify and code all "other considerations" based on a previously developed methodological framework, which also coded whether it was provided by stakeholders, and how it influenced the decision. A classification framework of scientific and social value judgments was developed and used throughout the study. A total of 125 "other considerations" were identified and grouped into ten subcategories based on the information provided. Eighteen to 100 percent of these, depending on the agency, were put forward as one of the main reasons for the final decision potentially contributing to accepting a higher incremental cost-effectiveness ratio or uncertain evidence. Some of these were nonquantified or nonelicited and pertained to the assessor's judgment. A taxonomy of these value judgments was created to be used in future cases. Results also contributed to better defining the determinants of social value and improving accountability for reasonableness. The systematic identification of the scientific and social value judgments enables to better understanding the dimensions of value, which can be used to improve their transparency and consistent use across decisions and settings.

Moving away from a cultural deficit to a holistic perspective: Traditional gender role values, academic attitudes, and educational goals for Mexican descent adolescents.

PubMed

Piña-Watson, Brandy; Lorenzo-Blanco, Elma I; Dornhecker, Marianela; Martinez, Ashley J; Nagoshi, Julie L

2016-04-01

Latina/o youth lag behind Asian American and non-Latina/o White youth in many academic areas. Previous research has taken a deficit approach to understand the factors that affect academic outcomes for Latina/o youth often neglecting to highlight both the potential positive and negative contributions of gender role values. The present study took a holistic perspective to understand the affect of traditional Latina/o gender role values (i.e., marianismo, machismo, and caballerismo) on the academic attitudes and educational goals of Mexican descent youth. Structural equation models were tested to examine the associations of "positive" and "negative" gender role values on educational goals using 524 Mexican descent adolescents from a mid-sized city in southern Texas. We hypothesized that positive aspects of traditional Latina/o gender role values (i.e., "positive marianismo" and caballerismo) would be associated with more positive attitudes toward academics and higher educational goals. We further expected negative gender role values (i.e., "negative marianismo" and machismo) to have the opposite effect. Additionally, based on the theory of planned behavior and gender schema theory, academic attitudes were hypothesized to mediate the relation between gender role values and educational goals. An alternative model was tested in which educational goals mediated the relation between gender roles and academic attitudes. Results indicated that both models fit the data well, and recommendations are made for future longitudinal research aimed at disentangling the directionality of the relations in the model. Implications for research and practice are discussed. (c) 2016 APA, all rights reserved).

Examining personal values in extreme environment contexts: Revisiting the question of generalizability

NASA Astrophysics Data System (ADS)

Smith, N.; Sandal, G. M.; Leon, G. R.; Kjærgaard, A.

2017-08-01

Land-based extreme environments (e.g. polar expeditions, Antarctic research stations, confinement chambers) have often been used as analog settings for spaceflight. These settings share similarities with the conditions experienced during space missions, including confinement, isolation and limited possibilities for evacuation. To determine the utility of analog settings for understanding human spaceflight, researchers have examined the extent to which the individual characteristics (e.g., personality) of people operating in extreme environments can be generalized across contexts (Sandal, 2000) [1]. Building on previous work, and utilising new and pre-existing data, the present study examined the extent to which personal value motives could be generalized across extreme environments. Four populations were assessed; mountaineers (N =59), military personnel (N = 25), Antarctic over-winterers (N = 21) and Mars simulation participants (N = 12). All participants completed the Portrait Values Questionnaire (PVQ; Schwartz; 2) capturing information on 10 personal values. Rank scores suggest that all groups identified Self-direction, Stimulation, Universalism and Benevolence as important values and acknowledged Power and Tradition as being low priorities. Results from difference testing suggest the extreme environment groups were most comparable on Self-direction, Stimulation, Benevolence, Tradition and Security. There were significant between-group differences on five of the ten values. Overall, findings pinpointed specific values that may be important for functioning in challenging environments. However, the differences that emerged on certain values highlight the importance of considering the specific population when comparing results across extreme settings. We recommend that further research examine the impact of personal value motives on indicators of adjustment, group working, and performance. Information from such studies could then be used to aid selection and training processes for personnel operating in extreme settings, and in space.

Evaluating, interpreting, and communicating performance of hydrologic/water quality models considering intended use: A review and recommendations

USDA-ARS?s Scientific Manuscript database

Previous publications have outlined recommended practices for hydrologic and water quality (H/WQ) modeling, but none have formulated comprehensive guidelines for the final stage of modeling applications, namely evaluation, interpretation, and communication of model results and the consideration of t...

77 FR 43855 - Secretarial Commission on Indian Trust Administration and Reform

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

... documents and identify recommendations from previous studies, and consider the nature and scope of necessary... of the Interior, 1849 C Street NW., Room 6119, Washington, DC 20240; or email to [email protected]ios... recommendations; Discussion of Commission Subcommittee progress and products; Review of and discussion of...

75 FR 4416 - Policy on Cooperating Associations, Draft Director's Order #32

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

...) agreement. This policy will apply to all units of the national park system, and will replace the previous... reflect the findings and recommendations of the Cooperating Association Steering Committee submitted to the National Leadership Council in August 2009. These recommendations include as follows: The primary...

Chapter 10: Management recommendations

Treesearch

Deborah M. Finch; Janie Agyagos; Tracy McCarthey; Robert M. Marshall; Scott H. Stoleson; Mary J. Whitfield

2000-01-01

This chapter was developed over a series of meetings using a group-consensus process. Our recommendations are based on published results, on information compiled in the previous chapters, on expert opinion, and on unpublished data of conservation team members. This chapter is available as temporary guidance until the Recovery Plan for the southwestern willow flycatcher...

[Measurements of vancomycin concentrations in the blood - a method of personalization the antibiotic therapy in patients with chronic kidney disease].

PubMed

Pondel, Joanna; Krajewski, Piotr; Królikowska, Natalia; Tobiasz, Aleksandra; Augustyniak-Bartosik, Hanna; Hurkacz, Magdalena

2017-04-21

Therapeutic Drug Monitoring is a recognized method of personalizing treatment, having particular application in patients with chronic kidney disease who have frequent infections, requiring administration of vancomycin. International guidelines indicate the need to adjust the dose of the drug to the state of renal function. The recommended therapeutic ranges of minimum and maximum levels should be achieved in order to increase the effectiveness and safety of treatment. The aim of this study was to evaluate the usefulness of measuring the concentration of vancomycin in patients with chronic kidney disease due to bacterial infection. The study included 96 adult patients with chronic kidney disease of varying severity treated with vancomycin Patients were divided into 3 groups: treated by haemodialysis (hd), after renal transplantations (ktx), do not require renal replacement therapy (nef). In subjects were examined the minimum and maximum concentrations of vancomycin in steady-state and were compared with recommended therapeutic ranges. Statistically significant decrease of inflammatory markers was observed only in patients treated with dialysis. In the other groups not significant changes in values of inflammatory parameters were confirmed. Trough concentrations of vancomycin marked in patients were consistent with the recommendation of EUCAST, but exceeded the value recommended by the manufacturers of the drug. Considering absolute values of the minimum concentrations, only about 50% of patients achieved the therapeutic range (58% for recommendation EUCAST and 36% for the manufacturer's instructions). Peak concentration values indicated in dialyzed patients were below the prescribed range of 20-50 mg/l and averaged 17.7 mg / l. In the other subgroups they were correct. The rating of the absolute values of the peak concentrations of vancomycin also showed that only 46% (64% in the ktx, 30% - hd and 53% - nef) was within the recommended range, while 50% were classified as concentrations of sub-therapeutic (36% in the ktx, 42% of the nef group and 65% in hd). Vancomycin concentrations measured in patients with chronic kidney disease, both minimum and maximum, were not fully comply with the recommended therapeutic ranges, despite the use of doses determined based on a calculation of glomerular filtration rate. This points to the need for particularly careful monitoring of therapy and analysis of antibiotic concentrations to improve the effectiveness and reduce the incidence of undesirable consequences of treatment.

UK audit of glomerular filtration rate measurement from plasma sampling in 2013.

PubMed

Murray, Anthony W; Lawson, Richard S; Cade, Sarah C; Hall, David O; Kenny, Bob; O'Shaughnessy, Emma; Taylor, Jon; Towey, David; White, Duncan; Carson, Kathryn

2014-11-01

An audit was carried out into UK glomerular filtration rate (GFR) calculation. The results were compared with an identical 2001 audit. Participants used their routine method to calculate GFR for 20 data sets (four plasma samples) in millilitres per minute and also the GFR normalized for body surface area. Some unsound data sets were included to analyse the applied quality control (QC) methods. Variability between centres was assessed for each data set, compared with the national median and a reference value calculated using the method recommended in the British Nuclear Medicine Society guidelines. The influence of the number of samples on variability was studied. Supplementary data were requested on workload and methodology. The 59 returns showed widespread standardization. The applied early exponential clearance correction was the main contributor to the observed variability. These corrections were applied by 97% of centres (50% - 2001) with 80% using the recommended averaged Brochner-Mortenson correction. Approximately 75% applied the recommended Haycock body surface area formula for adults (78% for children). The effect of the number of samples used was not significant. There was wide variability in the applied QC techniques, especially in terms of the use of the volume of distribution. The widespread adoption of the guidelines has harmonized national GFR calculation compared with the previous audit. Further standardization could further reduce variability. This audit has highlighted the need to address the national standardization of QC methods. Radionuclide techniques are confirmed as the preferred method for GFR measurement when an unequivocal result is required.

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

PubMed

Upham, Susan J; Janamian, Tina; Crossland, Lisa; Jackson, Claire L

2016-04-18

To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC-PIT). A purposively recruited Expert Advisory Panel of 12 end users used a modified Delphi technique to evaluate 53 tools and resources identified through a previously conducted systematic review. The panel comprised six practice managers and six general practitioners who had participated in the PC-PIT pilot study in 2013-2014. Tools and resources were reviewed in three rounds using a standard pre-tested assessment form. Recommendations, scores and reasons for recommending or rejecting each tool or resource were analysed to determine the final suite of tools and resources. The evaluation was conducted from November 2014 to August 2015. Recommended tools and resources scored highly (mean score, 16/20) in Rounds 1 and 2 of review (n = 25). These tools and resources were perceived to be easily used, useful to the practice and supportive of the PC-PIT. Rejected resources scored considerably lower (mean score, 5/20) and were noted to have limitations such as having no value to the practice and poor utility (n = 6). A final review (Round 3) of 28 resources resulted in a suite of 21 to support the elements of the PC-PIT. This suite of tools and resources offers one approach to supporting the quality improvement initiatives currently in development in primary care reform.

Diet and pregnancy status in Australian women.

PubMed

Hure, Alexis; Young, Anne; Smith, Roger; Collins, Clare

2009-06-01

To investigate and report the diet quality of young Australian women by pregnancy status. Pregnancy status was defined as pregnant (n 606), trying to conceive (n 454), had a baby in the last 12 months (n 829) and other (n 5597). The Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology. Nutrient intakes were compared with the Nutrient Reference Values for Australia and New Zealand. A population-based cohort participating in the Australian Longitudinal Study on Women's Health (ALSWH). A nationally representative sample of Australian women, aged 25 to 30 years, who completed Survey 3 of the ALSWH. The 7486 women with biologically plausible energy intake estimates, defined as >4.5 but <20.0 MJ/d, were included in the analyses. Pregnancy status was not significantly predictive of diet quality, before or after adjusting for area of residence and socio-economic status. Pregnant women and those who had given birth in the previous 12 months had marginally higher ARFS (mean (se): 30.2 (0.4) and 30.2 (0.3), respectively) than 'other' women (29.1 (0.1)). No single food group accounted for this small difference. Across all pregnancy categories there were important nutrients that did not meet the current nationally recommended levels of intake, including dietary folate and fibre. Women do not appear to consume a wider variety of nutritious foods when planning to become pregnant or during pregnancy. Many young Australian women are failing to meet key nutrient targets as nationally recommended.

Current knowledge on radon risk: implications for practical radiation protection? radon workshop, 1/2 December 2015, Bonn, BMUB (Bundesministerium für Umwelt, Naturschutz, Bau und Reaktorsicherheit; Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety).

PubMed

Müller, Wolfgang-Ulrich; Giussani, Augusto; Rühm, Werner; Lecomte, Jean-Francois; Harrison, John; Kreuzer, Michaela; Sobotzki, Christina; Breckow, Joachim

2016-08-01

ICRP suggested a strategy based on the distinction between a protection approach for dwellings and one for workplaces in the previous recommendations on radon. Now, the Commission recommends an integrated approach for the protection against radon exposure in all buildings irrespective of their purpose and the status of their occupants. The strategy of protection in buildings, implemented through a national action plan, is based on the application of the optimisation principle below a derived reference level in concentration (maximum 300 Bq m(-3)). A problem, however, arises that due to new epidemiological findings and application of dosimetric models, ICRP 115 (Ann ICRP 40, 2010) presents nominal probability coefficients for radon exposure that are approximately by a factor of 2 larger than in the former recommendations of ICRP 65 (Ann ICRP 23, 1993). On the basis of the so-called epidemiological approach and the dosimetric approach, the doubling of risk per unit exposure is represented by a doubling of the dose coefficients, while the risk coefficient of ICRP 103 (2007) remains unchanged. Thus, an identical given radon exposure situation with the new dose coefficients would result in a doubling of dose compared with the former values. This is of serious conceptual implications. A possible solution of this problem was presented during the workshop.

Preserving Astronomy's Photographic Legacy: Current State and the Future of North American Astronomical Plates

NASA Astrophysics Data System (ADS)

Osborn, W.; Robbins, L.

2009-08-01

This book contains articles on preserving astronomy's valuable heritage of photographic observations, most of which are on glass plates. It is intended to serve as a reference for institutions charged with preserving and managing plate archives and astronomers interested in using archival photographic plates in their research. The first portion of the book focuses on previous activities and recommendations related to plate archiving. These include actions taken by the International Astronomical Union, activities in Europe and a detailed account of a workshop on preserving astronomical photographic data held in 2007 at the Pisgah Astronomical Research Institute, North Carolina. The workshop discussions covered a wide range of issues that must be considered in any effort to archive plates and culminated in a set of recommendations on preserving, cataloging and making publicly available these irreplaceable data. The second part of the book reports on some recent efforts to implement the recommendations. These include essays on the recently established Astronomical Photographic Data Archive, projects to make photographic collections available electronically, evaluations of commercial scanners for digitization of astronomical plates and the case for the continuing value of these data along with a report on the census of astronomical plate collections in North America carried out in 2008. The census cataloged the locations, numbers, and types of astronomical plates in the US and Canada. Comprehensive appendices identify all the significant collections in North America and detail the current contents, state and status of their holdings.

New Reference Values for Vitamin C Intake.

PubMed

2015-01-01

The German, Austrian, and Swiss nutrition societies are the editors of the 'reference values for nutrient intake'. They have revised the reference values for the intake of vitamin C and published them in February 2015. The average vitamin C requirement in healthy adults is considered to be the vitamin C amount that compensates for the metabolic losses of vitamin C, and ensures a fasting ascorbate plasma level of 50 µmol/l. Based on the present data from studies with non-smoking men, metabolic losses of 50 mg/day are assumed, as well as an absorption rate of 80% and an urinary excretion of 25% of the vitamin C intake. Taking this into account, the calculated average requirement in men is 91 mg/day. Considering a coefficient of variation of 10%, a reference value (recommended intake) of 110 mg/day for men is derived. The vitamin C requirement in women as well as in children and adolescents is extrapolated from the requirement in men and in relation to their body weight. This results in a recommended intake of about 95 mg/day for adult women. Because the requirement in pregnant and lactating women is increased, higher recommended intakes are derived for them, 105 mg/day for pregnant women from the fourth month on and 125 mg/day for lactating women, respectively. For boys and girls at the age of 1 to under 15 years, there are increasing recommended intake values from 20 to 85 mg/day. For male and female adolescents, at the age of 15 to under 19 years, the recommended intake is 105 and 90 mg, respectively. As smokers have higher metabolic losses and lower plasma levels of vitamin C than non-smokers (turnover is 40% higher), the reference value for vitamin C intake is set to 135 mg/day for female smokers and 155 mg/day for male smokers. For infants in their first year of life, the reference value (estimated value) is set to 20 mg vitamin C/ day, based upon the lowest observed vitamin C intake for infants in the United Kingdom and the United States, that obviously meets the requirement in infants and that is 3 times higher than the amount necessary to prevent scurvy (7 mg/day). © 2015 S. Karger AG, Basel.

Simulation optimization of PSA-threshold based prostate cancer screening policies

PubMed Central

Zhang, Jingyu; Denton, Brian T.; Shah, Nilay D.; Inman, Brant A.

2013-01-01

We describe a simulation optimization method to design PSA screening policies based on expected quality adjusted life years (QALYs). Our method integrates a simulation model in a genetic algorithm which uses a probabilistic method for selection of the best policy. We present computational results about the efficiency of our algorithm. The best policy generated by our algorithm is compared to previously recommended screening policies. Using the policies determined by our model, we present evidence that patients should be screened more aggressively but for a shorter length of time than previously published guidelines recommend. PMID:22302420

Predictive Values of the New Sarcopenia Index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults.

PubMed

Moon, Joon Ho; Kim, Kyoung Min; Kim, Jung Hee; Moon, Jae Hoon; Choi, Sung Hee; Lim, Soo; Lim, Jae-Young; Kim, Ki Woong; Park, Kyong Soo; Jang, Hak Chul

2016-01-01

We evaluated the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project's recommended criteria for sarcopenia's association with mortality among older Korean adults. We conducted a community-based prospective cohort study which included 560 (285 men and 275 women) older Korean adults aged ≥65 years. Muscle mass (appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI)), handgrip strength, and walking velocity were evaluated in association with all-cause mortality during 6-year follow-up. Both the lowest quintile for each parameter (ethnic-specific cutoff) and FNIH-recommended values were used as cutoffs. Forty men (14.0%) and 21 women (7.6%) died during 6-year follow-up. The deceased subjects were older and had lower ASM, handgrip strength, and walking velocity. Sarcopenia defined by both low lean mass and weakness had a 4.13 (95% CI, 1.69-10.11) times higher risk of death, and sarcopenia defined by a combination of low lean mass, weakness, and slowness had a 9.56 (3.16-28.90) times higher risk of death after adjusting for covariates in men. However, these significant associations were not observed in women. In terms of cutoffs of each parameter, using the lowest quintile showed better predictive values in mortality than using the FNIH-recommended values. Moreover, new muscle mass index, ASM/BMI, provided better prognostic values than ASM/height2 in all associations. New sarcopenia definition by FNIH was better able to predict 6-year mortality among Korean men. Moreover, ethnic-specific cutoffs, the lowest quintile for each parameter, predicted the higher risk of mortality than the FNIH-recommended values.

Predictive Values of the New Sarcopenia Index by the Foundation for the National Institutes of Health Sarcopenia Project for Mortality among Older Korean Adults

PubMed Central

Kim, Jung Hee; Moon, Jae Hoon; Choi, Sung Hee; Lim, Soo; Lim, Jae-Young; Kim, Ki Woong; Park, Kyong Soo; Jang, Hak Chul

2016-01-01

Objective We evaluated the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project’s recommended criteria for sarcopenia’s association with mortality among older Korean adults. Methods We conducted a community-based prospective cohort study which included 560 (285 men and 275 women) older Korean adults aged ≥65 years. Muscle mass (appendicular skeletal muscle mass-to-body mass index ratio (ASM/BMI)), handgrip strength, and walking velocity were evaluated in association with all-cause mortality during 6-year follow-up. Both the lowest quintile for each parameter (ethnic-specific cutoff) and FNIH-recommended values were used as cutoffs. Results Forty men (14.0%) and 21 women (7.6%) died during 6-year follow-up. The deceased subjects were older and had lower ASM, handgrip strength, and walking velocity. Sarcopenia defined by both low lean mass and weakness had a 4.13 (95% CI, 1.69–10.11) times higher risk of death, and sarcopenia defined by a combination of low lean mass, weakness, and slowness had a 9.56 (3.16–28.90) times higher risk of death after adjusting for covariates in men. However, these significant associations were not observed in women. In terms of cutoffs of each parameter, using the lowest quintile showed better predictive values in mortality than using the FNIH-recommended values. Moreover, new muscle mass index, ASM/BMI, provided better prognostic values than ASM/height2 in all associations. Conclusions New sarcopenia definition by FNIH was better able to predict 6-year mortality among Korean men. Moreover, ethnic-specific cutoffs, the lowest quintile for each parameter, predicted the higher risk of mortality than the FNIH-recommended values. PMID:27832145

Information filtering via preferential diffusion.

PubMed

Lü, Linyuan; Liu, Weiping

2011-06-01

Recommender systems have shown great potential in addressing the information overload problem, namely helping users in finding interesting and relevant objects within a huge information space. Some physical dynamics, including the heat conduction process and mass or energy diffusion on networks, have recently found applications in personalized recommendation. Most of the previous studies focus overwhelmingly on recommendation accuracy as the only important factor, while overlooking the significance of diversity and novelty that indeed provide the vitality of the system. In this paper, we propose a recommendation algorithm based on the preferential diffusion process on a user-object bipartite network. Numerical analyses on two benchmark data sets, MovieLens and Netflix, indicate that our method outperforms the state-of-the-art methods. Specifically, it can not only provide more accurate recommendations, but also generate more diverse and novel recommendations by accurately recommending unpopular objects.

Information filtering via preferential diffusion

NASA Astrophysics Data System (ADS)

Lü, Linyuan; Liu, Weiping

2011-06-01

Recommender systems have shown great potential in addressing the information overload problem, namely helping users in finding interesting and relevant objects within a huge information space. Some physical dynamics, including the heat conduction process and mass or energy diffusion on networks, have recently found applications in personalized recommendation. Most of the previous studies focus overwhelmingly on recommendation accuracy as the only important factor, while overlooking the significance of diversity and novelty that indeed provide the vitality of the system. In this paper, we propose a recommendation algorithm based on the preferential diffusion process on a user-object bipartite network. Numerical analyses on two benchmark data sets, MovieLens and Netflix, indicate that our method outperforms the state-of-the-art methods. Specifically, it can not only provide more accurate recommendations, but also generate more diverse and novel recommendations by accurately recommending unpopular objects.

Representation of occupational information across resources and validation of the occupational data for health model.

PubMed

Rajamani, Sripriya; Chen, Elizabeth S; Lindemann, Elizabeth; Aldekhyyel, Ranyah; Wang, Yan; Melton, Genevieve B

2018-02-01

Reports by the National Academy of Medicine and leading public health organizations advocate including occupational information as part of an individual's social context. Given recent National Academy of Medicine recommendations on occupation-related data in the electronic health record, there is a critical need for improved representation. The National Institute for Occupational Safety and Health has developed an Occupational Data for Health (ODH) model, currently in draft format. This study aimed to validate the ODH model by mapping occupation-related elements from resources representing recommendations, standards, public health reports and surveys, and research measures, along with preliminary evaluation of associated value sets. All 247 occupation-related items across 20 resources mapped to the ODH model. Recommended value sets had high variability across the evaluated resources. This study demonstrates the ODH model's value, the multifaceted nature of occupation information, and the critical need for occupation value sets to support clinical care, population health, and research. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Speed limits set lower than engineering recommendations.

DOT National Transportation Integrated Search

2016-08-01

The purpose of this project is to provide the Montana Department of Transportation (MDT) with a better understanding of the : operational and safety impacts of setting posted speed limits below engineering recommended values. This practice has been :...

The definition, diagnostic testing, and management of chronic inducible urticarias - The EAACI/GA(2) LEN/EDF/UNEV consensus recommendations 2016 update and revision.

PubMed

Magerl, M; Altrichter, S; Borzova, E; Giménez-Arnau, A; Grattan, C E H; Lawlor, F; Mathelier-Fusade, P; Meshkova, R Y; Zuberbier, T; Metz, M; Maurer, M

2016-06-01

These recommendations for the definition, diagnosis and management of chronic inducible urticaria (CIndU) extend, revise and update our previous consensus report on physical urticarias and cholinergic urticaria (Allergy, 2009). The aim of these recommendations is to improve the diagnosis and management of patients with CIndU. Our recommendations acknowledge the latest changes in our understanding of CIndU, and the available therapeutic options, as well as the development of novel diagnostic tools. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

25 CFR 700.119 - Establishment of fair market value.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Establishment of fair market value. 700.119 Section 700... value. (a) General. The Commission shall establish the amount of fair market value to be offered to the... recommendations as to the fair market value of the habitations and/or improvements; or (2) The fair market value...

Information presentation features and comprehensibility of hospital report cards: design analysis and online survey among users.

PubMed

Sander, Uwe; Emmert, Martin; Dickel, Jochen; Meszmer, Nina; Kolb, Benjamin

2015-03-16

Improving the transparency of information about the quality of health care providers is one way to improve health care quality. It is assumed that Internet information steers patients toward better-performing health care providers and will motivate providers to improve quality. However, the effect of public reporting on hospital quality is still small. One of the reasons is that users find it difficult to understand the formats in which information is presented. We analyzed the presentation of risk-adjusted mortality rate (RAMR) for coronary angiography in the 10 most commonly used German public report cards to analyze the impact of information presentation features on their comprehensibility. We wanted to determine which information presentation features were utilized, were preferred by users, led to better comprehension, and had similar effects to those reported in evidence-based recommendations described in the literature. The study consisted of 5 steps: (1) identification of best-practice evidence about the presentation of information on hospital report cards; (2) selection of a single risk-adjusted quality indicator; (3) selection of a sample of designs adopted by German public report cards; (4) identification of the information presentation elements used in public reporting initiatives in Germany; and (5) an online panel completed an online questionnaire that was conducted to determine if respondents were able to identify the hospital with the lowest RAMR and if respondents' hospital choices were associated with particular information design elements. Evidence-based recommendations were made relating to the following information presentation features relevant to report cards: evaluative table with symbols, tables without symbols, bar charts, bar charts without symbols, bar charts with symbols, symbols, evaluative word labels, highlighting, order of providers, high values to indicate good performance, explicit statements of whether high or low values indicate good performance, and incomplete data ("N/A" as a value). When investigating the RAMR in a sample of 10 hospitals' report cards, 7 of these information presentation features were identified. Of these, 5 information presentation features improved comprehensibility in a manner reported previously in literature. To our knowledge, this is the first study to systematically analyze the most commonly used public reporting card designs used in Germany. Best-practice evidence identified in international literature was in agreement with 5 findings about German report card designs: (1) avoid tables without symbols, (2) include bar charts with symbols, (3) state explicitly whether high or low values indicate good performance or provide a "good quality" range, (4) avoid incomplete data (N/A given as a value), and (5) rank hospitals by performance. However, these findings are preliminary and should be subject of further evaluation. The implementation of 4 of these recommendations should not present insurmountable obstacles. However, ranking hospitals by performance may present substantial difficulties.

Utility of Pretest Probability and Exercise Treadmill Test in Korean Women with Suspected Coronary Artery Disease.

PubMed

Kim, Yong-Hyun; Shim, Wan-Joo; Kim, Myung-A; Hong, Kyung-Soon; Shin, Mi-Seung; Park, Seong-Mi; Cho, Kyoung Im; Kim, Mina; Kim, Sihun; Kim, Hak-Lyoung; Yoon, Hyun-Ju; Na, Jin-Oh; Kim, Sung-Eun

2016-06-01

Pretest probability (PTP) and an exercise treadmill test (ETT) are recommended for the initial evaluation of possible coronary artery disease (CAD), but the applicability of these tests in Korean women has not been evaluated. Korean women with PTP, ETT, and invasive coronary angiography results were enrolled. Across all PTP levels, PTP and ETT statistics were evaluated and independent CAD predictors obtained. Of the 335 patients (mean age 58.0 ± 10.2 years), 99 and 236 were in the low (LPTP) and intermediate PTP (IPTP) groups, respectively. The observed prevalence of CAD was significantly lower than the PTP. (7.1% vs. 9.1 ± 4.9% in LPTP, p < 0.001; 23.3% vs. 33.0 ± 15.1% in IPTP, p < 0.001) The ETT's sensitivity and positive predictive values (PPVs) appeared lower than previously reported (LPTP: 42.9% and 16.7%; IPTP: 61.8% and 37.0%), whereas the negative predictive values (NPVs) were higher (LPTP: 95.1%; IPTP: 85.4%). After multivariate adjustments, positive ETT (odds ratio 3.276, 95% confidence interval 1.643-6.532, p = 0.001) independently predicted the presence of CAD, but the PTP showed only marginal predictability (odds ratio 1.019, 95% confidence interval 0.998-1.041, p = 0.069). In Korean women, the observed prevalence of CAD was lower than the PTP, and PTP showed only marginal CAD predictability. Although a positive ETT independently predicted CAD, the ETT showed lower sensitivity and PPVs than previously reported. Despite the limited value of PTP and ETT, the high NPVs of ETT appear useful for saving patients from unnecessary further examinations.

Initiating undergraduate medical students into communities of research practise: what do supervisors recommend?

PubMed Central

2010-01-01

Background Much has been written in the educational literature on the value of communities of practise in enhancing student learning. Here, we take the experience of senior undergraduate medical students involved in short-term research as a member of a team as a paradigm for learning in a community of practise. Based on feedback from experienced supervisors, we offer recommendations for initiating students into the research culture of their team. In so doing, we endeavour to create a bridge between theory and practise through disseminating advice on good supervisory practise, where the supervisor is perceived as an educator responsible for designing the research process to optimize student learning. Methods Using the questionnaire design tool SurveyMonkey and comprehensive lists of contact details of staff who had supervised research projects at the University of Edinburgh during 1995 - 2008, current and previous supervisors were invited to recommend procedures which they had found successful in initiating students into the research culture of a team. Text responses were then coded in the form of derivative recommendations and categorized under general themes and sub-themes. Results Using the chi-square tests of linear trend and association, evidence was found for a positive trend towards more experienced supervisors offering responses (χ2 = 16.833, p < 0.0005, n = 215) while there was a lack of evidence of bias in the gender distribution of respondents (χ2 = 0.482, p = 0.487, n = 203), respectively. A total of 126 codes were extracted from the text responses of 65 respondents. These codes were simplified to form a complete list of 52 recommendations, which were in turn categorized under seven derivative overarching themes, the most highly represented themes being Connecting the student with others and Cultivating self-efficacy in research competence. Conclusions Through the design of a coding frame for supervisor responses, a wealth of ideas has been captured to make communities of research practise effective mediums for undergraduate student learning. The majority of these recommendations are underpinned by educational theory and have the potential to take the learner beyond the stage of initiation to that of integration within their community of research practise. PMID:21092088

HIF evaluation of In-Situ Aqua TROLL 400

USGS Publications Warehouse

Tillman, Evan F.

2017-10-18

The In-Situ Aqua TROLL 400 (Aqua TROLL 400) was tested at the U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility (HIF) against known standards over the Aqua TROLL 400’s operating temperature to verify the manufacturer’s stated accuracy specifications and the USGS recommendations for pH, dissolved oxygen (DO), and specific conductance (SC). The Aqua TROLL 400 manufacturer’s specifications are within the USGS recommendations for all parameters tested, except for DO, which is outside the USGS recommendation at DO concentrations of 8.0 milligrams per liter (mg/L) and higher. The Aqua TROLL 400 was compliant with Serial Digital Interface at 1200 baud (SDI-12) version 1.3. During laboratory testing of pH, the Aqua TROLL 400 sonde met the U.S. Geological Survey “National Field Manual for the Collection of Water-Quality Data” (NFM) recommendations for pH at all values tested, except at 4 degrees Celsius (°C) at pH 9.395 and pH 3.998. The Aqua TROLL 400 met the manufacturer specifications for pH at all values tested, except for pH buffers 3.998, 9.395, and 10.245 at 4 °C; pH 2.990 and 3.998 at 15 °C; and pH 3.040 at 40 °C. The Aqua TROLL 400 met the NFM recommendations at 93.7 percent of the SC values tested and met the manufacturer’s accuracy specifications at 56.3 percent of the SC values tested. During the laboratory testing for DO, the Aqua TROLL 400 met the manufacturer specifications, except at 5.55 mg/L, and met the NFM recommendations at all concentrations tested. An Aqua TROLL 400 was field tested at USGS Station 02492620, National Space Technology Laboratories (NSTL) Station, Mississippi, on the Pearl River for 6 weeks and showed good agreement with the well-maintained site sonde data for pH, DO, temperature, and SC.

Quantitative and descriptive comparison of four acoustic analysis systems: vowel measurements.

PubMed

Burris, Carlyn; Vorperian, Houri K; Fourakis, Marios; Kent, Ray D; Bolt, Daniel M

2014-02-01

This study examines accuracy and comparability of 4 trademarked acoustic analysis software packages (AASPs): Praat, WaveSurfer, TF32, and CSL by using synthesized and natural vowels. Features of AASPs are also described. Synthesized and natural vowels were analyzed using each of the AASP's default settings to secure 9 acoustic measures: fundamental frequency (F0), formant frequencies (F1-F4), and formant bandwidths (B1-B4). The discrepancy between the software measured values and the input values (synthesized, previously reported, and manual measurements) was used to assess comparability and accuracy. Basic AASP features are described. Results indicate that Praat, WaveSurfer, and TF32 generate accurate and comparable F0 and F1-F4 data for synthesized vowels and adult male natural vowels. Results varied by vowel for women and children, with some serious errors. Bandwidth measurements by AASPs were highly inaccurate as compared with manual measurements and published data on formant bandwidths. Values of F0 and F1-F4 are generally consistent and fairly accurate for adult vowels and for some child vowels using the default settings in Praat, WaveSurfer, and TF32. Manipulation of default settings yields improved output values in TF32 and CSL. Caution is recommended especially before accepting F1-F4 results for children and B1-B4 results for all speakers.

[Somatic disorders in outpatient psychiatry: the added value of a standard physical examination during the intake of outpatients].

PubMed

van den Berg, K E M; Rijnders, C A Th; van Dam, A; van de Ven, A L M; van der Feltz-Cornelis, C M; Graafsma, S J

2014-01-01

It is well-known that psychiatric patients often suffer from severe somatic problems, such as diabetes mellitus and cardiovascular disease. Up till now, research has concentrated almost exclusively on the inpatient setting, but there is strong evidence that the correlation also exists in psychiatric patients who are outpatients. In the Netherlands there are, as yet, no clear recommendations regarding a standard form of somatic screening for the outpatient population. A pilot study performed by GGz Breburg has shown that somatic screening (without a physical examination) gave substantial additional value to treatment planning. To investigate the added value that a physical examination can provide when new psychiatric patients are screened for aspects of somatic concern (ASC). Newly referred outpatients (n = 70) were screened somatically by means of a questionnaire and supplementary medical interview, and by laboratory tests and physical examination. If a somatic problem was found which had not been detected previously, the patient was referred back to to the general practitioner. At least one ASC was found in 81,4% of all patients. In 45,7% of all patients the asc had not been detected. 12% of all the newly discovered somatic problems were found exclusively via the physical examination. A physical examination provides substantial information and adds value to the somatic screening of psychiatric outpatients.

Identification and mapping of heavy metal pollution in soils of a sports ground in Galway City, Ireland, using a portable XRF analyser and GIS.

PubMed

Carr, Ramona; Zhang, Chaosheng; Moles, Norman; Harder, Marie

2008-02-01

Heavy metals in urban soils continue to attract attention because of their potential long-term effects on human health. During a previous investigation of urban soils in Galway City, Ireland, a pollution hotspot of Pb, Cu, Zn and As was identified in the sports ground of South Park in the Claddagh. The sports ground was formerly a rubbish dumping site for both municipal and industrial wastes. In the present study, a portable X-ray fluorescence (PXRF) analyser was used to obtain rapid in-situ elemental analyses of the topsoil (depth: about 5-10 cm) at 200 locations on a 20 x 20-m grid in South Park. Extremely high values of the pollutants were found, with maximum values of Pb, Zn, Cu and As of 10,297, 24,716, 2224 and 744 mg/kg soil, respectively. High values occur particularly where the topsoil cover is thin, whereas lower values were found in areas where imported topsoil covers the polluted substrate. Geographic Information Systems (GIS) techniques were applied to the dataset to create elemental spatial distribution maps, three-dimensional images and interpretive hazard maps of the pollutants in the study area. Immediate action to remediate the contaminated topsoil is recommended to safeguard the health of children who play at the sports ground.

Subliminal perception of complex visual stimuli.

PubMed

Ionescu, Mihai Radu

2016-01-01

Rationale: Unconscious perception of various sensory modalities is an active subject of research though its function and effect on behavior is uncertain. Objective: The present study tried to assess if unconscious visual perception could occur with more complex visual stimuli than previously utilized. Methods and Results: Videos containing slideshows of indifferent complex images with interspersed frames of interest of various durations were presented to 24 healthy volunteers. The perception of the stimulus was evaluated with a forced-choice questionnaire while awareness was quantified by self-assessment with a modified awareness scale annexed to each question with 4 categories of awareness. At values of 16.66 ms of stimulus duration, conscious awareness was not possible and answers regarding the stimulus were random. At 50 ms, nonrandom answers were coupled with no self-reported awareness suggesting unconscious perception of the stimulus. At larger durations of stimulus presentation, significantly correct answers were coupled with a certain conscious awareness. Discussion: At values of 50 ms, unconscious perception is possible even with complex visual stimuli. Further studies are recommended with a focus on a range of interest of stimulus duration between 50 to 16.66 ms.

2012: no trans fatty acids in Spanish bakery products.

PubMed

Ansorena, Diana; Echarte, Andrea; Ollé, Rebeca; Astiasarán, Iciar

2013-05-01

Trans fatty acids (TFA) are strongly correlated with an increased risk of cardiovascular and other chronic diseases. Current dietary recommendations exclude bakery products from frequent consumption basically due to their traditionally high content of TFA. The aim of this work was to analyse the lipid profile of different bakery products currently commercialised in Spain and with a conventionally high fat and TFA content. Premium and store brands for each product were included in the study. No significant amounts of TFA were found in any of the analysed products, regardless the brand. TFA content ranged between 0.17 g and 0.22 g/100 g product (mean=0.19 g/100 g product). Expressed on percentage of fatty acids, the maximum value was 0.87 g/100 g fatty acids and the mean value was 0.68%. These data are significantly lower than those observed in previously published papers for these types of products, and highlighted the importance of updating food composition databases in order to accurately estimate the real and current intake of TFA. Copyright © 2012 Elsevier Ltd. All rights reserved.

Application of matched asymptotic expansions to lunar and interplanetary trajectories. Volume 1: Technical discussion

NASA Technical Reports Server (NTRS)

Lancaster, J. E.

1973-01-01

Previously published asymptotic solutions for lunar and interplanetary trajectories have been modified and combined to formulate a general analytical solution to the problem on N-bodies. The earlier first-order solutions, derived by the method of matched asymptotic expansions, have been extended to second order for the purpose of obtaining increased accuracy. The derivation of the second-order solution is summarized by showing the essential steps, some in functional form. The general asymptotic solution has been used as a basis for formulating a number of analytical two-point boundary value solutions. These include earth-to-moon, one- and two-impulse moon-to-earth, and interplanetary solutions. The results show that the accuracies of the asymptotic solutions range from an order of magnitude better than conic approximations to that of numerical integration itself. Also, since no iterations are required, the asymptotic boundary value solutions are obtained in a fraction of the time required for comparable numerically integrated solutions. The subject of minimizing the second-order error is discussed, and recommendations made for further work directed toward achieving a uniform accuracy in all applications.

A cost-benefit analysis of Wisconsin's screening, brief intervention, and referral to treatment program: adding the employer's perspective.

PubMed

Quanbeck, Andrew; Lang, Katharine; Enami, Kohei; Brown, Richard L

2010-02-01

A previous cost-benefit analysis found Screening, Brief Intervention, and Referral to Treatment (SBIRT) to be cost-beneficial from a societal perspective. This paper develops a cost-benefit model that includes the employer's perspective by considering the costs of absenteeism and impaired presenteeism due to problem drinking. We developed a Monte Carlo simulation model to estimate the costs and benefits of SBIRT implementation to an employer. We first presented the likely costs of problem drinking to a theoretical Wisconsin firm that does not currently provide SBIRT services. We then constructed a cost-benefit model in which the firm funds SBIRT for its employees. The net present value of SBIRT adoption was computed by comparing costs due to problem drinking both with and without the program. When absenteeism and impaired presenteeism costs were considered from the employer's perspective, the net present value of SBIRT adoption was $771 per employee. We concluded that implementing SBIRT is cost-beneficial from the employer's perspective and recommend that Wisconsin employers consider covering SBIRT services for their employees.

In-Situ Visualization Experiments with ParaView Cinema in RAGE

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

Kares, Robert John

2015-10-15

A previous paper described some numerical experiments performed using the ParaView/Catalyst in-situ visualization infrastructure deployed in the Los Alamos RAGE radiation-hydrodynamics code to produce images from a running large scale 3D ICF simulation. One challenge of the in-situ approach apparent in these experiments was the difficulty of choosing parameters likes isosurface values for the visualizations to be produced from the running simulation without the benefit of prior knowledge of the simulation results and the resultant cost of recomputing in-situ generated images when parameters are chosen suboptimally. A proposed method of addressing this difficulty is to simply render multiple images atmore » runtime with a range of possible parameter values to produce a large database of images and to provide the user with a tool for managing the resulting database of imagery. Recently, ParaView/Catalyst has been extended to include such a capability via the so-called Cinema framework. Here I describe some initial experiments with the first delivery of Cinema and make some recommendations for future extensions of Cinema’s capabilities.« less

Lead, cadmium and mercury levels in pregnancy: the need for international consensus on levels of concern.

PubMed

Taylor, C M; Golding, J; Emond, A M

2014-02-01

For heavy metals that have any degree of transfer though the placenta to the fetus, it is unlikely that there are safe limits for maternal blood levels. The only means of reducing fetal exposure is to minimise maternal exposure. There are few recommendations for levels of concern. With the exception of US recommendations for maternal Pb levels, but there are no international levels of concern or cut-off levels specifically for pregnancy for heavy metals, so that comparisons can generally only be made with national reference values relating to similar physiological statuses or age groups. These include recommendations for Cd levels by Germany (reference value for non-smoking adults aged 18-69 years, 1 µg/l) and for Hg by Germany (reference value for adults age 18-60 years with fish intake < or =3 times per month, 2.0 µg/l) and the USA (cut-off level for women, 5.8 µg/dl). To illustrate the lack of cohesion, we present data on blood Pb, Cd and Hg levels from pregnant women enroled in the UK Avon Longitudinal Study of Parents and Children study and compare the values with present levels of concern and recommended cut-off values. We also compare the levels with those found in other groups of pregnant women worldwide to strengthen the database for the development of levels of concern in pregnancy. The need for clarity of terminology in describing levels of concern is discussed. There is a pressing need for international consensus on levels of concern for all age groups and physiological statuses, particularly for pregnancy.

Texas Triaxial - R Value correlation.

DOT National Transportation Integrated Search

1963-03-01

At the time of the instigation of this research the recommended AASHO design formula was based on a Soil Support Value which directly correlated with the "R-Value" system developed by F. N. Haveem, whereas, the flexible pavement design method current...

Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia.

PubMed

Aktimur, R; Cetinkunar, S; Yildirim, K; Aktimur, S H; Ugurlucan, M; Ozlem, N

2016-06-01

Due to the diagnostic challenges and dreadful consequences of delayed treatment of acute mesenteric ischemia (AMI), a variety of diagnostic markers have been previously studied. However, the diagnostic value of neutrophil-to-lymphocyte ratio (NLR), which has been suggested to be a predictor of inflammation, has never been studied for AMI. The data of 70 patients who underwent laparotomy (n = 8) and/or bowel resection (n = 62) for AMI (n = 70) between January 2009 and March 2014 were retrospectively analyzed. To investigate the studied parameters' role in the differential diagnosis of AMI, control groups were selected from most common reasons of inflammation-related emergent surgery, acute appendicitis (AA, n = 62) and normal appendix (NA, n = 61). White blood cell (WBC), red cell distribution width (RDW), NLR and mean platelet volume (MPV) values were recorded. Outcome variables of the study were defined as diagnostic and prognostic role of NLR in AMI. RDW and NLR values were found to be higher in the AMI group than the AA group (p < 0.001 and p < 0.001). Also, WBC and MPV values were higher in the AMI group than the NA group (p = 0.001 and p < 0.001). Combined sensitivity, specificity, positive predictive value and negative predictive value of RDW and NLR for recommended cut-off values were 69.4, 71.2, 57.8 and 80.4 %, respectively. High NLR value (>9.9) seems to be a valuable diagnostic marker of acute mesenteric ischemia. Combined use of NLR, RDW and other clinical assessment, could help the diagnosis of AMI, especially in the absence of advanced imaging modalities and expert radiologic interpretation.

What Experiences Do Expository Books on Recommended Book Lists Offer to K-2 Students?

ERIC Educational Resources Information Center

Kletzien, Sharon B.; Dreher, Mariam Jean

2017-01-01

Teachers can use expository texts to teach academic vocabulary, content knowledge, text structure, and text features. National associations' recommended book lists are often used to identify books for classrooms. Previously we identified expository texts on these lists from 2001-2002 and 2011-2012. The current study explored instructional…

Information Technology Research: Investing in Our Future. Report to the President.

ERIC Educational Resources Information Center

National Coordination Office for Information Technology Research and Development, Arlington, VA.

This is the final report on future directions for Federal support of research and development (R&D) for information technology. This report adds detail to the findings and recommendations in the interim report dated August 1998, and strengthens previous recommendations regarding the importance of social and economic research on the impacts of…

Simplified and age-appropriate recommendations for added sugars in children.

PubMed

Goran, M I; Riemer, S L; Alderete, T L

2018-04-01

Excess sugar intake increases risk for obesity and related comorbidities among children. The World Health Organization (WHO), American Heart Association (AHA) and the 2015 USDA dietary recommendations have proposed guidelines for added sugar intake to reduce risk for disease. WHO and USDA recommendations are presented as a percentage of daily calories from added sugar. This approach is not easily understood or translated to children, where energy needs increase with age. The AHA recommendation is based on a fixed value of 25 g of added sugar for all children 2-19 years of age. This approach does not take into account the different levels of intake across this wide age range. Due to these limitations, we adapted current recommendations for added sugars based on daily energy needs of children 2-19 years. We used those values to derive simple regression equations to predict grams or teaspoons of added sugars per day based on age that would be equivalent to 10% of daily energy needs. This proposed approach aligns with the changing nutritional needs of children and adolescents during growth. © 2017 World Obesity Federation.

Dietary fats and cardiovascular health: a summary of the scientific evidence and current debate.

PubMed

Fattore, Elena; Massa, Elena

2018-04-04

This narrative review summarises the main studies of the role of the different fatty acids in coronary heart disease (CHD) and cardiovascular disease (CVD) risk and the current scientific debate on dietary recommendations. Reduction and substitution of the saturated fatty acids (SFAs) with the polyunsaturated fatty acids (PUFAs) are still the main dietary recommendation to prevent CHD and CVD. In the last few years, however, the strength of the scientific evidence underlying this dietary advice has been questioned. Recent investigations reappraise the previously declared deleterious role of the SFAs and reduce the positive role of PUFAs, mainly the omega-6, whereas the role of monounsaturated fatty acids (MUFAs) remains unclear. In contrast, the negative effects of trans fatty acids (TFAs) seem stronger than previously thought. Finally, criticisms have emerged from a dietary recommendation approach focussed on individual components rather than on wide food items and eating habits.

Fatigue and Fracture-Toughness Characterization of SAW and SMA A537 Class I Ship-Steel Weldments.

DTIC Science & Technology

1981-12-01

Charpy criterion and proposed NDT-DT criterion of Rolfe . Recommendations are made and further research is suggested to help clarify the assessment of...acceptable performance at -60aF. Likewise, at -60OF the NDT and DT data for these weldments marginally exceed the criteria proposed by Rolfe when the...exceed the CVN values equivalent to the 5/8 DT values required by Rolfe . The 5/8-inch dynamic-tear specimen is not recommended as a quality-control test

Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature

PubMed Central

Wilffert, Bob; Boersma, Cornelis; Annemans, Lieven; Vegter, Stefan; van Boven, Job F. M.; Postma, Maarten J.

2016-01-01

Objective Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx) tests it is important to assess whether they provide good value for money. This review provides an update of the literature. Methods A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies’ overall quality was assessed with the Quality of Health Economic Studies (QHES) instrument. Results We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing. Conclusions Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests’ efficacy remains of utmost importance. PMID:26752539

Spectral analysis software improves confidence in plant and soil water stable isotope analyses performed by isotope ratio infrared spectroscopy (IRIS).

PubMed

West, A G; Goldsmith, G R; Matimati, I; Dawson, T E

2011-08-30

Previous studies have demonstrated the potential for large errors to occur when analyzing waters containing organic contaminants using isotope ratio infrared spectroscopy (IRIS). In an attempt to address this problem, IRIS manufacturers now provide post-processing spectral analysis software capable of identifying samples with the types of spectral interference that compromises their stable isotope analysis. Here we report two independent tests of this post-processing spectral analysis software on two IRIS systems, OA-ICOS (Los Gatos Research Inc.) and WS-CRDS (Picarro Inc.). Following a similar methodology to a previous study, we cryogenically extracted plant leaf water and soil water and measured the δ(2)H and δ(18)O values of identical samples by isotope ratio mass spectrometry (IRMS) and IRIS. As an additional test, we analyzed plant stem waters and tap waters by IRMS and IRIS in an independent laboratory. For all tests we assumed that the IRMS value represented the "true" value against which we could compare the stable isotope results from the IRIS methods. Samples showing significant deviations from the IRMS value (>2σ) were considered to be contaminated and representative of spectral interference in the IRIS measurement. Over the two studies, 83% of plant species were considered contaminated on OA-ICOS and 58% on WS-CRDS. Post-analysis, spectra were analyzed using the manufacturer's spectral analysis software, in order to see if the software correctly identified contaminated samples. In our tests the software performed well, identifying all the samples with major errors. However, some false negatives indicate that user evaluation and testing of the software are necessary. Repeat sampling of plants showed considerable variation in the discrepancies between IRIS and IRMS. As such, we recommend that spectral analysis of IRIS data must be incorporated into standard post-processing routines. Furthermore, we suggest that the results from spectral analysis be included when reporting stable isotope data from IRIS. Copyright © 2011 John Wiley & Sons, Ltd.

Tour Recommendation Guide- Personalized travel sequence recommendation

NASA Astrophysics Data System (ADS)

Sivakumar, Akshitha; Prabadevi, B.

2017-11-01

Presents a personalized travel sequence for the given area the individual wants to visit. It not only helps to personalize the travel but also recommend a travel sequence based on the area mentioned. Firstly the frequently visited routes are ranked then top ranked routes are chosen based on previous travel records. The data is being collected using data mining and the famous routes are ranked based on user and the route. It helps in bridging the gap between user travel preference and routes.

2H NMR and 13C-IRMS analyses of acetic acid from vinegar, 18O-IRMS analysis of water in vinegar: international collaborative study report.

PubMed

Thomas, Freddy; Jamin, Eric

2009-09-01

An international collaborative study of isotopic methods applied to control the authenticity of vinegar was organized in order to support the recognition of these procedures as official methods. The determination of the 2H/1H ratio of the methyl site of acetic acid by SNIF-NMR (site-specific natural isotopic fractionation-nuclear magnetic resonance) and the determination of the 13C/12C ratio, by IRMS (isotope ratio mass spectrometry) provide complementary information to characterize the botanical origin of acetic acid and to detect adulterations of vinegar using synthetic acetic acid. Both methods use the same initial steps to recover pure acetic acid from vinegar. In the case of wine vinegar, the determination of the 18O/16O ratio of water by IRMS allows to differentiate wine vinegar from vinegars made from dried grapes. The same set of vinegar samples was used to validate these three determinations. The precision parameters of the method for measuring delta13C (carbon isotopic deviation) were found to be similar to the values previously obtained for similar methods applied to wine ethanol or sugars extracted from fruit juices: the average repeatability (r) was 0.45 per thousand, and the average reproducibility (R) was 0.91 per thousand. As expected from previous in-house study of the uncertainties, the precision parameters of the method for measuring the 2H/1H ratio of the methyl site were found to be slightly higher than the values previously obtained for similar methods applied to wine ethanol or fermentation ethanol in fruit juices: the average repeatability was 1.34 ppm, and the average reproducibility was 1.62 ppm. This precision is still significantly smaller than the differences between various acetic acid sources (delta13C and delta18O) and allows a satisfactory discrimination of vinegar types. The precision parameters of the method for measuring delta18O were found to be similar to the values previously obtained for other methods applied to wine and fruit juices: the average repeatability was 0.15 per thousand, and the average reproducibility was 0.59 per thousand. The above values are proposed as repeatability and reproducibility limits in the current state of the art. On the basis of this satisfactory inter-laboratory precision and on the accuracy demonstrated by a spiking experiment, the authors recommend the adoption of the three isotopic determinations included in this study as official methods for controlling the authenticity of vinegar.

The Epidemiology of Anti-Sperm Antibodies Among Couples with Unexplained Infertility in North West Bank, Palestine.

PubMed

Yasin, Anas Lotfi; Yasin, Ahmad Lotfi; Basha, Walid Salim

2016-03-01

Anti sperm antibodies (ASA) can present in serum and semen and they may lead to impair the sperms function leading to infertility. The precise mechanism of generation of these antibodies is yet to be discovered. This study was performed to determine the prevalence of anti-sperm antibodies (ASA) in patients with unexplained infertility. The study was initiated also to explore the possible factors that may associate with ASA formation and how ASA status is associated with pregnancy rates after going with in vitro fertilization - intracytoplasmic sperm injection (IVF-ICSI). A cross-sectional study was conducted on 42 normal infertile couples consulting Razan Medical Center for Infertility & I.V.F. in Nablus, Palestine, from December 2012 - March 2013. Serum levels of immunoglobulins G (IgG) ASA were measured in participants (males and females) using enzyme-linked immunosorbent assay (ELISA). In addition, participants also filled a questionnaire about the presence of previous varicocele repair, inguinal hernia repair, orchitis, testicular trauma and vasectomy reversal among males and severe coitus bleeding and coitus during menses or puerperium among females. Couples were also asked about previous IVF-ICSI procedures and the outcome of the procedure in terms of either they got pregnant or not. Data was analysed using SPSS software. The prevalence of ASA was 14.3% (6/42) among all couples, 9.5% (4/42) among males and 4.8% (2/42) among females. There was no significant relationship between previous varicocele repair, previous inguinal hernia repair, or orchitis and formation of ASA (p value =0.64, 0.56, and 0.26 respectively). Previous trauma, vasovasostomy, severe coitus bleeding and coitus during menses or puerperium were not observed in any of the study sample. ASA did not seem to affect the outcome of IVF-ICSI (p-value =0.54). Prevalence of ASA in infertile couples in the north part of Palestine is similar to that obtained worldwide. ASA formation does not relate to any of the studied risk factors and does not seem to associate with pregnancy rate after IVF-ICSI. We recommend further studies using a larger sample size and including all parts of Palestine in order to generalize the obtained results.

Practitioners' Perception of the Impact of the Vision of Policy-Makers on Practice: The Example of the Recommendations of the Moser Commission

ERIC Educational Resources Information Center

Ade-Ojo, Gordon O.

2011-01-01

This paper presents the perception of practitioners of the impact of the Moser Committee recommendations and the Skills for Life agenda it generated. The paper further explores areas of convergence and divergence between practitioners' perceptions and the underpinning values of the Moser Committee recommendations. The study utilised a range of…

I should not recommend it to you even if you will like it: the ethics of recommender systems

NASA Astrophysics Data System (ADS)

Tang, Tiffany Ya; Winoto, Pinata

2016-01-01

In this paper, we extend the current research in the recommendation system community by showing that users did attach ethical consideration to items. In an experiment (N = 111) that manipulated several moral factors regarding the potentially harmful content in movies, books, and games, users were asked to evaluate the appropriateness of recommending these items to teenagers and adult couples. Results agreed with previous studies in that gender plays a key role in making moral judgment, especially regarding the ethical appropriateness of an item. The pilot study further identifies degrees of aversion regarding the appeal of these elements in media for ethical recommendations. Based on the study, we propose a user-initiated ethical recommender system to help users pick up morally appropriate items during the post-recommendation process. We believe that the ethical appropriateness of items perceived by end users could predict the trust and credibility of the system.

Urging Affordable Access to High-Value Cancer Drugs

Cancer.gov

This infographic highlights some of the main messages from the President’s Cancer Panel report Promoting Value, Affordability, and Innovation in Cancer Drug Treatment. The graphic includes the panel’s recommendations to maximize the value and affordability of cancer drug treatment.

Do petroleum-based protective coatings add fuel value to slash

Treesearch

James L. Murphy; Charles W. Philpot

1965-01-01

Asphalts and wax emulsions have been recommended as protective coatings to help obtain clean, safe burns in slash disposal work. Fuel value determinations in the laboratory indicate that such coatings add little to the fuel value of slash.

National Diet and Nutrition Survey: fat and fatty acid intake from the first year of the rolling programme and comparison with previous surveys.

PubMed

Pot, Gerda K; Prynne, Celia J; Roberts, Caireen; Olson, Ashley; Nicholson, Sonja K; Whitton, Clare; Teucher, Birgit; Bates, Beverley; Henderson, Helen; Pigott, Sarah; Swan, Gillian; Stephen, Alison M

2012-02-01

High saturated fat intake is an established risk factor for several chronic diseases. The objective of the present study is to report dietary intakes and main food sources of fat and fatty acids (FA) from the first year of the National Diet and Nutrition Survey (NDNS) rolling programme in the UK. Dietary data were collected using 4 d estimated food diaries (n 896) and compared with dietary reference values (DRV) and previous NDNS results. Total fat provided 34-36 % food energy (FE) across all age groups, which was similar to previous surveys for adults. Men (19-64 years) and older girls (11-18 years) had mean intakes just above the DRV, while all other groups had mean total fat intakes of < 35 % FE. SFA intakes were lower compared with previous surveys, ranging from 13 to 15 % FE, but still above the DRV. Mean MUFA intakes were 12·5 % FE for adults and children aged 4-18 years and all were below the DRV. Mean n-3 PUFA intake represented 0·7-1·1 % FE. Compared with previous survey data, the direction of change for n-3 PUFA was upwards for all age groups, although the differences in absolute terms were very small. Trans-FA intakes were lower than in previous NDNS and were less than 2 g/d for all age groups, representing 0·8 % FE and lower than the DRV in all age groups. In conclusion, dietary intake of fat and FA is moving towards recommended levels for the UK population. However, there remains room for considerable further improvement.

National Diet and Nutrition Survey: fat and fatty acid intakes from the first year of the rolling programme and comparison with previous surveys

PubMed Central

Pot, Gerda K.; Prynne, Celia J.; Roberts, Caireen; Olson, Ashley; Nicholson, Sonja K.; Whitton, Clare; Teucher, Birgit; Bates, Beverley; Henderson, Helen; Pigott, Sarah; Swan, Gillian; Stephen, Alison M.

2012-01-01

High saturated fat intake is an established risk factor for several chronic diseases. The objective of the present study is to report dietary intakes and main food sources of fat and fatty acids (FA) from the first year of the National Diet and Nutrition Survey (NDNS) rolling programme in the UK. Dietary data were collected using 4d estimated food diaries (n896) and compared with dietary reference values (DRV) and previous NDNS results. Total fat provided 34–36% food energy (FE) across all age groups, which was similar to previous surveys for adults. Men (19–64 years) and older girls (11–18 years) had mean intakes just above the DRV, while all other groups had mean total fat intakes of <35% FE. SFA intakes were lower compared with previous surveys, ranging from 13 to 15% FE, but still above the DRV. Mean MUFA intakes were 12.5% FE for adults and children aged 4–18 years and all were below the DRV. Mean n–3 PUFA intake represented 0.7–1.1% FE. Compared with previous survey data, the direction of change for n–3 PUFA was upwards for all age groups, although the differences in absolute terms were very small. Trans-FA intakes were lower than in previous NDNS and were less than 2g/d for all age groups, representing 0.8% FE and lower than the DRV in all age groups. In conclusion, dietary intake of fat and FA is moving towards recommended levels for the UK population. However, there remains room for considerable further improvement. PMID:21767448

Out of sight, out of mind? Does terminating the physical presence of a geriatric consultant in the community clinic reduce the implementation rate for geriatric recommendations.

PubMed

Freud, Tamar; Punchik, Boris; Biderman, Aya; Peleg, Roni; Kagan, Ella; Barzak, Alex; Press, Yan

2016-01-01

To assess the effect of moving the geriatric consultation from the primary care clinic to another setting, on the rate of implementation of geriatric recommendations by family physicians. A retrospective review of the computerized medical records of elderly patients in four primary care clinics. The rate of implementation of geriatric recommendations was compared between clinics in which a geriatric consultant was physically present (control clinics) and a clinic where the consultation took place elsewhere (study clinic). In addition, the results of the present study were compared to a previous study in which the geriatric consultation was carried out in the study clinic and the family doctor was an active participant. 127 computerized files were reviewed in the study clinic and 133 in the control clinics. The mean age of the patients was 81.1±6.3 years and 63.1% were women. The overall implementation of geriatric recommendations by family doctors in the study clinic was 55.9%, a statistically significant decrease compared to the previous study where the rate was 73.9% (p<0.0001). In contrast, there was no change in the implementation rate in the control clinics at 65.0% in the present study and 59.9% in the previous one (p=0.205). Direct, person-to-person contact between the geriatric consultant and the family doctor has a beneficial effect on the implementation of geriatric recommendations. This should be considered by healthcare policy makers when planning geriatric services in the community. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Optimization of exposure index values for the antero-posterior pelvis and antero-posterior knee examination

NASA Astrophysics Data System (ADS)

Butler, M. L.; Rainford, L.; Last, J.; Brennan, P. C.

2009-02-01

Introduction The American Association of Medical Physicists is currently standardizing the exposure index (EI) value. Recent studies have questioned whether the EI value offered by manufacturers is optimal. This current work establishes optimum EIs for the antero-posterior (AP) projections of a pelvis and knee on a Carestream Health (Kodak) CR system and compares these with manufacturers recommended EI values from a patient dose and image quality perspective. Methodology Human cadavers were used to produce images of clinically relevant standards. Several exposures were taken to achieve various EI values and corresponding entrance surface doses (ESD) were measured using thermoluminescent dosimeters. Image quality was assessed by 5 experienced clinicians using anatomical criteria judged against a reference image. Visualization of image specific common abnormalities was also analyzed to establish diagnostic efficacy. Results A rise in ESD for both examinations, consistent with increasing EI was shown. Anatomic image quality was deemed to be acceptable at an EI of 1560 for the AP pelvis and 1590 for the AP knee. From manufacturers recommended values, a significant reduction in ESD (p=0.02) of 38% and 33% for the pelvis and knee respectively was noted. Initial pathological analysis suggests that diagnostic efficacy at lower EI values may be projection-specific. Conclusion The data in this study emphasize the need for clinical centres to consider establishing their own EI guidelines, and not necessarily relying on manufacturers recommendations. Normal and abnormal images must be used in this process.

Study of vaporization of sodium metaborate by transpiration thermogravimetry and Knudsen effusion mass spectrometry.

PubMed

Narasimhan, T S Lakshmi; Viswanathan, R; Nalini, S

2011-11-17

The vaporization of solid sodium metaborate NaBO(2)(s) was studied by transpiration thermogravimetry (TTG) and Knudsen effusion mass spectrometry (KEMS). The transpiration measurements, performed for the first time on NaBO(2)(s), involved use of argon as the carrier gas for vapor transport and derivation of vapor pressure of NaBO(2)(g) (by assuming it as the sole vapor species) through many flow-dependence runs and temperature-dependence runs in the temperature range 1075-1218 K. The KEMS measurements performed in the temperature range 1060-1185 K confirmed NaBO(2)(g) as the principal vapor species over NaBO(2)(s), in accord with the previously reported KEMS studies. The values of p(NaBO(2)) obtained by both TTG and KEMS are consistent within the uncertainties associated with each method and so are the second- and third-law values of enthalpy of sublimation, the latter aspect consistently missing in all previous vaporization studies. The results of both TTG and KEMS were combined to recommend the following thermodynamic parameters pertinent to the sublimation reaction, NaBO(2)(s) = NaBO(2)(g): Log{p(NaBO(2))/Pa} = -(17056 ± 441)/(T/K) + (14.73 ± 0.35) for the temperature range 1060-1218 K; Δ(r)H°(m)(298.15 K) = (346.3 ± 9.4) kJ·mol(-1); and Δ(r)S°(m)(298.15 K) = (210.2 ± 6.8) J·mol(-1)·K(-1).

Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society.

PubMed

Galvagno, Samuel Michael; Smith, Charles E; Varon, Albert J; Hasenboehler, Erik A; Sultan, Shahnaz; Shaefer, Gregory; To, Kathleen B; Fox, Adam D; Alley, Darrell E R; Ditillo, Michael; Joseph, Bellal A; Robinson, Bryce R H; Haut, Elliot R

2016-11-01

Thoracic trauma is the second most prevalent nonintentional injury in the United States and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma. As a result, updated guidelines for this topic using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework recently adopted by EAST are presented. Five systematic reviews were conducted using multiple databases. The search retrieved articles regarding analgesia for blunt thoracic trauma from January1967 to August 2015. Critical outcomes of interest were analgesia, postoperative pulmonary complications, changes in pulmonary function tests, need for endotracheal intubation, and mortality. Important outcomes of interest examined included hospital and intensive care unit length of stay. Seventy articles were identified. Of these, 28 articles were selected to construct the guidelines. The overall risk of bias for all studies was high. The majority of included studies examined epidural analgesia. Epidural analgesia was associated with lower short-term pain scores in most studies, but the quality and quantity of evidence were very low, and no firm evidence of benefit or harm was found when this modality was compared with other analgesic interventions. The quality of evidence for paravertebral block, intrapleural analgesia, multimodal analgesia, and intercostal nerve blocks was very low as assessed by GRADE. The limitations with the available literature precluded the formulation of strong recommendations by our panel. We propose two evidence-based recommendations regarding analgesia for patients with blunt thoracic trauma. The overall risk of bias for all studies was high. The limitations with the available literature precluded the formulation of strong recommendations by our panel. We conditionally recommend epidural analgesia and multimodal analgesia as options for patients with blunt thoracic trauma, but the overall quality of evidence supporting these modalities is low in trauma patients. These recommendations are based on very low-quality evidence but place a high value on patient preferences for analgesia. These recommendations are in contradistinction to the previously published Practice Management Guideline published by EAST.

Critically Evaluated Energy Levels, Spectral Lines, Transition Probabilities, and Intensities of Singly Ionized Vanadium (V ii)

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

Saloman, Edward B.; Kramida, Alexander

2017-08-01

The energy levels, observed spectral lines, and transition probabilities of singly ionized vanadium, V ii, have been compiled. The experimentally derived energy levels belong to the configurations 3 d {sup 4}, 3 d {sup 3} ns ( n  = 4, 5, 6), 3 d {sup 3} np , and 3 d {sup 3} nd ( n  = 4, 5), 3 d {sup 3}4 f , 3 d {sup 2}4 s {sup 2}, and 3 d {sup 2}4 s 4 p . Also included are values for some forbidden lines that may be of interest to the astrophysical community. Experimental Landé g -factorsmore » and leading percentages for the levels are included when available, as well as Ritz wavelengths calculated from the energy levels. Wavelengths and transition probabilities are reported for 3568 and 1896 transitions, respectively. From the list of observed wavelengths, 407 energy levels are determined. The observed intensities, normalized to a common scale, are provided. From the newly optimized energy levels, a revised value for the ionization energy is derived, 118,030(60) cm{sup −1}, corresponding to 14.634(7) eV. This is 130 cm{sup −1} higher than the previously recommended value from Iglesias et al.« less

Influence of echo time in quantitative proton MR spectroscopy using LCModel.

PubMed

Yamamoto, Tetsuya; Isobe, Tomonori; Akutsu, Hiroyoshi; Masumoto, Tomohiko; Ando, Hiroki; Sato, Eisuke; Takada, Kenta; Anno, Izumi; Matsumura, Akira

2015-06-01

The objective of this study was to elucidate the influence on quantitative analysis using LCModel with the condition of echo time (TE) longer than the recommended values in the spectrum acquisition specifications. A 3T magnetic resonance system was used to perform proton magnetic resonance spectroscopy. The participants were 5 healthy volunteers and 11 patients with glioma. Data were collected at TE of 72, 144 and 288ms. LCModel was used to quantify several metabolites (N-acetylaspartate, creatine and phosphocreatine, and choline-containing compounds). The results were compared with quantitative values obtained by using the T2-corrected internal reference method. In healthy volunteers, when TE was long, the quantitative values obtained using LCModel were up to 6.8-fold larger (p<0.05) than those obtained using the T2-corrected internal reference method. The ratios of the quantitative values obtained by the two methods differed between metabolites (p<0.05). In patients with glioma, the ratios of quantitative values obtained by the two methods tended to be larger at longer TE, similarly to the case of healthy volunteers, and large between-individual variation in the ratios was observed. In clinical practice, TE is sometimes set longer than the value recommended for LCModel. If TE is long, LCModel overestimates the quantitative value since it cannot compensate for signal attenuation, and this effect is different for each metabolite and condition. Therefore, if TE is longer than recommended, it is necessary to account for the possibly reduced reliability of quantitative values calculated using LCModel. Copyright © 2015 Elsevier Inc. All rights reserved.

Effect of Age on Energy Requirement for Maintenance and Growth of Dorper and Hu Crossbred F1 Ewes Weighing 20 to 50 kg

PubMed Central

Nie, H. T.; Wan, Y. J.; You, J. H.; Wang, Z. Y.; Lan, S.; Fan, Y. X.; Wang, F.

2015-01-01

This research aimed to define the energy requirement of Dorper and Hu Hybrid F1 ewes 20 to 50 kg of body weight, furthermore to study energy requirement changes with age and evaluate the effect of age on energy requirement parameters. In comparative slaughter trial, thirty animals were divided into three dry matter intake treatments (ad libitum, n = 18; low restricted, n = 6; high restricted, n = 6), and were all slaughtered as baseline, intermediate, and final slaughter groups, to calculate body chemical components and energy retained. In digestibility trial, twelve ewes were housed in individual metabolic cages and randomly assigned to three feeding treatments in accordance with the design of a comparative slaughter trial, to evaluate dietary energetic values at different feed intake levels. The combined data indicated that, with increasing age, the net energy requirement for maintenance (NEm) decreased from 260.62±13.21 to 250.61±11.79 kJ/kg0.75 of shrunk body weight (SBW)/d, and metabolizable energy requirement for maintenance (MEm) decreased from 401.99±20.31 to 371.23±17.47 kJ/kg0.75 of SBW/d. Partial efficiency of ME utilization for maintenance (km, 0.65 vs 0.68) and growth (kg, 0.42 vs 0.41) did not differ (p>0.05) due to age; At the similar condition of average daily gain, net energy requirements for growth (NEg) and metabolizable energy requirements for growth (MEg) for ewes during late fattening period were 23% and 25% greater than corresponding values of ewes during early fattening period. In conclusion, the effect of age upon energy requirement parameters in the present study were similar in tendency with previous recommendations, values of energy requirement for growth (NEg and MEg) for Dorper and Hu crossbred female lambs ranged between the NRC (2007) recommendation for early and later maturating growing sheep. PMID:26104522

Increasing value and reducing waste in stroke research.

PubMed

Berge, Eivind; Al-Shahi Salman, Rustam; van der Worp, H Bart; Stapf, Christian; Sandercock, Peter; Sprigg, Nikola; Macleod, Malcolm R; Kelly, Peter J; Nederkoorn, Paul J; Ford, Gary A

2017-05-01

Stroke is a major burden to patients and society, and resources spent on stroke research must be used efficiently and produce good value in terms of improvements in human health. However, many instances of poor value from stroke research funding have resulted from the way in which stroke research topics have been chosen and how studies have been designed, conducted, analysed, regulated, managed, disseminated, or reported. A cooperative effort of European stroke researchers aimed to identify sources of inefficiency and waste, recommend approaches to increase value, and highlight examples of best practice in stroke research. Evidence suggests that progress has been made, but there is room for much improvement; researchers, funders, regulators, and other stakeholders in stroke research might consider these recommendations when planning new research. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of antihypertensives on kidney disease

PubMed Central

Marquez, Diego F; Ruiz-Hurtado, Gema; Ruilope, Luis

2017-01-01

Arterial hypertension and chronic kidney disease (CKD) are intimately related. The control of blood pressure (BP) levels is strongly recommended in patients with CKD in order to protect the kidney against the accompanying elevation in global cardiovascular (CV) risk. Actually, the goal BP in patients with CKD involves attaining values <140/90 mmHg except if albuminuria is present. In this case, it is often recommended to attain values <130/80 mmHg, although some guidelines still recommend <140/90 mmHg. Strict BP control to values of systolic BP around 120 mmHg was recently shown to be safe in CKD according to data from the SPRINT trial, albeit more data confirming this benefit are required. Usually, combination therapy initiated with an angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEi) and commonly followed by the addition of a calcium channel blocker and a diuretic is needed. Further studies are required as well as new drugs in particular after the positive data obtained from new oral anti-diabetic drugs. PMID:28529721

Consensus-based cross-European recommendations for the identification, measurement and valuation of costs in health economic evaluations: a European Delphi study.

PubMed

van Lier, Lisanne I; Bosmans, Judith E; van Hout, Hein P J; Mokkink, Lidwine B; van den Hout, Wilbert B; de Wit, G Ardine; Dirksen, Carmen D; Nies, Henk L G R; Hertogh, Cees M P M; van der Roest, Henriëtte G

2017-12-19

Differences between country-specific guidelines for economic evaluations complicate the execution of international economic evaluations. The aim of this study was to develop cross-European recommendations for the identification, measurement and valuation of resource use and lost productivity in economic evaluations using a Delphi procedure. A comprehensive literature search was conducted to identify European guidelines on the execution of economic evaluations or costing studies as part of economic evaluations. Guideline recommendations were extracted by two independent reviewers and formed the basis for the first round of the Delphi study, which was conducted among European health economic experts. During three written rounds, consensus (agreement of 67% or higher) was sought on items concerning the identification, measurement and valuation of costs. Recommendations from 18 guidelines were extracted. Consensus among 26 panellists from 17 European countries was reached on 61 of 68 items. The recommendations from the Delphi study are to adopt a societal perspective, to use patient report for measuring resource use and lost productivity, to value both constructs with use of country-specific standardized/unit costs and to use country-specific discounting rates. This study provides consensus-based cross-European recommendations on how to measure and value resource use and lost productivity in economic evaluations. These recommendations are expected to support researchers, healthcare professionals, and policymakers in executing and appraising economic evaluations performed in international contexts.

Academic Leadership Development: A Case Study.

PubMed

Berman, Audrey

2015-01-01

A dean at a private school of nursing implemented a leadership development program for early- to mid-career nursing faculty consisting of one 4-hour evening session per academic quarter for 7 quarters. Eight faculty members who had expressed interest in assuming a leadership role or been recommended by their supervisors as having strong leadership potential were invited to join. Program topics included leadership pathways, legal issues, budgeting and governance, diversity, the political arena, human resources, and student issues. Interviews with participants revealed 6 themes: the support a peer cohort provided, a desire for real-life application, a lack of previous exposure to related content or experiences, new perceptions of themselves as academic nurse leaders, the value of the program as preparation for academic nursing leadership roles, and broad program applicability. Copyright © 2015 Elsevier Inc. All rights reserved.

Half-life measurement of the medical radioisotope 177Lu produced from the 176Yb(n,γ) reaction

NASA Astrophysics Data System (ADS)

Ferreira, K. M.; Collins, S. M.; Fenwick, A. J.

2017-09-01

177Lu is a medium energy beta-emitter commonly used in Nuclear Medicine for radiotherapeutic applications. In this work, the half-life of 177Lu has been measured using a re-entrant ionisation chamber over a period of 82 days (approximately 12 half-lives). Unlike the majority of previous studies, the material used in this work was produced via the 176Yb(n,γ)177Yb reaction followed by the β-decay to 177Lu, producing insignificant quantities of 177mLu. This has resulted in the most precise half-life measurement of 177Lu to date. A half-life of 6.6430 (11) days has been determined. This value is in statistical agreement with the currently recommended half-life of 6.6463 (15) days (z-score = 1.8).

Comment on the International Atomic Energy Agency Report on the Advisory Group Meeting on Stable Isotope Reference Samples for Geochemical and Hydrological Investigation, Vienna, Austria, September 19-21, 1983

USGS Publications Warehouse

Coplen, T.B.; Friedman, Irving; O'Neil, J.R.

1984-01-01

According to U.S. Geological Survey records, a report prepared by R. Gonfiantini summarizing the findings and recommendations of the 1983 Advisory Group Meeting on Stable Isotope Reference Samples for Geochemical and Hydrologic Investigations held in Vienna does not accurately represent the consultants ' consensus on three important points. The consultants (1) recommended no value for the C02-H20 oxygen isotope fractionation factor, not the cited value of 1.04115, (2) adopted a value of 1.0309 rather than 1.03086 to relate the PDB and SMOW scales, and (3) adopted a firm 180 value of -2.20% for NBS-19 on the PDB scale rather than agreeing that this would be a tentative value subject to modification when more measurements in selected laboratories are available. (USGS)

Application of an automatic approach to calibrate the NEMURO nutrient-phytoplankton-zooplankton food web model in the Oyashio region

NASA Astrophysics Data System (ADS)

Ito, Shin-ichi; Yoshie, Naoki; Okunishi, Takeshi; Ono, Tsuneo; Okazaki, Yuji; Kuwata, Akira; Hashioka, Taketo; Rose, Kenneth A.; Megrey, Bernard A.; Kishi, Michio J.; Nakamachi, Miwa; Shimizu, Yugo; Kakehi, Shigeho; Saito, Hiroaki; Takahashi, Kazutaka; Tadokoro, Kazuaki; Kusaka, Akira; Kasai, Hiromi

2010-10-01

The Oyashio region in the western North Pacific supports high biological productivity and has been well monitored. We applied the NEMURO (North Pacific Ecosystem Model for Understanding Regional Oceanography) model to simulate the nutrients, phytoplankton, and zooplankton dynamics. Determination of parameters values is very important, yet ad hoc calibration methods are often used. We used the automatic calibration software PEST (model-independent Parameter ESTimation), which has been used previously with NEMURO but in a system without ontogenetic vertical migration of the large zooplankton functional group. Determining the performance of PEST with vertical migration, and obtaining a set of realistic parameter values for the Oyashio, will likely be useful in future applications of NEMURO. Five identical twin simulation experiments were performed with the one-box version of NEMURO. The experiments differed in whether monthly snapshot or averaged state variables were used, in whether state variables were model functional groups or were aggregated (total phytoplankton, small plus large zooplankton), and in whether vertical migration of large zooplankton was included or not. We then applied NEMURO to monthly climatological field data covering 1 year for the Oyashio, and compared model fits and parameter values between PEST-determined estimates and values used in previous applications to the Oyashio region that relied on ad hoc calibration. We substituted the PEST and ad hoc calibrated parameter values into a 3-D version of NEMURO for the western North Pacific, and compared the two sets of spatial maps of chlorophyll- a with satellite-derived data. The identical twin experiments demonstrated that PEST could recover the known model parameter values when vertical migration was included, and that over-fitting can occur as a result of slight differences in the values of the state variables. PEST recovered known parameter values when using monthly snapshots of aggregated state variables, but estimated a different set of parameters with monthly averaged values. Both sets of parameters resulted in good fits of the model to the simulated data. Disaggregating the variables provided to PEST into functional groups did not solve the over-fitting problem, and including vertical migration seemed to amplify the problem. When we used the climatological field data, simulated values with PEST-estimated parameters were closer to these field data than with the previously determined ad hoc set of parameter values. When these same PEST and ad hoc sets of parameter values were substituted into 3-D-NEMURO (without vertical migration), the PEST-estimated parameter values generated spatial maps that were similar to the satellite data for the Kuroshio Extension during January and March and for the subarctic ocean from May to November. With non-linear problems, such as vertical migration, PEST should be used with caution because parameter estimates can be sensitive to how the data are prepared and to the values used for the searching parameters of PEST. We recommend the usage of PEST, or other parameter optimization methods, to generate first-order parameter estimates for simulating specific systems and for insertion into 2-D and 3-D models. The parameter estimates that are generated are useful, and the inconsistencies between simulated values and the available field data provide valuable information on model behavior and the dynamics of the ecosystem.

NATIONAL CONFERENCE ON THE PREPARATION OF TEACHERS OF THE DEAF. (VIRGINIA BEACH, MARCH 15-19, 1964).

ERIC Educational Resources Information Center

QUIGLEY, STEPHEN P.

PARTICIPANTS IN THE FOUR-DAY NATIONAL CONFERENCE ON THE PREPARATION OF TEACHERS OF THE DEAF COMPILED RECOMMENDATIONS ABOUT TEACHER PREPARATION AFTER DISCUSSING FOUR MAJOR TOPIC AREAS. RECOMMENDATIONS ABOUT RECRUITMENT AND SELECTION OF STUDENTS INCLUDED RECRUITMENT OF TEACHERS, TIME OF ENTRY OF STUDENT INTO PROGRAM, PREVIOUS PREPARATION OF STUDENT,…

Improving information filtering via network manipulation

NASA Astrophysics Data System (ADS)

Zhang, Fuguo; Zeng, An

2012-12-01

The recommender system is a very promising way to address the problem of overabundant information for online users. Although the information filtering for the online commercial systems has received much attention recently, almost all of the previous works are dedicated to design new algorithms and consider the user-item bipartite networks as given and constant information. However, many problems for recommender systems such as the cold-start problem (i.e., low recommendation accuracy for the small-degree items) are actually due to the limitation of the underlying user-item bipartite networks. In this letter, we propose a strategy to enhance the performance of the already existing recommendation algorithms by directly manipulating the user-item bipartite networks, namely adding some virtual connections to the networks. Numerical analyses on two benchmark data sets, MovieLens and Netflix, show that our method can remarkably improves the recommendation performance. Specifically, it not only improves the recommendations accuracy (especially for the small-degree items), but also helps the recommender systems generate more diverse and novel recommendations.

Human Health Toxicity Values in Superfund Risk Assessments

EPA Pesticide Factsheets

This memorandum revises the hierarchy of human health toxicity values generally recommended for use inr isk assessments, originally presented in Risk Assessment Guidance for Superfund Volume I, Part A.

EURRECA: development of tools to improve the alignment of micronutrient recommendations.

PubMed

Matthys, C; Bucchini, L; Busstra, M C; Cavelaars, A E J M; Eleftheriou, P; Garcia-Alvarez, A; Fairweather-Tait, S; Gurinović, M; van Ommen, B; Contor, L

2010-11-01

Approaches through which reference values for micronutrients are derived, as well as the reference values themselves, vary considerably across countries. Harmonisation is needed to improve nutrition policy and public health strategies. The EURRECA (EURopean micronutrient RECommendations Aligned, http://www.eurreca.org) Network of Excellence is developing generic tools for systematically establishing and updating micronutrient reference values or recommendations. Different types of instruments (including best practice guidelines, interlinked web pages, online databases and decision trees) have been identified. The first set of instruments is for training purposes and includes mainly interactive digital learning materials. The second set of instruments comprises collection and interlinkage of diverse information sources that have widely varying contents and purposes. In general, these sources are collections of existing information. The purpose of the majority of these information sources is to provide guidance on best practice for use in a wider scientific community or for users and stakeholders of reference values. The third set of instruments includes decision trees and frameworks. The purpose of these tools is to guide non-scientists in decision making based on scientific evidence. This platform of instruments will, in particular in Central and Eastern European countries, contribute to future capacity-building development in nutrition. The use of these tools by the scientific community, the European Food Safety Authority, bodies responsible for setting national nutrient requirements and others should ultimately help to align nutrient-based recommendations across Europe. Therefore, EURRECA can contribute towards nutrition policy development and public health strategies.

The experiences of women, midwives and obstetricians when women decline recommended maternity care: A feminist thematic analysis.

PubMed

Jenkinson, Bec; Kruske, Sue; Kildea, Sue

2017-09-01

pregnant women, like all competent adults, have the right to refuse medical treatment, although concerns about maternal and fetal safety can make doing so problematic. Empirical research about refusal of recommended maternity care has mostly described the attitudes of clinicians, with women's perspectives notably absent. feminist thematic analysis of in-depth, semi-structured interviews with women's (n=9), midwives' (n=12) and obstetricians' (n=9) about their experiences of refusal of recommended maternity care. three major interrelated themes were identified. "Valuing the woman's journey", encapsulated care experiences that women valued and clinicians espoused, while "The clinician's line in the sand" reflected the bounded nature of support for maternal autonomy. When women's birth intentions were perceived by clinicians to transgress their line in the sand, a range of strategies were reportedly used to convince the woman to accept recommended care. These strategies formed a pattern of "Escalating intrusion". declining recommended care situated women at the intersection of two powerful normative discourses: medical dominance and the patriarchal institution of motherhood. Significant pressures on women's autonomy resulted from an apparent gap between clinicians' espoused and reported practices. Implications for policy and practice include a need for specific guidance for clinicians providing care in situations of maternal refusal, the potential value of an independent third-party for advice and advocacy, and the development of models that support reflexive practice amongst clinicians. Copyright © 2017 Elsevier Ltd. All rights reserved.

AME position statement on adrenal incidentaloma.

PubMed

Terzolo, M; Stigliano, A; Chiodini, I; Loli, P; Furlani, L; Arnaldi, G; Reimondo, G; Pia, A; Toscano, V; Zini, M; Borretta, G; Papini, E; Garofalo, P; Allolio, B; Dupas, B; Mantero, F; Tabarin, A

2011-06-01

To assess currently available evidence on adrenal incidentaloma and provide recommendations for clinical practice. A panel of experts (appointed by the Italian Association of Clinical Endocrinologists (AME)) appraised the methodological quality of the relevant studies, summarized their results, and discussed the evidence reports to find consensus. Unenhanced computed tomography (CT) is recommended as the initial test with the use of an attenuation value of ≤10 Hounsfield units (HU) to differentiate between adenomas and non-adenomas. For tumors with a higher baseline attenuation value, we suggest considering delayed contrast-enhanced CT studies. Positron emission tomography (PET) or PET/CT should be considered when CT is inconclusive, whereas fine needle aspiration biopsy may be used only in selected cases suspicious of metastases (after biochemical exclusion of pheochromocytoma). HORMONAL ASSESSMENT: Pheochromocytoma and excessive overt cortisol should be ruled out in all patients, whereas primary aldosteronism has to be considered in hypertensive and/or hypokalemic patients. The 1 mg overnight dexamethasone suppression test is the test recommended for screening of subclinical Cushing's syndrome (SCS) with a threshold at 138 nmol/l for considering this condition. A value of 50 nmol/l virtually excludes SCS with an area of uncertainty between 50 and 138 nmol/l. Surgery is recommended for masses with suspicious radiological aspects and masses causing overt catecholamine or steroid excess. Data are insufficient to make firm recommendations for or against surgery in patients with SCS. However, adrenalectomy may be considered when an adequate medical therapy does not reach the treatment goals of associated diseases potentially linked to hypercortisolism.

The cost-utility of photodynamic therapy in eyes with neovascular macular degeneration--a value-based reappraisal with 5-year data.

PubMed

Brown, Gary C; Brown, Melissa M; Campanella, Joseph; Beauchamp, George R

2005-10-01

To assess the value conferred by photodynamic therapy (PDT) and the cost-utility of PDT for the treatment of classic, subfoveal choroidal neovascularization associated with age-related macular degeneration (ARMD). Average cost-utility analysis utilizing clinical trial data, patient-based time tradeoff utility preferences, and a third party insurer cost perspective. Five-year visual acuity data from the TAP (Treatment of Age-related Macular Degeneration With Photodynamic Therapy) Investigation were modeled into a 12-year, value-based, reference case, cost-utility model utilizing year 2004 Medicare costs and an outcome of dollar/QALY (dollars/quality-adjusted life-year). Discounting of outcomes and costs using net present value analysis with a 3% annual rate was performed as recommended by the Panel for Cost-Effectiveness in Health and Medicine. PDT with verteporfin (Visudyne) dye for classic subfoveal choroidal neovascularization confers an 8.1% quality of life (value) improvement over the 12-year life expectancy of the reference case, while during the last 8 years the value improvement is 9.5%. The average cost-utility of the intervention is dollar 31,103/QALY (quality-adjusted life-year). Extensive one-way sensitivity analysis values range from dollar 20,736/QALY if treatment efficacy is increased by 50% to dollar 62,207 if treatment efficacy is decreased by 50%, indicating robustness of the model. PDT using verteporfin dye to treat classic subfoveal choroidal neovascularization is a very cost-effective treatment by conventional standards. The marked improvement in cost-effectiveness compared with a previous report results from the facts that the treatment benefit increasingly accrues during 5 years of follow-up while the number of yearly treatments diminishes markedly during that time.

Use of Simpson's method of disc to detect early echocardiographic changes in Doberman Pinschers with dilated cardiomyopathy.

PubMed

Wess, G; Mäurer, J; Simak, J; Hartmann, K

2010-01-01

M-mode is the echocardiographic gold standard to diagnose dilated cardiomyopathy (DCM) in dogs, whereas Simpson's method of discs (SMOD) is the preferred method to detect echocardiographic evidence of disease in humans. To establish reference values for SMOD and to compare those with M-mode measurements. Nine hundred and sixty-nine examinations of 471 Doberman Pinschers. Using a prospective longitudinal study design. Reference values for SMOD were established using 75 healthy Doberman Pinschers >8 years old with <50 ventricular premature contractions (VPCs) in 24 hours. The ability of the new SMOD cut-off values, normalized to body surface area (BSA), for left ventricular end-diastolic volume (LVEDV/BSA >95mL/m(2) ) and end-systolic volume (LVESV/BSA > 55mL/m(2) ) to detect echocardiographic changes in Doberman Pinschers with DCM was compared with currently recommended M-mode values. Dogs with elevated SMOD values but normal M-mode measurements were followed-up using a prospective longitudinal study design. At the final examination 175 dogs were diagnosed with DCM according to both methods (M-mode and SMOD). At previous examinations, M-mode values were abnormal in 142 examinations only, whereas all 175 SMOD already had detected changes. Additionally, 19 of 154 dogs with >100 VPCs/24 hours and normal M-mode values had abnormal SMOD measurement. Six dogs with increased SMOD measurements remained healthy at several follow-up examinations (classified as false positive); in 24 dogs with increased SMOD measurements, no follow-up examinations were available (classified as unclear). SMOD measurements are superior to M-mode to detect early echocardiographic changes in Dobermans with occult DCM. Copyright © 2010 by the American College of Veterinary Internal Medicine.

Screening breast magnetic resonance imaging in women with atypia or lobular carcinoma in situ.

PubMed

Schwartz, Theresa; Cyr, Amy; Margenthaler, Julie

2015-02-01

Atypical lesions and lobular carcinoma in situ (LCIS) are associated with an increased risk of breast malignancy. The utility of breast magnetic resonance imaging (MRI) screening in this cohort of women after excision of a high-risk lesion has not been previously established. The objective of this study was to investigate outcomes of breast MRI surveillance in this subgroup of high-risk patients. We performed a retrospective review of women who required excision of an atypical lesion or LCIS who underwent at least one screening breast MRI from April 2005-December 2011. We collected information on demographics, number of second-look imaging studies recommended, number of biopsies performed and pathologic outcomes. A total of 179 patients met the inclusion criteria, including 131 (73%) with atypical lesions and 48 (27%) with LCIS. Second-look imaging was recommended for 31 of 131 (23.7%) patients with atypical lesions and 8 of 48 (16.7%) with LCIS. Ten biopsies were performed in the atypical cohort (7.6%) with two revealing a malignancy (Positive Predictive Value [PPV] of 20%). In the LCIS cohort, five biopsies were performed (10.4%) with one revealing a malignancy (PPV of 20%). The benefit of breast MRI surveillance in patients after excision of atypical lesions or LCIS has not been clearly delineated previously. Our data demonstrate that the use of screening breast MRI in this cohort results in additional work-up in one-fifth of patients, but a PPV of only 20%. Large, prospective studies would be needed to determine whether breast cancer outcomes differ between patients undergoing conventional breast screening and those undergoing conventional breast screening plus breast MRI surveillance. Copyright © 2015 Elsevier Inc. All rights reserved.

Risks and Recommendations in Prenatally Detected De Novo Balanced Chromosomal Rearrangements from Assessment of Long-Term Outcomes.

PubMed

Halgren, Christina; Nielsen, Nete M; Nazaryan-Petersen, Lusine; Silahtaroglu, Asli; Collins, Ryan L; Lowther, Chelsea; Kjaergaard, Susanne; Frisch, Morten; Kirchhoff, Maria; Brøndum-Nielsen, Karen; Lind-Thomsen, Allan; Mang, Yuan; El-Schich, Zahra; Boring, Claire A; Mehrjouy, Mana M; Jensen, Peter K A; Fagerberg, Christina; Krogh, Lotte N; Hansen, Jan; Bryndorf, Thue; Hansen, Claus; Talkowski, Michael E; Bak, Mads; Tommerup, Niels; Bache, Iben

2018-06-07

The 6%-9% risk of an untoward outcome previously established by Warburton for prenatally detected de novo balanced chromosomal rearrangements (BCRs) does not account for long-term morbidity. We performed long-term follow-up (mean 17 years) of a registry-based nationwide cohort of 41 individuals carrying a prenatally detected de novo BCR with normal first trimester screening/ultrasound scan. We observed a significantly higher frequency of neurodevelopmental and/or neuropsychiatric disorders than in a matched control group (19.5% versus 8.3%, p = 0.04), which was increased to 26.8% upon clinical follow-up. Chromosomal microarray of 32 carriers revealed no pathogenic imbalances, illustrating a low prognostic value when fetal ultrasound scan is normal. In contrast, mate-pair sequencing revealed disrupted genes (ARID1B, NPAS3, CELF4), regulatory domains of known developmental genes (ZEB2, HOXC), and complex BCRs associated with adverse outcomes. Seven unmappable autosomal-autosomal BCRs with breakpoints involving pericentromeric/heterochromatic regions may represent a low-risk group. We performed independent phenotype-aware and blinded interpretation, which accurately predicted benign outcomes (specificity = 100%) but demonstrated relatively low sensitivity for prediction of the clinical outcome in affected carriers (sensitivity = 45%-55%). This sensitivity emphasizes the challenges associated with prenatal risk prediction for long-term morbidity in the absence of phenotypic data given the still immature annotation of the morbidity genome and poorly understood long-range regulatory mechanisms. In conclusion, we upwardly revise the previous estimates of Warburton to a morbidity risk of 27% and recommend sequencing of the chromosomal breakpoints as the first-tier diagnostic test in pregnancies with a de novo BCR. Copyright © 2018 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Preventive eye care in people with diabetes is cost-saving to the federal government. Implications for health-care reform.

PubMed

Javitt, J C; Aiello, L P; Chiang, Y; Ferris, F L; Canner, J K; Greenfield, S

1994-08-01

Diabetic retinopathy, which leads to macular edema and retinal neovascularization, is the leading cause of blindness among working-age Americans. Previous research has demonstrated significant cost savings associated with detection of eye disease in Americans with type I diabetes. However, detection and treatment of eye disease among those with type II diabetes was previously thought not to be cost-saving. Our purpose was to estimate the current and potential federal savings resulting from the screening and treatment of retinopathy in patients with type II diabetes, based on recently available data concerning efficacy of treating both macular edema and neovascularization along with new data on federal budgetary costs of blindness. We used computer modeling, incorporating data from population-based epidemiological studies and multicenter clinical trials. Monte Carlo simulation was used, combined with sensitivity analysis and present value analysis of cost savings. Screening and treatment for eye disease in patients with type II diabetes generates annual savings of $247.9 million to the federal budget and 53,986 person-years of sight, even at current suboptimal (60%) levels of care. If all patients with type II diabetes receive recommended care, the predicted net savings (discounted at 5%) exceeds $472.1 million and 94,304 person-years of sight. Nearly all savings are associated with detection and treatment of diabetic macular edema. Enrolling each additional person with type II diabetes into currently recommended ophthalmological care results in an average net savings of $975/person, even if all costs of care are borne by the federal government. Our analysis indicates that prevention programs aimed at improving eye care for patients with diabetes not only reduce needless vision loss but also will provide a financial return on the investment of public funds.

Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease.

PubMed

Cheung, Gary; Patrick, Colin; Sullivan, Glenda; Cooray, Manisha; Chang, Catherina L

2012-01-01

Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population. Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale. Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%. Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

Technology assessment of future intercity passenger transportation systems. Volume 7: Study recommendations

NASA Technical Reports Server (NTRS)

1976-01-01

Research and analysis tasks to alleviate negative impacts, to augment positive impacts, or to better understand the impacts produced by the potential introduction of the alternate transportation technologies are identified. The project team's recommendations on research and analysis efforts which have resulted from the technology assessment are provided. Many of the recommendations apply to the future supply of intercity passenger transportation services, categorized by mode. Other recommendations pertain to broad issues in intercity transportation--e.g., finance, regulation, traveler values--that will affect all modes.

Prevalence of abnormal findings when adopting new national and international Global Lung Function Initiative reference values for spirometry in the Finnish general population

PubMed Central

Kainu, Annette; Lindqvist, Ari; Sovijärvi, Anssi R. A.

2016-01-01

Background New Finnish (Kainu2015) and international Global Lung Function Initiative (GLI2012) reference values for spirometry were recently published. The aim of this study is to compare the interpretative consequences of adopting these new reference values with older, currently used Finnish reference values (Viljanen1982) in the general population of native Finns. Methods Two Finnish general population samples including 1,328 adults (45% males) aged 21–74 years were evaluated. Airway obstruction was defined as a reduced ratio of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), possible restrictive pattern as reduced FVC, and decreased ventilatory capacity as reduced FEV1 below their respective 2.5th percentiles. The severity gradings of reduced lung function were also compared. Results Using the Kainu2015 reference values, the prevalence of airway obstruction in the population was 5.6%; using GLI2012 it was 4.0% and with Viljanen1982 it was 13.0%. Possible restrictive pattern was found in 4.2% using the Kainu2015 values, in 2.0% with GLI2012, and 7.9% with the Viljanen1982 values. The prevalence of decreased ventilatory capacity was 6.8, 4.0, and 13.3% with the Kainu2015, GLI2012 and Viljanen1982 values, respectively. Conclusions The application of the GLI2012 reference values underestimates the prevalence of abnormal spirometric findings in native Finns. The adoption of the Kainu2015 reference values reduces the prevalences of airways obstruction, decreased ventilatory capacity, and restrictive impairment by approximately 50%. Changing from the 2.5th percentile, the previously used lower limit of normal, to the 5th percentile recommended by the American Thoracic Society/European Respiratory Society will not increase the prevalence of abnormal findings in the implementation of spirometry reference values. PMID:27608270

Tinkering around the Edges?

ERIC Educational Resources Information Center

Meyer, Luanna H.

1997-01-01

This article comments on recommended changes to the Individuals with Disabilities Education Act (IDEA) included in "Perspectives on the Future of the IDEA" (Hardman and others), and makes alternative recommendations that focus upon building the capacities of schools to support all children as active participants and valued members of…

40 CFR 90.703 - Production line testing by the manufacturer.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Manufacturers of small SI engines shall test production line engines from each engine family according to the... recommended to the ultimate purchaser, unless otherwise specified by the Administrator. The Administrator may specify values within or without the range recommended to the ultimate purchaser. ...

Weathering effects on fuel moisture sticks: corrections and recommendations.

Treesearch

Donald A. Haines; John S. Frost

1978-01-01

Describes response to weathering of 100-gram (1/2-inch) fuel moisture sticks over 6-month fire season in the Northeast. Presents a chart for correcting weathered-stick values and gives replacement recommendations for those sticks used in the National Fire Danger Rating System.

Contribution made by biomarkers of status to an FP6 Network of Excellence, EURopean micronutrient RECommendations Aligned (EURRECA).

PubMed

Fairweather-Tait, Susan J

2011-08-01

Dietary reference values for micronutrients vary considerably among countries, and harmonization is needed to facilitate nutrition policy and public health strategies at the European and global levels. The EURopean micronutrient RECommendations Aligned (EURRECA) Network of Excellence is developing generic instruments for systematically deriving and updating micronutrient reference values and dietary recommendations. These include best practice guidelines, interlinked web pages, online databases, and decision trees. Journal supplements have been published on micronutrient intakes and status, and an ongoing activity of EURRECA is the completion of systematic reviews on associations between intakes, status, and various health outcomes for priority micronutrients (ie, iron, zinc, folate, vitamin B-12, and iodine), which were selected by using a triage technique. Future activities include meta-analyses to identify dose-response relations and the variability, factorial estimates of requirements, bioavailability from whole diets, effects of genotype, and modeling techniques for addressing dietary recommendations for combinations of nutrients with common health endpoints.

Comparison of therapy augmentation and deviation rates from the recommended once-daily dosing regimen between LDX and commonly prescribed long-acting stimulants for the treatment of ADHD in youth and adults.

PubMed

Setyawan, Juliana; Hodgkins, Paul; Guérin, Annie; Gauthier, Geneviève; Cloutier, Martin; Wu, Eric; Erder, M Haim

2013-10-01

To compare therapy augmentation and deviation rates from the recommended once-daily dosing regimen in Attention Deficit Hyperactivity Disorder (ADHD) patients initiated on lisdexamfetamine (LDX) vs other once-daily Food and Drug Administration (FDA) approved stimulants. ADHD patients initiated on a long-acting ADHD stimulant medication (index medication) in/after 2007 were selected from a large U.S. administrative claims database. Patients were required to be persistent for ≥90 days and continuously enrolled in their healthcare plan for ≥12 months following treatment initiation date. Based on age and previous treatment status, patients were classified into treatment-naïve children and adolescents (6-17 years old), previously treated children and adolescents, treatment-naïve adults (≥18 years old), and previously treated adults. Furthermore, patients were classified into four mutually exclusive treatment groups, based on index medication: lisdexamfetamine (LDX), osmotic release methylphenidate hydrochloride long-acting (OROS MPH), other methylphenidate/dexmethylphenidate long-acting (MPH LA), and amphetamine/dextroamphetamine long-acting (AMPH LA). The average daily consumption was measured as the quantity of index medication supplied in the 12-month study period divided by the total number of days of supply. Therapy augmentation was defined as the use of another ADHD medication concomitantly with the index medication for ≥28 consecutive days. Therapy augmentation and deviation rates from the recommended once-daily dosing regimen were compared between treatment groups using multivariate logistic regression models. Compared to the other treatment groups, LDX patients were less likely to augment with another ADHD medication (range odds ratios [OR]; 1.28-3.30) and to deviate from the recommended once-daily dosing regimen (range OR; 1.73-4.55), except for previously treated adult patients, where therapy augmentation differences were not statistically significant when compared to OROS MPH and MPH LA patients. This study did not control for ADHD severity. Overall, compared to LDX-treated patients, patients initiated on other ADHD medications were equally or more likely to have a therapy augmentation and more likely to deviate from the recommended once-daily dosing regimen.

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

Hund, Gretchen; Kurzrok, Andrew J.

This paper investigates nonproliferation as a potential corporate sustainability value. It reviews the history of corporate sustainability, builds the case for nonproliferation as a sustainability value, and develops recommendations for the integration of nonproliferation into the frameworks of sustainability.

Appropriate indices for color rendition and their recommended values for UHDTV production using white LED lighting.

PubMed

Hayashida, Tetsuya; Iwasaki, Hiroaki; Masaoka, Kenichiro; Shimizu, Masanori; Yamashita, Takayuki; Iwai, Wataru

2017-06-26

We selected appropriate indices for color rendition and determined their recommended values for ultra-high-definition television (UHDTV) production using white LED lighting. Since the spectral sensitivities of UHDTV cameras can be designed to approximate the ideal spectral sensitivities of UHDTV colorimetry, they have more accurate color reproduction than HDTV cameras, and thus the color-rendering properties of the lighting are critical. Comparing images taken under white LEDs with conventional color rendering indices (R a , R 9-14 ) and recently proposed methods for evaluating color rendition of CQS, TM-30, Q a , and SSI, we found the combination of R a and R 9 appropriate. For white LED lighting, R a ≥ 90 and R 9 ≥ 80 are recommended for UHDTV production.

Automatic stress-relieving music recommendation system based on photoplethysmography-derived heart rate variability analysis.

PubMed

Shin, Il-Hyung; Cha, Jaepyeong; Cheon, Gyeong Woo; Lee, Choonghee; Lee, Seung Yup; Yoon, Hyung-Jin; Kim, Hee Chan

2014-01-01

This paper presents an automatic stress-relieving music recommendation system (ASMRS) for individual music listeners. The ASMRS uses a portable, wireless photoplethysmography module with a finger-type sensor, and a program that translates heartbeat signals from the sensor to the stress index. The sympathovagal balance index (SVI) was calculated from heart rate variability to assess the user's stress levels while listening to music. Twenty-two healthy volunteers participated in the experiment. The results have shown that the participants' SVI values are highly correlated with their prespecified music preferences. The sensitivity and specificity of the favorable music classification also improved as the number of music repetitions increased to 20 times. Based on the SVI values, the system automatically recommends favorable music lists to relieve stress for individuals.

Body composition and physical fitness in women with bulimia nervosa or binge‐eating disorder

PubMed Central

Rosenvinge, Jan H.; Friborg, Oddgeir; Pettersen, Gunn; Stensrud, Trine; Hansen, Bjørge Herman; Underhaug, Karoline E.; Teinung, Elisabeth; Vrabel, KariAnne; Svendsen, Mette; Bratland‐Sanda, Solfrid; Sundgot‐Borgen, Jorunn

2018-01-01

Abstract Objective Knowledge about physical fitness in women with bulimia nervosa (BN) or binge‐eating disorder (BED) is sparse. Previous studies have measured physical activity largely through self‐report, and physical fitness variables are mainly restricted to body mass index (BMI) and bone mineral density. We expanded the current knowledge in these groups by including a wider range of physical fitness indicators and objective measures of physical activity, assessed the influence of a history of anorexia nervosa (AN), and evaluated predictive variables for physical fitness. Method Physical activity, blood pressure, cardiorespiratory fitness (CRF), muscle strength, body composition, and bone mineral density were measured in 156 women with BN or BED, with mean (SD) age 28.4 years (5.7) and BMI 25.3 (4.8) kg m−2. Results Level of physical activity was higher than normative levels, still <50% met the official physical activity recommendation. Fitness in women with BN were on an average comparable with recommendations or normative levels, while women with BED had lower CRF and higher BMI, VAT, and body fat percentage. We found 10–12% with masked obesity. A history of AN did not predict current physical fitness, still values for current body composition were lower when comparing those with history of AN to those with no such history. Discussion Overall, participants with BN or BED displayed adequate physical fitness; however, a high number had unfavorable CRF and body composition. This finding calls for inclusion of physical fitness in routine clinical examinations and guided physical activity and dietary recommendations in the treatment of BN and BED. PMID:29473191

Nursing lives in the blogosphere: A thematic analysis of anonymous online nursing narratives.

PubMed

Castro, Aimee; Andrews, Gavin

2018-02-01

The aim of this study was to explore the work-life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. Many nurses participate on social media. Blogs have been advocated as a self-reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses' individual blogs for their potential to reveal nurses' perceptions of nursing work. The research design was qualitative description. Between May-August 2015, Internet search engines were used to discover lists of nursing blogs recommended by organizations representing nurses' interests. Recommended blogs were purposively sampled. Four anonymous blogs written by nurses from different nursing specialties met the sampling criteria. All 520 of their entries from 2014 were read and copied into NVivo 10, where an inductive coding process was followed. Three major themes arose in these nurses' online discussions of their work lives: they truly care about and value their nursing work, but they are feeling stressed and burnt out and they are using their anonymous blogs to share factors that frustrate them in their nursing work. Three main areas of frustration were revealed: teamwork problems, challenging patients and families, and management issues. Anonymous nursing blogs offer valuable, longitudinal insights into nurses' perceptions of their work lives. Nursing blogs should be further explored for ongoing insights into nurses' experiences of nursing work, as well as nurses' recommendations for addressing issues causing them to feel frustrated in their work environments. © 2017 John Wiley & Sons Ltd.

The Insertion and Management of External Ventricular Drains: An Evidence-Based Consensus Statement : A Statement for Healthcare Professionals from the Neurocritical Care Society.

PubMed

Fried, Herbert I; Nathan, Barnett R; Rowe, A Shaun; Zabramski, Joseph M; Andaluz, Norberto; Bhimraj, Adarsh; Guanci, Mary McKenna; Seder, David B; Singh, Jeffrey M

2016-02-01

External ventricular drains (EVDs) are commonly placed to monitor intracranial pressure and manage acute hydrocephalus in patients with a variety of intracranial pathologies. The indications for EVD insertion and their efficacy in the management of these various conditions have been previously addressed in guidelines published by the Brain Trauma Foundation, American Heart Association and combined committees of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. While it is well recognized that placement of an EVD may be a lifesaving intervention, the benefits can be offset by procedural and catheter-related complications, such as hemorrhage along the catheter tract, catheter malposition, and CSF infection. Despite their widespread use, there are a lack of high-quality data regarding the best methods for placement and management of EVDs to minimize these risks. Existing recommendations are frequently based on observational data from a single center and may be biased to the authors' view. To address the need for a comprehensive set of evidence-based guidelines for EVD management, the Neurocritical Care Society organized a committee of experts in the fields of neurosurgery, neurology, neuroinfectious disease, critical care, pharmacotherapy, and nursing. The Committee generated clinical questions relevant to EVD placement and management. They developed recommendations based on a thorough literature review using the Grading of Recommendations Assessment, Development, and Evaluation system, with emphasis placed not only on the quality of the evidence, but also on the balance of benefits versus risks, patient values and preferences, and resource considerations.

Working plan for the use of patient-reported outcome measures in adults with brain tumours: a Response Assessment in Neuro-Oncology (RANO) initiative.

PubMed

Dirven, Linda; Armstrong, Terri S; Blakeley, Jaishri O; Brown, Paul D; Grant, Robin; Jalali, Rakesh; Leeper, Heather; Mendoza, Tito; Nayak, Lakshmi; Reijneveld, Jaap C; Le Rhun, Emilie; Walbert, Tobias; Weller, Michael; Wen, Patrick Y; Taphoorn, Martin J B

2018-03-01

The Response Assessment in Neuro-Oncology-Patient-Reported Outcome (RANO-PRO) working group is an international multidisciplinary collaboration that provides guidance on the use of patient-reported outcome (PRO) measures in clinical trials and practice for adult patients with brain tumours. Findings from both PROs and traditional outcome measures, such as survival, and clinical or radiological response, are essential to inform the research community, policy makers, physicians, and patients in the treatment decision-making process. Previous initiatives in oncology have focused on guidelines concerning the collection, analysis, interpretation, and reporting of PRO data. However, we recommend the application of appropriate PRO instruments, with respect to its content and measurement properties (ie, research question, content validity, and other measurement properties), in brain tumour research. PROs should be well defined and reliable to generate high-quality evidence, and our recommendations on the use of specific PRO measures could help to improve the quality of PRO evidence derived from neuro-oncological studies, and might add a new dimension in how the value of therapeutics is assessed in patients with brain tumours. In this Policy Review, we present the RANO-PRO working plan for the use of PROs in adults with brain tumours. Copyright © 2018 Elsevier Ltd. All rights reserved.

Potential for Rabies Control through Dog Vaccination in Wildlife-Abundant Communities of Tanzania

PubMed Central

Fitzpatrick, Meagan C.; Hampson, Katie; Cleaveland, Sarah; Meyers, Lauren Ancel; Townsend, Jeffrey P.; Galvani, Alison P.

2012-01-01

Canine vaccination has been successful in controlling rabies in diverse settings worldwide. However, concerns remain that coverage levels which have previously been sufficient might be insufficient in systems where transmission occurs both between and within populations of domestic dogs and other carnivores. To evaluate the effectiveness of vaccination targeted at domestic dogs when wildlife also contributes to transmission, we applied a next-generation matrix model based on contract tracing data from the Ngorongoro and Serengeti Districts in northwest Tanzania. We calculated corresponding values of R 0, and determined, for policy purposes, the probabilities that various annual vaccination targets would control the disease, taking into account the empirical uncertainty in our field data. We found that transition rate estimates and corresponding probabilities of vaccination-based control indicate that rabies transmission in this region is driven by transmission within domestic dogs. Different patterns of rabies transmission between the two districts exist, with wildlife playing a more important part in Ngorongoro and leading to higher recommended coverage levels in that district. Nonetheless, our findings indicate that an annual dog vaccination campaign achieving the WHO-recommended target of 70% will control rabies in both districts with a high level of certainty. Our results support the feasibility of controlling rabies in Tanzania through dog vaccination. PMID:22928056

Actions and beliefs related to hepatitis B and influenza immunization among registered nurses in Texas.

PubMed

McEwen, Melanie; Farren, Elizabeth

2005-01-01

Studies indicate that roughly half of health care workers are not immunized against hepatitis B and influenza. Findings from a survey of 1,000 registered nurses (RNs) conducted to analyze their beliefs and actions related to immunization recommendations are reported. Only 8% of the responding RNs chose not to receive vaccination against hepatitis B. The primary reasons that nurses declined hepatitis B vaccination were because they were not working in nursing or did not believe they were at risk of exposure. Similarly, 86% of the RNs reported they had ever received a flu shot, and 69% reported of being immunized during 2 of the previous 4 years. Rationale for receiving immunization included belief in its effectiveness, belief that they were at risk of exposure, and that it was provided free of charge. Reasons for declining included concerns about side effects, lack of concern about getting the illness, and doubts about effectiveness. The nurses who responded to the survey appear to value immunizations and generally adhere to immunization recommendations. Further study needs to be conducted on related issues, including follow-up for assessment of long-term protection of hepatitis B immunization and adherence to guidelines for postexposure prophylaxis. Ongoing monitoring and further study of serious complications of hepatitis B immunizations are also needed.

Experimental research on safety impacts of the inside shoulder based on driving simulation.

PubMed

Zhao, Xiaohua; Ding, Han; Wu, Yiping; Ma, Jianming; Zhong, Liande

2015-03-01

Statistical data shows that single-vehicle crashes account for half of all traffic crashes on expressways in China, and previous research has indicated that main contributing factors were related to whether and how the inside shoulder was paved. The inside shoulder provides space for drivers to make evasive maneuvers and accommodate driver errors. However, lower-cost construction solutions in China have resulted in the design of numerous urban expressway segments that lack inside shoulders. This paper has two objectives. The first is to reveal the safety impacts of inside shoulders on urban expressways by driving simulator experiment. The second objective is to propose optimal range and recommended value of inside shoulder width for designing inside shoulders of urban expressways. The empirical data, including subjects' eye movement data, heart rate (HR) and the lateral position of vehicles, were collected in a driving simulator. The data were analyzed to evaluate the safety impacts of the inside shoulder. The results have revealed that the inside shoulder has an impact on drivers' visual perception, behaviors, and psychology; in particular, it has a significant effect on vehicle operations. In addition, this paper recommends the desired and optimal inside shoulder widths for eight-lane, two-way divided expressways. Copyright © 2014 Elsevier Ltd. All rights reserved.

Analysis of Convective Weather Impact on Pre-Departure Routing of Flights from Fort Worth Center to New York Center

NASA Technical Reports Server (NTRS)

Arneson, Heather; Bombelli, Alessandro; Segarra-Torne, Adria; Tse, Elmer

2017-01-01

In response to severe weather conditions, Traffic Managers specify flow constraints and reroutes to route air traffic around affected regions of airspace. Providing analysis and recommendations of available reroute options and associated airspace capacities would assist Traffic Managers in making more efficient decisions in response to convective weather. These recommendations can be developed by examining historical data to determine which previous reroute options were used in similar weather and traffic conditions. This paper describes the initial steps and methodology used towards this goal. The focus of this work is flights departing from Fort Worth Center destined for New York Center. Dominant routing structures used in the absence of convective weather are identified. A method to extract relevant features from the large volume of weather data available to quantify the impact of convective weather on this routing structure over a given time range is presented. Finally, a method of estimating flow rate capacity along commonly used routes during convective weather events is described. Results show that the flow rates drop exponentially as a function of the values of the proposed feature and that convective weather on the final third of the route was found to have a greater impact on the flow rate restriction than other portions of the route.

The Schmidt hammer as a relative-age dating tool and its potential for calibrated-age dating in Holocene glaciated environments

NASA Astrophysics Data System (ADS)

Shakesby, Richard A.; Matthews, John A.; Owen, Geraint

2006-11-01

The Schmidt hammer is a relatively cheap, portable, sturdy instrument with proven value over the last two decades or so in rapidly dating coarse inorganic deposits of diverse origins. Early views were that its dating role was limited to distinguishing recently exposed from much older. Typically, either a few sites of possibly different ages or occasional older surfaces amongst many young sites were studied. More recently, calibration curves based on individual R-value means from small numbers (2-4) of sites of known ages have been used to estimate the ages of undated sites. We present Schmidt hammer rebound ( R-) values from 28 'Little Ice Age' (and younger), 23 Preboreal and 7 Younger Dryas glaciated surfaces in southern Norway in order, first, to test rigorously the robustness of the instrument as a relative-age dating tool. Despite being obtained from different surfaces (moraines, glaciofluvial deposits and bedrock) and varied metamorphic lithologies, the R-value overall means and 95% confidence intervals for the 'Little Ice Age', Preboreal and Younger Dryas age categories (respectively, 60.0±1.6, 41.6±1.4 and 34.2±2.0) are statistically significantly different. Only two outlying sites in the two younger age categories have overlapping confidence intervals, demonstrating remarkable robustness in differentiating early- and late-Holocene surfaces. The distinction between Preboreal and Younger Dryas sites (with terminal dates <2000 years apart) is less clear but still statistically significant, though possibly partly because of enhanced weathering conditions at the predominantly well vegetated Younger Dryas sites. Second, we examine the feasibility and desirability of controlling non-age-related factors, including some previously considered critical (instrument wear, operator bias, initial rock surface texture), which emerge either as less important than previously argued or as relatively unimportant, together with others previously unreported (e.g. long-term changes in lichen, soil, snow and vegetation covers). Third, we investigate the potential for calibrated-age dating by applying exploratory, linear rates of R-value decline to selected combinations of sites. The results suggest that error limits of ca ±700 to ±1600 years should be achievable over the Holocene timescale. This improved dating capability, however, will require adequate numbers of site means not only for each age category used to define these curves but also for each set of test surfaces of the same ages. Recommendations are made for a suitable sampling protocol for developing further the Schmidt hammer as a calibrated-age dating tool.

Basic Psychiatric Literature: II. Articles and Article Sources*†

PubMed Central

Woods, Joan B.; Pieper, Sam; Frazier, Shervert H.

1968-01-01

Widely varying reading lists for general psychiatry residents were obtained from 140 three-year approved training programs. The material recommended for reading was listed on index cards, and the number of programs recommending each item was posted on the cards. Approximately 4,000 articles, 2,800 books, and 200 serials were recommended. A statistical evaluation of the book list appeared in a previous paper (3).* Part II is a similar evaluation of the article list and the limited editions and serials in which the articles appear. PMID:4883158

Guidelines for the Primary Prevention of Stroke

PubMed Central

Meschia, James F.; Bushnell, Cheryl; Boden-Albala, Bernadette; Braun, Lynne T.; Bravata, Dawn M.; Chaturvedi, Seemant; Creager, Mark A.; Eckel, Robert H.; Elkind, Mitchell S.V.; Fornage, Myriam; Goldstein, Larry B.; Greenberg, Steven M.; Horvath, Susanna E.; Iadecola, Costantino; Jauch, Edward C.; Moore, Wesley S.; Wilson, John A.

2016-01-01

The aim of this updated statement is to provide comprehensive and timely evidence-based recommendations on the prevention of stroke among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence-based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances, including sickle cell disease and patent foramen ovale. PMID:25355838

Top down, bottom up structured programming and program structuring

NASA Technical Reports Server (NTRS)

Hamilton, M.; Zeldin, S.

1972-01-01

New design and programming techniques for shuttle software. Based on previous Apollo experience, recommendations are made to apply top-down structured programming techniques to shuttle software. New software verification techniques for large software systems are recommended. HAL, the higher order language selected for the shuttle flight code, is discussed and found to be adequate for implementing these techniques. Recommendations are made to apply the workable combination of top-down, bottom-up methods in the management of shuttle software. Program structuring is discussed relevant to both programming and management techniques.

A Review of Recent Studies on Differential Reinforcement during Skill Acquisition in Early Intervention

ERIC Educational Resources Information Center

Vladescu, Jason C.; Kodak, Tiffany

2010-01-01

Although the use of differential reinforcement has been recommended in previous investigations and in early intervention curriculum manuals, few studies have evaluated the best method for providing differential reinforcement to maximize independent responding. This paper reviews previous research on the effectiveness of differential reinforcement…

Utilities Privatization in the United States Air Force

DTIC Science & Technology

2007-01-01

75 3.2.6. Independent Review............................................................................ 77 3.2.7. Fair Market Value ...101 3.5.15. Fair Market Value ............................................................................. 106 3.5.16. Recommendations by the GAO...Private Competition Decisions for FY 1995-2005... 125 4.3. Fair Market Value and Use of Should Cost .......................................... 125

The Effect of a Poster, Display, and Recommended Listening List on the Circulation of Audiobooks in the Public Library.

ERIC Educational Resources Information Center

Kucalaba, Linda

Previous studies have found that the librarian's use of book displays and recommended lists are an effective means to increase circulation in the public library. Yet conflicting results were found when these merchandising techniques were used with collection materials in the nonprint format, specifically audiobooks and videos, instead of books.…

Recommended Systems for the Incremental Automation of the Morgue of "The Daily Texan."

ERIC Educational Resources Information Center

Voges, Mickie; And Others

A modular program is recommended for automation of the clippings file of "The Daily Texan" (student newspaper of the University of Texas at Austin). The proposed system will lead ultimately to on-line storage of the index, on-line storage of local, staff-written news stories from the previous twenty-four months, micrographic storage for backup and…

Injury risk factors, screening tests and preventative strategies: a systematic review of the evidence that underpins the perceptions and practices of 44 football (soccer) teams from various premier leagues

PubMed Central

McCall, Alan; Carling, Chris; Davison, Michael; Nedelec, Mathieu; Le Gall, Franck; Berthoin, Serge; Dupont, Gregory

2015-01-01

Purpose To systematically review the scientific level of evidence for the ‘Top 3’ risk factors, screening tests and preventative exercises identified by a previously published survey of 44 premier league football (soccer) teams. Also, to provide an overall scientific level of evidence and graded recommendation based on the current research literature. Methods A systematic literature search (Pubmed [MEDLINE], SportDiscus, PEDRO and Cochrane databases). The quality of the articles was assessed and a level of evidence (1++ to 4) was assigned. Level 1++ corresponded to the highest level of evidence available and 4, the lowest. A graded recommendation (A: strong, B: moderate, C: weak, D: insufficient evidence to assign a specific recommendation) for use in the practical setting was given. Results Fourteen studies were analysed. The overall level of evidence for the risk factors previous injury, fatigue and muscle imbalance were 2++, 4 and ‘inconclusive’, respectively. The graded recommendation for functional movement screen, psychological questionnaire and isokinetic muscle testing were all ‘D’. Hamstring eccentric had a weak graded ‘C’ recommendation, and eccentric exercise for other body parts was ‘D’. Balance/proprioception exercise to reduce ankle and knee sprain injury was assigned a graded recommendation ‘D’. Conclusions The majority of perceptions and practices of premier league teams have a low level of evidence and low graded recommendation. This does not imply that these perceptions and practices are not important or not valid, as it may simply be that they are yet to be sufficiently validated or refuted by research. PMID:25576530

FELASA recommendations for the health monitoring of mouse, rat, hamster, guinea pig and rabbit colonies in breeding and experimental units.

PubMed

Mähler Convenor, M; Berard, M; Feinstein, R; Gallagher, A; Illgen-Wilcke, B; Pritchett-Corning, K; Raspa, M

2014-07-01

The microbiological quality of experimental animals can critically influence animal welfare and the validity and reproducibility of research data. It is therefore important for breeding and experimental facilities to establish a laboratory animal health monitoring (HM) programme as an integrated part of any quality assurance system. FELASA has published recommendations for the HM of rodent and rabbit colonies in breeding and experimental units (Nicklas et al. Laboratory Animals, 2002), with the intention of harmonizing HM programmes. As stated in the preamble, these recommendations need to be adapted periodically to meet current developments in laboratory animal medicine. Accordingly, previous recommendations have been revised and shall be replaced by the present recommendations. These recommendations are aimed at all breeders and users of laboratory mice, rats, Syrian hamsters, guinea pigs and rabbits as well as diagnostic laboratories. They describe essential aspects of HM, such as the choice of agents, selection of animals and tissues for testing, frequency of sampling, commonly used test methods, interpretation of results and HM reporting. Compared with previous recommendations, more emphasis is put on the role of a person with sufficient understanding of the principles of HM, opportunistic agents, the use of sentinel animals (particularly under conditions of cage-level containment) and the interpretation and reporting of HM results. Relevant agents, testing frequencies and literature references are updated. Supplementary information on specific agents and the number of animals to be monitored and an example of a HM programme description is provided in the appendices. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Early responses to H7N9 in southern Mainland China

PubMed Central

2014-01-01

Background H7N9 posed potentially serious health challenges for Chinese society. The previous SARS outbreak in this country was accompanied by contradictory information, while worries about wide-spread influenza led to discrimination worldwide. Early understanding of public threat perceptions is therefore important for effective public health communication and intervention. Methods We interviewed 1011 respondents by phone two weeks after the first case. Questions examined risk awareness and media use, beliefs about the emergence of the threat and those most at risk, anxiety about infection and preventive and avoidant behaviours. Results Results demonstrate moderate levels of anxiety but relatively high levels of trust towards government officials. Threat emergence was associated with hygiene levels, temperature change, floating pigs in the Huangpu River and migration to the city. Anxiety predicted both recommended and non-recommended behavioural changes. Conclusions Comparatively high levels of trust in Chinese government advice about H7N9 contrast positively with previous pandemic communications in China. Anxiety helped drive both recommended and non-recommended behaviours, with potentially important economic and social implications. This included evidence of 'othering’ of those associated with the threat (e.g. migrants). Findings emphasise the need to manage public communications early during new influenza outbreaks. PMID:24397830

Early responses to H7N9 in southern Mainland China.

PubMed

Goodwin, Robin; Sun, Shaojing

2014-01-07

H7N9 posed potentially serious health challenges for Chinese society. The previous SARS outbreak in this country was accompanied by contradictory information, while worries about wide-spread influenza led to discrimination worldwide. Early understanding of public threat perceptions is therefore important for effective public health communication and intervention. We interviewed 1011 respondents by phone two weeks after the first case. Questions examined risk awareness and media use, beliefs about the emergence of the threat and those most at risk, anxiety about infection and preventive and avoidant behaviours. Results demonstrate moderate levels of anxiety but relatively high levels of trust towards government officials. Threat emergence was associated with hygiene levels, temperature change, floating pigs in the Huangpu River and migration to the city. Anxiety predicted both recommended and non-recommended behavioural changes. Comparatively high levels of trust in Chinese government advice about H7N9 contrast positively with previous pandemic communications in China. Anxiety helped drive both recommended and non-recommended behaviours, with potentially important economic and social implications. This included evidence of 'othering' of those associated with the threat (e.g. migrants). Findings emphasise the need to manage public communications early during new influenza outbreaks.

Information Filtering via Heterogeneous Diffusion in Online Bipartite Networks

PubMed Central

Zhang, Fu-Guo; Zeng, An

2015-01-01

The rapid expansion of Internet brings us overwhelming online information, which is impossible for an individual to go through all of it. Therefore, recommender systems were created to help people dig through this abundance of information. In networks composed by users and objects, recommender algorithms based on diffusion have been proven to be one of the best performing methods. Previous works considered the diffusion process from user to object, and from object to user to be equivalent. We show in this work that it is not the case and we improve the quality of the recommendation by taking into account the asymmetrical nature of this process. We apply this idea to modify the state-of-the-art recommendation methods. The simulation results show that the new methods can outperform these existing methods in both recommendation accuracy and diversity. Finally, this modification is checked to be able to improve the recommendation in a realistic case. PMID:26125631

Information Filtering via Heterogeneous Diffusion in Online Bipartite Networks.

PubMed

Zhang, Fu-Guo; Zeng, An

2015-01-01

The rapid expansion of Internet brings us overwhelming online information, which is impossible for an individual to go through all of it. Therefore, recommender systems were created to help people dig through this abundance of information. In networks composed by users and objects, recommender algorithms based on diffusion have been proven to be one of the best performing methods. Previous works considered the diffusion process from user to object, and from object to user to be equivalent. We show in this work that it is not the case and we improve the quality of the recommendation by taking into account the asymmetrical nature of this process. We apply this idea to modify the state-of-the-art recommendation methods. The simulation results show that the new methods can outperform these existing methods in both recommendation accuracy and diversity. Finally, this modification is checked to be able to improve the recommendation in a realistic case.

Reentry Women: A Literature Review with Recommendations for Counseling and Research.

ERIC Educational Resources Information Center

Padula, Marjorie A.

1994-01-01

Provides a comprehensive literature review of research--from 1980 to 1990--regarding reentry women. Discusses reentry trends; general characteristics; reasons for reentry; personality; role, values, and family; satisfaction in the student role; career choice; reentry women after graduation; research limitations; and research recommendations.…

Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach.

PubMed

Zhang, Yuan; Coello, Pablo Alonso; Brożek, Jan; Wiercioch, Wojtek; Etxeandia-Ikobaltzeta, Itziar; Akl, Elie A; Meerpohl, Joerg J; Alhazzani, Waleed; Carrasco-Labra, Alonso; Morgan, Rebecca L; Mustafa, Reem A; Riva, John J; Moore, Ainsley; Yepes-Nuñez, Juan José; Cuello-Garcia, Carlos; AlRayees, Zulfa; Manja, Veena; Falavigna, Maicon; Neumann, Ignacio; Brignardello-Petersen, Romina; Santesso, Nancy; Rochwerg, Bram; Darzi, Andrea; Rojas, Maria Ximena; Adi, Yaser; Bollig, Claudia; Waziry, Reem; Schünemann, Holger J

2017-05-02

There are diverse opinions and confusion about defining and including patient values and preferences (i.e. the importance people place on the health outcomes) in the guideline development processes. This article aims to provide an overview of a process for systematically incorporating values and preferences in guideline development. In 2013 and 2014, we followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to adopt, adapt and develop 226 recommendations in 22 guidelines for the Ministry of Health of the Kingdom of Saudi Arabia. To collect context-specific values and preferences for each recommendation, we performed systematic reviews, asked clinical experts to provide feedback according to their clinical experience, and consulted patient representatives. We found several types of studies addressing the importance of outcomes, including those reporting utilities, non-utility measures of health states based on structured questionnaires or scales, and qualitative studies. Guideline panels used the relative importance of outcomes based on values and preferences to weigh the balance of desirable and undesirable consequences of alternative intervention options. However, we found few studies addressing local values and preferences. Currently there are different but no firmly established processes for integrating patient values and preferences in healthcare decision-making of practice guideline development. With GRADE Evidence-to-Decision (EtD) frameworks, we provide an empirical strategy to find and incorporate values and preferences in guidelines by performing systematic reviews and eliciting information from guideline panel members and patient representatives. However, more research and practical guidance are needed on how to search for relevant studies and grey literature, assess the certainty of this evidence, and best summarize and present the findings.

Optimal mixing rate in linear solvent strength gradient liquid chromatography. Balanced mixing program.

PubMed

Blumberg, Leonid M; Desmet, Gert

2016-12-09

The mixing rate (R ϕ ) is the temporal rate of increase in the solvent strength in gradient LC. The optimal R ϕ (R ϕ ,Opt ) is the one at which a required peak capacity of gradient LC analysis is obtained in the shortest time. The balanced mixing program is a one where, for better separation of early eluting solutes, the mixing ramp is preceded by a balanced isocratic hold of the duration depending on R ϕ . The improvement in the separation of the earlier eluites due to the balanced programming has been evaluated. The value of R ϕ ,Opt depends on the solvent composition range covered by the mixing ramp and on the column pressure conditions. The R ϕ ,Opt for a column operating at maximum instrumental pressure is different from R ϕ ,Opt for a column operating below the instrumental pressure limit. On the other hand, it has been shown that the difference in the R ϕ ,Opt values under different conditions is not very large so that a single default R ϕ previously recommended for gradient analyses without the isocratic hold also yields a good approximation to the shortest analysis time for all conditions in the balanced analyses. With or without the initial balance isocratic hold, the recommended default R ϕ is about 5%/t 0 (5% increase in the solvent strength per each t 0 -long increment in time) for small-molecule samples, and about an order of magnitude slower (0.5%/t 0 ) for protein samples. A discussion illustrating the use of the optimization criteria employed here for the techniques other than LSS gradient LC is included. Copyright © 2016 Elsevier B.V. All rights reserved.

Conversion of gestational diabetes mellitus to future Type 2 diabetes mellitus and the predictive value of HbA1c in an Indian cohort.

PubMed

Gupta, Y; Kapoor, D; Desai, A; Praveen, D; Joshi, R; Rozati, R; Bhatla, N; Prabhakaran, D; Reddy, P; Patel, A; Tandon, N

2017-01-01

To investigate the distribution of and risk factors for dysglycaemia (Type 2 diabetes and prediabetes) in women with previous gestational diabetes mellitus in India. All women (n = 989) from two obstetric units in New Delhi and Hyderabad with a history of gestational diabetes were invited to participate, of whom 366 (37%) agreed. Sociodemographic, medical and anthropometric data were collected and 75-g oral glucose tolerance test were carried out. Within 5 years (median 14 months) of the pregnancy in which they were diagnosed with gestational diabetes, 263 (72%) women were dysglycaemic, including 119 (32%) and 144 (40%) with Type 2 diabetes and prediabetes, respectively. A higher BMI [odds ratio 1.16 per 1-kg/m 2 greater BMI (95% CI 1.10, 1.28)], presence of acanthosis nigricans [odds ratio 3.10, 95% CI (1.64, 5.87)], postpartum screening interval [odds ratio 1.02 per 1 month greater screening interval 95% CI (1.01, 1.04)] and age [odds ratio 1.10 per 1-year older age 95% CI (1.04, 1.16)] had a higher likelihood of having dysglycaemia. The American Diabetes Association-recommended threshold HbA 1c value of ≥ 48 mmol/mol (6.5%) had a sensitivity and specificity of 81.4 and 90.7%, respectively, for determining the presence of Type 2 diabetes postpartum. The high post-pregnancy conversion rates of gestational diabetes to diabetes reported in the present study reinforce the need for mandatory postpartum screening and identification of strategies for preventing progression to Type 2 diabetes. Use of the American Diabetes Association-recommended HbA 1c threshold for diabetes may lead to significant under-diagnosis. © 2016 Diabetes UK.

Industry Perspective on Contemporary Protein-Binding Methodologies: Considerations for Regulatory Drug-Drug Interaction and Related Guidelines on Highly Bound Drugs.

PubMed

Di, Li; Breen, Christopher; Chambers, Rob; Eckley, Sean T; Fricke, Robert; Ghosh, Avijit; Harradine, Paul; Kalvass, J Cory; Ho, Stacy; Lee, Caroline A; Marathe, Punit; Perkins, Everett J; Qian, Mark; Tse, Susanna; Yan, Zhengyin; Zamek-Gliszczynski, Maciej J

2017-12-01

Regulatory agencies have recently issued drug-drug interaction guidelines, which require determination of plasma protein binding (PPB). To err on the conservative side, the agencies recommend that a 0.01 lower limit of fraction unbound (f u ) be used for highly bound compounds (>99%), irrespective of the actual measured values. While this may avoid false negatives, the recommendation would likely result in a high rate of false positive predictions, resulting in unnecessary clinical studies and more stringent inclusion/exclusion criteria, which may add cost and time in delivery of new medicines to patients. In this perspective, we provide a review of current approaches to measure PPB, and important determinants in enabling the accuracy and precision in these measurements. The ability to measure f u is further illustrated by a cross-company data comparison of PPB for warfarin and itraconazole, demonstrating good concordance of the measured f u values. The data indicate that f u values of ≤0.01 may be determined accurately across laboratories when appropriate methods are used. These data, along with numerous other examples presented in the literature, support the use of experimentally measured f u values for drug-drug interaction predictions, rather than using the arbitrary cutoff value of 0.01 as recommended in current regulatory guidelines. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Consumer understanding of calorie labeling: a healthy monday e-mail and text message intervention.

PubMed

Abel, Michelle L; Lee, Katherine; Loglisci, Ralph; Righter, Allison; Hipper, Thomas J; Cheskin, Lawrence J

2015-03-01

To assess caloric knowledge of participants and determine if an e-mail and/or text message intervention could increase knowledge of recommended daily caloric intake. Randomized, control trial. Johns Hopkins Hospital Cobblestone Café. The 246 participants reported eating at the Café at least twice/week. Participants randomized to control, e-mail, or text condition. The text and e-mail conditions received a message on four consecutive Mondays stating the recommended daily caloric intake. Knowledge of the government reference value of 2,000 calories. Intention-to-treat analysis was conducted. Multivariate logistic regression examined the effectiveness of text and e-mail messaging for improving knowledge of the government calorie reference value. Baseline awareness of the daily calorie reference value in study population was low. Participants in the text message condition were twice as likely to know the government calorie reference value compared to controls (p = .047, odds ratio = 2.2, 95% confidence interval [1.01, 4.73]). No significant differences were found for the e-mail condition (p = .5). Many people do not know the daily recommended caloric intake. Public education on the government calorie reference value is necessary for menu-labeling interventions to be more effective. Weekly text messaging can serve as an effective modality for delivering calorie information and nutrition education. © 2014 Society for Public Health Education.

The Mediating Effect of Kaizen between Total Quality Management (TQM) and Business Performance

NASA Astrophysics Data System (ADS)

Shan, Ang Wei; Fauzi Ahmad, Mohd; Hisyamudin Muhd Nor, Nik

2016-11-01

Every customer preference is different but yet important. The global market is shifting rapidly, organizations are needed to continuously identify new opportunity to obtain competitive advantages. Literature suggested that manufacturing companies are needed to differentiate themselves through emphasize on quality and continuous improvement in product and services as a crucial part to secure and success in the future. The Total Quality Management (TQM) practices has developed a strong bearing on growth and competitiveness in market. Therefore, a proper continuous improvement (Kaizen) practice is needed to eliminate waste and value added in production to remain competitiveness and retained the potential customer. However, based on the previous study it had indicated an inconsistent result between TQM and BP. Besides that, researcher also less emphasized on mediator in previous work. Therefore, the purpose of this paper is to recommend the relationship between TQM and business performance with a mediator's effect of Kaizen. This proposed model attempt to create knowledge to both academician and company players to acquire a better understanding among the TQM and Kaizen practices. Consequently, the Structural Equation Modelling (SEM) techniques is applying to identify and evaluate the relationship among TQM, Kaizen, and business performance in developing a new TQM model.

The value and impact of information provided through library services for patient care: developing guidance for best practice.

PubMed

Weightman, Alison; Urquhart, Christine; Spink, Siân; Thomas, Rhian

2009-03-01

Previous impact tool-kits for UK health libraries required updating to reflect recent evidence and changes in library services. The National Knowledge Service funded development of updated guidance. Survey tools were developed based on previous impact studies and a systematic review. The resulting draft questionnaire survey was tested at four sites, and the interview schedule was investigated in a fifth area. A literature search in ASSIA, Google Scholar, INTUTE, LISA, LISTA, SCIRUS, Social Sciences Citation Index (Web of Knowledge), and the major UK University and National Libraries Catalogue (COPAC), identified ways to improve response rates. Other expert advice contributed to the guidance. The resulting guidance contains evidence-based advice and a planning pathway for conducting an impact survey as a service audit. The survey tools (critical incident questionnaire and interview schedule) are available online. The evidence-based advice recommends personalizing the request, assuring confidentiality, and using follow-up reminders. Questionnaires should be brief, and small incentives, such as a lottery draw should be considered. Bias is minimized if the survey is conducted and analysed by independent researchers. The guidance is a starting point for a pragmatic survey to assess the impact of health library services.

The CRUTEM4 land-surface air temperature data set: construction, previous versions and dissemination via Google Earth

NASA Astrophysics Data System (ADS)

Osborn, T. J.; Jones, P. D.

2014-02-01

The CRUTEM4 (Climatic Research Unit Temperature, version 4) land-surface air temperature data set is one of the most widely used records of the climate system. Here we provide an important additional dissemination route for this data set: online access to monthly, seasonal and annual data values and time series graphs via Google Earth. This is achieved via an interface written in Keyhole Markup Language (KML) and also provides access to the underlying weather station data used to construct the CRUTEM4 data set. A mathematical description of the construction of the CRUTEM4 data set (and its predecessor versions) is also provided, together with an archive of some previous versions and a recommendation for identifying the precise version of the data set used in a particular study. The CRUTEM4 data set used here is available from doi:10.5285/EECBA94F-62F9-4B7C-88D3-482F2C93C468.

Recommendations for reducing ambiguity in written procedures.

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

Matzen, Laura E.

Previous studies in the nuclear weapons complex have shown that ambiguous work instructions (WIs) and operating procedures (OPs) can lead to human error, which is a major cause for concern. This report outlines some of the sources of ambiguity in written English and describes three recommendations for reducing ambiguity in WIs and OPs. The recommendations are based on commonly used research techniques in the fields of linguistics and cognitive psychology. The first recommendation is to gather empirical data that can be used to improve the recommended word lists that are provided to technical writers. The second recommendation is to havemore » a review in which new WIs and OPs and checked for ambiguities and clarity. The third recommendation is to use self-paced reading time studies to identify any remaining ambiguities before the new WIs and OPs are put into use. If these three steps are followed for new WIs and OPs, the likelihood of human errors related to ambiguity could be greatly reduced.« less

Diagnosis and management of dementia with Lewy bodies

PubMed Central

Boeve, Bradley F.; Dickson, Dennis W.; Halliday, Glenda; Taylor, John-Paul; Weintraub, Daniel; Aarsland, Dag; Galvin, James; Attems, Johannes; Ballard, Clive G.; Bayston, Ashley; Beach, Thomas G.; Blanc, Frédéric; Bohnen, Nicolaas; Bonanni, Laura; Bras, Jose; Brundin, Patrik; Burn, David; Chen-Plotkin, Alice; Duda, John E.; El-Agnaf, Omar; Feldman, Howard; Ferman, Tanis J.; ffytche, Dominic; Fujishiro, Hiroshige; Galasko, Douglas; Goldman, Jennifer G.; Gomperts, Stephen N.; Graff-Radford, Neill R.; Honig, Lawrence S.; Iranzo, Alex; Kantarci, Kejal; Kaufer, Daniel; Kukull, Walter; Lee, Virginia M.Y.; Leverenz, James B.; Lewis, Simon; Lippa, Carol; Lunde, Angela; Masellis, Mario; Masliah, Eliezer; McLean, Pamela; Mollenhauer, Brit; Montine, Thomas J.; Moreno, Emilio; Mori, Etsuro; Murray, Melissa; O'Brien, John T.; Orimo, Sotoshi; Postuma, Ronald B.; Ramaswamy, Shankar; Ross, Owen A.; Salmon, David P.; Singleton, Andrew; Taylor, Angela; Thomas, Alan; Tiraboschi, Pietro; Toledo, Jon B.; Trojanowski, John Q.; Tsuang, Debby; Walker, Zuzana; Yamada, Masahito; Kosaka, Kenji

2017-01-01

The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these. Substantial new information has been incorporated about previously reported aspects of DLB, with increased diagnostic weighting given to REM sleep behavior disorder and 123iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. The diagnostic role of other neuroimaging, electrophysiologic, and laboratory investigations is also described. Minor modifications to pathologic methods and criteria are recommended to take account of Alzheimer disease neuropathologic change, to add previously omitted Lewy-related pathology categories, and to include assessments for substantia nigra neuronal loss. Recommendations about clinical management are largely based upon expert opinion since randomized controlled trials in DLB are few. Substantial progress has been made since the previous report in the detection and recognition of DLB as a common and important clinical disorder. During that period it has been incorporated into DSM-5, as major neurocognitive disorder with Lewy bodies. There remains a pressing need to understand the underlying neurobiology and pathophysiology of DLB, to develop and deliver clinical trials with both symptomatic and disease-modifying agents, and to help patients and carers worldwide to inform themselves about the disease, its prognosis, best available treatments, ongoing research, and how to get adequate support. PMID:28592453

UNICEF's contribution to the adoption and implementation of option B+ for preventing mother-to-child transmission of HIV: a policy analysis.

PubMed

Chersich, M F; Newbatt, E; Ng'oma, K; de Zoysa, I

2018-06-01

Between 2011 and 2013, global and national guidelines for preventing mother-to-child transmission (PMTCT) of HIV shifted to recommend Option B+, the provision of lifelong antiretroviral treatment for all HIV-infected pregnant women. We aimed to analyse how Option B+ reached the policy agenda, and unpack the processes, actors and politics that explain its adoption, with a focus on examining UNICEF's contribution to these events. Analysis drew on published articles and other documentation, 30 key informants interviews with staff at UNICEF, partner organisations and government officials, and country case studies. Cameroon, India, South Africa and Zimbabwe were each visited for 5-8 days. Interview transcripts were analysed using Dedoose software, reviewed several times and then coded thematically. A national policy initiative in Malawi in 2011, in which the country adopted Option B+, rather than existing WHO recommended regimens, irrevocably placed the policy on the global agenda. UNICEF and other organisations recognised the policy's potential impact and strategically crafted arguments to support it, framing these around operational considerations, cost-effectiveness and values. As 'policy entrepreneurs', these organisations vigorously promoted the policy through a variety of channels and means, overcoming concerted opposition. WHO, on the basis of scanty evidence, released a series of documents towards the policy's endorsement, paving the way for its widespread adoption. National-level policy transformation was rapid and definitive, distinct from previous incremental policy processes. Many organisations, including UNICEF, facilitated these changes in country, acting individually, or in concert. The adoption of the Option B+ policy marked a departure from established processes for PMTCT policy formulation which had been led by WHO with the support of technical experts, and in which recommendations were developed following shifts in evidence. Rather, changes were spurred by a country-level initiative, and a set of strategically framed arguments that resonated with funders and country-level actors. This bottom-up approach, supported by normative agencies, was transformative. For UNICEF, alignment between the organisation's country focus and the policy's underpinning values, enabled it to work with partners and accelerate widespread policy change.

Values Education and Some Suggestions to Teachers

ERIC Educational Resources Information Center

Demirhan Iscan, Canay

2011-01-01

This paper focuses on the process, approaches and teacher roles in values education and offers recommendations for teachers. It uses print materials and Internet sources on values education. These sources were analyzed and synthesized to reveal certain cases and/or opinions. In addition to contemporary sources, older reference materials were also…

Reporting of nitrogen-isotope abundances (Technical Report)

USGS Publications Warehouse

Coplen, Tyler B.; Krouse, H.R.; Böhlke, John Karl

1992-01-01

To eliminate possible confusion in the reporting of nitrogen-isotope analyses, the Commission on Atomic Weights and Isotopic Abundances recommends that the value 272 be employed for the 14N/15N value of N2 in air for calculating atom percent 15N from measured δ15N values.

Perception of Current and Ideal Practices Related to Public Value in Extension

ERIC Educational Resources Information Center

Downey, Laura H.; Peterson, Donna J.; Franz, Nancy

2017-01-01

Extension professionals are increasingly encouraged to engage in practices that can advance the public value movement. It is unclear, however, whether recommended practices related to public value are being adopted. In 2014, 235 Extension professionals at Mississippi State University responded to an organizational capacity survey that included…

The clinical content of preconception care: reproductive history.

PubMed

Stubblefield, Phillip G; Coonrod, Dean V; Reddy, Uma M; Sayegh, Raja; Nicholson, Wanda; Rychlik, Daniel F; Jack, Brian W

2008-12-01

A history of previous birth of a low birthweight infant, previous cesarean sections, multiple previous spontaneous abortions, prior stillbirth, or uterine anomaly identifies women at increased risk for recurrent abortion, preterm birth, or stillbirth. We review the evidence for the potential benefit of reproductive history in identifying strategies for evaluation and treatment to prevent recurrent adverse pregnancy outcome. We offer evidence-based recommendations for management of women with these histories.

Department Chair Advice on Teaching and Research at U.S. Research Universities

ERIC Educational Resources Information Center

Taggart, Gabel

2015-01-01

Using data from a 2010 survey of academic chairs, this study reports on academic department chairs' recommended time allocations to new assistant professors. I contend that personal values about research and teaching influence the department chair's recommendations along with organizational characteristics. Multi-level modeling indicates that…

Effect of ethnicity on first trimester biomarkers for combined trisomy 21 screening: results from a multicenter study in six Asian countries.

PubMed

Manotaya, Saknan; Zitzler, Juergen; Li, Xiaotian; Wibowo, Noroyono; Pham, Thi Mai; Kang, Myung Seo; Lee, Chien-Nan

2015-08-01

To assess differences between first trimester trisomy 21 screening markers free beta chain of the human chorionic gonadotrophin (βhCG) and pregnancy-associated plasma protein A (PAPP-A) in pregnant women of six different Asian countries (China, Indonesia, Korea, Taiwan, Thailand, and Vietnam) and compare serum levels with those in women of European countries. Median and multiple of median (MoM) values of free βhCG and PAPP-A were determined in more than 3000 pregnant women from the Asian countries during their first trimester of pregnancy. Differences in MoM values between a European reference group from a previous multicenter evaluation and the Asian population were evaluated. Two different types of population correction factors for T21 risk estimation were assessed. An at least 10% difference of median MoMs between European and Asian PAPP-A values was found to be statistically significant (p < 0.0001). The specificity of the screening did not show a big difference in individual countries, when using the country-specific correction factor compared with the overall Asian correction factor (<1.4%). The use of a correction factor is recommended based on the differences in European and Asian MoM values. Developing country-specific medians in larger study populations can help identify clinical relevant differences and give the opportunity to explore a more accurate risk calculation. © 2015 John Wiley & Sons, Ltd.

Fostering Integrity in Research

NASA Astrophysics Data System (ADS)

McNutt, M. K.

2017-12-01

The responsible conduct of research requires that all involved in the research enterprise - researchers, sponsors, reviewers, publishers, and communicators - adhere to a set of integrity principles to protect the public's investment. Given the increasing complexity and globalization of the research enterprise, the National Academies recently re-examined and updated its integrity recommendations for researchers in the report Fostering Integrity in Research, with sponsorship from the National Science Foundation. Major departures from the previous recommendations 25-years earlier are the recognition that practices that were previously classified as merely questionable are indeed detrimental to the responsible conduct of research. Furthermore, the report concludes that there has been insufficient effort to respond to the threats that lapses in research integrity pose to the quality of research products and the reputation of researchers as deserving of the public trust. It recommends the creation of an independent, non-profit entity dedicated to promoting research integrity by serving as a resource and clearing house for expertise, advice, materials, and best practices on fostering research integrity and responding to allegations of research misconduct.

The newest international trend about regulation of indoor radon.

PubMed

Bochicchio, Francesco

2011-07-01

On the basis of recent epidemiological findings, many international and national organisations have revised their recommendations and regulations on radon exposure in dwellings and workplaces, or are in the process to do it. In particular, new recommendations and regulations were recently published (or are going to be) by World Health Organization, Nordic Countries, International Commission on Radiological Protection, International, Atomic Energy Agency (and the other international organisations sponsoring the International Basic Safety Standards), European Commission. Although with some differences, these new documents recommend lower radon concentrations in indoor air, especially in dwellings, compared with previous ones. Moreover, preventive measures in all new buildings are more and more considered as one of the most cost-effective way to reduce the radon-related lung cancers, compared with previous approach restricting preventive measures in radon-prone areas only. A comprehensive national action plan, involving several national and local authorities, is generally considered a necessary tool to deal with the many complex actions needed to reduce the risk from radon exposure in an effective way.

Normal range of human dietary sodium intake: a perspective based on 24-hour urinary sodium excretion worldwide.

PubMed

McCarron, David A; Kazaks, Alexandra G; Geerling, Joel C; Stern, Judith S; Graudal, Niels A

2013-10-01

The recommendation to restrict dietary sodium for management of hypertensive cardiovascular disease assumes that sodium intake exceeds physiologic need, that it can be significantly reduced, and that the reduction can be maintained over time. In contrast, neuroscientists have identified neural circuits in vertebrate animals that regulate sodium appetite within a narrow physiologic range. This study further validates our previous report that sodium intake, consistent with the neuroscience, tracks within a narrow range, consistent over time and across cultures. Peer-reviewed publications reporting 24-hour urinary sodium excretion (UNaV) in a defined population that were not included in our 2009 publication were identified from the medical literature. These datasets were combined with those in our previous report of worldwide dietary sodium consumption. The new data included 129 surveys, representing 50,060 participants. The mean value and range of 24-hour UNaV in each of these datasets were within 1 SD of our previous estimate. The combined mean and normal range of sodium intake of the 129 datasets were nearly identical to that we previously reported (mean = 158.3±22.5 vs. 162.4±22.4 mmol/d). Merging the previous and new datasets (n = 190) yielded sodium consumption of 159.4±22.3 mmol/d (range = 114-210 mmol/d; 2,622-4,830mg/d). Human sodium intake, as defined by 24-hour UNaV, is characterized by a narrow range that is remarkably reproducible over at least 5 decades and across 45 countries. As documented here, this range is determined by physiologic needs rather than environmental factors. Future guidelines should be based on this biologically determined range.

Supplement use and other characteristics among pregnant women with a previous pregnancy affected by a neural tube defect - United States, 1997-2009.

PubMed

Arth, Annelise; Tinker, Sarah; Moore, Cynthia; Canfield, Mark; Agopian, Aj; Reefhuis, Jennita

2015-01-16

Neural tube defects (NTDs) include anomalies of the brain (anencephaly and encephalocele) and spine (spina bifida). Even with ongoing mandatory folic acid fortification of enriched cereal grain products, the U.S. Preventive Services Task Force recommends that women of childbearing potential consume a daily supplement containing 400 µg-800 µg of folic acid. Women with a prior NTD-affected pregnancy have an increased risk for having another NTD-affected pregnancy, and if they are planning another pregnancy, the recommendation is that they consume high-dosage folic acid supplements (4.0 mg/day) beginning ≥4 weeks before conception and continuing through the first 12 weeks of pregnancy. To learn whether folic acid supplementation (from multivitamins or single- ingredient supplements) was commonly used during pregnancy by women with a previous NTD-affected pregnancy, supplement use was assessed among a convenience sample of women with a previous NTD-affected pregnancy who participated in the National Birth Defects Prevention Study (NBDPS), a case-control study of major birth defects in the United States. Characteristics of women who previously had an NTD-affected pregnancy and whose index pregnancy (pregnancy included in NBDPS) was either affected by an NTD (N = 17) (i.e., recurrence-cases) or resulted in a live-born infant without a major birth defect (N = 10) (i.e., recurrence-controls) were assessed. Taking a supplement that included folic acid was more common among recurrence-control mothers (80%) than recurrence-case mothers (35%). The recommendation that women should take folic acid supplements just before and during early pregnancy is not being followed by many women and offers an opportunity for NTD prevention, especially among women who are at a higher risk because they have had a previous pregnancy affected by an NTD.

High-Precision Mass Measurement of Cu 56 and the Redirection of the r p -Process Flow

NASA Astrophysics Data System (ADS)

Valverde, A. A.; Brodeur, M.; Bollen, G.; Eibach, M.; Gulyuz, K.; Hamaker, A.; Izzo, C.; Ong, W.-J.; Puentes, D.; Redshaw, M.; Ringle, R.; Sandler, R.; Schwarz, S.; Sumithrarachchi, C. S.; Surbrook, J.; Villari, A. C. C.; Yandow, I. T.

2018-01-01

We report the mass measurement of Cu 56 , using the LEBIT 9.4 T Penning trap mass spectrometer at the National Superconducting Cyclotron Laboratory at Michigan State University. The mass of Cu 56 is critical for constraining the reaction rates of the Ni 55 (p ,γ ) Cu 56 (p ,γ ) Zn 57 (β+) Cu 57 bypass around the Ni 56 waiting point. Previous recommended mass excess values have disagreed by several hundred keV. Our new value, ME =-38 626.7 (7.1 ) keV , is a factor of 30 more precise than the extrapolated value suggested in the 2012 atomic mass evaluation [Chin. Phys. C 36, 1603 (2012), 10.1088/1674-1137/36/12/003], and more than a factor of 12 more precise than values calculated using local mass extrapolations, while agreeing with the newest 2016 atomic mass evaluation value [Chin. Phys. C 41, 030003 (2017), 10.1088/1674-1137/41/3/030003]. The new experimental average, using our new mass and the value from AME2016, is used to calculate the astrophysical Ni 55 (p ,γ ) and Cu 56 (p ,γ ) forward and reverse rates and perform reaction network calculations of the r p process. These show that the r p -process flow redirects around the Ni 56 waiting point through the Ni 55 (p ,γ ) route, allowing it to proceed to higher masses more quickly and resulting in a reduction in ashes around this waiting point and an enhancement to higher-mass ashes.

Decay of intestinal enterococci concentrations in high-energy estuarine and coastal waters: towards real-time T90 values for modelling faecal indicators in recreational waters.

PubMed

Kay, D; Stapleton, C M; Wyer, M D; McDonald, A T; Crowther, J; Paul, N; Jones, K; Francis, C; Watkins, J; Wilkinson, J; Humphrey, N; Lin, B; Yang, L; Falconer, R A; Gardner, S

2005-02-01

Intestinal enterococci are the principal 'health-evidence-based' parameter recommended by WHO for the assessment of marine recreational water compliance. Understanding the survival characteristics of these organisms in nearshore waters is central to public health protection using robust modelling to effect real-time prediction of water quality at recreation sites as recently suggested by WHO and the Commission of the European Communities Previous models have more often focused on the coliform parameters and assumed two static day-time and night-time T90 values to characterise the decay process. The principal driver for enterococci survival is the received dose of irradiance from sunlight. In the water column, transmission of irradiance is determined by turbidity produced by suspended material. This paper reports the results of irradiated microcosm experiments using simulated sunlight to investigate the decay of intestinal enterococci in relatively turbid estuarine and coastal waters collected from the Severn Estuary and Bristol Channel, UK. High-turbidity estuarine waters produced a T90 value of 39.5 h. Low-turbidity coastal waters produced a much shorter T90 value of 6.6 h. In experiments receiving no irradiation, high-turbidity estuarine waters also produced a longer T90 of 65.1 h compared with corresponding low-turbidity coastal waters, T90 24.8 h. Irradiated T90 values were correlated with salinity, turbidity and suspended solids (r>0.8, p<0.001). The results suggest that enterococci decay in irradiated experiments with turbidity >200 NTU is similar to decay observed under dark conditions. Most significantly, these results suggest that modelling turbidity and or suspended solids offers a potential means of predicting T90 values in 'real-time' for discrete cells of a hydrodynamic model.

Behavioral Recommendations in Health Research News as Cues to Action: Self-Relevancy and Self-Efficacy Processes.

PubMed

Chang, Chingching

2016-08-01

This study argues that behavioral recommendations in health news function as cues to action. A proposed self-oriented model seeks to explore the impacts of behavioral recommendations in health research news as cues to action through their influences on self-relevancy and self-efficacy. A content analysis (Study 1) first establishes that health research news commonly features behavioral recommendations. A message experiment (Study 2) then explores the utility of behavioral recommendations as cues to action by demonstrating a self-relevancy effect: Health research news with, as opposed to without, behavioral recommendations increases the self-relevancy of advocated health behaviors, which then improve people's attitudes toward and intentions to adopt those behaviors. A second message experiment (Study 3) tests whether varying presentations of behavioral recommendations alter their effectiveness as cues to action and thus people's behavioral intentions through a dual effect process. In addition to the previously demonstrated self-relevancy effect, this experiment shows that concrete, as opposed to abstract, behavioral recommendations trigger a self-efficacy effect, increasing perceived self-efficacy and further improving behavioral intentions.

The APOSTEL recommendations for reporting quantitative optical coherence tomography studies.

PubMed

Cruz-Herranz, Andrés; Balk, Lisanne J; Oberwahrenbrock, Timm; Saidha, Shiv; Martinez-Lapiscina, Elena H; Lagreze, Wolf A; Schuman, Joel S; Villoslada, Pablo; Calabresi, Peter; Balcer, Laura; Petzold, Axel; Green, Ari J; Paul, Friedemann; Brandt, Alexander U; Albrecht, Philipp

2016-06-14

To develop consensus recommendations for reporting of quantitative optical coherence tomography (OCT) study results. A panel of experienced OCT researchers (including 11 neurologists, 2 ophthalmologists, and 2 neuroscientists) discussed requirements for performing and reporting quantitative analyses of retinal morphology and developed a list of initial recommendations based on experience and previous studies. The list of recommendations was subsequently revised during several meetings of the coordinating group. We provide a 9-point checklist encompassing aspects deemed relevant when reporting quantitative OCT studies. The areas covered are study protocol, acquisition device, acquisition settings, scanning protocol, funduscopic imaging, postacquisition data selection, postacquisition data analysis, recommended nomenclature, and statistical analysis. The Advised Protocol for OCT Study Terminology and Elements recommendations include core items to standardize and improve quality of reporting in quantitative OCT studies. The recommendations will make reporting of quantitative OCT studies more consistent and in line with existing standards for reporting research in other biomedical areas. The recommendations originated from expert consensus and thus represent Class IV evidence. They will need to be regularly adjusted according to new insights and practices. © 2016 American Academy of Neurology.

[Reference values of calcium, vitamin D, phosphorus, magnesium and fluoride for the Venezuelan population].

PubMed

Macías-Tomei, Coromoto; Palacios, Cristina; Mariño Elizondo, Mariana; Carías, Diamela; Noguera, Dalmacia; Chávez Pérez, José Félix

2013-12-01

The following micronutrients were considered together for their role in bone health: calcium, vitamin D, phosphorus, magnesium and fluoride. Calcium: not enough is known to change current recommendations. In adolescents and adults, limited data suggest that consuming the recommended level is associated with normal bone mass. In older adults, the limited data reported low consumption and a high rate of fractures but there is no information on whether the current values are adequate. Vitamin D: the limited data reported high deficiency in older adults, which was related to osteoporosis. Given the recent increase in North American recommendation for their contribution to bone health, we proposed to increase the recommendation to 400-600 IU/d for Venezuela. Phosphorus, magnesium and fluoride: the lack of local data does not support changing the latest recommendations. Therefore, it highlights the lack of local studies to assess current recommendations. Studies are needed to estimate the intake of these micronutrients in the population and evaluate their interaction and their relation to bone and overall health. Information of the adequacy of these nutrients in human milk for infants is needed. Alto, it is necessary to implement an effective nutrition surveillance system and implement interventions that maximize bone health from an early stage, including the design and implementation of a dairy policy that leads to an increase in production and consumption by the population.

The CIPM list of recommended frequency standard values: guidelines and procedures

NASA Astrophysics Data System (ADS)

Riehle, Fritz; Gill, Patrick; Arias, Felicitas; Robertsson, Lennart

2018-04-01

A list of standard reference frequency values (LoF) of quantum transitions from the microwave to the optical regime has been recommended by the International Committee for Weights and Measures (Comité international des poids et mesures, CIPM) for use in basic research, technology, and for the metrology of time, frequency and length. The CIPM LoF contains entries that are recommended as secondary representations of the second in the International System of Units, and entries that can be used to serve as realizations of the definition of the metre. The historical perspective that led to the CIPM LoF is outlined. Procedures have been developed for updating existing, and validating new, entries into the CIPM LoF. The CIPM LoF might serve as an entry for a future redefinition of the second by an optical transition.

Possible Impact of Incremental Cost-Effectiveness Ratio (ICER) on Decision Making for Cancer Screening in Hong Kong: A Systematic Review.

PubMed

Wong, Carlos K H; Lang, Brian H H; Guo, Vivian Y W; Lam, Cindy L K

2016-12-01

The aim of this paper was to critically review the literature on the cost effectiveness of cancer screening interventions, and examine the incremental cost-effectiveness ratios (ICERs) that may influence government recommendations on cancer screening strategies and funding for mass implementation in the Hong Kong healthcare system. We conducted a literature review of cost-effectiveness studies in the Hong Kong population related to cancer screening published up to 2015, through a hand search and database search of PubMed, Web of Science, Embase, and OVID Medline. Binary data on the government's decisions were obtained from the Cancer Expert Working Group, Department of Health. Mixed-effect logistic regression analysis was used to examine the impact of ICERs on decision making. Using Youden's index, an optimal ICER threshold value for positive decisions was examined by area under receiver operating characteristic curve (AUC). Eight studies reporting 30 cost-effectiveness pairwise comparisons of population-based cancer screening were identified. Most studies reported an ICER for a cancer screening strategy versus a comparator with outcomes in terms of cost per life-years (55.6 %), or cost per quality-adjusted life-years (55.6 %). Among comparisons with a mean ICER of US$102,931 (range 800-715,137), the increase in ICER value by 1000 was associated with decreased odds (odds ratio 0.990, 0.981-0.999; p = 0.033) of a positive recommendation. An optimal ICER value of US$61,600 per effectiveness unit yielded a high sensitivity of 90 % and specificity of 85 % for a positive recommendation. A lower ICER threshold value of below US$8044 per effectiveness unit was detected for a positive funding decision. Linking published evidence to Government recommendations and practice on cancer screening, ICERs influence decisions on the adoption of health technologies in Hong Kong. The potential ICER threshold for recommendation in Hong Kong may be higher than those of developed countries.

Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial

PubMed Central

Vandvik, Per Olav; Alonso-Coello, Pablo; Akl, Elie A; Thornton, Judith; Rigau, David; Adams, Katie; O'Connor, Paul; Guyatt, Gordon; Kristiansen, Annette

2017-01-01

Objectives To investigate practicing physicians' preferences, perceived usefulness and understanding of a new multilayered guideline presentation format—compared to a standard format—as well as conceptual understanding of trustworthy guideline concepts. Design Participants attended a standardised lecture in which they were presented with a clinical scenario and randomised to view a guideline recommendation in a multilayered format or standard format after which they answered multiple-choice questions using clickers. Both groups were also presented and asked about guideline concepts. Setting Mandatory educational lectures in 7 non-academic and academic hospitals, and 2 settings involving primary care in Lebanon, Norway, Spain and the UK. Participants 181 practicing physicians in internal medicine (156) and general practice (25). Interventions A new digitally structured, multilayered guideline presentation format and a standard narrative presentation format currently in widespread use. Primary and secondary outcome measures Our primary outcome was preference for presentation format. Understanding, perceived usefulness and perception of absolute effects were secondary outcomes. Results 72% (95% CI 65 to 79) of participants preferred the multilayered format and 16% (95% CI 10 to 22) preferred the standard format. A majority agreed that recommendations (multilayered 86% vs standard 91%, p value=0.31) and evidence summaries (79% vs 77%, p value=0.76) were useful in the context of the clinical scenario. 72% of participants randomised to the multilayered format vs 58% for standard formats reported correct understanding of the recommendations (p value=0.06). Most participants elected an appropriate clinical action after viewing the recommendations (98% vs 92%, p value=0.10). 82% of the participants considered absolute effect estimates in evidence summaries helpful or crucial. Conclusions Clinicians clearly preferred a novel multilayered presentation format to the standard format. Whether the preferred format improves decision-making and has an impact on patient important outcomes merits further investigation. PMID:28188149

Factors associated with herpes zoster vaccination status and acceptance of vaccine recommendation in community pharmacies.

PubMed

Teeter, Benjamin S; Garza, Kimberly B; Stevenson, T Lynn; Williamson, Margaret A; Zeek, Megan L; Westrick, Salisa C

2014-09-29

1. Identify patient characteristics, awareness and knowledge associated with herpes zoster (HZ) vaccination status. 2. Identify self-reported reasons for not receiving Zostavax(®). 3. Assess the impact of a patient education program by measuring post-intervention interest in obtaining the Zostavax(®) vaccine across reasons for being unvaccinated. A cross-sectional design with patients aged 60 years or older in 51 community pharmacies in Alabama and Florida was utilized. During the Introductory Pharmacy Practice Experience in summer 2013, 137 immunization-certified student pharmacists provided patient education on HZ and Zostavax(®) to unvaccinated patients using the Shingles Vaccine Information Statement. An interviewer-administered questionnaire assessed patient awareness of HZ, receipt of recommendations to receive Zostavax(®), and patient characteristics as well as vaccination status, reasons for being unvaccinated and interest in obtaining Zostavax(®) after the educational session. A total of 681 patients participated in a conversation with a student pharmacist regarding their HZ vaccination status. The majority were female (57.6%), white (84.6%), and unvaccinated (73.6%). Results from logistic regression suggest that participants were more likely to be vaccinated if they received a recommendation from a healthcare provider (OR=5.15), received the influenza vaccine during the previous year (OR=3.56), or knew that Zostavax(®) was recommended for individuals over 60 years of age (OR=3.55). The most frequently provided reasons for being unvaccinated were "haven't gotten around to it/forgot" (27.2%) and "didn't know it was needed" (27.1%). After the educational session, the majority (72.5%) of unvaccinated patients were interested in speaking with their pharmacist or physician about receiving Zostavax(®). Analysis suggests that interest differed across initial reason for being unvaccinated (χ(2)=64.44; p<0.01). Recommendations from healthcare providers are valued by patients and can improve vaccination rates. The patient education program increased interest in receiving Zostavax(®) and this interest differed depending on the reason provided for being unvaccinated. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Effect of Knowledge, Risk Factors and Intent to Modify Diet on Fat Consumption.

ERIC Educational Resources Information Center

Hunt, Alice E.; Pope, Janet F.

1996-01-01

Responses from 94 men and 116 women aged 35-55 revealed that only 18% were aware of dietary recommendations and only 23% correctly estimated their daily fat intake. Those with a history of heart disease or previous nutrition counseling were more likely to have low fat intake. A focus on eating behavior rather than fat intake recommendations was…

Efforts to Bridge the Gap between Research and Practice in Social Work: Precedents and Prospects: Keynote Address at the Bridging the Gap Symposium

ERIC Educational Resources Information Center

Rubin, Allen

2015-01-01

This keynote address discusses previous and ongoing efforts to reduce the persistent gap between research and practice in social work and offers recommendations for further bridging that gap. Key among those recommendations is the need to conduct descriptive outcome studies of efforts to adapt research-supported interventions in everyday practice…

Ambient radiation levels in positron emission tomography/computed tomography (PET/CT) imaging center

PubMed Central

Santana, Priscila do Carmo; de Oliveira, Paulo Marcio Campos; Mamede, Marcelo; Silveira, Mariana de Castro; Aguiar, Polyanna; Real, Raphaela Vila; da Silva, Teógenes Augusto

2015-01-01

Objective To evaluate the level of ambient radiation in a PET/CT center. Materials and Methods Previously selected and calibrated TLD-100H thermoluminescent dosimeters were utilized to measure room radiation levels. During 32 days, the detectors were placed in several strategically selected points inside the PET/CT center and in adjacent buildings. After the exposure period the dosimeters were collected and processed to determine the radiation level. Results In none of the points selected for measurements the values exceeded the radiation dose threshold for controlled area (5 mSv/year) or free area (0.5 mSv/year) as recommended by the Brazilian regulations. Conclusion In the present study the authors demonstrated that the whole shielding system is appropriate and, consequently, the workers are exposed to doses below the threshold established by Brazilian standards, provided the radiation protection standards are followed. PMID:25798004

Bioethics education for practicing nurses in Taiwan: Confucian-Western clash.

PubMed

Yang, Wan-Ping; Chen, Ching-Huey; Chao, Co-Shi Chantal; Lai, Wei-Shu

2010-07-01

To understand the gaps between current bioethics education and the requirements of practicing nurses, a semistructured questionnaire was used to invite the directors of nursing departments at all 82 teaching hospitals in Taiwan to participate in this survey. The response rate was 64.6%. Through content analysis we obtained information about previous bioethical training, required themes and content, recommended teaching strategies, and difficulties with education and its application. The results suggest that Taiwanese nursing personnel need to be instilled with both self-cultivation of morality and mental cultivation to acquire nursing virtues and the right attitudes toward bioethical issues. Good communication skills to prevent damage to the harmonious relationships between patients, their families and medical team members, policies that support the provision of systematic formal knowledge of ethics, small group training, and clarification of values were also shown to be important in bioethics education.

Evidence, illness, and causation: an epidemiological perspective on the Russo-Williamson Thesis.

PubMed

Fiorentino, Alexander R; Dammann, Olaf

2015-12-01

According to the Russo-Williamson Thesis, causal claims in the health sciences need to be supported by both difference-making and mechanistic evidence. In this article, we attempt to determine whether Evidence-based Medicine (EBM) can be improved through the consideration of mechanistic evidence. We discuss the practical composition and function of each RWT evidence type and propose that exposure-outcome evidence (previously known as difference-making evidence) provides associations that can be explained through a hypothesis of causation, while mechanistic evidence provides finer-grained associations and knowledge of entities that ultimately explains a causal hypothesis. We suggest that mechanistic evidence holds untapped potential to add value to the assessment of evidence quality in EBM and propose initial recommendations for the integration of mechanistic and exposure-outcome evidence to improve EBM by robustly leveraging available evidence in support of good medical decisions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Vinyl Chloride: A Case Study of Data Suppression and Misrepresentation

PubMed Central

Sass, Jennifer Beth; Castleman, Barry; Wallinga, David

2005-01-01

When the U.S. Environmental Protection Agency (EPA) finalized its 2000 update of the toxicological effects of vinyl chloride (VC), it was concerned with two issues: the classification of VC as a carcinogen and the numerical estimate of its potency. In this commentary we describe how the U.S. EPA review of VC toxicology, which was drafted with substantial input from the chemical industry, weakened safeguards on both points. First, the assessment downplays risks from all cancer sites other than the liver. Second, the estimate of cancer potency was reduced 10-fold from values previously used for environmental decision making, a finding that reduces the cost and extent of pollution reduction and cleanup measures. We suggest that this assessment reflects discredited scientific practices and recommend that the U.S. EPA reverse its trend toward ever-increasing collaborations with the regulated industries when generating scientific reviews and risk assessments. PMID:16002366

Reactions to intragroup deviance: does disidentification have a role?

PubMed

Cameira, Miguel; Ribeiro, Tiago Azevedo

2014-01-01

In this study, we address previous evidence about the interchangeable use of derogation and disidentification in protecting the self from intragroup deviance. We argue that when the in-group stands for a valued social identity, members may disidentify from the group, but only if the immediate context provides no opportunity to derogate. In the present experiments (n = 80 and n = 79), we provided or did not provide participants with the opportunity to recommend a punishment for an in-group or an out-group deviant. We also measured in-group identification before and after exposure to deviant behavior and after judgment. The results show that participants first disidentified from the in-group but, when presented with an opportunity to judge the deviant, also derogated. Importantly, participants who could judge the deviant also recovered their initial in-group identification level. Participants' reactions to the out-group deviant suggest they used an intergroup rather than intragroup strategy.

[Comparison of reproducibility measurements for calibration of dental caries epidemiological surveys].

PubMed

Assaf, Andréa Videira; Zanin, Luciane; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos; Ambrosano, Gláucia Maria Bovi

2006-09-01

This study compares three measurements (Kappa, general agreement percentage, or GAP, and dice index) used to determine the reproducibility of caries diagnosis in epidemiological surveys under different clinical diagnostic thresholds. Eleven examiners with previous experience in epidemiological surveys were submitted to a theoretical and clinical calibration process. Data analysis used two caries detection thresholds: World Health Organization (WHO) and WHO with the inclusion of initial enamel lesions (WHO + IL). Twenty-three children 6-7 years of age were examined, with and without caries. Mean values for Kappa index, GAP, and Dice were considered high (> 0.90), except for the dice index for the WHO + IL threshold (0.69). Since Kappa is an adjusted agreement index, it can be considered the instrument of choice for calibration of examiners. However, when it is impossible to use, the GAP is recommended together with the dice index in order to orient and improve examiners when examining caries lesions.

Public and stakeholder participation for managing and reducing the risks of shale gas development.

PubMed

North, D Warner; Stern, Paul C; Webler, Thomas; Field, Patrick

2014-01-01

Emerging technologies pose particularly strong challenges for risk governance when they have multidimensional and inequitable impacts, when there is scientific uncertainty about the technology and its risks, when there are strong value conflicts over the perceived benefits and risks, when decisions must be made urgently, and when the decision making environment is rife with mistrust. Shale gas development is one such emerging technology. Drawing on previous U.S. National Research Council committee reports that examined risk decision making for complex issues like these, we point to the benefits and challenges of applying the analytic-deliberative process recommended in those reports for stakeholder and public engagement in risk decision making about shale gas development in the United States. We discuss the different phases of such a process and conclude by noting the dangers of allowing controversy to ossify and the benefits of sound dialogue and learning among publics, stakeholders, industry, and regulatory decision makers.

Single Measure and Gated Screening Approaches for Identifying Students At-Risk for Academic Problems: Implications for Sensitivity and Specificity

ERIC Educational Resources Information Center

Van Norman, Ethan R.; Nelson, Peter M.; Klingbeil, David A.

2017-01-01

Educators need recommendations to improve screening practices without limiting students' instructional opportunities. Repurposing previous years' state test scores has shown promise in identifying at-risk students within multitiered systems of support. However, researchers have not directly compared the diagnostic accuracy of previous years' state…

Comparative statistical analysis of carcinogenic and non-carcinogenic effects of uranium in groundwater samples from different regions of Punjab, India.

PubMed

Saini, Komal; Singh, Parminder; Bajwa, Bikramjit Singh

2016-12-01

LED flourimeter has been used for microanalysis of uranium concentration in groundwater samples collected from six districts of South West (SW), West (W) and North East (NE) Punjab, India. Average value of uranium content in water samples of SW Punjab is observed to be higher than WHO, USEPA recommended safe limit of 30µgl -1 as well as AERB proposed limit of 60µgl -1 . Whereas, for W and NE region of Punjab, average level of uranium concentration was within AERB recommended limit of 60µgl -1 . Average value observed in SW Punjab is around 3-4 times the value observed in W Punjab, whereas its value is more than 17 times the average value observed in NE region of Punjab. Statistical analysis of carcinogenic as well as non carcinogenic risks due to uranium have been evaluated for each studied district. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reporting and methodological quality of sample size calculations in cluster randomized trials could be improved: a review.

PubMed

Rutterford, Clare; Taljaard, Monica; Dixon, Stephanie; Copas, Andrew; Eldridge, Sandra

2015-06-01

To assess the quality of reporting and accuracy of a priori estimates used in sample size calculations for cluster randomized trials (CRTs). We reviewed 300 CRTs published between 2000 and 2008. The prevalence of reporting sample size elements from the 2004 CONSORT recommendations was evaluated and a priori estimates compared with those observed in the trial. Of the 300 trials, 166 (55%) reported a sample size calculation. Only 36 of 166 (22%) reported all recommended descriptive elements. Elements specific to CRTs were the worst reported: a measure of within-cluster correlation was specified in only 58 of 166 (35%). Only 18 of 166 articles (11%) reported both a priori and observed within-cluster correlation values. Except in two cases, observed within-cluster correlation values were either close to or less than a priori values. Even with the CONSORT extension for cluster randomization, the reporting of sample size elements specific to these trials remains below that necessary for transparent reporting. Journal editors and peer reviewers should implement stricter requirements for authors to follow CONSORT recommendations. Authors should report observed and a priori within-cluster correlation values to enable comparisons between these over a wider range of trials. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

An item-oriented recommendation algorithm on cold-start problem

NASA Astrophysics Data System (ADS)

Qiu, Tian; Chen, Guang; Zhang, Zi-Ke; Zhou, Tao

2011-09-01

Based on a hybrid algorithm incorporating the heat conduction and probability spreading processes (Proc. Natl. Acad. Sci. U.S.A., 107 (2010) 4511), in this letter, we propose an improved method by introducing an item-oriented function, focusing on solving the dilemma of the recommendation accuracy between the cold and popular items. Differently from previous works, the present algorithm does not require any additional information (e.g., tags). Further experimental results obtained in three real datasets, RYM, Netflix and MovieLens, show that, compared with the original hybrid method, the proposed algorithm significantly enhances the recommendation accuracy of the cold items, while it keeps the recommendation accuracy of the overall and the popular items. This work might shed some light on both understanding and designing effective methods for long-tailed online applications of recommender systems.

Recommended procedures for measuring aircraft noise and associated parameters

NASA Technical Reports Server (NTRS)

Marsh, A. H.

1977-01-01

Procedures are recommended for obtaining experimental values of aircraft flyover noise levels (and associated parameters). Specific recommendations are made for test criteria, instrumentation performance requirements, data-acquisition procedures, and test operations. The recommendations are based on state-of-the-art measurement capabilities available in 1976 and are consistent with the measurement objectives of the NASA Aircraft Noise Prediction Program. The recommendations are applicable to measurements of the noise produced by an airplane flying subsonically over (or past) microphones located near the surface of the ground. Aircraft types covered by the recommendations are fixed-wing airplanes powered by turbojet or turbofan engines and using conventional aerodynamic means for takeoff and landing. Various assumptions with respect to subsequent data processing and analysis were made (and are described) and the recommended measurement procedures are compatible with the assumptions. Some areas where additional research is needed relative to aircraft flyover noise measurement techniques are also discussed.

Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.

PubMed

Siu, Albert L

2016-02-16

Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer. The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiation-induced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime. This recommendation applies to asymptomatic women aged 40 years or older who do not have preexisting breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. (B recommendation) The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. (C recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging (MRI), DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement).

The Association of Sport Specialization and Training Volume With Injury History in Youth Athletes.

PubMed

Post, Eric G; Trigsted, Stephanie M; Riekena, Jeremy W; Hetzel, Scott; McGuine, Timothy A; Brooks, M Alison; Bell, David R

2017-05-01

Recommendations exist to encourage safe youth participation in sport. These recommendations include not specializing in 1 sport, limiting participation to less than 8 months per year, and limiting participation to fewer hours per week than a child's age. However, limited evidence exists to support or refute these recommendations. High levels of specialization will be associated with a history of injuries and especially overuse injuries, independent of age, sex, or weekly sport training hours. Athletes who exceed current sport volume recommendations will be more likely to have a history of injuries and overuse injuries. Case-control study; Level of evidence, 3. Youth athletes (n = 2011; 989 female and 1022 male; 12-18 years of age) completed a questionnaire regarding their specialization status, yearly and weekly sport participation volume, and injury history. Specialization was classified as low, moderate, or high using a previously utilized 3-point scale. Athletes were classified into groups based on either meeting or exceeding current volume recommendations (months per year and hours per week). Odds ratios (ORs) and 95% CIs were calculated to investigate associations of specialization and volume of participation with a history of sport-related injuries in the past year ( P ≤ .05). Highly specialized athletes were more likely to report a previous injury of any kind ( P < .001; OR, 1.59; 95% CI, 1.26-2.02) or an overuse injury ( P = .011; OR, 1.45; 95% CI, 1.07-1.99) in the previous year compared with athletes in the low specialization group. Athletes who played their primary sport more than 8 months of the year were more likely to report an upper extremity overuse injury ( P = .04; OR, 1.68; 95% CI, 1.06-2.80) or a lower extremity overuse injury ( P = .001; OR, 1.66; 95% CI, 1.22-2.30). Athletes who participated in their primary sport for more hours per week than their age (ie, a 16-year-old athlete who participated in his or her primary sport for more than 16 h/wk) were more likely to report an injury of any type ( P = .001; OR, 1.34; 95% CI, 1.12-1.61) in the previous year. High levels of specialization were associated with a history of injuries, independent of age, sex, and weekly organized sport volume. Athletes who exceeded volume recommendations were more likely to have a history of overuse injuries. Parents and youth athletes should be aware of the risks of specialization and excessive sport volume to maximize safe sport participation.

Money is essential: ownership intuitions are linked to physical currency.

PubMed

Uhlmann, Eric Luis; Lei Zhu, Luke

2013-05-01

Due to basic processes of psychological essentialism and contagion, one particular token of monetary currency is not always interchangeable with another piece of currency of equal economic value. When money loses its physical form it is perceived as "not quite the same" money (i.e., to have partly lost the original essence that distinguished it from other monetary tokens), diminishing its intuitive link with its original owner. Participants were less likely to recommend stolen or lost money be returned when it had been subsequently deposited in an electronic bank account, as opposed to retaining its original physical form (Studies 1a and 1b). Conversely, an intuitive sense of ownership is enhanced through physical contact with a piece of hard currency. Participants felt the piece of currency a person had originally lost should be returned to him rather than another piece of currency of equivalent value, even when they did not believe he would be able to tell the difference and considered distinguishing it from other money illogical. This effect was reduced when the currency had been sterilized, wiping it clean of all physical traces of its previous owner (Studies 2a, 2b, and 3). Copyright © 2013 Elsevier B.V. All rights reserved.

Olive leaf extract activity against Candida albicans and C. dubliniensis - the in vitro viability study.

PubMed

Zorić, Nataša; Kopjar, Nevenka; Kraljić, Klara; Oršolić, Nada; Tomić, Siniša; Kosalec, Ivan

2016-09-01

Olive leaf extract is characterized by a high content of polyphenols (oleuropein, hydroxytyrosol and their derivatives), which is associated with its therapeutic properties. The objective of the present research was to evaluate the antifungal activity of olive leaf extract against Candida albicans ATCC 10231 and C. dubliniensis CBS 7987 strains. Minimum inhibitory concentrations (MIC) of the extract were determined by several in vitro assays. The extract showed a concentration depended effect on the viability of C. albicans with MIC value of 46.875 mg mL-1 and C. dubliniensis with MIC value 62.5 mg mL-1. Most sensitive methods for testing the antifungal effect of the extracts were the trypan blue exclusion method and fluorescent dye exclusion method while MIC could not be determined by the method according to the EUCAST recommendation suggesting that herbal preparations contain compounds that may interfere with this susceptibility testing. The fluorescent dye exclusion method was also used for the assessment of morphological changes in the nuclei of treated cells. According to the obtained results, olive leaf extract is less effective against the tested strains than hydroxytyrosol, an olive plant constituent tested in our previous study.

Hazardous Compounds in Tobacco Smoke

PubMed Central

Talhout, Reinskje; Schulz, Thomas; Florek, Ewa; van Benthem, Jan; Wester, Piet; Opperhuizen, Antoon

2011-01-01

Tobacco smoke is a toxic and carcinogenic mixture of more than 5,000 chemicals. The present article provides a list of 98 hazardous smoke components, based on an extensive literature search for known smoke components and their human health inhalation risks. An electronic database of smoke components containing more than 2,200 entries was generated. Emission levels in mainstream smoke have been found for 542 of the components and a human inhalation risk value for 98 components. As components with potential carcinogenic, cardiovascular and respiratory effects have been included, the three major smoke-related causes of death are all covered by the list. Given that the currently used Hoffmann list of hazardous smoke components is based on data from the 1990s and only includes carcinogens, it is recommended that the current list of 98 hazardous components is used for regulatory purposes instead. To enable risk assessment of components not covered by this list, thresholds of toxicological concern (TTC) have been established from the inhalation risk values found: 0.0018 μg day−1 for all risks, and 1.2 μg day−1 for all risks excluding carcinogenicity, the latter being similar to previously reported inhalation TTCs. PMID:21556207

Critical Evaluation of the Oscillator Strengths of NH2 and the Heats of Formation of NH and NH2

DTIC Science & Technology

1988-07-01

recommendation, although they are somewhf1 on the high side (see Tables 5 and 7). However, Chou, Dean , and Stern found a value of "about" 87 kcal/mole. A careful... Dean , and Stern I0 are mitch too high. It is believed that the recommended value has a strong enough basis to be used as a test of the validity of the...flame results. Therefore, the result of Chou, Dean , and Stern appears to be in error. It is not clear why a systematic error should be present in

[Management of breast nipple discharge: Recommendations].

PubMed

Ouldamer, L; Kellal, I; Legendre, G; Ngô, C; Chopier, J; Body, G

2015-12-01

To investigate diagnostic value of imaging procedures and management strategies of the patients with nipple discharge (ND) to establish management recommendations. Bibliographical search in French and English languages by consultation of PubMed, Cochrane and Embase databases. Although, all ND require an systematic evaluation guided by clinical data, bloody ND could be a predictor of breast cancer risk among different colors of discharge particularly in patients of more than 50 years (LE2). The mammography and breast ultrasography are the imaging procedures to realize in first intention (grade C) but they turn out useful only when they detect radiological abnormalities (LE4). Galactography has only a localizing value of possible ductal abnormalities (when standard imaging procedures is not contributive) (LE4). Thus, in the diagnostic investigation of a suspicious ND, galactography it is not recommended in standard practice (grade C). The breast Magnetic Resonance Imaging (MRI) is recommended when breast standard imaging procedures are not contributive (grade C). The ND cytology is useful only if it is positive (i.e. reveal cancer cells). There is no proof on the diagnostic performance of the cytological analysis of the ND to allow a recommendation on its realization or not. In front of a suspicious ND, when breast-imaging procedures reveals an associated radiological lesion, an adapted percutaneous biopsy is recommended by percutaneous way (grade C). Vacuum-assisted breast biopsies is a diagnostic tool but can also be therapeutic allowing to avoid surgery in case of benign lesion but current literature data do not allow recommendations on the therapeutic aspect of vacuum-assisted breast biopsy (LE4). In the absence of associated radiological signal, and in case of reproducible bloody persistent ND, a pyramidectomy is recommended (grade C). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A Health Economics Approach to US Value Assessment Frameworks-Summary and Recommendations of the ISPOR Special Task Force Report [7].

PubMed

Garrison, Louis P; Neumann, Peter J; Willke, Richard J; Basu, Anirban; Danzon, Patricia M; Doshi, Jalpa A; Drummond, Michael F; Lakdawalla, Darius N; Pauly, Mark V; Phelps, Charles E; Ramsey, Scott D; Towse, Adrian; Weinstein, Milton C

2018-02-01

This summary section first lists key points from each of the six sections of the report, followed by six key recommendations. The Special Task Force chose to take a health economics approach to the question of whether a health plan should cover and reimburse a specific technology, beginning with the view that the conventional cost-per-quality-adjusted life-year metric has both strengths as a starting point and recognized limitations. This report calls for the development of a more comprehensive economic evaluation that could include novel elements of value (e.g., insurance value and equity) as part of either an "augmented" cost-effectiveness analysis or a multicriteria decision analysis. Given an aggregation of elements to a measure of value, consistent use of a cost-effectiveness threshold can help ensure the maximization of health gain and well-being for a given budget. These decisions can benefit from the use of deliberative processes. The six recommendations are to: 1) be explicit about decision context and perspective in value assessment frameworks; 2) base health plan coverage and reimbursement decisions on an evaluation of the incremental costs and benefits of health care technologies as is provided by cost-effectiveness analysis; 3) develop value thresholds to serve as one important input to help guide coverage and reimbursement decisions; 4) manage budget constraints and affordability on the basis of cost-effectiveness principles; 5) test and consider using structured deliberative processes for health plan coverage and reimbursement decisions; and 6) explore and test novel elements of benefit to improve value measures that reflect the perspectives of both plan members and patients. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Assessment of natural radioactivity levels in soil samples from some areas in Assiut, Egypt.

PubMed

El-Gamal, Hany; Farid, M El-Azab; Abdel Mageed, A I; Hasabelnaby, M; Hassanien, Hassanien M

2013-12-01

The natural radioactivity of soil samples from Assiut city, Egypt, was studied. The activity concentrations of 28 samples were measured with a NaI(Tl) detector. The radioactivity concentrations of (226)Ra, (232)Th, and (40)K showed large variations, so the results were classified into two groups (A and B) to facilitate the interpretation of the results. Group A represents samples collected from different locations in Assiut and characterized by low activity concentrations with average values of 46.15 ± 9.69, 30.57 ± 4.90, and 553.14 ± 23.19 for (226)Ra, (232)Th, and (40)K, respectively. Group B represents samples mainly collected from the area around Assiut Thermal Power Plant and characterized by very high activity concentrations with average values of 3,803 ± 145, 1,782 ± 98, and 1,377 ± 78 for (226)Ra, (232)Th, and (40)K, respectively. In order to evaluate the radiological hazard of the natural radioactivity, the radium equivalent activity (Raeq), the absorbed dose rate (D), the annual effective dose rate (E), the external hazard index (H ex), and the annual gonadal dose equivalent (AGDE) have been calculated and compared with the internationally approved values. For group A, the calculated averages of these parameters are in good agreement with the international recommended values except for the absorbed dose rate and the AGDE values which are slightly higher than the international recommended values. However, for group B, all obtained averages of these parameters are much higher by several orders of magnitude than the international recommended values. The present work provides a background of radioactivity concentrations in the soil of Assiut.

The Puerto Rican Prison Experience: A Multicultural Understanding of Values, Beliefs, and Attitudes.

ERIC Educational Resources Information Center

Rivera, Edil Torres; Wilbur, Michael P.; Roberts-Wilbur, Janice

1998-01-01

Counselors are challenged to use a nontraditional, multicultural approach with Puerto Rican inmates, to strive to understand their values, beliefs, experiences, and behaviors; and to question their own underlying assumptions and linear models of therapy. Five specific recommendations are made, and a comparison of beliefs and values is appended.…

Caring, Citizenship, and Conscience: The Cornerstones of a Values Education Curriculum for Elementary Schools.

ERIC Educational Resources Information Center

Braun, Joseph A., Jr.

1992-01-01

Reviews approaches to teaching values in elementary schools. Describes a model consistent with the core values of the United States. Recommends an elementary curriculum resting on three cornerstones: (1) caring, (2) citizenship, and (3) conscience. Points out that controversial issues must be discussed openly within such a curriculum. (CFR)

Model Recommended Values of Corporate Culture for Industrial Companies in Slovak Republic

NASA Astrophysics Data System (ADS)

Urbanovičová, Petra; Mikulášková, Justína; Čambál, Miloš

2017-09-01

The main objective of the paper is to describe the recommended values model of corporate culture and supporting business performance for industrial companies operating in the Slovak Republic. This model was developed on the basis of research results within the STU Project to support young researchers entitled "Changing the potential of the companýs success using the principles of spiral management and its impact on corporate culture". The current paper is a part of submitted VEGA project No.1/0348/17 "The impact of the coexistence of different generations of employees on the sustainable performance of organisations". This model will be the basis for defining corporate values and developing or changing corporate culture for the companies operating on or coming (from abroad) to the Slovak market. The characteristic features of the value model are simplicity, complexity and applicability. This model takes into account the current situation on the Slovak market. The values of this model have a different level of significance given and each value is defined by the specified principles.

Publication Ethics: A Case Series with Recommendations According to Committee on Publication Ethics (COPE).

PubMed

Fazly Bazzaz, Bibi Seddigheh; Sadeghi, Ramin

2012-09-01

Ethical misconduct is not a new issue in the history of science and literature. However, ethical misconducts in science have grown considerably in the modern era which is due to emphasis on the scientific proliferation in research institutes and gauging scientists according to their publications. In the current case series, several misconducts occurring over the previous years in Mashhad University of Medical Sciences (Mashhad, Iran) either for Journals or Faculty members were gathered and specific recommendations were provided to avoid similar events in the future. All recommendations are according to Committee on Publication Ethics (COPE).

Enhancing National Security in Jamaica Through the Development and Employment of Special Forces

DTIC Science & Technology

2005-06-01

face Jamaica. This study examines the value, utility, and possible roles of such a unit in the Jamaican security landscape, and makes recommendations...and possible roles of such a unit in the Jamaican security landscape, and makes recommendations for the establishment and employment of such a unit...

Shedding subspecies: The influence of genetics on reptile subspecies taxonomy.

PubMed

Torstrom, Shannon M; Pangle, Kevin L; Swanson, Bradley J

2014-07-01

The subspecies concept influences multiple aspects of biology and management. The 'molecular revolution' altered traditional methods (morphological traits) of subspecies classification by applying genetic analyses resulting in alternative or contradictory classifications. We evaluated recent reptile literature for bias in the recommendations regarding subspecies status when genetic data were included. Reviewing characteristics of the study, genetic variables, genetic distance values and noting the species concepts, we found that subspecies were more likely elevated to species when using genetic analysis. However, there was no predictive relationship between variables used and taxonomic recommendation. There was a significant difference between the median genetic distance values when researchers elevated or collapsed a subspecies. Our review found nine different concepts of species used when recommending taxonomic change, and studies incorporating multiple species concepts were more likely to recommend a taxonomic change. Since using genetic techniques significantly alter reptile taxonomy there is a need to establish a standard method to determine the species-subspecies boundary in order to effectively use the subspecies classification for research and conservation purposes. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparability among four invertebrate sampling methods and two multimetric indexes, Fountain Creek Basin, Colorado, 2010–2012

USGS Publications Warehouse

Bruce, James F.; Roberts, James J.; Zuellig, Robert E.

2018-05-24

The U.S. Geological Survey (USGS), in cooperation with Colorado Springs City Engineering and Colorado Springs Utilities, analyzed previously collected invertebrate data to determine the comparability among four sampling methods and two versions (2010 and 2017) of the Colorado Benthic Macroinvertebrate Multimetric Index (MMI). For this study, annual macroinvertebrate samples were collected concurrently (in space and time) at 15 USGS surface-water gaging stations in the Fountain Creek Basin from 2010 to 2012 using four sampling methods. The USGS monitoring project in the basin uses two of the methods and the Colorado Department of Public Health and Environment recommends the other two. These methods belong to two distinct sample types, one that targets single habitats and one that targets multiple habitats. The study results indicate that there are significant differences in MMI values obtained from the single-habitat and multihabitat sample types but methods from each program within each sample type produced comparable values. This study also determined that MMI values calculated by different versions of the Colorado Benthic Macroinvertebrate MMI are indistinguishable. This indicates that the Colorado Department of Public Health and Environment methods are comparable with the USGS monitoring project methods for single-habitat and multihabitat sample types. This report discusses the direct application of the study results to inform the revision of the existing USGS monitoring project in the Fountain Creek Basin.

A Biochar Classification System and Associated Test Methods

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

Camps-Arbestain, Marta; Amonette, James E.; Singh, Balwant

2015-02-18

In this chapter, a biochar classification system related to its use as soil amendment is proposed. This document builds upon previous work and constrains its scope to materials with properties that satisfy the criteria for biochar as defined by either the International Biochar Initiative (IBI) Biochar Standards or the European Biochar Community (EBC) Standards, and it is intended to minimise the need for testing in addition to those required according to the above-mentioned standards. The classification system envisions enabling stakeholders and commercial entities to (i) identify the most suitable biochar to fulfil the requirements for a particular soil and/or land-use,more » and (ii) distinguish the application of biochar for specific niches (e.g., soilless agriculture). It is based on the best current knowledge and the intention is to periodically review and update the document based on new data and knowledge that become available in the scientific literature. The main thrust of this classification system is based on the direct or indirect beneficial effects that biochar provides from its application to soil. We have classified the potential beneficial effects of biochar application to soils into five categories with their corresponding classes, where applicable: (i) carbon (C) storage value, (ii) fertiliser value, (iii) liming value, (iv) particle-size, and (v) use in soil-less agriculture. A summary of recommended test methods is provided at the end of the chapter.« less

Unraveling Health Risk and Speciation of Arsenic from Groundwater in Rural Areas of Punjab, Pakistan.

PubMed

Shakoor, Muhammad Bilal; Niazi, Nabeel Khan; Bibi, Irshad; Rahman, Mohammad Mahmudur; Naidu, Ravi; Dong, Zhaomin; Shahid, Muhammad; Arshad, Muhammad

2015-10-05

This study determined the total and speciated arsenic (As) concentrations and other health-related water quality parameters for unraveling the health risk of As from drinking water to humans. Groundwater samples (n = 62) were collected from three previously unexplored rural areas (Chichawatni, Vehari, Rahim Yar Khan) of Punjab in Pakistan. The mean and median As concentrations in groundwater were 37.9 and 12.7 µg·L(-1) (range = 1.5-201 µg·L(-1)). Fifty three percent groundwater samples showed higher As value than WHO safe limit of 10 µg·L(-1). Speciation of As in groundwater samples (n = 13) showed the presence of inorganic As only; arsenite (As(III)) constituted 13%-67% of total As and arsenate (As(V)) ranged from 33% to 100%. For As health risk assessment, the hazard quotient and cancer risk values were 11-18 and 46-600 times higher than the recommended values of US-EPA (i.e., 1.00 and 10(-6), respectively). In addition to As, various water quality parameters (e.g., electrical conductivity, Na, Ca, Cl(-), NO₃(-), SO₄(2-), Fe, Mn, Pb) also enhanced the health risk. The results show that consumption of As-contaminated groundwater poses an emerging health threat to the communities in the study area, and hence needs urgent remedial and management measures.

Unraveling Health Risk and Speciation of Arsenic from Groundwater in Rural Areas of Punjab, Pakistan

PubMed Central

Shakoor, Muhammad Bilal; Niazi, Nabeel Khan; Bibi, Irshad; Rahman, Mohammad Mahmudur; Naidu, Ravi; Dong, Zhaomin; Shahid, Muhammad; Arshad, Muhammad

2015-01-01

This study determined the total and speciated arsenic (As) concentrations and other health-related water quality parameters for unraveling the health risk of As from drinking water to humans. Groundwater samples (n = 62) were collected from three previously unexplored rural areas (Chichawatni, Vehari, Rahim Yar Khan) of Punjab in Pakistan. The mean and median As concentrations in groundwater were 37.9 and 12.7 µg·L−1 (range = 1.5–201 µg·L−1). Fifty three percent groundwater samples showed higher As value than WHO safe limit of 10 µg·L−1. Speciation of As in groundwater samples (n = 13) showed the presence of inorganic As only; arsenite (As(III)) constituted 13%–67% of total As and arsenate (As(V)) ranged from 33% to 100%. For As health risk assessment, the hazard quotient and cancer risk values were 11–18 and 46–600 times higher than the recommended values of US-EPA (i.e., 1.00 and 10−6, respectively). In addition to As, various water quality parameters (e.g., electrical conductivity, Na, Ca, Cl−, NO3−, SO42−, Fe, Mn, Pb) also enhanced the health risk. The results show that consumption of As-contaminated groundwater poses an emerging health threat to the communities in the study area, and hence needs urgent remedial and management measures. PMID:26445051

The American Academy of Neurology's top five choosing wisely recommendations.

PubMed

Langer-Gould, Annette M; Anderson, Wayne E; Armstrong, Melissa J; Cohen, Adam B; Eccher, Matthew A; Iverson, Donald J; Potrebic, Sonja B; Becker, Amanda; Larson, Rod; Gedan, Alicia; Getchius, Thomas S D; Gronseth, Gary S

2013-09-10

To discuss the American Academy of Neurology (AAN)'s Top Five Recommendations in the Choosing Wisely campaign promoting high-value neurologic medicine and physician-patient communication. The AAN published its Top Five Recommendations in February 2013 in collaboration with the American Board of Internal Medicine Foundation and Consumer Reports. A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations. The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (<3%).

Treating Women with Bulimia from a Sociocultural Perspective.

ERIC Educational Resources Information Center

Hotelling, Kathy

1986-01-01

Outlines a sociocultural perspective of bulimia. Notes that since bulimia occurs in a sociocultural context, which includes a socialized developmental path with concomittant norms and values, effective treatment must address those norms and values. Recommends group therapy. (ABB)

Assessment of learning, memory, and attention in developmental neurotoxicity regulatory studies: synthesis, commentary, and recommendations.

PubMed

Vorhees, Charles V; Makris, Susan L

2015-01-01

Cognitive tests of learning and memory (L&M) have been required by U.S. Environmental Protection Agency (EPA) developmental neurotoxicity test (DNT) guidelines for more than two decades. To evaluate the utility of these guidelines, the EPA reviewed 69 pesticide DNT studies. This review found that the DNT provided or could provide the point-of-departure for risk assessment by showing the Lowest Observable Adverse Effect Level (LOAEL) in 28 of these studies in relation to other reported end points. Among the behavioral tests, locomotor activity and auditory/acoustic startle provided the most LOAELs, and tests of cognitive function and the Functional Observational Battery (FOB) the fewest. Two issues arose from the review: (1) what is the relative utility of cognitive tests versus tests of unconditioned behavior, and (2) how might cognitive tests be improved? The EPA sponsored a symposium to address this. Bushnell reviewed studies in which both screening (locomotor activity, FOB, reflex ontogeny, etc.) and complex tests (those requiring training) were used within the same study; he found relatively little evidence that complex tests provided a LOAEL lower than screening tests (with exceptions). Levin reviewed reasons for including cognitive tests in regulatory studies and methods and evidence for the radial arm maze and its place in developmental neurotoxicity assessments. Driscoll and Strupp reviewed the value of serial reaction time operant methods for assessing executive function in developmental neurotoxicity studies. Vorhees and Williams reviewed the value of allocentric (spatial) and egocentric cognitive tests and presented methods for using the Morris water maze for spatial and the Cincinnati water maze for egocentric cognitive assessment. They also reviewed the possible use of water radial mazes. The relatively lower impact of cognitive tests in previous DNT studies in the face of the frequency of human complaints of chemical-induced cognitive dysfunction indicates that animal cognitive tests need improvement. The contributors to this symposium suggest that if the guidelines are updated, they be made more specific by recommending preferred tests and providing greater detail on key characteristics of such tests. Additionally, it is recommended that guidance be developed to address important issues with cognitive tests and to provide the information needed to improve the design, conduct, and interpretation of tests of higher function within a regulatory context. These steps will maximize the value of cognitive tests for use in hazard evaluation and risk assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

An assessment of quality of water from boreholes in Bindura District, Zimbabwe

NASA Astrophysics Data System (ADS)

Hoko, Zvikomborero

This study assessed the water quality of 144 boreholes in Bindura District in Mashonaland Province of Zimbabwe as part of a borehole rehabilitation project implemented by a local NGO. In previous studies it has been observed that some boreholes are not used for domestic purposes because of consumer perceived poor water quality. Consequently, communities have resorted to unsafe alternative water sources thus creating health risks. The study was carried out in June 2005. The objectives of the study were to assess the levels of parameters associated with the aesthetics of the water and to compare them with guideline values for drinking water. The study also investigated the relationship between some of the measured water quality and the consumer perceived water quality. Measured water quality parameters included pH, temperature, electrical conductivity (EC), turbidity, calcium (Ca), magnesium (Mg) and iron (Fe). All parameters were measured in the field except Ca, Mg and Fe, which were measured in a laboratory using a spectrophotometer. Consumer perceptions on water quality were investigated through interviews with the consumer community. Turbidity was found to be 0.75-428(20.8 ± 59.2; n = 144) NTU, pH 5.7-9.3 (6.88 ± 0.46; n = 144), temperature 18-26.8 (22.6 ± 2.1; n = 144) °C. EC 26-546 (199 ± 116; n = 144) μS/cm, Ca 6-71.6 (26.9 ± 14.1; n = 81) mg/l, Mg 1.2-49.6 (12.3 ± 10.0; n = 81) mg/l and Fe 0.08-9.60 (0.56 ± 1.15; n = 81) mg/l. Some 23% of the samples had pH outside the recommended range of 6.5-8.5, whilst 59% of the samples had turbidity values exceeding the 5NTU WHO limit. For EC, all samples had values less than the WHO derived limit of 1380 μS/cm. All Ca and magnesium values were within the common and recommended levels of 100 mg/l and 70 mg/l respectively. Iron had values greater than the WHO and SAZ limit of 0.3 mg/l in 36% of the samples. Water quality was deemed satisfactory for taste and soap consumption by 95% and 72% of the respondents respectively. Satisfaction was higher for drinking compared to soap consumption meaning that generally hard waters may still be acceptable for drinking purposes. The water quality met the stipulated standard or guideline value from a minimum of 41% (turbidity) to a maximum of 100% (EC, Ca and Mg). There was no correlation between taste and conductivity as some 5% of the respondents suggested the water was unsatisfactory although all EC values were far below the maximum limit. Again there was no correlation between iron and taste as iron had 36% of the samples above the threshold of 0.3 mg/l whilst objectionable taste perception was only in 5% of the cases. It is recommended that priority in future projects should be given to repairs of boreholes whose water quality is acceptable according to consumer perceptions obtained at project planning stage. Low cost household treatment aimed at improving quality should be investigated.

Comparing the Values Hierarchy of the Kentucky Department of Education's Character/Values Task Force. Comparing a Character/Values Task Force to a National Sample.

ERIC Educational Resources Information Center

Butler, Fonda P.

In March 1989, the Kentucky Department of Education assembled a task force to make recommendations regarding the issue of teaching values and character in public schools in Kentucky. The 23-member task force represented educators, parents, the legislature, state and local school boards, law enforcement agencies, higher education, Catholic…

Dissipation pattern and risk assessment studies of triazophos residues on capsicum (Capsicum annuum L.) using GLC-FPD and GC-MS.

PubMed

Singh, Yadwinder; Mandal, Kousik; Singh, Balwinder

2015-10-01

The present study was carried out to observe the dissipation pattern of triazophos on capsicum and risk assessment of its residues on human beings and to suggest a waiting period for the safety of consumers. Following two applications of triazophos (Truzo 40 EC) at 500 and 1000 g a.i. ha(-1), the average initial deposits were found to be 3.61 and 6.26 mg kg(-1), respectively. These residues dissipated below the limit of quantification (LOQ) of 0.05 mg kg(-1) in 10 and 15 days at the recommended and double the recommended dosages, respectively. The calculated values of half-life were 2.31 and 2.14 days at recommended and double the recommended dosages, respectively. Theoretical maximum residue contribution (TMRC) values were found to be 28.8 and 41.6 μg person(-1) day(-1) at 500 and 1000 g a.i. ha(-1), respectively, and found to be below the maximum permissible intake on capsicum fruit on the 7th day. Therefore, a waiting period of 7 days is suggested for consumption of capsicum sprayed with triazophos at the recommended dosages.

Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans

PubMed Central

Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

2017-01-01

ABSTRACT Background: Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective: This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods: Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results: The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions: Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment. PMID:29435200

Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans.

PubMed

Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

2017-01-01

Background : Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective : This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods : Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results : The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions : Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment.

An Interlaboratory Validation of the Radiation Dose Response Relationship (DRR) for H-ARS in the Rhesus Macaque.

PubMed

Thrall, Karla D; Love, Ruschelle; OʼDonnell, Kyle C; Farese, Ann M; Manning, Ronald; MacVittie, Thomas J

2015-11-01

The Medical Countermeasures against Radiological Threats (MCART) consortium has established a dose response relationship for the hematopoietic acute radiation syndrome (HARS) in the rhesus macaque conducted under an individualized supportive care protocol, including blood transfusions. Application of this animal model as a platform for demonstrating efficacy of candidate medical countermeasures is significantly strengthened when the model is independently validated at multiple institutions. The study reported here describes implementation of standard operating procedures at an institute outside the consortium in order to evaluate the ability to establish an equivalent radiation dose response relationship in a selected species. Validation of the animal model is a significant component for consideration of the model protocol as an FDA-recommended drug development tool in the context of the "Animal Rule." In the current study, 48 male rhesus macaques (4-8 kg) were exposed to total-body irradiation (TBI) using 6 MV photon energy at a dose rate of approximately 0.8 Gy min. Results show that onset and duration of the hematological response, including anemia, neutropenia, and thrombocytopenia, following TBI ranging from 6.25 to 8.75 Gy correlate well with previously reported findings. The lethality values at 60 d following TBI were estimated to be 6.88 Gy (LD30/60), 7.43 Gy (LD50/60), and 7.98 Gy (LD70/60). These values are equivalent to those published previously of 7.06 Gy (LD30/60), 7.52 Gy (LD50/60), and 7.99 Gy (LD70/60); the DRR slope (p = 0.68) and y-intercepts show agreement along the complete dose range for HARS. The ability to replicate the previously established institutional lethality profile (PROBIT) and model outcomes through careful implementation of defined procedures is a testament to the robustness of the model and highlights the need for consistency in procedures.

Recommended values of clean metal surface work functions

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

Derry, Gregory N., E-mail: gderry@loyola.edu; Kern, Megan E.; Worth, Eli H.

2015-11-15

A critical review of the experimental literature for measurements of the work functions of clean metal surfaces of single-crystals is presented. The tables presented include all results found for low-index crystal faces except cases that were known to be contaminated surfaces. These results are used to construct a recommended value of the work function for each surface examined, along with an uncertainty estimate for that value. The uncertainties are based in part on the error distribution for all measured work functions in the literature, which is included here. The metals included in this review are silver (Ag), aluminum (Al), goldmore » (Au), copper (Cu), iron (Fe), iridium (Ir), molybdenum (Mo), niobium (Nb), nickel (Ni), palladium (Pd), platinum (Pt), rhodium (Rh), ruthenium (Ru), tantalum (Ta), and tungsten (W)« less

[Guidelines for the management of hypertension].

PubMed

Prieto-Díaz, Miguel Ángel

2014-09-01

In the last year, several scientific societies have published guidelines for the management of arterial hypertension. In Spain, two clinical practice guidelines have had a strong impact and have been closely followed in the last few years: the first is the Guideline of the National Heart, Lung and Blood Institute, although their last report (JNC 7) was published in 2003; the second is the clinical practice guideline for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH), whose latest version was published in 2007, although an update was published in 2009. A new ESC/ESH document, published in 2013, adopts a mainly educational stance, closely rooted in clinical practice. Many of the recommendations maintain the same criteria as previous guidelines. However, the new publication shows greater rigor and contains major contributions such as specification of the level of evidence and grade of recommendation for each recommendation, which was lacking in the previous guidelines of these societies. The document is both practical and easy to consult, consisting of 17 tables, 5 figures and 18 blocks of recommendations. The JNC 8 report, however, has a single objective: to respond to three questions that are considered a priority and which refer exclusively to drug therapy. Nine recommendations are made relating to these three questions. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

Participation in recreation and sports for persons with spinal cord injury: review and recommendations.

PubMed

Slater, Daniel; Meade, Michelle A

2004-01-01

Recreation and sports following Spinal Cord Injury (SCI) are beneficial, but under-studied, aspects of community integration. Previous studies have shown that sports and recreation can offer numerous physiological and psychological benefits to those who participate. This manuscript critically reviews available literature focused upon participation in recreation and sports among persons with SCI. Issues of participation, technology and safety are discussed and recommendations are provided.

Summary Report: DoD Information Technology Contracts Awarded Without Competition Were Generally Justified

DTIC Science & Technology

2015-09-09

fifth and final report in a series of audits on IT contracts issued without competition. We nonstatistically selected for review 232 of 602...We are not making any recommendations in this report because we made recommendations in the previous reports in this audit series. If implemented...written justification. We conducted this audit in accordance with generally accepted government auditing standards, except for planning and evidence

Observed and Modeled HOCl Profiles in the Midlatitude Stratosphere: Implication for Ozone Loss

NASA Technical Reports Server (NTRS)

Kovalenko, L. J.; Jucks, K. W.; Salawitch, R. J.; Toon, G. C.; Blavier, J. F.; Johnson, D. G.; Kleinbohl, A.; Livesey, N. J .; Margitan, J. J.; Pickett, H. M.;

Evaluation of exposure parameters in plain radiography: a comparative study with European guidelines.

PubMed

Lança, L; Silva, A; Alves, E; Serranheira, F; Correia, M

2008-01-01

Typical distribution of exposure parameters in plain radiography is unknown in Portugal. This study aims to identify exposure parameters that are being used in plain radiography in the Lisbon area and to compare the collected data with European references [Commission of European Communities (CEC) guidelines]. The results show that in four examinations (skull, chest, lumbar spine and pelvis), there is a strong tendency of using exposure times above the European recommendation. The X-ray tube potential values (in kV) are below the recommended values from CEC guidelines. This study shows that at a local level (Lisbon region), radiographic practice does not comply with CEC guidelines concerning exposure techniques. Further national/local studies are recommended with the objective to improve exposure optimisation and technical procedures in plain radiography. This study also suggests the need to establish national/local diagnostic reference levels and to proceed to effective measurements for exposure optimisation.

Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals

PubMed Central

2012-01-01

Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were positive to learning such therapy. Communication about CAM between patients and the health care professions was found to be rare. Conclusion There is a lack of knowledge about CAM and research about it among registered health care professions in Swedish surgical care. However, in contrast to previous studies the results revealed that the majority perceived it as important to gain knowledge in this field. PMID:22498305

Standardization for Ki-67 Assessment in Moderately Differentiated Breast Cancer. A Retrospective Analysis of the SAKK 28/12 Study

PubMed Central

Varga, Zsuzsanna; Cassoly, Estelle; Li, Qiyu; Oehlschlegel, Christian; Tapia, Coya; Lehr, Hans Anton; Klingbiel, Dirk; Thürlimann, Beat; Ruhstaller, Thomas

2015-01-01

Background Proliferative activity (Ki-67 Labelling Index) in breast cancer increasingly serves as an additional tool in the decision for or against adjuvant chemotherapy in midrange hormone receptor positive breast cancer. Ki-67 Index has been previously shown to suffer from high inter-observer variability especially in midrange (G2) breast carcinomas. In this study we conducted a systematic approach using different Ki-67 assessments on large tissue sections in order to identify the method with the highest reliability and the lowest variability. Materials and Methods Five breast pathologists retrospectively analyzed proliferative activity of 50 G2 invasive breast carcinomas using large tissue sections by assessing Ki-67 immunohistochemistry. Ki-67-assessments were done on light microscopy and on digital images following these methods: 1) assessing five regions, 2) assessing only darkly stained nuclei and 3) considering only condensed proliferative areas (‘hotspots’). An individual review (the first described assessment from 2008) was also performed. The assessments on light microscopy were done by estimating. All measurements were performed three times. Inter-observer and intra-observer reliabilities were calculated using the approach proposed by Eliasziw et al. Clinical cutoffs (14% and 20%) were tested using Fleiss’ Kappa. Results There was a good intra-observer reliability in 5 of 7 methods (ICC: 0.76–0.89). The two highest inter-observer reliability was fair to moderate (ICC: 0.71 and 0.74) in 2 methods (region-analysis and individual-review) on light microscopy. Fleiss’-kappa-values (14% cut-off) were the highest (moderate) using the original recommendation on light-microscope (Kappa 0.58). Fleiss’ kappa values (20% cut-off) were the highest (Kappa 0.48 each) in analyzing hotspots on light-microscopy and digital-analysis. No methodologies using digital-analysis were superior to the methods on light microscope. Conclusion Our results show that all methods on light-microscopy for Ki-67 assessment in large tissue sections resulted in a good intra-observer reliability. Region analysis and individual review (the original recommendation) on light-microscopy yielded the highest inter-observer reliability. These results show slight improvement to previously published data on poor-reproducibility and thus might be a practical-pragmatic way for routine assessment of Ki-67 Index in G2 breast carcinomas. PMID:25885288

Evaluation of an adult insulin infusion protocol at an academic medical center.

PubMed

Petrov, Katerina I; Burns, Tammy L; Drincic, Andjela

2012-05-01

Acknowledging evidence of possible detrimental effects of tightly controlled blood glucose levels, the American Association of Clinical Endocrinologists and the American Diabetes Association published a consensus statement recommending less strict control for most diabetic patients. As a result of these recommendations, our academic center at Creighton University Medical Center revised its adult insulin infusion protocol to target blood glucose levels ranging from 120 to 180 mg/dL for regular (standard) glycemic control and 80 to 120 mg/dL for tight control; previous targets had ranged from 80 to 180 mg/dL and 70 to 110 mg/dL, respectively. The primary objective was to evaluate the time that blood glucose values were within the target range for patients receiving the new protocol, compared with patients receiving the previous protocol. Our study was designed to evaluate the effectiveness and safety of the revised protocol. Using a retrospective chart review, we collected data for 4 months from patients on the old insulin protocol (May to August 2009) and for 4 months from patients on the new protocol (September to December 2009). Secondary endpoints included the number of hypoglycemic episodes (blood glucose below 70 mg/dL) and severe hypoglycemic episodes (blood glucose 40 mg/dL or lower) experienced by patients receiving the new insulin protocol compared with those receiving the former protocol. Patient characteristics were similar at baseline. Blood glucose values stayed within the target range for a significantly shorter time with the new protocol than with the former protocol (44.6% vs. 56.8%, respectively; P < 0.001), probably because of the narrower target range in the revised protocol. No statistically significant differences in hypoglycemia were observed after the protocol was changed. Hypoglycemia occurred in 31% of the former-protocol patients compared with 18% of the revised-protocol patients. Severe hypoglycemia was experienced by 2.1% of patients on the old protocol and by 3.1% of patients on the new protocol. Rates of severe hypoglycemia were low (2.6%) with the original protocol. Patients' blood glucose levels were within the target range for a shorter time with the new protocol. Fewer episodes of hypoglycemia were recorded with the new protocol, but rates of severe hypoglycemia were similar with both protocols.

Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals.

PubMed

Bjerså, Kristofer; Stener Victorin, Elisabet; Fagevik Olsén, Monika

2012-04-12

Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were positive to learning such therapy. Communication about CAM between patients and the health care professions was found to be rare. There is a lack of knowledge about CAM and research about it among registered health care professions in Swedish surgical care. However, in contrast to previous studies the results revealed that the majority perceived it as important to gain knowledge in this field.

A review of recent studies on differential reinforcement during skill acquisition in early intervention.

PubMed

Vladescu, Jason C; Kodak, Tiffany

2010-01-01

Although the use of differential reinforcement has been recommended in previous investigations and in early intervention curriculum manuals, few studies have evaluated the best method for providing differential reinforcement to maximize independent responding. This paper reviews previous research on the effectiveness of differential reinforcement as treatment and describes important areas of future research.

Development of a Reading Material Recommendation System Based on a Knowledge Engineering Approach

ERIC Educational Resources Information Center

Hsu, Ching-Kun; Hwang, Gwo-Jen; Chang, Chih-Kai

2010-01-01

In a language curriculum, the training of reading ability is one of the most important aspects. Previous studies have shown the importance of assigning proper articles to individual students for training their reading ability; nevertheless, previous experience has also shown the challenges of this issue owing to the complexity of personal factors…

[The latest in paediatric resuscitation recommendations].

PubMed

López-Herce, Jesús; Rodríguez, Antonio; Carrillo, Angel; de Lucas, Nieves; Calvo, Custodio; Civantos, Eva; Suárez, Eva; Pons, Sara; Manrique, Ignacio

2017-04-01

Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation. This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Impact of different recommendations on adequacy rate for sleep duration in children.

PubMed

Bruni, Oliviero; Brambilla, Paolo

2017-01-25

A huge amount of literature in the last decades showed that sleep is essential for children's health and well-being and that short sleep duration is associated with several negative health outcomes. Many developmental phases in infancy and childhood are in strict relationship with an healthy sleep.In the last years some specific recommendations made for how much sleep children need have been published. The empirical evidences for contemporary sleep recommendations has changed and the new recommendations are clearly different from the previous ones and reflect clearly the changes in the sleep need of the children and adolescents in the last decades although seem still to be largely unfitting for preadolescence and adolescence.If sleep is to be treated as a therapeutic intervention, then consensus guidelines, statements, and evidence-based best-practice documents are needed to underpin sleep recommendations for children.Sleep recommendations for children play an important role for public policies and interventions, and to advertise parents and children of the negative consequences of sleep deprivation/reduction.

Hot news recommendation system from heterogeneous websites based on bayesian model.

PubMed

Xia, Zhengyou; Xu, Shengwu; Liu, Ningzhong; Zhao, Zhengkang

2014-01-01

The most current news recommendations are suitable for news which comes from a single news website, not for news from different heterogeneous news websites. Previous researches about news recommender systems based on different strategies have been proposed to provide news personalization services for online news readers. However, little research work has been reported on utilizing hundreds of heterogeneous news websites to provide top hot news services for group customers (e.g., government staffs). In this paper, we propose a hot news recommendation model based on Bayesian model, which is from hundreds of different news websites. In the model, we determine whether the news is hot news by calculating the joint probability of the news. We evaluate and compare our proposed recommendation model with the results of human experts on the real data sets. Experimental results demonstrate the reliability and effectiveness of our method. We also implement this model in hot news recommendation system of Hangzhou city government in year 2013, which achieves very good results.

Hot News Recommendation System from Heterogeneous Websites Based on Bayesian Model

PubMed Central

Xia, Zhengyou; Xu, Shengwu; Liu, Ningzhong; Zhao, Zhengkang

2014-01-01

The most current news recommendations are suitable for news which comes from a single news website, not for news from different heterogeneous news websites. Previous researches about news recommender systems based on different strategies have been proposed to provide news personalization services for online news readers. However, little research work has been reported on utilizing hundreds of heterogeneous news websites to provide top hot news services for group customers (e.g., government staffs). In this paper, we propose a hot news recommendation model based on Bayesian model, which is from hundreds of different news websites. In the model, we determine whether the news is hot news by calculating the joint probability of the news. We evaluate and compare our proposed recommendation model with the results of human experts on the real data sets. Experimental results demonstrate the reliability and effectiveness of our method. We also implement this model in hot news recommendation system of Hangzhou city government in year 2013, which achieves very good results. PMID:25093207

A number of factors explain why WHO guideline developers make strong recommendations inconsistent with GRADE guidance.

PubMed

Alexander, Paul E; Gionfriddo, Michael R; Li, Shelly-Anne; Bero, Lisa; Stoltzfus, Rebecca J; Neumann, Ignacio; Brito, Juan P; Djulbegovic, Benjamin; Montori, Victor M; Norris, Susan L; Schünemann, Holger J; Thabane, Lehana; Guyatt, Gordon H

2016-02-01

Many strong recommendations issued by the World Health Organization (WHO) are based on low- or very low-quality (low certainty) evidence (discordant recommendations). Many such discordant recommendations are inconsistent with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidance. We sought to understand why WHO makes discordant recommendations inconsistent with GRADE guidance. We interviewed panel members involved in guidelines approved by WHO (2007-2012) that included discordant recommendations. Interviews, recorded and transcribed, focused on use of GRADE including the reasoning underlying, and factors contributing to, discordant recommendations. Four themes emerged: strengths of GRADE, challenges and barriers to GRADE, strategies to improve GRADE application, and explanations for discordant recommendations. Reasons for discordant recommendations included skepticism about the value of making conditional recommendations; political considerations; high certainty in benefits (sometimes warranted, sometimes not) despite assessing evidence as low certainty; and concerns that conditional recommendations will be ignored. WHO panelists make discordant recommendations inconsistent with GRADE guidance for reasons that include limitations in their understanding of GRADE. Ensuring optimal application of GRADE at WHO and elsewhere likely requires selecting panelists who have a commitment to GRADE principles, additional training of panelists, and formal processes to maximize adherence to GRADE principles. Copyright © 2016 Elsevier Inc. All rights reserved.

Transit value capture coordination : case studies, best practices, and recommendations.

DOT National Transportation Integrated Search

2015-02-17

This study is based on the hypothesis that coordination between transit capital planners, municipal taxation authorities, and private developers and stakeholders can be a benefit to transit capital projects that choose to use value capture as a fundi...

Personalized recommendation based on preferential bidirectional mass diffusion

NASA Astrophysics Data System (ADS)

Chen, Guilin; Gao, Tianrun; Zhu, Xuzhen; Tian, Hui; Yang, Zhao

2017-03-01

Recommendation system provides a promising way to alleviate the dilemma of information overload. In physical dynamics, mass diffusion has been used to design effective recommendation algorithms on bipartite network. However, most of the previous studies focus overwhelmingly on unidirectional mass diffusion from collected objects to uncollected objects, while overlooking the opposite direction, leading to the risk of similarity estimation deviation and performance degradation. In addition, they are biased towards recommending popular objects which will not necessarily promote the accuracy but make the recommendation lack diversity and novelty that indeed contribute to the vitality of the system. To overcome the aforementioned disadvantages, we propose a preferential bidirectional mass diffusion (PBMD) algorithm by penalizing the weight of popular objects in bidirectional diffusion. Experiments are evaluated on three benchmark datasets (Movielens, Netflix and Amazon) by 10-fold cross validation, and results indicate that PBMD remarkably outperforms the mainstream methods in accuracy, diversity and novelty.

CE: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States.

PubMed

Parmer, John; Allen, Leeanna; Walton, Wanda

2017-08-01

: Nurses play a critical role in the diagnosis and treatment of tuberculosis and in the prevention of tuberculosis transmission through infection control practices. To eliminate tuberculosis in the United States, however, an expanded approach to testing and treating people with latent tuberculosis infection must be implemented. Recently, the U.S. Preventive Services Task Force (USPSTF) issued a new recommendation statement on latent tuberculosis infection testing that expands nurses' opportunities to identify at-risk populations for tuberculosis prevention. In combination with newer testing methodologies and shorter treatment regimens, implementation of the USPSTF recommendation has the potential to remove previously existing barriers to screening and treatment of both patients and health care providers. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation's applicability to public health and primary care practice in the United States.

Participatory and evidence-based recommendations for urban redevelopment following natural disasters: older adults as policy advisers.

PubMed

Annear, Michael; Keeling, Sally; Wilkinson, Tim

2014-03-01

To develop community-generated recommendations to inform urban environmental remediation following earthquakes in Christchurch, New Zealand, and share these with local decision-makers during a participatory action research process. This study employed three focus group discussions to critique mixed-methods and multiphase results and develop evidence-based recommendations. Participants included 30 volunteers and 8 knowledgeable advisers aged 65 years and older. Participant recommendations addressed the remediation of earthquake-affected suburbs, access to transportation, age-friendly design, safer communities, resilient support agencies, and restoration of resources for social and cultural activities. Older collaborators identified salient barriers to active ageing and options for post-earthquake redevelopment that had not previously been considered in research or policy. Independently living older adults are well placed to work with researchers to develop recommendations to improve the urban environment following natural disasters as well as in times of relative stability. © 2013 ACOTA.

Management of Subclinical Hypothyroidism in Pregnancy: A Comment from the Italian Society of Endocrinology and the Italian Thyroid Association to the 2017 American Thyroid Association Guidelines-"The Italian Way".

PubMed

Rotondi, Mario; Chiovato, Luca; Pacini, Furio; Bartalena, Luigi; Vitti, Paolo

2018-05-01

The 2017 American Thyroid Association guidelines for the diagnosis and management of thyroid disease during pregnancy and the postpartum were published six years after the previous ones. They provide comprehensive clinical recommendations for the whole spectrum of thyroid diseases, as well as for optimal iodine intake during pregnancy, postpartum, and lactation. The present position statement mainly regards the recommended flow chart for therapeutic decision making in pregnant women being diagnosed with subclinical hypothyroidism. Here, we comment on the major biochemical and clinical situations and the corresponding therapeutic recommendations. In particular, we welcome the critical revision of the thyrotropin (TSH) reference range in pregnancy, and we agree that there is no need to treat thyroid peroxidase antibody-negative women with a serum TSH ranging from 2.5 μIU/mL to the upper limit of the reference range. This recommendation will hopefully reduce the huge proportion of healthy pregnant women in whom, according to the previous guidelines, levothyroxine therapy had to be initiated. On the other hand, we are concerned with the recommendation to only "consider treatment" in thyroid peroxidase antibody-negative pregnant women with a serum TSH ranging from the upper limit of the reference range to 10.0 μIU/mL. This is because thyroid antibodies may be falsely negative during gestation, and serum negative chronic autoimmune thyroiditis is a well-known clinical entity even outside pregnancy. Based on these and other arguments, we recommend treatment with levothyroxine in pregnant women with TSH levels ranging between the upper limit of the reference range and 10.0 μIU/mL independently from their thyroid antibody status.

2018 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Focused Update of the Guidelines for the Use of Antiplatelet Therapy.

PubMed

Mehta, Shamir R; Bainey, Kevin R; Cantor, Warren J; Lordkipanidzé, Marie; Marquis-Gravel, Guillaume; Robinson, Simon D; Sibbald, Matthew; So, Derek Y; Wong, Graham C; Abunassar, Joseph G; Ackman, Margaret L; Bell, Alan D; Cartier, Raymond; Douketis, James D; Lawler, Patrick R; McMurtry, Michael S; Udell, Jacob A; van Diepen, Sean; Verma, Subodh; Mancini, G B John; Cairns, John A; Tanguay, Jean-François

2018-03-01

Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence. The present update to the 2011 and 2013 Canadian Cardiovascular Society APT guidelines incorporates new evidence on how to optimize APT use, particularly in situations in which few to no data were previously available. The recommendations update focuses on the following primary topics: (1) the duration of dual APT (DAPT) in patients who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome and non-acute coronary syndrome indications; (2) management of DAPT in patients who undergo noncardiac surgery; (3) management of DAPT in patients who undergo elective and semiurgent coronary artery bypass graft surgery; (4) when and how to switch between different oral antiplatelet therapies; and (5) management of antiplatelet and anticoagulant therapy in patients who undergo PCI. For PCI patients, we specifically analyze the particular considerations in patients with atrial fibrillation, mechanical or bioprosthetic valves (including transcatheter aortic valve replacement), venous thromboembolic disease, and established left ventricular thrombus or possible left ventricular thrombus with reduced ejection fraction after ST-segment elevation myocardial infarction. In addition to specific recommendations, we provide values and preferences and practical tips to aid the practicing clinician in the day to day use of these important agents. Copyright © 2018. Published by Elsevier Inc.

Use of the UKHCDO Database for a postmarketing surveillance study of different doses of recombinant factor VIIa in haemophilia.

PubMed

Hay, C R M; Sharpe, T; Dolan, G

2017-05-01

Recombinant factor VIIa (rFVIIa) is recommended in Europe at standard (3 × 90 μg kg -1 ) or high (1 × 270 μg kg -1 ) doses. When granting the license for the high dose, the European Medicines Agency (EMA) requested postmarketing surveillance for thrombosis. This was conducted by the United Kingdom National Haemophilia Database (NHD) on behalf of Novo Nordisk and the EMA. To assess the use and safety of rFVIIa utilizing prospective data collected by the NHD (1 January 2008 to 30 June 2011). Data were obtained from 67 haemophilia A/B patients with inhibitors treated for 1057 bleeds and 31 acquired haemophilia patients treated for 70 bleeds. Initial rFVIIa dose was categorized post hoc as low (<90 μg kg -1 ), intermediate (≥90-<180 μg kg -1 ) or high (≥180-<270 or ≥270 μg kg -1 ). For haemophilia A/B, high and lower initial rFVIIa dose was used for 38.4% and 51.4% of episodes, respectively, while for acquired haemophilia, the values were 11.4% and 77.1% respectively. Median initial doses were higher for haemophilia A/B (146.3 μg kg -1 ) than acquired haemophilia (90.5 μg kg -1 ). A single administration of rFVIIa was the most frequently used regimen for haemophilia A/B, in contrast with standard recommendations and previous reports. For acquired haemophilia, most episodes were treated with multiple doses. No adverse drug reactions or thromboembolic events were reported for any rFVIIa dose. The novel use of a national database for postmarketing surveillance has demonstrated acceptable safety for all recommended doses of rFVIIa. © 2016 John Wiley & Sons Ltd.

Body composition and physical fitness in women with bulimia nervosa or binge-eating disorder.

PubMed

Mathisen, Therese Fostervold; Rosenvinge, Jan H; Friborg, Oddgeir; Pettersen, Gunn; Stensrud, Trine; Hansen, Bjørge Herman; Underhaug, Karoline E; Teinung, Elisabeth; Vrabel, KariAnne; Svendsen, Mette; Bratland-Sanda, Solfrid; Sundgot-Borgen, Jorunn

2018-04-01

Knowledge about physical fitness in women with bulimia nervosa (BN) or binge-eating disorder (BED) is sparse. Previous studies have measured physical activity largely through self-report, and physical fitness variables are mainly restricted to body mass index (BMI) and bone mineral density. We expanded the current knowledge in these groups by including a wider range of physical fitness indicators and objective measures of physical activity, assessed the influence of a history of anorexia nervosa (AN), and evaluated predictive variables for physical fitness. Physical activity, blood pressure, cardiorespiratory fitness (CRF), muscle strength, body composition, and bone mineral density were measured in 156 women with BN or BED, with mean (SD) age 28.4 years (5.7) and BMI 25.3 (4.8) kg m -2 . Level of physical activity was higher than normative levels, still <50% met the official physical activity recommendation. Fitness in women with BN were on an average comparable with recommendations or normative levels, while women with BED had lower CRF and higher BMI, VAT, and body fat percentage. We found 10-12% with masked obesity. A history of AN did not predict current physical fitness, still values for current body composition were lower when comparing those with history of AN to those with no such history. Overall, participants with BN or BED displayed adequate physical fitness; however, a high number had unfavorable CRF and body composition. This finding calls for inclusion of physical fitness in routine clinical examinations and guided physical activity and dietary recommendations in the treatment of BN and BED. © 2018 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc.

Resource values in analyzing fire management programs for economic efficiency

Treesearch

Irene A. Althaus; Thomas J. Mills

1982-01-01

In analyzing fire management programs for their economic efficiency, it is necessary to assign monetary values to the changes in resource outputs caused by, fire. The derivation of resource values is complicated by imperfect or nonexistent commercial market structures. The valuation concept recommended for fire program analyses is willingness-to-pay because it permits...

Physician Assessment of Pretest Probability of Malignancy and Adherence With Guidelines for Pulmonary Nodule Evaluation.

PubMed

Tanner, Nichole T; Porter, Alexander; Gould, Michael K; Li, Xiao-Jun; Vachani, Anil; Silvestri, Gerard A

2017-08-01

The annual incidence of pulmonary nodules is estimated at 1.57 million. Guidelines recommend using an initial assessment of nodule probability of malignancy (pCA). A previous study found that despite this recommendation, physicians did not follow guidelines. Physician assessments (N = 337) and two previously validated risk model assessments of pretest probability of cancer were evaluated for performance in 337 patients with pulmonary nodules based on final diagnosis and compared. Physician-assessed pCA was categorized into low, intermediate, and high risk, and the next test ordered was evaluated. The prevalence of malignancy was 47% (n = 158) at 1 year. Physician-assessed pCA performed better than nodule prediction calculators (area under the curve, 0.85 vs 0.75; P < .001 and .78; P = .0001). Physicians did not follow indicated guidelines when selecting the next test in 61% of cases (n = 205). Despite recommendations for serial CT imaging in those with low pCA, 52% (n = 13) were managed more aggressively with PET imaging or biopsy; 12% (n = 3) underwent biopsy procedures for benign disease. Alternatively, in the high-risk category, the majority (n = 103 [75%]) were managed more conservatively. Stratified by diagnosis, 92% (n = 22) with benign disease underwent more conservative management with CT imaging (20%), PET scanning (15%), or biopsy (8%), although three had surgery (8%). Physician assessment as a means for predicting malignancy in pulmonary nodules is more accurate than previously validated nodule prediction calculators. Despite the accuracy of clinical intuition, physicians did not follow guideline-based recommendations when selecting the next diagnostic test. To provide optimal patient care, focus in the areas of guideline refinement, implementation, and dissemination is needed. Published by Elsevier Inc.

Improving the understanding of sleep apnea characterization using Recurrence Quantification Analysis by defining overall acceptable values for the dimensionality of the system, the delay, and the distance threshold

PubMed Central

Navarro-Mesa, Juan L.; Juliá-Serdá, Gabriel; Ramírez-Ávila, G. Marcelo; Ravelo-García, Antonio G.

2018-01-01

Our contribution focuses on the characterization of sleep apnea from a cardiac rate point of view, using Recurrence Quantification Analysis (RQA), based on a Heart Rate Variability (HRV) feature selection process. Three parameters are crucial in RQA: those related to the embedding process (dimension and delay) and the threshold distance. There are no overall accepted parameters for the study of HRV using RQA in sleep apnea. We focus on finding an overall acceptable combination, sweeping a range of values for each of them simultaneously. Together with the commonly used RQA measures, we include features related to recurrence times, and features originating in the complex network theory. To the best of our knowledge, no author has used them all for sleep apnea previously. The best performing feature subset is entered into a Linear Discriminant classifier. The best results in the “Apnea-ECG Physionet database” and the “HuGCDN2014 database” are, according to the area under the receiver operating characteristic curve, 0.93 (Accuracy: 86.33%) and 0.86 (Accuracy: 84.18%), respectively. Our system outperforms, using a relatively small set of features, previously existing studies in the context of sleep apnea. We conclude that working with dimensions around 7–8 and delays about 4–5, and using for the threshold distance the Fixed Amount of Nearest Neighbours (FAN) method with 5% of neighbours, yield the best results. Therefore, we would recommend these reference values for future work when applying RQA to the analysis of HRV in sleep apnea. We also conclude that, together with the commonly used vertical and diagonal RQA measures, there are newly used features that contribute valuable information for apnea minutes discrimination. Therefore, they are especially interesting for characterization purposes. Using two different databases supports that the conclusions reached are potentially generalizable, and are not limited by database variability. PMID:29621264

Improving the understanding of sleep apnea characterization using Recurrence Quantification Analysis by defining overall acceptable values for the dimensionality of the system, the delay, and the distance threshold.

PubMed

Martín-González, Sofía; Navarro-Mesa, Juan L; Juliá-Serdá, Gabriel; Ramírez-Ávila, G Marcelo; Ravelo-García, Antonio G

2018-01-01

Our contribution focuses on the characterization of sleep apnea from a cardiac rate point of view, using Recurrence Quantification Analysis (RQA), based on a Heart Rate Variability (HRV) feature selection process. Three parameters are crucial in RQA: those related to the embedding process (dimension and delay) and the threshold distance. There are no overall accepted parameters for the study of HRV using RQA in sleep apnea. We focus on finding an overall acceptable combination, sweeping a range of values for each of them simultaneously. Together with the commonly used RQA measures, we include features related to recurrence times, and features originating in the complex network theory. To the best of our knowledge, no author has used them all for sleep apnea previously. The best performing feature subset is entered into a Linear Discriminant classifier. The best results in the "Apnea-ECG Physionet database" and the "HuGCDN2014 database" are, according to the area under the receiver operating characteristic curve, 0.93 (Accuracy: 86.33%) and 0.86 (Accuracy: 84.18%), respectively. Our system outperforms, using a relatively small set of features, previously existing studies in the context of sleep apnea. We conclude that working with dimensions around 7-8 and delays about 4-5, and using for the threshold distance the Fixed Amount of Nearest Neighbours (FAN) method with 5% of neighbours, yield the best results. Therefore, we would recommend these reference values for future work when applying RQA to the analysis of HRV in sleep apnea. We also conclude that, together with the commonly used vertical and diagonal RQA measures, there are newly used features that contribute valuable information for apnea minutes discrimination. Therefore, they are especially interesting for characterization purposes. Using two different databases supports that the conclusions reached are potentially generalizable, and are not limited by database variability.

Proton affinity and enthalpy of formation of formaldehyde

NASA Astrophysics Data System (ADS)

Czakó, Gábor; Nagy, Balázs; Tasi, Gyula; Somogyi, Árpád; Šimunek, Ján; Noga, Jozef; Braams, Bastiaan J.; Bowman, Joel M.; Császár; , Attila G.

The proton affinity and the enthalpy of formation of the prototypical carbonyl, formaldehyde, have been determined by the first-principles composite focal-point analysis (FPA) approach. The electronic structure computations employed the all-electron coupled-cluster method with up to single, double, triple, quadruple, and even pentuple excitations. In these computations the aug-cc-p(C)VXZ [X = 2(D), 3(T), 4(Q), 5, and 6] correlation-consistent Gaussian basis sets for C and O were used in conjunction with the corresponding aug-cc-pVXZ (X = 2-6) sets for H. The basis set limit values have been confirmed via explicitly correlated computations. Our FPA study supersedes previous computational work for the proton affinity and to some extent the enthalpy of formation of formaldehyde by accounting for (a) electron correlation beyond the "gold standard" CCSD(T) level; (b) the non-additivity of core electron correlation effects; (c) scalar relativity; (d) diagonal Born-Oppenheimer corrections computed at a correlated level; (e) anharmonicity of zero-point vibrational energies, based on global potential energy surfaces and variational vibrational computations; and (f) thermal corrections to enthalpies by direct summation over rovibrational energy levels. Our final proton affinities at 298.15 (0.0) K are ΔpaHo (H2CO) = 711.02 (704.98) ± 0.39 kJ mol-1. Our final enthalpies of formation at 298.15 (0.0) K are ΔfHo (H2CO) = -109.23 (-105.42) ± 0.33 kJ mol-1. The latter values are based on the enthalpy of the H2 + CO → H2CO reaction but supported by two further reaction schemes, H2O + C → H2CO and 2H + C + O → H2CO. These values, especially ΔpaHo (H2CO), have better accuracy and considerably lower uncertainty than the best previous recommendations and thus should be employed in future studies.

Discovering that the shoe fits: the self-validating role of stereotypes.

PubMed

Clark, Jason K; Wegener, Duane T; Briñol, Pablo; Petty, Richard E

2009-07-01

Stereotypes can influence social perceptions in many ways. The current research examined a previously unexplored possibility-that activation of a stereotype can validate thoughts about other people when the thoughts are stereotype consistent (i.e., that stereotype activation can increase people's confidence in their previous stereotype-consistent thoughts). Given previous results for other forms of metacognition, this thought validation from stereotype activation should be most likely when people have the cognitive capacity to carefully process individuating information. In two experiments, participants were given information about a target person and then a description designed to activate a stereotype. When processing capacity was high, confidence in thoughts was greater when the initial information produced thoughts consistent, rather than inconsistent, with the stereotype that was later activated, and higher confidence in thoughts was associated with stronger perception-consistent recommendations related to the target. When processing capacity was low, an activated stereotype served its familiar heuristic role in judgment, and thought confidence played no role in judgment-related recommendations.

40 CFR 246.200-5 - Recommended procedures: Methods of separation and collection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... designed to recover high grades of office paper at the source of generation, i.e., the desk, are the... recommended system is the desk-top system because it is designed to maximize recovery of high value material... desk-top system has been designed to minimize these problems. (d) The precise method of separation and...

40 CFR 246.200-5 - Recommended procedures: Methods of separation and collection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... designed to recover high grades of office paper at the source of generation, i.e., the desk, are the... recommended system is the desk-top system because it is designed to maximize recovery of high value material... desk-top system has been designed to minimize these problems. (d) The precise method of separation and...

40 CFR 246.200-5 - Recommended procedures: Methods of separation and collection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... designed to recover high grades of office paper at the source of generation, i.e., the desk, are the... recommended system is the desk-top system because it is designed to maximize recovery of high value material... desk-top system has been designed to minimize these problems. (d) The precise method of separation and...

40 CFR 246.200-5 - Recommended procedures: Methods of separation and collection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... designed to recover high grades of office paper at the source of generation, i.e., the desk, are the... recommended system is the desk-top system because it is designed to maximize recovery of high value material... desk-top system has been designed to minimize these problems. (d) The precise method of separation and...

40 CFR 246.200-5 - Recommended procedures: Methods of separation and collection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... designed to recover high grades of office paper at the source of generation, i.e., the desk, are the... recommended system is the desk-top system because it is designed to maximize recovery of high value material... desk-top system has been designed to minimize these problems. (d) The precise method of separation and...

Something of Value. A Summary of Findings and Recommendations for Improving Elementary Science in Massachusetts.

ERIC Educational Resources Information Center

Whitla, Dean K.; Pinck, Dan C.

Presented is a summary of findings and recommendations provided by the Harvard Study Committee under the auspices of the Massachusetts Advisory Council on Education. The study is mainly concerned with the four National Science Foundation (NSF) programs: Elementary Science Study, Science Curriculum Improvement Study, Science - A Process Approach,…

Handling Missing Data in Structural Equation Models in R: A Replication Study for Applied Researchers

ERIC Educational Resources Information Center

Wolgast, Anett; Schwinger, Malte; Hahnel, Carolin; Stiensmeier-Pelster, Joachim

2017-01-01

Introduction: Multiple imputation (MI) is one of the most highly recommended methods for replacing missing values in research data. The scope of this paper is to demonstrate missing data handling in SEM by analyzing two modified data examples from educational psychology, and to give practical recommendations for applied researchers. Method: We…

Practical Recommendations on Students' Tolerant Behavior Formation in Universities

ERIC Educational Resources Information Center

Kutuev, Ruslan A.; Katicheva, Marina G.; Rassolov, Ilya M.; Derdizova, Farida V.; Yevgrafova, Olga G.; Kozhanov, Igor V.

2016-01-01

The relevance of the study is conditioned by the development of civil society and legal state, which are characterized by the observance of and respect for the rights and freedoms of man and citizen, a recognition of individual freedom and the values of each person. The purpose of this article is to develop practical recommendations on formation…

Study design for a randomized controlled trial to increase the relative reinforcing value of vegetable consumption using incentive sensitization among obese and overweight people

USDA-ARS?s Scientific Manuscript database

Federal dietary guidance recommends consumption of a variety of vegetables, but Americans only consume a small fraction of recommended amounts. Studies have attempted to increase consumption with modest results. In this manuscript, we present the protocol for a study that applies incentive sensitiza...

Recommended Toxicity Equivalence Factors (TEFs) for Human Health Risk Assessments of 2,3,7,8-Tetrachlorodibenzo-p-dioxin and Dioxin-Like Compounds

EPA Science Inventory

The Risk Assessment Forum (RAF) Human Health TEFs document describes EPA’s updated approach for evaluating the human health risks from exposures to environmental media containing dioxin-like compounds. It recommends the use of consensus TEF values for 2,3,7,8-tetrachlorodibenzo-...

ESTIMATION OF GIARDIA CT VALUES AT HIGH PH FOR THE SURFACE WATER TREATMENT RULE

EPA Science Inventory

The U.S. Environmental Protection Agency currently recommends Ct (disinfectant concentration multiplied by the exposure time) values to achieve required levels of inactivation of Giardia lamblia cysts by different disinfectants including free chlorine. Current guidance covers ina...

National survey on current situation of critical value reporting in 973 laboratories in China.

PubMed

Fei, Yang; Zhao, Haijian; Wang, Wei; He, Falin; Zhong, Kun; Yuan, Shuai; Wang, Zhiguo

2017-10-15

The aim of the study was to investigate the state-of-the-art of the performance of critical value reporting and provide recommendations for laboratories setting critical value reporting time frames. The National Centre for Clinical Laboratories in China initiated a critical value reporting investigation in 2015. A questionnaire related to critical value reporting policy was sent to 1589 clinical laboratories in China online. The questionnaire consisted of a set of questions related to critical value reporting policy and a set of questions related to timeliness of critical value reporting. The survey data were collected between March and April 2015. A total survey response rate was 61.2%. The critical value unreported rate, unreported timely rate, and clinical unacknowledged rate of more than half of participants were all 0.0%. More than 75.0% of participants could report half of critical values to clinicians within 20 minutes and could report 90.0% of critical values to clinicians within 25 minutes (from result validation to result communication to the clinician). The median of target critical value reporting time was 15 minutes. "Reporting omission caused by laboratory staff", "communications equipment failure to connect", and "uncompleted application form without contact information of clinician" were the three major reasons for unreported critical value. The majority of laboratories can report critical values to responsible clinical staff within 25 minutes. Thus, this value could be recommended as suitable critical value reporting time frame for biochemistry laboratories in China. However, careful monitoring of the complete reporting process and improvement of information systems should ensure further improvement of critical value reporting timeliness.

Validation of a dye stain assay for vaginally inserted HEC-filled microbicide applicators

PubMed Central

Katzen, Lauren L.; Fernández-Romero, José A.; Sarna, Avina; Murugavel, Kailapuri G.; Gawarecki, Daniel; Zydowsky, Thomas M.; Mensch, Barbara S.

2011-01-01

Background The reliability and validity of self-reports of vaginal microbicide use are questionable given the explicit understanding that participants are expected to comply with study protocols. Our objective was to optimize the Population Council's previously validated dye stain assay (DSA) and related procedures, and establish predictive values for the DSA's ability to identify vaginally inserted single-use, low-density polyethylene microbicide applicators filled with hydroxyethylcellulose gel. Methods Applicators, inserted by 252 female sex workers enrolled in a microbicide feasibility study in Southern India, served as positive controls for optimization and validation experiments. Prior to validation, optimal dye concentration and staining time were ascertained. Three validation experiments were conducted to determine sensitivity, specificity, negative predictive values and positive predictive values. Results The dye concentration of 0.05% (w/v) FD&C Blue No. 1 Granular Food Dye and staining time of five seconds were determined to be optimal and were used for the three validation experiments. There were a total of 1,848 possible applicator readings across validation experiments; 1,703 (92.2%) applicator readings were correct. On average, the DSA performed with 90.6% sensitivity, 93.9% specificity, and had a negative predictive value of 93.8% and a positive predictive value of 91.0%. No statistically significant differences between experiments were noted. Conclusions The DSA was optimized and successfully validated for use with single-use, low-density polyethylene applicators filled with hydroxyethylcellulose (HEC) gel. We recommend including the DSA in future microbicide trials involving vaginal gels in order to identify participants who have low adherence to dosing regimens. In doing so, we can develop strategies to improve adherence as well as investigate the association between product use and efficacy. PMID:21992983

Incentivizing the public to support invasive species management: eurasian milfoil reduces lakefront property values.

PubMed

Olden, Julian D; Tamayo, Mariana

2014-01-01

Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum) invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing) and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995-2006) in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA). After accounting for structural (e.g., house size), locational (e.g., boat launch), and environmental characteristics (e.g., water clarity) of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price), corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue), justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management.

77 FR 45331 - White Pine-Nye Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-31

... INFORMATION CONTACT. SUPPLEMENTARY INFORMATION: The following business will be conducted: Review and approve previous meeting's minutes and business expenses, Recommend funding allocation for proposed projects, and...

Failure of Quality Control Measures To Prevent Reporting of False Resistance to Imipenem, Resulting in a Pseudo-Outbreak of Imipenem-Resistant Pseudomonas aeruginosa

PubMed Central

Carmeli, Yehuda; Eichelberger, Karen; Soja, Don; Dakos, Joanna; Venkataraman, Lata; DeGirolami, Paola; Samore, Matthew

1998-01-01

False results showing an outbreak of Pseudomonas aeruginosa with resistance to imipenem were traced to a defective lot of microdilution MIC testing panels. These panels contained two- to threefold lower concentrations of imipenem than expected and resulted in artifactual two- to fourfold increases in MICs of imipenem. The quality-control MIC results for Pseudomonas aeruginosa ATCC 27853 were 4 μg/ml, the highest value within the range recommended by the National Committee for Clinical Laboratory Standards. We recommend that this value be considered out of the quality-control range. PMID:9466787

New Standards for Diagnosing Hypertension Are Met with Skepticism | Poster

Cancer.gov

Members of the Eighth Joint National Committee recently released new standards for treating hypertension, also referred to as high blood pressure (BP). The new standards do not recommend treatment changes for individuals under 60 years of age. However, treatment changes were recommended for people over the age of 60 who do not have conditions such as diabetes or chronic kidney disease (CKD), but whose BP numbers are 150/90 or higher. This BP threshold is up from the previously recommended threshold of 140/90. The panel also recommended that for people over 60 years of age who have diabetes or CKD, treatment should begin when BP is 140/90, which is an increase from 130/80. Treatment may involve lifestyle changes and/or medication to bring the BP numbers into a healthy range.

Ethical issues in cancer screening and prevention.

PubMed

Plutynski, Anya

2012-06-01

November 2009's announcement of the USPSTF's recommendations for screening for breast cancer raised a firestorm of objections. Chief among them were that the panel had insufficiently valued patients' lives or allowed cost considerations to influence recommendations. The publicity about the recommendations, however, often either simplified the actual content of the recommendations or bypassed significant methodological issues, which a philosophical examination of both the science behind screening recommendations and their import reveals. In this article, I discuss two of the leading ethical considerations at issue in screening recommendations: respect for patient autonomy and beneficence and then turn to the most significant methodological issues raised by cancer screening: the potential biases that may infect a trial of screening effectiveness, the problem of base rates in communicating risk, and the trade-offs involved in a judgment of screening effectiveness. These issues reach more broadly, into the use of "evidence-based" medicine generally, and have important implications for informed consent.

The danger of lime use in agricultural anthrax disinfection procedures: The potential role of calcium in the preservation of anthrax spores

PubMed Central

Himsworth, Chelsea G.

2008-01-01

Previously, lime (calcium oxide) was recommended by the Canadian Food Inspection Agency (CFIA) as an anthrax disinfectant. However, a recent scientific review of the subject has found evidence to suggest that exposure of anthrax spores to calcium may aid in their survival and viability. For this reason, the CFIA no longer recommends the use of lime for agricultural anthrax disinfection. PMID:19252713

Actual waste demonstration of the nitric-glycolic flowsheet for sludge batch 9 qualification

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

Newell, D.; Pareizs, J.; Martino, C.

For each sludge batch that is processed in the Defense Waste Processing Facility (DWPF), the Savannah River National Laboratory (SRNL) performs qualification testing to demonstrate that the sludge batch is processable. Based on the results of this actual-waste qualification and previous simulant studies, SRNL recommends implementation of the nitric-glycolic acid flowsheet in DWPF. Other recommendations resulting from this demonstration are reported in section 5.0.

2016 Update of the Italian Pediatric Society Guidelines for Management of Fever in Children.

PubMed

Chiappini, Elena; Venturini, Elisabetta; Remaschi, Giulia; Principi, Nicola; Longhi, Riccardo; Tovo, Pier-Angelo; Becherucci, Paolo; Bonsignori, Francesca; Esposito, Susanna; Festini, Filippo; Galli, Luisa; Lucchesi, Bice; Mugelli, Alessandro; Marseglia, Gian Luigi; de Martino, Maurizio

2017-01-01

To review new scientific evidence to update the Italian guidelines for managing fever in children as drafted by the panel of the Italian Pediatric Society. Relevant publications in English and Italian were identified through search of MEDLINE and the Cochrane Database of Systematic Reviews from May 2012 to November 2015. Previous recommendations are substantially reaffirmed. Antipyretics should be administered with the purpose to control the child's discomfort. Antipyretics should be administered orally; rectal administration is discouraged except in the setting of vomiting. Combined use of paracetamol and ibuprofen is discouraged, considering risk and benefit. Antipyretics are not recommended preemptively to reduce the incidence of fever and local reactions in children undergoing vaccination, or in attempt to prevent febrile convulsions in children. Ibuprofen and paracetamol are not contraindicated in children who are febrile with asthma, with the exception of known cases of paracetamol- or nonsteroidal anti-inflammatory drug-induced asthma. Recent medical literature leads to reaffirmation of previous recommendations for use of antipyretics in children who are febrile. Copyright © 2016 Elsevier Inc. All rights reserved.

Evidence-based guideline update: Treatment of essential tremor

PubMed Central

Zesiewicz, T.A.; Elble, R.J.; Louis, E.D.; Gronseth, G.S.; Ondo, W.G.; Dewey, R.B.; Okun, M.S.; Sullivan, K.L.; Weiner, W.J.

2011-01-01

Background: This evidence-based guideline is an update of the 2005 American Academy of Neurology practice parameter on the treatment of essential tremor (ET). Methods: A literature review using MEDLINE, EMBASE, Science Citation Index, and CINAHL was performed to identify clinical trials in patients with ET published between 2004 and April 2010. Results and Recommendations: Conclusions and recommendations for the use of propranolol, primidone (Level A, established as effective); alprazolam, atenolol, gabapentin (monotherapy), sotalol, topiramate (Level B, probably effective); nadolol, nimodipine, clonazepam, botulinum toxin A, deep brain stimulation, thalamotomy (Level C, possibly effective); and gamma knife thalamotomy (Level U, insufficient evidence) are unchanged from the previous guideline. Changes to conclusions and recommendations from the previous guideline include the following: 1) levetiracetam and 3,4-diaminopyridine probably do not reduce limb tremor in ET and should not be considered (Level B); 2) flunarizine possibly has no effect in treating limb tremor in ET and may not be considered (Level C); and 3) there is insufficient evidence to support or refute the use of pregabalin, zonisamide, or clozapine as treatment for ET (Level U). PMID:22013182

[Consequences of new patient discharge guidelines on the cost structure of radioiodine therapy].

PubMed

Dietlein, M; Troche, C J; Moka, D; Bausch, V; Lauterbach, K W; Schicha, H

1998-01-01

Consequences of the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines (residual activity of 250 MBq for I-131) were calculated for duration of stay and radioiodine therapy cost management. For 601 consecutively admitted patients with hyperthyreosis, actual duration of stay and duration of stay according to previous guidelines (from 1993) were calculated, as well as duration of stay according to recommended values. Following BPflV statutes, cost-analysis considered the cause and volume of goitre, and by using sensitivity analyses included a range of diagnostics, service assessment, and duration of stay. Duration of stay following I-131 therapy (in Germany) is expected to fall by 35-50% (average future stay 4.0 +/- 2.8 days), average costs from DM 4,452 to DM 3,680 (-17.4%). Not including pretreatment diagnostics, cost reduction (service assessment 17-24%) was estimated at 21-25%. Compared to strumectomy, I-131 therapy costs are expected to be lower for goitres (Graves' disease) up to at least 60 ml, toxic nodules of at least 25 ml, and toxic multinodular goitres of at least 90 ml. In the future, I-131 therapy will be more cost-effective even with larger goitres. Since reimbursement is determined by the duration of stay, new reimbursement procedures are discussed in this paper.

Equations for estimating horizontal response spectra and peak acceleration from western North American earthquakes: A summary of recent work

USGS Publications Warehouse

Boore, D.M.; Joyner, W.B.; Fumal, T.E.

1997-01-01

In this paper we summarize our recently-published work on estimating horizontal response spectra and peak acceleration for shallow earthquakes in western North America. Although none of the sets of coefficients given here for the equations are new, for the convenience of the reader and in keeping with the style of this special issue, we provide tables for estimating random horizontal-component peak acceleration and 5 percent damped pseudo-acceleration response spectra in terms of the natural, rather than common, logarithm of the ground-motion parameter. The equations give ground motion in terms of moment magnitude, distance, and site conditions for strike-slip, reverse-slip, or unspecified faulting mechanisms. Site conditions are represented by the shear velocity averaged over the upper 30 m, and recommended values of average shear velocity are given for typical rock and soil sites and for site categories used in the National Earthquake Hazards Reduction Program's recommended seismic code provisions. In addition, we stipulate more restrictive ranges of magnitude and distance for the use of our equations than in our previous publications. Finally, we provide tables of input parameters that include a few corrections to site classifications and earthquake magnitude (the corrections made a small enough difference in the ground-motion predictions that we chose not to change the coefficients of the prediction equations).

Flight motor set 360L008 (STS-32R). Volume 1: System overview

NASA Technical Reports Server (NTRS)

Garecht, D. M.

1990-01-01

Flight motor set 360L008 was launched as part of NASA space shuttle mission STS-32R. As with all previous redesigned solid rocket motor launches, overall motor performance was excellent. All ballistic contract end item specification parameters were verified with the exception of ignition interval and rise rates, which could not be verified due to elimination of developmental flight instrumentation. But the available low sample rate data showed nominal propulsion performance. All ballistic and mass property parameters closely matched the predicted values and were well within the required contract end item specification levels that could be assessed. All field joint heaters and igniter joint heaters performed without anomalies. Redesigned field joint heaters and the redesigned left-hand igniter heater were used on this flight. The changes to the heaters were primarily to improve durability and reducing handling damage. Evaluation of the ground environment instrumentation measurements again verified thermal mode analysis data and showed agreement with predicted environmental effects. No launch commit criteria violation occurred. Postflight inspection again verified superior performance of the insulation, phenolics, metal parts, and seals. Postflight evaluation indicated both nozzles performed as expected during flight. All combustion gas was contained by insulation in the field and case-to-nozzle joints. Recommendations were made concerning improved thermal modeling and measurements. The rationale for these recommendations and complete result details are presented.

Reference Value Advisor: a new freeware set of macroinstructions to calculate reference intervals with Microsoft Excel.

PubMed

Geffré, Anne; Concordet, Didier; Braun, Jean-Pierre; Trumel, Catherine

2011-03-01

International recommendations for determination of reference intervals have been recently updated, especially for small reference sample groups, and use of the robust method and Box-Cox transformation is now recommended. Unfortunately, these methods are not included in most software programs used for data analysis by clinical laboratories. We have created a set of macroinstructions, named Reference Value Advisor, for use in Microsoft Excel to calculate reference limits applying different methods. For any series of data, Reference Value Advisor calculates reference limits (with 90% confidence intervals [CI]) using a nonparametric method when n≥40 and by parametric and robust methods from native and Box-Cox transformed values; tests normality of distributions using the Anderson-Darling test and outliers using Tukey and Dixon-Reed tests; displays the distribution of values in dot plots and histograms and constructs Q-Q plots for visual inspection of normality; and provides minimal guidelines in the form of comments based on international recommendations. The critical steps in determination of reference intervals are correct selection of as many reference individuals as possible and analysis of specimens in controlled preanalytical and analytical conditions. Computing tools cannot compensate for flaws in selection and size of the reference sample group and handling and analysis of samples. However, if those steps are performed properly, Reference Value Advisor, available as freeware at http://www.biostat.envt.fr/spip/spip.php?article63, permits rapid assessment and comparison of results calculated using different methods, including currently unavailable methods. This allows for selection of the most appropriate method, especially as the program provides the CI of limits. It should be useful in veterinary clinical pathology when only small reference sample groups are available. ©2011 American Society for Veterinary Clinical Pathology.

Clinical tooth preparations and associated measuring methods: a systematic review.

PubMed

Tiu, Janine; Al-Amleh, Basil; Waddell, J Neil; Duncan, Warwick J

2015-03-01

The geometries of tooth preparations are important features that aid in the retention and resistance of cemented complete crowns. The clinically relevant values and the methods used to measure these are not clear. The purpose of this systematic review was to retrieve, organize, and critically appraise studies measuring clinical tooth preparation parameters, specifically the methodology used to measure the preparation geometry. A database search was performed in Scopus, PubMed, and ScienceDirect with an additional hand search on December 5, 2013. The articles were screened for inclusion and exclusion criteria and information regarding the total occlusal convergence (TOC) angle, margin design, and associated measuring methods were extracted. The values and associated measuring methods were tabulated. A total of 1006 publications were initially retrieved. After removing duplicates and filtering by using exclusion and inclusion criteria, 983 articles were excluded. Twenty-three articles reported clinical tooth preparation values. Twenty articles reported the TOC, 4 articles reported margin designs, 4 articles reported margin angles, and 3 articles reported the abutment height of preparations. A variety of methods were used to measure these parameters. TOC values seem to be the most important preparation parameter. Recommended TOC values have increased over the past 4 decades from an unachievable 2- to 5-degree taper to a more realistic 10 to 22 degrees. Recommended values are more likely to be achieved under experimental conditions if crown preparations are performed outside of the mouth. We recommend that a standardized measurement method based on the cross sections of crown preparations and standardized reporting be developed for future studies analyzing preparation geometry. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Implementing the SOHN-endorsed AORN guidelines for reprocessing reusable upper airway endoscopes.

PubMed

Rudy, Susan F; Adams, Jan; Waddington, Carolyn

2012-01-01

This is a companion paper to two previous publications on recommended practices for cleaning and reprocessing flexible endoscopes used in Otolaryngology (Burlingame, Arcilla, & McDermott, 2008; Adams & Baker, 2010). In this paper we capture and expand upon the audience question and answer session in which the Society of Otorhinolaryngology and Head-Neck Nurse (SOHN)--endorsed the Association of periOperative Registered Nurses (AORN) recommended practices were presented to the SOHN membership (Adams & Waddington, September, 2010). We include additional background information to assist readers in understanding some of the science behind the recommendations and share successful implementation strategies from Otorhinolaryngology (ORL) outpatient nurses and published references.

Integration of Latino/a cultural values into palliative health care: a culture centered model.

PubMed

Adames, Hector Y; Chavez-Dueñas, Nayeli Y; Fuentes, Milton A; Salas, Silvia P; Perez-Chavez, Jessica G

2014-04-01

Culture helps us grapple with, understand, and navigate the dying process. Although often overlooked, cultural values play a critical and influential role in palliative care. The purpose of the present study was two-fold: one, to review whether Latino/a cultural values have been integrated into the palliative care literature for Latinos/as; two, identify publications that provide recommendations on how palliative care providers can integrate Latino/a cultural values into the end-of-life care. A comprehensive systematic review on the area of Latino/a cultural values in palliative care was conducted via an electronic literature search of publications between 1930-2013. Five articles were identified for reviewing, discussing, or mentioning Latino/a cultural values and palliative care. Only one article specifically addressed Latino/a cultural values in palliative care. The four remaining articles discuss or mention cultural values; however, the cultural values were not the main focus of each article's thesis. The results of the current study highlight the lack of literature specifically addressing the importance of integrating Latino/a cultural values into the delivery of palliative care. As a result, this article introduces the Culture-Centered Palliative Care Model (CCPC). The article defines five key traditional Latino/a cultural values (i.e., familismo, personalismo, respeto, confianza, and dignidad), discusses the influence of each value on palliative health care, and ends with practical recommendations for service providers. Special attention is given to the stages of acculturation and ethnic identity.

Hybrid context aware recommender systems

NASA Astrophysics Data System (ADS)

Jain, Rajshree; Tyagi, Jaya; Singh, Sandeep Kumar; Alam, Taj

2017-10-01

Recommender systems and context awareness is currently a vital field of research. Most hybrid recommendation systems implement content based and collaborative filtering techniques whereas this work combines context and collaborative filtering. The paper presents a hybrid context aware recommender system for books and movies that gives recommendations based on the user context as well as user or item similarity. It also addresses the issue of dimensionality reduction using weighted pre filtering based on dynamically entered user context and preference of context. This unique step helps to reduce the size of dataset for collaborative filtering. Bias subtracted collaborative filtering is used so as to consider the relative rating of a particular user and not the absolute values. Cosine similarity is used as a metric to determine the similarity between users or items. The unknown ratings are calculated and evaluated using MSE (Mean Squared Error) in test and train datasets. The overall process of recommendation has helped to personalize recommendations and give more accurate results with reduced complexity in collaborative filtering.

Total body irradiation, toward optimal individual delivery: dose evaluation with metal oxide field effect transistors, thermoluminescence detectors, and a treatment planning system.

PubMed

Bloemen-van Gurp, Esther J; Mijnheer, Ben J; Verschueren, Tom A M; Lambin, Philippe

2007-11-15

To predict the three-dimensional dose distribution of our total body irradiation technique, using a commercial treatment planning system (TPS). In vivo dosimetry, using metal oxide field effect transistors (MOSFETs) and thermoluminescence detectors (TLDs), was used to verify the calculated dose distributions. A total body computed tomography scan was performed and loaded into our TPS, and a three-dimensional-dose distribution was generated. In vivo dosimetry was performed at five locations on the patient. Entrance and exit dose values were converted to midline doses using conversion factors, previously determined with phantom measurements. The TPS-predicted dose values were compared with the MOSFET and TLD in vivo dose values. The MOSFET and TLD dose values agreed within 3.0% and the MOSFET and TPS data within 0.5%. The convolution algorithm of the TPS, which is routinely applied in the clinic, overestimated the dose in the lung region. Using a superposition algorithm reduced the calculated lung dose by approximately 3%. The dose inhomogeneity, as predicted by the TPS, can be reduced using a simple intensity-modulated radiotherapy technique. The use of a TPS to calculate the dose distributions in individual patients during total body irradiation is strongly recommended. Using a TPS gives good insight of the over- and underdosage in a patient and the influence of patient positioning on dose homogeneity. MOSFETs are suitable for in vivo dosimetry purposes during total body irradiation, when using appropriate conversion factors. The MOSFET, TLD, and TPS results agreed within acceptable margins.

Ten years of medical education registrars: Value added?

PubMed

Brazil, Victoria; Davin, Lorna

2018-05-22

There is a paucity of any long-term follow up of trainees' career pathways or organisational outcomes from medical education registrar posts in emergency medicine training. We report on the experience of a selected group of medical education trainees during and subsequent to their post and reflect on the value added to emergency medical education at three institutions. We conducted an online survey study, examining quantitative outcomes and qualitative reflections, of emergency physicians who had previously undertaken a medical education registrar post. Descriptive statistics were used to summarise responses to Likert items. The authors independently analysed and interpreted the reflective responses to identify key themes and sub-themes. Nineteen of 21 surveys were completed. Most respondents were in formal educational roles, in addition to clinical practice. The thematic analysis revealed that the medical education registrar experience, and the subsequent contribution of these trainees to medical education, is significantly shaped by external factors. These include the extent of faculty support, and the value placed on medical education by hospitals/departments/leaders. Acquisition of knowledge and skills in medical education was only part of a broader developmental journey and transitioning of identity for the trainees. Our findings suggest that medical education trainees in emergency medicine progress to educational roles, and most respondents attribute their career progression to the medical education training experience. We recommend that medical education registrar programmes need to be valued within the clinical service, supported by faculty and a 'community of practice', to support trainees' transition to clinician educator leadership roles. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Estimation of Canopy Clumping Index From MISR and MODIS Sensors Using the Normalized Difference Hotspot and Darkspot (NDHD) Method: The Influence of BRDF Models and Solar Zenith Angle

NASA Astrophysics Data System (ADS)

Wei, S.; Fang, H.

2016-12-01

The Clumping index (CI) describes the spatial distribution pattern of foliage, and is a critical parameter used to characterize the terrestrial ecosystem and model land-surface processes. Global and regional scale CI maps have been generated from POLDER, MODIS, and MISR sensors based on an empirical relationship with the normalized difference between hotspot and darkspot (NDHD) index by previous studies. However, the hotspot and darkspot values and CI values can be considerably different from different bidirectional reflectance distribution function (BRDF) models and solar zenith angles (SZA). In this study, we evaluated the effects of different configurations of BRDF models and SZA values on CI estimation using the NDHD method. CI maps estimated from MISR and MODIS were compared with reference data at the VALERI sites. Results show that for moderate to least clumped vegetation (CI > 0.5), CIs retrieved with the observational SZA agree well with field values, while SZA =0° results in underestimates, and SZA = 60° results in overestimates. For highly clumped (CI < 0.5) and sparsely vegetated areas (FCOVER<25%), the Ross-Li model with 60° SZA is recommended for CI estimation. The suitable NDHD configuration was further used to estimate a 15-year time series CI from MODIS BRDF data. The time series CI shows a reasonable seasonal trajectory, and varies consistently with the MODIS leaf area index (LAI). This study enables better usage of the NDHD method for CI estimation, and can be a useful reference for research on CI validation.

The in vitro antimicrobial evaluation of commercially essential oils and their combinations against acne.

PubMed

Orchard, A; van Vuuren, S F; Viljoen, A; Kamatou, Guy

2018-03-24

The study investigated the efficacy of commercial essential oil combinations against the two pathogens responsible for acne with the aim to identify synergy and favourable oils to possibly use in a blend. Antimicrobial activity was assessed using the minimum inhibitory concentration (MIC) assay against Staphylococcus epidermidis (ATCC 2223) and Propionibacterium acnes (ATCC 11827), and the fractional inhibitory concentration index (ΣFIC) was calculated. Combinations displaying synergistic interactions were further investigated at varied ratios and the results plotted on isobolograms. From the 408 combinations investigated, 167 combinations were identified as displaying noteworthy antimicrobial activity (MIC value ≤ 1.00 mg ml -1 ). Thirteen synergistic interactions were observed against S. epidermidis and three synergistic combinations were observed against P. acnes. It was found that not one of the synergistic interactions identified were based on the combinations recommended in the layman's aroma-therapeutic literature. Synergy was evident rather from leads based on antimicrobial activity from previous studies, thus emphasising the importance of scientific validation. Leptospermum scoparium J.R.Forst. and G.Forst (manuka) was the essential oil mostly involved in synergistic interactions (four) against S. epidermidis. Cananga odorata (Lam.) Hook.f. and Thomson (ylang ylang) essential oil was also frequently involved in synergy where synergistic interactions could be observed against both pathogens. The combination with the lowest MIC value against both acne pathogens was and Vetiveria zizanioides Stapf (vetiver) with Cinnamomum verum J.Presl (cinnamon bark) (MIC values 0.19-0.25 mg ml -1 ). Pogostemon patchouli Benth. (patchouli), V. zizanioides, C. verum and Santalum spp. (sandalwood) could be identified as the oils that contributed the most noteworthy antimicrobial activity towards the combinations. The different chemotypes of the essential oils used in the combinations predominantly resulted in similar antimicrobial activity. The investigated essential oil combinations resulted in at least 50% of the combinations displaying noteworthy antimicrobial activity. Most of the synergistic interactions do not necessarily correspond to the recommended aroma-therapeutic literature, which highlights a need for scientific validation of essential oil antimicrobial activity. No antagonism was observed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Drain Management after Pancreatoduodenectomy: Reappraisal of a Prospective Randomized Trial Using Risk Stratification.

PubMed

McMillan, Matthew T; Malleo, Giuseppe; Bassi, Claudio; Butturini, Giovanni; Salvia, Roberto; Roses, Robert E; Lee, Major K; Fraker, Douglas L; Drebin, Jeffrey A; Vollmer, Charles M

2015-10-01

A recent randomized trial used the Fistula Risk Score (FRS) to develop guidelines for selective drainage based on clinically relevant fistula (CR-POPF) risk. Additionally, postoperative day (POD) 1 drain and serum amylase have been identified as accurate postoperative predictors of CR-POPF. This study sought to identify patients who may benefit from selective drainage, as well as the optimal timing for drain removal after pancreatoduodenectomy. One hundred six pancreatoduodenectomies from a previously reported RCT were assessed using risk-adjustment. The incidence of CR-POPF was compared between FRS risk cohorts. Drain and serum amylase values from POD 1 were evaluated using receiver operating characteristic (ROC) analysis to establish cut-offs predictive of CR-POPF occurrence. A regression analysis compared drain removal randomizations (POD 3 vs POD 5). Three-quarters of patients had moderate/high CR-POPF risk. This group had a CR-POPF rate of 36.3% vs 7.7% among negligible/low risk patients (p = 0.005). The areas under the ROC curve for CR-POPF prediction using POD 1 drain and serum amylase values were 0.800 (p = 0.000001; 95% CI 0.70-0.90) and 0.655 (p = 0.012; 95% CI 0.55-0.77), respectively. No significant serum amylase cut-offs were identified. Moderate/high risk patients with POD 1 drain amylase ≤ 5,000 U/L had significantly lower rates of CR-POPF when randomized to POD 3 drain removal (4.2% vs 38.5%; p = 0.003); moreover, these patients experienced fewer complications and shorter hospital stays. A clinical care protocol is proposed whereby drains are recommended for moderate/high FRS risk patients, but may be omitted in patients with negligible/low risk. Drain amylase values in moderate/high risk patients should then be evaluated on POD 1 to determine the optimal timing for drain removal. Moderate/high risk patients with POD 1 drain amylase ≤ 5,000 U/L have lower rates of CR-POPF with POD 3 (vs POD ≥ 5) drain removal; early drain removal is recommended for these patients. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A Novel Approach to Professional Development in Middle School Science: Instructional Coaching by University Professors to Improve the Instructional Core

ERIC Educational Resources Information Center

Mchenry, Nadine; Borger, Laurie; Liable-Sands, Louise

2017-01-01

The current study was constructed based on the recommendations of a previous study (McHenry & Borger, 2013). Though inquiry-based teaching has long been touted as an effective pedagogy, its application by middle school science teachers has been problematic. Using tools developed from the previous study in conjunction with professional…

ESD Implementation at the School Organisation Level, Part 2--Investigating the Transformative Perspective in School Leaders' Quality Strategies at ESD Schools

ERIC Educational Resources Information Center

Mogren, Anna; Gericke, Niklas

2017-01-01

Previous research has suggested that adopting a transformative school organisation perspective when implementing ESD may be more productive than the previously recommended transmissive perspectives, but it is not clear how transformative perspectives could be introduced. To address this issue, we conducted an empirical mixed methods study of…

A REVIEW OF RECENT STUDIES ON DIFFERENTIAL REINFORCEMENT DURING SKILL ACQUISITION IN EARLY INTERVENTION

PubMed Central

Vladescu, Jason C; Kodak, Tiffany

2010-01-01

Although the use of differential reinforcement has been recommended in previous investigations and in early intervention curriculum manuals, few studies have evaluated the best method for providing differential reinforcement to maximize independent responding. This paper reviews previous research on the effectiveness of differential reinforcement as treatment and describes important areas of future research. PMID:21119913

76 FR 25298 - White Pine-Nye County Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... person listed FOR FURTHER INFORMATION CONTACT. SUPPLEMENTARY INFORMATION: The following business will be conducted: Review and approve previous meeting's minutes and business expenses, Recommend funding allocation...

Health hazards of ultrafine metal and metal oxide powders

NASA Technical Reports Server (NTRS)

Boylen, G. W., Jr.; Chamberlin, R. I.; Viles, F. J.

1969-01-01

Study reveals that suggested threshold limit values are from two to fifty times lower than current recommended threshold limit values. Proposed safe limits of exposure to the ultrafine dusts are based on known toxic potential of various materials as determined in particle size ranges.

Recommendations for and Documentation of Biological Values for Use in Risk Assessment

EPA Science Inventory

The document was prepared by the Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office, Cincinnati, OH for the Office of Solid Waste and Emergency Response. The document consists of an extensive compliation of values gleaned from published li...

TU-FG-209-04: Testing of Digital Image Receptors Using AAPM TG-150’s Draft Recommendations - Investigating the Impact of Different Processing Parameters

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

Finley, C; Dave, J

Purpose: To evaluate implementation of AAPM TG-150’s draft recommendations via a parameter study for testing the performance of digital image receptors. Methods: Flat field images were acquired from 9 calibrated digital image receptors associated with 9 new portable digital radiography systems (Carestream Health, Inc.) based on the draft recommendations and manufacturer-specified calibration conditions (set of 4 images at input detector air kerma ranging from 1 to 25 µGy). Effects of exposure response function (linearized and logarithmic), ‘Presentation Intent Type’ (‘For Processing’ and ‘For Presentation’), detector orientation with respect to the anode-cathode axis (4 orientations; 900 rotations per iteration), different ROImore » sizes (5×5–40×40 mm{sup 2}) and elimination of varying dimensions of image border (0 mm i.e., without boundary elimination to 150 mm) on signal, noise, signal-to-noise ratio (SNR) and the associated nonuniformities were evaluated. Images were analyzed in Matlab and quantities were compared using ANOVA. Results: Signal, noise and SNR values averaged over 9 systems with default parameter values in draft recommendations were 4837.2±139.4, 19.7±0.9 and 246.4±10.1 (mean ± standard deviation), respectively (at input detector air kerma: 12.5 µGy). Signal, noise and SNR showed characteristic dependency on exposure response function and on ‘Presentation Intent Type’. These values were not affected by ROI size and detector orientation, but analysis showed that eliminating the edge pixels along the boundary was required for the noise parameter (coefficient of variation range for noise: 72%–106% and 3%–4% without and with boundary elimination; respectively). Local and global nonuniformities showed a similar dependence on the need for boundary elimination. Interestingly, computed non-uniformities showed agreement with manufacturer-reported values except for noise non-uniformities in two units; artifacts were seen in images from these two units highlighting the importance of independent evaluations. Conclusion: The effect of different parameters on performance characterization of digital image receptors was evaluated based on TG-150’s draft recommendations.« less

When should video be added to conventional urodynamics in adults and is it justified by the evidence? ICI-RS 2014.

PubMed

Anding, Ralf; Rosier, Peter; Smith, Phillip; Gammie, Andrew; Giarenis, Ilias; Rantell, Angela; Thiruchelvam, Nikesh; Arlandis, Salvador; Cardozo, Linda

2016-02-01

To debate and evaluate the evidence base regarding the added value of video to urodynamics in adults and to define research questions. In the ICI-RS Meeting 2014 a Think Tank analyzed the current guidelines recommending video urodynamics (VUD) and performed a literature search to determine the level of evidence for the additional value of the imaging with urodynamic assessment of both neurogenic and non-neurogenic lower urinary tract dysfunction. Current guidelines do not specify the added value of imaging to urodynamics. Recommendations are based on single center series and expert opinion. Standard imaging protocols are not available and evidence regarding the balance between number and timing of pictures, patient positioning, and exposure time on the one hand and diagnosis on the other hand is lacking. On the basis of expert consensus VUD is relevant in the follow-up of patients with spinal dysraphism. Evidence for the value of VUD in non-neurogenic lower urinary tract dysfunction is sparse. There is some evidence that VUD is not necessary in uncomplicated female SUI, but expert opinion suggests it might improve the evaluation of patients with recurrent SUI. There is only low level evidence for the addition of video to urodynamics. The ICI-RS Think Tank encourages better reporting of results of imaging and systematic reporting of X-ray doses. Specific research hypotheses regarding the added value of imaging are recommended. The panel suggests the development of standards for technically optimal VUD that is practically achievable with machines that are on the market. © 2016 Wiley Periodicals, Inc.

Effectiveness of automated notification and customer service call centers for timely and accurate reporting of critical values: a laboratory medicine best practices systematic review and meta-analysis.

PubMed

Liebow, Edward B; Derzon, James H; Fontanesi, John; Favoretto, Alessandra M; Baetz, Rich Ann; Shaw, Colleen; Thompson, Pamela; Mass, Diana; Christenson, Robert; Epner, Paul; Snyder, Susan R

2012-09-01

To conduct a systematic review of the evidence available in support of automated notification methods and call centers and to acknowledge other considerations in making evidence-based recommendations for best practices in improving the timeliness and accuracy of critical value reporting. This review followed the Laboratory Medicine Best Practices (LMBP) review methods (Christenson, et al. 2011). A broad literature search and call for unpublished submissions returned 196 bibliographic records which were screened for eligibility. 41 studies were retrieved. Of these, 4 contained credible evidence for the timeliness and accuracy of automatic notification systems and 5 provided credible evidence for call centers for communicating critical value information in in-patient care settings. Studies reporting improvement from implementing automated notification findings report mean differences and were standardized using the standard difference in means (d=0.42; 95% CI=0.2-0.62) while studies reporting improvement from implementing call centers generally reported criterion referenced findings and were standardized using odds ratios (OR=22.1; 95% CI=17.1-28.6). The evidence, although suggestive, is not sufficient to make an LMBP recommendation for or against using automated notification systems as a best practice to improve the timeliness of critical value reporting in an in-patient care setting. Call centers, however, are effective in improving the timeliness of critical value reporting in an in-patient care setting, and meet LMBP criteria to be recommended as an "evidence-based best practice." Copyright © 2012 The Canadian Society of Clinical Chemists. All rights reserved.

Ottawa Panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight.

PubMed

Brosseau, Lucie; Wells, George A; Tugwell, Peter; Egan, Mary; Dubouloz, Claire-Jehanne; Casimiro, Lynn; Bugnariu, Nicoleta; Welch, Vivian A; De Angelis, Gino; Francoeur, Lilliane; Milne, Sarah; Loew, Laurianne; McEwan, Jessica; Messier, Steven P; Doucet, Eric; Kenny, Glen P; Prud'homme, Denis; Lineker, Sydney; Bell, Mary; Poitras, Stéphane; Li, Jing Xian; Finestone, Hillel M; Laferrière, Lucie; Haines-Wangda, Angela; Russell-Doreleyers, Marion; Lambert, Kim; Marshall, Alison D; Cartizzone, Margot; Teav, Adam

2011-06-01

The objective of this review was to construct an updated evidence-based clinical practice guideline on the use of physical activity and diet for the management of osteoarthritis (OA) in adults (>18 years of age) who are obese or overweight (body mass index ≥25 kg/m(2)). Articles were extracted from the following databases: MEDLINE, EMBASE (Current Contents), SPORTDiscus, SUM, Scopus, CINAHL, AMED, BIOMED, PubMed, ERIC, the Cochrane Controlled Trials, and PEDro. The Ottawa Panel and research assistance team strictly applied the inclusion and exclusion criteria from previous Ottawa Panel publications. An a priori literature search was conducted for articles related to obesity and OA of the lower extremities that were published from January 1, 1966, to November 30, 2010. Inclusion criteria and the methods to grade the recommendations were created by the Ottawa Panel. were graded based on the strength of evidence (A, B, C, C+, D, D+, or D-) as well as experimental design (I for randomized controlled trials and II for nonrandomized studies). In agreement with previous Ottawa Panel methods, Cochrane Collaboration methods were utilized for statistical analysis. Clinical significance was established by an improvement of ≥15% in the experimental group compared with the control group. There were a total of 79 recommendations from 9 articles. From these recommendations, there were 36 positive recommendations: 21 grade A and 15 grade C+. There were no grade B recommendations, and all recommendations were of clinical benefit. Further research is needed, as more than half of the trials were of low methodological quality. This review suggests that physical activity and diet programs are beneficial, specifically for pain relief (9 grade A recommendations) and improved functional status (6 grade A and 7 grade C+ recommendations), for adults with OA who are obese or overweight. The Ottawa Panel was able to demonstrate that when comparing physical activity alone, diet alone, physical activity combined with diet, and control groups, the intervention including physical activity and diet produced the most beneficial results.

Benefits of breastfeeding

MedlinePlus

... Breast cancer or other cancer Breast infection or breast abscess Poor milk supply (uncommon) Previous surgery or radiation treatment Breastfeeding is not recommended for mothers who have: Active ... tuberculosis Human immunodeficiency virus (HIV) infection ...

Some Recommendations for Education (and All of Us): Valuing Differences as Collaboration beyond Outcomes Assessment and Total Quality Management/Demingism.

ERIC Educational Resources Information Center

Sadler, Lynn Veach

Recommendations for a national educational agenda that is based on tolerance for cultural diversity and real collaboration are presented in this paper with emphasis on the W. E. Deming model of Total Quality Management, or "Demingism." Two problems in American education are academic performance and the failure of disadvantaged schools. Ten…

Restoring Complexity to Industrially Managed Timberlands: The Mill Creek Interim Management Recommendations and Early Restoration Thinning Treatments

Treesearch

Dan Porter; Valerie Gizinski; Ruskin Hartley; Sharon Hendrix Kramer

2007-01-01

The Mill Creek Property was a commercial timberland acquired by the State of California to protect and restore local and regional ecological values and provide opportunities for compatible recreation. Interim Management Recommendations (IMR) were developed to guide protection, restoration, and public access of the Property until the California Department of Parks and...

Strategic Mobility 21: Baseline Joint Experimentation Campaign Plan

DTIC Science & Technology

2008-06-19

including energy. The Value Stream Analysis Future State then designed Kaizens (process optimizations) for an improved Future State to help drive waste...Recommended Improvements and Experimentation Opportunities Initial recommended Kaizens (improvement opportunities) for waste reduction, constraint...Trucking, Service Craft Logistics, BNSF, and Madison Warehouse, Inc. • Kaizen 1 (Figure 17): Full upload electronically of the Dole ANS files • Kaizen

Are Recommended Daily Allowances for Vitamin C Adequate?

PubMed Central

Pauling, Linus

1974-01-01

The Recommended Dietary Allowance of vitamin C (ascorbic acid) for adults has now been set at 45 mg day-1 by the U.S. Food and Nutrition Board. This intake suffices to prevent scurvy in most people. It is, however, much less than the optimum intake, the intake that leads to the best of health. A larger intake decreases the incidence and severity of the common cold and other diseases. Ascorbic acid has antiviral and antibacterial activity and is required for phagocytic activity of leukocytes. Several arguments indicate that for different human beings the optimum intake lies between 250 mg day-1 and a much higher value, 5000 mg day-1 or more. It is proposed that the present Recommended Dietary Allowance of 45 mg day-1 of vitamin C for adults be renamed the Minimum Dietary Allowance, defined as the amount needed to prevent scurvy, and that, after consideration of the evidence about intake and the best of health, there be formulated another category of values, the Recommended Daily Intake, with the suggested range of 250 mg day-1 to 4000 mg day-1 of ascorbic acid for an adult. PMID:4612519

Assessing the risk of laparoscopic morcellation of occult uterine sarcomas during hysterectomy and myomectomy: Literature review and the ISGE recommendations.

PubMed

Sizzi, Ornella; Manganaro, Lucia; Rossetti, Alfonso; Saldari, Matteo; Florio, Giuseppe; Loddo, Alessandro; Zurawin, Robert; van Herendael, Bruno; Djokovic, Dusan

2018-01-01

This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment. A literature search within the Medline/PubMed and Cochrane Database was carried out using keywords "morcellation", "uterine fibroids", "uterine sarcoma", "myomectomy" and "hysterectomy". Relevant publications (original studies, meta-analyses and previous reviews), written in English and published until May 30th, 2017, were selected and analyzed. Previously emitted statements of 12 recognized professional societies or government institutions and their supporting literature were also studied. For each topic/clinical question, the available information was graded by the level of evidence. The ISGE recommendations were established in accordance with the evidence quality. In the light of available information, 9 recommendations on preoperative clinical, laboratorial and imaging evaluation of the candidates for intracorporeal uterus/leiomyoma morcellation were formulated, mainly based on consensus and expert opinions. There is a lack of high-quality evidence, which does not allow the establishment of strong recommendations. Electromechanical tissue morcellation may be used in gynecological patients who are considered "low risk" upon appropriate preoperative evaluation; however, further studies and prospective data collection are greatly needed to improve sarcoma risk assessment in women with presumed uterine leiomyomas. Copyright © 2017 Elsevier B.V. All rights reserved.

Groundwater fluoride contamination and its possible health implications in Indi taluk of Vijayapura District (Karnataka State), India.

PubMed

Ugran, Vidyavati; Desai, Naveen N; Chakraborti, Dipankar; Masali, Kallappa A; Mantur, Prakash; Kulkarni, Shreepad; Deshmukh, Niranjan; Chadchan, Kailash S; Das, Swastika N; Tanksali, Anuradha S; Arwikar, Asha S; Guggarigoudar, Suresh P; Vallabha, Tejaswini; Patil, Shailaja S; Das, Kusal K

2017-10-01

Groundwater fluoride concentration and fluoride-related health problems were studied in twenty-two villages of Indi taluk of Vijayapura district, Karnataka, India. Present study (2015) was also used to compare groundwater fluoride concentration in same 22 villages with previous government report (2000). Groundwater fluoride concentrations of 62 bore wells of 22 villages were analyzed by using an ion-sensitive electrode. A total of 660 adults and 600 children were screened for fluorosis symptoms and signs. Sixty clinically suspected fluorosis patients' urine samples were further analyzed for fluoride. The mean value (1.22 ± 0.75 mg/L) of fluoride concentration of 62 bore wells and 54.83 % bore wells with ≥1.0 mg/L of fluoride concentrations in Indi taluk indicates higher than the permissible limit of drinking water fluoride concentration recommended for India. Clinical symptoms like arthritis, joint pains, gastrointestinal discomfort and lower limb deformities with high urinary fluoride concentrations in some subjects suggest fluorosis. Results also showed an increase in groundwater fluoride concentration of the same 22 villages between previous and present study. Preliminary arthritis symptom of the villagers could be due to drinking fluoride-contaminated water. Increase in fluoride concentration with time to the bore wells definitely indicates future danger.

Breckinridge Project, initial effort. Report VII, Volume III. Cultural resource assessment socioeconomic background data

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

Macfarlane, Heather; Janzen, Donald E.

1980-11-26

This report has been prepared in conjunction with an environmental baseline study for a commercial coal conversion facility being conducted by Ashland Synthetic Fuels, Inc. (ASFI) and Airco Energy Company (AECO). This report represents a cultural resource assessment for the proposed plant site and two potential solid waste disposal areas. This assessment presents data collected by Dames and Moore during a recent archaeological reconnaissance of the unsurveyed southeastern portion of the proposed plant site and two potential solid waste disposal areas. Also, results of two previous surveys on the northern and southwestern portion of the plant site for American Smeltingmore » and Refining Company (ASARCO) and Kentucky Utilities are included. The Dames and Moore survey of the southeastern portion of the plant site identified one archaeological site, three standing structures and one historic cemetery. In addition 47 archaeological sites and six standing structures are known from two previous surveys of the remainder of the plant site (Cowan 1975 and Turnbow et al 1980). Eleven of the previously recorded archaeological sites were recommended for further assessment to evaluate their potential for inclusion within the Holt Bottoms Archaeological District currently listed on the National Register of Historic Places. None of the archaeological sites or standing structures located within the plant site during the Dames and Moore survey were recommended for further assessment. A total of eight archaeological sites were located during the Dames and Moore survey of the two potential solid waste disposal areas. Of this total only two sites were recommended for further assessment. Also, one previously unknown historic cemetry was located in the southernmost potential waste disposal area.« less

Filtration and transport of Bacillus subtilis spores and the F-RNA phage MS2 in a coarse alluvial gravel aquifer: implications in the estimation of setback distances.

PubMed

Pang, Liping; Close, Murray; Goltz, Mark; Noonan, Mike; Sinton, Lester

2005-04-01

Filtration of Bacillus subtilis spores and the F-RNA phage MS2 (MS2) on a field scale in a coarse alluvial gravel aquifer was evaluated from the authors' previously published data. An advection-dispersion model that is coupled with first-order attachment kinetics was used in this study to interpret microbial concentration vs. time breakthrough curves (BTC) at sampling wells. Based on attachment rates (katt) that were determined by applying the model to the breakthrough data, filter factors (f) were calculated and compared with f values estimated from the slopes of log (cmax/co) vs. distance plots. These two independent approaches resulted in nearly identical filter factors, suggesting that both approaches are useful in determining reductions in microbial concentrations over transport distance. Applying the graphic approach to analyse spatial data, we have also estimated the f values for different aquifers using information provided by some other published field studies. The results show that values of f, in units of log (cmax/co) m(-1), are consistently in the order of 10(-2) for clean coarse gravel aquifers, 10(-3) for contaminated coarse gravel aquifers, and generally 10(-1) for sandy fine gravel aquifers and river and coastal sand aquifers. For each aquifer category, the f values for bacteriophages and bacteria are in the same order-of-magnitude. The f values estimated in this study indicate that for every one-log reduction in microbial concentration in groundwater, it requires a few tens of meters of travel in clean coarse gravel aquifers, but a few hundreds of meters in contaminated coarse gravel aquifers. In contrast, a one-log reduction generally only requires a few meters of travel in sandy fine gravel aquifers and sand aquifers. Considering the highest concentration in human effluent is in the order of 10(4) pfu/l for enteroviruses and 10(6) cfu/100 ml for faecal coliform bacteria, a 7-log reduction in microbial concentration would comply with the drinking water standards for the downgradient wells under natural gradient conditions. Based on the results of this study, a 7-log reduction would require 125-280 m travel in clean coarse gravel aquifers, 1.7-3.9 km travel in contaminated coarse gravel aquifers, 33-61 m travel in clean sandy fine gravel aquifers, 33-129 m travel in contaminated sandy fine gravel aquifers, and 37-44 m travel in contaminated river and coastal sand aquifers. These recommended setback distances are for a worst-case scenario, assuming direct discharge of raw effluent into the saturated zone of an aquifer. Filtration theory was applied to calculate collision efficiency (alpha) from model-derived attachment rates (katt), and the results are compared with those reported in the literature. The calculated alpha values vary by two orders-of-magnitude, depending on whether collision efficiency is estimated from the effective particle size (d10) or the mean particle size (d50). Collision efficiency values for MS-2 are similar to those previously reported in the literature (e.g. ) [DeBorde, D.C., Woessner, W.W., Kiley, QT., Ball, P., 1999. Rapid transport of viruses in a floodplain aquifer. Water Res. 33 (10), 2229-2238]. However, the collision efficiency values calculated for Bacillus subtilis spores were unrealistic, suggesting that filtration theory is not appropriate for theoretically estimating filtration capacity for poorly sorted coarse gravel aquifer media. This is not surprising, as filtration theory was developed for uniform sand filters and does not consider particle size distribution. Thus, we do not recommend the use of filtration theory to estimate the filter factor or setback distances. Either of the methods applied in this work (BTC or concentration vs. distance analyses), which takes into account aquifer heterogeneities and site-specific conditions, appear to be most useful in determining filter factors and setback distances.

Filtration and transport of Bacillus subtilis spores and the F-RNA phage MS2 in a coarse alluvial gravel aquifer: Implications in the estimation of setback distances

NASA Astrophysics Data System (ADS)

Pang, Liping; Close, Murray; Goltz, Mark; Noonan, Mike; Sinton, Lester

2005-04-01

Filtration of Bacillus subtilis spores and the F-RNA phage MS2 (MS2) on a field scale in a coarse alluvial gravel aquifer was evaluated from the authors' previously published data. An advection-dispersion model that is coupled with first-order attachment kinetics was used in this study to interpret microbial concentration vs. time breakthrough curves (BTC) at sampling wells. Based on attachment rates ( katt) that were determined by applying the model to the breakthrough data, filter factors ( f) were calculated and compared with f values estimated from the slopes of log ( cmax/ co) vs. distance plots. These two independent approaches resulted in nearly identical filter factors, suggesting that both approaches are useful in determining reductions in microbial concentrations over transport distance. Applying the graphic approach to analyse spatial data, we have also estimated the f values for different aquifers using information provided by some other published field studies. The results show that values of f, in units of log ( cmax/ co) m -1, are consistently in the order of 10 -2 for clean coarse gravel aquifers, 10 -3 for contaminated coarse gravel aquifers, and generally 10 -1 for sandy fine gravel aquifers and river and coastal sand aquifers. For each aquifer category, the f values for bacteriophages and bacteria are in the same order-of-magnitude. The f values estimated in this study indicate that for every one-log reduction in microbial concentration in groundwater, it requires a few tens of meters of travel in clean coarse gravel aquifers, but a few hundreds of meters in contaminated coarse gravel aquifers. In contrast, a one-log reduction generally only requires a few meters of travel in sandy fine gravel aquifers and sand aquifers. Considering the highest concentration in human effluent is in the order of 10 4 pfu/l for enteroviruses and 10 6 cfu/100 ml for faecal coliform bacteria, a 7-log reduction in microbial concentration would comply with the drinking water standards for the downgradient wells under natural gradient conditions. Based on the results of this study, a 7-log reduction would require 125-280 m travel in clean coarse gravel aquifers, 1.7-3.9 km travel in contaminated coarse gravel aquifers, 33-61 m travel in clean sandy fine gravel aquifers, 33-129 m travel in contaminated sandy fine gravel aquifers, and 37-44 m travel in contaminated river and coastal sand aquifers. These recommended setback distances are for a worst-case scenario, assuming direct discharge of raw effluent into the saturated zone of an aquifer. Filtration theory was applied to calculate collision efficiency ( α) from model-derived attachment rates ( katt), and the results are compared with those reported in the literature. The calculated α values vary by two orders-of-magnitude, depending on whether collision efficiency is estimated from the effective particle size ( d10) or the mean particle size ( d50). Collision efficiency values for MS-2 are similar to those previously reported in the literature (e.g. DeBorde et al., 1999) [DeBorde, D.C., Woessner, W.W., Kiley, QT., Ball, P., 1999. Rapid transport of viruses in a floodplain aquifer. Water Res. 33 (10), 2229-2238]. However, the collision efficiency values calculated for Bacillus subtilis spores were unrealistic, suggesting that filtration theory is not appropriate for theoretically estimating filtration capacity for poorly sorted coarse gravel aquifer media. This is not surprising, as filtration theory was developed for uniform sand filters and does not consider particle size distribution. Thus, we do not recommend the use of filtration theory to estimate the filter factor or setback distances. Either of the methods applied in this work (BTC or concentration vs. distance analyses), which takes into account aquifer heterogeneities and site-specific conditions, appear to be most useful in determining filter factors and setback distances.

Perfluorinated compounds in human breast milk from several Asian countries, and in infant formula and dairy milk from the United States.

PubMed

Tao, Lin; Ma, Jing; Kunisue, Tatsuya; Libelo, E Laurence; Tanabe, Shinsuke; Kannan, Kurunthachalam

2008-11-15

The occurrence of perfluorinated compounds (PFCs) in human blood is known to be widespread; nevertheless, the sources of exposure to humans, including infants, are not well understood. In this study, breast milk collected from seven countries in Asia was analyzed (n=184) for nine PFCs, including perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA). In addition, five brands of infant formula (n=21) and 11 brands of dairy milk (n=12) collected from retail stores in the United States were analyzed, for comparison with PFC concentrations previously reported for breast milk from the U.S. PFOS was the predominant PFC detected in almost all Asian breast milk samples, followed by perfluorohexanesulfonate (PFHxS) and PFOA. Median concentrations of PFOS in breast milk from Asian countries varied significantly;the lowest concentration of 39.4 pg/mL was found in India, and the highest concentration of 196 pg/mL was found in Japan. The measured concentrations were similarto or less than the concentrations previously reported from Sweden, the United States, and Germany (median, 106-166 pg/mL). PFHxS was found in more than 70% of the samples analyzed from Japan, Malaysia, Philippines, and Vietnam, at mean concentrations ranging from 6.45 (Malaysia) to 15.8 (Philippines) pg/mL PFOA was found frequently only in samples from Japan; the mean concentration for that country was 77.7 pg/mL. None of the PFCs were detected in the infant-formula or dairy-milk samples from the U.S. except a few samples that contained concentrations close to the limit of detection. The estimated average daily intake of PFOS by infants from seven Asian countries, via breastfeeding, was 11.8 +/- 10.6 ng/kg bw/ day; this value is 7-12 times higher than the estimated adult dietary intakes previously reported from Germany, Canada, and Spain. The average daily intake of PFOA by Japanese infants was 9.6 +/- 4.9 ng/kg bw/day, a value 3-10 times greater than the estimated adult dietary intakes reported from Germany and Canada. The highest estimated daily intakes of PFOS and PFOA by infants from seven Asian countries studied were 1-2 orders of magnitude below the tolerable daily intake values recommended by the U.K. Food Standards Agency.

Pediatric reference value distributions and covariate-stratified reference intervals for 29 endocrine and special chemistry biomarkers on the Beckman Coulter Immunoassay Systems: a CALIPER study of healthy community children.

PubMed

Karbasy, Kimiya; Lin, Danny C C; Stoianov, Alexandra; Chan, Man Khun; Bevilacqua, Victoria; Chen, Yunqi; Adeli, Khosrow

2016-04-01

The CALIPER program is a national research initiative aimed at closing the gaps in pediatric reference intervals. CALIPER previously reported reference intervals for endocrine and special chemistry markers on Abbott immunoassays. We now report new pediatric reference intervals for immunoassays on the Beckman Coulter Immunoassay Systems and assess platform-specific differences in reference values. A total of 711 healthy children and adolescents from birth to <19 years of age were recruited from the community. Serum samples were collected for measurement of 29 biomarkers on the Beckman Coulter Immunoassay Systems. Statistically relevant age and/or gender-based partitions were determined, outliers removed, and reference intervals calculated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. Complex profiles were observed for all 29 analytes, necessitating unique age and/or sex-specific partitions. Overall, changes in analyte concentrations observed over the course of development were similar to trends previously reported, and are consistent with biochemical and physiological changes that occur during childhood. Marked differences were observed for some assays including progesterone, luteinizing hormone and follicle-stimulating hormone where reference intervals were higher than those reported on Abbott immunoassays and parathyroid hormone where intervals were lower. This study highlights the importance of determining reference intervals specific for each analytical platform. The CALIPER Pediatric Reference Interval database will enable accurate diagnosis and laboratory assessment of children monitored by Beckman Coulter Immunoassay Systems in health care institutions worldwide. These reference intervals must however be validated by individual labs for the local pediatric population as recommended by CLSI.

Defluoridation of water using activated alumina in presence of natural organic matter via response surface methodology.

PubMed

Samarghandi, Mohammad Reza; Khiadani, Mehdi; Foroughi, Maryam; Zolghadr Nasab, Hasan

2016-01-01

Adsorption by activated alumina is considered to be one of the most practiced methods for defluoridation of freshwater. This study was conducted, therefore, to investigate the effect of natural organic matters (NOMs) on the removal of fluoride by activated alumina using response surface methodology. To the authors' knowledge, this has not been previously investigated. Physico-chemical characterization of the alumina was determined by scanning electron microscope (SEM), Brunauer-Emmett-Teller (BET), Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence (XRF), and X-ray diffractometer (XRD). Response surface methodology (RSM) was applied to evaluate the effect of single and combined parameters on the independent variables such as the initial concentration of fluoride, NOMs, and pH on the process. The results revealed that while presence of NOM and increase of pH enhance fluoride adsorption on the activated alumina, initial concentration of fluoride has an adverse effect on the efficiency. The experimental data were analyzed and found to be accurately and reliably fitted to a second-order polynomial model. Under optimum removal condition (fluoride concentration 20 mg/L, NOM concentration 20 mg/L, and pH 7) with a desirability value of 0.93 and fluoride removal efficiency of 80.6%, no significant difference was noticed with the previously reported sequence of the co-exiting ion affinity to activated alumina for fluoride removal. Moreover, aluminum residual was found to be below the recommended value by the guideline for drinking water. Also, the increase of fluoride adsorption on the activated alumina, as NOM concentrations increase, could be due to the complexation between fluoride and adsorbed NOM. Graphical abstract ᅟ.

Structured settlement annuities, part 2: mortality experience 1967--95 and the estimation of life expectancy in the presence of excess mortality.

PubMed

Singer, R B; Schmidt, C J

2000-01-01

the mortality experience for structured settlement (SS) annuitants issued both standard (Std) and substandard (SStd) has been reported twice previously by the Society of Actuaries (SOA), but the 1995 mortality described here has not previously been published. We describe in detail the 1995 SS mortality, and we also discuss the methodology of calculating life expectancy (e), contrasting three different life-table models. With SOA permission, we present in four tables the unpublished results of its 1995 SS mortality experience by Std and SStd issue, sex, and a combination of 8 age and 6 duration groups. Overall results on mortality expected from the 1983a Individual Annuity Table showed a mortality ratio (MR) of about 140% for Std cases and about 650% for all SStd cases. Life expectancy in a group with excess mortality may be computed by either adding the decimal excess death rate (EDR) to q' for each year of attained age to age 109 or multiplying q' by the decimal MR for each year to age 109. An example is given for men age 60 with localized prostate cancer; annual EDRs from a large published cancer study are used at duration 0-24 years, and the last EDR is assumed constant to age 109. This value of e is compared with e from constant initial values of EDR or MR after the first year. Interrelations of age, sex, e, and EDR and MR are discussed and illustrated with tabular data. It is shown that a constant MR for life-table calculation of e consistently overestimates projected annual mortality at older attained ages and underestimates e. The EDR method, approved for reserve calculations, is also recommended for use in underwriting conversion tables.

77 FR 30014 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

..., including worker characteristics, injury types, injury circumstances, injury outcomes, and use of personal protective equipment. Previous reports describing occupational injuries and illnesses to EMS workers provide...

Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia.

PubMed

Chen, Liang-Kung; Liu, Li-Kuo; Woo, Jean; Assantachai, Prasert; Auyeung, Tung-Wai; Bahyah, Kamaruzzaman Shahrul; Chou, Ming-Yueh; Chen, Liang-Yu; Hsu, Pi-Shan; Krairit, Orapitchaya; Lee, Jenny S W; Lee, Wei-Ju; Lee, Yunhwan; Liang, Chih-Kuang; Limpawattana, Panita; Lin, Chu-Sheng; Peng, Li-Ning; Satake, Shosuke; Suzuki, Takao; Won, Chang Won; Wu, Chih-Hsing; Wu, Si-Nan; Zhang, Teimei; Zeng, Ping; Akishita, Masahiro; Arai, Hidenori

2014-02-01

Sarcopenia, a newly recognized geriatric syndrome, is characterized by age-related decline of skeletal muscle plus low muscle strength and/or physical performance. Previous studies have confirmed the association of sarcopenia and adverse health outcomes, such as falls, disability, hospital admission, long term care placement, poorer quality of life, and mortality, which denotes the importance of sarcopenia in the health care for older people. Despite the clinical significance of sarcopenia, the operational definition of sarcopenia and standardized intervention programs are still lacking. It is generally agreed by the different working groups for sarcopenia in the world that sarcopenia should be defined through a combined approach of muscle mass and muscle quality, however, selecting appropriate diagnostic cutoff values for all the measurements in Asian populations is challenging. Asia is a rapidly aging region with a huge population, so the impact of sarcopenia to this region is estimated to be huge as well. Asian Working Group for Sarcopenia (AWGS) aimed to promote sarcopenia research in Asia, and we collected the best available evidences of sarcopenia researches from Asian countries to establish the consensus for sarcopenia diagnosis. AWGS has agreed with the previous reports that sarcopenia should be described as low muscle mass plus low muscle strength and/or low physical performance, and we also recommend outcome indicators for further researches, as well as the conditions that sarcopenia should be assessed. In addition to sarcopenia screening for community-dwelling older people, AWGS recommends sarcopenia assessment in certain clinical conditions and healthcare settings to facilitate implementing sarcopenia in clinical practice. Moreover, we also recommend cutoff values for muscle mass measurements (7.0 kg/m(2) for men and 5.4 kg/m(2) for women by using dual X-ray absorptiometry, and 7.0 kg/m(2) for men and 5.7 kg/m(2) for women by using bioimpedance analysis), handgrip strength (<26 kg for men and <18 kg for women), and usual gait speed (<0.8 m/s). However, a number of challenges remained to be solved in the future. Asia is made up of a great number of ethnicities. The majority of currently available studies have been published from eastern Asia, therefore, more studies of sarcopenia in south, southeastern, and western Asia should be promoted. On the other hand, most Asian studies have been conducted in a cross-sectional design and few longitudinal studies have not necessarily collected the commonly used outcome indicators as other reports from Western countries. Nevertheless, the AWGS consensus report is believed to promote more Asian sarcopenia research, and most important of all, to focus on sarcopenia intervention studies and the implementation of sarcopenia in clinical practice to improve health care outcomes of older people in the communities and the healthcare settings in Asia. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Fathers’ Perceived Reasons for Their Underrepresentation in Child Health Research and Strategies to Increase Their Involvement

PubMed Central

Charles, Jo N.; Khandpur, Neha; Nelson, Timothy J.

2017-01-01

Purpose Examine fathers’ perceived reasons for their lack of inclusion in pediatric research and strategies to increase their participation. Description We conducted expert interviews with researchers and practitioners (N = 13) working with fathers to inform the development of an online survey. The survey—which measured fathers’ perceived reasons for their underrepresentation in pediatric research, recommended recruitment venues, and research personnel and study characteristics valued by fathers—was distributed online and in-person to fathers. Assessment Respondents included 303 fathers. Over 80 % of respondents reported that fathers are underrepresented in pediatric research because they have not been asked to participate. Frequently recommended recruitment venues included community sports events (52 %), social service programs (48 %) and the internet (60 %). Compared with white fathers, more non-white fathers recommended public transit (19 % vs. 10 %, p = .02), playgrounds (16 % vs. 6 %, p = .007) and barber shops (34 % vs. 14 %, p <.0001) and fewer recommended doctors’ offices (31 % vs. 43 %, p = .046) as recruitment venues. Compared with residential fathers (100 % resident with the target child), more non-residential fathers recommended social services programs (45 % vs. 63 %, p = .03) and public transit (10 % vs. 27 %, p = .001) and fewer recommended the workplace (17 % vs. 40 %, p = .002) as recruitment venues. Study brevity, perceived benefits for fathers and their families, and the credibility of the lead organization were valued by fathers. Conclusion Fathers’ participation in pediatric research may increase if researchers explicitly invite father to participate, target father-focused recruitment venues, clearly communicate the benefits of the research for fathers and their families and adopt streamlined study procedures. PMID:27473093

[GRADE system: classification of quality of evidence and strength of recommendation].

PubMed

Aguayo-Albasini, José Luis; Flores-Pastor, Benito; Soria-Aledo, Víctor

2014-02-01

The acquisition and classification of scientific evidence, and subsequent formulation of recommendations constitute the basis for the development of clinical practice guidelines. There are several systems for the classification of evidence and strength of recommendations; the most commonly used nowadays is the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). The GRADE system initially classifies the evidence into high or low, coming from experimental or observational studies; subsequently and following a series of considerations, the evidence is classified into high, moderate, low or very low. The strength of recommendations is based not only on the quality of the evidence, but also on a series of factors such as the risk/benefit balance, values and preferences of the patients and professionals, and the use of resources or costs. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

Footwear recommendations and patterns among orthopaedic foot and ankle surgeons: a survey.

PubMed

Farber, Daniel C; Knutsen, Elisa J

2013-12-01

Foot and ankle surgeons are in a unique position to educate patients about the importance of proper footwear. Neither their recommendations regarding shoe selection nor their own footwear patterns have previously been reported. A total of 866 members of the American Orthopaedic Foot & Ankle Society (AOFAS) were asked to complete a survey via the Internet. Topics included specific shoe brands recommended to patients, how attributes of footwear are communicated, and respondents' footwear habits. In all, 276 (32%) surgeons responded, and 64% recommended New Balance athletic shoes to patients; 26% did not recommend specific brands. It was found that 50% wear New Balance athletic shoes; 25% wear Nike. Rockport (27%) and SAS (27%) were the most recommended dress shoes. In all, 76% are familiar with AOFAS guidelines for proper shoe fit, but only 56% educated their patients about the guidelines; 43% do not consider what patients might think of their shoes when selecting what to wear in the clinical setting. Despite the multitude of different brands, several were commonly recommended. Respondents seem to be aware of the impact of their own shoe selection on patients' perspectives of footwear, but many do not consider themselves role models for proper footwear.

The Impact of Excluding Food Guarding from a Standardized Behavioral Canine Assessment in Animal Shelters

PubMed Central

Mohan-Gibbons, Heather; Dolan, Emily D.; Reid, Pamela; Slater, Margaret R.; Mulligan, Hugh; Weiss, Emily

2018-01-01

Simple Summary Recent research has called into question the value of the food guarding assessment as a predictive tool for determining the safety of shelter dogs. This study examined the effect of eliminating the food guarding assessment in nine U.S. animal shelters. It was found that when the food guarding assessment was removed, bites or other injuries to staff or adopters did not increase. However, dogs exhibiting food guarding behavior were less likely to be adopted, had a longer shelter stay, and were more likely to be euthanized than dogs in the general population. Based on previous research and this study’s findings, the authors recommend that shelters discontinue the food guarding assessment. Abstract Many shelters euthanize or restrict adoptions for dogs that exhibit food guarding while in the animal shelter. However, previous research showed that only half the dogs exhibiting food guarding during an assessment food guard in the home. So, dogs are often misidentified as future food guarders during shelter assessments. We examined the impact of shelters omitting food guarding assessments. Nine shelters conducted a two-month baseline period of assessing for food guarding followed by a two-month investigative period during which they omitted the food guarding assessment. Dogs that guarded their food during a standardized assessment were less likely to be adopted, had a longer shelter stay, and were more likely to be euthanized. When the shelters stopped assessing for food guarding, there was no significant difference in the rate of returns of food guarding dogs, even though more dogs were adopted because fewer were identified with food guarding behavior. Additionally, the number of injuries to staff, volunteers, and adopters was low (104 incidents from a total of 14,180 dogs) and did not change when the food guarding assessment was omitted. These results support a recommendation that shelters discontinue the food guarding assessment. PMID:29419746

Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older - Advisory Committee on Immunization Practices (ACIP), 2012.

PubMed

2012-06-29

Since 2005, the Advisory Committee on Immunization Practices (ACIP) has recommended a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine booster dose for all adolescents aged 11 through 18 years (preferred at 11 through 12 years) and for those adults aged 19 through 64 years who have not yet received a dose. In October 2010, despite the lack of an approved Tdap vaccine for adults aged 65 years and older, ACIP recommended that unvaccinated adults aged 65 years and older be vaccinated with Tdap if in close contact with an infant, and that other adults aged 65 years and older may receive Tdap. In July 2011, the Food and Drug Administration (FDA) approved expanding the age indication for Boostrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) to aged 65 years and older. In February 2012, ACIP recommended Tdap for all adults aged 65 years and older. This recommendation supersedes previous Tdap recommendations regarding adults aged 65 years and older.

[Update of recommendations for evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology].

PubMed

Reyes-García, Rebeca; García-Martín, Antonia; Varsavsky, Mariela; Rozas-Moreno, Pedro; Cortés-Berdonces, María; Luque-Fernández, Inés; Gómez Sáez, José Manuel; Vidal Casariego, Alfonso; Romero Muñoz, Manuel; Guadalix Iglesias, Sonsoles; Fernández García, Diego; Jódar Gimeno, Esteban; Muñoz Torres, Manuel

2015-05-01

To update previous recommendations developed by the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition for the evaluation and treatment of osteoporosis associated to different endocrine and nutritional diseases. Members of the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition. Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date between 18 October 2011 and 30 October 2014 were included. The recommendations were discussed and approved by all members of the Working Group. This update summarizes the new data regarding evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Adherence to guidelines for cardiovascular screening in current high school preparticipation evaluation forms.

PubMed

Rausch, Christopher M; Phillips, George C

2009-10-01

We compared the content of the cardiac screening questions on US state high school athletic association preparticipation evaluation forms with current consensus recommendations. We reviewed the high school athletic association's approved, recommended, or required sports preparticipation form from each of the 50 US states and the District of Columbia, and compared the content of the personal and family history components with current recommendations for cardiac screening questions. We found that 85% of the preparticipation forms in current use contain all elements of the formerly recommended guidelines, but only 17% contain all elements of the new consensus guidelines. We conclude that although there appears to be some improvement in the content of the preparticipation forms in current use compared with previous studies, the vast majority of these forms are incomplete compared with current consensus guidelines.

Examination of value of the future and health beliefs to explain dietary and physical activity behaviors.

PubMed

Garza, Kimberly Bosworth; Harris, Carole V; Bolding, Mark S

2013-01-01

Studies have shown a negative association between value of the future (preference for long-term vs. short-term rewards) and harmful addictive behaviors; however, research in the area of preventive behaviors is limited and has shown conflicting results. The primary objectives were: (1) to examine the association among value of the future and diet and physical activity (PA) behaviors, and (2) to assess whether value of the future explained additional variance in behaviors after controlling for theory-based health beliefs related to coronary heart disease (CHD). An online survey was conducted in adults (N = 172) with no prior history of CHD. A delay discounting task was administered to measure value of the future. Questionnaire items were based on the Health Belief Model (HBM) and included CHD knowledge, perceived risk, perceived severity, perceived benefits of and barriers to behavior change, self-efficacy, cues to action, diet and PA behaviors and demographic variables. High value of the future was associated with younger age, lower BMI, more healthful diet, and increased PA. After controlling for HBM components and demographics, value of the future did not explain any additional variance in diet or PA behaviors. Significant predictors of healthful diet included female gender (P = .013), increased age (P = .029), greater than high school education (P = .023), greater diet-related self-efficacy (P = .021), and not having received a healthcare provider recommendation to improve diet (P = .018). Significant predictors of PA level included income between $20,000 and $69,999 (P = .014), greater exercise-related self-efficacy (P < .001) and not having received a healthcare provider recommendation to increase levels of PA (P = .015). Behaviors to prevent CHD may be associated with a person's outlook on the future; however, self-efficacy was a stronger predictor of behavior. These findings support recommendations for enhancement of diet- and PA-related self-efficacy and problem-solving to address myopia in terms of long-term health benefits. Copyright © 2013 Elsevier Inc. All rights reserved.

Value to Whom? The Patient Voice in the Value Discussion.

PubMed

Perfetto, Eleanor M; Oehrlein, Elisabeth M; Boutin, Marc; Reid, Sarah; Gascho, Eric

2017-02-01

Professional societies and other organizations have recently taken a visible role trying to define treatment value via value frameworks and assessments, providing payer or provider recommendations, and potentially impacting patient access. Patient perspectives routinely differ from those of other stakeholders. Yet, it is not always apparent that patients were engaged in value framework development or assessment. To describe the development and content of the National Health Council's (NHC's) Rubric, a tool that includes criteria for evaluation of value frameworks specifically with regard to patient-centeredness and meaningful patient engagement. The NHC held a multistakeholder, invitational roundtable in Washington, DC, in 2016. Participants reviewed existing patient-engagement rubrics, discussed experiences with value frameworks, debated and thematically grouped hallmark patient-centeredness characteristics, and developed illustrative examples of the characteristics. These materials were organized into the rubric, and subsequently vetted via multistakeholder peer review. The resulting rubric describes six domains of patient-centered value frameworks: partnership, transparency, inclusiveness, diversity, outcomes, and data sources. Each domain includes specific examples illustrating how patient engagement and patient-centeredness can be operationalized in value framework processes. The NHC multistakeholder roundtable's recommendations are captured in the NHC's Rubric to assess value framework and model patient-centeredness and patient engagement. The Rubric is a tool that will be refined over time on the basis of feedback from patient, patient group, framework developer, and other stakeholder-use experiences. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Conflicting national recommendations and the use of screening mammography: does the physician's recommendation matter?

PubMed

Taplin, S H; Urban, N; Taylor, V M; Savarino, J

1997-01-01

This study evaluated whether women's perceptions of the conflicting recommendations for breast cancer screening were associated with decreased use of mammography. We conducted a random-digit-dial telephone survey of 1024 women in four communities of western Washington State. In addition to collecting data for demographics, beliefs about mammography, and insurance coverage, we inquired whether the respondents were aware of any conflicting recommendations about when to begin or how frequently to perform screening mammography, whether their physicians had recommended a mammogram, and whether they were likely to do what their physicians recommended. After grouping women according to whether they perceived conflicting recommendations, we used chi-square statistics to compare the distribution of proportions of women by age, race, household income, education, and insurance coverage. To estimate the odds of their having a mammogram in the previous 2 years (yes or no), we used multivariate logistic regression and included the above variables as covariates. Sixty-two percent of eligible women completed the survey, and 49 percent (479 of 985) perceived conflicting recommendations. The association between perceiving conflict and mammography use was not significant. Eighty-three percent of women who perceived conflicting recommendations reported being more comfortable using their own judgment about getting the procedure. After controlling for whether women perceived conflicting recommendations and all other factors, women who said they followed their physician's advice but did not recall their physician recommending mammography were 71 percent less likely to have received a recent mammogram than were women who reported their physician did recommend it (odds ratio 0.29, confidence interval 0.16-0.51). The conflicting recommendations surrounding breast cancer screening are not influencing women's choices about mammography. The physician recommendation and women's self-reported likeliness to follow it are the most important factors associated with mammography use.

Precommitting to choose wisely about low-value services: a stepped wedge cluster randomised trial.

PubMed

Kullgren, Jeffrey Todd; Krupka, Erin; Schachter, Abigail; Linden, Ariel; Miller, Jacquelyn; Acharya, Yubraj; Alford, James; Duffy, Richard; Adler-Milstein, Julia

2018-05-01

Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. We conducted a 12-month stepped wedge cluster randomised trial among 45 primary care physicians and advanced practice providers in six adult primary care clinics of a US community group practice.Clinicians were invited to precommit to Choosing Wisely recommendations against imaging for uncomplicated low back pain, imaging for uncomplicated headaches and unnecessary antibiotics for acute sinusitis. Clinicians who precommitted received 1-6 months of point-of-care precommitment reminders as well as patient education handouts and weekly emails with resources to support communication about low-value services.The primary outcome was the difference between control and intervention period percentages of visits with potentially low-value orders. Secondary outcomes were differences between control and intervention period percentages of visits with possible alternate orders, and differences between control and 3-month postintervention follow-up period percentages of visits with potentially low-value orders. The intervention was not associated with a change in the percentage of visits with potentially low-value orders overall, for headaches or for acute sinusitis, but was associated with a 1.7% overall increase in alternate orders (p=0.01). For low back pain, the intervention was associated with a 1.2% decrease in the percentage of visits with potentially low-value orders (p=0.001) and a 1.9% increase in the percentage of visits with alternate orders (p=0.007). No changes were sustained in follow-up. Clinician precommitment to follow Choosing Wisely recommendations was associated with a small, unsustained decrease in potentially low-value orders for only one of three targeted conditions and may have increased alternate orders. NCT02247050; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hepatitis A vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity, United States.

PubMed

Lu, Peng-Jun; Byrd, Kathy K; Murphy, Trudy V

2013-05-01

Since 1996, hepatitis A vaccine (HepA) has been recommended for adults at increased risk for infection including travelers to high or intermediate hepatitis A endemic countries. In 2009, travel outside the United States and Canada was the most common exposure nationally reported for persons with hepatitis A virus (HAV) infection. To assess HepA vaccination coverage among adults 18-49 years traveling to a country of high or intermediate endemicity in the United States. We analyzed data from the 2010 National Health Interview Survey (NHIS), to determine self-reported HepA vaccination coverage (≥1 dose) and series completion (≥2 dose) among persons 18-49 years who traveled, since 1995, to a country of high or intermediate HAV endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with HepA vaccine receipt. In 2010, approximately 36.6% of adults 18-49 years reported traveling to high or intermediate hepatitis A endemic countries; among this group unadjusted HepA vaccination coverage was 26.6% compared to 12.7% among non-travelers (P-values<0.001) and series completion were 16.9% and 7.6%, respectively (P-values<0.001). On multivariable analysis among all respondents, travel status was an independent predictor of HepA coverage and series completion (both P-values<0.001). Among travelers, HepA coverage and series completion (≥2 doses) were higher for travelers 18-25 years (prevalence ratios 2.3, 2.8, respectively, P-values<0.001) and for travelers 26-39 years (prevalence ratios 1.5, 1.5, respectively, P-value<0.001, P-value=0.002, respectively) compared to travelers 40-49 years. Other characteristics independently associated with a higher likelihood of HepA receipt among travelers included Asian race/ethnicity, male sex, never having been married, having a high school or higher education, living in the western United States, having greater number of physician contacts or receipt of influenza vaccination in the previous year. HepB vaccination was excluded from the model because of the significant correlation between receipt of HepA vaccination and HepB vaccination could distort the model. Although travel to a country of high or intermediate hepatitis A endemicity was associated with higher likelihood of HepA vaccination in 2010 among adults 18-49 years, self-reported HepA vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients' upcoming travel plans and recommend and offer travel related vaccinations to their patients. Published by Elsevier Ltd.

Ecological Screening Values for Surface Water, Sediment, and Soil: 2005 Update

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

Friday, G. P.

2005-07-18

One of the principal components of the environmental remediation program at the Savannah River Site (SRS) is the assessment of ecological risk. Used to support CERCLA, RCRA, and DOE orders, the ecological risk assessment (ERA) can identify environmental hazards and evaluate remedial action alternatives. Ecological risk assessment is also an essential means for achieving DOE's risk based end state vision for the disposition of nuclear material and waste hazards, the decommissioning of facilities, and the remediation of inactive waste units at SRS. The complexity of an ERA ranges from a screening level ERA (SLERA) to a full baseline ERA. Amore » screening level ecological risk assessments, although abbreviated from a baseline risk assessment, is nonetheless considered a complete risk assessment (EPA, 2001a). One of the initial tasks of any ERA is to identify constituents that potentially or adversely affect the environment. Typically, this is accomplished by comparing a constituent's maximum concentration in surface water, sediment, or soil with an ecological screening value (ESV). The screening process can eliminate many constituents from further consideration in the risk assessment, but it also identifies those that require additional evaluation. This document is an update of a previous compilation (Friday, 1998) and provides a comprehensive listing of ecological screening values for surface water, sediment, and soil. It describes how the screening values were derived and recommends benchmarks that can be used for ecological risk assessment. The sources of these updated benchmarks include the U.S. Environmental Protection Agency (EPA), U.S. Fish and Wildlife Service (USFWS), U.S. Geological Survey (USGS), National Oceanic and Atmospheric Administration (NOAA), Oak Ridge National Laboratory (ORNL), the State of Florida, the Canadian Council of Ministers of the Environment (CCME), the Dutch Ministry of the Environment (RIVM), and the scientific literature. It should be noted that ESV's are continuously revised by the various issuing agencies. The references in this report provide the citations of each source and, where applicable, the internet address where they can be accessed. Although radiological screening values are not included herein due to space limitations, these have been recently derived by a technical working committee sponsored by the U.S. Department of Energy (DOE 2002, 2004). The recommended ecological screening values represent the most conservative concentrations of the cited sources, and are to be used for screening purposes only. They do not represent remedial action cleanup levels. Their use at locations other than SRS should take into account environmental variables such as water quality, soil chemistry, flora and fauna, and other ecological attributes specific to the ecosystem potentially at risk.« less

New biotite and muscovite isotopic reference materials, USGS57 and USGS58, for δ2H measurements–A replacement for NBS 30

USGS Publications Warehouse

Qi, Haiping; Coplen, Tyler B.; Gehre, Matthias; Vennemann, Torsten W.; Brand, Willi A.; Geilmann, Heike; Olack, Gerard; Bindeman, Ilya N.; Palandri, Jim; Huang, Li; Longstaffe, Fred J.

2017-01-01

The advent of continuous-flow isotope-ratio mass spectrometry (CF-IRMS) coupled with a high temperature conversion (HTC) system enabled faster, more cost effective, and more precise δ2H analysis of hydrogen-bearing solids. Accurate hydrogen isotopic analysis by on-line or off-line techniques requires appropriate isotopic reference materials (RMs). A strategy of two-point calibrations spanning δ2H range of the unknowns using two RMs is recommended. Unfortunately, the supply of the previously widely used isotopic RM, NBS 30 biotite, is exhausted. In addition, recent measurements have shown that the determination of δ2H values of NBS 30 biotite on the VSMOW-SLAP isotope-delta scale by on-line HTC systems with CF-IRMS may be unreliable because hydrogen in this biotite may not be converted quantitatively to molecular hydrogen. The δ2HVSMOW-SLAP values of NBS 30 biotite analyzed by on-line HTC systems can be as much as 21 mUr (or ‰) too positive compared to the accepted value of − 65.7 mUr, determined by only a few conventional off-line measurements. To ensure accurate and traceable on-line hydrogen isotope-ratio determinations in mineral samples, we here propose two isotopically homogeneous, hydrous mineral RMs with well-characterized isotope-ratio values, which are urgently needed. The U.S. Geological Survey (USGS) has prepared two such RMs, USGS57 biotite and USGS58 muscovite. The δ2H values were determined by both glassy carbon-based on-line conversion and chromium-based on-line conversion, and results were confirmed by off-line conversion. The quantitative conversion of hydrogen from the two RMs using the on-line HTC method was carefully evaluated in this study. The isotopic compositions of these new RMs with 1-σ uncertainties and mass fractions of hydrogen are:USGS57 (biotite)δ2HVSMOW-SLAP = − 91.5 ± 2.4 mUr (n = 24)Mass fraction hydrogen = 0.416 ± 0.002% (n = 4)Mass fraction water = 3.74 ± 0.02% (n = 4)USGS58 (muscovite)δ2HVSMOW-SLAP = − 28.4 ± 1.6 mUr (n = 24)Mass fraction hydrogen = 0.448 ± 0.002% (n = 4)Mass fraction water = 4.03 ± 0.02% (n = 4).These δ2HVSMOW-SLAP values encompass typical ranges for solid unknowns of crustal and mantle origin and are available to users for recommended two-point calibration.

Hepatitis A vaccination coverage among adults 18–49 years traveling to a country of high or intermediate endemicity, United States

PubMed Central

Lu, Peng-jun; Byrd, Kathy K.; Murphy, Trudy V.

2018-01-01

Background Since 1996, hepatitis A vaccine (HepA) has been recommended for adults at increased risk for infection including travelers to high or intermediate hepatitis A endemic countries. In 2009, travel outside the United States and Canada was the most common exposure nationally reported for persons with hepatitis A virus (HAV) infection. Objective To assess HepA vaccination coverage among adults 18–49 years traveling to a country of high or intermediate endemicity in the United States. Methods We analyzed data from the 2010 National Health Interview Survey (NHIS), to determine self-reported HepA vaccination coverage (≥1 dose) and series completion (≥2 dose) among persons 18–49 years who traveled, since 1995, to a country of high or intermediate HAV endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with HepA vaccine receipt. Results In 2010, approximately 36.6% of adults 18–49 years reported traveling to high or intermediate hepatitis A endemic countries; among this group unadjusted HepA vaccination coverage was 26.6% compared to 12.7% among non-travelers (P-values < 0.001) and series completion were 16.9% and 7.6%, respectively (P-values < 0.001). On multivariable analysis among all respondents, travel status was an independent predictor of HepA coverage and series completion (both P-values < 0.001). Among travelers, HepA coverage and series completion (≥2 doses) were higher for travelers 18–25 years (prevalence ratios 2.3, 2.8, respectively, P-values < 0.001) and for travelers 26–39 years (prevalence ratios 1.5, 1.5, respectively, P-value < 0.001, P-value = 0.002, respectively) compared to travelers 40–49 years. Other characteristics independently associated with a higher likelihood of HepA receipt among travelers included Asian race/ethnicity, male sex, never having been married, having a high school or higher education, living in the western United States, having greater number of physician contacts or receipt of influenza vaccination in the previous year. HepB vaccination was excluded from the model because of the significant correlation between receipt of HepA vaccination and HepB vaccination could distort the model. Conclusions Although travel to a country of high or intermediate hepatitis A endemicity was associated with higher likelihood of HepA vaccination in 2010 among adults 18–49 years, self-reported HepA vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients’ upcoming travel plans and recommend and offer travel related vaccinations to their patients. PMID:23523408

[The linear dimensions of human body measurements of Chinese male pilots in standing posture].

PubMed

Guo, Xiao-chao; Liu, Bao-shan; Xiao, Hui; Wang, Zhi-jie; Li, Rong; Guo, Hui

2003-02-01

To provide the latest anthropometric data of Chinese male pilots on a large scale. 94 linear dimensions of human body measurements were defined, of which there are 42 fundamental items and 52 recommended items. The computer databanks were programmed, in which the subprograms were preset for data checking such as extreme value examination, logical judgement for data relationship, and measuring-remeasuring difference test. All workers were well trained before pilot measurements. 1739 male pilots from China Air Force was measured for the 42 fundamental items, and of which 904 pilots were measured for the 52 recommended items. Mean, standard deviation, the maximum value, the minimal value, and the 5th, 50th, 95th percentile data of all the 94 items were given. The quality of the data was stable and reliable. All data of the 94 linear dimensions of human body measurements were valid and reliable with high precision.