Healthcare team training programs aimed at improving depression management in primary care: A systematic review.

PubMed

Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela

2016-08-01

Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.

Cosmic ray antimatter: Is it primary or secondary?

NASA Technical Reports Server (NTRS)

Stecker, F. W.; Protheroe, R. J.; Kazanas, D.

1981-01-01

The relative merits and difficulties of the primary and secondary origin hypotheses for the observed cosmic ray antiprotons, including the low energy measurement of Buffington, were examined. It is concluded that the cosmic ray antiproton data may be strong evidence for antimatter galaxies and baryon symmetric cosmology. The present antiproton data are consistent with a primary extragalactic component having antiproton/proton approximately equal to .0032 + or - 0.7.

Multiscale Modeling of Primary Cilium Deformations Under Local Forces and Shear Flows

NASA Astrophysics Data System (ADS)

Peng, Zhangli; Feng, Zhe; Resnick, Andrew; Young, Yuan-Nan

2017-11-01

We study the detailed deformations of a primary cilium under local forces and shear flows by developing a multiscale model based on the state-of-the-art understanding of its molecular structure. Most eukaryotic cells are ciliated with primary cilia. Primary cilia play important roles in chemosensation, thermosensation, and mechanosensation, but the detailed mechanism for mechanosensation is not well understood. We apply the dissipative particle dynamics (DPD) to model an entire well with a primary cilium and consider its different components, including the basal body, microtubule doublets, actin cortex, and lipid bilayer. We calibrate the mechanical properties of individual components and their interactions from experimental measurements and molecular dynamics simulations. We validate the simulations by comparing the deformation profile of the cilium and the rotation of the basal body with optical trapping experiments. After validations, we investigate the deformation of the primary cilium under shear flows. Furthermore, we calculate the membrane tensions and cytoskeleton stresses, and use them to predict the activation of mechanosensitive channels.

Primary Mental Health in Elementary Schools: Its Impact on Psychosocial Measures.

ERIC Educational Resources Information Center

Munoz, Marco A.

The Primary Mental Health Project (PMHP) is a research-based, selective program implemented by the Jefferson County Public Schools. The goal of the program is to enhance learning and other school-related competencies. Key structural components of the program include a focus on young children, early screening and selection, use of paraprofessionals…

Pediatric primary care as a component of systems of care.

PubMed

Brown, Jonathan D

2010-02-01

Systems of care should be defined in a manner that includes primary care. The current definition of systems of care shares several attributes with the definition of primary care: both are defined as community-based services that are accessible, accountable, comprehensive, coordinated, culturally competent, and family focused. However, systems of care is defined as serving only children and youth with serious emotional disturbance and their families and does not fully embrace the concept of primary prevention. Although similarities in the definitions of primary care and systems of care may provide a theoretical foundation for including primary care within the systems of care framework, a definition of systems of care that incorporates the idea of prevention and takes into account the broad population served in primary care would provide communities with a definition that can be used to further the work of integrating primary care into systems of care.

The design of components for an advanced Rankine cycle test facility.

NASA Technical Reports Server (NTRS)

Bond, J. A.

1972-01-01

The design of a facility for testing components of an advanced Rankine cycle power system is summarized. The facility is a three-loop system in which lithium, potassium and NaK-78 are the working fluids of the primary, secondary and heat-rejection loops, respectively. Design bases and performance predictions for the major loop components, including the lithium heater and the potassium boiler, condenser and preheater, are outlined.

After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

PubMed

Kelly, Michelle M; Blunt, Elizabeth; Nestor, Kelly

2017-12-01

Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum. ©2017 American Association of Nurse Practitioners.

Fabrication of experimental three-meter space telescope primary and secondary mirror support structure

NASA Technical Reports Server (NTRS)

Mishler, H. W.

1974-01-01

The fabrication of prototype titanium alloy primary and secondary mirror support structures for a proposed experimental three-meter space telescope is discussed. The structure was fabricated entirely of Ti-6Al-4V tubing and plate. Fabrication included the development of procedures including welding, forming, and machining. Most of the structures was fabricated by gas-shielding tungsten-arc (GTA) welding with several major components fabricated by high frequency resistance (HFR) welding.

The role of magmas in the formation of hydrothermal ore deposits

USGS Publications Warehouse

Hedenquist, Jeffrey W.; Lowenstern, Jacob B.

1994-01-01

Magmatic fluids, both vapour and hypersaline liquid, are a primary source of many components in hydrothermal ore deposits formed in volcanic arcs. These components, including metals and their ligands, become concentrated in magmas in various ways from various sources, including subducted oceanic crust. Leaching of rocks also contributes components to the hydrothermal fluid—a process enhanced where acid magmatic vapours are absorbed by deeply circulating meteoric waters. Advances in understanding the hydrothermal systems that formed these ore deposits have come from the study of their active equivalents, represented at the surface by hot springs and volcanic fumaroles.

ACEE composite structures technology

NASA Technical Reports Server (NTRS)

Klotzsche, M. (Compiler)

1984-01-01

The NASA Aircraft Energy Efficiency (ACEE) Composite Primary Aircraft Structures Program has made significant progress in the development of technology for advanced composites in commercial aircraft. Commercial airframe manufacturers have demonstrated technology readiness and cost effectiveness of advanced composites for secondary and medium primary components and have initiated a concerted program to develop the data base required for efficient application to safety-of-flight wing and fuselage structures. Oral presentations were compiled into five papers. Topics addressed include: damage tolerance and failsafe testing of composite vertical stabilizer; optimization of composite multi-row bolted joints; large wing joint demonstation components; and joints and cutouts in fuselage structure.

Numerical study on static component generation from the primary Lamb waves propagating in a plate with nonlinearity

NASA Astrophysics Data System (ADS)

Wan, Xiang; Tse, Peter W.; Zhang, Xuhui; Xu, Guanghua; Zhang, Qing; Fan, Hongwei; Mao, Qinghua; Dong, Ming; Wang, Chuanwei; Ma, Hongwei

2018-04-01

Under the discipline of nonlinear ultrasonics, in addition to second harmonic generation, static component generation is another frequently used nonlinear ultrasonic behavior in non-destructive testing (NDT) and structural health monitoring (SHM) communities. However, most previous studies on static component generation are mainly based on using longitudinal waves. It is desirable to extend static component generation from primary longitudinal waves to primary Lamb waves. In this paper, static component generation from the primary Lamb waves is studied. Two major issues are numerically investigated. First, the mode of static displacement component generated from different primary Lamb wave modes is identified. Second, cumulative effect of static displacement component from different primary Lamb wave modes is also discussed. Our study results show that the static component wave packets generated from the primary S0, A0 and S1 modes share the almost same group velocity equal to the phase velocity of S0 mode tending to zero frequency c plate . The finding indicates that whether the primary mode is S0, A0 or S1, the static components generated from these primary modes always share the nature of S0 mode. This conclusion is also verified by the displacement filed of these static components that the horizontal displacement field is almost uniform and the vertical displacement filed is antisymmetric across the thickness of the plate. The uniform distribution of horizontal displacement filed enables the static component, regardless of the primary Lamb modes, to be a promising technique for evaluating microstructural damages buried in the interior of a structure. Our study also illustrates that the static components are cumulative regardless of whether the phase velocity of the primary and secondary waves is matched or not. This observation indicates that the static component overcomes the limitations of the traditional nonlinear Lamb waves satisfying phase velocity matching condition to achieve cumulative second harmonic generation. This nature also enables the primary Lamb waves excited at a low center frequency to generate static component used for inspecting large-scale structures with micro-scale damages.

AAC Modeling Intervention Research Review

ERIC Educational Resources Information Center

Sennott, Samuel C.; Light, Janice C.; McNaughton, David

2016-01-01

A systematic review of research on the effects of interventions that include communication partner modeling of aided augmentative and alternative communication (AAC) on the language acquisition of individuals with complex communication needs was conducted. Included studies incorporated AAC modeling as a primary component of the intervention,…

Adipogenic Effects and Gene Expression Profiling of Firemaster® 550 Components in Human Primary Preadipocytes

PubMed Central

Tung, Emily W.Y.; Peshdary, Vian; Gagné, Remi; Rowan-Carroll, Andrea; Yauk, Carole L.; Boudreau, Adéle

2017-01-01

Background: Exposure to flame retardants has been associated with negative health outcomes including metabolic effects. As polybrominated diphenyl ether flame retardants were pulled from commerce, human exposure to new flame retardants such as Firemaster® 550 (FM550) has increased. Although previous studies in murine systems have shown that FM550 and its main components increase adipogenesis, the effects of FM550 in human models have not been elucidated. Objectives: The objectives of this study were to determine if FM550 and its components are active in human preadipocytes, and to further investigate their mode of action. Methods: Human primary preadipocytes were differentiated in the presence of FM550 and its components. Differentiation was assessed by lipid accumulation and expression of peroxisome proliferator-activated receptor γ (PPARG), fatty acid binding protein (FABP) 4 and lipoprotein lipase (LPL). mRNA was collected for Poly (A) RNA sequencing and was used to identify differentially expressed genes (DEGs). Functional analysis of DEGs was undertaken in Ingenuity Pathway Analysis. Results: FM550 triphenyl phosphate (TPP) and isopropylated triphenyl phosphates (IPTP), increased adipogenesis in human primary preadipocytes as assessed by lipid accumulation and mRNA expression of regulators of adipogenesis such as PPARγ, CCAAT enhancer binding protein (C/EBP) α and sterol regulatory element binding protein (SREBP) 1 as well as the adipogenic markers FABP4 LPL and perilipin. Poly (A) RNA sequencing analysis revealed potential modes of action including liver X receptor/retinoid X receptor (LXR/RXR) activation, thyroid receptor (TR)/RXR, protein kinase A, and nuclear receptor subfamily 1 group H members activation. Conclusions: We found that FM550, and two of its components, induced adipogenesis in human primary preadipocytes. Further, using global gene expression analysis we showed that both TPP and IPTP likely exert their effects through PPARG to induce adipogenesis. In addition, IPTP perturbed signaling pathways that were not affected by TPP. https://doi.org/10.1289/EHP1318 PMID:28934090

Carbon-carbon primary structure for SSTO vehicles

NASA Astrophysics Data System (ADS)

Croop, Harold C.; Lowndes, Holland B.

1997-01-01

A hot structures development program is nearing completion to validate use of carbon-carbon composite structure for primary load carrying members in a single-stage-to-orbit, or SSTO, vehicle. A four phase program was pursued which involved design development and fabrication of a full-scale wing torque box demonstration component. The design development included vehicle and component selection, design criteria and approach, design data development, demonstration component design and analysis, test fixture design and analysis, demonstration component test planning, and high temperature test instrumentation development. The fabrication effort encompassed fabrication of structural elements for mechanical property verification as well as fabrication of the demonstration component itself and associated test fixturing. The demonstration component features 3D woven graphite preforms, integral spars, oxidation inhibited matrix, chemical vapor deposited (CVD) SiC oxidation protection coating, and ceramic matrix composite fasteners. The demonstration component has been delivered to the United States Air Force (USAF) for testing in the Wright Laboratory Structural Test Facility, WPAFB, OH. Multiple thermal-mechanical load cycles will be applied simulating two atmospheric cruise missions and one orbital mission. This paper discusses the overall approach to validation testing of the wing box component and presents some preliminary analytical test predictions.

Food Sustainability Education as a Route to Healthier Eating: Evaluation of a Multi-Component School Programme in English Primary Schools

ERIC Educational Resources Information Center

Jones, M.; Dailami, N.; Weitkamp, E.; Salmon, D.; Kimberlee, R.; Morley, A.; Orme, J.

2012-01-01

Promising approaches to the promotion of healthier eating among children in primary school settings include the opportunity to practise practical cooking and growing, promoting the take up of healthier school meals and nutritional education. However, less is known about the potential for strategies that integrate approaches through a focus on food…

Ryan Beach | NREL

Science.gov Websites

team. His primary responsibilities include mechanical component design, test instrumentation and layout design, and data analysis for static and fatigue tests on full-scale wind turbine blades. Education B.S

Vocabulary Learning in Primary School Children: Working Memory and Long-Term Memory Components

ERIC Educational Resources Information Center

Morra, Sergio; Camba, Roberta

2009-01-01

The goal of this study was to investigate which working memory and long-term memory components predict vocabulary learning. We used a nonword learning paradigm in which 8- to 10-year-olds learned picture-nonword pairs. The nonwords varied in length (two vs. four syllables) and phonology (native sounding vs. including one Russian phoneme). Short,…

100-kWe lunar/Mars surface power utilizing the SP-100 reactor with dynamic conversion

NASA Technical Reports Server (NTRS)

Harty, Richard B.; Mason, Lee S.

1992-01-01

Results are presented from a study of the coupling of an SP-100 nuclear reactor with either a Stirling or Brayton power system, at the 100 kWe level, for a power generating system suitable for operation in the lunar and Martian surface environments. In the lunar environment, the reactor and primary coolant loop would be contained in a guard vessel to protect from a loss of primary loop containment. For Mars, all refractory components, including the reactor, coolant, and power conversion components will be contained in a vacuum vessel for protection against the CO2 environment.

Durability of commercial aircraft and helicopter composite structures

NASA Technical Reports Server (NTRS)

Dexter, H. B.

1982-01-01

The development of advanced composite technology during the past decade is discussed. Both secondary and primary components fabricated with boron, graphite, and Kevlar composites are evaluated. Included are spoilers, rudders, and fairings on commercial transports, boron/epoxy reinforced wing structure on C-130 military transports, and doors, fairings, tail rotors, vertical fins, and horizontal stabilizers on commercial helicopters. The development of composite structures resulted in advances in design and manufacturing technology for secondary and primary composite structures for commercial transports. Design concepts and inspection and maintenance results for the components in service are reported. The flight, outdoor ground, and controlled laboratory environmental effects on composites were also determined. Effects of moisture absorption, ultraviolet radiation, aircraft fuels and fluids, and sustained tensile stress are included. Critical parameters affecting the long term durability of composite materials are identified.

Shaping the future: a primary care research and development strategy for Scotland.

PubMed

Hannaford, P; Hunt, J; Sullivan, F; Wyke, S

1999-09-01

Primary care is at the centre of the National Health Service (NHS) in Scotland; however, its R & D capacity is insufficiently developed. R&D is a potentially powerful way of improving the health and well-being of the population, and of securing high quality care for those who need it. In order to achieve this, any Scottish strategy for primary care R&D should aim to develop both a knowledge-based service and a research culture in primary care. In this way, decisions will be made based upon best available evidence, whatever the context. Building on existing practice and resources within primary care research, this strategy for achieving a thriving research culture in Scottish primary care has three key components: A Scottish School of Primary Care which will stimulate and co-ordinate a cohesive programme of research and training. A comprehensive system of funding for training and career development which will ensure access to a range of research training which will ensure that Scotland secures effective leadership for its primary care R&D. Designated research and development practices (DRDPs) which will build on the work of existing research practices, in the context of Local Health Care Co-operatives (LHCCs) and Primary Care Trusts (PCTs), to create a co-operative environment in which a range of primary care professionals can work together to improve their personal and teams' research skills, and to support research development in their areas. A modest investment will create substantial increases in both the quality and quantity of research being undertaken in primary care. This investment should be targeted at both existing primary care professionals working in service settings in primary care, LHCCs and PCTs, and at centres of excellence (including University departments). A dual approach will foster collaboration and will allow existing centres of excellence both to undertake more primary care research and to support the development of service based primary care professionals in their research. Resources should be distributed equitably, taking into account demography, geography and the health needs of patients in Scotland. The strategy and its components must be seen as a whole. The Scottish School of Primary Care will stimulate and co-ordinate both research and training programmes. DRDPs will become research active and will participate in School-led training and research, and will contribute to research programmes. Comprehensive funding for training and career development will ensure that staff have the skills to participate in both DRDPs and in the School's activities. Thus, inadequate commitment to any one component of the strategy will mean that other components will be less successful. Commitment to all three components will maximise the chances of success.

Should the position of the patellar component replicate the vertical median ridge of the native patella?

PubMed

Lee, Rae Hyeong; Jeong, Hae Won; Lee, Jin Kyu; Choi, Choong Hyeok

2017-01-01

In total knee arthroplasty (TKA), the position of the patellar component can affect patellar tracking. However, the patellar component cannot always replicate the original high point of the patella because of anatomical variance. This study investigated whether altering the highest point of the patella can affect outcomes of primary TKA, especially in patients having a patella with a far-medialized median ridge. A retrospective review was performed for 177 knees (143 patients) treated with primary TKA between July 2011 and March 2014. Group 1 (34 knees) had the patellar component displaced over three millimeters from the median ridge, while Group 2 (143 knees) had the patellar component placed on the original median ridge position. The one-year follow-up outcomes were reviewed, including: patellar tilt angle, Knee Society Score, Feller Patellar Score, and modified Kujala Anterior Knee Pain Score. Mean (±standard deviation) displacement of the patellar component in Group 1 was 3.97±0.97mm lateral to the original position of the median ridge, with a significant decrease in lateral patellar tilt angle (P<0.001). Lateral patellar tilt showed a positive correlation with the medialization of the patellar component (P<0.001, r=0.401). Ability to rise from a chair was better in Group 1 (P=0.025). There were no other between-group differences in other clinical outcomes. There should be no need for the patellar component to replicate the original highest point of the native patella in primary TKA. Copyright © 2016 Elsevier B.V. All rights reserved.

Study of advanced techniques for determining the long-term performance of components

NASA Technical Reports Server (NTRS)

1972-01-01

A study was conducted of techniques having the capability of determining the performance and reliability of components for spacecraft liquid propulsion applications for long term missions. The study utilized two major approaches; improvement in the existing technology, and the evolution of new technology. The criteria established and methods evolved are applicable to valve components. Primary emphasis was placed on the propellants oxygen difluoride and diborane combination. The investigation included analysis, fabrication, and tests of experimental equipment to provide data and performance criteria.

The non-motor syndrome of primary dystonia: clinical and pathophysiological implications

PubMed Central

Stamelou, Maria; Edwards, Mark J.; Hallett, Mark

2012-01-01

Dystonia is typically considered a movement disorder characterized by motor manifestations, primarily involuntary muscle contractions causing twisting movements and abnormal postures. However, growing evidence indicates an important non-motor component to primary dystonia, including abnormalities in sensory and perceptual functions, as well as neuropsychiatric, cognitive and sleep domains. Here, we review this evidence and discuss its clinical and pathophysiological implications. PMID:21933808

An Evolutionary Perspective on Learning Disability in Mathematics

PubMed Central

Geary, David C.

2015-01-01

A distinction between potentially evolved, or biologically-primary forms of cognition, and the culturally-specific, or biologically-secondary forms of cognition that are built from primary systems is used to explore mathematical learning disability (MLD). Using this model, MLD could result from deficits in the brain and cognitive systems that support biologically-primary mathematical competencies, or from the brain and cognitive systems that support the modification of primary systems for the creation of secondary knowledge and secondary cognitive competencies. The former include visuospatial long-term and working memory and the intraparietal sulcus, whereas the latter include the central executive component of working memory and the anterior cingulate cortex and lateral prefrontal cortex. Different forms of MLD are discussed as related to each of the cognitive and brain systems. PMID:17650991

The Development and Validation of a Rapid Assessment Tool of Primary Care in China

PubMed Central

Mei, Jie; Liang, Yuan; Shi, LeiYu; Zhao, JingGe; Wang, YuTan; Kuang, Li

2016-01-01

Introduction. With Chinese health care reform increasingly emphasizing the importance of primary care, the need for a tool to evaluate primary care performance and service delivery is clear. This study presents a methodology for a rapid assessment of primary care organizations and service delivery in China. Methods. The study translated and adapted the Primary Care Assessment Tool-Adult Edition (PCAT-AE) into a Chinese version to measure core dimensions of primary care, namely, first contact, continuity, comprehensiveness, and coordination. A cross-sectional survey was conducted to assess the validity and reliability of the Chinese Rapid Primary Care Assessment Tool (CR-PCAT). Eight community health centers in Guangdong province have been selected to participate in the survey. Results. A total of 1465 effective samples were included for data analysis. Eight items were eliminated following principal component analysis and reliability testing. The principal component analysis extracted five multiple-item scales (first contact utilization, first contact accessibility, ongoing care, comprehensiveness, and coordination). The tests of scaling assumptions were basically met. Conclusion. The standard psychometric evaluation indicates that the scales have achieved relatively good reliability and validity. The CR-PCAT provides a rapid and reliable measure of four core dimensions of primary care, which could be applied in various scenarios. PMID:26885509

Clinical features and management of primary sclerosing cholangitis

PubMed Central

Silveira, Marina G; Lindor, Keith D

2008-01-01

Primary sclerosing cholangitis is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the bile ducts, resulting in cirrhosis and need for liver transplantation and reduced life expectancy. The majority of cases occur in young and middle-aged men, often in association with inflammatory bowel disease. The etiology of primary sclerosing cholangitis includes immune-mediated components and elements of undefined nature. No effective medical therapy has been identified. The multiple complications of primary sclerosing cholangitis include metabolic bone disease, dominant strictures, bacterial cholangitis, and malignancy, particularly cholangiocarcinoma, which is the most lethal complication of primary sclerosing cholangitis. Liver transplantation is currently the only life-extending therapeutic alternative for patients with end-stage disease, although recurrence in the allografted liver has been described. A PSC-like variant attracting attention is cholangitis marked by raised levels of the immunoglobulin G4 subclass, prominence of plasma cells within the lesions, and steroid responsiveness. PMID:18528931

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA.

PubMed

Chughtai, Morad; Mistry, Jaydev B; Diedrich, Aloise M; Jauregui, Julio J; Elmallah, Randa K; Bonutti, Peter M; Harwin, Steven F; Malkani, Arthur L; Kolisek, Frank R; Mont, Michael A

2016-10-01

Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting. (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes? (4) What are the complications of dual-mobility articulations in primary THA? Between 2011 and 2013, the five participating surgeons performed 495 cementless primary THAs. During that time, one of the five surgeons used dual-mobility articulations for all THAs, and the other four used it whenever the acetabular cup size was 52 mm or greater to enable a 28-mm head. Of the 495 patients, 453 (92%) were performed using this device. Smaller patients were treated with a standard THA. Of the 453 patients, a total of 43 patients (10%) were lost to followup before the 2-year minimum. The resulting 410 patients who were included in the analysis (164 men, 246 women) had a mean age of 64 years (SD, 12 years). The mean followup was 3 years (SD, 0.7 years). We performed Kaplan-Meier analyses to assess survivorship to aseptic failure and all-cause acetabular component survivorship. Clinical outcomes were evaluated using the Harris hip score (HHS); radiographs were assessed for cup migration, progressive radiolucencies, and positional changes of the components; and any surgery-related complications were recorded. The survivorship to aseptic failure and all-cause acetabular component survivorship was 99.8% (failures, n = 1) (95% confidence interval [CI], 4.517-4.547) and 99.3% (failures, aseptic, n = 1; septic, n = 2) (95% CI, 4.494-4.543); one hip had trunnion notching caused by impingement of a malpositioned cup, which was treated with revision of the cup and stem; and two patients had periprosthetic infections that were treated with two-stage revisions. There were no dislocations. Patients had a mean HHS of 94 (SD, 6) at final followup. On radiographic evaluation, no progressive radiolucencies or positional changes of the components were identified. Surgical complications included one traumatic avulsion of the abductors, one traumatic avulsion of the greater trochanter, which was repaired without revision of any of the components, and one loose femoral stem, which required revision of the femoral component only. Dual-mobility cups in primary THA yield seemingly comparable survivorship and complications to conventional THA bearings at short-term followup. Because serious complications have occasionally been reported with the use of these bearings, larger, longer term, comparative-and ideally, randomized-trials will be needed to establish the superiority of one approach over the other. Until or unless such studies show the superiority of dual-mobility designs for primary THA, we recommend that in the setting of uncomplicated primary THA, dual-mobility articulations be used only in centers that track their results carefully or in research protocols. Level IV, therapeutic study.

33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

Code of Federal Regulations, 2014 CFR

2014-07-01

... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

Code of Federal Regulations, 2013 CFR

2013-07-01

... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

Code of Federal Regulations, 2011 CFR

2011-07-01

... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

33 CFR 155.1035 - Response plan requirements for manned vessels carrying oil as a primary cargo.

Code of Federal Regulations, 2012 CFR

2012-07-01

... be used to manage the response actions. This structure must include the following functional areas and must further include information for key components within each functional area: (i) Command and... operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The responsibilities of, duties...

JEN-1 Reactor Control System; SISTEMA DE CONTROL DEL REACTOR JEN-1

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

Cantillo, M.F.; Nuno, C.M.; Andreu, J.L.M.

1963-01-01

ABS>The JEN-1 3Mw power swimming pool reactor electrical control circuits are described. Start-up, power generation in the core, and shutdown are controlled by the reactor control system. This control system guarantees in each moment the safety conditions during reactor operation. Each circuit was represented by a scheme, complemented with a description of its function, components, and operation theory. Components described include: scram circuit; fission counter control circuit; servo control circuit; control circuit of safety sheets; control circuits of primary, secondary, and clean-up pump motors and tower fan motor; primary valve motor circuit; center cubicle alarm circuit; and process alarm circuit.more » (auth)« less

High Resolution Numerical Simulations of Primary Atomization in Diesel Sprays with Single Component Reference Fuels

DTIC Science & Technology

2015-09-01

NC. 14. ABSTRACT A high-resolution numerical simulation of jet breakup and spray formation from a complex diesel fuel injector at diesel engine... diesel fuel injector at diesel engine type conditions has been performed. A full understanding of the primary atomization process in diesel fuel... diesel liquid sprays the complexity is further compounded by the physical attributes present including nozzle turbulence, large density ratios

Plastid proteomics for elucidating iron limited remodeling of plastid physiology in diatoms

NASA Astrophysics Data System (ADS)

Gomes, K. M.; Nunn, B. L.; Jenkins, B. D.

2016-02-01

Diatoms are important primary producers in the world's oceans and their growth is constrained in large regions by low iron availability. This low iron-induced limitation of primary production is due to the requirement for iron in components of essential metabolic pathways including key chloroplast functions such as photosynthesis and nitrate assimilation. Diatoms can bloom and accumulate high biomass during introduction of iron into low iron waters, indicating adaptations allowing for their survival in iron-limited waters and rapid growth when iron becomes more abundant. Prior studies have shown that under iron limited stress, diatoms alter plastid-specific processes including components of electron transport, size of light harvesting capacity and chlorophyll content, suggesting plastid-specific protein regulation. Due to their complex evolutionary history, resulting from a secondary endosymbiosis, knowledge regarding the complement of plastid localized proteins remains limited in comparison to other model photosynthetic organisms. While in-silico prediction of diatom protein localization provides putative candidates for plastid-localization, these analyses can be limited as most plastid prediction models were developed using plants, primary endosymbionts. In order to characterize proteins enriched in diatom chloroplast and to understand how the plastid proteome is remodeled in response to iron limitation, we used mass spectrometry based proteomics to compare plastid- enriched protein fractions from Thalassiosira pseudonana, grown in iron replete and limited conditions. These analyses show that iron stress alters regulation of major metabolic pathways in the plastid including the Calvin cycle and fatty acid synthesis. These components provide promising targets to further characterize the plastid specific response to iron limitation.

The Click It or Ticket Evaluation, 2013

DOT National Transportation Integrated Search

2016-01-01

The Click It or Ticket (CIOT) high-visibility enforcement (HVE) program has been a primary component of national, State, and local efforts to increase seat belt use, being conducted at least annually since 2003. The 2013 CIOT mobilization included 48...

78 FR 27364 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... produces composite Hickory, NC 28602. components; primary manufacturing materials include carbon fiber and fiber glass. Lines Unlimited, Inc 715 Park Centre Drive, 4/18/2013 The firm produces laser cut...

Air Pollution

MedlinePlus

... include: Fine particles produced by the burning of fossil fuels (i.e. the coal and petroleum used in energy production) Noxious gases (sulfur dioxide, nitrogen oxides, carbon monoxide, chemical vapors, etc.) Ground-level ozone (a reactive form of oxygen and a primary component of urban ...

3-component beamforming analysis of ambient seismic noise field for Love and Rayleigh wave source directions

NASA Astrophysics Data System (ADS)

Juretzek, Carina; Hadziioannou, Céline

2014-05-01

Our knowledge about common and different origins of Love and Rayleigh waves observed in the microseism band of the ambient seismic noise field is still limited, including the understanding of source locations and source mechanisms. Multi-component array methods are suitable to address this issue. In this work we use a 3-component beamforming algorithm to obtain source directions and polarization states of the ambient seismic noise field within the primary and secondary microseism bands recorded at the Gräfenberg array in southern Germany. The method allows to distinguish between different polarized waves present in the seismic noise field and estimates Love and Rayleigh wave source directions and their seasonal variations using one year of array data. We find mainly coinciding directions for the strongest acting sources of both wave types at the primary microseism and different source directions at the secondary microseism.

A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

PubMed

Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen

2012-01-01

Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs). We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. Of 258 initially active participants, 225 (225/258=87.2%) successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85%) attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001). The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001). A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired through the process, and could continue working within their underserved communities while participating in the online component and then implement interventions that successfully converted theoretical knowledge to action to improve integration of HIV care into primary care.

Identifying Drivers of Overall Satisfaction in Patients Receiving HIV Primary Care: A Cross-Sectional Study

PubMed Central

Dang, Bich N.; Westbrook, Robert A.; Rodriguez-Barradas, Maria C.; Giordano, Thomas P.

2012-01-01

Objective This study seeks to understand the drivers of overall patient satisfaction in a predominantly low-income, ethnic-minority population of HIV primary care patients. The study’s primary aims were to determine 1) the component experiences which contribute to patients’ evaluations of their overall satisfaction with care received, and 2) the relative contribution of each component experience in explaining patients’ evaluation of overall satisfaction. Methods We conducted a cross-sectional study of 489 adult patients receiving HIV primary care at two clinics in Houston, Texas, from January 13–April 21, 2011. The participation rate among eligible patients was 94%. The survey included 15 questions about various components of the care experience, 4 questions about the provider experience and 3 questions about overall care. To ensure that the survey was appropriately tailored to our clinic population and the list of component experiences reflected all aspects of the care experience salient to patients, we conducted in-depth interviews with key providers and clinic staff and pre-tested the survey instrument with patients. Results Patients’ evaluation of their provider correlated the strongest with their overall satisfaction (standardized β = 0.445, p<0.001) and accounted for almost half of the explained variance. Access and availability, like clinic hours and ease of calling the clinic, also correlated with overall satisfaction, but less strongly. Wait time and parking, despite receiving low patient ratings, did not correlate with overall satisfaction. Conclusions The patient-provider relationship far exceeds other component experiences of care in its association with overall satisfaction. Our study suggests that interventions to improve overall patient satisfaction should focus on improving patients’ evaluation of their provider. PMID:22912770

Investigating the contribution of shipping emissions to atmospheric PM2.5 using a combined source apportionment approach.

PubMed

Lang, Jianlei; Zhou, Ying; Chen, Dongsheng; Xing, Xiaofan; Wei, Lin; Wang, Xiaotong; Zhao, Na; Zhang, Yanyun; Guo, Xiurui; Han, Lihui; Cheng, Shuiyuan

2017-10-01

Many studies have been conducted focusing on the contribution of land emission sources to PM 2.5 in China; however, little attention had been paid to other contributions, especially the secondary contributions from shipping emissions to atmospheric PM 2.5 . In this study, a combined source apportionment approach, including principle component analysis (PCA) and WRF-CMAQ simulation, was applied to identify both primary and secondary contributions from ships to atmospheric PM 2.5 . An intensive PM 2.5 observation was conducted from April 2014 to January 2015 in Qinhuangdao, which was close to the largest energy output port of China. The chemical components analysis results showed that the primary component was the major contributor to PM 2.5 , with proportions of 48.3%, 48.9%, 55.1% and 55.4% in spring, summer, autumn and winter, respectively. The secondary component contributed higher fractions in summer (48.2%) and winter (36.8%), but had lower percentages in spring (30.1%) and autumn (32.7%). The hybrid source apportionment results indicated that the secondary contribution (SC) of shipping emissions to PM 2.5 could not be ignored. The annual average SC was 2.7%, which was comparable to the primary contribution (2.9%). The SC was higher in summer (5.3%), but lower in winter (1.1%). The primary contributions to atmospheric PM 2.5 were 3.0%, 2.5%, 3.4% and 2.7% in spring, summer, autumn and winter, respectively. As for the detailed chemical components, the contributions of shipping emissions were 2.3%, 0.5%, 0.1%, 1.0%, 1.7% and 0.1% to elements & sea salt, primary organic aerosol (POA), element carbon (EC), nitrate, sulfate and secondary organic carbon (SOA), respectively. The results of this study will further the understanding of the implications of shipping emissions in PM 2.5 pollution. Copyright © 2017 Elsevier Ltd. All rights reserved.

32 CFR 318.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Component, including but not limited to, his or her education, financial transactions, medical history, criminal or employment history and that contains his or her name, or the identifying number, symbol, or... automated technology, systematic procedures, and trained personnel for the primary purpose of manipulating...

The prevention of tobacco-related disease.

PubMed

Raw, M; McNeill, A

1994-11-01

The key components of a strategy to prevent tobacco-related disease are outlined. These measures aim to increase the cessation of tobacco use and reduce its uptake. Components are wide-ranging, including a taxation policy, a ban on advertising and promotion, a comprehensive health promotion programme including advice from primary health care professionals and the development of campaigning skills, particularly by the medical profession. The prevention of tobacco-related disease has moved into the domain of campaigners and lobbyists at political, economic and international levels. The key target is countering the activities, especially the unethical trade practices, of the wealthy and powerful tobacco industry.

Token Economy: A Systematic Review of Procedural Descriptions.

PubMed

Ivy, Jonathan W; Meindl, James N; Overley, Eric; Robson, Kristen M

2017-09-01

The token economy is a well-established and widely used behavioral intervention. A token economy is comprised of six procedural components: the target response(s), a token that functions as a conditioned reinforcer, backup reinforcers, and three interconnected schedules of reinforcement. Despite decades of applied research, the extent to which the procedures of a token economy are described in complete and replicable detail has not been evaluated. Given the inherent complexity of a token economy, an analysis of the procedural descriptions may benefit future token economy research and practice. Articles published between 2000 and 2015 that included implementation of a token economy within an applied setting were identified and reviewed with a focus on evaluating the thoroughness of procedural descriptions. The results show that token economy components are regularly omitted or described in vague terms. Of the articles included in this analysis, only 19% (18 of 96 articles reviewed) included replicable and complete descriptions of all primary components. Missing or vague component descriptions could negatively affect future research or applied practice. Recommendations are provided to improve component descriptions.

Development and Process Evaluation of a Primary Care Internet-Based Intervention to Prevent Depression in Emerging Adults

PubMed Central

Van Voorhees, Benjamin W.; Ellis, Justin M.; Gollan, Jackie K.; Bell, Carl C.; Stuart, Scott S.; Fogel, Joshua; Corrigan, Patrick W.; Ford, Daniel E.

2007-01-01

Background: Primary care is a potential setting for implementation of depression prevention interventions using cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT). The purpose of this study was to develop and conduct a process evaluation of a primary care/ Internet-based intervention that addresses key dissemination barriers in a community setting. Method: We used an interdisciplinary team of investigators in a multistep intervention development process among a sample of primary care patients (aged 18 to 24 years). The intervention included an initial primary care motivational interview to engage the participant, 11 Internet-based modules based on CBT (to counter pessimistic thinking) and IPT (to activate social networks and strengthen relationship skills), and a follow-up motivational interview in primary care to enhance behavior change. Each component of the intervention was rated with regard to dissemination barriers of (1) fidelity, (2) motivation, (3) dose, (4) perceived helpfulness (rated on a Likert scale), and (5) potential costs. The study was conducted from April through June of 2004. Results: Fidelity checklist and serial reviews were satisfactory (100% core concepts translated into intervention). Key motivations for participation included (1) risk reduction, (2) intervention effectiveness, (3) “resiliency,” and (4) altruism. In terms of dose, 13 of 14 participants engaged the Internet-based components, completing a mean of 7.2 modules (SD = 3.9). The 2 primary care interviews and the self-assessment and resiliency modules received the highest helpfulness ratings. The duration of the 2 motivational interviews was approximately 17–18 minutes, which is similar to a typical primary care visit. Conclusions: By using multidisciplinary teams and incorporating the opinions of potential users, complex preventive mental health interventions can be translated into primary care settings with adequate fidelity, motivation, dose, and perceived helpfulness, and at a reasonably low cost. PMID:17998953

Outcome of prosthesis matched and unmatched patella components in primary and revision total knee replacement.

PubMed

Lewis, Peter L; Gamboa, Ai E; Campbell, David G; Lorimer, Michelle

2017-10-01

Although knee replacements have specifically designed patella prostheses that correspond to the geometry of their femoral components, a patella prosthesis that is unmatched to the femoral component may occasionally be inserted. In revision total knee arthroplasty (TKA), an originally resurfaced patella may be left, but the femoral component revised to one that does not match the patella. Few studies have compared the outcome of matched and unmatched patella components in TKA. This study compared the primary or revision TKA outcome of procedures where patella components matched to their femoral counterparts were inserted, with procedures using patella and femoral components that were unmatched. Data on all primary and revision TKA procedures without a patella component or a matched or an unmatched patella component were obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Revision surgery was the outcome measure. Cumulative percent revised (CPR) were calculated and Hazard ratios with p values were used to test statistical significance. In primary TKA, there were higher rates of revision where unmatched patella components were used, regardless of implant design. There was no difference in the second revision rates of unmatched versus matched patella component groups. This was evident where delayed resurfacing was carried out, and where the patella prosthesis was left alone but the femoral component was changed. All primary TKA procedures require a patella component corresponding to the femoral component if the patella is resurfaced. Conversely, revision knee arthroplasties are not affected by the use of dissimilar patella and femoral components. Copyright © 2017 Elsevier B.V. All rights reserved.

GEOSYNTHETIC DESIGN GUIDANCE FOR HAZARDOUS WASTE LANDFILL CELLS AND SURFACE IMPOUNDMENTS

EPA Science Inventory

The report provides guidance design procedures for the use of geosynthetic materials in hazardous waste land disposal cells. Primary geosynthetic components include flexible membrane liners (FML) used to limit the flow of leachate, and leachate collection and removal systems (LCR...

Accumulation of Carotenoids and Metabolic Profiling in Different Cultivars of Tagetes Flowers.

PubMed

Park, Yun Ji; Park, Soo-Yun; Valan Arasu, Mariadhas; Al-Dhabi, Naif Abdullah; Ahn, Hyung-Geun; Kim, Jae Kwang; Park, Sang Un

2017-02-18

Species of Tagetes , which belong to the family Asteraceae show different characteristics including, bloom size, shape, and color; plant size; and leaf shape. In this study, we determined the differences in primary metabolites and carotenoid yields among six cultivars from two Tagetes species, T. erecta and T. patula . In total, we detected seven carotenoids in the examined cultivars: violaxanthin, lutein, zeaxanthin, α-carotene, β-carotene, 9- cis -β-carotene, and 13- cis -β-carotene. In all the cultivars, lutein was the most abundant carotenoid. Furthermore, the contents of each carotenoid in flowers varied depending on the cultivar. Principal component analysis (PCA) facilitated metabolic discrimination between Tagetes cultivars, with the exception of Inca Yellow and Discovery Orange. Moreover, PCA and orthogonal projection to latent structure-discriminant analysis (OPLS-DA) results provided a clear discrimination between T. erecta and T. patula . Primary metabolites, including xylose, citric acid, valine, glycine, and galactose were the main components facilitating separation of the species. Positive relationships were apparent between carbon-rich metabolites, including those of the TCA cycle and sugar metabolism, and carotenoids.

Durability of aircraft composite materials

NASA Technical Reports Server (NTRS)

Dextern, H. B.

1982-01-01

Confidence in the long term durability of advanced composites is developed through a series of flight service programs. Service experience is obtained by installing secondary and primary composite components on commercial and military transport aircraft and helicopters. Included are spoilers, rudders, elevators, ailerons, fairings and wing boxes on transport aircraft and doors, fairings, tail rotors, vertical fins, and horizontal stabilizers on helicopters. Materials included in the evaluation are boron/epoxy, Kevlar/epoxy, graphite/epoxy and boron/aluminum. Inspection, maintenance, and repair results for the components in service are reported. The effects of long term exposure to laboratory, flight, and outdoor environmental conditions are reported for various composite materials. Included are effects of moisture absorption, ultraviolet radiation, and aircraft fuels and fluids.

Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT.

PubMed

Rossen, Jenny; Yngve, Agneta; Hagströmer, Maria; Brismar, Kerstin; Ainsworth, Barbara E; Iskull, Christina; Möller, Peter; Johansson, Unn-Britt

2015-07-12

Physical activity prevents or delays progression of impaired glucose tolerance in high-risk individuals. Physical activity promotion should serve as a basis in diabetes care. It is necessary to develop and evaluate health-promoting methods that are feasible as well as cost-effective within diabetes care. The aim of Sophia Step Study is to evaluate the impact of a multi-component and a single component physical activity intervention aiming at improving HbA1c (primary outcome) and other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes. Sophia Step Study is a randomized controlled trial and participants are randomly assigned to either a multi-component intervention group (A), a pedometer group (B) or a control group (C). In total, 310 patients will be included and followed for 24 months. Group A participants are offered pedometers and a website to register steps, physical activity on prescription with yearly follow-ups, motivational interviewing (10 occasions) and group consultations (including walks, 12 occasions). Group B participants are offered pedometers and a website to register steps. Group C are offered usual care. The theoretical framework underpinning the interventions is the Health Belief Model, the Stages of Change Model, and the Social Cognitive Theory. Both the multi-component intervention (group A) and the pedometer intervention (group B) are using several techniques for behavior change such as self-monitoring, goal setting, feedback and relapse prevention. Measurements are made at week 0, 8, 12, 16, month 6, 9, 12, 18 and 24, including metabolic and cardiovascular biomarkers (HbA1c as primary health outcome), accelerometry and daily steps. Furthermore, questionnaires were used to evaluate dietary intake, physical activity, perceived ability to perform physical activity, perceived support for being active, quality of life, anxiety, depression, well-being, perceived treatment, perceived stress and diabetes self- efficacy. This study will show if a multi-component intervention using pedometers with group- and individual consultations is more effective than a single- component intervention using pedometers alone, in increasing physical activity and improving HbA1c, other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes. ClinicalTrials.gov Identifier: NCT02374788 . Registered 28 January 2015.

Compression strength of composite primary structural components

NASA Technical Reports Server (NTRS)

Johnson, Eric R.

1993-01-01

Two projects are summarized. The first project is entitled 'Stiffener Crippling Inititated by Delaminations' and its objective is to develop a computational model of the stiffener specimens that includes the capability to predict the interlaminar stress response at the flange free edge in postbuckling. The second is entitled 'Pressure Pillowing of an Orthogonally Stiffened Cylindrical Shell'. A paper written on this project is included.

Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal.

PubMed

Kohrt, Brandon A; Jordans, Mark J D; Turner, Elizabeth L; Sikkema, Kathleen J; Luitel, Nagendra P; Rai, Sauharda; Singla, Daisy R; Lamichhane, Jagannath; Lund, Crick; Patel, Vikram

2018-01-01

Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, RE ducing S tigma among H ealthc A re P roviders to Improv E mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k  = 34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities ( n  = 150); indirect beneficiaries are their patients ( n  = 100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mhGAP), clinical competency (ENhancing Assessment of Common Therapeutic factors, ENACT), and implicit attitudes (Implicit Association Test, IAT), and patient outcomes including stigma-related barriers to care, daily functioning, and symptoms. The pilot and feasibility study will contribute to refining recommendations for implementation of mhGAP and other mental health services in primary healthcare settings in low-resource health systems. The pilot c-RCT findings will inform an effectiveness trial of RESHAPE to advance the evidence-base for optimal approaches to training and supervision for non-specialist providers. ClinicalTrials.gov identifier, NCT02793271.

An Innovative Pharmaceutical Care Practical Course

ERIC Educational Resources Information Center

Bulatova, N. R.; Aburuz, S.; Yousef, A. M.

2007-01-01

The innovative practical course was developed to improve the students' ability to acquire pharmaceutical care skills. The primary components of the course were in-school training using small group discussions and hospital experience including identification, analysis, prevention and resolution of drug-therapy problems, patient counseling on their…

Engine balance apparatus and accessory drive device

NASA Technical Reports Server (NTRS)

Egleston, Robert W. (Inventor)

2002-01-01

A balancing mechanism for an engine that has a rotating crankshaft and reciprocating pistons. The balancing mechanism comprises a primary balance mass assembly non-rotatably and removably affixed to the crankshaft. The primary mass assembly comprises a primary mass affixed to a primary hub portion and a primary cap portion removably affixed to the primary hub portion to clamp a portion of the crankshaft therebetween. A secondary balance mass assembly may be rotatably and removably supported on the crankshaft. A driver assembly is affixed to the crankshaft to cause the secondary balance mass to rotate in a direction that is opposite to the direction in which the crank shaft is rotating. The driver assembly may include auxiliary gears configured to transport rotary power to auxiliary components. The gears are readily detachable from the apparatus to facilitate inspection and repair operations.

Computational Methods for Biomolecular Electrostatics

PubMed Central

Dong, Feng; Olsen, Brett; Baker, Nathan A.

2008-01-01

An understanding of intermolecular interactions is essential for insight into how cells develop, operate, communicate and control their activities. Such interactions include several components: contributions from linear, angular, and torsional forces in covalent bonds, van der Waals forces, as well as electrostatics. Among the various components of molecular interactions, electrostatics are of special importance because of their long range and their influence on polar or charged molecules, including water, aqueous ions, and amino or nucleic acids, which are some of the primary components of living systems. Electrostatics, therefore, play important roles in determining the structure, motion and function of a wide range of biological molecules. This chapter presents a brief overview of electrostatic interactions in cellular systems with a particular focus on how computational tools can be used to investigate these types of interactions. PMID:17964951

Rationale and Study Protocol for a Multi-component Health Information Technology (HIT) Screening Tool for Depression and Post-traumatic Stress Disorder in the Primary Care Setting

PubMed Central

Biegler, Kelly; Mollica, Richard; Sim, Susan Elliott; Nicholas, Elisa; Chandler, Maria; Ngo-Metzger, Quyen; Paigne, Kittya; Paigne, Sompia; Nguyen, Danh V.; Sorkin, Dara H.

2016-01-01

The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under-diagnosis of depression may be further exacerbated in limited English-language proficient (LEP) populations. Language barriers may result in less discussion of patients’ mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers’ time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered-randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi-component approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web-based provider training, 2) multimedia electronic screening of depression and PTSD in the patients’ primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and PTSD among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting. PMID:27394385

Rationale and study protocol for a multi-component Health Information Technology (HIT) screening tool for depression and post-traumatic stress disorder in the primary care setting.

PubMed

Biegler, Kelly; Mollica, Richard; Sim, Susan Elliott; Nicholas, Elisa; Chandler, Maria; Ngo-Metzger, Quyen; Paigne, Kittya; Paigne, Sompia; Nguyen, Danh V; Sorkin, Dara H

2016-09-01

The prevalence rate of depression in primary care is high. Primary care providers serve as the initial point of contact for the majority of patients with depression, yet, approximately 50% of cases remain unrecognized. The under-diagnosis of depression may be further exacerbated in limited English-language proficient (LEP) populations. Language barriers may result in less discussion of patients' mental health needs and fewer referrals to mental health services, particularly given competing priorities of other medical conditions and providers' time pressures. Recent advances in Health Information Technology (HIT) may facilitate novel ways to screen for depression and other mental health disorders in LEP populations. The purpose of this paper is to describe the rationale and protocol of a clustered randomized controlled trial that will test the effectiveness of an HIT intervention that provides a multi-component approach to delivering culturally competent, mental health care in the primary care setting. The HIT intervention has four components: 1) web-based provider training, 2) multimedia electronic screening of depression and PTSD in the patients' primary language, 3) Computer generated risk assessment scores delivered directly to the provider, and 4) clinical decision support. The outcomes of the study include assessing the potential of the HIT intervention to improve screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder (PTSD) among LEP Cambodian refugees who experienced war atrocities and trauma during the Khmer Rouge. This technology has the potential to be adapted to any LEP population in order to facilitate mental health screening and treatment in the primary care setting. Copyright © 2016 Elsevier Inc. All rights reserved.

How Do Primary School Students Acquire the Skill of Making Hypothesis

ERIC Educational Resources Information Center

Darus, Faridah Binti; Saat, Rohaida Mohd

2014-01-01

Science education in Malaysia emphasizes three components: namely knowledge, scientific skills which include science process skills and manipulative skills; scientific attitudes; and noble values. The science process skills are important in enhancing students' cognitive development and also to facilitate students' active participation during the…

78 FR 52771 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... natural resilience of survivors. Two primary research questions will guide the proposed study: 1. How did... recovery. Specifically, the study design includes two main components (qualitative and quantitative... disasters. The total estimated burden for the 98 one-time qualitative interviews for public health/mental...

Determination of the appropriate use of pavement surface history in the KDOT life-cycle analysis process.

DOT National Transportation Integrated Search

2008-09-01

The primary objective of this study was to evaluate KDOTs pavement surfacing history and recommend : whether or not the departments life-cycle cost analysis (LCCA) procedure should include a surfacing history : component, and, if so, how the LC...

Evidence for modality-independent order coding in working memory.

PubMed

Depoorter, Ann; Vandierendonck, André

2009-03-01

The aim of the present study was to investigate the representation of serial order in working memory, more specifically whether serial order is coded by means of a modality-dependent or a modality-independent order code. This was investigated by means of a series of four experiments based on a dual-task methodology in which one short-term memory task was embedded between the presentation and recall of another short-term memory task. Two aspects were varied in these memory tasks--namely, the modality of the stimulus materials (verbal or visuo-spatial) and the presence of an order component in the task (an order or an item memory task). The results of this study showed impaired primary-task recognition performance when both the primary and the embedded task included an order component, irrespective of the modality of the stimulus materials. If one or both of the tasks did not contain an order component, less interference was found. The results of this study support the existence of a modality-independent order code.

Patient-Centered Appointment Scheduling Using Agent-Based Simulation

PubMed Central

Turkcan, Ayten; Toscos, Tammy; Doebbeling, Brad N.

2014-01-01

Enhanced access and continuity are key components of patient-centered care. Existing studies show that several interventions such as providing same day appointments, walk-in services, after-hours care, and group appointments, have been used to redesign the healthcare systems for improved access to primary care. However, an intervention focusing on a single component of care delivery (i.e. improving access to acute care) might have a negative impact other components of the system (i.e. reduced continuity of care for chronic patients). Therefore, primary care clinics should consider implementing multiple interventions tailored for their patient population needs. We collected rapid ethnography and observations to better understand clinic workflow and key constraints. We then developed an agent-based simulation model that includes all access modalities (appointments, walk-ins, and after-hours access), incorporate resources and key constraints and determine the best appointment scheduling method that improves access and continuity of care. This paper demonstrates the value of simulation models to test a variety of alternative strategies to improve access to care through scheduling. PMID:25954423

Multi-scale remote sensing sagebrush characterization with regression trees over Wyoming, USA: laying a foundation for monitoring

USGS Publications Warehouse

Homer, Collin G.; Aldridge, Cameron L.; Meyer, Debra K.; Schell, Spencer J.

2012-01-01

agebrush ecosystems in North America have experienced extensive degradation since European settlement. Further degradation continues from exotic invasive plants, altered fire frequency, intensive grazing practices, oil and gas development, and climate change – adding urgency to the need for ecosystem-wide understanding. Remote sensing is often identified as a key information source to facilitate ecosystem-wide characterization, monitoring, and analysis; however, approaches that characterize sagebrush with sufficient and accurate local detail across large enough areas to support this paradigm are unavailable. We describe the development of a new remote sensing sagebrush characterization approach for the state of Wyoming, U.S.A. This approach integrates 2.4 m QuickBird, 30 m Landsat TM, and 56 m AWiFS imagery into the characterization of four primary continuous field components including percent bare ground, percent herbaceous cover, percent litter, and percent shrub, and four secondary components including percent sagebrush (Artemisia spp.), percent big sagebrush (Artemisia tridentata), percent Wyoming sagebrush (Artemisia tridentata Wyomingensis), and shrub height using a regression tree. According to an independent accuracy assessment, primary component root mean square error (RMSE) values ranged from 4.90 to 10.16 for 2.4 m QuickBird, 6.01 to 15.54 for 30 m Landsat, and 6.97 to 16.14 for 56 m AWiFS. Shrub and herbaceous components outperformed the current data standard called LANDFIRE, with a shrub RMSE value of 6.04 versus 12.64 and a herbaceous component RMSE value of 12.89 versus 14.63. This approach offers new advancements in sagebrush characterization from remote sensing and provides a foundation to quantitatively monitor these components into the future.

Vehicle for Space Transfer and Recovery (VSTAR), volume 2: Substantiating analyses and data

NASA Technical Reports Server (NTRS)

1988-01-01

The Vehicle Space Transfer and Recovery (VSTAR) system is designed as a manned orbital transfer vehicle (MOTV) with the primary mission of Satellite Launch and Repair (SLR). Reference materials, calculations and trade studies used in the analysis and selection of VSTAR components. Each major VSTAR system is examined separately. Simple graphs and tables are used to make qualitative comparisons of various VSTAR component candidates. Equations and/or calculations used for a particular analysis are also included where applicable.

The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review.

PubMed

Morton, Katie; Beauchamp, Mark; Prothero, Anna; Joyce, Lauren; Saunders, Laura; Spencer-Bowdage, Sarah; Dancy, Bernadette; Pedlar, Charles

2015-01-01

Motivational interviewing (MI) is a patient-centred approach to behaviour change that was originally developed in the addiction field but has increasingly been applied to public health settings with a focus on health promotion. The purpose of this review was to examine the evidence base for MI interventions in primary care settings with non-clinical populations to achieve behaviour change for physical activity, dietary behaviours and/or alcohol intake. We also sought to explore the specific behaviour change techniques included in MI interventions within primary care. Electronic databases were searched for relevant articles and 33 papers met inclusion criteria and were included. Approximately 50% of the included studies (n = 18) demonstrated positive effects in relation to health behaviour change. The efficacy of MI approaches is unclear given the inconsistency of MI descriptions and intervention components. Furthermore, research designs that do not isolate the effects of MI make it difficult to determine the effectiveness of such approaches. We offer a number of recommendations for researchers and practitioners seeking to include MI within behaviour change interventions to help improve the quality of the research and the effectiveness of MI-based interventions within primary care settings.

Primary care in Cuba: a public health approach.

PubMed

Swanson, K A; Swanson, J M; Gill, A E; Walter, C

1995-01-01

Cuba's primary health care model is presented. Unlike ambulatory care services, which are but one component of primary care, Cuba's model is a comprehensive public health approach that meets the World Health Organization's definition of primary care. The history of the development of Cuba's model is presented, including an update on the innovative neighborhood/home clinics. Achievements in health outcomes as a result of Cuba's model and the consequences for women's health care are discussed. Examples are presented of the effects on health care delivery of the economic hardship that Cuba has experienced since 1991 as a result of the loss of 85% of its trade with the former Soviet Union and the intensified U.S. embargo. A critique of Cuba's model concludes the article.

An integrated multi-layered analysis of the metabolic networks of different tissues uncovers key genetic components of primary metabolism in maize.

PubMed

Wen, Weiwei; Jin, Min; Li, Kun; Liu, Haijun; Xiao, Yingjie; Zhao, Mingchao; Alseekh, Saleh; Li, Wenqiang; de Abreu E Lima, Francisco; Brotman, Yariv; Willmitzer, Lothar; Fernie, Alisdair R; Yan, Jianbing

2018-03-01

Primary metabolism plays a pivotal role in normal plant growth, development and reproduction. As maize is a major crop worldwide, the primary metabolites produced by maize plants are of immense importance from both calorific and nutritional perspectives. Here a genome-wide association study (GWAS) of 61 primary metabolites using a maize association panel containing 513 inbred lines identified 153 significant loci associated with the level of these metabolites in four independent tissues. The genome-wide expression level of 760 genes was also linked with metabolite levels within the same tissue. On average, the genetic variants at each locus or transcriptional variance of each gene identified here were estimated to have a minor effect (4.4-7.8%) on primary metabolic variation. Thirty-six loci or genes were prioritized as being worthy of future investigation, either with regard to functional characterization or for their utility for genetic improvement. This target list includes the well-known opaque 2 (O2) and lkr/sdh genes as well as many less well-characterized genes. During our investigation of these 36 loci, we analyzed the genetic components and variations underlying the trehalose, aspartate and aromatic amino acid pathways, thereby functionally characterizing four genes involved in primary metabolism in maize. © 2018 The Authors The Plant Journal © 2018 John Wiley & Sons Ltd.

The Solutions of the Agricultural Land Use Monitoring Problems

ERIC Educational Resources Information Center

Vershinin, Valentin V.; Murasheva, Alla A.; Shirokova, Vera A.; Khutorova, Alla O.; Shapovalov, Dmitriy A.; Tarbaev, Vladimir A.

2016-01-01

Modern landscape--it's a holistic system of interconnected and interacting components. To questions of primary importance belongs evaluation of stability of modern landscape (including agrarian) and its optimization. As a main complex characteristic and landscape inhomogeneity in a process of agricultural usage serves materials of quantitative and…

Development of a British Road Safety Education Support Materials Curriculum.

ERIC Educational Resources Information Center

Bouck, Linda H.

Road safety education needs to be a vital component in the school curriculum. This paper describes a planned road safety education support materials curriculum developed to aid educators in the Wiltshire County (England) primary schools. Teaching strategies include topic webs, lecture, class discussion, group activities, and investigative learning…

75 FR 52309 - Notice of Petitions by Firms for Determination of Eligibility To Apply for Trade Adjustment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-25

... manufactures parts and assemblies. Bracalente Manufacturing Company, Inc. 20 W. Creamery Road, 8/2/2010 The.... electrical wiring harnesses and lighting fixture components whose primary manufacturing material is copper... and Mill, SC 29715. coatings whose manufacturing materials include pigments, resins, solvents...

PREDICTING IMPACTS OF REROUTING DRAINAGE WATER FROM THE PAMLICO SOUND TO RESTORED WETLANDS—A CRITICAL COMPONENT TO GALVANIZE STAKEHOLDER COOPERATION

EPA Science Inventory

Denitrification, a microbially mediated transformation of nitrate to nitrogen gas that escapes from the wetland to the atmosphere, has been identified as the primary pathway for nitrogen removal in wetlands. Requirements for denitrification, which include anoxic conditions,...

Mental health and primary dysmenorrhea: a systematic review.

PubMed

Bajalan, Zahra; Moafi, Farnoosh; MoradiBaglooei, Mohammad; Alimoradi, Zainab

2018-05-10

Several factors including demographic, reproductive, lifestyle, psychological and social factors can affect incidence and severity of primary dysmenorrhea. This study aimed to systematically review the psychological risk factors associated with primary dysmenorrhea. Embase, ISI web of knowledge, ProQuest, Science Direct, Scopus and PubMed central were searched using keywords related to risk factors and primary dysmenorrhea. Observational studies, published in English after 2000, focusing solely on psychological factors affecting primary dysmenorrhea were included. The search process retrieved 11,928 potential related articles. Thirty three articles met inclusion criteria and were assessed for final synthesis. The STROBE checklist was used to quality assessment of studies. Results of study showed that few studies had investigated relationship between dysmenorrhea and most psychological disorders. Most studies have investigated the relationship between dysmenorrhea and depression, anxiety, stress, alcohol abuse and somatic disorders. So, further studies are needed to investigate relation between most psychological disorders with primary dysmenorrhea. Significant relationship between some mental health components such as depression, anxiety and stress with primary dysmenorrhea shows the importance of psychological assessment before the choice of therapeutic methods. Also, the feasibility of designing and evaluating the effectiveness of the use of psychotherapy interventions for the treatment of primary dysmenorrhea as alternative therapies can be considered.

An exercise trial for wheelchair users: Project Workout on Wheels

PubMed Central

Froehlich-Grobe, Katherine; Aaronson, Lauren S.; Washburn, Richard A.; Little, Todd D.; Lee, Jaehoon; Nary, Dorothy E.; VanSciver, Angela; Nesbitt, Jill; Norman, Sarah E.

2011-01-01

There is growing interest in promoting health for people with disabilities, yet evidence regarding community-based interventions is sparse. This paper describes the design details of a randomized controlled trial (RCT) that will test the effectiveness of a multi-component behaviorally-based, intervention to promote exercise adoption (over 6 months) and maintenance (up to one year) among wheelchair users and includes descriptive data on participant characteristics at baseline. Participants were randomly assigned to either a staff-supported intervention group or a self-guided comparison group. The primary study aim is to assess the effectiveness of the multi-component behaviorally-based intervention for promoting physical activity adoption and maintenance. The RCT will also assess the physical and psychosocial effects of the intervention and the complex interplay of factors that influence the effectiveness of the intervention. Therefore, the primary outcome derives from participant reports of weekly exercise (type, frequency, duration) over 52 weeks. Secondary outcomes collected on four occasions (baseline, 3 months, 6 months, 12 months) included physiological outcomes (VO2 peak, strength), disability-related outcomes (pain, fatigue, participation), and psychosocial outcomes (exercise self-efficacy, exercise barriers, quality of life, depression, mood). This study will provide evidence regarding the effectiveness of a multi-component behaviorally-based intervention for promoting exercise adoption among people with mobility impairments that necessitate wheelchair use. PMID:22101206

Evaluation of patient centered medical home practice transformation initiatives.

PubMed

Crabtree, Benjamin F; Chase, Sabrina M; Wise, Christopher G; Schiff, Gordon D; Schmidt, Laura A; Goyzueta, Jeanette R; Malouin, Rebecca A; Payne, Susan M C; Quinn, Michael T; Nutting, Paul A; Miller, William L; Jaén, Carlos Roberto

2011-01-01

The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures.

Improved E-ELT subsystem and component specifications, thanks to M1 test facility

NASA Astrophysics Data System (ADS)

Dimmler, M.; Marrero, J.; Leveque, S.; Barriga, Pablo; Sedghi, B.; Kornweibel, N.

2014-07-01

During the last 2 years ESO has operated the "M1 Test Facility", a test stand consisting of a representative section of the E-ELT primary mirror equipped with 4 complete prototype segment subunits including sensors, actuators and control system. The purpose of the test facility is twofold: it serves to study and get familiar with component and system aspects like calibration, alignment and handling procedures and suitable control strategies on real hardware long before the primary mirror (hereafter M1) components are commissioned. Secondly, and of major benefit to the project, it offered the possibility to evaluate component and subsystem performance and interface issues in a system context in such detail, that issues could be identified early enough to feed back into the subsystem and component specifications. This considerably reduces risk and cost of the production units and allows refocusing the project team on important issues for the follow-up of the production contracts. Experiences are presented in which areas the results of the M1 Test Facility particularly helped to improve subsystem specifications and areas, where additional tests were adopted independent of the main test facility. Presented are the key experiences of the M1 Test Facility which lead to improved specifications or identified the need for additional testing outside of the M1 Test Facility.

Primary care in the United States and its precarious future.

PubMed

Starfield, Barbara; Oliver, Thomas

1999-09-01

Primary care has not secured a firm place within the US health services system. Since primary care lacks a strong research base, is not institutionalized in medical education or in policy-making and is marginalized in both proposed and actual reforms, it has not developed into a central component of the health care infrastructure. We discuss recent efforts that promised modest improvements, including the Clinton health care reform proposals and subsequent federal and state actions, in the role of primary care within the health services system. We also assess the likely fate of primary care given the accelerated growth of managed care and market competition, the dissatisfaction of large segments of the population with managed care and misperceptions of managed care as synonymous with primary care. We highlight how managed care fails to achieve the cardinal functions of primary care and summarize initiatives that, at a minimum, would be required to secure a stronger position for primary care in the future.

HD 143 418 - An Interacting Binary with a Subsynchronously Rotating Primary

NASA Astrophysics Data System (ADS)

Mikulášek, Z.; Zverko, J.; Žižňovský, J.; Krtička, J.; Iliev, I. Kh.; Kudryavtsev, D. O.; Gráf, T.; Zejda, M.

2010-12-01

HD 143418 is a non-eclipsing double-lined close binary with orbital period Porb=2.282520 d. The photometrically and spectroscopically dominant primary component is a normal A5V star in the middle of its stay on the main sequence with extremely slow, subsynchronous rotation (Prot being about 14 days!). Its photometric monitoring since 1982 revealed orbitally modulated variations with changing form and amplitude. The advanced principal component analysis (APCA) disentangling extract-ed a steady part of light curves obviously caused by the ellipticity of the primary. Seasonal components of the light curves may be related to an expected incidence of circumstellar matter ejected from the tidally spinning up primary component. A possible scenario of the synchronisation process is also briefly discussed.

[Health Index applied to the city of Araraquara, SP: an instrument to accompaniment the primary care].

PubMed

Mattos, Augustus Tadeu Relo de; Caccia-Bava, Maria do Carmo G G; Barbosa, Débora Cristina Modesto

2013-03-01

The improvement of the process of evaluation and monitoring of the Primary Care Attention has been yearned by the managers of the different spheres in the context of the Unified System Health - UHS. Thus, in the order to identify the conditions of the health assistance in the city of Araraquara/SP, based on the particular features presented in the inscribe areas of each unit of health. It was adopted by means of a composed indicator aiming to favor a broader view which contemplates the emergency of phenomena from a more including vision. It was used the methodology developed in the Index of Health of Drumond Jr, whose final value of the Index is gotten by the average of the values of the components of each health district. To the components originally adopted - Coefficient of Infant Mortality, Coefficient of Tuberculosis Incidence, Coefficient of Mortality by External Causes and Coefficient of Precocious Mortality by Chronic Diseases - was still added in this study, the Tax of Alphabetization and the Monthly Nominal Average Income of Responsible People for the Domiciles. The 24 Units of Health had been classified according to values obtained in the relation among its components. The results point intra-urban differentials in relation to the majority of the components and lower values for the Health Units located at the periphery of the city. Knowing this fact municipal administration is of fundamental importance to progress in improving the process of evaluation of primary care in the county.

Survey for δ Sct components in eclipsing binaries and new correlations between pulsation frequency and fundamental stellar characteristics

NASA Astrophysics Data System (ADS)

Liakos, A.; Niarchos, P.; Soydugan, E.; Zasche, P.

2012-05-01

CCD observations of 68 eclipsing binary systems, candidates for containing δ Scuti components, were obtained. Their light curves are analysed using the PERIOD04 software for possible pulsational behaviour. For the systems QY Aql, CZ Aqr, TY Cap, WY Cet, UW Cyg, HL Dra, HZ Dra, AU Lac, CL Lyn and IO UMa, complete light curves were observed due to the detection of a pulsating component. All of them, except QY Aql and IO UMa, are analysed with modern astronomical softwares in order to determine their geometrical and pulsational characteristics. Spectroscopic observations of WY Cet and UW Cyg were used to estimate the spectral class of their primary components, while for HZ Dra radial velocities of its primary were measured. O - C diagram analysis was performed for the cases showing peculiar orbital period variations, namely CZ Aqr, TY Cap, WY Cet and UW Cyg, with the aim of obtaining a comprehensive picture of these systems. An updated catalogue of 74 close binaries including a δ Scuti companion is presented. Moreover, a connection between orbital and pulsation periods, as well as a correlation between evolutionary status and dominant pulsation frequency for these systems, is discussed.

Pilot study evaluating the feasibility and initial outcomes of a primary care weight loss intervention with peer coaches.

PubMed

Dutton, Gareth R; Phillips, Janice M; Kukkamalla, Meghana; Cherrington, Andrea L; Safford, Monika M

2015-06-01

The purpose of this single-group pilot study was to evaluate the feasibility, acceptability, and initial outcomes of a novel approach to delivering weight loss treatment in primary care using peer coaches and targeting predominantly African American patients with diabetes or prediabetes. Participants (N = 33) were recruited from a family medicine practice for a 6-month lifestyle intervention. Eligible patients were obese adults (body mass index [BMI] ≥30 kg/m(2)) with ≥1 additional cardiometabolic risk factor(s), including (1) elevated hemoglobin A1C or diagnosed diabetes, (2) elevated blood pressure, (3) elevated triglycerides, and/or (4) low high-density lipoprotein. The intervention included a combination of 12 group-based office visits with health professionals plus 12 individual phone contacts with peer coaches. Outcomes included weight loss, program adherence, and program satisfaction. Participants (mean age = 56 ± 10 years; BMI = 42.9 ± 11.0 kg/m(2)) were predominantly female (88%) and African American (85%). Treatment resulted in a significant mean weight loss of -4.5 ± 7.2 kg, and approximately 27% of participants lost ≥5% of their initial body weight. Participants completed approximately 50% of the group visits and 40% of the telephone calls with peer coaches. Participants rated both components of the intervention favorably. Results of this pilot study indicated that a primary care weight management program including group-based visits and peer-delivered telephone contacts achieved significant weight loss among predominantly African American patients with weight-related comorbidities, including diabetes and prediabetes. Additional research is needed to examine the long-term outcomes of this novel approach and to identify program components supporting patients' success. © 2015 The Author(s).

Model-based recursive partitioning to identify risk clusters for metabolic syndrome and its components: findings from the International Mobility in Aging Study

PubMed Central

Pirkle, Catherine M; Wu, Yan Yan; Zunzunegui, Maria-Victoria; Gómez, José Fernando

2018-01-01

Objective Conceptual models underpinning much epidemiological research on ageing acknowledge that environmental, social and biological systems interact to influence health outcomes. Recursive partitioning is a data-driven approach that allows for concurrent exploration of distinct mixtures, or clusters, of individuals that have a particular outcome. Our aim is to use recursive partitioning to examine risk clusters for metabolic syndrome (MetS) and its components, in order to identify vulnerable populations. Study design Cross-sectional analysis of baseline data from a prospective longitudinal cohort called the International Mobility in Aging Study (IMIAS). Setting IMIAS includes sites from three middle-income countries—Tirana (Albania), Natal (Brazil) and Manizales (Colombia)—and two from Canada—Kingston (Ontario) and Saint-Hyacinthe (Quebec). Participants Community-dwelling male and female adults, aged 64–75 years (n=2002). Primary and secondary outcome measures We apply recursive partitioning to investigate social and behavioural risk factors for MetS and its components. Model-based recursive partitioning (MOB) was used to cluster participants into age-adjusted risk groups based on variabilities in: study site, sex, education, living arrangements, childhood adversities, adult occupation, current employment status, income, perceived income sufficiency, smoking status and weekly minutes of physical activity. Results 43% of participants had MetS. Using MOB, the primary partitioning variable was participant sex. Among women from middle-incomes sites, the predicted proportion with MetS ranged from 58% to 68%. Canadian women with limited physical activity had elevated predicted proportions of MetS (49%, 95% CI 39% to 58%). Among men, MetS ranged from 26% to 41% depending on childhood social adversity and education. Clustering for MetS components differed from the syndrome and across components. Study site was a primary partitioning variable for all components except HDL cholesterol. Sex was important for most components. Conclusion MOB is a promising technique for identifying disease risk clusters (eg, vulnerable populations) in modestly sized samples. PMID:29500203

Mixotrophy in the Marine Plankton

NASA Astrophysics Data System (ADS)

Stoecker, Diane K.; Hansen, Per Juel; Caron, David A.; Mitra, Aditee

2017-01-01

Mixotrophs are important components of the bacterioplankton, phytoplankton, microzooplankton, and (sometimes) zooplankton in coastal and oceanic waters. Bacterivory among the phytoplankton may be important for alleviating inorganic nutrient stress and may increase primary production in oligotrophic waters. Mixotrophic phytoflagellates and dinoflagellates are often dominant components of the plankton during seasonal stratification. Many of the microzooplankton grazers, including ciliates and Rhizaria, are mixotrophic owing to their retention of functional algal organelles or maintenance of algal endosymbionts. Phototrophy among the microzooplankton may increase gross growth efficiency and carbon transfer through the microzooplankton to higher trophic levels. Characteristic assemblages of mixotrophs are associated with warm, temperate, and cold seas and with stratification, fronts, and upwelling zones. Modeling has indicated that mixotrophy has a profound impact on marine planktonic ecosystems and may enhance primary production, biomass transfer to higher trophic levels, and the functioning of the biological carbon pump.

Demonstration of fully coupled simplified extended station black-out accident simulation with RELAP-7

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

Zhao, Haihua; Zhang, Hongbin; Zou, Ling

2014-10-01

The RELAP-7 code is the next generation nuclear reactor system safety analysis code being developed at the Idaho National Laboratory (INL). The RELAP-7 code develop-ment effort started in October of 2011 and by the end of the second development year, a number of physical components with simplified two phase flow capability have been de-veloped to support the simplified boiling water reactor (BWR) extended station blackout (SBO) analyses. The demonstration case includes the major components for the primary system of a BWR, as well as the safety system components for the safety relief valve (SRV), the reactor core isolation cooling (RCIC)more » system, and the wet well. Three scenar-ios for the SBO simulations have been considered. Since RELAP-7 is not a severe acci-dent analysis code, the simulation stops when fuel clad temperature reaches damage point. Scenario I represents an extreme station blackout accident without any external cooling and cooling water injection. The system pressure is controlled by automatically releasing steam through SRVs. Scenario II includes the RCIC system but without SRV. The RCIC system is fully coupled with the reactor primary system and all the major components are dynamically simulated. The third scenario includes both the RCIC system and the SRV to provide a more realistic simulation. This paper will describe the major models and dis-cuss the results for the three scenarios. The RELAP-7 simulations for the three simplified SBO scenarios show the importance of dynamically simulating the SRVs, the RCIC sys-tem, and the wet well system to the reactor safety during extended SBO accidents.« less

Physical Activity on Prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care.

PubMed

Lundqvist, Stefan; Börjesson, Mats; Larsson, Maria E H; Hagberg, Lars; Cider, Åsa

2017-01-01

There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27-85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83%) completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p≤ 0.05) in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1-2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people's PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with minimum effort from healthcare professionals.

Physical Activity on Prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care

PubMed Central

Börjesson, Mats; Larsson, Maria E. H.; Hagberg, Lars; Cider, Åsa

2017-01-01

There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27–85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83%) completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p≤ 0.05) in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1–2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people’s PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with minimum effort from healthcare professionals. PMID:28403151

Operational and maintenance instruction manual for the Ingham County Geriatric Medical Care Facility solar water-heating system

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

Not Available

The Ingham County solar system consists of approximately 10,000 square feet of solar collectors connected in a closed configuration loop. The primary loop solution is a 1:12 mixture of water and propylene glycol which flows through the tube side of a heat exchanger connected to the primary storage tank. The heat energy which is supplied to the primary storage tank is subsequently used to preheat the temperature of the laundry water, kitchen water, and domestic potable water. Included in this report are: detailed drawings and flow chart; operational methodology; preventive maintenance instructions; general instructions and safety precautions; and a correctivemore » maintenance and tabulation of failure modes. Appendices include: manufacturers technical manual and component specifications; IBM data sensors and responsibilities; digital county monitor operations manual; and on site monitor operations manual. Reference CAPE-2834. (LS)« less

Dietary Management in Hyperlipidemia. Nutrition in Primary Care Series, Number 12.

ERIC Educational Resources Information Center

Gallagher-Allred, Charlette R.; Townley, Nancy A.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Dietary Management in Obesity. Nutrition in Primary Care Series, Number 9.

ERIC Educational Resources Information Center

Gallagher-Allred, Charlette R.; Townley, Nancy A.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Appraisal of Nutritional Status. Nutrition in Primary Care Series, Number 2.

ERIC Educational Resources Information Center

Latanick, Maureen Rogan; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Teenage Pregnancy and Primary Prevention: New Approaches to an Old Problem.

ERIC Educational Resources Information Center

Pate, David J., Jr.; Knight, Susan

This document describes the Parents Too Soon (PTS) program, a project which integrated a comprehensive array of services for teenagers in an effort to help prevent premature and unwanted pregnancies. Four components of the PTS program are listed: (1) comprehensive family planning medical services including provision of contraceptives; (2) social…

33 CFR 155.1040 - Response plan requirements for unmanned tank barges carrying oil as a primary cargo.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the towing vessel crew and facility or fleeting area personnel, if any, to initiate a response and... functional areas and must further include information for key components within each functional area: (i...) Spill response operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The...

33 CFR 155.1040 - Response plan requirements for unmanned tank barges carrying oil as a primary cargo.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the towing vessel crew and facility or fleeting area personnel, if any, to initiate a response and... functional areas and must further include information for key components within each functional area: (i...) Spill response operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The...

33 CFR 155.1040 - Response plan requirements for unmanned tank barges carrying oil as a primary cargo.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the towing vessel crew and facility or fleeting area personnel, if any, to initiate a response and... functional areas and must further include information for key components within each functional area: (i...) Spill response operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The...

33 CFR 155.1040 - Response plan requirements for unmanned tank barges carrying oil as a primary cargo.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the towing vessel crew and facility or fleeting area personnel, if any, to initiate a response and... functional areas and must further include information for key components within each functional area: (i...) Spill response operations; (vi) Planning; (vii) Logistics support; and (viii) Finance. (5) The...

FOBT Completion in FQHCs: Impact of Physician Recommendation, FOBT Information, or Receipt of the FOBT Kit

ERIC Educational Resources Information Center

Davis, Terry C.; Arnold, Connie L.; Rademaker, Alfred W.; Platt, Daci J.; Esparza, Julia; Liu, Dachao; Wolf, Michael S.

2012-01-01

Purpose: To determine the effect of common components of primary care-based colorectal cancer (CRC) screening interventions on fecal occult blood test (FOBT) completion "within" rural and urban community clinics, including: (1) physician's spoken recommendation, (2) providing information or education about FOBTs, and (3) physician providing the…

Dietary Management in Hypertension. Nutrition in Primary Care Series, Number 11.

ERIC Educational Resources Information Center

Molleson, Ann L.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Normal Diet: Geriatrics. Nutrition in Primary Care Series, Number 8.

ERIC Educational Resources Information Center

Molleson, Ann L.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Visible Parts, Invisible Whole: Swedish Technology Student Teachers' Conceptions about Technological Systems

ERIC Educational Resources Information Center

Hallström, Jonas; Klasander, Claes

2017-01-01

Technological systems are included as a component of national technology curricula and standards for primary and secondary education as well as corresponding teacher education around the world. Little is known, however, of how pupils, students, and teachers conceive of technological systems. In this article we report on a study investigating…

Correlation between Teacher's PCK (Pedagogical Content Knowledge) and Student's Motivation in Primary School

ERIC Educational Resources Information Center

Maryani, Ika; Martaningsih, Sri Tutur

2015-01-01

Various learning problems occur due to the teachers' inability in managing the learning process. Teacher's learning skill is influenced by their understanding in the curriculum components which are including pedagogical knowledge and content knowledge. The aims of this research were to determine: 1) the condition of Pedagogical Content Knowledge…

Nutrient and Drug Interactions. Nutrition in Primary Care Series, Number 3.

ERIC Educational Resources Information Center

Molleson, Ann L.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

75 FR 41214 - Agency Information Collection Activities: Extension of a Currently Approved Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-15

... proper performance of the functions of the agency, including whether the information will have practical.../Collection: Non-Immigrant Checkout Letter. (3) Agency form number, if any, and the applicable component of... abstract: Primary: Individual or Households. When an alien (other than one who is required to depart under...

Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review

PubMed Central

Pindus, Dominika M; Lim, Lisa; Rundell, A Viona; Hobbs, Victoria; Aziz, Noorazah Abd; Mullis, Ricky; Mant, Jonathan

2016-01-01

Introduction Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were successful in addressing long-term outcomes, and (3) developments in current clinical practice. Methods and analysis Studies that focused on adult community dwelling stroke survivors and informal carers were included. Academic electronic databases will be searched to identify reviews of randomised controlled trials (RCTs) and controlled trials, trials from the past 5 years; reviews of observational studies. Practice exemplars from grey literature will be identified through advanced Google search. Reports, guidelines and other documents of major health organisations, clinical professional bodies, and stroke charities in the UK and internationally will be included. Two reviewers will independently screen titles, abstracts and full texts for inclusion of published literature. One reviewer will screen search results from the grey literature and identify relevant documents for inclusion. Data synthesis will include analysis of the number, type of studies, year and country of publication, a summary of intervention components/service or practice, outcomes addressed, main results (an indicator of effectiveness) and a description of included interventions. Ethics and dissemination The review will help identify components of care and care pathways for primary care services for stroke. By comparing the results with stroke survivors' and carers' needs identified in the literature, the review will highlight potential gaps in research and practice relevant to long-term care after stroke. PMID:27798023

Hydrophobic Surfaces of Spacecraft Components Enhance the Aggregation of Microorganisms and May Lead to Higher Survival Rates on Mars

NASA Technical Reports Server (NTRS)

Schuerger, A. C.; Kern, R. G.

2003-01-01

In order to minimize the forward contamination of Mars, spacecraft are assembled under clean-room conditions that often require several procedures to clean and sterilize components. Surface characteristics of spacecraft materials may contribute to microbial survival by protecting spores from sterilizing agents, including UV irradiation on the surface of Mars. The primary objective of this study was to evaluate the effects of surface characteristics of several spacecraft materials on the survival of Bacillus subtilis spores under simulated Martian conditions.

Hydrophobic Surfaces of Spacecraft Components Enhance the Aggregation of Microorganisms and May Lead to Higher Survival Rates of Bacteria on Mars Landers

NASA Technical Reports Server (NTRS)

Schuerger, Andrew C.; Kern, Roger G.

2004-01-01

In order to minimize the forward contamination of Mars, spacecraft are assembled under cleanroom conditions that require several procedures to clean and sterilize components. Surface characteristics of spacecraft materials may contribute to microbial survival on the surface of Mars by protecting spores from sterilizing agents, including UV irradiation. The primary objective of this study was to evaluate the effects of surface characteristics of several spacecraft materials on the survival of Bacillus subtilis spores under simulated Martian conditions.

Improving primary care for persons with spinal cord injury: Development of a toolkit to guide care.

PubMed

Milligan, James; Lee, Joseph; Hillier, Loretta M; Slonim, Karen; Craven, Catharine

2018-05-07

To identify a set of essential components for primary care for patients with spinal cord injury (SCI) for inclusion in a point-of-practice toolkit for primary care practitioners (PCP) and identification of the essential elements of SCI care that are required in primary care and those that should be the focus of specialist care. Modified Delphi consensus process; survey methodology. Primary care. Three family physicians, six specialist physicians, and five inter-disciplinary health professionals completed surveys. Importance of care elements for inclusion in the toolkit (9-point scale: 1 = lowest level of importance, 9 = greatest level of importance) and identification of most responsible physician (family physician, specialist) for completing key categories of care. Open-ended comments were solicited. There was consensus between the respondent groups on the level of importance of various care elements. Mean importance scores were highest for autonomic dysreflexia, pain, and skin care and lowest for preventive care, social issues, and vital signs. Although, there was agreement across all respondents that family physicians should assume responsibility for assessing mental health, there was variability in who should be responsible for other care categories. Comments were related to the need for shared care approaches and capacity building and lack of knowledge and specialized equipment as barriers to optimal care. This study identified important components of SCI care to be included in a point-of-practice toolkit to facilitate primary care for persons with SCI.

Validated Measures of Illness Perception and Behavior in People with Knee Pain and Knee Osteoarthritis: A Scoping Review.

PubMed

Hamilton, Clayon B; Wong, Ming-Kin; Gignac, Monique A M; Davis, Aileen M; Chesworth, Bert M

2017-01-01

To identify validated measures that capture illness perception and behavior and have been used to assess people who have knee pain/osteoarthritis. A scoping review was performed. Nine electronic databases were searched for records from inception through April 19, 2015. Search terms included illness perception, illness behavior, knee, pain, osteoarthritis, and their related terms. This review included English language publications of primary data on people with knee pain/osteoarthritis who were assessed with validated measures capturing any of 4 components of illness perception and behavior: monitor body, define and interpret symptoms, take remedial action, and utilize sources of help. Seventy-one publications included relevant measures. Two reviewers independently coded and analyzed each relevant measure within the 4 components. Sixteen measures were identified that capture components of illness perception and behavior in the target population. These measures were originally developed to capture constructs that include coping strategies/skills/styles, illness belief, illness perception, self-efficacy, and pain behavior. Coding results indicated that 5, 11, 12, and 5 of these measures included the monitor body, define and interpret symptoms, take remedial action, and utilize sources of help components, respectively. Several validated measures were interpreted as capturing some components, and only 1 measure was interpreted as capturing all of the components of illness perception and behavior in the target population. A measure that comprehensively captures illness perception and behavior could be valuable for informing and evaluating therapy for patients along a continuum of symptomatic knee osteoarthritis. © 2016 World Institute of Pain.

Primary perivascular epithelioid cell tumors of the liver: CT/MRI findings and clinical outcomes.

PubMed

O'Malley, Martin E; Chawla, Tanya P; Lavelle, Lisa P; Cleary, Sean; Fischer, Sandra

2017-06-01

The purpose of our study was to describe the CT and MRI features of primary PEComas of the liver and to document the associated clinical outcomes. Retrospective study included 20 patients with primary hepatic perivascular epithelioid cell tumors (PEComa) with pathology and clinical outcomes for correlation. Study group included 20 patients: 16 women, 4 men; mean age 53 (range 35-77) years. Initial pathology diagnoses were classic angiomyolipoma (AML) (n = 11), epithelioid AML (n = 7), and PEComa not otherwise specified (n = 2). Mean tumor size was 5.1 (range 1.3-15.0) cm. CT/MRI features included well-defined margins 20/20 (100%), arterial enhancement 18/19 (95%), subcapsular location 17/20 (85%), heterogeneous 16/20 (80%), dysmorphic vessels 14/20 (70%), fat 13/20 (65%), hemorrhage 4/20 (20%), cystic components 4/20 (20%), and calcification 1/20 (5%). At the time of discovery, 18 patients were asymptomatic and their tumors were incidentally detected on imaging, and 2 patients were symptomatic. Ultimately, 18 tumors were benign and 2 developed metastases. On CT/MRI, most primary hepatic PEComas were well-defined, arterial enhancing, subcapsular, heterogeneous masses that often had dysmorphic vessels and contained fat. Most tumors were benign but complications included local symptoms, bleeding, and malignant change.

Intermetallic alloy welding wires and method for fabricating the same

DOEpatents

Santella, M.L.; Sikka, V.K.

1996-06-11

Welding wires for welding together intermetallic alloys of nickel aluminides, nickel-iron aluminides, iron aluminides, or titanium aluminides, and preferably including additional alloying constituents are fabricated as two-component, clad structures in which one component contains the primary alloying constituent(s) except for aluminum and the other component contains the aluminum constituent. This two-component approach for fabricating the welding wire overcomes the difficulties associated with mechanically forming welding wires from intermetallic alloys which possess high strength and limited ductilities at elevated temperatures normally employed in conventional metal working processes. The composition of the clad welding wires is readily tailored so that the welding wire composition when melted will form an alloy defined by the weld deposit which substantially corresponds to the composition of the intermetallic alloy being joined. 4 figs.

Intermetallic alloy welding wires and method for fabricating the same

DOEpatents

Santella, Michael L.; Sikka, Vinod K.

1996-01-01

Welding wires for welding together intermetallic alloys of nickel aluminides, nickel-iron aluminides, iron aluminides, or titanium aluminides, and preferably including additional alloying constituents are fabricated as two-component, clad structures in which one component contains the primary alloying constituent(s) except for aluminum and the other component contains the aluminum constituent. This two-component approach for fabricating the welding wire overcomes the difficulties associated with mechanically forming welding wires from intermetallic alloys which possess high strength and limited ductilities at elevated temperatures normally employed in conventional metal working processes. The composition of the clad welding wires is readily tailored so that the welding wire composition when melted will form an alloy defined by the weld deposit which substantially corresponds to the composition of the intermetallic alloy being joined.

Facial growth and development in unilateral cleft lip and palate: comparison between secondary alveolar bone grafting and primary periosteoplasty.

PubMed

Cagáňová, Veronika; Borský, Jiří; Smahel, Zbyněk; Velemínská, Jana

2014-01-01

To describe the effect of secondary alveolar bone grafting in patients with unilateral cleft lip and palate by comparison with a sample of patients who have undergone primary periosteoplasty. Cephalometric analysis of lateral x-ray films in a retrospective semilongitudinal study. Lateral x-ray films of 18 secondary alveolar bone grafting patients and 48 primary periosteoplasty patients at 10 years of age and again at 15 years of age. The treatment of secondary alveolar bone grafting patients included lip repair according to Tennison, palatoplasty including retropositioning, pharyngeal flap surgery, and secondary alveolar bone grafting. The lips of primary periosteoplasty patient were repaired using the methods of Tennison and Veau, followed by primary periosteoplasty, palatoplasty including retropositioning, and pharyngeal flap surgery. Lateral radiographs were assessed using classical morphometry. There were few significant differences at 10 years of age between the secondary alveolar bone grafting and primary periosteoplasty patients. At 15 years of age, there were several significant differences. Compared with primary periosteoplasty patients, subsequent development in patients who had undergone secondary alveolar bone grafting was characterized by a significantly better position of the upper and lower dentoalveolar components in relation to the facial plane, a higher increase in the global convexity of the soft profile, a significantly better maxillary inclination, and a more favorable development of vertical intermaxillary relationships. Craniofacial development in secondary alveolar bone grafting patients was better than that in primary periosteoplasty patients due to the more marked facial convexity, the increased prominence of the nose, and better vertical intermaxillary relationships.

Comparison of soft tissue balancing, femoral component rotation, and joint line change between the gap balancing and measured resection techniques in primary total knee arthroplasty: A meta-analysis.

PubMed

Moon, Young-Wan; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Park, Chan-Deok; Lee, Dae-Hee

2016-09-01

This meta-analysis was designed to compare the accuracy of soft tissue balancing and femoral component rotation as well as change in joint line positions, between the measured resection and gap balancing techniques in primary total knee arthroplasty. Studies were included in the meta-analysis if they compared soft tissue balancing and/or radiologic outcomes in patients who underwent total knee arthroplasty with the gap balancing and measured resection techniques. Comparisons included differences in flexion/extension, medial/lateral flexion, and medial/lateral extension gaps (LEGs), femoral component rotation, and change in joint line positions. Finally, 8 studies identified via electronic (MEDLINE, EMBASE, and the Cochrane Library) and manual searches were included. All 8 studies showed a low risk of selection bias and provided detailed demographic data. There was some inherent heterogeneity due to uncontrolled bias, because all included studies were observational comparison studies. The pooled mean difference in gap differences between the gap balancing and measured resection techniques did not differ significantly (-0.09 mm, 95% confidence interval [CI]: -0.40 to +0.21 mm; P = 0.55), except that the medial/LEG difference was 0.58 mm greater for measured resection than gap balancing (95% CI: -1.01 to -0.15 mm; P = 0.008). Conversely, the pooled mean difference in femoral component external rotation (0.77°, 95% CI: 0.18° to 1.35°; P = 0.01) and joint line change (1.17 mm, 95% CI: 0.82 to 1.52 mm; P < 0.001) were significantly greater for the gap balancing than the measured resection technique. The gap balancing and measured resection techniques showed similar soft tissue balancing, except for medial/LEG difference. However, the femoral component was more externally rotated and the joint line was more elevated with gap balancing than measured resection. These differences were minimal (around 1 mm or 1°) and therefore may have little effect on the biomechanics of the knee joint. This suggests that the gap balancing and measured resection techniques are not mutually exclusive.

Primary cooling check valve steam generator and loose parts events of November 1985

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

Not Available

1985-12-23

On November 10, 1985, a primary coolant check valve, CV-3-8, was opened for inspection. The valve flapper and mounting bracket were found to have become detached from the valve body and were resting in the bottom of the valve. Normally, the bracket is secured to the valve body with three studs and nuts. All three sets of studs, nuts and stud retainers were missing. As part of the effort to locate the missing valve parts, the primary side of the No. 2A steam generator was opened for inspection. Three cap screws and an associated locking bar used to secure certainmore » internals were found to be missing. In response, the Director, Reactor Engineering Department was assigned lead responsibility for developing and directing the implementation of a plan to correct deficiencies and ready the plant to return to operation. Next, a Special Safety Assessment Team was established to provide a structured assessment of the safety aspect of the component failures and the implications of such failures to other components in the primary coolant system. This structured assessment was to result in the development of an action plan that included the development of specific safety criteria, and identification and conduct of special investigations and analyses required for recovery from the event. Finally, an independent Management Review Team was created. The purpose of this report is to document the work of the Management Review Team, including the causal factors analyses, and various reviews required to support the recovery process.« less

Evaluation of Patient Centered Medical Home Practice Transformation Initiatives

PubMed Central

Crabtree, Benjamin F.; Chase, Sabrina M.; Wise, Christopher G.; Schiff, Gordon D.; Schmidt, Laura A.; Goyzueta, Jeanette R.; Malouin, Rebecca A.; Payne, Susan M. C.; Quinn, Michael T.; Nutting, Paul A.; Miller, William L.; Jaén, Carlos Roberto

2011-01-01

Background The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on whole-system redesign, and not just isolated parts of medical practices. Methods Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. Results A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. Conclusions Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures. PMID:21079525

Optimizing the management of depression: primary care experience.

PubMed

Cameron, Catherine; Habert, Jeff; Anand, Leena; Furtado, Melissa

2014-12-01

This article is intended to identify some of the most important challenges faced by family physicians when treating MDD and to provide practical solutions. Key issues, reviewed from a primary care view point will include: treating to remission (and not just response), identification of high-risk groups, diagnosis, acute treatment approaches (including pharmacotherapy and the management of related side effects), the use of psychotherapy and somatic therapies, assessment of the adequacy of treatment including the assessment of remission, response measurement, optimal follow-up care throughout the phase of treatment, the key components of patient education and strategies for partial/limited response to the first-line antidepressant (switching, augmentation and combination strategies), how to provide support for improved treatment adherence, and approaches to prevent the recurrence of depressive episodes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chronic care management for patients with COPD: a critical review of available evidence.

PubMed

Lemmens, Karin M M; Lemmens, Lidwien C; Boom, José H C; Drewes, Hanneke W; Meeuwissen, Jolanda A C; Steuten, Lotte M G; Vrijhoef, Hubertus J M; Baan, Caroline A

2013-10-01

Clinical diversity and methodological heterogeneity exists between studies on chronic care management. This study aimed to examine the effectiveness of chronic care management in chronic obstructive pulmonary disease (COPD) while taking heterogeneity into account, enabling the understanding of and the decision making about such programmes. Three investigated sources of heterogeneity were study quality, length of follow-up, and number of intervention components. We performed a review of previously published reviews and meta-analyses on COPD chronic care management. Their primary studies that were analyzed as statistical, clinical and methodological heterogeneity were present. Meta-regression analyses were performed to explain the variances among the primary studies. Generally, the included reviews showed positive results on quality of life and hospitalizations. Inconclusive effects were found on emergency department visits and no effects on mortality. Pooled effects on hospitalizations, emergency department visits and quality of life of primary studies did not reach significant improvement. No effects were found on mortality. Meta-regression showed that the number of components of chronic care management programmes explained present heterogeneity for hospitalizations and emergency department visits. Four components showed significant effects on hospitalizations, whereas two components had significant effects on emergency department visits. Methodological study quality and length of follow-up did not significantly explain heterogeneity. This study demonstrated that COPD chronic care management has the potential to improve outcomes of care; heterogeneity in outcomes was explained. Further research is needed to elucidate the diversity between COPD chronic care management studies in terms of the effects measured and strengthen the support for chronic care management. © 2011 John Wiley & Sons Ltd.

Comprehensive Diagnostic Assessment of Health Status of Patients with Asthma or COPD: A Delphi Panel Study among Dutch Experts.

PubMed

van den Akker, Edmée F M M; Van't Hul, Alex J; Birnie, Erwin; Chavannes, Niels H; Rutten-van Mölken, Maureen P M H; In't Veen, Johannes C C M

2017-04-01

A comprehensive diagnostic assessment is needed to improve understanding of the health status of patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, this study investigated which components and subsequent instruments should be part of a holistic assessment in secondary care. We also explored which data need to be exchanged for an adequate transfer of patients between primary and secondary care, and vice versa. A cross-sectional Web-based survey was conducted among Dutch healthcare professionals using a Delphi-like procedure; these included professionals working in primary or secondary care, medical advisors of health insurance companies and patients' representatives. The national guidelines were used as a starting point, resulting in a questionnaire addressing 55 components related to a comprehensive diagnostic assessment, covering the domains physiological impairments, symptoms, functional limitations and quality of life. Of the 151 experts and stakeholders invited, 92 (60.9%) completed the first round and 79 (52.3%) the second round; most respondents were pulmonologists. There was a high level of agreement between respondents from primary versus secondary care regarding which components should be measured during a comprehensive assessment of patients with asthma or COPD in secondary care and the instruments to measure these components. Regarding the exchange of information, upon referral, pulmonologists required little information from the general practitioners, whereas general practitioners required more extensive information after referral. An overview is provided of what should be part of a holistic assessment of health status in asthma and COPD. This information can be used as input for integrated care pathways.

Primary sources of PM2.5 organic aerosol in an industrial Mediterranean city, Marseille

NASA Astrophysics Data System (ADS)

El Haddad, I.; Marchand, N.; Wortham, H.; Piot, C.; Besombes, J.-L.; Cozic, J.; Chauvel, C.; Armengaud, A.; Robin, D.; Jaffrezo, J.-L.

2011-03-01

Marseille, the most important port of the Mediterranean Sea, represents a challenging case study for source apportionment exercises, combining an active photochemistry and multiple emission sources, including fugitive emissions from industrial sources and shipping. This paper presents a Chemical Mass Balance (CMB) approach based on organic markers and metals to apportion the primary sources of organic aerosol in Marseille, with a special focus on industrial emissions. Overall, the CMB model accounts for the major primary anthropogenic sources including motor vehicles, biomass burning and the aggregate emissions from three industrial processes (heavy fuel oil combustion/shipping, coke production and steel manufacturing) as well as some primary biogenic emissions. This source apportionment exercise is well corroborated by 14C measurements. Primary OC estimated by the CMB accounts on average for 22% of total OC and is dominated by the vehicular emissions that contribute on average for 17% of OC mass concentration (vehicular PM contributes for 17% of PM2.5). Even though industrial emissions contribute only 2.3% of the total OC (7% of PM2.5), they are associated with ultrafine particles (Dp<80 nm) and high concentrations of Polycyclic Aromatic Hydrocarbons (PAH) and heavy metals such as Pb, Ni and V. On one hand, given that industrial emissions governed key primary markers, their omission would lead to substantial uncertainties in the CMB analysis performed in areas heavily impacted by such sources, hindering accurate estimation of non-industrial primary sources and secondary sources. On the other hand, being associated with bursts of submicron particles and carcinogenic and mutagenic components such as PAH, these emissions are most likely related with acute ill-health outcomes and should be regulated despite their small contributions to OC. Another important result is the fact that 78% of OC mass cannot be attributed to the major primary sources and, thus, remains un-apportioned. We have consequently critically investigated the uncertainties underlying our CMB apportionments. While we have provided some evidence for photochemical decay of hopanes, this decay does not appear to significantly alter the CMB estimates of the total primary OC. Sampling artifacts and unaccounted primary sources also appear to marginally influence the amount of un-apportioned OC. Therefore, this significant amount of un-apportioned OC is mostly attributed to secondary organic carbon that appears to be the major component of OC during the whole period of study.

Efficacy and safety of desloratadine/pseudoephedrine combination vs its components in seasonal allergic rhinitis.

PubMed

Grubbe, R E; Lumry, W R; Anolik, R

2009-01-01

Antihistamines are first-line therapy for the treatment of seasonal allergic rhinitis (AR); however, an oral decongestant is often added to improve control of nasal congestion. To examine whether a tablet combining the nonsedating antihistamine desloratadine and the decongestant pseudoephedrine was more effective than either drug administered alone in reducing the symptoms of seasonal AR, including nasal congestion. In this multicenter, double-blind study, participants (N = 598) with symptomatic seasonal AR were administered either a combination tablet of desloratadine 2.5 mg/pseudoephedrine 120 mg (DL/PSE) bid, a desloratadine 5.0 mg qd and a placebo tablet, or pseudoephedrine 120 mg bid. Participants assessed their symptom severity twice daily over the 2-week treatment period. The primary variable to assess the effects of the antihistamine component--mean change from baseline in average AM/PM reflective total symptom score (TSS), excluding nasal congestion--was significantly greater (-6.54) for DL/PSE than for desloratadine (-5.09) or pseudoephedrine (-5.07) monotherapy (P < .001 for both). The primary variable to assess the effects of the decongestant component--mean change from baseline in average AM/PM reflective nasal congestion score--was also significantly greater (-0.93) for DL/PSE than for desloratadine (-0.66) or pseudoephedrine (-0.75) (P < .001 vs desloratadine; P = .006 vs pseudoephedrine). This study demonstrated that DL/PSE therapy was more effective in reducing symptoms of seasonal AR, including nasal congestion, than the individual components when administered alone, thus supporting use of this combination in participants with symptomatic seasonal AR and prominent nasal congestion.

Secondary Prevention Efforts at the Middle School Level: An Application of the Behavior Education Program

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Capizzi, Andrea M.; Fisher, Marisa H.; Ennis, Robin Parks

2012-01-01

In this study we examine the impact of the Behavior Education Program (BEP; Hawken, MacLeod, & Rawlings, 2007) with four middle school students who were not responsive to a comprehensive primary prevention program including academic, behavioral and social components. To extend this line of inquiry we (a) conducted a functional behavioral…

Dietary Management in Diabetes Mellitus. Nutrition in Primary Care Series, Number 10.

ERIC Educational Resources Information Center

Bossetti, Brenda; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Learning "A La Carte": A Theory-Based Tool for Maximizing Student Engagement

ERIC Educational Resources Information Center

Sibold, Jeremy

2016-01-01

It is well-established that motivation is a critical component of one's best performance of a task. A primary model in the field of motivation is the self-determination theory (SDT). The three pillars of SDT include competency, autonomy, and relatedness; when supported these have been shown to improve the quality, consistency, and persistence of…

Normal Diet: Age of Parental Control. Nutrition in Primary Care Series, Number 5.

ERIC Educational Resources Information Center

Tuckermanty, Elizabeth; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Normal Diet: Age of Dependency. Nutrition in Primary Care Series, Number 4.

ERIC Educational Resources Information Center

Cox, Janice Hovasi; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Normal Diet: Pregnancy and Lactation. Nutrition in Primary Care Series, Number 7.

ERIC Educational Resources Information Center

Cox, Janice Hovasi; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

National Seminar on Research in Evaluation of Occupational Education.

ERIC Educational Resources Information Center

North Carolina State Univ., Raleigh. Center for Occupational Education.

The purpose of this seminar, attended by 21 participants, was to examine issues, problems, and components of models for the evaluation of occupational education. A primary objective was to stimulate interest in evaluation as an object of research effort. Papers presented include: (1) "The Value Structure of Society Toward Work" by Arthur R. Jones,…

Creating Interactive Student Workbook for Primary Education Social Studies Class and Researching Its Efficiency

ERIC Educational Resources Information Center

Ulu Kalin, Özlem

2017-01-01

Student workbook is an education material including components that support learning, help ensuring knowledge and ability to students in line with the acquisitions stated in teaching programs. Students have different learning styles and necessities. Their needs should be satisfied by benefiting from some additional materials in order to make their…

Dietary Management for Alcoholic Patients. Nutrition in Primary Care Series, Number 14.

ERIC Educational Resources Information Center

Hurley, Roberta Smith; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

The Impact of Every Classroom, Every Day on High School Student Achievement: Results from a School-Randomized Trial

ERIC Educational Resources Information Center

Early, Diane M.; Berg, Juliette K.; Alicea, Stacey; Si, Yajuan; Aber, J. Lawrence; Ryan, Richard M.; Deci, Edward L.

2016-01-01

Every Classroom, Every Day (ECED) is a set of instructional improvement interventions designed to increase student achievement in math and English/language arts (ELA). ECED includes three primary components: (a) systematic classroom observations by school leaders, (b) intensive professional development and support for math teachers and…

Dietary Management in Gastrointestinal Diseases. Nutrition in Primary Care Series, Number 13.

ERIC Educational Resources Information Center

Stein, Joan Z.; Gallagher-Allred, Charlette R.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Code System to Calculate Tornado-Induced Flow Material Transport.

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

ANDRAE, R. W.

1999-11-18

Version: 00 TORAC models tornado-induced flows, pressures, and material transport within structures. Its use is directed toward nuclear fuel cycle facilities and their primary release pathway, the ventilation system. However, it is applicable to other structures and can model other airflow pathways within a facility. In a nuclear facility, this network system could include process cells, canyons, laboratory offices, corridors, and offgas systems. TORAC predicts flow through a network system that also includes ventilation system components such as filters, dampers, ducts, and blowers. These ventilation system components are connected to the rooms and corridors of the facility to form amore » complete network for moving air through the structure and, perhaps, maintaining pressure levels in certain areas. The material transport capability in TORAC is very basic and includes convection, depletion, entrainment, and filtration of material.« less

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial.

PubMed

Bernhardsson, Susanne; Larsson, Maria E H; Eggertsen, Robert; Olsén, Monika Fagevik; Johansson, Kajsa; Nilsen, Per; Nordeman, Lena; van Tulder, Maurits; Öberg, Birgitta

2014-03-04

Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's χ2 test and approximative z-test. 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.

Children with Obesity Prioritize Social Support against Stigma: A Qualitative Study for Development of an Obesity Prevention Intervention

PubMed Central

Amini, Maryam; Djazayery, Abolghassem; Majdzadeh, Reza; Taghdisi, Mohammad-Hossein; Sadrzadeh-Yeganeh, Haleh; Eslami-Amirabadi, Maryam

2014-01-01

Background: Childhood obesity is a world-wide health problem and development of interventions to prevent or control it is a priority. Obesity is prevalent and on the increase among school-students in Iran, too. As the first step for development of an intervention, the current study was designed to complete our understanding of ideas, attitudes, beliefs, and preferences of primary school children in Tehran, Iran. Methods: Twenty-seven primary school-students (11 boys, 16 girls) in grade-five, most of whom were overweight or obese, participated in four focus-group discussions (FGDs). All FGD notes were analyzed to find the main themes. Results: Nine themes in three main categories emerged after analysis. The themes in the category of barriers of losing weight included environmental, psychological and physiological barriers. Category of intervention components included nutrition improvement, physical activity promotion, social support and education. Setting and deliverer of the intervention were included in the intervention conditions category. The children proposed a multi-component approach for development of an intervention. They mentioned nutrition and physical activity improvement, social support and education as the main elements of an effective intervention. Conclusions: The findings indicate that obese children need to be supported against different barriers of losing weight, mainly social barriers, especially humiliation by the community. PMID:25489443

Portfolio of prospective clinical trials including brachytherapy: an analysis of the ClinicalTrials.gov database.

PubMed

Cihoric, Nikola; Tsikkinis, Alexandros; Miguelez, Cristina Gutierrez; Strnad, Vratislav; Soldatovic, Ivan; Ghadjar, Pirus; Jeremic, Branislav; Dal Pra, Alan; Aebersold, Daniel M; Lössl, Kristina

2016-03-22

To evaluate the current status of prospective interventional clinical trials that includes brachytherapy (BT) procedures. The records of 175,538 (100 %) clinical trials registered at ClinicalTrials.gov were downloaded on September 2014 and a database was established. Trials using BT as an intervention were identified for further analyses. The selected trials were manually categorized according to indication(s), BT source, applied dose rate, primary sponsor type, location, protocol initiator and funding source. We analyzed trials across 8 available trial protocol elements registered within the database. In total 245 clinical trials were identified, 147 with BT as primary investigated treatment modality and 98 that included BT as an optional treatment component or as part of the standard treatment. Academic centers were the most frequent protocol initiators in trials where BT was the primary investigational treatment modality (p < 0.01). High dose rate (HDR) BT was the most frequently investigated type of BT dose rate (46.3 %) followed by low dose rate (LDR) (42.0 %). Prostate was the most frequently investigated tumor entity in trials with BT as the primary treatment modality (40.1 %) followed by breast cancer (17.0 %). BT was rarely the primary investigated treatment modality for cervical cancer (6.8 %). Most clinical trials using BT are predominantly in early phases, investigator-initiated and with low accrual numbers. Current investigational activities that include BT mainly focus on prostate and breast cancers. Important questions concerning the optimal usage of BT will not be answered in the near future.

Cosmic ray antimatter and baryon symmetric cosmology

NASA Technical Reports Server (NTRS)

Stecker, F. W.; Protheroe, R. J.; Kazanas, D.

1982-01-01

The relative merits and difficulties of the primary and secondary origin hypotheses for the observed cosmic-ray antiprotons, including the new low-energy measurement of Buffington, et al. We conclude that the cosmic-ray antiproton data may be evidence for antimatter galaxies and baryon symmetric cosmology. The present bar P data are consistent with a primary extragalactic component having /p=/equiv 1+/- 3.2/0.7x10 = to the -4 independent of energy. We propose that the primary extragalactic cosmic ray antiprotons are most likely from active galaxies and that expected disintegration of bar alpha/alpha ban alpha/alpha. We further predict a value for ban alpha/alpha =/equiv 10 to the -5, within range of future cosmic ray detectors.

Clinical and genetic aspects of primary ciliary dyskinesia/Kartagener syndrome.

PubMed

Leigh, Margaret W; Pittman, Jessica E; Carson, Johnny L; Ferkol, Thomas W; Dell, Sharon D; Davis, Stephanie D; Knowles, Michael R; Zariwala, Maimoona A

2009-07-01

Primary ciliary dyskinesia is a genetically heterogeneous disorder of motile cilia. Most of the disease-causing mutations identified to date involve the heavy (dynein axonemal heavy chain 5) or intermediate(dynein axonemal intermediate chain 1) chain dynein genes in ciliary outer dynein arms, although a few mutations have been noted in other genes. Clinical molecular genetic testing for primary ciliary dyskinesia is available for the most common mutations. The respiratory manifestations of primary ciliary dyskinesia (chronic bronchitis leading to bronchiectasis, chronic rhino-sinusitis, and chronic otitis media)reflect impaired mucociliary clearance owing to defective axonemal structure. Ciliary ultrastructural analysis in most patients (>80%) reveals defective dynein arms, although defects in other axonemal components have also been observed. Approximately 50% of patients with primary ciliary dyskinesia have laterality defects (including situs inversus totalis and, less commonly, heterotaxy, and congenital heart disease),reflecting dysfunction of embryological nodal cilia. Male infertility is common and reflects defects in sperm tail axonemes. Most patients with primary ciliary dyskinesia have a history of neonatal respiratory distress, suggesting that motile cilia play a role in fluid clearance during the transition from a fetal to neonatal lung. Ciliopathies involving sensory cilia, including autosomal dominant or recessive polycystic kidney disease, Bardet-Biedl syndrome, and Alstrom syndrome, may have chronic respiratory symptoms and even bronchiectasis suggesting clinical overlap with primary ciliary dyskinesia.

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

PubMed

Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

2018-01-01

Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and surgeons in identifying the best practices to implement in the surgical care of TKA and THA patients.

Global water cycle

NASA Technical Reports Server (NTRS)

Robertson, Franklin; Goodman, Steven J.; Christy, John R.; Fitzjarrald, Daniel E.; Chou, Shi-Hung; Crosson, William; Wang, Shouping; Ramirez, Jorge

1993-01-01

This research is the MSFC component of a joint MSFC/Pennsylvania State University Eos Interdisciplinary Investigation on the global water cycle extension across the earth sciences. The primary long-term objective of this investigation is to determine the scope and interactions of the global water cycle with all components of the Earth system and to understand how it stimulates and regulates change on both global and regional scales. Significant accomplishments in the past year are presented and include the following: (1) water vapor variability; (2) multi-phase water analysis; (3) global modeling; and (4) optimal precipitation and stream flow analysis and hydrologic processes.

Service evaluation of aircraft composite structural components

NASA Technical Reports Server (NTRS)

Brooks, W. A., Jr.; Dow, M. B.

1973-01-01

The advantages of the use of composite materials in structural applications have been identified in numerous engineering studies. Technology development programs are underway to correct known deficiencies and to provide needed improvements. However, in the final analysis, flight service programs are necessary to develop broader acceptance of, and confidence in, any new class of materials such as composites. Such flight programs, initiated by NASA Langley Research Center, are reviewed. These programs which include the selectively reinforced metal and the all-composite concepts applied to both secondary and primary aircraft structural components, are described and current status is indicated.

Electric prototype power processor for a 30cm ion thruster

NASA Technical Reports Server (NTRS)

Biess, J. J.; Inouye, L. Y.; Schoenfeld, A. D.

1977-01-01

An electrical prototype power processor unit was designed, fabricated and tested with a 30 cm mercury ion engine for primary space propulsion. The power processor unit used the thyristor series resonant inverter as the basic power stage for the high power beam and discharge supplies. A transistorized series resonant inverter processed the remaining power for the low power outputs. The power processor included a digital interface unit to process all input commands and internal telemetry signals so that electric propulsion systems could be operated with a central computer system. The electrical prototype unit included design improvement in the power components such as thyristors, transistors, filters and resonant capacitors, and power transformers and inductors in order to reduce component weight, to minimize losses, and to control the component temperature rise. A design analysis for the electrical prototype is also presented on the component weight, losses, part count and reliability estimate. The electrical prototype was tested in a thermal vacuum environment. Integration tests were performed with a 30 cm ion engine and demonstrated operational compatibility. Electromagnetic interference data was also recorded on the design to provide information for spacecraft integration.

Feasibility of a physical activity pathway for Irish primary care physiotherapy services.

PubMed

Barrett, Emer M; Hussey, Juliette; Darker, Catherine D

2017-03-01

To establish consensus on a physical activity pathway suitable for use by physiotherapists in Irish primary care. The physical activity pathway "Let's Get Moving" was examined to agree recruitment criteria and seek consensus on component parts. Modified Delphi approach which attempts to achieve a convergence of opinion, over a series of iterations. Three rounds of questionnaires were used. Primary care. 41 senior physiotherapists working in primary care for a median of 6 years (IQR 3.7 to 8.5). Statements achieving consensus; defined as at least 70% of participants scoring a 6 or a 7, indicating high agreement, on a 7 point Likert scale. The response rate was 98%. There was a high degree of consensus for many components of the pathway. Participants agreed that all patients attending physiotherapy should be eligible for recruitment onto the pathway as well as accepting referrals from other health professionals and direct access from the public. Private physiotherapists highlighted concerns about recruiting fee paying patients onto the pathway. The pathway should be integrated into other preventative and chronic disease programmes in primary care. Modifications to the original pathway included the use of a pedometer in addition to the General Practice Physical Activity Questionnaire. Training needs in physical activity screening and motivational interviewing, as well as additional staffing were identified to support implementation. The Physical Activity Pathway "Let's Get Moving" was accepted as a clinically feasible resource to primary care physiotherapists with some modifications and with the support of additional resources. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Unmet needs of children with special health care needs in a specialized day school setting.

PubMed

Aruda, Mary M; Kelly, Mary; Newinsky, Karina

2011-06-01

Children with Special Health Care Needs (CSHCN) represent a significant component of the pediatric population. They often present to schools with multiple and increasingly complex health issues, including medical technology dependency. Their daily variation in health status requires close monitoring and communication among caregivers. Limited research exists regarding parental concerns and communication between health providers, schools, and families. This study identifies the concerns of parents with CSHCN families, including satisfaction with communication between medical providers and schools. Parents completed a survey adapted from the American Academy of Pediatrics (AAP). Analysis of data indicated a high utilization of primary care services but highlighted persistent difficulty accessing services. This study demonstrates families have basic unmet needs in attaining services, including respite and palliative care; indicated an interest in improved communication and coordination of health information between schools and their primary health care providers; and expressed interest in augmenting school health services.

Deriving Biomass Estimation Equations for Seven Plantation Hardwood Species

Treesearch

Bryce E. Schlaegel; Harvey E. Kennedy

1986-01-01

Trees of seven species sampled from a plantation over 7 years were used to derive weight equations to predict primary tree components. The seven species required the use of five different model forms to insure the greatest precision. Regardless of model form, all equations include variables for tree diameter, tree height, age, and number of trees planted. The most...

Teaching Inquiry to High School Teachers through the Use of Mathematics Action Research Projects

ERIC Educational Resources Information Center

Miller, Nathaniel

2017-01-01

This paper describes the use of Mathematics Action Research Projects (ARPs) as a capstone experience in lieu of a Master's Thesis in a Master's program for in-service secondary teachers. The ARPs include two primary components: (i) each teacher participant conducts mathematical research that is new to them on a topic that is connected in some way…

Transforming Joint Warfighting Capabilities

DTIC Science & Technology

2004-01-01

Certification guidance covers Internet or Web compatibility and the layout to include window size, color, typography , and graphic format. Further require...developed the JMF concept, defined as a package of 20,000 personnel from designated component ready forces. It is aug- mented by supporting commands...trust and confidence in joint warfighting. PACOM established standing com- mand and control relationships for cri- sis response by designating primary

Potential Teaching Model for Applying Novel Approaches of Renewed Estonian National Curriculum into Visual Art Classes in Primary School

ERIC Educational Resources Information Center

Vahter, Edna

2015-01-01

In 2010, the renewed national curriculum was legislated in Estonia. Major changes include a new list of cross-curricular topics, increased importance of integration and specification of the components of the art learning process. In this situation, the question arises--how to fully implement the challenges of the renewed curriculum in primary…

Nutrient Content of Foods, Nutritional Supplements, and Food Fallacies. Nutrition in Primary Care Series, Number 1.

ERIC Educational Resources Information Center

Gallagher-Allred, Charlette R.; Stein, Joan Z.

Nutrition is well-recognized as a necessary component of educational programs for physicians. This is to be valued in that of all factors affecting health in the United States, none is more important than nutrition. This can be argued from various perspectives, including health promotion, disease prevention, and therapeutic management. In all…

Saturn Apollo Program

NASA Image and Video Library

1966-08-01

AS-202, the second Saturn IB launch vehicle developed by the Marshall Space Flight Center, lifts off from Cape Canaveral, Florida, August 25, 1966. Primary mission objectives included the confirmation of projected launch loads, demonstration of spacecraft component separation, and verification of heat shield adequacy at high reentry rates. In all, nine Saturn IB flights were made, ending with the Apollo-Soyuz Test Project (ASTP) in July 1975.

Development and Evolution of Agriculturally Related Merit Badges Offered by the Boy Scouts of America

ERIC Educational Resources Information Center

Terry, Robert, Jr.

2013-01-01

Badges of Merit have been a primary component of Scouting programs since the inception of the movement more than 100 years ago. The diverse range of subjects for merit badges has included 32 programs relating directly to agriculture. The focus of this historical research was to identify when agriculturally related merit badges were introduced,…

Using the ISS as a testbed to prepare for the next generation of space-based telescopes

NASA Astrophysics Data System (ADS)

Postman, Marc; Sparks, William B.; Liu, Fengchuan; Ess, Kim; Green, Joseph; Carpenter, Kenneth G.; Thronson, Harley; Goullioud, Renaud

2012-09-01

The infrastructure available on the ISS provides a unique opportunity to develop the technologies necessary to assemble large space telescopes. Assembling telescopes in space is a game-changing approach to space astronomy. Using the ISS as a testbed enables a concentration of resources on reducing the technical risks associated with integrating the technologies, such as laser metrology and wavefront sensing and control (WFS&C), with the robotic assembly of major components including very light-weight primary and secondary mirrors and the alignment of the optical elements to a diffraction-limited optical system in space. The capability to assemble the optical system and remove and replace components via the existing ISS robotic systems such as the Special Purpose Dexterous Manipulator (SPDM), or by the ISS Flight Crew, allows for future experimentation as well as repair if necessary. In 2015, first light will be obtained by the Optical Testbed and Integration on ISS eXperiment (OpTIIX), a small 1.5-meter optical telescope assembled on the ISS. The primary objectives of OpTIIX include demonstrating telescope assembly technologies and end-to-end optical system technologies that will advance future large optical telescopes.

Mineral resource of the month: germanium

USGS Publications Warehouse

Guberman, David

2010-01-01

The article provides information on germanium, an element with electrical properties between those of a metal and an insulator. Applications of germanium include its use as a component of the glass in fiber-optic cable, in infrared optics devices and as a semiconductor and substrate used in electronic and solar applications. Germanium was first isolated by German chemist Clemens Winkler in 1886 and was named after Winkler's native country. In 2008, the leading sources of primary germanium from coal or zinc include Canada, China and Russia.

Journal Clubs in Sports Medicine Fellowship Programs: Results From a National Survey and Recommendations for Quality Improvement.

PubMed

Asif, Irfan M; Wiederman, Michael; Kapur, Rahul

2017-11-01

Journal club is a pervasive component of graduate medical education, yet there is no gold standard as to format and logistics. Survey of primary care sports medicine fellowship directors in the United States. Sixty-nine program directors completed the online questionnaire (40% response rate). There were some common aspects to journal club exhibited by a majority of programs, including the general format, required attendance by fellows and expected or required attendance by faculty, the expectation that participants had at least read the article before the meeting, and that meetings occurred during the workday in the work setting without provision of food. There was considerable variation on other aspects, including the objectives of journal club, who had primary responsibility for organizing the session, the criteria for selection of articles, who was invited to attend, and the perceived problems with journal club. This is the first survey investigating the current state of journal club in primary care sports medicine fellowship programs. Several opportunities for educational enhancements exist within journal clubs in primary care sports medicine, including the use of structured tools to guide discussion, providing mechanisms to evaluate the journal club experience as a whole, inviting multidisciplinary team members (eg, statisticians) to discussions, and ensuring that objectives are explicitly stated to participants.

Rationale and study protocol for the supporting children’s outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial: A physical activity and fundamental movement skills intervention for primary schools in low-income communities

PubMed Central

2012-01-01

Background Many Australian children are insufficiently active to accrue health benefits and physical activity (PA) levels are consistently lower among youth of low socio-economic position. PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills (FMS) may serve as a protective factor against this trend. Methods/design The Supporting Children’s Outcomes Using Rewards Exercise and Skills (SCORES) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities, which will be evaluated using a group randomized controlled trial. The socio-ecological model provided a framework for the 12-month intervention, which includes the following components: teacher professional learning, student leadership workshops (including leadership accreditation and rewards, e.g., stickers, water bottles), PA policy review, PA equipment packs, parental engagement via newsletters, FMS homework and a parent evening, and community partnerships with local sporting organizations. Outcomes will be assessed at baseline, 6- and 12-months. The primary outcomes are PA (accelerometers), FMS (Test of Gross Motor Development II) and cardiorespiratory fitness (multi-stage fitness test). Secondary outcomes include body mass index [using weight (kg)/height (m2)], perceived competence, physical self-esteem, and resilience. Individual and environmental mediators of behavior change (e.g. social support and enjoyment) will also be assessed. The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons. Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored. Discussion SCORES is an innovative primary school-based PA and FMS intervention designed to support students attending schools in low-income communities to be more skilled and active. The findings from the study may be used to guide teacher pre-service education, professional learning and school policy in primary schools. Trial registration Australian New Zealand Clinical Trials Registry No: ACTRN12611001080910 PMID:22691451

Rationale and study protocol for the supporting children's outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial: a physical activity and fundamental movement skills intervention for primary schools in low-income communities.

PubMed

Lubans, David R; Morgan, Philip J; Weaver, Kristen; Callister, Robin; Dewar, Deborah L; Costigan, Sarah A; Finn, Tara L; Smith, Jordan; Upton, Lee; Plotnikoff, Ronald C

2012-06-12

Many Australian children are insufficiently active to accrue health benefits and physical activity (PA) levels are consistently lower among youth of low socio-economic position. PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills (FMS) may serve as a protective factor against this trend. The Supporting Children's Outcomes Using Rewards Exercise and Skills (SCORES) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities, which will be evaluated using a group randomized controlled trial. The socio-ecological model provided a framework for the 12-month intervention, which includes the following components: teacher professional learning, student leadership workshops (including leadership accreditation and rewards, e.g., stickers, water bottles), PA policy review, PA equipment packs, parental engagement via newsletters, FMS homework and a parent evening, and community partnerships with local sporting organizations. Outcomes will be assessed at baseline, 6- and 12-months. The primary outcomes are PA (accelerometers), FMS (Test of Gross Motor Development II) and cardiorespiratory fitness (multi-stage fitness test). Secondary outcomes include body mass index [using weight (kg)/height (m2)], perceived competence, physical self-esteem, and resilience. Individual and environmental mediators of behavior change (e.g. social support and enjoyment) will also be assessed. The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons. Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored. SCORES is an innovative primary school-based PA and FMS intervention designed to support students attending schools in low-income communities to be more skilled and active. The findings from the study may be used to guide teacher pre-service education, professional learning and school policy in primary schools. Australian New Zealand Clinical Trials Registry No: ACTRN12611001080910.

Total elbow arthroplasty for primary osteoarthritis.

PubMed

Schoch, Bradley S; Werthel, Jean-David; Sánchez-Sotelo, Joaquín; Morrey, Bernard F; Morrey, Mark

2017-08-01

Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up. Mean age at surgery was 68 years (range, 51-85 years). Outcome measures included pain, motion, Mayo Elbow Performance Score, satisfaction, complications, and reoperations. Mean follow-up was 8.9 years (range, 2-20 years). Three elbows sustained mechanical failures. Complications included intraoperative fracture (n = 2), wound irrigation and débridement (n = 1), bony ankylosis (n = 1), humeral loosening (n = 1), humeral component fracture (n = 1), and mechanical failure of a radial head component (n = 1). Fifteen elbows without mechanical failure were examined clinically. Pain improved from 3.6 to 1.5 (P < .001). Range of motion remained clinically unchanged (P > .05), with preoperative flexion contractures not improving. Mayo Elbow Performance Scores were available for 13 elbows without mechanical failure, averaging 81.5 points (range, 60-100 points); these were graded as excellent (n = 5), good (n = 2), and fair (n = 6). Subjectively, all patients without mechanical failure were satisfied. TEA represents a reliable surgical option for pain relief in patients with primary osteoarthritis. However, restoration of extension is not always obtained, indicating that more aggressive soft tissue releases or bony resection should be considered. Complications occurred in a large number of elbows, but mechanical failure was low considering the nature of this population and the length of follow-up. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Developing, delivering and evaluating primary mental health care: the co-production of a new complex intervention.

PubMed

Reeve, Joanne; Cooper, Lucy; Harrington, Sean; Rosbottom, Peter; Watkins, Jane

2016-09-06

Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care. Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes. The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed.

Sources and contents of air pollution affecting term low birth weight in Los Angeles County, California, 2001-2008.

PubMed

Laurent, Olivier; Hu, Jianlin; Li, Lianfa; Cockburn, Myles; Escobedo, Loraine; Kleeman, Michael J; Wu, Jun

2014-10-01

Low birth weight (LBW, <2500 g) has been associated with exposure to air pollution, but it is still unclear which sources or components of air pollution might be in play. The association between ultrafine particles and LBW has never been studied. To study the relationships between LBW in term born infants and exposure to particles by size fraction, source and chemical composition, and complementary components of air pollution in Los Angeles County (California, USA) over the period 2001-2008. Birth certificates (n=960,945) were geocoded to maternal residence. Primary particulate matter (PM) concentrations by source and composition were modeled. Measured fine PM, nitrogen dioxide and ozone concentrations were interpolated using empirical Bayesian kriging. Traffic indices were estimated. Associations between LBW and air pollution metrics were examined using generalized additive models, adjusting for maternal age, parity, race/ethnicity, education, neighborhood income, gestational age and infant sex. Increased LBW risks were associated with the mass of primary fine and ultrafine PM, with several major sources (especially gasoline, wood burning and commercial meat cooking) of primary PM, and chemical species in primary PM (elemental and organic carbon, potassium, iron, chromium, nickel, and titanium but not lead or arsenic). Increased LBW risks were also associated with total fine PM mass, nitrogen dioxide and local traffic indices (especially within 50 m from home), but not with ozone. Stronger associations were observed in infants born to women with low socioeconomic status, chronic hypertension, diabetes and a high body mass index. This study supports previously reported associations between traffic-related pollutants and LBW and suggests other pollution sources and components, including ultrafine particles, as possible risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

[Reconsideration of nicotine and other substance dependence: a clue from dependence-related mentation including reward, motivation, learning, delusion and hallucination toward understanding the concept of non-substance-related addiction].

PubMed

Miyata, Hisatsugu

2013-11-01

Nicotine produces core symptoms of substance dependence (craving and withdrawal) without any psychotic symptoms. The psychopharmacological structure of craving is hypothesized to be constituted by three components: the primary reinforcing property of a substance, the secondary reinforcing property of that substance (conditioned aspects of the environment, such as contextual or specific cues associated with substance taking), and the negative affective motivational property during withdrawal (i.e. the desire to avoid the dysphoric withdrawal symptoms elicits craving). Among the three components, the primary reinforcing property of a substance forms the most fundamental factor for establishing substance dependence. Sensitization or reverse tolerance observed in locomotor activity of animals, which had been believed to be a methamphetamine psychosis model, is demonstrated to reflect the establishment of conditioned reinforcement. Finally, non-substance-related addiction such as gambling, internet, and sex is discussed. From the aspect of the above hypothetical psychopharmacological structure of craving, the most significant difference between substance dependence and non-substance-related addiction is that the primary reinforcing property of non-substance reward is relatively intangible in comparison with that of a substance of abuse.

Effects of Direct Instruction and Strategy Modeling on Upper-Primary Students’ Writing Development

PubMed Central

López, Paula; Torrance, Mark; Rijlaarsdam, Gert; Fidalgo, Raquel

2017-01-01

Strategy-focused instruction is one of the most effective approaches to improve writing skills. It aims to teach developing writers strategies that give them executive control over their writing processes. Programs under this kind of instruction tend to have multiple components that include direct instruction, modeling and scaffolded practice. This multi-component nature has two drawbacks: it makes implementation challenging due to the amount of time and training required to perform each stage, and it is difficult to determine the underlying mechanisms that contribute to its effectiveness. To unpack why strategy-focused instruction is effective, we explored the specific effects of two key components: direct teaching of writing strategies and modeling of strategy use. Six classes (133 students) of upper-primary education were randomly assigned to one of the two experimental conditions, in which students received instruction aimed at developing effective strategies for planning and drafting, or control group with no strategy instruction: Direct Instruction (N = 46), Modeling (N = 45), and Control (N = 42). Writing performance was assessed before the intervention and immediately after the intervention with two tasks, one collaborative and the other one individual to explore whether differential effects resulted from students writing alone or in pairs. Writing performance was assessed through reader-based and text-based measures of text quality. Results at post-test showed similar improvement in both intervention conditions, relatively to controls, in all measures and in both the collaborative and the individual task. No statistically significant differences were observed between experimental conditions. These findings suggest that both components, direct teaching and modeling, are equally effective in improving writing skills in upper primary students, and these effects are present even after a short training. PMID:28713299

THE PHOTOMETRIC STUDY OF A NEGLECTED NEAR CONTACT BINARY: BS VULPECULAE

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

Zhu, L.-Y.; Qian, S.-B.; Zejda, M.

2012-08-15

We present a detailed study of the close eclipsing binary BS Vulpeculae. Although it is relatively bright (V: 10.9-11.6 mag) and belongs to short-periodic variable stars (P = 0.48 days), it is rather neglected. To perform a thorough period analysis, we collected all available photometric observations that span the time interval of 1898-2010. Observations include archive photographic plate measurements and visually determined eclipse minima timings done in 1979-2003, which were later shown to be biased to accommodate the existing linear ephemeris. Applying our own direct period analysis we found a well-defined shortening of the orbital period of dP/dt = -6.70(17)more » Multiplication-Sign 10{sup -11} = -2.11(6) ms yr{sup -1}, which implies a continual mass flow from the primary to the secondary component. Using the 2003 version of the Wilson-Van Hamme code, our new complete BV(IR){sub C} light curves were analyzed and the physical parameters of the system were derived. We found that BS Vul is a near contact binary system with the primary component filling its critical Roche lobe. The luminosity enhancement on the left shoulder of the secondary minimum shown in the light curves can be explained as a result of a persistent hot spot on the secondary due to the mass transfer from the primary component to the secondary one and heating the facing hemisphere of the secondary component, which is consistent with our result of period analysis. With the period decrease, BS Vul will evolve toward the contact phase. It is another good observational example as predicted by the theory of thermal relaxation oscillations.« less

Directional connectivity of resting state human fMRI data using cascaded ICA-PDC analysis.

PubMed

Silfverhuth, Minna J; Remes, Jukka; Starck, Tuomo; Nikkinen, Juha; Veijola, Juha; Tervonen, Osmo; Kiviniemi, Vesa

2011-11-01

Directional connectivity measures, such as partial directed coherence (PDC), give us means to explore effective connectivity in the human brain. By utilizing independent component analysis (ICA), the original data-set reduction was performed for further PDC analysis. To test this cascaded ICA-PDC approach in causality studies of human functional magnetic resonance imaging (fMRI) data. Resting state group data was imaged from 55 subjects using a 1.5 T scanner (TR 1800 ms, 250 volumes). Temporal concatenation group ICA in a probabilistic ICA and further repeatability runs (n = 200) were overtaken. The reduced data-set included the time series presentation of the following nine ICA components: secondary somatosensory cortex, inferior temporal gyrus, intracalcarine cortex, primary auditory cortex, amygdala, putamen and the frontal medial cortex, posterior cingulate cortex and precuneus, comprising the default mode network components. Re-normalized PDC (rPDC) values were computed to determine directional connectivity at the group level at each frequency. The integrative role was suggested for precuneus while the role of major divergence region may be proposed to primary auditory cortex and amygdala. This study demonstrates the potential of the cascaded ICA-PDC approach in directional connectivity studies of human fMRI.

Bantam System Technology Project

NASA Technical Reports Server (NTRS)

Moon, J. M.; Beveridge, J. R.

1998-01-01

This report focuses on determining a best value, low risk, low cost and highly reliable Data and Command System for support of the launch of low cost vehicles which are to carry small payloads into low earth orbit. The ground-based DCS is considered as a component of the overall ground and flight support system which includes the DCS, flight computer, mission planning system and simulator. Interfaces between the DCS and these other component systems are considered. Consideration is also given to the operational aspects of the mission and of the DCS selected. This project involved: defining requirements, defining an efficient operations concept, defining a DCS architecture which satisfies the requirements and concept, conducting a market survey of commercial and government off-the-shelf DCS candidate systems and rating the candidate systems against the requirements/concept. The primary conclusions are that several low cost, off-the-shelf DCS solutions exist and these can be employed to provide for very low cost operations and low recurring maintenance cost. The primary recommendation is that the DCS design/specification should be integrated within the ground and flight support system design as early as possible to ensure ease of interoperability and efficient allocation of automation functions among the component systems.

Cosmic Ray Interactions in Shielding Materials

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

Aguayo Navarrete, Estanislao; Kouzes, Richard T.; Ankney, Austin S.

2011-09-08

This document provides a detailed study of materials used to shield against the hadronic particles from cosmic ray showers at Earth’s surface. This work was motivated by the need for a shield that minimizes activation of the enriched germanium during transport for the MAJORANA collaboration. The materials suitable for cosmic-ray shield design are materials such as lead and iron that will stop the primary protons, and materials like polyethylene, borated polyethylene, concrete and water that will stop the induced neutrons. The interaction of the different cosmic-ray components at ground level (protons, neutrons, muons) with their wide energy range (from kilo-electronmore » volts to giga-electron volts) is a complex calculation. Monte Carlo calculations have proven to be a suitable tool for the simulation of nucleon transport, including hadron interactions and radioactive isotope production. The industry standard Monte Carlo simulation tool, Geant4, was used for this study. The result of this study is the assertion that activation at Earth’s surface is a result of the neutronic and protonic components of the cosmic-ray shower. The best material to shield against these cosmic-ray components is iron, which has the best combination of primary shielding and minimal secondary neutron production.« less

A multi-sensor remote sensing approach for measuring primary production from space

NASA Technical Reports Server (NTRS)

Gautier, Catherine

1989-01-01

It is proposed to develop a multi-sensor remote sensing method for computing marine primary productivity from space, based on the capability to measure the primary ocean variables which regulate photosynthesis. The three variables and the sensors which measure them are: (1) downwelling photosynthetically available irradiance, measured by the VISSR sensor on the GOES satellite, (2) sea-surface temperature from AVHRR on NOAA series satellites, and (3) chlorophyll-like pigment concentration from the Nimbus-7/CZCS sensor. These and other measured variables would be combined within empirical or analytical models to compute primary productivity. With this proposed capability of mapping primary productivity on a regional scale, we could begin realizing a more precise and accurate global assessment of its magnitude and variability. Applications would include supplementation and expansion on the horizontal scale of ship-acquired biological data, which is more accurate and which supplies the vertical components of the field, monitoring oceanic response to increased atmospheric carbon dioxide levels, correlation with observed sedimentation patterns and processes, and fisheries management.

Primary Care Integration of Psychiatric and Behavioral Health Services: A Primer for Providers and Case Report of Local Implementation.

PubMed

Guerrero, Anthony Ps; Takesue, Cori L; Medeiros, Jared Hn; Duran, Aileen A; Humphry, Joseph W; Lunsford, Ryan M; Shaw, Diana V; Fukuda, Michael H; Hishinuma, Earl S

2017-06-01

Mental health conditions are common, disabling, potentially life-threatening, and costly; however, they are mostly treatable with early detection and intervention. Unfortunately, mental healthcare is in significantly short supply both nationally and locally, and particularly in small, rural, and relatively isolated communities. This article provides physicians and other health practitioners with a primer on the basic rationale and principles of integrating behavioral healthcare - particularly psychiatric specialty care - in primary care settings, including effective use of teleconferencing. Referring to a local-based example, this paper describes the programmatic components (universal screening, telephone availability, mutually educational team rounds, as-needed consultations, etc) that operationalize and facilitate successful primary care integration, and illustrates how these elements are applied to population segments with differing needs for behavioral healthcare involvement. Lastly, the article discusses the potential value of primary care integration in promoting quality, accessibility, and provider retention; discusses how new developments in healthcare financing could enhance the sustainability of primary care integration models; and summarizes lessons learned.

The influence of professional values on the implementation of Aboriginal health policy.

PubMed

Lloyd, Jane; Wise, Marilyn; Weeramanthri, Tarun; Nugus, Peter

2009-01-01

This article explores the role of professional values and the culture of the Australian health care system in facilitating and constraining the implementation of an Aboriginal health policy. Thirty-five semi-structured in-depth interviews were conducted in a case study on the implementation of the Northern Territory Preventable Chronic Disease Strategy (PCDS). PCDS included three major evidence-based components - primary prevention, early detection and better management. The research revealed that PCDS changed as it was implemented. The values of the medical and nursing professions favoured the implementation of the clinically-based component of PCDS - better management. But there was dissonance between the values of these dominant professional groups and the values and expertise in public health that were necessary to implement fully the primary prevention component of PCDS. While Aboriginal health workers have valuable knowledge and skills in this area, they were not accorded sufficient power and training to influence decision-making on priorities and resources, and were able to exercise only limited influence on the components of the PCDS that were implemented. The findings highlight the role that a myriad of values play in influencing which aspects of a policy are implemented by organizations and their agents. Comprehensive and equitable implementation of policy requires an investigation and awareness of different professional values, and an examination of whose voices will be privileged in the decision-making process. If the advances in developing evidence-based, culturally-appropriate and inclusive policy are to be translated into practice, then care needs to be taken to monitor and influence whose values are being included at what point in the policy implementation process.

Geophysical Factor Resolving of Rainfall Mechanism for Super Typhoons by Using Multiple Spatiotemporal Components Analysis

NASA Astrophysics Data System (ADS)

Huang, Chien-Lin; Hsu, Nien-Sheng

2016-04-01

This study develops a novel methodology to resolve the geophysical cause of typhoon-induced rainfall considering diverse dynamic co-evolution at multiple spatiotemporal components. The multi-order hidden patterns of complex hydrological process in chaos are detected to understand the fundamental laws of rainfall mechanism. The discovered spatiotemporal features are utilized to develop a state-of-the-art descriptive statistical model for mechanism validation, modeling and further prediction during typhoons. The time series of hourly typhoon precipitation from different types of moving track, atmospheric field and landforms are respectively precede the signal analytical process to qualify each type of rainfall cause and to quantify the corresponding affected degree based on the measured geophysical atmospheric-hydrological variables. This study applies the developed methodology in Taiwan Island which is constituted by complex diverse landform formation. The identified driving-causes include: (1) cloud height to ground surface; (2) co-movement effect induced by typhoon wind field with monsoon; (3) stem capacity; (4) interaction between typhoon rain band and terrain; (5) structural intensity variance of typhoon; and (6) integrated cloudy density of rain band. Results show that: (1) for the central maximum wind speed exceeding 51 m/sec, Causes (1) and (3) are the primary ones to generate rainfall; (2) for the typhoon moving toward the direction of 155° to 175°, Cause (2) is the primary one; (3) for the direction of 90° to 155°, Cause (4) is the primary one; (4) for the typhoon passing through mountain chain which above 3500 m, Cause (5) is the primary one; and (5) for the moving speed lower than 18 km/hr, Cause (6) is the primary one. Besides, the multiple geophysical component-based precipitation modeling can achieve 81% of average accuracy and 0.732 of average correlation coefficient (CC) within average 46 hours of duration, that improve their predictability.

Neoadjuvant radiation in primary extremity liposarcoma: correlation of MRI features with histopathology.

PubMed

Wortman, Jeremy R; Tirumani, Sree Harsha; Tirumani, Harika; Shinagare, Atul B; Jagannathan, Jyothi P; Hornick, Jason L; Ramaiya, Nikhil H

2016-05-01

To evaluate MRI features of response of primary extremity liposarcoma (LPS) to neoadjuvant radiation therapy (RT) with histopathologic correlation. In this IRB-approved study including 125 patients with extremity LPS treated with neoadjuvant RT from 2000 to 2013, MRI of the primary tumour in 18 patients (5 pleomorphic LPS, 13 myxoid LPS) before and after RT were reviewed by two radiologists by consensus. Histopathology of the surgical specimens was reviewed by a pathologist with expertise in sarcomas. In the pleomorphic LPS cohort, 3/5 tumours increased in size; 3/5 decreased in enhancing component; and 3/5 increased in peritumoral oedema, intratumoral haemorrhage, and necrosis. In the myxoid LPS cohort, 12/13 tumours decreased in size, 8/13 decreased in enhancing component, and 5/13 increased in internal fat following RT. Histopathology showed ≥50% residual tumour in 1/5 pleomorphic LPS and 2/13 myxoid LPS. Hyalinization/necrosis of ≥75% was noted in 4/5 pleomorphic LPS and 11/13 myxoid LPS. Cytodifferentiation was noted in 1/5 pleomorphic and 9/13 myxoid LPS. While pleomorphic LPS showed an increase in size, peritumoral oedema, intratumoral haemorrhage, and necrosis on MRI following neoadjuvant RT, myxoid LPS showed a decrease in size and enhancement with an increase in internal fat. • Pleomorphic LPS commonly increase in size and necrosis on MRI following RT. • Myxoid LPS commonly decrease in size and enhancement on MRI following RT. • Myxoid LPS often increase in fatty component on MRI following RT.

The Role of Communities in Mental Health Care in Low- and Middle-Income Countries: A Meta-Review of Components and Competencies.

PubMed

Kohrt, Brandon A; Asher, Laura; Bhardwaj, Anvita; Fazel, Mina; Jordans, Mark J D; Mutamba, Byamah B; Nadkarni, Abhijit; Pedersen, Gloria A; Singla, Daisy R; Patel, Vikram

2018-06-16

Community-based mental health services are emphasized in the World Health Organization’s Mental Health Action Plan , the World Bank’s Disease Control Priorities , and the Action Plan of the World Psychiatric Association. There is increasing evidence for effectiveness of mental health interventions delivered by non-specialists in community platforms in low- and middle-income countries (LMIC). However, the role of community components has yet to be summarized. Our objective was to map community interventions in LMIC, identify competencies for community-based providers, and highlight research gaps. Using a review-of-reviews strategy, we identified 23 reviews for the narrative synthesis. Motivations to employ community components included greater accessibility and acceptability compared to healthcare facilities, greater clinical effectiveness through ongoing contact and use of trusted local providers, family involvement, and economic benefits. Locations included homes, schools, and refugee camps, as well as technology-aided delivery. Activities included awareness raising, psychoeducation, skills training, rehabilitation, and psychological treatments. There was substantial variation in the degree to which community components were integrated with primary care services. Addressing gaps in current practice will require assuring collaboration with service users, utilizing implementation science methods, creating tools to facilitate community services and evaluate competencies of providers, and developing standardized reporting for community-based programs.

Elevated Patient Body Mass Index Does Not Negatively Affect Self-Reported Outcomes of Thoracolumbar Surgery: Results of a Comparative Observational Study with Minimum 1-Year Follow-Up

PubMed Central

Manson, Neil A.; Green, Alana J.; Abraham, Edward P.

2015-01-01

Study Design Retrospective study. Objective Quantify the effect of obesity on elective thoracolumbar spine surgery patients. Methods Five hundred consecutive adult patients undergoing thoracolumbar spine surgery to treat degenerative pathologies with minimum follow-up of at least 1 year were included. Primary outcome measures included Numerical Rating Scales for back and leg pain, the Short Form 36 Physical Component Summary and Mental Component Summary, the modified Oswestry Disability Index, and patient satisfaction scores collected preoperatively and at 3, 6, 12, and 24 months postoperatively. Secondary outcome measures included perioperative and postoperative adverse events, postoperative emergency department presentation, hospital readmission, and revision surgeries. Patients were grouped according to World Health Organization body mass index (BMI) guidelines to isolate the effect of obesity on primary and secondary outcome measures. Results Mean BMI was 30 kg/m2, reflecting a significantly overweight population. Each BMI group reported statistically significant improvement on all self-reported outcome measures. Contrary to our hypothesis, however, there was no association between BMI group and primary outcome measures. Patients with BMI of 35 to 39.99 visited the emergency department with complaints of pain significantly more often than the other groups. Otherwise, we did not detect any differences in the secondary outcome measures between BMI groups. Conclusions Patients of all levels of obesity experienced significant improvement following elective thoracolumbar spine surgery. These outcomes were achieved without increased risk of postoperative complications such as infection and reoperation. A risk–benefit algorithm to assist with surgical decision making for obese patients would be valuable to surgeons and patients alike. PMID:26933611

Primary care interventions and current service innovations in modifying long-term outcomes after stroke: a protocol for a scoping review.

PubMed

Pindus, Dominika M; Lim, Lisa; Rundell, A Viona; Hobbs, Victoria; Aziz, Noorazah Abd; Mullis, Ricky; Mant, Jonathan

2016-10-24

Interventions delivered by primary and/or community care have the potential to reach the majority of stroke survivors and carers and offer ongoing support. However, an integrative account emerging from the reviews of interventions addressing specific long-term outcomes after stroke is lacking. The aims of the proposed scoping review are to provide an overview of: (1) primary care and community healthcare interventions by generalist healthcare professionals to stroke survivors and/or their informal carers to address long-term outcomes after stroke, (2) the scope and characteristics of interventions which were successful in addressing long-term outcomes, and (3) developments in current clinical practice. Studies that focused on adult community dwelling stroke survivors and informal carers were included. Academic electronic databases will be searched to identify reviews of randomised controlled trials (RCTs) and controlled trials, trials from the past 5 years; reviews of observational studies. Practice exemplars from grey literature will be identified through advanced Google search. Reports, guidelines and other documents of major health organisations, clinical professional bodies, and stroke charities in the UK and internationally will be included. Two reviewers will independently screen titles, abstracts and full texts for inclusion of published literature. One reviewer will screen search results from the grey literature and identify relevant documents for inclusion. Data synthesis will include analysis of the number, type of studies, year and country of publication, a summary of intervention components/service or practice, outcomes addressed, main results (an indicator of effectiveness) and a description of included interventions. The review will help identify components of care and care pathways for primary care services for stroke. By comparing the results with stroke survivors' and carers' needs identified in the literature, the review will highlight potential gaps in research and practice relevant to long-term care after stroke. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cradle-to-Gate Impact Assessment of a High-Pressure Die-Casting Safety-Relevant Automotive Component

NASA Astrophysics Data System (ADS)

Cecchel, Silvia; Cornacchia, Giovanna; Panvini, Andrea

2016-09-01

The mass of automotive components has a direct influence on several aspects of vehicle performance, including both fuel consumption and tailpipe emissions, but the real environmental benefit has to be evaluated considering the entire life of the products with a proper life cycle assessment. In this context, the present paper analyzes the environmental burden connected to the production of a safety-relevant aluminum high-pressure die-casting component for commercial vehicles (a suspension cross-beam) considering all the phases connected to its manufacture. The focus on aluminum high-pressure die casting reflects the current trend of the industry and its high energy consumption. This work shows a new method that deeply analyzes every single step of the component's production through the implementation of a wide database of primary data collected thanks to collaborations of some automotive supplier companies. This energy analysis shows significant environmental benefits of aluminum recycling.

Christodoulou Memory of GW150914 - Prospects of Detection in LIGO and Future Detectors

NASA Astrophysics Data System (ADS)

Johnson, Aaron; Kapadia, Shasvath; Kennefick, Daniel

2017-01-01

The event GW150914 produced strains of the order 10-21 in the two instruments comprising the Laser Interferometric Gravitational Wave Observatory (LIGO). The event has been interpreted as originating in a coalescing black hole binary, with individual components of about 30 solar masses each. A striking aspect of the coalescence deduced from the signal is the emission of 3 solar masses of energy in the oscillating gravitational wave. Theory predicts a DC component of the gravitational signal associated with the emission of such large amounts of gravitational wave energy known as the Christodoulou memory. The memory, as a non-linear component of the signal, is expected to be an order of magnitude smaller than the amplitude of the primary AC component of the gravitational waves. We discuss the prospects of detecting the Christodoulou memory in similar future signals, both with LIGO and with other detectors, including future space-based instruments.

Kinematic principles of primate rotational vestibulo-ocular reflex. II. Gravity-dependent modulation of primary eye position

NASA Technical Reports Server (NTRS)

Hess, B. J.; Angelaki, D. E.

1997-01-01

The kinematic constraints of three-dimensional eye positions were investigated in rhesus monkeys during passive head and body rotations relative to gravity. We studied fast and slow phase components of the vestibulo-ocular reflex (VOR) elicited by constant-velocity yaw rotations and sinusoidal oscillations about an earth-horizontal axis. We found that the spatial orientation of both fast and slow phase eye positions could be described locally by a planar surface with torsional variation of <2.0 +/- 0.4 degrees (displacement planes) that systematically rotated and/or shifted relative to Listing's plane. In supine/prone positions, displacement planes pitched forward/backward; in left/right ear-down positions, displacement planes were parallel shifted along the positive/negative torsional axis. Dynamically changing primary eye positions were computed from displacement planes. Torsional and vertical components of primary eye position modulated as a sinusoidal function of head orientation in space. The torsional component was maximal in ear-down positions and approximately zero in supine/prone orientations. The opposite was observed for the vertical component. Modulation of the horizontal component of primary eye position exhibited a more complex dependence. In contrast to the torsional component, which was relatively independent of rotational speed, modulation of the vertical and horizontal components of primary position depended strongly on the speed of head rotation (i.e., on the frequency of oscillation of the gravity vector component): the faster the head rotated relative to gravity, the larger was the modulation. Corresponding results were obtained when a model based on a sinusoidal dependence of instantaneous displacement planes (and primary eye position) on head orientation relative to gravity was fitted to VOR fast phase positions. When VOR fast phase positions were expressed relative to primary eye position estimated from the model fits, they were confined approximately to a single plane with a small torsional standard deviation ( approximately 1.4-2.6 degrees). This reduced torsional variation was in contrast to the large torsional spread (well >10-15 degrees ) of fast phase positions when expressed relative to Listing's plane. We conclude that primary eye position depends dynamically on head orientation relative to space rather than being fixed to the head. It defines a gravity-dependent coordinate system relative to which the torsional variability of eye positions is minimized even when the head is moved passively and vestibulo-ocular reflexes are evoked. In this general sense, Listing's law is preserved with respect to an otolith-controlled reference system that is defined dynamically by gravity.

Effectiveness of differing levels of support for family meals on obesity prevention among head start preschoolers: the simply dinner study.

PubMed

Brophy-Herb, Holly E; Horodynski, Mildred; Contreras, Dawn; Kerver, Jean; Kaciroti, Niko; Stein, Mara; Lee, Hannah Jong; Motz, Brittany; Hebert, Sheilah; Prine, Erika; Gardiner, Candace; Van Egeren, Laurie A; Lumeng, Julie C

2017-02-10

Despite slight decreases in obesity prevalence in children, nearly 25% of preschool-aged children are overweight or obese. Most interventions focused on promoting family meals as an obesity-prevention strategy target meal planning skills, knowledge and modeling of healthy eating without addressing the practical resources that enable implementation of family meals. There is a striking lack of evidence about what level of resources low-income parents need to implement family meals. This study will identify resources most effective in promoting family meals and, subsequently, test associations among the frequency of family meals, dietary quality and children's adiposity indices among children enrolled in Head Start. The Multiphase Optimization Strategy, employed in this study, is a cutting-edge approach to maximizing resources in behavioral interventions by identifying the most effective intervention components. We are currently testing the main, additive and interactive effects of 6 intervention components, thought to support family meals, on family meal frequency and dietary quality (Primary Outcomes) as compared to Usual Head Start Exposure in a Screening Phase (N = 512 low-income families). Components yielding the most robust effects will be bundled and evaluated in a two-group randomized controlled trial (intervention and Usual Head Start Exposure) in the Confirming Phase (N = 250), testing the effects of the bundled intervention on children's adiposity indices (Primary Outcomes; body mass index and skinfolds). The current intervention components include: (1) home delivery of pre-made healthy family meals; (2) home delivery of healthy meal ingredients; (3) community kitchens in which parents make healthy meals to cook at home; (4) healthy eating classes; (5) cooking demonstrations; and (6) cookware/flatware delivery. Secondary outcomes include cooking self-efficacy and family mealtime barriers. Moderators of the intervention include family functioning and food security. Process evaluation data includes fidelity, attendance/use of supports, and satisfaction. Results will advance fundamental science and translational research by generating new knowledge of effective intervention components more rapidly and efficiently than the standard randomized controlled trial approach evaluating a bundled intervention alone. Study results will have implications for funding decisions within public programs to implement and disseminate effective interventions to prevent obesity in children. Clincaltrials.gov Identifier NCT02487251 ; Registered June 26, 2015.

Comparison of soft tissue balancing, femoral component rotation, and joint line change between the gap balancing and measured resection techniques in primary total knee arthroplasty

PubMed Central

Moon, Young-Wan; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Park, Chan-Deok; Lee, Dae-Hee

2016-01-01

Abstract Background: This meta-analysis was designed to compare the accuracy of soft tissue balancing and femoral component rotation as well as change in joint line positions, between the measured resection and gap balancing techniques in primary total knee arthroplasty. Methods: Studies were included in the meta-analysis if they compared soft tissue balancing and/or radiologic outcomes in patients who underwent total knee arthroplasty with the gap balancing and measured resection techniques. Comparisons included differences in flexion/extension, medial/lateral flexion, and medial/lateral extension gaps (LEGs), femoral component rotation, and change in joint line positions. Finally, 8 studies identified via electronic (MEDLINE, EMBASE, and the Cochrane Library) and manual searches were included. All 8 studies showed a low risk of selection bias and provided detailed demographic data. There was some inherent heterogeneity due to uncontrolled bias, because all included studies were observational comparison studies. Results: The pooled mean difference in gap differences between the gap balancing and measured resection techniques did not differ significantly (−0.09 mm, 95% confidence interval [CI]: −0.40 to +0.21 mm; P = 0.55), except that the medial/LEG difference was 0.58 mm greater for measured resection than gap balancing (95% CI: −1.01 to −0.15 mm; P = 0.008). Conversely, the pooled mean difference in femoral component external rotation (0.77°, 95% CI: 0.18° to 1.35°; P = 0.01) and joint line change (1.17 mm, 95% CI: 0.82 to 1.52 mm; P < 0.001) were significantly greater for the gap balancing than the measured resection technique. Conclusion: The gap balancing and measured resection techniques showed similar soft tissue balancing, except for medial/LEG difference. However, the femoral component was more externally rotated and the joint line was more elevated with gap balancing than measured resection. These differences were minimal (around 1 mm or 1°) and therefore may have little effect on the biomechanics of the knee joint. This suggests that the gap balancing and measured resection techniques are not mutually exclusive. PMID:27684862

Prevalence of dental caries in primary and permanent teeth and its relation with tooth brushing habits among schoolchildren in Eastern Saudi Arabia

PubMed Central

Farooqi, Faraz A.; Khabeer, Abdul; Moheet, Imran A.; Khan, Soban Q.; Farooq, Imran; ArRejaie, Aws S.,

2015-01-01

Objectives: To determine the prevalence of dental caries in the primary and permanent teeth, and evaluate the brushing habits of school children in Dammam, Kingdom of Saudi Arabia (KSA). Methods: This study was conducted at Dammam, KSA. Oral examination of the participants was conducted from February to May 2014. The total sample size for this cross-sectional study was 711. There were 397 children between the age of 6-9 years, who were examined for primary teeth caries, and 314 between the age 10-12 years were examined for permanent teeth caries. Primary and permanent dentitions were studied for decayed, missing, and filled teeth (dmft [primary teeth], DMFT [permanent teeth]). Results: The overall prevalence of dental caries in primary and permanent teeth was almost 73% (n=711). Among the 6-9-year-old, the prevalence of caries was approximately 78% (n=397) whereas, among the 10-12-year-old children, it was approximately 68% (n=314). Mean dmft value among the 6-9-year-olds was 3.66±3.13 with decayed (d) component of 3.28±2.92, missing (m) component of 0.11±0.69, and filled (f) component of 0.26±0.9. Mean DMFT value among the 10-12-year-old children was 1.94±2.0 with decayed (D) component of 1.76±1.85, missing (M) component of 0.03±0.22, and filled (F) of component 0.15±0.73. Daily tooth brushing had a positive effect on caries prevention, and this effect was statistically significant for caries in primary teeth. Conclusion: Although the prevalence of dental caries in primary and permanent teeth was not found to be as high as other researchers reported from different cities of KSA, still the prevalence was high considering the World Health Organization future oral health goals. Awareness should be provided to students, as well as, teachers and parents regarding the importance of good brushing habits and regular dental visits. PMID:25987118

Prevalence of dental caries in primary and permanent teeth and its relation with tooth brushing habits among schoolchildren in Eastern Saudi Arabia‬‬‬‬‬‬‬‬.

PubMed

Farooqi, Faraz A; Khabeer, Abdul; Moheet, Imran A; Khan, Soban Q; Farooq, Imran; ArRejaie, Aws S

2015-06-01

To determine the prevalence of dental caries in the primary and permanent teeth, and evaluate the brushing habits of school children in Dammam, Kingdom of Saudi Arabia (KSA).  Methods. This study was conducted at Dammam, KSA. Oral examination of the participants was conducted from February to May 2014. The total sample size for this cross-sectional study was 711. There were 397 children between the age of 6-9 years, who were examined for primary teeth caries, and 314 between the age 10-12 years were examined for permanent teeth caries. Primary and permanent dentitions were studied for decayed, missing, and filled teeth (dmft [primary teeth], DMFT [permanent teeth]).   The overall prevalence of dental caries in primary and permanent teeth was almost 73% (n=711). Among the 6-9-year-old, the prevalence of caries was approximately 78% (n=397) whereas, among the 10-12-year-old children, it was approximately 68% (n=314). Mean dmft value among the 6-9-year-olds was 3.66±3.13 with decayed (d) component of 3.28±2.92, missing (m) component of 0.11±0.69, and filled (f) component of 0.26±0.9. Mean DMFT value among the 10-12-year-old children was 1.94±2.0 with decayed (D) component of 1.76±1.85, missing (M) component of 0.03±0.22, and filled (F) of component 0.15±0.73. Daily tooth brushing had a positive effect on caries prevention, and this effect was statistically significant for caries in primary teeth.   Although the prevalence of dental caries in primary and permanent teeth was not found to be as high as other researchers reported from different cities of KSA, still the prevalence was high considering the World Health Organization future oral health goals. Awareness should be provided to students, as well as, teachers and parents regarding the importance of good brushing habits and regular dental visits.

Model aerodynamic test results for two variable cycle engine coannular exhaust systems at simulated takeoff and cruise conditions. Comprehensive data report. Volume 3: Graphical data book 1

NASA Technical Reports Server (NTRS)

Nelson, D. P.

1981-01-01

A graphical presentation of the aerodynamic data acquired during coannular nozzle performance wind tunnel tests is given. The graphical data consist of plots of nozzle gross thrust coefficient, fan nozzle discharge coefficient, and primary nozzle discharge coefficient. Normalized model component static pressure distributions are presented as a function of primary total pressure, fan total pressure, and ambient static pressure for selected operating conditions. In addition, the supersonic cruise configuration data include plots of nozzle efficiency and secondary-to-fan total pressure pumping characteristics. Supersonic and subsonic cruise data are given.

Primary sources of PM2.5 organic aerosol in an industrial Mediterranean city, Marseille

NASA Astrophysics Data System (ADS)

El Haddad, I.; Marchand, N.; Wortham, H.; Piot, C.; Besombes, J.-L.; Cozic, J.; Chauvel, C.; Armengaud, A.; Robin, D.; Jaffrezo, J.-L.

2010-11-01

Marseille, the most important port of the Mediterranean Sea, represents a challenging case study for source apportionment exercises, combining an active photochemistry and multiple emission sources, including fugitive emissions from industrial sources and shipping. This paper presents a Chemical Mass Balance (CMB) approach based on organic markers and metals to apportion the primary sources of organic aerosol in Marseille, with a special focus on industrial emissions. Overall, the CMB model accounts for the major primary anthropogenic sources including motor vehicles, biomass burning, and the aggregate emissions from three industrial processes (HFO combustion/shipping, coke production and steel manufacturing) as well as some primary biogenic emissions. This source apportionment exercise is well corroborated by 14C measurements. Primary OC estimated by the CMB accounts on average for 22% and is dominated by the vehicular emissions that contribute on average for 17% of OC mass concentration (17% of PM2.5). Even though, industrial emissions contribute for only 2.3% of the total OC (7% of PM2.5), they are associated with ultrafine particles (Dp<80 nm) and high concentrations of Polycyclic Aromatic Hydrocarbons (PAH) and heavy metals such as Pb, Ni and V. On one hand, given that industrial emissions governed key primary markers, their omission would lead to substantial uncertainties in the CMB analysis performed in areas heavily impacted by such sources, hindering accurate estimation of non-industrial primary sources and secondary sources. This result implies that CMB modelling should not be a straightforward exercise and one have to carefully investigate the marker behaviours and trends beforehand, especially in complex environments such as Marseille. On the other hand, being associated with bursts of submicron particles and carcinogenic and mutagenic components such as PAH, these emissions are most likely related with acute health outcomes and should be regulated despite their small contributions to OC. Another important result is the fact that 78% of OC mass cannot be attributed to the major primary sources and thus remains un-apportioned. We have consequently critically investigated the uncertainties underlying our CMB apportionments. While we have provided some evidence for photochemical decay of hopanes, this decay does not appear to significantly alter the CMB estimates of the total primary OC. Sampling artefacts and unaccounted primary sources also appear to marginally influence the amount of un-apportioned OC. Therefore, this significant amount of un-apportioned OC is mostly attributed to secondary organic carbon that appears to be the major component of OC, during the whole period of study.

Tracking the Key Constituents of Concern of the WTP LAW Stream

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

Mabrouki, Ridha B.; Matlack, Keith S.; Abramowitz, Howard

The testing results presented in the present report were also obtained on a DM10 melter system operated with the primary WTP LAW offgas system components with recycle, as specified in the statement of work (SOW) [6] and detailed in the Test Plan for this work [7]. The primary offgas system components include the SBS, the WESP, and a recycle system that allows recycle of liquid effluents back to the melter, as in the present baseline for the WTP LAW vitrification. The partitioning of technetium and other key constituents between the glass waste form, the offgas system liquid effluents, the offgasmore » stream that exits the WESP, and the liquid condensate from the vacuum evaporator were quantified in this work. The tests employed three different LAW streams spanning a range of waste compositions anticipated for WTP. Modifications to the offgas system and operational strategy were made to expedite the approach to steady state concentrations of key constituents in the glass and offgas effluent solutions during each test.« less

IKONOS imagery for the Large Scale Biosphere–Atmosphere Experiment in Amazonia (LBA).

Treesearch

George Hurtt; Xiangming Xiao; Michael Keller; Michael Palace; Gregory P. Asner; Rob Braswell; Brond& #305; Eduardo S. zio; Manoel Cardoso; Claudio J.R. Carvalho; Matthew G. Fearon; Liane Guild; Steve Hagen; Scott Hetrick; Berrien Moore III; Carlos Nobre; Jane M. Read; S& aacute; Tatiana NO-VALUE; Annette Schloss; George Vourlitis; Albertus J. Wickel

2003-01-01

The LBA-ECO program is one of several international research components under the Brazilian-led Large Scale Biosphere–Atmosphere Experiment in Amazonia (LBA). The field-oriented research activities of this study are organized along transects and include a set of primary field sites, where the major objective is to study land-use change and ecosystem dynamics, and a...

Team Performance and Risk-Adjusted Health Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

ERIC Educational Resources Information Center

Mukamel, Dana B.; Temkin-Greener, Helena; Delavan, Rachel; Peterson, Derick R.; Gross, Diane; Kunitz, Stephen; Williams, T. Franklin

2006-01-01

Purpose: The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program providing primary, acute, and long-term care to frail elderly individuals. A central component of the PACE model is the interdisciplinary care team, which includes both professionals and non-professionals. The purpose of this study was to examine the…

Low Temperature Fluorination of Aerosol Suspensions of Hydrocarbons Utilizing Elemental Fluorine.

DTIC Science & Technology

1982-09-01

admitting boron trifluoride into the aerosol direct florination of neopentane. The aerosol direct fluorination of ketones indicates the carbonyl group...fluorination of molecules with primary, secondary and tertiary hydro- gens is also included as is the effect of admitting boron trifluoride into the...significantly different physical and chemical properties than either of their components. For example, both ammonia and boron trifluoride are low

Electronic Collection Management and Electronic Information Services

DTIC Science & Technology

2003-04-01

compilation report, use: ADA415655 The component part is provided here to allow users access to individually authored sections f proceedings, annals...providers or as brokers between the user and the primary service provider. There has also been a significant reorientation from concept of "ownership...access. It will also look at the major trends in electronic user services including electronic information delivery and electronic reference. Finally, it

Evapotranspiration of a Mid-Rotation Loblolly Pine Plantation and a Recently Harvested Stands on the Coastal Plain of North Carolina, U.S.A.

Treesearch

W. Cao; Ge Sun; Steve G. McNulty; J. Chen; A. Noormets; R. W. Skaggs; Devendra M. Amatya

2006-01-01

Evapotranspiration (ET) is the primary component of the forest hydrologic cycle, which includes plant transpiration, canopy rainfall interception, and soil evaporation. Quantifying ET processes and potential biophysical regulations is needed for assessing forest water management options. Loblolly pines are widely planted in the coastal plain of the Southeastern US, but...

Visual Characterization of VX Droplets on Plant Foliage

DTIC Science & Technology

2016-07-01

epicuticular waxes, which are complex lipophilic mixtures of primarily long-chain aliphatics, including primary alcohols (n-alkan-1-ols), aldehydes, fatty...2006). Trichomes act in a complex way relative to spread of herbicide solution and sorption of herbicide. Trichomes may cause reduced wetting and...Bicellular trichomes discharge a mucilage-type secretion that contains callose, a carbohydrate component (1,3-glucan) usually associated with “walling

Effectiveness of a Time-Limited Incentive on Participation by Hard-to-Reach Respondents in a Panel Study

ERIC Educational Resources Information Center

Fomby, Paula; Sastry, Narayan; McGonagle, Katherine A.

2017-01-01

We describe an experiment to provide a time-limited incentive among a random sample of 594 hard-to-reach respondents, 200 of whom were offered the incentive to complete all survey components of a study during a three-week winter holiday period. Sample members were primary caregivers of children included in the 2014 Child Development Supplement to…

GEMINI-TITAN (GT)-9 - MOCKUP - ADAPTER EQUIPMENT SECTION - FUEL CELL - MSC

NASA Image and Video Library

1966-03-01

S66-22686 (March 1966) --- Mock-up of the adapter equipment section to be used on the Gemini-9 spaceflight. This section provides volume and attach points for several system modules, including Orbit Attitude Maneuver System, Environmental Control System primary oxygen supply, batteries, coolant, and electrical and electric components. This section will also hold the Astronaut Maneuvering Unit (AMU) backpack (center). Photo credit: NASA

Primary Prevention Efforts: How Do We Implement and Monitor the Tier 1 Component of Our Comprehensive, Integrated, Three-Tiered (CI3T) Model?

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Magill, Lauren

2014-01-01

In this article, the authors clarify the role of the leadership team, providing a rationale for one integrated team to examine academic, social, and behavioral programming, with careful attention to including all key stakeholders. Next, the authors discuss the procedures for teaching all key stakeholders the comprehensive, integrated, three-tiered…

Analysis of radiation risk from alpha particle component of solar particle events

NASA Technical Reports Server (NTRS)

Cucinotta, F. A.; Townsend, L. W.; Wilson, J. W.; Golightly, M. J.; Weyland, M.

1994-01-01

The solar particle events (SPE) will contain a primary alpha particle component, representing a possible increase in the potential risk to astronauts during an SPE over the often studied proton component. We discuss the physical interactions of alpha particles important in describing the transport of these particles through spacecraft and body shielding. Models of light ion reactions are presented and their effects on energy and linear energy transfer (LET) spectra in shielding discussed. We present predictions of particle spectra, dose, and dose equivalent in organs of interest for SPE spectra typical of those occurring in recent solar cycles. The large events of solar cycle 19 are found to have substantial increase in biological risk from alpha particles, including a large increase in secondary neutron production from alpha particle breakup.

Greater Success of Primary Fascial Closure of the Open Abdomen: A Retrospective Study Analyzing Applied Surgical Techniques, Success of Fascial Closure, and Variables Affecting the Results.

PubMed

Kääriäinen, M; Kuuskeri, M; Helminen, M; Kuokkanen, H

2017-06-01

The open abdomen technique is a standard procedure in the treatment of intra-abdominal catastrophe. Achieving primary abdominal closure within the initial hospitalization is a main objective. This study aimed to analyze the success of closure rate and the effect of negative pressure wound therapy, mesh-mediated medial traction, and component separation on the results. We present the treatment algorithm used in our institution in open abdomen situations based on these findings. Open abdomen patients (n = 61) treated in Tampere University Hospital from May 2005 until October 2013 were included in the study. Patient characteristics, treatment prior to closure, closure technique, and results were retrospectively collected and analyzed. The first group included patients in whom direct or bridged fascial closure was achieved, and the second group included those in whom only the skin was closed or a free skin graft was used. Background variables and variables related to surgery were compared between groups. Most of the open abdomen patients (72.1%) underwent fascial defect repair during the primary hospitalization, and 70.5% of them underwent direct fascial closure. Negative pressure wound therapy was used as a temporary closure method for 86.9% of the patients. Negative pressure wound therapy combined with mesh-mediated medial traction resulted in the shortest open abdomen time (p = 0.039) and the highest fascial repair rate (p = 0.000) compared to negative pressure wound therapy only or no negative pressure wound therapy. The component separation technique was used for 11 patients; direct fascial closure was achieved in 5 and fascial repair by bridging the defect with mesh was achieved in 6. A total of 8 of 37 (21.6%) patients with mesh repair had a mesh infection. The negative pressure wound therapy combined with mesh-mediated medial traction promotes definitive fascial closure with a high closure rate and a shortened open abdomen time. The component separation technique can be used to facilitate fascial repair but it does not guarantee direct fascial closure in open abdomen patients.

Compression Strength of Composite Primary Structural Components

NASA Technical Reports Server (NTRS)

Johnson, Eric R.; Starnes, James H., Jr. (Technical Monitor)

2000-01-01

The focus of research activities under NASA Grant NAG-1-2035 was the response and failure of thin-walled structural components. The research is applicable to the primary load carrying structure of flight vehicles, with particular emphasis on fuselage and wing'structure. Analyses and tests were performed that are applicable to the following structural components an aft pressure bulkhead, or a composite pressure dome, pressure cabin damage containment, and fuselage frames subject to crash-type loads.

Primary mental health prevention themes in published research and academic programs in Israel.

PubMed

Nakash, Ora; Razon, Liat; Levav, Itzhak

2015-01-01

The World Health Organization Comprehensive Mental Health Action Plan (CMHAP) 2013-2020 proposes the implementation of primary prevention strategies to reduce the mental health burden of disease. The extent to which Israeli academic programs and published research adhere to the principles spelled out by the CMHAP is unknown. To investigate the presence of mental health primary prevention themes in published research and academic programs in Israel. We searched for mental health primary prevention themes in: (1) three major journals of psychiatry and social sciences during the years 2001-2012; (2) university graduate programs in psychology, social work and medicine in leading universities for the academic year of 2011-2012; and (3) doctoral and master's theses approved in psychology and social work departments in five universities between the years 2007-2012. We used a liberal definition of primary prevention to guide the above identification of themes, including those related to theory, methods or research information of direct or indirect application in practice. Of the 934 articles published in the three journals, 7.2%, n = 67, addressed primary prevention. Of the 899 courses in the 19 graduate programs 5.2%, n = 47, elective courses addressed primary prevention. Of the 1960 approved doctoral and master's theses 6.2%, n = 123, addressed primary prevention. Only 11 (4.7%) articles, 5 (0.6%) courses, and 5 (0.3%) doctoral and master's theses addressed primary prevention directly. The psychiatric reform currently implemented in Israel and WHO CMHAP call for novel policies and course of action in all levels of prevention, including primary prevention. Yet, the latter is rarely a component of mental health education and research activities. The baseline we drew could serve to evaluate future progress in the field.

Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial

PubMed Central

2014-01-01

Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected. PMID:24589291

Recall initiation strategies must be controlled in training studies that use immediate free recall tasks to measure the components of working memory capacity across time.

PubMed

Gibson, Bradley S; Gondoli, Dawn M; Johnson, Ann C; Robison, Matthew K

2014-01-01

There has been great interest in using working memory (WM) training regimens as an alternative treatment for ADHD, but it has recently been concluded that existing training regimens may not be optimally designed because they target the primary memory component but not the secondary component of WM capacity. This conclusion requires the ability to accurately measure changes in primary and secondary memory abilities over time. The immediate free recall task has been used in previous studies to measure these changes; however, one concern with these tasks is that the recall order required on training exercises may influence the recall strategy used during free recall, which may in turn influence the relative number of items recalled from primary and secondary memory. To address this issue, previous training studies have explicitly controlled recall strategy before and after training. However, the necessity of controlling for recall strategies has not been explicitly tested. The present study investigated the effects of forward-serial-order training on free recall performance under conditions in which recall strategy was not controlled using a sample of adolescents with ADHD. Unlike when recall order was controlled, the main findings showed selective improvement of the secondary memory component (as opposed to the primary memory component) when recall order was uncontrolled. This finding advances our understanding of WM training by highlighting the importance of controlling for recall strategies when free recall tasks are used to measure changes in the primary and secondary components of WM across time.

USGS Tampa Bay Pilot Study

USGS Publications Warehouse

Yates, K.K.; Cronin, T. M.; Crane, M.; Hansen, M.; Nayeghandi, A.; Swarzenski, P.; Edgar, T.; Brooks, G.R.; Suthard, B.; Hine, A.; Locker, S.; Willard, D.A.; Hastings, D.; Flower, B.; Hollander, D.; Larson, R.A.; Smith, K.

2007-01-01

Providing a web-based digital information management system of information for scientists and the public, including a system that supports the work of those officials who must make decisions that affect the state of the bay. The Tampa Bay Study is in its sixth year and will continue through September 2007. This paper presents a non-inclusive summary of key findings associated with the six primary project components listed above. Component 4 (above) is described in detail in the following chapter 13. More information on the Tampa Bay Study is available from our on-line digital information system for the Tampa Bay Study at http://gulfsci.usgs.gov.

The New Absolute Parameters of OU Gem - The Star of BY Dra Type

NASA Astrophysics Data System (ADS)

Mishenina, T. V.; Glazunova, L. V.; Soubiran, C.; Kovtyukh, V. V.

2010-12-01

The spectra of OU Gem were obtained with the fiber-fed echelle spectrograph SOPHIE at the 1.93-m telescope of the Observatoire de Haute- Provence (France). The temperatures of components of the system were defined and are equal to 5013 ± 15 K and 4486±50 K for primary (A) and secondary (B) components, accordingly. The rotation velocity of components are measured: for primary component it is equal to 5.1±1 km/s and 6.2 ± km/s for the secondary one. The definition of radial velocities of components by LSD profile method and redetermination of spectral orbital elements were carried out. New absolute parameters of components were obtained too.

Use of a shorter humeral stem in revision reverse shoulder arthroplasty.

PubMed

Wagner, Eric R; Statz, Joseph M; Houdek, Matthew T; Cofield, Robert H; Sánchez-Sotelo, Joaquín; Sperling, John W

2017-08-01

The purpose of this study was to examine the outcomes of revision reverse arthroplasty using short bone-preserving humeral components in revising a long-stemmed component. During a 7-year period, 39 patients who underwent revision reverse shoulder arthroplasty using the long to short humeral component technique were included. The mean age was 72 years. Prior implants used in the primary setting included anatomic (n = 26), hemiarthroplasty (n = 11), and reverse (n = 2). At a follow-up of 3 years (2-5), 5 shoulders (13%) required revision surgery, including 1 for a periprosthetic humerus fracture and 4 for glenoid component loosening. The survival free of revision for any reason and revision for humeral disease was 84% and 94%, respectively. One patient experienced a nondisplaced greater tuberosity fracture at 18 months postoperatively that healed without operative intervention. There were no dislocations or infections. Overall, patients experienced excellent overall improvements in their pain levels and shoulder motion (P < .001), with a postoperative 91% satisfaction rate as well as postoperative American Shoulder and Elbow Surgeons score of 68 and Simple Shoulder Test score of 6.7. At most recent radiographic follow-up, 1 (5%) patient had grade 3 humeral lucency. Preserving bone stock through conversion to a shorter reverse humeral stem in the revision setting is a reasonable option with good short- to intermediate-term results and low rates of humeral complications. Using the shorter stem components provides adequate stability and high rates of humeral component ingrowth. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Primary Care Clinic Re-Design for Prescription Opioid Management.

PubMed

Parchman, Michael L; Von Korff, Michael; Baldwin, Laura-Mae; Stephens, Mark; Ike, Brooke; Cromp, DeAnn; Hsu, Clarissa; Wagner, Ed H

The challenge of responding to prescription opioid overuse within the United States has fallen disproportionately on the primary care clinic setting. Here we describe a framework comprised of 6 Building Blocks to guide efforts within this setting to address the use of opioids for chronic pain. Investigators conducted site visits to thirty primary care clinics across the United States selected for their use of team-based workforce innovations. Site visits included interviews with leadership, clinic tours, observations of clinic processes and team meetings, and interviews with staff and clinicians. Data were reviewed to identify common attributes of clinic system changes around chronic opioid therapy (COT) management. These concepts were reviewed to develop narrative descriptions of key components of changes made to improve COT use. Twenty of the thirty sites had addressed improvements in COT prescribing. Across these sites a common set of 6 Building Blocks were identified: 1) providing leadership support; 2) revising and aligning clinic policies, patient agreements (contracts) and workflows; 3) implementing a registry tracking system; 4) conducting planned, patient-centered visits; 5) identifying resources for complex patients; and 6) measuring progress toward achieving clinic objectives. Common components of clinic policies, patient agreements and data tracked in registries to assess progress are described. In response to prescription opioid overuse and the resulting epidemic of overdose and addiction, primary care clinics are making improvements driven by a common set of best practices that address complex challenges of managing COT patients in primary care settings. © Copyright 2017 by the American Board of Family Medicine.

Judicious use of custom development in an open source component architecture

NASA Astrophysics Data System (ADS)

Bristol, S.; Latysh, N.; Long, D.; Tekell, S.; Allen, J.

2014-12-01

Modern software engineering is not as much programming from scratch as innovative assembly of existing components. Seamlessly integrating disparate components into scalable, performant architecture requires sound engineering craftsmanship and can often result in increased cost efficiency and accelerated capabilities if software teams focus their creativity on the edges of the problem space. ScienceBase is part of the U.S. Geological Survey scientific cyberinfrastructure, providing data and information management, distribution services, and analysis capabilities in a way that strives to follow this pattern. ScienceBase leverages open source NoSQL and relational databases, search indexing technology, spatial service engines, numerous libraries, and one proprietary but necessary software component in its architecture. The primary engineering focus is cohesive component interaction, including construction of a seamless Application Programming Interface (API) across all elements. The API allows researchers and software developers alike to leverage the infrastructure in unique, creative ways. Scaling the ScienceBase architecture and core API with increasing data volume (more databases) and complexity (integrated science problems) is a primary challenge addressed by judicious use of custom development in the component architecture. Other data management and informatics activities in the earth sciences have independently resolved to a similar design of reusing and building upon established technology and are working through similar issues for managing and developing information (e.g., U.S. Geoscience Information Network; NASA's Earth Observing System Clearing House; GSToRE at the University of New Mexico). Recent discussions facilitated through the Earth Science Information Partners are exploring potential avenues to exploit the implicit relationships between similar projects for explicit gains in our ability to more rapidly advance global scientific cyberinfrastructure.

Location, Location, Location: Eye-Tracking Evidence that Consumers Preferentially View Prominently Positioned Nutrition Information

PubMed Central

Graham, Dan J.; Jeffery, Robert W.

2012-01-01

Background Nutrition Facts labels can keep consumers better informed about their diets' nutritional composition, however, consumers currently do not understand these labels well or use them often. Thus, modifying existing labels may benefit public health. Objective The present study tracked the visual attention of individuals making simulated food-purchasing decisions to assess Nutrition Facts label viewing. Primary research questions were how self-reported viewing of Nutrition Facts labels and their components relates to measured viewing and whether locations of labels and specific label components relate to viewing. Design The study involved a simulated grocery shopping exercise conducted on a computer equipped with an eye-tracking camera. A post-task survey assessed self-reported nutrition information viewing, health behaviors, and demographics. Subjects/setting Individuals 18 years old and older and capable of reading English words on a computer (n=203) completed the 1-hour protocol at the University of Minnesota during Spring 2010. Statistical analyses Primary analyses included χ2, analysis of variance, and t tests comparing self-reported and measured viewing of label components in different presentation configurations. Results Self-reported viewing of Nutrition Facts label components was higher than objectively measured viewing. Label components at the top of the label were viewed more than those at the bottom, and labels positioned in the center of the screen were viewed more than those located on the sides. Conclusions Nutrition Facts label position within a viewing area and position of specific components on a label relate to viewing. Eye tracking is a valuable technology for evaluating consumers' attention to nutrition information, informing nutrition labeling policy (eg, front-of-pack labels), and designing labels that best support healthy dietary decisions. PMID:22027053

Hydrogeologic setting, ground-water flow, and ground-water quality at the Lake Wheeler Road research station, 2001-03 : North Carolina Piedmont and Mountains Resource Evaluation Program

USGS Publications Warehouse

Chapman, Melinda J.; Bolich, Richard E.; Huffman, Brad A.

2005-01-01

Results of a 2-year field study of the regolith-fractured bedrock ground-water system at the Lake Wheeler Road research station in Wake County, North Carolina, indicate both disconnection and interaction among components of the ground-water system. The three components of the ground-water system include (1) shallow, porous regolith; (2) a transition zone, including partially weathered rock, having both secondary (fractures) and primary porosity; and (3) deeper, fractured bedrock that has little, if any, primary porosity and is dominated by secondary fractures. The research station includes 15 wells (including a well transect from topographic high to low settings) completed in the three major components of the ground-water-flow system and a surface-water gaging station on an unnamed tributary. The Lake Wheeler Road research station is considered representative of a felsic gneiss hydrogeologic unit having steeply dipping foliation and a relatively thick overlying regolith. Bedrock foliation generally strikes N. 10? E. to N. 30? E. and N. 20? W. to N. 40? W. to a depth of about 400 feet and dips between 70? and 80? SE. and NE., respectively. From 400 to 600 feet, the foliation generally strikes N. 70? E. to N. 80? E., dipping 70? to 80? SE. Depth to bedrock locally ranges from about 67 to 77 feet below land surface. Fractures in the bedrock generally occur in two primary sets: low dip angle, stress relief fractures that cross cut foliation, and steeply dipping fractures parallel to foliation. Findings of this study generally support the conceptual models of ground-water flow from high to low topographic settings developed for the Piedmont and Blue Ridge Provinces in previous investigations, but are considered a refinement of the generalized conceptual model based on a detailed local-scale investigation. Ground water flows toward a surface-water boundary, and hydraulic gradients generally are downward in recharge areas and upward in discharge areas; however, local variations in vertical gradients are apparent. Water-quality sampling and monitoring efforts were conducted to characterize the interaction of components of the ground-water system. Elevated nitrate concentrations as high as 22 milligrams per liter were detected in shallow ground water from the regolith at the study site. These elevated nitrate concentrations likely are related to land use, which includes agricultural practices that involve animal feeding operations and crop fertilization. Continuous ground-water-quality data indicate seasonal fluctuations in field water-quality properties, differences with respect to depth, and fluctuations during recharge events. Water-quality properties recorded in the regolith well following rainfall indicate the upwelling of deeper ground water in the discharge area, likely from ground water in the transition-zone fractures. Additionally, interaction with a surface-water boundary appears likely in the ground-water discharge area, as water levels in all three ground-water zones, including the deep bedrock, mimic the surface-water rise during rainfall.

Longitudinal Evaluation of Sleep-Disordered Breathing and Sleep Symptoms with Change in Quality of Life: The Sleep Heart Health Study (SHHS)

PubMed Central

Silva, Graciela E.; An, Ming-Wen; Goodwin, James L.; Shahar, Eyal; Redline, Susan; Resnick, Helaine; Baldwin, Carol M.; Quan, Stuart F.

2009-01-01

Study Objectives: Findings from population studies evaluating the progression and incidence of sleep disordered breathing have shown evidence of a longitudinal increase in the severity of sleep disordered breathing. The present study evaluates the association among changes in sleep disordered breathing, sleep symptoms, and quality of life over time. Design: Prospective cohort study. Data were from the Sleep Heart Health Study. Setting: Multicenter study. Participants: Three thousand seventy-eight subjects aged 40 years and older from the baseline and follow-up examination cycles were included. Measurements: The primary outcomes were changes in the Physical Component Summary and Mental Component Summary scales obtained from the Medical Outcomes Study Short-Form Health Survey. The primary exposure was change in the respiratory disturbance index obtained from unattended overnight polysomnograms performed approximately 5 years apart. Other covariates included measures of excessive daytime sleepiness and difficulty initiating and maintaining sleep. Results: Mean respiratory disturbance index increased from 8.1 ± 11 SD at baseline to 10.9 ± 14 (P < 0.0001) at follow-up. The mean Physical Component Summary and Mental Component Summary scores were 48.5 and 54.1 at baseline and 46.3 and 54.8 at follow-up. No associations between change in respiratory disturbance index and changes in Physical Component Summary or Mental Component Summary scores were seen. However, worsening of difficulty initiating and maintaining sleep and excessive daytime sleepiness were significantly associated with lower quality of life. Conclusions: A slight increase in severity of sleep disordered breathing was seen over 5 years; this was not associated with worsening of quality of life. However, subjective symptoms of quality of sleep and daytime sleepiness were associated with declining quality of life. Citation: Silva GE; An MW; Goodwin JL; Shahar E; Redline S; Resnick H; Baldwin CM; Quan SF. Longitudinal evaluation of sleep-disordered breathing and sleep symptoms with change in quality of life: the Sleep Heart Health Study (SHHS). SLEEP 2009;32(8):1049-1057. PMID:19725256

Development of a filter regeneration system for advanced spacecraft fluid systems

NASA Technical Reports Server (NTRS)

Behrend, A. F., Jr.; Descamp, V. A.

1974-01-01

The development of a filter regeneration system for efficiently cleaning fluid particulate filters is presented. Based on a backflush/jet impingement technique, the regeneration system demonstrated a cleaning efficiency of 98.7 to 100%. The operating principles and design features are discussed with emphasis on the primary system components that include a regenerable filter, vortex particle separator, and zero-g particle trap. Techniques and equipment used for ground and zero-g performance tests are described. Test results and conclusions, as well as possible areas for commercial application, are included.

Use of Switchgrass as the Primary Potting Component in Nursery Containers

USDA-ARS?s Scientific Manuscript database

Pine bark is the primary potting component for nursery containers in Ohio and other Upper Midwest states. Most pine bark comes from lumber or paper mills in southern states. Due to the recent energy crisis, availability of pine bark has declined while the cost to import pine bark from southern sta...

Revisiting the utility of technical performance scores following tetralogy of Fallot repair.

PubMed

Lodin, Daud; Mavrothalassitis, Orestes; Haberer, Kim; Sunderji, Sherzana; Quek, Ruben G W; Peyvandi, Shabnam; Moon-Grady, Anita; Karamlou, Tara

2017-08-01

Although an important quality metric, current technical performance scores may not be generalizable and may omit operative factors that influence outcomes. We examined factors not included in current technical performance scores that may contribute to increased postoperative length of stay, major complications, and cost after primary repair of tetralogy of Fallot. This is a retrospective single site study of patients younger than age 2 years with tetralogy of Fallot undergoing complete repair between 2007 and 2015. Medical record data and discharge echocardiograms were reviewed to ascertain component and composite technical performance scores. Primary outcomes included postoperative length of stay, major complications, and total hospital costs. Multivariable logistic and linear regression identified determinants of each outcome. Patient population (n = 115) had a median postoperative length of stay of 8 days (interquartile range, 6-10 days), and a median total cost of $71,147. Major complications occurred in 33 patients (29%) with 1 death. Technical performance scores assigned were optimum in 28 patients (25%), adequate in 59 patients (52%), and inadequate in 26 patients (23%). Neither technical performance score components nor composite scores were associated with increased postoperative length of stay. Optimum or adequate repairs versus inadequate had equal risk of a complication (P = .79), and equivalent mean total cost ($100,000 vs $187,000; P = .25). Longer cardiopulmonary bypass time per 1-minute increase (P < .01) was associated with longer postoperative length of stay and reintervention (P = .02). The need to return to bypass also increased total cost (P < .01). Current tetralogy of Fallot technical performance scores were not associated with selected outcomes in our postoperative population. Although returning to bypass and bypass length are not included as components in the current score, these are important factors influencing complications and resource use in our population. Revisions anticipated from a prospective trial should consider including these variables. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

RACLETTE: a model for evaluating the thermal response of plasma facing components to slow high power plasma transients. Part I: Theory and description of model capabilities

NASA Astrophysics Data System (ADS)

Raffray, A. René; Federici, Gianfranco

1997-04-01

RACLETTE (Rate Analysis Code for pLasma Energy Transfer Transient Evaluation), a comprehensive but relatively simple and versatile model, was developed to help in the design analysis of plasma facing components (PFCs) under 'slow' high power transients, such as those associated with plasma vertical displacement events. The model includes all the key surface heat transfer processes such as evaporation, melting, and radiation, and their interaction with the PFC block thermal response and the coolant behaviour. This paper represents part I of two sister and complementary papers. It covers the model description, calibration and validation, and presents a number of parametric analyses shedding light on and identifying trends in the PFC armour block response to high plasma energy deposition transients. Parameters investigated include the plasma energy density and deposition time, the armour thickness and the presence of vapour shielding effects. Part II of the paper focuses on specific design analyses of ITER plasma facing components (divertor, limiter, primary first wall and baffle), including improvements in the thermal-hydraulic modeling required for better understanding the consequences of high energy deposition transients in particular for the ITER limiter case.

Tmproving the Consult Management Process at David Grant Medical Center

DTIC Science & Technology

1998-08-01

and the regional referral facility for the DoD Health Services Region 10 in Northern California. It offers most major medical, surgical , and dental...services (Payne, 1987). The primary components of UM include pre -certification, concurrent and retrospective review, case management, and discharge...6-13. O’Brien, K., McComb, J., Fox, N., Beam, D., & Wright, J. (1996). Do dentists refer orthodontic patients inappropriately. British Dental

Alkali Metal Heat Pipe Life Issues

NASA Technical Reports Server (NTRS)

Reid, Robert S.

2004-01-01

One approach to space fission power system design is predicated on the use of alkali metal heat pipes, either as radiator elements, thermal management components, or as part of the core primary heat-transfer system. This synopsis characterizes long-life core heat pipes. References are included where more detailed information can be found. Specifics shown here are for demonstrational purposes and do not necessarily reflect current Project Prometheus point designs.

Command and General Staff College CrossFit Study 2010

DTIC Science & Technology

2010-05-30

program includes four primary components: functional fitness, performance nutrition , sports medicine and mental toughness. The perceived importance of...over the course of a week and athletes were given at least one day of recovery between assessments. Each assessment had prescribed weights to lift or... recovery for athletes during the week, especially in the first two weeks of the program. For this reason, the training plan specifically sought to avoid

The Evolving Relations of Japan and India

DTIC Science & Technology

2014-12-01

Does it Affect Us?,” Malaysia Chronicle, December 22, 2013, http://www.malaysia- chronicle.com/index.php?option=com_k2&view=item&id=201131:chinese... food industries” while Japan’s primary exports have been machinery components like boilers, marine products, jewels, and iron and steel.147 These areas...that time, Japan has been seeking alternative sources of rare earth metals, including India, Australia, Kazakhstan, and Malaysia with the intention of

Ceramic Matrix Composite (CMC) Thermal Protection Systems (TPS) and Hot Structures for Hypersonic Vehicles

NASA Technical Reports Server (NTRS)

Glass, David E.

2008-01-01

Thermal protection systems (TPS) and hot structures are required for a range of hypersonic vehicles ranging from ballistic reentry to hypersonic cruise vehicles, both within Earth's atmosphere and non-Earth atmospheres. The focus of this paper is on air breathing hypersonic vehicles in the Earth's atmosphere. This includes single-stage to orbit (SSTO), two-stage to orbit (TSTO) accelerators, access to space vehicles, and hypersonic cruise vehicles. This paper will start out with a brief discussion of aerodynamic heating and thermal management techniques to address the high heating, followed by an overview of TPS for rocket-launched and air-breathing vehicles. The argument is presented that as we move from rocket-based vehicles to air-breathing vehicles, we need to move away from the insulated airplane approach used on the Space Shuttle Orbiter to a wide range of TPS and hot structure approaches. The primary portion of the paper will discuss issues and design options for CMC TPS and hot structure components, including leading edges, acreage TPS, and control surfaces. The current state-of-the-art will be briefly discussed for some of the components. The two primary technical challenges impacting the use of CMC TPS and hot structures for hypersonic vehicles are environmental durability and fabrication, and will be discussed briefly.

KENNEDY SPACE CENTER, FLA. - Members of the STS-114 crew take a look at the Japanese Experiment Module (JEM) pressure module in the Space Station Processing Facility. A research laboratory, the pressurized module is the first element of the JEM, named "Kibo" (Hope), to be delivered to KSC. The National Space Development Agency of Japan (NASDA) developed the laboratory at the Tsukuba Space Center near Tokyo and is Japan's primary contribution to the Station. The JEM also includes an exposed facility (platform) for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

NASA Image and Video Library

2003-06-09

KENNEDY SPACE CENTER, FLA. - Members of the STS-114 crew take a look at the Japanese Experiment Module (JEM) pressure module in the Space Station Processing Facility. A research laboratory, the pressurized module is the first element of the JEM, named "Kibo" (Hope), to be delivered to KSC. The National Space Development Agency of Japan (NASDA) developed the laboratory at the Tsukuba Space Center near Tokyo and is Japan's primary contribution to the Station. The JEM also includes an exposed facility (platform) for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

Primary Phase Field of the Pb-Doped 2223 High-Tc Superconductor in the (Bi, Pb)-Sr-Ca-Cu-O System

PubMed Central

Wong-Ng, W.; Cook, L. P.; Kearsley, A.; Greenwood, W.

1999-01-01

Both liquidus and subsolidus phase equilibrium data are of central importance for applications of high temperature superconductors in the (Bi, Pb)-Sr-Ca-Cu-O system, including material synthesis, melt processing and single crystal growth. The subsolidus equilibria of the 110 K high-Tc Pb-doped 2223 ([Bi, Pb], Sr, Ca, Cu) phase and the location of the primary phase field (crystallization field) have been determined in this study. For the quantitative determination of liquidus data, a wicking technique was developed to capture the melt for quantitative microchemical analysis. A total of 29 five-phase volumes that include the 2223 phase as a component was obtained. The initial melt compositions of these volumes range from a mole fraction of 7.3 % to 28.0 % for Bi, 11.3 % to 27.8 % for Sr, 1.2 % to 19.4 % for Pb, 9.8 % to 30.8 % for Ca, and 17.1 % to 47.0 % for Cu. Based on these data, the crystallization field for the 2223 phase was constructed using the convex hull technique. A section of this “volume” was obtained by holding two components of the composition at the median value, allowing projection on the other three axes to show the extent of the field.

Using program impact pathways to understand and improve program delivery, utilization, and potential for impact of Helen Keller International's homestead food production program in Cambodia.

PubMed

Olney, Deanna K; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

2013-06-01

Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to understand why these programs, which have been successful in increasing intake of micronutrient-rich foods, have had such limited documented impact on nutrition outcomes. To conduct a process evaluation of Helen Keller International's (HKI's) homestead food production program in Cambodia to assess whether the program was operating as planned (in terms of design, delivery, and utilization) and to identify ways in which the program might need to be strengthened in order to increase its potential for impact. A program theory framework, which laid out the primary components along the hypothesized program impact pathways, was developed in collaboration with HKI and used to design the research. Semistructured interviews and focus group discussions with program beneficiaries (n = 36 and 12, respectively), nonbeneficiaries (n = 12), and program implementers (n = 17 and 2, respectively) and observations of key program delivery points, including health and nutrition training sessions (n = 6), village model farms (n = 6), and household gardens of beneficiaries (n = 36) and nonbeneficiaries (n = 12), were conducted to assess the delivery and utilization of the primary program components along the impact pathways. The majority of program components were being delivered and utilized as planned. However, challenges with some of the key components posited to improve outcomes such as anemia and growth were noted. Among these were a gap in the expected pathway from poultry production to increased intake of eggs and poultry meat, and some weaknesses in the delivery of the health and nutrition training sessions and related improvements in knowledge among the village health volunteers and beneficiaries. Although the program has been successful in delivering the majority of the program components as planned and has documented achievements in improving household production and intake of micronutrient-rich foods, it is likely that strengthening delivery and increasing utilization of some program components would increase its potential for nutritional impacts. This research has highlighted the importance of designing a program theory framework and assessing the components that lie along the primary program impact pathways to optimize program service delivery and utilization and, in turn, potential for impact.

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

PubMed Central

Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

2018-01-01

Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and surgeons in identifying the best practices to implement in the surgical care of TKA and THA patients. PMID:29468091

Conceptual studies for a mercury target circuit

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

Sigg, B.

1996-06-01

For the now favored target design of the European Spallation Source project, i.e. the version using mercury as target material, a basic concept of the primary system has been worked out. It does not include a detailed design of the various components of the target circuit, but tries to outline a feasible solution for the system. Besides the removal of the thermal power of about 3MW produced in the target by the proton beam, the primary system has to satisfy a number of other requirements related to processing, safety, and operation. The basic proposal uses an electromagnetic pump and amore » mercury-water intermediate heat excanger, but other alternatives are also being discussed. Basic safety requirements, i.e. protection against radiation and toxic mercury vapours, are satisfied by a design using an air-tight primary system containment, double-walled tubes in the intermediate heat exchanger, a fail-safe system for decay heat removal, and a remote handling facility for the active part of the system. Much engineering work has still to be done, because many details of the design of the mercury and gas processing systems remain to be clarified, the thermal-hydraulic components need further optimisation, the system for control and instrumentation is only known in outline and a through safety analysis will be required.« less

Verification of the Polish Geodetic Reference Frame by Means of a New Solution Based on Permanent GNSS Data from the Years 2011-2014

NASA Astrophysics Data System (ADS)

Liwosz, T.; Ryczywolski, M.

2016-12-01

The new solution for the Polish geodetic primary GNSS network was created to verify the currently used reference frame (PL-ETRF2000). The new solution is based on more GNSS data (more daily observation sessions included, a longer data timespan, GLONASS observations added) which were processed in a newer reference frame (IGb08) according to up-to-date methodology and using the latest version of Bernese GNSS Software. The new long-term solution (spanning 3.7 years) was aligned to the IGb08 reference frame using a minimum constraints approach. We categorized Polish reference stations into two categories according to their data length. We obtained good agreement of the new solution with the PL-ETRF2000: for most stations position differences did not exceed 5 mm in horizontal, and 10 mm in vertical components. However, for 30 stations we observed discontinuities in position time series, mostly due to GNSS equipment changes, which occured after the introduction of PL-ETRF2000. Position changes due to the discontinuities reached 9.1 mm in horizontal components, and 26.9 mm in vertical components. The new solution takes into account position discontinuities, and in addition also includes six new stations which were installed after the introduction of the PL-ETRF2000. Therefore, we propose to update the currently-used reference frame for the Polish geodetic primary network (PL-ETRF2000) with the new solution. The new solution was also accepted by the EUREF Technical Working Group as a class A solution (highest accuracy) according to EUREF standards.

Advanced nozzle and engine components test facility

NASA Technical Reports Server (NTRS)

Beltran, Luis R.; Delroso, Richard L.; Delrosario, Ruben

1992-01-01

A test facility for conducting scaled advanced nozzle and engine component research is described. The CE-22 test facility, located in the Engine Research Building of the NASA Lewis Research Center, contains many systems for the economical testing of advanced scale-model nozzles and engine components. The combustion air and altitude exhaust systems are described. Combustion air can be supplied to a model up to 40 psig for primary air flow, and 40, 125, and 450 psig for secondary air flow. Altitude exhaust can be simulated up to 48,000 ft, or the exhaust can be atmospheric. Descriptions of the multiaxis thrust stand, a color schlieren flow visualization system used for qualitative flow analysis, a labyrinth flow measurement system, a data acquisition system, and auxiliary systems are discussed. Model recommended design information and temperature and pressure instrumentation recommendations are included.

Metabolic Syndrome as a Cardiovascular Disease Risk Factor: Patients Evaluated in Primary Care

PubMed Central

Cabré, Joan-Josep; Martín, Francisco; Costa, Bernardo; Piñol, Josep L; Llor, Josep L; Ortega, Yolanda; Basora, Josep; Baldrich, Marta; Solà, Rosa; Daniel, Jordi; Hernández, Josep Ma; Saumell, Judit; Bladé, Jordi; Sagarra, Ramon; Basora, Teresa; Montañés, Dolors; Frigola, Joan L; Donado-Mazarrón, Angel; García-Vidal, Maria Teresa; Sánchez-Oro, Isabel; de Magriñà, Josep M; Urbaneja, Ana; Barrio, Francisco; Vizcaíno, Jesús; Sabaté, Josep M; Pascual, Irene; Revuelta, Vanesa

2008-01-01

To estimate the prevalence of metabolic syndrome (MS) in a population receiving attention in primary care centers (PCC) we selected a random cohort of ostensibly normal subjects from the registers of 5 basic-health area (BHA) PCC. Diagnosis of MS was with the WHO, NCEP and IDF criteria. Variables recorded were: socio-demographic data, CVD risk factors including lipids, obesity, diabetes, blood pressure and smoking habit and a glucose tolerance test outcome. Of the 720 individuals selected (age 60.3 ± 11.5 years), 431 were female, 352 hypertensive, 142 diabetic, 233 pre-diabetic, 285 obese, 209 dyslipemic and 106 smokers. CVD risk according to the Framingham and REGICOR calculation was 13.8 ± 10% and 8.8 ± 9.8%, respectively. Using the WHO, NCEP and IDF criteria, MS was diagnosed in 166, 210 and 252 subjects, respectively and the relative risk of CVD complications in MS subjects was 2.56. Logistic regression analysis indicated that the MS components (WHO set), the MS components (IDF set) and the female gender had an increased odds ratio for CVD of 3.48 (95CI%: 2.26–5.37), 2.28 (95%CI: 1.84–4.90) and 2.26 (95%CI: 1.48–3.47), respectively. We conclude that MS and concomitant CVD risk is high in ostensibly normal population attending primary care clinics, and this would necessarily impinge on resource allocation in primary care. PMID:18647383

Evaluation of coated columbium alloy heat shields for space shuttle thermal protection system application. Volume 3, phase 3: Full size TPS evaluation

NASA Technical Reports Server (NTRS)

Baer, J. W.; Black, W. E.

1974-01-01

The thermal protection system (TPS), designed for incorporation with space shuttle orbiter systems, consists of one primary heat shield thermally and structurally isolated from the test fixture by eight peripheral guard panels, all encompassing an area of approximately 12 sq ft. TPS components include tee-stiffened Cb 752/R-512E heat shields, bi-metallic support posts, panel retainers, and high temperature insulation blankets. The vehicle primary structure was simulated by a titanium skin, frames, and stiffeners. Test procedures, manufacturing processes, and methods of analysis are fully documented. For Vol. 1, see N72-30948; for Vol. 2, see N74-15660.

Primary Ovarian Insufficiency: X chromosome defects and autoimmunity.

PubMed

Persani, Luca; Rossetti, Raffaella; Cacciatore, Chiara; Bonomi, Marco

2009-08-01

Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche or premature depletion of ovarian follicles before the age of 40 years. However, in several instances the distinction between definitive or intermittent POF may be difficult on clinical bases, therefore the more appropriate term Primary Ovarian Insufficiency (POI) has been recently proposed and will be used in this review. POI is a heterogeneous disorder affecting approximately 1% of women <40 years. The most severe forms present with absent pubertal development and primary amenorrhea, whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with a defective folliculogenesis. POI is generally characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Heterogeneity of POI is reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. Several data indicate that POI has a strong genetic component. In this manuscript we discuss the X chromosome abnormalities that are associated with POI.

Revision total hip arthroplasty: the femoral side using cemented implants.

PubMed

Holt, Graeme; Hook, Samantha; Hubble, Matthew

2011-02-01

Advances in surgical technique and implant technology have improved the ten-year survival after primary total hip arthroplasty (THA). Despite this, the number of revision procedures has been increasing in recent years, a trend which is predicted to continue into the future. Revision THA is a technically demanding procedure often complicated by a loss of host bone stock which may be compounded by the need to remove primary implants. Both cemented and uncemented implant designs are commonly used in the United Kingdom for primary and revision THA and much controversy still exists as to the ideal method of stem fixation. In this article we discuss revision of the femur using cemented components during revision THA. We focus on three clinical scenarios including femoral cement-in-cement revision where the primary femoral cement-bone interface remains well fixed, femoral cement-in-cement revision for peri-prosthetic femoral fractures, and femoral impaction grafting. We discuss the clinical indications, surgical techniques and clinical outcomes for each of these procedures.

An in-depth study of a teacher engaged in an innovative primary science trial professional development project

NASA Astrophysics Data System (ADS)

Watters, James J.; Ginns, Ian S.

1997-03-01

The implementation of effective science programmes in primary schools is of continuing interest and concern for professional developers. As part of the Australian Academy of science's approach to creating an awareness of Primary Investigations, a project team trialed a series of satellite television broadcasts of lessons related to two units of the curriculum for Year 3 and 4 children in 48 participating schools. The professional development project entitled Simply Science, included a focused component for the respective classroom teachers, which was also conducted by satellite. This paper reports the involvement of a Year 4 teacher in the project and describes her professional growth. Already an experienced and confident teacher, no quantitative changes in science teaching self efficacy were detected. However, her pedagogical content knowledge and confidence to teach science in the concept areas of matter and energy were enhanced. Changes in the teacher's views about the co-operative learning strategies espoused by Primary Investigations were also evident. Implications for the design of professional development programmes for primary science teachers are discussed.

Facilitators and barriers of implementing the chronic care model in primary care: a systematic review.

PubMed

Kadu, Mudathira K; Stolee, Paul

2015-02-06

The Chronic Care Model (CCM) is a framework developed to redesign care delivery for individuals living with chronic diseases in primary care. The CCM and its various components have been widely adopted and evaluated, however, little is known about different primary care experiences with its implementation, and the factors that influence its successful uptake. The purpose of this review is to synthesize findings of studies that implemented the CCM in primary care, in order to identify facilitators and barriers encountered during implementation. This study identified English-language, peer-reviewed research articles, describing the CCM in primary care settings. Searches were performed in three data bases: Web of Knowledge, Pubmed and Scopus. Article abstracts and titles were read based on whether they met the following inclusion criteria: 1) studies published after 2003 that described or evaluated the implementation of the CCM; 2) the care setting was primary care; 3) the target population of the study was adults over the age of 18 with chronic conditions. Studies were categorized by reference, study design and methods, participants and setting, study objective, CCM components used, and description of the intervention. The next stage of data abstraction involved qualitative analysis of cited barriers and facilitators using the Consolidating Framework for Research Implementation. This review identified barriers and facilitators of implementation across various primary care settings in 22 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation and characteristics of the individual healthcare providers. These included: organizational culture, its structural characteristics, networks and communication, implementation climate and readiness, presence of supportive leadership, and provider attitudes and beliefs. These findings highlight the importance of assessing organizational capacity and needs prior to and during the implementation of the CCM, as well as gaining a better understanding of health care providers' and organizational perspective.

Primary Surface Particle Motion as a Mechanism for YORP-Driven Binary Asteroid Evolution

NASA Astrophysics Data System (ADS)

Fahnestock, Eugene G.; Scheeres, D. J.

2008-09-01

Within the largest class of binary asteroid systems -- asynchronous binaries typified by 1999 KW4 -- we hypothesize continued YORP spin-up of the rapidly rotating primary leads to recurring episodic lofting motion of primary equator regolith. We theorize this is a mechanism for transporting YORP-injected angular momentum from primary spin into the mutual orbit. This both enables binary primaries to continue to spin at near surface fission rates and produces continued orbit expansion on time scales several times faster than expansion predicted by tidal dissipation alone. This is distinct from the Binary Yorp (BYORP) phenomenon, not studied in this work but to be added to it later. We evaluate our hypotheses using a combination of techniques for an example binary system. First high-fidelity dynamic simulation of surface-originating particles in the full-detail gravity field of the binary components, themselves propagated according to the full two body problem, gives particle final disposition (return impact, transfer impact, escape). Trajectory end states found for regolith lofted at different initial primary spin rates and relative poses are collected into probability matrices, allowing probabilistic propagation of surface particles for long durations at low computational cost. We track changes to mass, inertia dyad, rotation state, and centroid position and velocity for each component in response to this mapped particle motion. This allows tracking of primary, secondary, and mutual orbit angular momenta over time, clearly demonstrating the angular momentum transfer mechanism and validating our hypotheses. We present current orbit expansion rates and estimated orbit size doubling times consistent with this mechanism, for a few binary systems. We also discuss ramifications of this type of rapid binary evolution towards separation, including the frequency with which "divorced binaries" on similar heliocentric orbits are produced, formation of triple systems such as 2001 SN263, and separation timescale dependence on heliocentric distance.

Perspectives of primary health care staff on the implementation of a sexual health quality improvement program: a qualitative study in remote aboriginal communities in Australia.

PubMed

Hengel, Belinda; Bell, Stephen; Garton, Linda; Ward, James; Rumbold, Alice; Taylor-Thomson, Debbie; Silver, Bronwyn; McGregor, Skye; Dyda, Amalie; Knox, Janet; Guy, Rebecca; Maher, Lisa; Kaldor, John Martin

2018-04-02

Young people living in remote Australian Aboriginal communities experience high rates of sexually transmissible infections (STIs). STRIVE (STIs in Remote communities, ImproVed and Enhanced primary care) was a cluster randomised control trial of a sexual health continuous quality improvement (CQI) program. As part of the trial, qualitative research was conducted to explore staff perceptions of the CQI components, their normalisation and integration into routine practice, and the factors which influenced these processes. In-depth semi-structured interviews were conducted with 41 clinical staff at 22 remote community clinics during 2011-2013. Normalisation process theory was used to frame the analysis of interview data and to provide insights into enablers and barriers to the integration and normalisation of the CQI program and its six specific components. Of the CQI components, participants reported that the clinical data reports had the highest degree of integration and normalisation. Action plan setting, the Systems Assessment Tool, and the STRIVE coordinator role, were perceived as adding value to the program, but were less readily integrated or normalised. The remaining two components (dedicated funding for health promotion and service incentive payments) were seen as least relevant. Our analysis also highlighted factors which enabled greater integration of the CQI components. These included familiarity with CQI tools, increased accountability of health centre staff and the translation of the CQI program into guideline-driven care. The analysis also identified barriers, including high staff turnover, limited time involved in the program and competing clinical demands and programs. Across all of the CQI components, the clinical data reports had the highest degree of integration and normalisation. The action plans, systems assessment tool and the STRIVE coordinator role all complemented the data reports and allowed these components to be translated directly into clinical activity. To ensure their uptake, CQI programs must acknowledge local clinical guidelines, be compatible with translation into clinical activity and have managerial support. Sexual health CQI needs to align with other CQI activities, engage staff and promote accountability through the provision of clinic specific data and regular face-to-face meetings. Australian and New Zealand Clinical Trials Registry ACTRN12610000358044 . Registered 6/05/2010. Prospectively Registered.

Healthy urban environments for children and young people: A systematic review of intervention studies.

PubMed

Audrey, Suzanne; Batista-Ferrer, Harriet

2015-11-01

This systematic review collates, and presents as a narrative synthesis, evidence from interventions which included changes to the urban environment and reported at least one health behaviour or outcome for children and young people. Following a comprehensive search of six databases, 33 primary studies relating to 27 urban environment interventions were included. The majority of interventions related to active travel. Others included park and playground renovations, road traffic safety, and multi-component community-based initiatives. Public health evidence for effectiveness of such interventions is often weak because study designs tend to be opportunistic, non-randomised, use subjective outcome measures, and do not incorporate follow-up of study participants. However, there is some evidence of potential health benefits to children and young people from urban environment interventions relating to road safety and active travel, with evidence of promise for a multi-component obesity prevention initiative. Future research requires more robust study designs incorporating objective outcome measures. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Summary of Numerous Strain-Gage Load Calibrations on Aircraft Wings and Tails in a Technological Format

NASA Technical Reports Server (NTRS)

Jenkins, Jerald M.; DeAngelis, V. Michael

1997-01-01

Fifteen aircraft structures that were calibrated for flight loads using strain gages are examined. The primary purpose of this paper is to document important examples of load calibrations on airplanes during the past four decades. The emphasis is placed on studying the physical procedures of calibrating strain-gaged structures and all the supporting analyses and computational techniques that have been used. The results and experiences obtained from actual data from 14 structures (on 13 airplanes and 1 laboratory test structure) are presented. This group of structures includes fins, tails, and wings with a wide variety of aspect ratios. Straight- wing, swept-wing, and delta-wing configurations are studied. Some of the structures have skin-dominant construction; others are spar-dominant. Anisotropic materials, heat shields, corrugated components, nonorthogonal primary structures, and truss-type structures are particular characteristics that are included.

Survivorship analysis of failure pattern after revision total hip arthroplasty.

PubMed

Retpen, J B; Varmarken, J E; Jensen, J S

1989-12-01

Failure, defined as established indication for or performed re-revision of one or both components, was analyzed using survivorship methods in 306 revision total hip arthroplasties. The longevity of revision total hip arthroplasties was inferior to that of previously reported primary total hip arthroplasties. The overall survival curve was two-phased, with a late failure period associated with aseptic loosening of one or both components and an early failure period associated with causes of failure other than loosening. Separate survival curves for aseptic loosening of femoral and acetabular components showed late and almost simultaneous decline, but with a tendency toward a higher rate of failure for the femoral component. No differences in survival could be found between the Stanmore, Lubinus standard, and Lubinus long-stemmed femoral components. A short interval between the index operation and the revision and intraoperative and postoperative complications were risk factors for early failure. Young age was a risk factor for aseptic loosening of the femoral component. Intraoperative fracture of the femoral shaft was not a risk factor for secondary loosening. No difference in survival was found between primary cemented total arthroplasty and primary noncemented hemiarthroplasty.

Downhole tool

DOEpatents

Hall, David R.; Muradov, Andrei; Pixton, David S.; Dahlgren, Scott Steven; Briscoe, Michael A.

2007-03-20

A double shouldered downhole tool connection comprises box and pin connections having mating threads intermediate mating primary and secondary shoulders. The connection further comprises a secondary shoulder component retained in the box connection intermediate a floating component and the primary shoulders. The secondary shoulder component and the pin connection cooperate to transfer a portion of makeup load to the box connection. The downhole tool may be selected from the group consisting of drill pipe, drill collars, production pipe, and reamers. The floating component may be selected from the group consisting of electronics modules, generators, gyroscopes, power sources, and stators. The secondary shoulder component may comprises an interface to the box connection selected from the group consisting of radial grooves, axial grooves, tapered grooves, radial protrusions, axial protrusions, tapered protrusions, shoulders, and threads.

A Simplified View of the Geochemical Diversity Surrounding Home Plate

NASA Technical Reports Server (NTRS)

Yen, A. S.; Morris, R. V.; Clark, B. C.; Gellert, R.

2008-01-01

The Home Plate feature (Fig. 1) within the Inner Basin of the Columbia Hills consists of layered rocks and has been interpreted as an accumulation of pyroclastic deposits [1]. Samples analyzed by the Alpha Particle X-ray Spectrometer within 25 meters of the eastern margin of Home Plate exhibit a strikingly diverse range of geochemical compositions, including the highest levels of Mg, Si, K, Zn, and Ni measured at Gusev Crater. This wide range of chemical variability across the 40+ samples analyzed on and near Home Plate can be represented by contributions from only six primary components. This reconstruction is not reflected in the M ssbauer mineralogy suggesting that significant alteration of the contributing components has occurred.

Basic Science Considerations in Primary Total Hip Replacement Arthroplasty

PubMed Central

Mirza, Saqeb B; Dunlop, Douglas G; Panesar, Sukhmeet S; Naqvi, Syed G; Gangoo, Shafat; Salih, Saif

2010-01-01

Total Hip Replacement is one of the most common operations performed in the developed world today. An increasingly ageing population means that the numbers of people undergoing this operation is set to rise. There are a numerous number of prosthesis on the market and it is often difficult to choose between them. It is therefore necessary to have a good understanding of the basic scientific principles in Total Hip Replacement and the evidence base underpinning them. This paper reviews the relevant anatomical and biomechanical principles in THA. It goes on to elaborate on the structural properties of materials used in modern implants and looks at the evidence base for different types of fixation including cemented and uncemented components. Modern bearing surfaces are discussed in addition to the scientific basis of various surface engineering modifications in THA prostheses. The basic science considerations in component alignment and abductor tension are also discussed. A brief discussion on modular and custom designs of THR is also included. This article reviews basic science concepts and the rationale underpinning the use of the femoral and acetabular component in total hip replacement. PMID:20582240

Measurements Methods for the analysis of Nuclear Reactors Thermal Hydraulic in Water Scaled Facilities

NASA Astrophysics Data System (ADS)

Spaccapaniccia, C.; Planquart, P.; Buchlin, J. M. AB(; ), AC(; )

2018-01-01

The Belgian nuclear research institute (SCK•CEN) is developing MYRRHA. MYRRHA is a flexible fast spectrum research reactor, conceived as an accelerator driven system (ADS). The configuration of the primary loop is pool-type: the primary coolant and all the primary system components (core and heat exchangers) are contained within the reactor vessel, while the secondary fluid is circulating in the heat exchangers. The primary coolant is Lead Bismuth Eutectic (LBE). The recent nuclear accident of Fukushima in 2011 changed the requirements for the design of new reactors, which should include the possibility to remove the residual decay heat through passive primary and secondary systems, i.e. natural convection (NC). After the reactor shut down, in the unlucky event of propeller failures, the primary and secondary loops should be able to remove the decay heat in passive way (Natural Convection). The present study analyses the flow and the temperature distribution in the upper plenum by applying laser imaging techniques in a laboratory scaled water model. A parametric study is proposed to study stratification mitigation strategies by varying the geometry of the buffer tank simulating the upper plenum.

HealthKick: a nutrition and physical activity intervention for primary schools in low-income settings

PubMed Central

2010-01-01

Background The burden of non-communicable diseases, including type 2 diabetes, is growing in South Africa. This country has a complex mix of over- and under-nutrition, especially in low-income communities, and concerning levels of physical inactivity in children and youth. This paper describes HealthKick, a school-based nutrition and physical activity intervention in primary schools in these settings aimed at reducing diabetes risk factors. Methods/Design This study includes schools within historically disadvantaged, low-income communities from an urban area close to the city of Cape Town and from two rural areas outside of Cape Town, South Africa. The three Educational Districts involved are Metropole North, Cape Winelands and the Overberg. The study has three phases: intervention mapping and formative assessment, intervention development, and outcome and process evaluation. Sixteen schools were purposively selected to participate in the study and randomly allocated as intervention (eight schools) and control (eight schools). The primary aims of HealthKick are to promote healthful eating habits and increase regular participation in health-enhancing physical activity in children, parents and teachers, to prevent overweight, and reduce risk of chronic diseases (particularly type 2 diabetes); as well as to promote the development of an environment within the school and community that facilitates the adoption of healthy lifestyles. The components of HealthKick are: action planning, toolkit (resource guide, a resource box and physical activity resource bin), and an Educators' Manual, which includes a curriculum component. Discussion This study continues to highlight the key role that educators play in implementing a school-based intervention, but that developing capacity within school staff and stakeholders is not a simple or easy task. In spite of the challenges experienced thus far, valuable findings are being produced from this study, especially from Phase 1. Materials developed could be disseminated to other schools in low-income settings both within and outside of South Africa. Owing to the novelty of the HealthKick intervention in low-income South African primary schools, the findings of the evaluation phase have the potential to impact on policy and practice within these settings. PMID:20604914

Attitude control compensator for flexible spacecraft

NASA Technical Reports Server (NTRS)

Goodzeit, Neil E. (Inventor); Linder, David M. (Inventor)

1991-01-01

An attitude control loop for a spacecraft uses a proportional-integral-derivative (PID) controller for control about an axis. The spacecraft body has at least a primary mechanical resonance. The attitude sensors are collocated, or both on the rigid portion of the spacecraft. The flexure attributable to the resonance may result in instability of the system. A compensator for the control loop has an amplitude response which includes a component which rolls off beginning at frequencies below the resonance, and which also includes a component having a notch at a notch frequency somewhat below the resonant frequency. The phase response of the compensator tends toward zero at low frequencies, and tends toward -180.degree. as frequency increases toward the notch frequency. At frequencies above the notch frequency, the phase decreases from +180.degree., becoming more negative, and tending toward -90.degree. at frequencies far above the resonance frequency. Near the resonance frequency, the compensator phase is near zero.

Proceedings of RIKEN BNL Research Center Workshop: Thermal Photons and Dileptons in Heavy-Ion Collisions. Volume 119

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

David, G.; Rapp, R.; Ruan, L.

The RIKEN BNL Research Center (RBRC) was established in April 1997 at Brookhaven National Laboratory. It is funded by the ''Rikagaku Kenkyusho'' (RIKEN, The Institute of Physical and Chemical Research) of Japan and the U. S. Department of Energy’s Office of Science. The RBRC is dedicated to the study of strong interactions, including spin physics, lattice QCD, and RHIC physics through the nurturing of a new generation of young physicists. The RBRC has theory, lattice gauge computing and experimental components. It is presently exploring the possibility of an astrophysics component being added to the program. The primary theme for thismore » workshop related to sharing the latest experimental and theoretical developments in area of low transverse momentum (p T) dielectron and photons. All the presentations given at the workshop are included in this proceedings, primarily as PowerPoint presentations.« less

Planning and development of the Better Bites program: a pricing manipulation strategy to improve healthy eating in a hospital cafeteria.

PubMed

Liebert, Mina L; Patsch, Amy J; Smith, Jennifer Howard; Behrens, Timothy K; Charles, Tami; Bailey, Taryn R

2013-07-01

The Better Bites program, a hospital cafeteria nutrition intervention strategy, was developed by combining evidence-based practices with hospital-specific formative research, including key informant interviews, the Nutrition Environment Measures Study in Restaurants, hospital employee surveys, and nutrition services staff surveys. The primary program components are pricing manipulation and marketing to promote delicious, affordable, and healthy foods to hospital employees and other cafeteria patrons. The pricing manipulation component includes decreasing the price of the healthy items and increasing the price of the unhealthy items using a 35% price differential. Point-of-purchase marketing highlights taste, cost, and health benefits of the healthy items. The program aims to increase purchases of healthy foods and decrease purchases of unhealthy foods, while maintaining revenue neutrality. This article addresses the formative research, planning, and development that informed the Better Bites program.

Baseline high heat flux and plasma facing materials for fusion

NASA Astrophysics Data System (ADS)

Ueda, Y.; Schmid, K.; Balden, M.; Coenen, J. W.; Loewenhoff, Th.; Ito, A.; Hasegawa, A.; Hardie, C.; Porton, M.; Gilbert, M.

2017-09-01

In fusion reactors, surfaces of plasma facing components (PFCs) are exposed to high heat and particle flux. Tungsten and Copper alloys are primary candidates for plasma facing materials (PFMs) and coolant tube materials, respectively, mainly due to high thermal conductivity and, in the case of tungsten, its high melting point. In this paper, recent understandings and future issues on responses of tungsten and Cu alloys to fusion environments (high particle flux (including T and He), high heat flux, and high neutron doses) are reviewed. This review paper includes; Tritium retention in tungsten (K. Schmid and M. Balden), Impact of stationary and transient heat loads on tungsten (J.W. Coenen and Th. Loewenhoff), Helium effects on surface morphology of tungsten (Y. Ueda and A. Ito), Neutron radiation effects in tungsten (A. Hasegawa), and Copper and copper alloys development for high heat flux components (C. Hardie, M. Porton, and M. Gilbert).

Complications in reverse shoulder arthroplasty

PubMed Central

Barco, Raul; Savvidou, Olga D.; Sperling, John W.; Sanchez-Sotelo, Joaquín; Cofield, Robert H.

2016-01-01

The reported rate of complications of reverse shoulder arthroplasty (RSA) seems to be higher than the complication rate of anatomical total shoulder arthroplasty. The reported overall complication rate of primary RSA is approximately 15%; when RSA is used in the revision setting, the complication rate may approach 40%. The most common complications of RSA include instability, infection, notching, loosening, nerve injury, acromial and scapular spine fractures, intra-operative fractures and component disengagement. Careful attention to implant design and surgical technique, including implantation of components in the correct version and height, selection of the best glenosphere-humeral bearing match, avoidance of impingement, and adequate management of the soft tissues will hopefully translate in a decreasing number of complications in the future. Cite this article: Barco R, Savvidou OD, Sperling JW, Sanchez-Sotelo J, Cofield RH. Complications in reverse shoulder arthroplasty. EFORT Open Rev 2016;1:72-80. DOI: 10.1302/2058-5241.1.160003. PMID:28461931

Complications in reverse shoulder arthroplasty.

PubMed

Barco, Raul; Savvidou, Olga D; Sperling, John W; Sanchez-Sotelo, Joaquín; Cofield, Robert H

2016-03-01

The reported rate of complications of reverse shoulder arthroplasty (RSA) seems to be higher than the complication rate of anatomical total shoulder arthroplasty.The reported overall complication rate of primary RSA is approximately 15%; when RSA is used in the revision setting, the complication rate may approach 40%.The most common complications of RSA include instability, infection, notching, loosening, nerve injury, acromial and scapular spine fractures, intra-operative fractures and component disengagement.Careful attention to implant design and surgical technique, including implantation of components in the correct version and height, selection of the best glenosphere-humeral bearing match, avoidance of impingement, and adequate management of the soft tissues will hopefully translate in a decreasing number of complications in the future. Cite this article: Barco R, Savvidou OD, Sperling JW, Sanchez-Sotelo J, Cofield RH. Complications in reverse shoulder arthroplasty. EFORT Open Rev 2016;1:72-80. DOI: 10.1302/2058-5241.1.160003.

Source apportionment of submicron organic aerosol at an urban background and a road site in Barcelona (Spain) during SAPUSS

NASA Astrophysics Data System (ADS)

Alier, M.; van Drooge, B. L.; Dall'Osto, M.; Querol, X.; Grimalt, J. O.; Tauler, R.

2013-10-01

This study investigates the contribution of potential sources to the submicron (PM1) organic aerosol (OA) simultaneously detected at an urban background (UB) and a road site (RS) in Barcelona during the 30 days of the intensive field campaign of SAPUSS (Solving Aerosol Problems by Using Synergistic Strategies, September-October 2010). A total of 103 filters at 12 h sampling time resolution were collected at both sites. Thirty-six neutral and polar organic compounds of known emission sources and photo-chemical transformation processes were analyzed by gas chromatography-mass spectrometry (GC-MS). The concentrations of the trace chemical compounds analyzed are herein presented and discussed. Additionally, OA source apportionment was performed by multivariate curve resolution-alternating least squares (MCR-ALS) and six OA components were identified at both sites: two were of primary anthropogenic OA origin and three of secondary OA origin, while a sixth one was not clearly defined. Primary organics from emissions of local anthropogenic activities (urban primary organic aerosol, or POA Urban), mainly traffic emissions but also cigarette smoke, contributed 43% (1.5 μg OC m-3) and 18% (0.4 μg OC m-3) to OA at RS and UB, respectively. A secondary primary source - biomass burning (BBOA) - was found in all the samples (average values 7% RS; 12% UB; 0.3 μg OC m-3), but this component was substantially contributing to OA only when the sampling sites were under influence of regional air mass circulation (REG.). Three secondary organic aerosol (SOA) components (describing overall 60% of the variance) were observed in the urban ambient PM1. Products of isoprene oxidation (SOA ISO) - i.e. 2-methylglyceric acid, C5 alkene triols and 2-methyltetrols - showed the highest abundance at both sites when the city was under influence of inland air masses. The overall concentrations of SOA ISO were similar at both sites (0.4 and 0.3 μg m-3, or 16% and 7%, at UB and RS, respectively). By contrast, a SOA biogenic component attributed to α-pinene oxidation (SOA BIO PIN) presented average concentrations of 0.5 μg m-3 at UB (24% of OA) and 0.2 μg m-3 at RS (7%), respectively, suggesting that this SOA component did not impact the two monitoring sites at the same level. A clear anti-correlation was observed between SOA ISO and SOA PIN during nucleation days, surprisingly suggesting that some of the growth of urban freshly nucleating particles may be driven by biogenic α-pinene oxidation products but inhibited by isoprene organic compounds. A third SOA component was formed by a mixture of aged anthropogenic and biogenic secondary organic compounds (SOA Aged) that accumulated under stagnant atmospheric conditions, contributing for 12% to OA at RS (0.4 μg OC m-3) and for 18% at UB (0.4 μg OC m-3). A sixth component, formed by C7-C9 dicarboxylic acids and detected especially during daytime, was called "urban oxygenated organic aerosol" (OOA Urban) due to its high abundance at urban RS (23%; 0.8 μg OCm-3) vs. UB (10%; 0.2 μg OCm-3), with a well-defined daytime maximum. This temporal trend and geographical differentiation suggests that local anthropogenic sources were determining this component. However, the changes of these organic molecules were also influenced by the air mass trajectories, indicating that atmospheric conditions have an influence on this component, although the specific origin on this component remains unclear. It points to a secondary organic component driven by primary urban sources including cooking and traffic (mainly gasoline) activities.

Source apportionment of submicron organic aerosol at an urban background and a road site in Barcelona, Spain

NASA Astrophysics Data System (ADS)

Alier, M.; van Drooge, B. L.; Dall'Osto, M.; Querol, X.; Grimalt, J. O.; Tauler, R.

2013-04-01

This study investigates the contribution of potential sources to the sub-micron (PM1) organic aerosol (OA) simultaneously detected at an urban background (UB) and a road site (RS) in Barcelona during the 30 days of the intensive field campaign of SAPUSS (Solving Aerosol Problems by Using Synergistic Strategies, September-October 2010). 103 filters at 12 h sampling time resolution were collected at both sites. Thirty-six neutral and polar organic compounds of known emission sources and photo-chemical transformation processes were analyzed by Gas Chromatography-Mass Spectrometry (GC-MS). The concentrations of the trace chemical compounds analyzed are herein presented and discussed. Additionally, OA source apportionment was performed by Multivariate Curve Resolution-Alternating Least Squares (MCR-ALS) and six OA components were identified at both sites: two were of primary anthropogenic OA origin, three of secondary OA origin while a sixth one was not clearly defined. Primary organics from emissions of local anthropogenic activities (Urban primary organic aerosol, Urban POA) contributed for 43% (1.5 μg OC m-3) and 18% (0.4 μg OC m-3) to OA in RS and UB, respectively. A secondary primary source - biomass burning (BBOA) - was found in all the samples (average values 7% RS; 12% UB; 0.3 μg OC m-3), but this component was substantially contributing to OA only when the sampling sites were under influence of regional air mass circulation. Three Secondary Organic Aerosol (SOA) components (describing overall 60% of the variance) were observed in the urban ambient PM1. Products of isoprene oxidation (SOA ISO), i.e. 2-methylglyceric acid, C5 alkene triols and 2-methyltetrols, showed the highest abundance at both sites when the city was under influence of inland air masses. The overall concentrations of SOA ISO were similar at both sites (0.4 and 0.3 μg m-3, 16% and 7%, at UB and RS, respectively). By contrast, a SOA biogenic component attributed to α-pinene oxidation (SOA BIO PIN) presented average concentrations of 0.5 μg m-3 at UB (24% of OA) and 0.2 μg m-3 at RS (7%), respectively, suggesting that this SOA component did not impact the two monitoring site at the same level. A clear anti correlation was observed between SOA ISO and SOA PIN during nucleation days, surprisingly suggesting that some of the growth of urban freshly nucleating particles may be driven by biogenic α-pinene oxidation products but inhibited by isoprene organic compounds. A third SOA component was formed by a mixture of aged anthropogenic and biogenic secondary organic compounds (Aged SOA) that accumulated under stagnant atmospheric conditions, contributing for 12% to OA at RS (0.4 μg OC m-3) and for 18% at UB (0.4 μg OC m-3). A sixth component, formed by C7-C9 dicarboxylic acids and detected especially during daytime, was called "urban oxygenated organic aerosol" (Urban OOA) due to its high abundance in urban RS (23%; 0.8 μg OC m-3) vs. UB (10%; 0.2 μg OC m-3), with a well-defined daytime maximum. This temporal trend and geographical differentiation suggests that local anthropogenic sources were determining this component. However, the changes of these organic molecules were also influenced by the air mass trajectories, indicating that atmospheric conditions had an influence on this component although the specific origin on this component remains unclear. It points to a secondary organic component driven by primary urban sources including cooking and traffic (mainly gasoline) activities.

Observations and Analysis of the F-type Near-Contact Binary, NSVS 1054 1123

NASA Astrophysics Data System (ADS)

Caton, Daniel Bruce; Samec, Ronald G.; Faulkner, Danny R.

2018-01-01

NSVS 1054 1123 is a F2±2 type (T~ 6750K) eclipsing binary. It was observed in April and May, 2015 at the Appalachian State University’s Dark Sky Observatory in North Carolina with the 32-inch telescope. Six times of minimum light were determined from our present observations, which include two primary eclipses and four secondary eclipses:HJD Min I = 2457113.9330 ±0. 0.0002, 24 57147.8761 ±0.0001,HJD Min II = 2457117.80391 ±0.0006, 2457136.8600 ±0. 0007, 2457148.77040 ±0.0004, 2457151.7468 ±0.0002In addition, six observations at minima were introduced as low weighted times of minimum light taken from archived NSVS Data.The following quadratic ephemerides was determined from all available times of minimum light:JD Hel Min I=2457147.87646±0.00049d + 0 .5954966±0.0000065 X E -0.0000000017± 0.0000000007 X E2A period decrease may indicate that the binary is undergoing magnetic braking and is approaching its contact configuration. A BVRcIc simultaneous (preliminary) Wilson-Devinney Program (W-D) solution indicates that the system has a mass ratio of 0.5828±0.0004, and a component temperature difference of 2350 K. The large DT in the components verify that the binary is not in contact. A Binary Maker fitted hot spot altered slightly but was not eliminated in the WD Synthetic Light Curve Computations. It remains on the larger component at the equator on the correct (following) side for a stream spot directed from the secondary component (as dictated by the Coriolis effect). This could indicate that the components are near filling their respective Roche Lobes. The fill-out of our model is -0.036 for the primary component and -0.048 for the secondary component. The inclination is ~79 degrees, not enough for the system to undergo a total eclipse.Additional and more detailed information is given in this report.

Diagnostic implications of IDH1-R132H and OLIG2 expression patterns in rare and challenging glioblastoma variants.

PubMed

Joseph, Nancy M; Phillips, Joanna; Dahiya, Sonika; M Felicella, Michelle; Tihan, Tarik; Brat, Daniel J; Perry, Arie

2013-03-01

Recent work has demonstrated that nearly all diffuse gliomas display nuclear immunoreactivity for the bHLH transcription factor OLIG2, and the R132H mutant isocitrate dehydrogenase 1 (IDH1) protein is expressed in the majority of diffuse gliomas other than primary glioblastoma. However, these antibodies have not been widely applied to rarer glioblastoma variants, which can be diagnostically challenging when the astrocytic features are subtle. We therefore surveyed the expression patterns of OLIG2 and IDH1 in 167 non-conventional glioblastomas, including 45 small cell glioblastomas, 45 gliosarcomas, 34 glioblastomas with primitive neuroectodermal tumor-like foci (PNET-like foci), 23 with an oligodendroglial component, 11 granular cell glioblastomas, and 9 giant cell glioblastomas. OLIG2 was strongly expressed in all glioblastomas with oligodendroglial component, 98% of small cell glioblastomas, and all granular cell glioblastomas, the latter being particularly helpful in ruling out macrophage-rich lesions. In 74% of glioblastomas with PNET-like foci, OLIG2 expression was retained in the PNET-like foci, providing a useful distinction from central nervous system PNETs. The glial component of gliosarcomas was OLIG2 positive in 93% of cases, but only 14% retained focal expression in the sarcomatous component; as such this marker would not reliably distinguish these from pure sarcoma in most cases. OLIG2 was expressed in 67% of giant cell glioblastomas. IDH1 was expressed in 55% of glioblastomas with oligodendroglial component, 15% of glioblastomas with PNET-like foci, 7% of gliosarcomas, and none of the small cell, granular cell, or giant cell glioblastomas. This provides further support for the notion that most glioblastomas with oligodendroglial component are secondary, while small cell glioblastomas, granular cell glioblastomas, and giant cell glioblastomas are primary variants. Therefore, in one of the most challenging differential diagnoses, IDH1 positivity could provide strong support for glioblastoma with oligodendroglial component, while essentially excluding small cell glioblastoma.

Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2011-June 2016.

PubMed

O'Donnell, Francis L; Taubman, Stephen B

2016-10-01

From July 2015 through June 2016, a total of 447 members of the active (n=383) and reserve (n=64) components had at least one medical encounter with a primary diagnosis of cold injury. The numbers of affected individuals in both components were the lowest since the 2011-2012 cold season, when the total was 394. In the active component, the service-specific incidence rates for each of the four services were lower than the respective rates for the previous (2014-2015) cold season. Frostbite was the most common type of cold injury. During the five cold seasons in the surveillance period (2011-2016), rates tended to be higher among service members who were in the youngest age groups; female; black, non-Hispanic; or in the Army. The numbers of cold injuries associated with service in Iraq and Afghanistan have fallen precipitously in the past four cold seasons and included just 11 cases in the most recent year.

Solid-State NMR Study of the Cicada Wing.

PubMed

Gullion, John D; Gullion, Terry

2017-08-17

Wings of flying insects are part of the cuticle which forms the exoskeleton. The primary molecular components of cuticle are protein, chitin, and lipid. How these components interact with one another to form the exoskeleton is not completely understood. The difficulty in characterizing the cuticle arises because it is insoluble and noncrystalline. These properties severely limit the experimental tools that can be used for molecular characterization. Solid-state nuclear magnetic resonance experiments have been used in the past to characterize the exoskeleton of beetles and have found that chitin and protein make comparable contributions to the molecular matrix. However, little work has been done to characterize the components of the wing, which includes vein and membrane. In this work, solid-state NMR was used to characterize the wing of the 17-year cycle cicada (Magicicada cassini) that appeared in northern West Virginia during the summer of 2016. The NMR results show noticeable differences between the molecular components of the vein and membrane.

Ion Thruster Development at NASA Lewis Research Center

NASA Technical Reports Server (NTRS)

Sovey, James S.; Hamley, John A.; Patterson, Michael J.; Rawlin, Vincent K.; Sarver-Verhey, Timothy R.

1992-01-01

Recent ion propulsion technology efforts at NASA's Lewis Research Center including development of kW-class xenon ion thrusters, high power xenon and krypton ion thrusters, and power processors are reviewed. Thruster physical characteristics, performance data, life projections, and power processor component technology are summarized. The ion propulsion technology program is structured to address a broad set of mission applications from satellite stationkeeping and repositioning to primary propulsion using solar or nuclear power systems.

Guilt by Association-Based Discovery of Botnet Footprints

DTIC Science & Technology

2010-11-01

our fast flux database using our Fast Flux Monitor ( FFM ); a Web service application designed to detect whether a domain exhibits fast flux (FF) or...double flux (DF) behaviour. The primary technical components of FFM include: (1) sensors which perform real-time detection of FF service networks...sensors for our FFM active sensors: (1) FF Activity Index, (2) Footprint Index, and (3) Time To Live (TTL), and (4) Guilt by Association Score. In

Aircraft energy efficiency. Overview

NASA Technical Reports Server (NTRS)

1981-01-01

Six advanced technology development projects that could cut fuel consumption of future civil air transports by as much as 50 percent are highlighted. These include improved engine components; better engine design; thin short blades for turboprop aircaft; using composite primary structures for weight reduction; the use of supercritical wings, higher aspect ratio, and winglets for improved aerodynamics; active controls; and laminar flow control. The time span of each of the six efforts and NASA's expected expenditures are also discussed.

Alternatives generation and analysis for double-shell tank primary ventilation systems emissions control and monitoring

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

SEDERBURG, J.P.

1999-09-30

This AGA addresses the question: ''What equipment upgrades, operational changes, and/or other actions are required relative to the DST tanks farms' ventilation systems to support retrieval, staging (including feed sampling), and delivery of tank waste to the Phase I private contractor?'' Issues and options for the various components within the ventilation subsystem affect each other. Recommended design requirements are presented and the preferred alternatives are detailed.

Two Stellar Components in the Halo of the Milky Way

DTIC Science & Technology

2007-12-13

that might be considered, multiple lines of evidence derived from these data clearly confirm that the halo can be resolved into (at least) two primary...of the inner-halo population. Evidence for the dichotomy of the halo The spectroscopy, photometry and astrometry for our large sample of stars were...0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing

Do Different Young Plantation-Grown Species Require Different Biomass Models?

Treesearch

Bryce E. Schlaegel; Harvey E. Kennedy

1985-01-01

Sweetgum and water oak trees sampled from a plantation over 7 years were used to test whether primary tree component (bole wood, bole bark, limb wood, limb bark, and leaves) predictions could be summed to estimate total bole, total limb, and total tree values. Estimations by summing primary component predictions were not significantly different from predictions for the...

The Limerick Reading Initiative: A Reading Intervention Targeted at Struggling Readers in Primary School

ERIC Educational Resources Information Center

O'Rourke, Diarmuid; Olshtroon, Aoife; O'Halloran, Claire

2016-01-01

In this study we examined the effectiveness of a reading intervention targeting a group of 24 struggling readers in ten primary schools in Ireland. The intervention consisted of two components; component one consisted of 15-20 minutes delivery of the Toe-by-Toe programme (a well established systematic synthetic phonics programme) and the second…

Molecular Orientation in Two Component Vapor-Deposited Glasses: Effect of Substrate Temperature and Molecular Shape

NASA Astrophysics Data System (ADS)

Powell, Charles; Jiang, Jing; Walters, Diane; Ediger, Mark

Vapor-deposited glasses are widely investigated for use in organic electronics including the emitting layers of OLED devices. These materials, while macroscopically homogenous, have anisotropic packing and molecular orientation. By controlling this orientation, outcoupling efficiency can be increased by aligning the transition dipole moment of the light-emitting molecules parallel to the substrate. Light-emitting molecules are typically dispersed in a host matrix, as such, it is imperative to understand molecular orientation in two-component systems. In this study we examine two-component vapor-deposited films and the orientations of the constituent molecules using spectroscopic ellipsometry, UV-vis and IR spectroscopy. The role of temperature, composition and molecular shape as it effects molecular orientation is examined for mixtures of DSA-Ph in Alq3 and in TPD. Deposition temperature relative to the glass transition temperature of the two-component mixture is the primary controlling factor for molecular orientation. In mixtures of DSA-Ph in Alq3, the linear DSA-Ph has a horizontal orientation at low temperatures and slight vertical orientation maximized at 0.96Tg,mixture, analogous to one-component films.

Seromucinous component in endometrioid endometrial carcinoma as a histological predictor of prognosis.

PubMed

Miyamoto, Morikazu; Takano, Masashi; Aoyama, Tadashi; Soyama, Hiroaki; Yoshikawa, Tomoyuki; Tsuda, Hitoshi; Furuya, Kenichi

2018-03-01

In 2014 World Health Organization criteria, seromucinous carcinoma was defined as a new histological subtype in ovarian carcinomas, but "seromucinous carcinoma" was not defined in endometrial carcinomas. The aim of this study was to identify seromucinous carcinoma resembling ovarian seromucinous carcinoma in endometrial carcinomas, and to evaluate the clinical significance for prognoses of the patients. Central pathological review was conducted for patients with endometrioid carcinoma of the endometrium treated by primary surgery at our hospital between 1990 and 2013. Among 340 cases included in the study, no case had all tumor cells resembling ovarian seromucinous carcinoma in all specimens, and 31 cases (9.1%) had seromucinous component in combination with endometrioid carcinomas. Immunohistochemical analysis revealed seromucinous component had positive reactivity for cytokeratin (CK) 7, and negative reactivity for CK20 and caudal type homeobox 2 (CDX2) in all cases. Seromucinous component showed lower immunoreactivity of estrogen receptor and progesterone receptor, compared with endometrioid carcinoma component. Progression-free survival of the cases with seromucinous component was better than those without seromucinous component (p=0.049). Seromucinous component was identified in approximately 10% of endometrioid carcinoma, and could be a histological predictor for prognosis. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

Study of Selected Components of Architectural Environment of Primary Schools - Preferences of Adults and Analysis of the Specialist Literature

NASA Astrophysics Data System (ADS)

Halarewicz, Aleksandra

2017-10-01

The school is one of the oldest social institutions designed to prepare a young man for an adult life. It performs a teaching and educational function in child’s life. It is a place where, apart from home, the child spends most of the time in a day, therefore it is one of the most important institutions in the life of a young person. The school environment has a direct impact on the student's personality and ambition, and it shapes an attitude of the young person. Therefore, the design process preceding the establishment of school facilities is extremely responsible and should be conducted in a conscious and thoughtful way. This article is a summary and an attempt to synthesize the data obtained from the survey carried out by the author in the context of the design guidelines contained in the specialist literature. The questionnaire survey was designed to make an attempt to determine adult’s preferences, opinions and perceptions about selected components of the primary school environment, including the factors which determine the choice of school for children, the priorities of architecture components made for early childhood use, also to specify the type and the scale of existing drawbacks and problems in the school construction industry, as well as expectations about the contemporary architecture of primary schools and its future changes. Moreover, in the article, based on the analysis of the available specialist’s literature, the following are broadly discussed: the general division and characterization of school spaces, issues related to the influence of selected components of the architectural environment on the physical, mental and psychological safety of children. Furthermore, the author raises the subject of the influence of the architectural interiors and furniture on the mood, emotions or comfort of children in the early school age, based on the anthropometric characteristics of children and issues related to the perception of space with an extra attention on the subject of perception of colours and the influence of the architectural space components on the frame of mind, fettle or comfort of children in the given age. Although there exists a limited body of literature on the subject and the results of the study show that the aspects of elementary school architecture relevant to adults, including parents of children, are different from those described in the literature, the analysis was necessary to show these differences and to highlight the different values and priorities of users and designers. The paper is also an introduction, which identify qualities and social preferences on educational architecture, to the deeper research aimed at developing the criteria of designing and shaping the architectural environment for primary school children, which takes into account the regularity and developmental needs of children at studied age.

Mineralogy of Sediments on a Cold and Icy Early Mars

NASA Astrophysics Data System (ADS)

Rampe, E. B.; Horgan, B. H. N.; Smith, R.; Scudder, N.; Rutledge, A. M.; Bamber, E.; Morris, R. V.

2017-12-01

The water-related minerals discovered in ancient martian terrains suggest liquid water was abundant on the surface and/or near subsurface during Mars' early history. The debate remains, however, whether these minerals are indicative of a warm and wet or cold and icy climate. To characterize mineral assemblages of cold and icy mafic terrains, we analyzed pro- and supraglacial rocks and sediments from the Collier and Diller glacial valleys in Three Sisters, Oregon. We identified primary and secondary phases using X-ray diffraction (XRD), scanning and transmission electron microscopies with energy dispersive spectroscopy (SEM, TEM, EDS), and visible/short-wave-infrared (VSWIR) and thermal-infrared (TIR) spectroscopies. Samples from both glacial valleys are dominated by primary igneous minerals (i.e., plagioclase and pyroxene). Sediments in the Collier glacial valley contain minor to trace amounts of phyllosilicates and zeolites, but these phases are likely detrital and sourced from hydrothermally altered units on North Sister. We find that the authigenic phases in cold and icy mafic terrains are poorly crystalline and/or amorphous. TEM-EDS analyses of the <2 um size fraction of glacial flour shows the presence of many different nanophase materials, including iron oxides, devitrified volcanic glass, and Fe-Si-Al (e.g., proto-clay) phases. A variety of primary and secondary amorphous materials (e.g., volcanic glass, leached glass, allophane) have been suggested from orbital IR data from Mars, and the CheMin XRD on the Curiosity rover has identified X-ray amorphous materials in all rocks and soils measured to date. The compositions of the Gale Crater amorphous components cannot be explained by primary volcanic glass alone and likely include secondary silicates, iron oxides, and sulfates. We suggest that the prevalence of amorphous materials on the martian surface and the variety of amorphous components may be a signature of a cold and icy climate on Early Mars.

Information system support as a critical success factor for chronic disease management: Necessary but not sufficient.

PubMed

Green, Carolyn J; Fortin, Patricia; Maclure, Malcolm; Macgregor, Art; Robinson, Sylvia

2006-12-01

Improvement of chronic disease management in primary care entails monitoring indicators of quality over time and across patients and practices. Informatics tools are needed, yet implementing them remains challenging. To identify critical success factors enabling the translation of clinical and operational knowledge about effective and efficient chronic care management into primary care practice. A prospective case study of positive deviants using key informant interviews, process observation, and document review. A chronic disease management (CDM) collaborative of primary care physicians with documented improvement in adherence to clinical practice guidelines using a web-based patient registry system with CDM guideline-based flow sheet. Thirty community-based physician participants using predominantly paper records, plus a project management team including the physician lead, project manager, evaluator and support team. A critical success factor (CSF) analysis of necessary and sufficient pathways to the translation of knowledge into clinical practice. A web-based CDM 'toolkit' was found to be a direct CSF that allowed this group of physicians to improve their practice by tracking patient care processes using evidence-based clinical practice guideline-based flow sheets. Moreover, the information and communication technology 'factor' was sufficient for success only as part of a set of seven direct CSF components including: health delivery system enhancements, organizational partnerships, funding mechanisms, project management, practice models, and formal knowledge translation practices. Indirect factors that orchestrated success through the direct factor components were also identified. A central insight of this analysis is that a comprehensive quality improvement model was the CSF that drew this set of factors into a functional framework for successful knowledge translation. In complex primary care settings environment where physicians have low adoption rates of electronic tools to support the care of patients with chronic conditions, successful implementation may require a set of interrelated system and technology factors.

From concept to content: assessing the implementation fidelity of a chronic care model for frail, older people who live at home.

PubMed

Muntinga, Maaike E; Van Leeuwen, Karen M; Schellevis, François G; Nijpels, Giel; Jansen, Aaltje P D

2015-01-22

Implementation fidelity, the degree to which a care program is implemented as intended, can influence program impact. Since results of trials that aim to implement comprehensive care programs for frail, older people have been conflicting, assessing implementation fidelity alongside these trials is essential to differentiate between flaws inherent to the program and implementation issues. This study demonstrates how a theory-based assessment of fidelity can increase insight in the implementation process of a complex intervention in primary elderly care. The Geriatric Care Model was implemented among 35 primary care practices in the Netherlands. During home visits, practice nurses conducted a comprehensive geriatric assessment and wrote a tailored care plan. Multidisciplinary team consultations were organized with the aim to enhance the coordination between professionals caring for a single patient with complex needs. To assess fidelity, we identified 5 key intervention components and formulated corresponding research questions using Carroll's framework for fidelity. Adherence (coverage, frequency, duration, content) was assessed per intervention component during and at the end of the intervention period. Two moderating factors (participant responsiveness and facilitation strategies) were assessed at the end of the intervention. Adherence to the geriatric assessments and care plans was high, but decreased over time. Adherence to multidisciplinary consultations was initially poor, but increased over time. We found that individual differences in adherence between practice nurses and primary care physicians were moderate, while differences in participant responsiveness (satisfaction, involvement) were more distinct. Nurses deviated from protocol due to contextual factors and personal work routines. Adherence to the Geriatric Care Model was high for most of the essential intervention components. Study limitations include the limited number of assessed moderating factors. We argue that a longitudinal investigation of adherence per intervention component is essential for a complete understanding of the implementation process, but that such investigations may be complicated by practical and methodological challenges. The Netherlands National Trial Register (NTR). 2160 .

Gamma Knife Radiosurgery for the Treatment of Cystic Cerebral Metastases

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

Ebinu, Julius O.; Lwu, Shelly; Monsalves, Eric

Purpose: To assess the role of Gamma Knife radiosurgery (GKRS) in the treatment of nonsurgical cystic brain metastasis, and to determine predictors of response to GKRS. Methods: We reviewed a prospectively maintained database of brain metastases patients treated at our institution between 2006 and 2010. All lesions with a cystic component were identified, and volumetric analysis was done to measure percentage of cystic volume on day of treatment and consecutive follow-up MRI scans. Clinical, radiologic, and dosimetry parameters were reviewed to establish the overall response of cystic metastases to GKRS as well as identify potential predictive factors of response. Results:more » A total of 111 lesions in 73 patients were analyzed; 57% of lesions received prior whole-brain radiation therapy (WBRT). Lung carcinoma was the primary cancer in 51% of patients, 10% breast, 10% colorectal, 4% melanoma, and 26% other. Fifty-seven percent of the patients were recursive partitioning analysis class 1, the remainder class 2. Mean target volume was 3.3 mL (range, 0.1-23 mL). Median prescription dose was 21 Gy (range, 15-24 Gy). Local control rates were 91%, 63%, and 37% at 6, 12, and 18 months, respectively. Local control was improved in lung primary and worse in patients with prior WBRT (univariate). Only lung primary predicted local control in multivariate analysis, whereas age and tumor volume did not. Lesions with a large cystic component did not show a poorer response compared with those with a small cystic component. Conclusions: This study supports the use of GKRS in the management of nonsurgical cystic metastases, despite a traditionally perceived poorer response. Our local control rates are comparable to a matched cohort of noncystic brain metastases, and therefore the presence of a large cystic component should not deter the use of GKRS. Predictors of response included tumor subtype. Prior WBRT decreased effectiveness of SRS for local control rates.« less

Predictors of health related quality of life in older people with non-communicable diseases attending three primary care clinics in Malaysia.

PubMed

Sazlina, S G; Zaiton, A; Nor Afiah, M Z; Hayati, K S

2012-05-01

To determine the health related quality of life and its predictive factors among older people with non-communicable diseases attending primary care clinics. Cross-sectional study. Three public primary care clinics in a district in Selangor, Malaysia. Registered patients aged 55 years and above. A face-to-face interview was conducted using a validated questionnaire of Medical Outcome Study 36-item short form health survey (SF-36). The outcome measure was the health related quality of life (HRQoL) and other factors measured were socio demography, physical activity, social support (Duke-UNC Functional Social Support Questionnaire), and presence of non-communicable diseases. A total of 347 participants had non-communicable diseases which included hypertension (41.8%), type 2 diabetes (33.7%), asthma (4.8%), hyperlipidaemia (1.7%), coronary heart disease (1.2%), and osteoarthritis (0.2%). Age ≥ 65 years old (OR =2.23; 95%CI=1.42, 3.50), single (OR=1.75; 95%CI=1.06,2.90), presence of co-morbid condition (OR=1.66; 95%CI=1.06, 2.61), and poorer social support (OR=2.11; 95%CI=1.27, 3.51; p=0.002) were significant predictors of poorer physical component of HRQoL . In predicting lower mental health component of HRQoL, the significant predictors were women (OR=2.28; 95%CI=1.44, 3.62), Indian ethnicity (OR=1.86; 95%CI=1.08, 3.21) and poorer social support (OR=2.71; 95%CI=1.63, 4.51). No interactions existed between these predictors. Older people with non-communicable diseases were susceptible to lower health related quality of life. Increasing age, single, presence of co-morbid conditions, and poorer social support were predictors of lower physical health component of HRQoL. While the older women, Indian ethnicity and poorer social support reported lower mental health component of HRQoL.

Innovative Home Visit Models Associated With Reductions In Costs, Hospitalizations, And Emergency Department Use.

PubMed

Ruiz, Sarah; Snyder, Lynne Page; Rotondo, Christina; Cross-Barnet, Caitlin; Colligan, Erin Murphy; Giuriceo, Katherine

2017-03-01

While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits. Two models achieved significant reductions in Medicare expenditures, and three models reduced utilization in the form of emergency department visits, hospitalizations, or both for beneficiaries relative to comparators. These findings present a strong case for the potential value of home visits by practice-extender teams to reduce Medicare expenditures and service use in a particularly vulnerable and costly segment of the Medicare population. Project HOPE—The People-to-People Health Foundation, Inc.

Understanding recovery: changes in the relationships of the International Classification of Functioning (ICF) components over time.

PubMed

Davis, A M; Perruccio, A V; Ibrahim, S; Hogg-Johnson, S; Wong, R; Badley, E M

2012-12-01

The International Classification of Functioning, Disability and Health framework describes human functioning through body structure and function, activity and participation in the context of a person's social and physical environment. This work tested the temporal relationships of these components. Our hypotheses were: 1) there would be associations among physical impairment, activity limitations and participation restrictions within time; 2) prior status of a component would be associated with future status; 3) prior status of one component would influence status of a second component (e.g. prior activity limitations would be associated with current participation restrictions); and, 4) the magnitude of the within time relationships of the components would vary over time. Participants from Canada with primary hip or knee joint replacement (n = 931), an intervention with predictable improvement in pain and disability, completed standardized outcome measures pre-surgery and five times in the first year post-surgery. These included physical impairment (pain), activity limitations and participation restrictions. ICF component relationships were evaluated cross-sectionally and longitudinally using path analysis adjusting for age, sex, BMI, hip vs. knee, low back pain and mood. All component scores improved significantly over time. The path coefficients supported the hypotheses in that both within and across time, physical impairment was associated with activity limitation and activity limitation was associated with participation restriction; prior status and change in a component were associated with current status in another component; and, the magnitude of the path coefficients varied over time with stronger associations among components to three months post surgery than later in recovery with the exception of the association between impairment and participation restrictions which was of similar magnitude at all times. This work enhances understanding of the complexities of the ICF component relationships in evaluating disability over time. Further longitudinal studies including evaluation of contextual factors are required. Copyright © 2012 Elsevier Ltd. All rights reserved.

Characterization of interdigitated electrode piezoelectric fiber composites under high electrical and mechanical loading

NASA Astrophysics Data System (ADS)

Rodgers, John P.; Bent, Aaron A.; Hagood, Nesbitt W.

1996-05-01

The primary objective of this work is to develop a standard methodology for characterizing structural actuation systems intended for operation in high electrical and mechanical loading environments. The designed set of tests evaluates the performance of the active materials system under realistic operating conditions. The tests are also used to characterize piezoelectric fiber composites which have been developed as an alternative to monolithic piezoceramic wafers for structural actuation applications. The performance of this actuator system has been improved using an interdigitated electrode pattern, which orients the primary component of the electric field into the plane of the structure, enabling the use of the primary piezoelectric effect along the active fibers. One possible application of this technology is in the integral twist actuation of helicopter rotor blades for higher harmonic control. This application requires actuators which can withstand the harsh rotor blade operating environment. This includes large numbers of electrical and mechanical cycles with considerable centripetal and bending loads. The characterization tests include standard active material tests as well as application-driven tests which evaluate the performance of the actuators during simulated operation. Test results for several actuator configurations are provided, including S2 glass- reinforced and E-glass laminated actuators. The study concludes that the interdigitated electrode piezoelectric fiber composite actuator has great potential for high loading applications.

Psychometric properties of the Late-Life Function and Disability Instrument: a systematic review

PubMed Central

2014-01-01

Background The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties. The Late-Life Function and Disability Instrument (LLFDI) has been widely used to assess functional limitations and disability in studies with older adults. The primary aim of this systematic review was to evaluate the current available evidence for the psychometric properties of the LLFDI. Methods Published studies of any design reporting results based on administration of the original version of the LLFDI in community-dwelling older adults were identified after searches of 9 electronic databases. Data related to construct validity (convergent/divergent and known-groups validity), test-retest reliability and sensitivity to change were extracted. Effect sizes were calculated for within-group changes and summarized graphically. Results Seventy-one studies including 17,301 older adults met inclusion criteria. Data supporting the convergent/divergent and known-groups validity for both the Function and Disability components were extracted from 30 and 18 studies, respectively. High test-retest reliability was found for the Function component, while results for the Disability component were more variable. Sensitivity to change of the LLFDI was confirmed based on findings from 25 studies. The basic lower extremity subscale and overall summary score of the Function component and limitation dimension of the Disability component were associated with the strongest relative effect sizes. Conclusions There is extensive evidence to support the construct validity and sensitivity to change of the LLFDI among various clinical populations of community-dwelling older adults. Further work is needed on predictive validity and values for clinically important change. Findings from this review can be used to guide the selection of the most appropriate LLFDI subscale for use an outcome measure in geriatric research and practice. PMID:24476510

LUTE telescope structural design

NASA Technical Reports Server (NTRS)

Ruthven, Gregory

1993-01-01

The major objective of the Lunar Ultraviolet Transit Experiment (LUTE) Telescope Structural Design Study was to investigate the feasibility of designing an ultralightweight 1-m aperture system within optical performance requirements and mass budget constraints. This study uses the results from our previous studies on LUTE as a basis for further developing the LUTE structural architecture. After summarizing our results in Section 2, Section 3 begins with the overall logic we used to determine which telescope 'structural form' should be adopted for further analysis and weight estimates. Specific telescope component analysis showing calculated fundamental frequencies and how they compare with our derived requirements are included. 'First-order' component stress analyses to ensure telescope optical and structural component (i.e. mirrors & main bulkhead) weights are realistic are presented. Layouts of both the primary and tertiary mirrors showing dimensions that are consistent with both our weight and frequency calculations also form part of Section 3. Section 4 presents our calculated values for the predicted thermally induced primary-to-secondary mirror despace motion due to the large temperature range over which LUTE must operate. Two different telescope design approaches (one which utilizes fused quartz metering rods and one which assumes the entire telescope is fabricated from beryllium) are considered in this analysis. We bound the secondary mirror focus mechanism range (in despace) based on these two telescope configurations. In Section 5 we show our overall design of the UVTA (Ultraviolet Telescope Assembly) via an 'exploded view' of the sub-system. The 'exploded view' is annotated to help aid in the understanding of each sub-assembly. We also include a two view layout of the UVTA from which telescope and telescope component dimensions can be measured. We conclude our study with a set of recommendations not only with respect to the LUTE structural architecture but also on other topics related to the overall feasibility of the LUTE telescope sub-system.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Ten Most Important Things to Know About Caring for Transgender Patients.

PubMed

Chipkin, Stuart R; Kim, Fred

2017-11-01

Transgender people have a gender that is not in agreement with their birth sex. Previous barriers, including lack of provider knowledge, have created significant healthcare disparities for this population. Recent societal changes are increasing the numbers of transgender people seen by primary care practitioners. Ten key principles are provided to help primary care practitioners create more welcoming environments and provide quality care to transgender patients. Overall, all members of the healthcare team (primary and specialty) need to become aware of the transition process and maintain communication regarding risks, benefits, and goals. Transwomen (aka male to female) can be treated with estrogens, antiandrogens, or a combination. Benefits include change in fat distribution, skin softening, and breast development. Significant risks for thrombosis from estrogens have been linked to genetic mutations, smoking, prolonged inactivity, and hormone formulation. Oral administration may provide increased risk over peripheral administration. Transmen (aka female to male) can be treated with peripheral testosterone preparations. Benefits include deepening of voice and development of facial and body hair with variable changes in muscle mass. Risks from testosterone appear to be less common than from estrogen. Laboratory monitoring can guide treatment decisions and provide early detection of some complications. Monitoring of "existing" anatomy (either hormonally or surgically created or removed) is an important component of healthcare for transgender patients. Primary care providers also should be aware of resources in their community and online, which can help patients optimize their transition. Copyright © 2017 Elsevier Inc. All rights reserved.

Oxy-Component in low-Pressure Kaersutite: How Much can be a Primary Magmatic Feature?

NASA Astrophysics Data System (ADS)

McCubbin, F.; Nekvasil, H.; Lindsley, D. H.

2006-05-01

Introduction: The presence of an oxy-component in kaersutite has been well established [1]. Many workers have attributed this oxy-component to dehydration or dehydrogenation [1, 2]. However, it has also been suggested that the oxy-component can be a primary magmatic feature because of a Ti-oxy substitution mechanism [2, 3], although the exact mechanism has yet to be determined experimentally [3]. This work focuses on experimentally determining how much oxy-component can be incorporated into kaersutite (specifically F-kaersutite) as a primary magmatic feature at 0 kbar. Additionally, substitution mechanisms involving Ti-oxy substitutions are con-sidered. Experimental Procedure: Powdered mixes of oxides and CaF2 were used as starting materials. F2/O ratios were different for each starting material in hopes of creating kaersutites with specific oxy- components for each starting composition. The powders were loaded into Fe-capsules and dried at 800°C under vacuum in silica-glass tubes. Next the silica-glass tubes were sealed and placed in a Deltech furnace. The temperature within the furnace was raised above the melting temperature of the starting material and main-tained for 3 hours to allow for liquid equilibration. The tempera-ture was then lowered to a crystallization temperature and left for several days. Pressures of both melting and crystallization were nominally 0 kbar (tensile strength of silica glass tubes used is ~3 atm). The resulting phases were considered to be nomi-nally water-free. [Quenched glass experiments at these conditions yielded 0.0 wt% H2O as determined by micro-FTIR]. Ex-perimental run products were analyzed by electron-microprobe. Results: To date, experiments on a starting mate-rial with 3.55 wt% fluorine yielded kaersutite that had ~75 mol% F-component and ~25 mol% oxy-component (as-suming O(3) site stoichiometry). Experiments on a starting mate-rial with 0.89 wt% F yielded kaersutites ranging from ~55 mol% F- component and ~45 mol% Oxy-component to ~70 mol% F-component and ~30 mol% Oxy- component. Conclusions: Significant primary magmatic oxy-component is apparently required in F-kaersutite crystallized at 0 kbar, which is consistent with suggested substitution mechanisms [2, 3], although the exact mechanism seems to be more complex than previously proposed. The availability of magmatic volatiles within the magma plays a role in the amount of oxy-component in kaersutite and could account for the complexity in the substitu-tion mechanism. Work is ongoing to establish upper and lower limits of oxy-component in kaersutite by primary magmatic proc-esses. References: [1] Hawthorne F.C., and Grundy, H.D. (1973) Mineralogical Magazine, Vol. 39, pp. 390-400. [2] Popp, R.K., and Bryndzia, L.T. (1992) American Mineralogist, Vol. 77, pp. 1250-1257. [3] Popp, R.K., Virgo, D., Phillips, M.W. (1995b) American Mineralogist, Vol. 80, pp. 1347-1350.

A Genealogical Interpretation of Principal Components Analysis

PubMed Central

McVean, Gil

2009-01-01

Principal components analysis, PCA, is a statistical method commonly used in population genetics to identify structure in the distribution of genetic variation across geographical location and ethnic background. However, while the method is often used to inform about historical demographic processes, little is known about the relationship between fundamental demographic parameters and the projection of samples onto the primary axes. Here I show that for SNP data the projection of samples onto the principal components can be obtained directly from considering the average coalescent times between pairs of haploid genomes. The result provides a framework for interpreting PCA projections in terms of underlying processes, including migration, geographical isolation, and admixture. I also demonstrate a link between PCA and Wright's fst and show that SNP ascertainment has a largely simple and predictable effect on the projection of samples. Using examples from human genetics, I discuss the application of these results to empirical data and the implications for inference. PMID:19834557

Wind tunnel investigation of nacelle-airframe interference at Mach numbers of 0.9 to 1.4 - pressure data, volume 1

NASA Technical Reports Server (NTRS)

Bencze, D. P.

1976-01-01

Detailed interference force and pressure data were obtained on a representative wing-body nacelle combination at Mach numbers of 0.9 to 1.4. The model consisted of a delta wing-body aerodynamic force model with four independently supported nacelles located beneath the wing-body combination. The model was mounted on a six component force balance, and the left hand wing was pressure instrumented. Each of the two right hand nacelles was mounted on a six component force balance housed in the thickness of the nacelle, while each of the left hand nacelles was pressure instrumented. The primary variables examined included Mach number, angle of attack, nacelle position, and nacelle mass flow ratio. Nacelle axial location, relative to both the wing-body combination and to each other, was the most important variable in determining the net interference among the components.

A probabilistic seismic risk assessment procedure for nuclear power plants: (II) Application

USGS Publications Warehouse

Huang, Y.-N.; Whittaker, A.S.; Luco, N.

2011-01-01

This paper presents the procedures and results of intensity- and time-based seismic risk assessments of a sample nuclear power plant (NPP) to demonstrate the risk-assessment methodology proposed in its companion paper. The intensity-based assessments include three sets of sensitivity studies to identify the impact of the following factors on the seismic vulnerability of the sample NPP, namely: (1) the description of fragility curves for primary and secondary components of NPPs, (2) the number of simulations of NPP response required for risk assessment, and (3) the correlation in responses between NPP components. The time-based assessment is performed as a series of intensity-based assessments. The studies illustrate the utility of the response-based fragility curves and the inclusion of the correlation in the responses of NPP components directly in the risk computation. ?? 2011 Published by Elsevier B.V.

KENNEDY SPACE CENTER, FLA. - At a ceremony highlighting the arrival of two major components of the International Space Station, William Gerstenmaier, International Space Station Program manager, points to one of the components as he speaks to guests and the media gathered in the Space Station Processing Facility. NASA's Node 2, built by the European Space Agency (ESA) in Italy, arrived at KSC on June 1. It will be the next pressurized module installed on the Station. The pressurized module of the Japanese Experiment Module (JEM), named "Kibo" (Hope), arrived at KSC on June 4. It is Japan's primary contribution to the Station. The ceremony held today included the official transfer of ownership signing of Node 2 between the ESA and NASA.. Emceed by Lisa Malone, deputy director of External Relations and Business Development at KSC, the ceremony also included these speakers: Center Director Roy Bridges Jr.; NASA’s Michael C. Kostelnik, deputy associate administrator for International Space Station and Shuttle Programs; Alan Thirkettle, International Space Station Program manager for Node 2, ESA; Andrea Lorenzoni, International Space Station Program manager for Node 2, Italian Space Agency; and Kuniaki Shiraki, JEM Project manager, National Aerospace and Development Agency of Japan.

NASA Image and Video Library

2003-06-18

KENNEDY SPACE CENTER, FLA. - At a ceremony highlighting the arrival of two major components of the International Space Station, William Gerstenmaier, International Space Station Program manager, points to one of the components as he speaks to guests and the media gathered in the Space Station Processing Facility. NASA's Node 2, built by the European Space Agency (ESA) in Italy, arrived at KSC on June 1. It will be the next pressurized module installed on the Station. The pressurized module of the Japanese Experiment Module (JEM), named "Kibo" (Hope), arrived at KSC on June 4. It is Japan's primary contribution to the Station. The ceremony held today included the official transfer of ownership signing of Node 2 between the ESA and NASA.. Emceed by Lisa Malone, deputy director of External Relations and Business Development at KSC, the ceremony also included these speakers: Center Director Roy Bridges Jr.; NASA’s Michael C. Kostelnik, deputy associate administrator for International Space Station and Shuttle Programs; Alan Thirkettle, International Space Station Program manager for Node 2, ESA; Andrea Lorenzoni, International Space Station Program manager for Node 2, Italian Space Agency; and Kuniaki Shiraki, JEM Project manager, National Aerospace and Development Agency of Japan.

Kottamia 74-inch telescope discovery of the new eclipsing binary KAO-EGYPT J225702.44+523222.1.: First CCD photometry and light curve analysis

NASA Astrophysics Data System (ADS)

Shokry, A.; Darwish, M. S.; Saad, S. M.; Eldepsy, M.; Zead, I.

2017-08-01

We present the first multicolor CCD photometry for the newly discovered binary system KAO-EGYPT J225702.44+523222.1. New times of light minimum and new ephemeris were obtained. The VR I light curves were analyzed using WD code, the difference in maximum light at phase 0.25 is modeled with a cool spot on the secondary component. The solution show that the system is A-subtype, overcontact binary with fill-out factor = 42% and low mass ratio, q = 0.275. The two components of spectral types K0 and K1 and the primary component is the massive one. The position of both components on the M-L and M-R relations revealed that the primary component is a main sequence star while the secondary is an evolved component.

Flight service environmental effects on composite materials and structures

NASA Technical Reports Server (NTRS)

Dexter, H. Benson; Baker, Donald J.

1992-01-01

NASA Langley and the U.S. Army have jointly sponsored programs to assess the effects of realistic flight environments and ground-based exposure on advanced composite materials and structures. Composite secondary structural components were initially installed on commercial transport aircraft in 1973; secondary and primary structural components were installed on commercial helicopters in 1979; and primary structural components were installed on commercial aircraft in the mid-to-late 1980's. Service performance, maintenance characteristics, and residual strength of numerous components are reported. In addition to data on flight components, 10 year ground exposure test results on material coupons are reported. Comparison between ground and flight environmental effects for several composite material systems are also presented. Test results indicate excellent in-service performance with the composite components during the 15 year period. Good correlation between ground-based material performance and operational structural performance has been achieved.

Eclipsing binary stars with a δ Scuti component

NASA Astrophysics Data System (ADS)

Kahraman Aliçavuş, F.; Soydugan, E.; Smalley, B.; Kubát, J.

2017-09-01

Eclipsing binaries with a δ Sct component are powerful tools to derive the fundamental parameters and probe the internal structure of stars. In this study, spectral analysis of six primary δ Sct components in eclipsing binaries has been performed. Values of Teff, v sin I, and metallicity for the stars have been derived from medium-resolution spectroscopy. Additionally, a revised list of δ Sct stars in eclipsing binaries is presented. In this list, we have only given the δ Sct stars in eclipsing binaries to show the effects of the secondary components and tidal-locking on the pulsations of primary δ Sct components. The stellar pulsation, atmospheric and fundamental parameters (e.g. mass, radius) of 92 δ Sct stars in eclipsing binaries have been gathered. Comparison of the properties of single and eclipsing binary member δ Sct stars has been made. We find that single δ Sct stars pulsate in longer periods and with higher amplitudes than the primary δ Sct components in eclipsing binaries. The v sin I of δ Sct components is found to be significantly lower than that of single δ Sct stars. Relationships between the pulsation periods, amplitudes and stellar parameters in our list have been examined. Significant correlations between the pulsation periods and the orbital periods, Teff, log g, radius, mass ratio, v sin I and the filling factor have been found.

Modeling Predictors of Duties Not Including Flying Status.

PubMed

Tvaryanas, Anthony P; Griffith, Converse

2018-01-01

The purpose of this study was to reuse available datasets to conduct an analysis of potential predictors of U.S. Air Force aircrew nonavailability in terms of being in "duties not to include flying" (DNIF) status. This study was a retrospective cohort analysis of U.S. Air Force aircrew on active duty during the period from 2003-2012. Predictor variables included age, Air Force Specialty Code (AFSC), clinic location, diagnosis, gender, pay grade, and service component. The response variable was DNIF duration. Nonparametric methods were used for the exploratory analysis and parametric methods were used for model building and statistical inference. Out of a set of 783 potential predictor variables, 339 variables were identified from the nonparametric exploratory analysis for inclusion in the parametric analysis. Of these, 54 variables had significant associations with DNIF duration in the final model fitted to the validation data set. The predicted results of this model for DNIF duration had a correlation of 0.45 with the actual number of DNIF days. Predictor variables included age, 6 AFSCs, 7 clinic locations, and 40 primary diagnosis categories. Specific demographic (i.e., age), occupational (i.e., AFSC), and health (i.e., clinic location and primary diagnosis category) DNIF drivers were identified. Subsequent research should focus on the application of primary, secondary, and tertiary prevention measures to ameliorate the potential impact of these DNIF drivers where possible.Tvaryanas AP, Griffith C Jr. Modeling predictors of duties not including flying status. Aerosp Med Hum Perform. 2018; 89(1):52-57.

Description and evaluation of GLOMAP-mode: a modal global aerosol microphysics model for the UKCA composition-climate model

NASA Astrophysics Data System (ADS)

Mann, G. W.; Carslaw, K. S.; Spracklen, D. V.; Ridley, D. A.; Manktelow, P. T.; Chipperfield, M. P.; Pickering, S. J.; Johnson, C. E.

2010-10-01

A new version of the Global Model of Aerosol Processes (GLOMAP) is described, which uses a two-moment pseudo-modal aerosol dynamics approach rather than the original two-moment bin scheme. GLOMAP-mode simulates the multi-component global aerosol, resolving sulfate, sea-salt, dust, black carbon (BC) and particulate organic matter (POM), the latter including primary and biogenic secondary POM. Aerosol processes are simulated in a size-resolved manner including primary emissions, secondary particle formation by binary homogeneous nucleation of sulfuric acid and water, particle growth by coagulation, condensation and cloud-processing and removal by dry deposition, in-cloud and below-cloud scavenging. A series of benchmark observational datasets are assembled against which the skill of the model is assessed in terms of normalised mean bias (b) and correlation coefficient (R). Overall, the model performs well against the datasets in simulating concentrations of aerosol precursor gases, chemically speciated particle mass, condensation nuclei (CN) and cloud condensation nuclei (CCN). Surface sulfate, sea-salt and dust mass concentrations are all captured well, while BC and POM are biased low (but correlate well). Surface CN concentrations compare reasonably well in free troposphere and marine sites, but are underestimated at continental and coastal sites related to underestimation of either primary particle emissions or new particle formation. The model compares well against a compilation of CCN observations covering a range of environments and against vertical profiles of size-resolved particle concentrations over Europe. The simulated global burden, lifetime and wet removal of each of the simulated aerosol components is also examined and each lies close to multi-model medians from the AEROCOM model intercomparison exercise.

Description and evaluation of GLOMAP-mode: a modal global aerosol microphysics model for the UKCA composition-climate model

NASA Astrophysics Data System (ADS)

Mann, G. W.; Carslaw, K. S.; Spracklen, D. V.; Ridley, D. A.; Manktelow, P. T.; Chipperfield, M. P.; Pickering, S. J.; Johnson, C. E.

2010-05-01

A new version of the Global Model of Aerosol Processes (GLOMAP) is described, which uses a two-moment modal aerosol scheme rather than the original two-moment bin scheme. GLOMAP-mode simulates the multi-component global aerosol, resolving sulphate, sea-salt, dust, black carbon (BC) and particulate organic matter (POM), the latter including primary and biogenic secondary POM. Aerosol processes are simulated in a size-resolved manner including primary emissions, secondary particle formation by binary homogeneous nucleation of sulphuric acid and water, particle growth by coagulation, condensation and cloud-processing and removal by dry deposition, in-cloud and below-cloud scavenging. A series of benchmark observational datasets are assembled against which the skill of the model is assessed in terms of normalised mean bias (b) and correlation coefficient (R). Overall, the model performs well against the datasets in simulating concentrations of aerosol precursor gases, chemically speciated particle mass, condensation nuclei (CN) and cloud condensation nuclei (CCN). Surface sulphate, sea-salt and dust mass concentrations are all captured well, while BC and POM are biased low (but correlate well). Surface CN concentrations compare reasonably well in free troposphere and marine sites, but are underestimated at continental and coastal sites related to underestimation of either primary particle emissions or new particle formation. The model compares well against a compilation of CCN observations covering a range of environments and against vertical profiles of size-resolved particle concentrations over Europe. The simulated global burden, lifetime and wet removal of each of the simulated aerosol components is also examined and each lies close to multi-model medians from the AEROCOM model intercomparison exercise.

Remagnetization mechanisms in Triassic red beds from South China

NASA Astrophysics Data System (ADS)

Jiang, Zhaoxia; Liu, Qingsong; Dekkers, Mark J.; Zhao, Xiang; Roberts, Andrew P.; Yang, Zhenyu; Jin, Chunsheng; Liu, Jianxing

2017-12-01

Paleogeographic reconstructions based on paleomagnetic data rely on the reliability of the natural remanent magnetization (NRM) as a primary geomagnetic signal. Remagnetizations, however, can be common in many rock types, including late Paleozoic and Mesozoic red beds, and they complicate paleogeographic interpretations. Extracting the primary NRM from partially remagnetized rocks, and understanding the remagnetization mechanism are important in these contexts. We carried out a systematic paleomagnetic study of red bed samples from the Triassic Huangmaqing Formation, Nanjing (32.0°N, 118.9°E), South China. Two NRM components carried by secondary and primary hematite are isolated in 47 of the 94 samples studied, where the latter component has a direction in stratigraphic coordinates of D = 29.2 °, I = 34.6 ° (α95 = 10.9 °, 47 samples from 6 sites) that yields a paleopole of λ = 60.8°N, ϕ = 228.1°E, dp / dm = 12.5 / 7.2, which is consistent with Triassic pole positions for the South China Block. A secondary chemical remanent magnetization (CRM) (D = 227.1 °, I = 80.8 °, α95 = 7.3 °) is documented in all 94 samples from 10 sites and is carried by pigmentary hematite that is inferred to have been generated by magnetite oxidation during orogenic activity. This secondary component has steep inclinations and is interpreted to have been influenced by a combination of the remanence carried by original parent magnetite, the orogenic stress field, and the prevailing geomagnetic field direction during deformation. This CRM direction is recorded commonly by red beds from the South China Block, and is significant for regional tectonic studies in the area.

Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis.

PubMed

Hofmeister, Mark; Memedovich, Ally; Dowsett, Laura E; Sevick, Laura; McCarron, Tamara; Spackman, Eldon; Stafinski, Tania; Menon, Devidas; Noseworthy, Tom; Clement, Fiona

2018-03-07

The aim of palliative care is to improve the quality of life of patients and families through the prevention and relief of suffering. Frequently, patients may choose to receive palliative care in the home. The objective of this paper is to summarize the quality and primary outcomes measured within the palliative care in the home literature. This will synthesize the current state of the literature and inform future work. A scoping review was completed using PRISMA guidelines. PubMed, Embase, CINAHL, Web of Science, Cochrane Library, EconLit, PsycINFO, Centre for Reviews and Dissemination, Database of Abstracts of Reviews of Effects, and National Health Service Economic Evaluation Database were searched from inception to August 2016. Inclusion criteria included: 1) care was provided in the "home of the patient" as defined by the study, 2) outcomes were reported, and 3) reported original data. Thematic component analysis was completed to categorize interventions. Fifty-three studies formed the final data set. The literature varied extensively. Five themes were identified: accessibility of healthcare, caregiver support, individualized patient centered care, multidisciplinary care provision, and quality improvement. Primary outcomes were resource use, symptom burden, quality of life, satisfaction, caregiver distress, place of death, cost analysis, or described experiences. The majority of studies were of moderate or unclear quality. There is robust literature of varying quality, assessing different components of palliative care in the home interventions, and measuring different outcomes. To be meaningful to patients, these interventions need to be consistently evaluated with outcomes that matter to patients. Future research could focus on reaching a consensus for outcomes to evaluate palliative care in the home interventions.

Correcting speleothem oxygen isotopic variations for growth-rate controlled kinetic fractionation effects

NASA Astrophysics Data System (ADS)

Stoll, Heather; Moreno, Ana; Cacho, Isabel; Mendez Vicence, Ana; Gonzalez Lemos, Saul; Pirla Casasayas, Gemma; Cheng, Hai; Wang, Xianfeng; Edwards, R. Lawrence

2015-04-01

The oxygen isotopic signature may be the most widely used climate indicator in stalagmites, but recent experimental and theoretical studies indicate the potential for kinetic fractionation effects which may be significant, especially in situations where the primary signal from rainfall isotopic composition and cave temperature is limited to a few permil. Here we use a natural set of stalagmites to illustrate the magnitude of such effects and the potential for deconvolving kinetic signals from the primary temperature and rainfall signals. We compare isotopic records from 6 coeval stalagmites covering the interval 140 to 70 ka, from two proximal caves in NW Spain which experienced the same primary variations in temperature and rainfall d18O, but exhibit a large range in growth rates and temporal trends in growth rate. Stalagmites growing at faster rates near 50 microns/year have oxygen isotopic ratios more than 1 permil more negative than coeval stalagmites with very slow (5 micron/year) growth rates. Because growth rate variations also occur over time within any given stalagmite, the measured oxygen isotopic time series for a given stalagmite includes both climatic and kinetic components. Removal of the kinetic component of variation in each stalagmite, based on the dependence of the kinetic component on growth rate, is effective at distilling a common temporal evolution among the oxygen isotopic records of the multiple stalagmites. However, this approach is limited by the quality of the age model. For time periods characterized by very slow growth and long durations between dates, the presence of crypto-hiatus may result in average growth rates which underestimate the instantaneous speleothem deposition rates and which therefore underestimate the magnitude of kinetic effects. We compare the composite corrected oxygen isotopic record with other records of the timing of glacial inception in the North Atlantic realm.

A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity): rationale, design and methodology of a randomized controlled trial in Nanjing city, China.

PubMed

Xu, Fei; Ware, Robert S; Tse, Lap Ah; Wang, Zhiyong; Hong, Xin; Song, Aiju; Li, Jiequan; Wang, Youfa

2012-06-15

The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between May 2010 and December 2013. Each school was randomly assigned to either the intervention or control group (four schools in each group). Participants were the 4th graders in each participating school. The multi-component program was implemented within the intervention group, while students in the control group followed their usual health and physical education curriculum with no additional intervention program. The intervention consisted of four components: a) classroom curriculum, (including physical education and healthy diet education), b) school environment support, c) family involvement, and d) fun programs/events. The primary study outcome was body composition, and secondary outcomes were behaviour and behavioural determinants. The intervention was designed with due consideration of Chinese cultural and familial tradition, social convention, and current primary education and exam system in Mainland China. We did our best to gain good support from educational authorities, school administrators, teachers and parents, and to integrate intervention components into schools' regular academic programs. The results of and lesson learned from this study will help guide future school-based childhood obesity prevention programs in Mainland China. ChiCTR-ERC-11001819.

Jet fuel based high pressure solid oxide fuel cell system

NASA Technical Reports Server (NTRS)

Gummalla, Mallika (Inventor); Yamanis, Jean (Inventor); Olsommer, Benoit (Inventor); Dardas, Zissis (Inventor); Bayt, Robert (Inventor); Srinivasan, Hari (Inventor); Dasgupta, Arindam (Inventor); Hardin, Larry (Inventor)

2013-01-01

A power system for an aircraft includes a solid oxide fuel cell system which generates electric power for the aircraft and an exhaust stream; and a heat exchanger for transferring heat from the exhaust stream of the solid oxide fuel cell to a heat requiring system or component of the aircraft. The heat can be transferred to fuel for the primary engine of the aircraft. Further, the same fuel can be used to power both the primary engine and the SOFC. A heat exchanger is positioned to cool reformate before feeding to the fuel cell. SOFC exhaust is treated and used as inerting gas. Finally, oxidant to the SOFC can be obtained from the aircraft cabin, or exterior, or both.

Causes and treatments of achalasia, and primary disorders of the esophageal body.

PubMed

Felix, Valter Nilton; DeVault, Kenneth; Penagini, Roberto; Elvevi, Alessandra; Swanstrom, Lee; Wassenaar, Eelco; Crespin, Oscar M; Pellegrini, Carlos A; Wong, Roy

2013-10-01

The following on achalasia and disorders of the esophageal body includes commentaries on controversies regarding whether patients with complete lower esophageal sphincter (LES) relaxation can be considered to exhibit early achalasia; the roles of different mucle components of the LES in achalasia; sensory neural pathways impaired in achalasia; indications for peroral endoscopic myotomy and advantages of the technique over laparoscopic and thorascopic myotomy; factors contributing to the success of surgical therapy for achalasia; modifications to the classification of esophageal body primary motility disorders in the advent of high-resolution manometry (HRM); analysis of the LES in differentiating between achalasia and diffuse esophageal spasm (DES); and appropriate treatment for DES, nutcracker esophagus (NE), and hypertensive LES (HTLES). © 2013 New York Academy of Sciences.

Jet Fuel Based High Pressure Solid Oxide Fuel Cell System

NASA Technical Reports Server (NTRS)

Srinivasan, Hari (Inventor); Hardin, Larry (Inventor); Gummalla, Mallika (Inventor); Yamanis, Jean (Inventor); Olsommer, Benoit (Inventor); Dardas, Zissis (Inventor); Dasgupta, Arindam (Inventor); Bayt, Robert (Inventor)

2015-01-01

A power system for an aircraft includes a solid oxide fuel cell system which generates electric power for the aircraft and an exhaust stream; and a heat exchanger for transferring heat from the exhaust stream of the solid oxide fuel cell to a heat requiring system or component of the aircraft. The heat can be transferred to fuel for the primary engine of the aircraft. Further, the same fuel can be used to power both the primary engine and the SOFC. A heat exchanger is positioned to cool reformate before feeding to the fuel cell. SOFC exhaust is treated and used as inerting gas. Finally, oxidant to the SOFC can be obtained from the aircraft cabin, or exterior, or both.

Computational study of duct and pipe flows using the method of pseudocompressibility

NASA Technical Reports Server (NTRS)

Williams, Robert W.

1991-01-01

A viscous, three-dimensional, incompressible, Navier-Stokes Computational Fluid Dynamics code employing pseudocompressibility is used for the prediction of laminar primary and secondary flows in two 90-degree bends of constant cross section. Under study are a square cross section duct bend with 2.3 radius ratio and a round cross section pipe bend with 2.8 radius ratio. Sensitivity of predicted primary and secondary flow to inlet boundary conditions, grid resolution, and code convergence is investigated. Contour and velocity versus spanwise coordinate plots comparing prediction to experimental data flow components are shown at several streamwise stations before, within, and after the duct and pipe bends. Discussion includes secondary flow physics, computational method, computational requirements, grid dependence, and convergence rates.

Total elbow arthroplasty in primary osteoarthritis of the elbow.

PubMed

Kozak, T K; Adams, R A; Morrey, B F

1998-10-01

Primary osteoarthritis of the elbow is an infrequent condition typically managed by some form of debridement. There is no comment in the literature regarding prosthetic replacement for this condition. We report 5 patients (mean age, 68), with a minimum assessment of 3 years (range, 37-125 years) after total elbow arthroplasty. Complications in 4 patients included subluxation, fracture of a humeral component with particulate synovitis, heterotopic ossification, recurrent osteophyte formation, and transient ulnar neuropathy. Although revision was required in 2 of the 5, currently all experience had satisfactory outcomes. While replacement has proven ultimately to be a successful option for this high-demand patient group because of the high complication rate, we do not recommend replacement unless alternate operative options are deemed unacceptable.

Air Pollution Exposures and Circulating Biomarkers of Effect in a Susceptible Population: Clues to Potential Causal Component mixtures and mechanisms

PubMed Central

Delfino, Ralph J.; Staimer, Norbert; Tjoa, Thomas; Gillen, Daniel L.; Polidori, Andrea; Arhami, Mohammad; Kleinman, Micheal T.; Vaziri, Nosratola D.; Longhurst, John; Sioutas, Constantinos

2009-01-01

Background Mechanisms involving oxidative stress and inflammation have been proposed to explain associations of ambient air pollution with cardiovascular morbidity and mortality. Experimental evidence suggests that organic components and ultrafine particles (UFP) are important. Methods We conducted a panel study of 60 elderly subjects with coronary artery disease living in retirement communities within the Los Angeles, California, air basin. Weekly biomarkers of inflammation included plasma interleukin-6, tumor necrosis factor-α soluble receptor II (sTNF-RII), soluble platelet selectin (sP-selectin), and C-reactive protein (CRP). Biomarkers of erythrocyte antioxidant activity included glutathione peroxidase-1 and superoxide dismutase. Exposures included outdoor home daily particle mass [particulate matter < 0.25, 0.25–2.5, and 2.5–10 μm in aerodynamic diameter (PM0.25, PM0.25–2.5, PM2.5–10)], and hourly elemental and black carbon (EC–BC), estimated primary and secondary organic carbon (OCpri, SOC), particle number (PN), carbon monoxide (CO), and nitrogen oxides–nitrogen dioxide (NOx–NO2). We analyzed the relation of biomarkers to exposures with mixed effects models adjusted for potential confounders. Results Primary combustion markers (EC–BC, OCpri, CO, NOx–NO2), but not SOC, were positively associated with inflammatory biomarkers and inversely associated with erythrocyte anti-oxidant enzymes (n = 578). PN and PM0.25 were more strongly associated with biomarkers than PM0.25–2.5. Associations for all exposures were stronger during cooler periods when only OCpri, PN, and NOx were higher. We found weaker associations with statin (sTNF-RII, CRP) and clopidogrel use (sP-selectin). Conclusions Traffic-related air pollutants are associated with increased systemic inflammation, increased platelet activation, and decreased erythrocyte antioxidant enzyme activity, which may be partly behind air pollutant–related increases in systemic inflammation. Differences in association by particle size, OC fraction, and seasonal period suggest components carried by UFP are important. PMID:19672402

Creating a driving profile for older adults using GPS devices and naturalistic driving methodology.

PubMed

Babulal, Ganesh M; Traub, Cindy M; Webb, Mollie; Stout, Sarah H; Addison, Aaron; Carr, David B; Ott, Brian R; Morris, John C; Roe, Catherine M

2016-01-01

Background/Objectives : Road tests and driving simulators are most commonly used in research studies and clinical evaluations of older drivers. Our objective was to describe the process and associated challenges in adapting an existing, commercial, off-the-shelf (COTS), in-vehicle device for naturalistic, longitudinal research to better understand daily driving behavior in older drivers. Design : The Azuga G2 Tracking Device TM was installed in each participant's vehicle, and we collected data over 5 months (speed, latitude/longitude) every 30-seconds when the vehicle was driven.  Setting : The Knight Alzheimer's Disease Research Center at Washington University School of Medicine. Participants : Five individuals enrolled in a larger, longitudinal study assessing preclinical Alzheimer disease and driving performance.  Participants were aged 65+ years and had normal cognition. Measurements :  Spatial components included Primary Location(s), Driving Areas, Mean Centers and Unique Destinations.  Temporal components included number of trips taken during different times of the day.  Behavioral components included number of hard braking, speeding and sudden acceleration events. Methods :  Individual 30-second observations, each comprising one breadcrumb, and trip-level data were collected and analyzed in R and ArcGIS.  Results : Primary locations were confirmed to be 100% accurate when compared to known addresses.  Based on the locations of the breadcrumbs, we were able to successfully identify frequently visited locations and general travel patterns.  Based on the reported time from the breadcrumbs, we could assess number of trips driven in daylight vs. night.  Data on additional events while driving allowed us to compute the number of adverse driving alerts over the course of the 5-month period. Conclusions : Compared to cameras and highly instrumented vehicle in other naturalistic studies, the compact COTS device was quickly installed and transmitted high volumes of data. Driving Profiles for older adults can be created and compared month-to-month or year-to-year, allowing researchers to identify changes in driving patterns that are unavailable in controlled conditions.

Changes in carbon allocation to aboveground versus belowground forest components is driven by a trade-off involving mycorrhizal fungi, not fine roots

NASA Astrophysics Data System (ADS)

Ouimette, A.; Ollinger, S. V.; Hobbie, E. A.; Lepine, L. C.; Stephens, R.; Rowe, R.; Vadeboncoeur, M. A.; Tumber-Davila, S. J.

2017-12-01

Species composition and resource availability exert a strong influence on the dynamics of carbon allocation among different forest ecosystem components. Recent work in temperate forests has highlighted a tradeoff between carbon allocation to aboveground woody tissues (access to light), and belowground to fine roots (access to soil nutrients). Although root-associated mycorrhizal fungi are crucial for N acquisition and can receive 20% or more of annual net primary production, most studies fail to explicitly include carbon allocation to mycorrhizal fungi. In part, this is due to the inherent difficulties in accurately quantifying fungal production. We took several approaches to quantify production of mycorrhizal fungi, including a carbon budget approach and isotopic techniques. Here we present data on patterns of carbon allocation to aboveground (wood and foliar production), and belowground components (production of fine roots and mycorrhizal fungi), across temperate forest stands spanning a range of nitrogen availability and species composition. We found that as the proportion of conifer species decreased, and stand nitrogen availability increased, both the absolute amount and the fraction of net primary production increased for foliage, aboveground wood, and fine roots ("a rising tide lifts all boats"). While allocation to plant pools increased, allocation to mycorrhizal fungi significantly decreased with decreasing conifer dominance and increasing soil nitrogen availability. We did not find a strong trade-off between carbon allocation to fine roots and aboveground wood or foliage. Instead, a negative relationship is seen between allocation to mycorrhizal fungi and other plant pools. Effort to estimate carbon allocation to mycorrhizal fungi is important for gaining a more complete understanding of how ecosystems respond to changes in growth-limiting resources.

Cardiocerebral Resuscitation: An Approach to Improving Survival of Patients With Primary Cardiac Arrest.

PubMed

Ewy, Gordon A; Bobrow, Bentley J

2016-01-01

Out-of-hospital cardiac arrest (OHCA) is a major public health problem. In the United States, OHCA accounts for more premature deaths than any other cause. For over a half-century, the national "Guidelines" for resuscitation have recommended the same initial treatment of primary and secondary cardiac arrests. Using this approach, the overall survival of patients with OHCA, while quite variable, was generally very poor. One reason is that the etiologies of cardiac arrests are not all the same. The vast majority of nontraumatic OHCA in adults are due to a "primary" cardiac arrest, rather than secondary to respiratory arrest. Decades of research and ongoing reviews of the literature led the University of Arizona Sarver Heart Center Resuscitation Research Group to conclude in 2003 that the national guidelines for patients with primary cardiac arrest were not optimal. Therefore, we instituted a new, nonguidelines approach to the therapy of primary cardiac arrest that dramatically improved survival. We called this approach cardiocerebral resuscitation (CCR), as it is the heart and the brain that are the most vulnerable and therefore need to be the focus of resuscitation efforts for these patients. In contrast, cardiopulmonary resuscitation should be reserved for respiratory arrests. Cardiocerebral resuscitation evolved into 3 components: the community, with emphasis for lay individuals to "Check, Call, Compress" and use an automated external defibrillator if available; the Emergency Medical Services, that emphasizes delayed intubation in favor of passive ventilation, urgent and near continuous chest compressions before and immediately after a single indicated shock, and the early administration of epinephrine; and the third component, added in 2007, the designations of hospitals in Arizona that request this designation and agree to receive patients with return of spontaneous circulation following OHCA and to institute state-of-the-art postresuscitation care that includes urgent therapeutic mild hypothermia and cardiac catheterization as a Cardiac Receiving Center. Each component of CCR is critical for optimal survival of patients with primary OHCA. In each city, county, and state where CCR was instituted, the result was a marked increase in survival of the subgroup of patients with OHCA most likely to survive, for example, those with a shockable rhythm. The purpose of this invited article on CCR is to review this alternative approach to resuscitation of patients with primary cardiac arrest and to encourage its adoption worldwide so that more lives can be saved. © The Author(s) 2014.

2. VIEW LOOKING NORTHEAST AT BUILDING 444 UNDER CONSTRUCTION. BUILDING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. VIEW LOOKING NORTHEAST AT BUILDING 444 UNDER CONSTRUCTION. BUILDING 444 WAS THE PRIMARY NON-PLUTONIUM MANUFACTURING FACILITY AT THE ROCKY FLATS PLANT. MANUFACTURING PROCESSES COMPLETED IN THIS BUILDING WERE USED TO FABRICATE WEAPONS COMPONENTS AND ASSEMBLIES FOR A VARIETY OF MATERIALS, INCLUDING DEPLETED URANIUM, BERYLLIUM, STAINLESS STEEL, ALUMINUM, AND VANADIUM. (4/25/52) - Rocky Flats Plant, Non-Nuclear Production Facility, South of Cottonwood Avenue, west of Seventh Avenue & east of Building 460, Golden, Jefferson County, CO

A New Measurement of the Cosmic-Ray Proton and Helium Spectra

NASA Astrophysics Data System (ADS)

Mocchiutti, E.; Ambriola, M.; Bartalucci, S.; Bellotti, R.; Bergström, D.; Boezio, M.; Bonicini, V.; Bravar, U.; Cafagna, F.; Carlson, P.; Casolino, M.; Ciacio, F.; Circella, M.; De Marzo, C. N.; De Pascale, M. P.; Finetti, N.; Francke, T.; Hansen, P.; Hof, M.; Kremer, J.; Menn, W.; Mitchell, J. W.; Mocchiutti, E.; Morselli, A.; Ormes, J. F.; Papini, P.; Piccardi, S.; Picozza, P.; Ricci, M.; Schiavon, P.; Simon, M.; Sparvoli, R.; Spillantini, P.; Stephens, S. A.; Stochaj, S. J.; Streitmatter, R. E.; Suffert, M.; Vacchi, A.; Vannuccini, E.; Zampa, N.; WIZARD/CAPRICE Collaboration

2001-08-01

A new measurement of the primary cosmic ray spectra was performed during the balloon-borne CAPRICE experiment in 1998. This apparatus consists of a magnet spectrometer, with a superconducting magnet and a driftchamber tracking device, a time of flight scintillator system, a silicon-tungsten imaging calorimeter and a gas ring imaging Cherenkov detector. This combination of state-of-the-art detectors provides excellent particle discrimination capabilities, such that detailed investigations of the antiproton, electron/positron, muon and primary components of cosmic rays have been performed. The analysis of the primary proton component is illustrated in this paper.

Interventionist training and intervention fidelity monitoring and maintenance for CONNECT, a nurse-led primary palliative care in oncology trial.

PubMed

Robbins-Welty, Gregg A; Mueser, Lisa; Mitchell, Chandler; Pope, Nicole; Arnold, Robert; Park, SeoYoung; White, Doug; Smith, Kenneth J; Reynolds, Charles; Rosenzweig, Margaret; Bakitas, Marie; Schenker, Yael

2018-06-01

Intervention fidelity is a critical component of behavioral research that has received inadequate attention in palliative care studies. With increasing focus on the need for palliative care models that can be widely disseminated and delivered by non-specialists, rigorous yet pragmatic strategies for training interventionists and maintaining intervention fidelity are needed. (1) Describe components of a plan for interventionist training and monitoring and maintaining intervention fidelity as part of a primary palliative care trial (CONNECT) and (2) present data about perceived training effectiveness and delivery of key intervention content. Post-training evaluations, visit checklists, and visit audio-recordings. Data were collected from June, 2016 through April, 2017. We include procedures for (1) identification, training and certification of oncology nurses as CONNECT interventionists; (2) monitoring intervention delivery; and (3) maintaining intervention quality. All nurses (N = 14) felt prepared to deliver key competencies after a 3-day in-person training. As assessed via visit checklists, interventionists delivered an average of 94% (SD 13%) of key content for first intervention visits and 85% (SD 14%) for subsequent visits. As assessed via audio-recordings, interventionists delivered an average of 85% (SD 8%) of key content for initial visits and 85% (SD 12%) for subsequent visits. We present a 3-part strategy for training interventionists and monitoring and maintaining intervention delivery in a primary palliative care trial. Training was effective in having nurses feel prepared to deliver primary palliative care skills. As assessed via nursing checklists and visit audio-recordings, intervention fidelity was high.

Overexpression of Arabidopsis Plasmodesmata Germin-Like Proteins Disrupts Root Growth and Development[C][W

PubMed Central

Ham, Byung-Kook; Li, Gang; Kang, Byung-Ho; Zeng, Fanchang; Lucas, William J.

2012-01-01

In plants, a population of non-cell-autonomous proteins (NCAPs), including numerous transcription factors, move cell to cell through plasmodesmata (PD). In many cases, the intercellular trafficking of these NCAPs is regulated by their interaction with specific PD components. To gain further insight into the functions of this NCAP pathway, coimmunoprecipitation experiments were performed on a tobacco (Nicotiana tabacum) plasmodesmal-enriched cell wall protein preparation using as bait the NCAP, pumpkin (Cucurbita maxima) PHLOEM PROTEIN16 (Cm-PP16). A Cm-PP16 interaction partner, Nt-PLASMODESMAL GERMIN-LIKE PROTEIN1 (Nt-PDGLP1) was identified and shown to be a PD-located component. Arabidopsis thaliana putative orthologs, PDGLP1 and PDGLP2, were identified; expression studies indicated that, postgermination, these proteins were preferentially expressed in the root system. The PDGLP1 signal peptide was shown to function in localization to the PD by a novel mechanism involving the endoplasmic reticulum-Golgi secretory pathway. Overexpression of various tagged versions altered root meristem function, leading to reduced primary root but enhanced lateral root growth. This effect on root growth was corrected with an inability of these chimeric proteins to form stable PD-localized complexes. PDGLP1 and PDGLP2 appear to be involved in regulating primary root growth by controlling phloem-mediated allocation of resources between the primary and lateral root meristems. PMID:22960910

School lunch program in India: background, objectives and components.

PubMed

Chutani, Alka Mohan

2012-01-01

The School Lunch Program in India (SLP) is the largest food and nutrition assistance program feeding millions of children every day. This paper provides a review of the background information on the SLP in India earlier known as national program for nutrition support to primary education (NP-NSPE) and later as mid day meal scheme, including historical trends and objectives and components/characteristics of the scheme. It also addresses steps being taken to meet challenges being faced by the administrators of the program in monitoring and evaluation of the program. This program was initially started in 1960 in few states to overcome the complex problems malnutrition and illiteracy. Mid Day Meal Scheme is the popular name for school meal program. In 2001, as per the supreme court orders, it became mandatory to give a mid day meal to all primary and later extended to upper primary school children studying in the government and government aided schools. This scheme benefitted 140 million children in government assisted schools across India in 2008, strengthening child nutrition and literacy. In a country with a large percent of illiterate population with a high percent of children unable to read or write; governmental and non-governmental organizations have reported that mid day meal scheme has consistently increased enrollment in schools in India. One of the main goals of school lunch program is to promote the health and well-being of the Nation's children.

Overexpression of Arabidopsis plasmodesmata germin-like proteins disrupts root growth and development.

PubMed

Ham, Byung-Kook; Li, Gang; Kang, Byung-Ho; Zeng, Fanchang; Lucas, William J

2012-09-01

In plants, a population of non-cell-autonomous proteins (NCAPs), including numerous transcription factors, move cell to cell through plasmodesmata (PD). In many cases, the intercellular trafficking of these NCAPs is regulated by their interaction with specific PD components. To gain further insight into the functions of this NCAP pathway, coimmunoprecipitation experiments were performed on a tobacco (Nicotiana tabacum) plasmodesmal-enriched cell wall protein preparation using as bait the NCAP, pumpkin (Cucurbita maxima) PHLOEM PROTEIN16 (Cm-PP16). A Cm-PP16 interaction partner, Nt-PLASMODESMAL GERMIN-LIKE PROTEIN1 (Nt-PDGLP1) was identified and shown to be a PD-located component. Arabidopsis thaliana putative orthologs, PDGLP1 and PDGLP2, were identified; expression studies indicated that, postgermination, these proteins were preferentially expressed in the root system. The PDGLP1 signal peptide was shown to function in localization to the PD by a novel mechanism involving the endoplasmic reticulum-Golgi secretory pathway. Overexpression of various tagged versions altered root meristem function, leading to reduced primary root but enhanced lateral root growth. This effect on root growth was corrected with an inability of these chimeric proteins to form stable PD-localized complexes. PDGLP1 and PDGLP2 appear to be involved in regulating primary root growth by controlling phloem-mediated allocation of resources between the primary and lateral root meristems.

Continuing care and long-term substance use outcomes in managed care: early evidence for a primary care-based model.

PubMed

Chi, Felicia W; Parthasarathy, Sujaya; Mertens, Jennifer R; Weisner, Constance M

2011-10-01

How best to provide ongoing services to patients with substance use disorders to sustain long-term recovery is a significant clinical and policy question that has not been adequately addressed. Analyzing nine years of prospective data for 991 adults who entered substance abuse treatment in a private, nonprofit managed care health plan, this study aimed to examine the components of a continuing care model (primary care, specialty substance abuse treatment, and psychiatric services) and their combined effect on outcomes over nine years after treatment entry. In a longitudinal observational study, follow-up measures included self-reported alcohol and drug use, Addiction Severity Index scores, and service utilization data extracted from the health plan databases. Remission, defined as abstinence or nonproblematic use, was the outcome measure. A mixed-effects logistic random intercept model controlling for time and other covariates found that yearly primary care, and specialty care based on need as measured at the prior time point, were positively associated with remission over time. Persons receiving continuing care (defined as having yearly primary care and specialty substance abuse treatment and psychiatric services when needed) had twice the odds of achieving remission at follow-ups (p<.001) as those without. Continuing care that included both primary care and specialty care management to support ongoing monitoring, self-care, and treatment as needed was important for long-term recovery of patients with substance use disorders.

An Assessment of Nondestructive Evaluation Capability for Complex Additive Manufacturing Aerospace Components

NASA Technical Reports Server (NTRS)

Walker, James; Beshears, Ron; Lambert, Dennis; Tilson, William

2016-01-01

The primary focus of this work is to investigate some of the fundamental relationships between processing, mechanical testing, materials characterization, and NDE for additively manufactured (AM) components using the powder bed fusion direct melt laser sintered process. The goal is to understand the criticality of defects unique to the AM process and then how conventional nondestructive evaluation methods as well as some of the more non-traditional methods such as computed tomography, are effected by the AM material. Specific defects including cracking, porosity and partially/unfused powder will be addressed. Besides line-of-site NDE, as appropriate these inspection capabilities will be put into the context of complex AM geometries where hidden features obscure, or inhibit traditional NDE methods.

Rec.2100 color gamut revelation using spectrally ultranarrow emitters

NASA Astrophysics Data System (ADS)

Genc, Sinan; Uguz, Mustafa; Yilmaz, Osman; Mutlugun, Evren

2017-11-01

We theoretically simulate the performance of ultranarrow emitters for the first time to achieve record high coverage for the International Telecommunication Union Radiocommunication Sector BT.2100 (Rec.2100) and National Television System Committee (NTSC) color gamut. Our results, employing more than 130-m parameter sets, include the investigation into peak emission wavelength and full width at half maximum (FWHM) values for three primaries that show ultranarrow emitters, i.e., nanoplatelets are potentially promising materials to fully cover the Rec.2100 color gamut. Using ultranarrow emitters having FWHM as low as 6 nm can provide the ability to attain 99.7% coverage area of the Rec.2100 color gamut as well as increasing the NTSC triangle to 133.7% with full coverage. The parameter set that provides possibility to fully reach Rec.2100 also has been shown to match with D65 white light by making use of the correct combination of those three primaries. Furthermore, we investigate the effect of the fourth color component on the CIE 1931 color space without sacrificing the achieved coverage percentages. The investigation into the fourth color component, cyan, is shown for the first time to enhance the Rec.2100 gamut area to 127.7% with 99.9% coverage. The fourth color component also provides an NTSC coverage ratio of 171.5%. The investigation into the potential of emitters with ultranarrow emission bandwidth holds great promise for future display applications.

Transfer and dissipation of energy during wave group propagation on a gentle beach slope

NASA Astrophysics Data System (ADS)

Padilla, Enrique M.; Alsina, José M.

2017-08-01

The propagation of bichromatic wave groups over a constant 1:100 beach slope and the influence of the group modulation is presented. The modulation is controlled by varying the group frequency, fg, which is shown to remarkably affect the energy transfer to high and low frequency components. The growth of the high frequency (hf) wave skewness increases when fg decreases. This is explained by nonlinear coupling between the primary frequencies, which results in a larger growth of hf components as fg decreases, causing the hf waves to break earlier. Due to high spatial resolution, wave tracking has provided an accurate measurement of the varying breakpoint. These breaking locations are very well described (R2>0.91) by the wave-height to effective-depth ratio (γ). However, for any given Iribarren number, this γ is shown to increase with fg. Therefore, a modified Iribarren number is proposed to include the grouping structure, leading to a considerable improvement in reproducing the measured γ-values. Within the surf zone, the behavior of the Incident Long Wave also depends on the group modulation. For low fg conditions, the lf wave decays only slightly by transferring energy back to the hf wave components. However, for high fg wave conditions, strong dissipation of low frequency (lf) components occurs close to the shoreline associated with lf wave breaking. This mechanism is explained by the growth of the lf wave height, induced partly by the self-self interaction of fg, and partly by the nonlinear coupling between the primary frequencies and fg.

Baseline Architecture of ITER Control System

NASA Astrophysics Data System (ADS)

Wallander, A.; Di Maio, F.; Journeaux, J.-Y.; Klotz, W.-D.; Makijarvi, P.; Yonekawa, I.

2011-08-01

The control system of ITER consists of thousands of computers processing hundreds of thousands of signals. The control system, being the primary tool for operating the machine, shall integrate, control and coordinate all these computers and signals and allow a limited number of staff to operate the machine from a central location with minimum human intervention. The primary functions of the ITER control system are plant control, supervision and coordination, both during experimental pulses and 24/7 continuous operation. The former can be split in three phases; preparation of the experiment by defining all parameters; executing the experiment including distributed feed-back control and finally collecting, archiving, analyzing and presenting all data produced by the experiment. We define the control system as a set of hardware and software components with well defined characteristics. The architecture addresses the organization of these components and their relationship to each other. We distinguish between physical and functional architecture, where the former defines the physical connections and the latter the data flow between components. In this paper, we identify the ITER control system based on the plant breakdown structure. Then, the control system is partitioned into a workable set of bounded subsystems. This partition considers at the same time the completeness and the integration of the subsystems. The components making up subsystems are identified and defined, a naming convention is introduced and the physical networks defined. Special attention is given to timing and real-time communication for distributed control. Finally we discuss baseline technologies for implementing the proposed architecture based on analysis, market surveys, prototyping and benchmarking carried out during the last year.

Characterization of Femoral Component Initial Stability and Cortical Strain in a Reduced Stem-Length Design.

PubMed

Small, Scott R; Hensley, Sarah E; Cook, Paige L; Stevens, Rebecca A; Rogge, Renee D; Meding, John B; Berend, Michael E

2017-02-01

Short-stemmed femoral components facilitate reduced exposure surgical techniques while preserving native bone. A clinically successful stem should ideally reduce risk for stress shielding while maintaining adequate primary stability for biological fixation. We asked (1) how stem-length changes cortical strain distribution in the proximal femur in a fit-and-fill geometry and (2) if short-stemmed components exhibit primary stability on par with clinically successful designs. Cortical strain was assessed via digital image correlation in composite femurs implanted with long, medium, and short metaphyseal fit-and-fill stem designs in a single-leg stance loading model. Strain was compared to a loaded, unimplanted femur. Bone-implant micromotion was then compared with reduced lateral shoulder short stem and short tapered-wedge designs in cyclic axial and torsional testing. Femurs implanted with short-stemmed components exhibited cortical strain response most closely matching that of the intact femur model, theoretically reducing the potential for proximal stress shielding. In micromotion testing, no difference in primary stability was observed as a function of reduced stem length within the same component design. Our findings demonstrate that within this fit-and-fill stem design, reduction in stem length improved proximal cortical strain distribution and maintained axial and torsional stability on par with other stem designs in a composite femur model. Short-stemmed implants may accommodate less invasive surgical techniques while facilitating more physiological femoral loading without sacrificing primary implant stability. Copyright © 2016 Elsevier Inc. All rights reserved.

[Screening of Active Fractions from Huanglian Jiedu Decoction against Primary Neuron Injury after Oxygen-Glucose Deprivation].

PubMed

Huang, Zhu-yan; Pan, Bei-bei; Huang, Chun-yan; Ye, Yi-lu; Liu, Dan-dan; Yu, Yue-ping; Zhang, Qi

2015-08-01

To observe the protective effect of active fractions of Huanglian Jiedu Decoction (HJD) on primary cortical neuron injury after oxygen-glucose deprivation (OGD)/reperfusion (R) injury. Methods Using macroporous resin method, HJDFE30, HJDFE50, HJDFE75, and HJDFE95 with 30%, 50%, 75%, and 95% alcohol were respectively prepared. Then the content of active components in different HJD fractions was determined with reverse phase high-performance liquid chromatography (RP-HPLC). The OGD/R injury model was induced by sodium dithionite on primary cortical neurons in neonate rats. MTT assay was used to observe the effect of four fractions (HJDFE30, HJDFE50, HJDFE75, and HJDFE95) and seven index components of HJD on the neuron viability. RP-HPLC showed active component(s) contained in HJDFE30 was geniposide; baicalin, palmatine, berberine, and wogonside contained in HJDFE50; baicalin, berberine, baicalein, and wogonin contained in HJDFE75. The neuron viability was decreased after OGD for 20 min and reperfusion for 1 h, (P <0. 01), and significantly increased after administered with HJD, HJDFE30, HJDFE50, and HJDFE75 (P <0. 05, P <0. 01). Geniposide, baicalin, baicalein, palmatine, wogonside, and wogonin could increase the cortical neuron viability (P <0. 05, P <0. 01). HJDFE30, HJDFE50, and HJDFE75, as active fractions of HJD, had protective effect on primary cortical neuron injury after OGD/R. Furthermore, geniposide, baicalin, and baicalein were main active components of HJD.

CRTC1/MAML2 fusion transcript in central mucoepidermoid carcinoma of mandible--diagnostic and histogenetic implications.

PubMed

Bell, Diana; Holsinger, Christopher F; El-Naggar, Adel K

2010-12-01

Intraosseous salivary gland carcinomas are extremely rare, comprising only 2% to 3% of all mucoepidermoid carcinomas (MECs) reported. The t(11;19) translocation and its CRTC1/MAML1 fusion transcript have been identified in MEC at different sites and are believed to be associated with the development of a subset of these tumors. However, the status of the fusion transcript has not been reported in intraosseous MEC. Here, we report 3 examples of central MEC of the mandible, including a case with a history of primary retromolar MEC. Reverse transcriptase-polymerase chain reaction and DNA sequencing analyses of the microdissected components of these tumors were used for the detection and verification of the fusion transcript. We identified, for the first time, the t(11;19) fusion gene transcript in central MEC, including in the previous primary retromolar MEC. No fusion transcript was detected in the second primary noncentral MEC or in another central MEC. The results indicate that central MEC can manifest the fusion transcript. This finding may have diagnostic and histogenetic roles in the future analysis of this entity. Published by Elsevier Inc.

Role Clarification Processes for Better Integration of Nurse Practitioners into Primary Healthcare Teams: A Multiple-Case Study

PubMed Central

D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy

2014-01-01

Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration. PMID:25692039

Role clarification processes for better integration of nurse practitioners into primary healthcare teams: a multiple-case study.

PubMed

Brault, Isabelle; Kilpatrick, Kelley; D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy; Perroux, Mélanie; Beaulieu, Marie-Dominique

2014-01-01

Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration.

Triple voltage dc-to-dc converter and method

DOEpatents

Su, Gui-Jia

2008-08-05

A circuit and method of providing three dc voltage buses and transforming power between a low voltage dc converter and a high voltage dc converter, by coupling a primary dc power circuit and a secondary dc power circuit through an isolation transformer; providing the gating signals to power semiconductor switches in the primary and secondary circuits to control power flow between the primary and secondary circuits and by controlling a phase shift between the primary voltage and the secondary voltage. The primary dc power circuit and the secondary dc power circuit each further comprising at least two tank capacitances arranged in series as a tank leg, at least two resonant switching devices arranged in series with each other and arranged in parallel with the tank leg, and at least one voltage source arranged in parallel with the tank leg and the resonant switching devices, said resonant switching devices including power semiconductor switches that are operated by gating signals. Additional embodiments having a center-tapped battery on the low voltage side and a plurality of modules on both the low voltage side and the high voltage side are also disclosed for the purpose of reducing ripple current and for reducing the size of the components.

Antibody response to Ehrlichia risticii and antibody reactivity to the component antigens in horses with induced Potomac horse fever.

PubMed

Dutta, S K; Mattingly, B L; Shankarappa, B

1989-10-01

The antibody response and the antibody reactivity to component antigens of Ehrlichia risticii were studied in horses with induced Potomac horse fever. These horses had no detectable antibodies to E. risticii in their preinoculation (PrI) sera by indirect fluorescent-antibody assay and enzyme-linked immunosorbent assay (ELISA). All the horses exhibited typical disease features following experimental infection and responded with specific antibodies, as measured by ELISA and indirect fluorescent-antibody assay. A primary antibody response was detected in 70% of the horses, while a secondary-type antibody response was detected in 30% of the horses by ELISA. In the primary antibody response, a distinct titer was observed at 2 weeks postinoculation (PI), when the immunoglobulin M (IgM)/IgG ratio was 2 to 5, and the overall antibody titer peaked at 6 to 8 weeks PI. The secondary-type antibody response exhibited a characteristic titer at 1 week PI, the IgM and IgG titers were about equal at 2 weeks PI, and the overall antibody titer peaked at 6 weeks PI. A transient depression in the IgG response at 4 weeks PI was observed in both response types. The antibody was maintained at a high titer for over a year in all horses. Western immunoblot reactivity showed that the antisera collected from these infected horses at 4 to 5 weeks PI recognized some or all of the six major E. risticii component antigens (70, 55, 51, 44, 33, and 28 kilodaltons), all of which were apparent surface components. The 6- to 8-week PI antisera recognized up to 16 component antigens, including 9 major antigens (110, 86, 70, 55, 51, 49, 44, 33, and 28 kilodaltons). However, the PrI sera of these horses showed reactivity at various intensities with one to seven of the component antigens. There was no apparent correlation between this reactivity pattern and the subsequent antibody response types.

Community governance in primary health care: towards an international Ideal Type.

PubMed

Meads, Geoffrey; Russell, Grant; Lees, Amanda

2017-10-01

Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept. The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non-governmental status. Future policy and research priorities are outlined. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Commercial Off-the-Shelf (COTS) Components and Enterprise Component Information System (eCIS)

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

John Minihan; Ed Schmidt; Greg Enserro

The purpose of the project was to develop the processes for using commercial off-the-shelf (COTS) parts for WR production and to put in place a system for implementing the data management tools required to disseminate, store, track procurement, and qualify vendors. Much of the effort was devoted to determining if the use of COTS parts was possible. A basic question: How does the Nuclear Weapons Complex (NWC) begin to use COTS in the weapon Stockpile Life Extension Programs with high reliability, affordability, while managing risk at acceptable levels? In FY00, it was determined that a certain weapon refurbishment program couldmore » not be accomplished without the use of COTS components. The elements driving the use of COTS components included decreased cost, greater availability, and shorter delivery time. Key factors that required implementation included identifying the best suppliers and components, defining life cycles and predictions of obsolescence, testing the feasibility of using COTS components with a test contractor to ensure capability, as well as quality and reliability, and implementing the data management tools required to disseminate, store, track procurement, and qualify vendors. The primary effort of this project then was to concentrate on the risks involved in the use of COTS and address the issues of part and vendor selection, procurement and acceptance processes, and qualification of the parts via part and sample testing. The Enterprise Component Information System (eCIS) was used to manage the information generated by the COTS process. eCIS is a common interface for both the design and production of NWC components and systems integrating information between SNL National Laboratory (SNL) and the Kansas City Plant (KCP). The implementation of COTS components utilizes eCIS from part selection through qualification release. All part related data is linked across an unclassified network for access by both SNL and KCP personnel. The system includes not only NWC part information but also includes technical reference data for over 25 Million electronic and electromechanical commercial and military parts via a data subscription. With the capabilities added to the system through this project, eCIS provides decision support, parts list/BOM analysis, editing, tracking, workflows, reporting, and history/legacy information integrating manufacturer reference, company technical, company business, and design data.« less

Status of mirror segment production for the Giant Magellan Telescope

NASA Astrophysics Data System (ADS)

Martin, H. M.; Burge, J. H.; Davis, J. M.; Kim, D. W.; Kingsley, J. S.; Law, K.; Loeff, A.; Lutz, R. D.; Merrill, C.; Strittmatter, P. A.; Tuell, M. T.; Weinberger, S. N.; West, S. C.

2016-07-01

The Richard F. Caris Mirror Lab at the University of Arizona is responsible for production of the eight 8.4 m segments for the primary mirror of the Giant Magellan Telescope, including one spare off-axis segment. We report on the successful casting of Segment 4, the center segment. Prior to generating the optical surface of Segment 2, we carried out a major upgrade of our 8.4 m Large Optical Generator. The upgrade includes new hardware and software to improve accuracy, safety, reliability and ease of use. We are currently carrying out an upgrade of our 8.4 m polishing machine that includes improved orbital polishing capabilities. We added and modified several components of the optical tests during the manufacture of Segment 1, and we have continued to improve the systems in preparation for Segments 2-8. We completed two projects that were prior commitments before GMT Segment 2: casting and polishing the combined primary and tertiary mirrors for the LSST, and casting and generating a 6.5 m mirror for the Tokyo Atacama Observatory.

Secondary targets of nitrite-derived reactive nitrogen species: nitrosation/nitration pathways, antioxidant defense mechanisms and toxicological implications.

PubMed

d'Ischia, Marco; Napolitano, Alessandra; Manini, Paola; Panzella, Lucia

2011-12-19

Nitrite, the primary metabolite of nitric oxide (NO) and a widely diffused component of human diet, plays distinct and increasingly appreciated roles in human physiology. However, when exposed to acidic environments, typically in the stomach, or under oxidative stress conditions, it may be converted to a range of reactive nitrogen species (RNS) which in turn can target a variety of biomolecules. Typical consequences of toxicological relevance include protein modification, DNA base deamination and the formation of N-nitrosamines, among the most potent mutagenic and carcinogenic compounds for humans. Besides primary biomolecules, nitrite can cause structural modifications to a variety of endogenous and exogenous organic compounds, ranging from polyunsaturated fatty acids to estrogens, tocopherol, catecholamines, furans, retinoids, dietary phenols, and a range of xenobiotics. The study of the interactions between nitrite and key food components, including phenolic antioxidants, has therefore emerged as an area of great promise for delineating innovative strategies in cancer chemoprevention. Depending on substrates and conditions, diverse reaction pathways may compete to determine product features and distribution patterns. These include nitrosation and nitration but also oxidation, via electron transfer to nitrosonium ion or nitrogen dioxide. This contribution aims to provide an overview of the main classes of compounds that can be targeted by nitrite and to discuss at chemical levels the possible reaction mechanisms under conditions that model those occurring in the stomach. The toxicological implications of the nitrite-modified molecules are finally addressed, and a rational chemical approach to the design of potent antinitrosing agents is illustrated. © 2011 American Chemical Society

Perceptions and Pedagogy: Exploring the Beliefs and Practices of an Effective Primary Science Teacher

ERIC Educational Resources Information Center

Fitzgerald, Angela; Dawson, Vaille; Hackling, Mark

2009-01-01

Effective science teaching is vital for improved student learning outcomes in primary school science. Therefore, there is a need to tease out the components of effective science teaching to better understand what effective primary teachers do in their classrooms and why they do it. Four primary teachers, each nominated as effective science…

Challenging Cosmic Ray Propagation with Antiprotons: Evidence for a "Fresh" Nuclei Component?

NASA Technical Reports Server (NTRS)

Moskalenko, Igor V.; Strong, Andrew W.; Mashnik, Stepan G.; Ormes, Jonathan F.

2002-01-01

Recent measurements of the cosmic ray (CR) antiproton flux have been shown to challenge existing CR propagation models. It was shown that the reacceleration models designed to match secondary to primary nuclei ratio (e.g., Boron/Carbon) produce too few antiprotons, while the traditional non-reacceleration models can reproduce the antiproton flux but fall short of explaining the low-energy decrease in the secondary to primary nuclei ratio. Matching both the secondary to primary nuclei ratio and antiproton flux requires artificial breaks in the diffusion coefficient and the primary injection spectrum suggesting the need for other approaches. In the present paper we discuss one possibility to overcome these difficulties. Using the measured antiproton flux to fix the diffusion coefficient, we show that the spectra of primary nuclei as measured in the heliosphere may contain a fresh local unprocessed component at low energies, thus decreasing the measured secondary to primary nuclei ratio. A model reproducing antiprotons, B/C ratio, and abundances up to Ni is presented.

A Comprehensive Plan for the Long-Term Calibration and Validation of Oceanic Biogeochemical Satellite Data

NASA Technical Reports Server (NTRS)

Hooker, Stanford B.; McClain, Charles R.; Mannino, Antonio

2007-01-01

The primary objective of this planning document is to establish a long-term capability and validating oceanic biogeochemical satellite data. It is a pragmatic solution to a practical problem based primarily o the lessons learned from prior satellite missions. All of the plan's elements are seen to be interdependent, so a horizontal organizational scheme is anticipated wherein the overall leadership comes from the NASA Ocean Biology and Biogeochemistry (OBB) Program Manager and the entire enterprise is split into two components of equal sature: calibration and validation plus satellite data processing. The detailed elements of the activity are based on the basic tasks of the two main components plus the current objectives of the Carbon Cycle and Ecosystems Roadmap. The former is distinguished by an internal core set of responsibilities and the latter is facilitated through an external connecting-core ring of competed or contracted activities. The core elements for the calibration and validation component include a) publish protocols and performance metrics; b) verify uncertainty budgets; c) manage the development and evaluation of instrumentation; and d) coordinate international partnerships. The core elements for the satellite data processing component are e) process and reprocess multisensor data; f) acquire, distribute, and archive data products; and g) implement new data products. Both components have shared responsibilities for initializing and temporally monitoring satellite calibration. Connecting-core elements include (but are not restricted to) atmospheric correction and characterization, standards and traceability, instrument and analysis round robins, field campaigns and vicarious calibration sites, in situ database, bio-optical algorithm (and product) validation, satellite characterization and vicarious calibration, and image processing software. The plan also includes an accountability process, creating a Calibration and Validation Team (to help manage the activity), and a discussion of issues associated with the plan's scientific focus.

Spacesuit Portable Life Support System Breadboard (PLSS 1.0) Development and Test Results

NASA Technical Reports Server (NTRS)

Vogel, Matt R.; Watts, Carly

2011-01-01

A multi-year effort has been carried out at NASA-JSC to develop an advanced Extravehicular Activity (EVA) PLSS design intended to further the current state of the art by increasing operational flexibility, reducing consumables, and increasing robustness. Previous efforts have focused on modeling and analyzing the advanced PLSS architecture, as well as developing key enabling technologies. Like the current International Space Station (ISS) Extravehicular Mobility Unit (EMU) PLSS, the advanced PLSS comprises of three subsystems required to sustain the crew during EVA including the Thermal, Ventilation, and Oxygen Subsystems. This multi-year effort has culminated in the construction and operation of PLSS 1.0, a test rig that simulates full functionality of the advanced PLSS design. PLSS 1.0 integrates commercial off the shelf hardware with prototype technology development components, including the primary and secondary oxygen regulators, ventilation loop fan, Rapid Cycle Amine (RCA) swingbed, and Spacesuit Water Membrane Evaporator (SWME). Testing accumulated 239 hours over 45 days, while executing 172 test points. Specific PLSS 1.0 test objectives assessed during this testing include: confirming key individual components perform in a system level test as they have performed during component level testing; identifying unexpected system-level interactions; operating PLSS 1.0 in nominal steady-state EVA modes to baseline subsystem performance with respect to metabolic rate, ventilation loop pressure and flow rate, and environmental conditions; simulating nominal transient EVA operational scenarios; simulating contingency EVA operational scenarios; and further evaluating individual technology development components. Successful testing of the PLSS 1.0 provided a large database of test results that characterize system level and component performance. With the exception of several minor anomalies, the PLSS 1.0 test rig performed as expected; furthermore, many system responses trended in accordance with pre-test predictions.

Targeting the Epigenome with Bioactive Food Components for Cancer Prevention

PubMed Central

Ong, Thomas Prates; Moreno, Fernando Salvador; Ross, Sharon Ann

2012-01-01

Epigenetic processes participate in cancer development and likely influence cancer prevention. Global DNA hypomethylation, gene promoter hypermethylation and aberrant histone post-translational modifications are hallmarks of neoplastic cells which have been associated with genomic instability and altered gene expression. Because epigenetic deregulation occurs early in carcinogenesis and is potentially reversible, intervention strategies targeting the epigenome have been proposed for cancer prevention. Bioactive food components (BFCs) with anticancer potential, including folate, polyphenols, selenium, retinoids, fatty acids, isothiocyanates and allyl compounds, influence DNA methylation and histone modification processes. Such activities have been shown to affect the expression of genes involved in cell proliferation, death and differentiation that are frequently altered in cancer. Although the epigenome represents a promising target for cancer prevention with BFCs, few studies have addressed the influence of dietary components on these mechanisms in vivo, particularly on the phenotype of humans, and thus the exact mechanisms whereby diet mediates an effect on cancer prevention remains unclear. Primary factors that should be elucidated include the effective doses and dose timing of BFCs to attain epigenetic effects. Because diet-epigenome interactions are likely to occur in utero, the impact of early-life nutrition on cancer risk programming should be further investigated. PMID:22353664

Harmonically mode-locked erbium-doped waveguide laser

NASA Astrophysics Data System (ADS)

Fanto, Michael L.; Malowicki, John E.; Bussjager, Rebecca J.; Johns, Steven T.; Vettese, Elizabeth K.; Hayduk, Michael J.

2004-08-01

The generation of ultrastable picosecond pulses in the 1550 nm range is required for numerous applications that include photonic analog-to-digital converter systems and high-bit rate optical communication systems. Mode-locked erbium-doped fiber ring lasers (EDFLs) are typically used to generate pulses at this wavelength. In addition to timing stability and output power, the physical size of the laser cavity is of primary importance to the Air Force. The length of the erbium (Er)-doped fiber used as the gain medium may be on the order of meters or even tens of meters which adds complexity to packaging. However, with the recent advancements in the production of multi-component glasses, higher doping concentrations can be achieved as compared to silicate glasses. Even more recent is the introduction of Er-doped multi-component glass waveguides, thus allowing the overall footprint of the gain medium to be reduced. We have constructed a novel harmonically mode-locked fiber ring laser using the Er-doped multi-component glass waveguide as the gain medium. The performance characteristics of this Er-doped waveguide laser (EDWL) including pulse width, spectral width, harmonic suppression, optical output power, laser stability and single sideband residual phase noise will be discussed in this paper.

What Safe Zone? The Vast Majority of Dislocated THAs Are Within the Lewinnek Safe Zone for Acetabular Component Position.

PubMed

Abdel, Matthew P; von Roth, Philipp; Jennings, Matthew T; Hanssen, Arlen D; Pagnano, Mark W

2016-02-01

Numerous factors influence total hip arthroplasty (THA) stability including surgical approach and soft tissue tension, patient compliance, and component position. One long-held tenet regarding component position is that cup inclination and anteversion of 40° ± 10° and 15° ± 10°, respectively, represent a "safe zone" as defined by Lewinnek that minimizes dislocation after primary THA; however, it is clear that components positioned in this zone can and do dislocate. We sought to determine if these classic radiographic targets for cup inclination and anteversion accurately predicted a safe zone limiting dislocation in a contemporary THA practice. From a cohort of 9784 primary THAs performed between 2003 and 2012 at one institution, we retrospectively identified 206 THAs (2%) that subsequently dislocated. Radiographic parameters including inclination, anteversion, center of rotation, and limb length discrepancy were analyzed. Mean followup was 27 months (range, 0-133 months). The majority (58% [120 of 206]) of dislocated THAs had a socket within the Lewinnek safe zone. Mean cup inclination was 44° ± 8° with 84% within the safe zone for inclination. Mean anteversion was 15° ± 9° with 69% within the safe zone for anteversion. Sixty-five percent of dislocated THAs that were performed through a posterior approach had an acetabular component within the combined acetabular safe zones, whereas this was true for only 33% performed through an anterolateral approach. An acetabular component performed through a posterior approach was three times as likely to be within the combined acetabular safe zones (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.1-1.6) than after an anterolateral approach (OR, 0.4; 95% CI, 0.2-0.7; p < 0.0001). In contrast, acetabular components performed through a posterior approach (OR, 1.6; 95% CI, 1.2-1.9) had an increased risk of dislocation compared with those performed through an anterolateral approach (OR, 0.8; 95% CI, 0.7-0.9; p < 0.0001). The historical target values for cup inclination and anteversion may be useful but should not be considered a safe zone given that the majority of these contemporary THAs that dislocated were within those target values. Stability is likely multifactorial; the ideal cup position for some patients may lie outside the Lewinnek safe zone and more advanced analysis is required to identify the right target in that subgroup. Level III, therapeutic study.

An elementary theory of eclipsing depths of the light curve and its application to Beta Lyrae

NASA Technical Reports Server (NTRS)

Huang, S.-S.; Brown, D. A.

1976-01-01

An elementary theory of the ratio of depths of secondary and primary eclipses of a light curve has been proposed for studying the nature of component stars. It has been applied to light curves of Beta Lyrae in the visual, blue, and far-ultraviolet regions with the purpose of investigating the energy sources for the luminosity of the disk surrounding the secondary component and determining the dominant radiative process in the disk. No trace of the spectrum of primary radiation has been found in the disk. Therefore, it is suggested that LTE is the main radiative process in the disk, which radiates at a temperature of approximately 12,000 K in the portion that undergoes eclipse. A small source corresponding to 14,500 K has also been tentatively detected and may represent a hot spot caused by hydrodynamic flow of matter from the primary component to the disk.

Spectroscopy of bright Algol-type semi-detached close binary system HU Tauri (HR 1471)

NASA Astrophysics Data System (ADS)

Parthasarathy, M.

2018-01-01

Radial velocities of the primary component (B8V) of HU Tauri derived from the photographic spectra obtained during January 1974 to December 1974 and spectroscopic orbital elements from the analysis of the radial velocity curve of the B8V primary are given. The H line of the late type secondary component is clearly detected on the photographic spectra taken around the quadratures and radial velocities of the secondary component are derived. The radial velocity semi amplitudes of the primary (K) and secondary (K) are found to be 60 km/sec and 234 km/sec respectively. The mass ratio M/M = K/K is found to be 0.2564. The detection of the H line of the secondary is confirmed from the high resolution spectra that I obtained during 1981 and 1983 at quadratures using the 2.1-m McDonald observatory Otto Struve reflector telescope and high resolution coude Reticon spectrograph.

Integrated system design report

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

Not Available

1989-07-01

The primary objective of the integrated system test phase is to demonstrate the commercial potential of a coal fueled diesel engine in its actual operating environment. The integrated system in this project is defined as a coal fueled diesel locomotive. This locomotive, shown on drawing 41D715542, is described in the separate Concept Design Report. The test locomotive will be converted from an existing oil fueled diesel locomotive in three stages, until it nearly emulates the concept locomotive. Design drawings of locomotive components (diesel engine, locomotive, flatcar, etc.) are included.

Hanford spent nuclear fuel hot conditioning system test procedure

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

Cleveland, K.J.

1997-09-16

This document provides the test procedures for cold testing of the prototype Hot Conditioning System (HCS) at the 306E Facility. The primary objective of this testing is to confirm design choices and provide data for the detailed design package prior to procurement of the process equipment. The current scope of testing in this document includes a fabricability study of the HCS, equipment performance testing of the HCS components, heat-up and cool-down cycle simulation, and robotic arm testing.

Engine Cycle Analysis for a Particle Bed Reactor Nuclear Rocket

DTIC Science & Technology

1991-03-01

0 DTIC USERS UNCLASSIFIED 22a. NAME OF RESPONSIBLE INDIVIDUAL ZZb. TELEPHONE (Include Area Code) 22c. OFFICE SYMBOL Lt Timothy J . Lawrence 805-275...Cycle with 2000 MW PBR and Uncooled Nozzle J : Output for Bleed Cycle with 2000 MW PBR and Cooled Nozzle K: Output for Expander Cycle with 2000 MW PBR L...Mars with carbon dioxide, the primary component of the Martian atmosphere. Carbon dioxide would delivera smaller ! j , but its use would eliminate the

Piping Connector

NASA Technical Reports Server (NTRS)

1993-01-01

A complex of high pressure piping at Stennis Space Center carries rocket propellants and other fluids/gases through the Center's Component Test Facility. Conventional clamped connectors tend to leak when propellant lines are chilled to extremely low temperatures. Reflange, Inc. customized an existing piping connector to include a secondary seal more tolerant of severe thermal gradients for Stennis. The T-Con connector solved the problem, and the company is now marketing a commercial version that permits testing, monitoring or collecting any emissions that may escape the primary seal during severe thermal transition.

Performance Charts for the Turbojet Engine

NASA Technical Reports Server (NTRS)

Pinkel, Benjamin; Karp, Irving M.

1947-01-01

Charts are presented for computing the thrust, fuel consumption, and other performance values of a turbojet engine for any given set of operating conditions and component efficiencies. The effects of the pressure losses in the inlet duct and combustion chamber, the variation in the physical properties of the gas as it passes through the cycle, and the change in mass flow by the addition of fuel are included. The principle performance charts show the effects of the primary variables and correction charts provide the effects of the secondary variables.

Laser Doppler velocimeter measurements and laser sheet imaging in an annular combustor model. M.S. Thesis, Final Report

NASA Technical Reports Server (NTRS)

Dwenger, Richard Dale

1995-01-01

An experimental study was conducted in annular combustor model to provide a better understanding of the flowfield. Combustor model configurations consisting of primary jets only, annular jets only, and a combination of annular and primary jets were investigated. The purpose of this research was to provide a better understanding of combustor flows and to provide a data base for comparison with computational models. The first part of this research used a laser Doppler velocimeter to measure mean velocity and statistically calculate root-mean-square velocity in two coordinate directions. From this data, one Reynolds shear stress component and a two-dimensional turbulent kinetic energy term was determined. Major features of the flowfield included recirculating flow, primary and annular jet interaction, and high turbulence. The most pronounced result from this data was the effect the primary jets had on the flowfield. The primary jets were seen to reduce flow asymmetries, create larger recirculation zones, and higher turbulence levels. The second part of this research used a technique called marker nephelometry to provide mean concentration values in the combustor. Results showed the flow to be very turbulent and unsteady. All configurations investigated were highly sensitive to alignment of the primary and annular jets in the model and inlet conditions. Any imbalance between primary jets or misalignment of the annular jets caused severe flow asymmetries.

The integrated care pathway for post stroke patients (iCaPPS): a shared care approach between stakeholders in areas with limited access to specialist stroke care services.

PubMed

Abdul Aziz, Aznida Firzah; Mohd Nordin, Nor Azlin; Ali, Mohd Fairuz; Abd Aziz, Noor Azah; Sulong, Saperi; Aljunid, Syed Mohamed

2017-01-13

Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. Care algorithms were designed around existing work schedules at public health centres. Indication for patients eligible for monitoring by primary care at public health centres were identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Essential information required during transfer of care from tertiary care to primary care providers was identified. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Shared care approaches with Specialist Stroke care team were outlined. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems. Coordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services. No.: ACTRN12616001322426 (Registration Date: 21st September 2016).

Propellant material compatibility program and results

NASA Technical Reports Server (NTRS)

Toth, L. R.; Cannon, W. A.; Coulbert, C. D.; Long, H. R.

1976-01-01

The effects of long-term (up to 10 years) contact of inert materials with earth-storable propellants were studied for the purpose of designing chemical propulsion system components that can be used for current as well as future planetary spacecraft. The primary experimental work, and results to date are reported. Investigations include the following propellants: hydrazine, hydrazine-hydrazine nitrate blends, monomethyl-hydrazine, and nitrogen tetroxide. Materials include: aluminum alloys, corrosion-resistant steels, and titanium alloys. More than 700 test specimen capsules were placed in long-term storage testing at 43 C in the special material compatibility facility. Material ratings relative to the 10-year requirement have been assigned.

Ground Robotic Hand Applications for the Space Program study (GRASP)

NASA Astrophysics Data System (ADS)

Grissom, William A.; Rafla, Nader I.

1992-04-01

This document reports on a NASA-STDP effort to address research interests of the NASA Kennedy Space Center (KSC) through a study entitled, Ground Robotic-Hand Applications for the Space Program (GRASP). The primary objective of the GRASP study was to identify beneficial applications of specialized end-effectors and robotic hand devices for automating any ground operations which are performed at the Kennedy Space Center. Thus, operations for expendable vehicles, the Space Shuttle and its components, and all payloads were included in the study. Typical benefits of automating operations, or augmenting human operators performing physical tasks, include: reduced costs; enhanced safety and reliability; and reduced processing turnaround time.

Ground Robotic Hand Applications for the Space Program study (GRASP)

NASA Technical Reports Server (NTRS)

Grissom, William A.; Rafla, Nader I. (Editor)

1992-01-01

This document reports on a NASA-STDP effort to address research interests of the NASA Kennedy Space Center (KSC) through a study entitled, Ground Robotic-Hand Applications for the Space Program (GRASP). The primary objective of the GRASP study was to identify beneficial applications of specialized end-effectors and robotic hand devices for automating any ground operations which are performed at the Kennedy Space Center. Thus, operations for expendable vehicles, the Space Shuttle and its components, and all payloads were included in the study. Typical benefits of automating operations, or augmenting human operators performing physical tasks, include: reduced costs; enhanced safety and reliability; and reduced processing turnaround time.

Motile cilia of human airway epithelia contain hedgehog signaling components that mediate noncanonical hedgehog signaling.

PubMed

Mao, Suifang; Shah, Alok S; Moninger, Thomas O; Ostedgaard, Lynda S; Lu, Lin; Tang, Xiao Xiao; Thornell, Ian M; Reznikov, Leah R; Ernst, Sarah E; Karp, Philip H; Tan, Ping; Keshavjee, Shaf; Abou Alaiwa, Mahmoud H; Welsh, Michael J

2018-02-06

Differentiated airway epithelia produce sonic hedgehog (SHH), which is found in the thin layer of liquid covering the airway surface. Although previous studies showed that vertebrate HH signaling requires primary cilia, as airway epithelia mature, the cells lose primary cilia and produce hundreds of motile cilia. Thus, whether airway epithelia have apical receptors for SHH has remained unknown. We discovered that motile cilia on airway epithelial cells have HH signaling proteins, including patched and smoothened. These cilia also have proteins affecting cAMP-dependent signaling, including Gα i and adenylyl cyclase 5/6. Apical SHH decreases intracellular levels of cAMP, which reduces ciliary beat frequency and pH in airway surface liquid. These results suggest that apical SHH may mediate noncanonical HH signaling through motile cilia to dampen respiratory defenses at the contact point between the environment and the lung, perhaps counterbalancing processes that stimulate airway defenses. Copyright © 2018 the Author(s). Published by PNAS.

Interventions for Primary School Children With Difficulties in Mathematics.

PubMed

Dowker, Ann

2017-01-01

Difficulty with arithmetic is a common problem for children and adults, though there has been some work on the topic for a surprisingly long time. This chapter will review some of the research that has been done over the years on interventions with primary school children. Interventions can be of various levels of intensiveness, ranging from whole-class approaches that take account of individual differences through small-group and limited-time individual interventions to extended-time individual interventions. Interventions discussed here include those involving peer tuition and group collaboration; those involving board and computer games; and those that involve assessing children's strengths and weaknesses in different components of mathematics; and targeting remedial activities to the assessed weaknesses. Most of the interventions discussed in this chapter specifically involve mathematics (usually mainly arithmetic), but there is also some discussion of attempts to improve mathematics by training children in domain-general skills, including Piagetian operations, metacognition, and executive functions. © 2017 Elsevier Inc. All rights reserved.

Qualitative evaluation of the iris and ciliary body by ultrasound biomicroscopy in subjects with angle closure.

PubMed

Ku, Judy Y; Nongpiur, Monisha E; Park, Judy; Narayanaswamy, Arun K; Perera, Shamira A; Tun, Tin A; Kumar, Rajesh S; Baskaran, Mani; Aung, Tin

2014-12-01

To qualitatively analyze anterior chamber structures imaged by ultrasound biomicroscopy (UBM) in primary angle-closure patients. Subjects diagnosed as primary angle-closure suspect (PACS), primary angle-closure glaucoma (PACG), and previous acute primary angle closure (APAC) were recruited prospectively along with a group of normal controls. UBM was performed under standardized dark room conditions and qualitative assessment was carried out using a set of reference photographs of standard UBM images to categorize the various anatomic features related to angle configuration. These included overall and basal iris thicknesses, iris convexity, iris angulation, ciliary body size, and ciliary sulcus. A total of 60 PACS, 114 PACG, 41 APAC, and 33 normal controls were included. Patients were predominantly older Chinese females. After controlling the confounding effect of age and sex, eyes with overall thicker irides [medium odds ratio (OR) 3.58, thick OR 2.84] when compared with thin irides have a significantly higher likelihood of having PACS/PACG/APAC versus controls. Thicker basal iris component (medium OR 4.13, thick OR 3.39) also have higher likelihood of having angle closure when compared with thin basal iris thickness. Subjects with basal iris insertion, mild iris angulation, and large ciliary body have a higher OR of having angle closure. In contrast, the presence/absence of a ciliary sulcus did not influence the likelihood of angle closure. Eyes with thicker overall and basal iris thicknesses are more likely to have angle closure than controls. Other features that increase the likelihood of angle closure include basal iris insertion, mild iris angulation, and large ciliary body.

Neural network for photoplethysmographic respiratory rate monitoring

NASA Astrophysics Data System (ADS)

Johansson, Anders

2001-10-01

The photoplethysmographic signal (PPG) includes respiratory components seen as frequency modulation of the heart rate (respiratory sinus arrhythmia, RSA), amplitude modulation of the cardiac pulse, and respiratory induced intensity variations (RIIV) in the PPG baseline. The aim of this study was to evaluate the accuracy of these components in determining respiratory rate, and to combine the components in a neural network for improved accuracy. The primary goal is to design a PPG ventilation monitoring system. PPG signals were recorded from 15 healthy subjects. From these signals, the systolic waveform, diastolic waveform, respiratory sinus arrhythmia, pulse amplitude and RIIV were extracted. By using simple algorithms, the rates of false positive and false negative detection of breaths were calculated for each of the five components in a separate analysis. Furthermore, a simple neural network (NN) was tried out in a combined pattern recognition approach. In the separate analysis, the error rates (sum of false positives and false negatives) ranged from 9.7% (pulse amplitude) to 14.5% (systolic waveform). The corresponding value of the NN analysis was 9.5-9.6%.

Cognitive and neural components of the phenomenology of agency.

PubMed

Morsella, Ezequiel; Berger, Christopher C; Krieger, Stepehen C

2011-06-01

A primary aspect of the self is the sense of agency – the sense that one is causing an action. In the spirit of recent reductionistic approaches to other complex, multifaceted phenomena (e.g., working memory; cf. Johnson &Johnson, 2009), we attempt to unravel the sense of agency by investigating its most basic components, without invoking high-level conceptual or 'central executive' processes. After considering the high-level components of agency, we examine the cognitive and neural underpinnings of its low-level components, which include basic consciousness and subjective urges (e.g., the urge to breathe when holding one's breath). Regarding urges, a quantitative review revealed that certain inter-representational dynamics (conflicts between action plans, as when holding one's breath) reliably engender fundamental aspects both of the phenomenology of agency and of 'something countering the will of the self'. The neural correlates of such dynamics, for both primordial urges (e.g., air hunger) and urges elicited in laboratory interference tasks, are entertained. In addition, we discuss the implications of this unique perspective for the study of disorders involving agency.

Health effects of carbon-containing particulate matter: focus on sources and recent research program results.

PubMed

Rohr, Annette; McDonald, Jacob

2016-02-01

Air pollution is a complex mixture of gas-, vapor-, and particulate-phase materials comprised of inorganic and organic species. Many of these components have been associated with adverse health effects in epidemiological and toxicological studies, including a broad spectrum of carbonaceous atmospheric components. This paper reviews recent literature on the health impacts of organic aerosols, with a focus on specific sources of organic material; it is not intended to be a comprehensive review of all the available literature. Specific emission sources reviewed include engine emissions, wood/biomass combustion emissions, biogenic emissions and secondary organic aerosol (SOA), resuspended road dust, tire and brake wear, and cooking emissions. In addition, recent findings from large toxicological and epidemiological research programs are reviewed in the context of organic PM, including SPHERES, NPACT, NERC, ACES, and TERESA. A review of the extant literature suggests that there are clear health impacts from emissions containing carbon-containing PM, but difficulty remains in apportioning responses to certain groupings of carbonaceous materials, such as organic and elemental carbon, condensed and gas phases, and primary and secondary material. More focused epidemiological and toxicological studies, including increased characterization of organic materials, would increase understanding of this issue.

Influenza A Virus Infection of Human Respiratory Cells Induces Primary MicroRNA Expression*

PubMed Central

Buggele, William A.; Johnson, Karen E.; Horvath, Curt M.

2012-01-01

The cellular response to virus infection is initiated by recognition of the invading pathogen and subsequent changes in gene expression mediated by both transcriptional and translational mechanisms. In addition to well established means of regulating antiviral gene expression, it has been demonstrated that RNA interference (RNAi) can play an important role in antiviral responses. Virus-derived small interfering RNA (siRNA) is a primary antiviral response exploited by plants and invertebrate animals, and host-encoded microRNA (miRNA) species have been clearly implicated in the regulation of innate and adaptive immune responses in mammals and other vertebrates. Examination of miRNA abundance in human lung cell lines revealed endogenous miRNAs, including miR-7, miR-132, miR-146a, miR-187, miR-200c, and miR-1275, to specifically accumulate in response to infection with two influenza A virus strains, A/Udorn/72 and A/WSN/33. Known antiviral response pathways, including Toll-like receptor, RIG-I-like receptor, and direct interferon or cytokine stimulation did not alter the abundance of the tested miRNAs to the extent of influenza A virus infection, which initiates primary miRNA transcription via a secondary response pathway. Gene expression profiling identified 26 cellular mRNAs targeted by these miRNAs, including IRAK1, MAPK3, and other components of innate immune signaling systems. PMID:22822053

Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting.

PubMed

Rönngren, Ylva; Björk, Annette; Kristiansen, Lisbeth; Haage, David; Enmarker, Ingela; Audulv, Åsa

2018-02-01

Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting. © 2017 Australian College of Mental Health Nurses Inc.

PcapDB: Search Optimized Packet Capture, Version 0.1.0.0

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

Ferrell, Paul; Steinfadt, Shannon

PcapDB is a packet capture system designed to optimize the captured data for fast search in the typical (network incident response) use case. The technology involved in this software has been submitted via the IDEAS system and has been filed as a provisional patent. It includes the following primary components: capture: The capture component utilizes existing capture libraries to retrieve packets from network interfaces. Once retrieved the packets are passed to additional threads for sorting into flows and indexing. The sorted flows and indexes are passed to other threads so that they can be written to disk. These components aremore » written in the C programming language. search: The search components provide a means to find relevant flows and the associated packets. A search query is parsed and represented as a search tree. Various search commands, written in C, are then used resolve this tree into a set of search results. The tree generation and search execution management components are written in python. interface: The PcapDB web interface is written in Python on the Django framework. It provides a series of pages, API's, and asynchronous tasks that allow the user to manage the capture system, perform searches, and retrieve results. Web page components are written in HTML,CSS and Javascript.« less

African Primary Care Research: writing a research report.

PubMed

Couper, Ian; Mash, Bob

2014-06-06

Presenting a research report is an important way of demonstrating one's ability to conduct research and is a requirement of most research-based degrees. Although known by various names across academic institutions, the structure required is mostly very similar, being based on the Introduction, Methods, Results, Discussion format of scientific articles.This article offers some guidance on the process of writing, aimed at helping readers to start and to continue their writing; and to assist them in presenting a report that is received positively by their readers, including examiners. It also details the typical components of the research report, providing some guidelines for each, as well as the pitfalls to avoid.This article is part of a series on African Primary Care Research that aims to build capacity for research particularly at a Master's level.

Nutritional quality and acceptability of a weekly vegetarian lunch in primary-school canteens in Ghent, Belgium: 'Thursday Veggie Day'.

PubMed

De Keyzer, Willem; Van Caneghem, Sven; Heath, Anne-Louise M; Vanaelst, Barbara; Verschraegen, Mia; De Henauw, Stefaan; Huybrechts, Inge

2012-12-01

To determine the nutritional adequacy and acceptability to children of vegetarian lunches served on 'Thursday Veggie Day' - a public health initiative in Ghent (Belgium) primary schools. A comparison of food leftovers from main courses on regular days and Thursdays was made using a visual plate waste method. The nutritional value of the vegetarian meat analogue and meat components of main courses served on five 'Thursday Veggie Days' and five comparable conventional main courses was evaluated using three criteria (maximum 30 % of energy from fat, maximum of one-third of fat as saturated fat and minimum 1.5 g of dietary fibre per 420 kJ). Two canteens from primary schools in Ghent, Belgium, participating in the 'Thursday Veggie Day' campaign. Primary-school children aged between 6 and 12 years. In total, 1242 and 472 main course plate waste observations of conventional and vegetarian menus, respectively, were evaluated. There was no significant difference in plate waste between vegetarian (16.7 %) and conventional (17.3 %) main courses. Overall, the five vegetarian components were found to be nutritionally adequate with a mean score of 2.2 out of 3, compared with 0.4 for the meat component. However, three of the vegetarian components provided >30 % of energy from fat and, in one, the amount of saturated fat exceeded one-third of total fat. Vegetarian canteen meals offered as part of 'Thursday Veggie Day' appear to be nutritionally appropriate and as acceptable as conventional main courses to children in primary schools in Ghent.

Chronic substance use and self-harm in a primary health care setting.

PubMed

Breet, Elsie; Bantjes, Jason; Lewis, Ian

2018-06-19

Chronic substance use (CSU) is associated with health problems, including selfharm, placing a significant burden on health care resources and emergency departments (EDs). This is problematic in low- and middle-income countries like South Africa (SA), where primary care facilitates and emergency departments (EDs) are often poorly resourced. To investigate the epidemiology of CSU and self-harm and to consider the implications for primary health care service delivery and suicide prevention in SA. Data were collected from 238 consecutive self-harm patients treated at the emergency department (ED) of an urban hospital in SA. The data were analysed using bivariate and multivariate analyses. Approximately 37% of self-harm patients reported CSU. The patients in the CSU subgroup, compared to other self-harm patients, were more likely to be men (odds ratio[OR] = 8.33, 95% confidence interval [CI] = 3.19-20.9, p < 0.001), to have self-harmed by inflicting damage to their body tissue OR = 4.45, 95% CI = 1.77-11.2, p < 0.01) and to have a history of self-harm (OR = 3.71, 95% CI = 1.44-9.54, p = 0.007). A significantly smaller proportion of CSU patients, compared to other self-harm patients, were referred for psychiatric assessment (OR = 8.05, 95% CI = 4.16-15.7, p < 0.001). The findings of this study confirm that CSU is associated with greater service utilisation and repetition of self-harm among patients in primary health care settings. Treating self-harm as the presenting problem within primary care settings does not necessarily ensure that patients receive the care that they need. It might be helpful to include psychiatric assessments and screening for CSU as an integral component of care for self-harm patientswho present in primary health care settings.

Process evaluation of a randomised controlled trial of a diabetes prevention intervention in Dutch primary health care: the SLIMMER study.

PubMed

van Dongen, Ellen Ji; Duijzer, Geerke; Jansen, Sophia C; Ter Beek, Josien; Huijg, Johanna M; Leerlooijer, Joanne N; Hiddink, Gerrit J; Feskens, Edith Jm; Haveman-Nies, Annemien

2016-11-01

To investigate (i) how the SLIMMER intervention was delivered and received in Dutch primary health care and (ii) how this could explain intervention effectiveness. A randomised controlled trial was conducted and subjects were randomly allocated to the intervention (10-month combined dietary and physical activity intervention) or the control group. A process evaluation including quantitative and qualitative methods was conducted. Data on process indicators (recruitment, reach, dose received, acceptability, implementation integrity and applicability) were collected via semi-structured interviews with health-care professionals (n 45) and intervention participant questionnaires (n 155). SLIMMER was implemented in Dutch primary health care in twenty-five general practices, eleven dietitians, nine physiotherapist practices and fifteen sports clubs. Subjects at increased risk of developing type 2 diabetes were included. It was possible to recruit the intended high-risk population (response rate 54 %) and the SLIMMER intervention was very well received by both participants and health-care professionals (mean acceptability rating of 82 and 80, respectively). The intervention programme was to a large extent implemented as planned and was applicable in Dutch primary health care. Higher dose received and participant acceptability were related to improved health outcomes and dietary behaviour, but not to physical activity behaviour. The present study showed that it is feasible to implement a diabetes prevention intervention in Dutch primary health care. Higher dose received and participant acceptability were associated with improved health outcomes and dietary behaviour. Using an extensive process evaluation plan to gain insight into how an intervention is delivered and received is a valuable way of identifying intervention components that contribute to implementation integrity and effective prevention of type 2 diabetes in primary health care.

Wind tunnel investigation of Nacelle-Airframe interference at Mach numbers of 0.9 to 1.4-pressure data, volume 2

NASA Technical Reports Server (NTRS)

Bencze, D. P.

1976-01-01

Detailed interference force and pressure data were obtained on a representative wing-body nacelle combination at Mach numbers of 0.9 to 1.4. The model consisted of a delta wing-body aerodynamic force model with four independently supported nacelles located beneath the wing-body combination. The primary variables examined included Mach number, angle of attack, nacelle position, and nacelle mass flow ratio. Four different configurations were tested to identify various interference forces and pressures on each component; these included tests of the isolated nacelle, the isolated wing-body combination, the four nacelles as a unit, and the total wing-body-nacelle combination. Nacelle axial location, relative to both the wing-body combination and to each other, was the most important variable in determining the net interference among the components. The overall interference effects were found to be essentially constant over the operating angle-of-attack range of the configuration, and nearly independent of nacelle mass flow ratio.

On the Use of 3dB Qualification Margin for Structural Parts on Expendable Launch Vehicles

NASA Technical Reports Server (NTRS)

Yunis, Isam

2007-01-01

The standard random vibration qualification test used for Expendable Launch Vehicle components is Maximum Predicted Environment (MPE) + 6dB for a duration of 4 times the service life of the part. This can be a severe qualification test for these fatigue-sensitive structures. This paper uses flight data from several launch vehicles to establish that reducing the qualification approach to MPE+3dB for the duration of the peak environment (1x life) is valid for fatigue-sensitive structural components. Items that can be classified as fatigue-sensitive are probes, ducts, tubing, bellows, hoses, and any non-functional structure. Non-functional structure may be flight critical or carry fluid, but it cannot include any moving parts or electronics. This reduced qualification approach does not include primary or secondary structure which would be exclusively designed by peak loads, either transient or quasi-static, that are so large and of so few cycles as to make fatigue a moot point.

Palladium-catalyzed one-pot three- or four-component coupling of aryl iodides, alkynes, and amines through C-N bond cleavage: efficient synthesis of indole derivatives.

PubMed

Hao, Wei; Geng, Weizhi; Zhang, Wen-Xiong; Xi, Zhenfeng

2014-02-24

An efficient synthesis of N-substituted indole derivatives was realized by combining the Pd-catalyzed one-pot multicomponent coupling approach with cleavage of the C(sp(3))-N bonds. Three or four components of aryl iodides, alkynes, and amines were involved in this coupling process. The cyclopentadiene-phosphine ligand showed high efficiency. A variety of aryl iodides, including cyclic and acyclic tertiary amino aryl iodides, and substituted 1-bromo-2-iodobenzene derivatives could be used. Both symmetric and unsymmetric alkynes substituted with alkyl, aryl, or trimethylsilyl groups could be applied. Cyclic secondary amines such as piperidine, morpholine, 4-methylpiperidine, 1-methylpiperazine, 2-methylpiperidine, and acyclic amines including secondary and primary amines all showed good reactivity. Further application of the resulting indole derivatives was demonstrated by the synthesis of benzosilolo[2,3-b]indole. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Marine mammals' influence on ecosystem processes affecting fisheries in the Barents Sea is trivial.

PubMed

Corkeron, Peter J

2009-04-23

Some interpretations of ecosystem-based fishery management include culling marine mammals as an integral component. The current Norwegian policy on marine mammal management is one example. Scientific support for this policy includes the Scenario Barents Sea (SBS) models. These modelled interactions between cod, Gadus morhua, herring, Clupea harengus, capelin, Mallotus villosus and northern minke whales, Balaenoptera acutorostrata. Adding harp seals Phoca groenlandica into this top-down modelling approach resulted in unrealistic model outputs. Another set of models of the Barents Sea fish-fisheries system focused on interactions within and between the three fish populations, fisheries and climate. These model key processes of the system successfully. Continuing calls to support the SBS models despite their failure suggest a belief that marine mammal predation must be a problem for fisheries. The best available scientific evidence provides no justification for marine mammal culls as a primary component of an ecosystem-based approach to managing the fisheries of the Barents Sea.

Narrative review of yoga intervention clinical trials including weight-related outcomes.

PubMed

Rioux, Jennifer Grace; Ritenbaugh, Cheryl

2013-01-01

Medical authorities have identified obesity as a causal factor in the development of diabetes, hypertension, and cardiovascular disease (CVD), and more broadly, of metabolic syndrome/insulin resistance syndrome. To provide solutions that can modify this risk factor, researchers need to identify methods of effective risk reduction and primary prevention of obesity. Research on the effectiveness of yoga as a treatment for obesity is limited, and studies vary in overall quality and methodological rigor. This narrative review assessed the quantity and quality of clinical trials of yoga as an intervention for weight loss or as a means of risk reduction or treatment for obesity and diseases in which obesity is a causal factor. This review summarized the studies' research designs and evaluated the efficacy of yoga for weight loss via the current evidence base. The research team evaluated published studies to determine the appropriateness of research designs, comparability of programs' intervention elements, and standardization of outcome measures. The research team's literature search used the key terms yoga and obesity or yoga and weight loss in three primary medical-literature databases (PubMed, PsychInfo, and Web of Science). The study excluded clinical trials with no quantitative obesity related measure. Extracted data included each study's (1) design; (2) setting and population; (3) nature, duration, and frequency of interventions; (4) comparison groups; (5) recruitment strategies; (6) outcome measures; (7) data analysis and presentation; and (8) results and conclusions. The research team developed an overall evaluation parameter to compare disparate trials. The research team reviewed each study to determine its key features, each worth a specified number of points, with a maximum total of 20 points. The features included a study's (1) duration, (2) frequency of yoga practice, (3) intensity of (length of) each practice, (4) number of yogic elements, (5) inclusion of dietary modification, (6) inclusion of a residential component, (7) the number of weight-related outcome measures, and (8) a discussion of the details of the yogic elements. Overall, therapeutic yoga programs are frequently effective in promoting weight loss and/or improvements in body composition. The effectiveness of yoga for weight loss is related to the following key features: (1) an increased frequency of practice; (2) a longer intervention duration (3) a yogic dietary component; (4) a residential component; (5) the comprehensive inclusion of yogic components; (5) and a home-practice component. Yoga appears to be an appropriate and potentially successful intervention for weight maintenance, prevention of obesity, and risk reduction for diseases in which obesity plays a significant causal role.

The relationship between components of tumour inflammatory cell infiltrate and clinicopathological factors and survival in patients with primary operable invasive ductal breast cancer

PubMed Central

Mohammed, Z MA; Going, J J; Edwards, J; Elsberger, B; Doughty, J C; McMillan, D C

2012-01-01

Background: The importance of the components of host local inflammatory response in determining outcome in primary operable ductal invasive breast cancer is not clear. The aim of this study was to examine the relationship between components of the tumour inflammatory cell infiltrate and standard clinicopathological factors including hormone status (oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER)-2), Ki-67 and survival in patients with primary operable invasive ductal breast cancer. Methods: Tumour inflammatory cell infiltrate, hormone status (ER, PR and HER-2), Ki-67 and standard clinicopathological factors were determined using routine pathological and immuno-histochemical techniques in 468 patients. Results: The large majority (94%) of ductal tumours had evidence of inflammatory cell infiltrate. The general inflammatory cell infiltrate was positively associated with high grade (P<0.001), the absence of ER (P<0.001), the absence of PR (P<0.01), the presence of vascular invasion (P<0.05) and high lymphocytic infiltrate, plasma cell infiltrate, other inflammatory cell infiltrate and macrophage infiltrate (all P<0.001). The median follow-up of the survivors was 165 months. During this period, 93 patients died of their cancer. On univariate analysis, stratified for ER status, tumour size (P<0.01), lymph node involvement (P<0.001), tumour plasma cell infiltrate (P<0.001), other inflammatory cell infiltrate (P<0.05) and treatment (P<0.05) were associated with poorer cancer-specific survival whereas lymphocyte infiltrate (P<0.001) was associated with improved cancer-specific survival. On multivariate analysis, stratified for ER status, lymph node involvement (P<0.05) was independently associated with poorer cancer-specific survival whereas increased tumour lymphocyte infiltrate (P<0.001) was independently associated with improved cancer-specific survival. Conclusion: The results of this study show that, using routine histology, the general inflammatory cell infiltrate was a common feature and was positively associated with high grade, the absence of ER, the absence of PR, the presence of vascular invasion and high-grade infiltration of lymphocytes, plasma cells, other inflammatory cells and macrophages. Also, that within a mature cohort of patients, a high lymphocytic infiltrate was associated with improved survival, independent of clinicopathological characteristics including ER status, in primary operable ductal invasive breast cancer. These results rationalise previous work and provide a sound basis for future studies in this important area of breast cancer research. PMID:22878371

DPOAE generation dependence on primary frequencies ratio

NASA Astrophysics Data System (ADS)

Botti, Teresa; Sisto, Renata; Moleti, Arturo; D'Amato, Luisa; Sanjust, Filippo

2015-12-01

Two different mechanisms are responsible for the DPOAE generation. The nonlinear distortion wave-fixed mechanism generates the DPOAE Zero-Latency (ZL) component, as a backward traveling wave from the "overlap" region. Linear reflection of the forward DP wave (IDP) generates the DPOAE Long-Latency (LL) component through a place-fixed mechanism. ZL and LL components add up vectorially to generate the DPOAE recorded in the ear canal. The 2f1 - f2 and 2f2 - f1 DPOAE intensity depends on the stimulus level and on the primary frequency ratio r = f2/f1, where f1 and f2 are the primary stimuli frequencies. Here we study the behavior of the ZL and LL DPOAE components as a function of r by both numerical and laboratory experiments, measuring DPAOEs with an equal primary levels (L1 = L2) paradigm in the range [35, 75] dB SPL, with r ranging in [1.1, 1.45]. Numerical simulations of a nonlocal nonlinear model have been performed without cochlear roughness, to suppress the linear reflection mechanism. In this way the model solution at the base represents the DPOAE ZL component, and the solution at the corresponding DPOAE tonotopic place corresponds to the IDP. This technique has been not effectual to study the 2f2 - f1 DPOAE, as a consequence of its generation mechanism. While the 2f1 - f2 generation place is known to be the tonotopic place x(f2), the 2f2 - f1 DPOAE one has to be assumed basal to its corresponding reflection place. That is because ZL components generated in x(f2) cannot significantly pass through their resonant place. Moreover increasing the ratio r, 2f2 - f1 ZL and LL generation place approach each other, because the overlap region of primary tones decreases. Consequently, the distinction between the two places becomes complicated. DPOAEs have been measured in six young normal-hearing subjects. DPOAE ZL and LL components have been separated by a time-frequency filtering method based on the wavelet transform 1. due to their different phase gradient delay. Amplitude/phase vs ratio and ratio-frequency maps have been analyzed both in numerical and laboratory data. As already observed in animal studies [4], the generation of 2f1 - f2 DPOAE is around the f2 tonotopic place with a maximum around r = 1.2 for the ZL component, while the LL component shows a decreasing trend with r. Instead, 2f2 - f1 DPOAEs show a decreasing trend with r for both ZL and LL components.

The Myriad Properties of Pasteurella multocida Lipopolysaccharide

PubMed Central

Harper, Marina; Boyce, John Dallas

2017-01-01

Pasteurella multocida is a heterogeneous species that is a primary pathogen of many different vertebrates. This Gram-negative bacterium can cause a range of diseases, including fowl cholera in birds, haemorrhagic septicaemia in ungulates, atrophic rhinitis in swine, and lower respiratory tract infections in cattle and pigs. One of the primary virulence factors of P. multocida is lipopolysaccharide (LPS). Recent work has shown that this crucial surface molecule shows significant structural variability across different P. multocida strains, with many producing LPS structures that are highly similar to the carbohydrate component of host glycoproteins. It is likely that this LPS mimicry of host molecules plays a major role in the survival of P. multocida in certain host niches. P. multocida LPS also plays a significant role in resisting the action of chicken cathelicidins, and is a strong stimulator of host immune responses. The inflammatory response to the endotoxic lipid A component is a major contributor to the pathogenesis of certain infections. Recent work has shown that vaccines containing killed bacteria give protection only against other strains with identical, or nearly identical, surface LPS structures. Conversely, live attenuated vaccines give protection that is broadly protective, and their efficacy is independent of LPS structure. PMID:28825691

Kinetics and advanced digester design for anaerobic digestion of water hyacinth and primary sludge

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

Chynoweth, D.P.; Dolenc, D.A.; Ghosh, S.

1982-01-01

A research program centered around a facility located at Walt Disney World (WDW) is in progress to evaluate the use of water hyacinth (WH) for secondary and tertiary wastewater treatment, to optimize growth of WH under these conditions, and to convert the resultant primary sludge (PS) and WH to methane via anaerobic digestion. This article describes the status of the biogasification component of this program, which includes baseline and advanced digestion experiments with individual feeds and blends and the design of an experimental test unit (ETU) to be installed at WDW. Experiments with several blends demonstrated that methane yields canmore » be predicted from the fractional content and methane yield of each component. The process was found to adhere to the Monod kinetic model for microbial growth, and associated kinetic parameters were developed for various feed combinations. A novel upflow digester is achieving significantly higher conversion than a stirred-tank digester. Of several pretreatment techniques used, only alkaline treatment resulted in increased biodegradability. A larger scale (4.5 m/sup 3/) experimental test unit is being designed for installation at WDW in 1982. 13 figures, 4 tables.« less

New Eclipsing Contact Binary System in Auriga

NASA Astrophysics Data System (ADS)

Austin, S. J.; Robertson, J. W.; Justice, C.; Campbell, R. T.; Hoskins, J.

2004-05-01

We present data on a newly discovered eclipsing binary system. The serendipitous discovery of this variable star was made by J.W. Robertson analyzing inhomogeneous ensemble photometry of stars in the field of the cataclysmic variable FS Aurigae from Indiana University RoboScope data. We obtained differential time-series BVR photometry during 2003 of this field variable using an ensemble of telescopes including the university observatories at ATU, UCA and joint ventures with amateur observatories in the state of Arkansas (Whispering Pines Observatory and Nubbin Ridge Observatory). The orbital period of this eclipsing system is 0.2508 days. The B-V light curve indicates colors of 1.2 around quadrature, to nearly 1.4 at primary eclipse. Binary star light curve models that best fit the BVR differential photometry suggest that the system is a contact binary overfilling the inner Roche Lobe by 12%, a primary component with a temperature of 4350K, a secondary component with a temperature of 3500K, a mass ratio of 0.37, and an inclination of 83 degrees. We present BVR light curves, an ephemeris, and best fit model parameters for the physical characteristics of this new eclipsing binary system.

A framework to measure the value of public health services.

PubMed

Jacobson, Peter D; Neumann, Peter J

2009-10-01

To develop a framework that public health practitioners could use to measure the value of public health services. Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers. Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected. The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services. Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability. We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.

Mental Health Education in Three Primary Care Specialities.

ERIC Educational Resources Information Center

Strain, James J.; And Others

1986-01-01

The characteristics of the mental health components of residency training in traditional internal medicine, primary care internal medicine, and family practice were examined. Internal medicine programs relied on the consultation method and in-patient facilities, and used the psychiatrist as the primary teacher. Evaluation of the outcome of…

78 FR 28896 - Design Limits and Loading Combinations for Metal Primary Reactor Containment System Components

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0095] Design Limits and Loading Combinations for Metal... Regulatory Guide (RG) 1.57, ``Design Limits and Loading Combinations for Metal Primary Reactor Containment... the NRC staff considers acceptable for design limits and loading combinations for metal primary...

Strengthening the Creative Transformational Leadership of Primary School Teachers

ERIC Educational Resources Information Center

Kallapadee, Yadapak; Tesaputa, Kowat; Somprach, Kanokorn

2017-01-01

This research and development aimed to: 1) study the components and indicators of creative transformational leadership of primary school teachers; 2) study the existing situation, and the desirable situation of creative transformational leadership of primary school teachers in the northeastern region of Thailand; 3) develop a program to strengthen…

Integrated Primary Care Readiness and Behaviors Scale: Development and validation in behavioral health professionals.

PubMed

Blaney, Cerissa L; Redding, Colleen A; Paiva, Andrea L; Rossi, Joseph S; Prochaska, James O; Blissmer, Bryan; Burditt, Caitlin T; Nash, Justin M; Bayley, Keri Dotson

2018-03-01

Although integrated primary care (IPC) is growing, several barriers remain. Better understanding of behavioral health professionals' (BHPs') readiness for and engagement in IPC behaviors could improve IPC research and training. This study developed measures of IPC behaviors and stage of change. The sample included 319 licensed, practicing BHPs with a range of interests and experience with IPC. Sequential measurement development procedures, with split-half cross-validation were conducted. Exploratory principal components analyses (N = 152) and confirmatory factor analyses (N = 167) yielded a 12-item scale with 2 factors: consultation/practice management (CPM) and intervention/knowledge (IK). A higher-order Integrated Primary Care Behavior Scale (IPCBS) model showed good fit to the data, and excellent internal consistencies. The multivariate analysis of variance (MANOVA) on the IPCBS demonstrated significant large-sized differences across stage and behavior groups. The IPCBS demonstrated good psychometric properties and external validation, advancing research, education, and training for IPC practice. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A field guide for selecting the most appropriate treatment in sagebrush and pinon-juniper ecosystems in the Great Basin: Evaluating resilience to disturbance and resistance to invasive annual grasses, and predicting vegetation response

Treesearch

Richard F. Miller; Jeanne C. Chambers; Mike Pellant

2014-01-01

This field guide identifies seven primary components that largely determine resilience to disturbance, as well as resistance to invasive grasses and plant succession following treatment of areas of concern. The primary components are (1) characteristics of the ecological site, (2) current vegetation prior to treatment, (3) disturbance history, (4) type, timing, and...

Methods Development for the Isolation and Culture of Primary Corneal Endothelial Cells

DTIC Science & Technology

2017-02-01

are collectively referred to as mustard gas keratopathy (MGK). Prevailing evidence suggests that late onset MGK may result from a deficit in corneal...and PBK is similar to that seen in mustard gas keratopathy (MGK).3,6,7 MGK can occur years after ocular sulfur mustard (SM) exposure. Treatment...component into the stage component such that the O-ring creates a liquid -tight seal. The final assembled device is shown in panel D. A primary

BVRI Photometric Study of the High Mass Ratio, Detached, Pre-contact W UMa Binary GQ Cancri

NASA Astrophysics Data System (ADS)

Samec, R. G.; Olson, A.; Caton, D.; Faulkner, D. R.

2017-12-01

CCD BVRcIc light curves of GQ Cancri were observed in April 2013 using the SARA North 0.9-meter Telescope at Kitt Peak National Observatory in Arizona in remote mode. It is a high-amplitude (V 0.9 magnitude) K0±V type eclipsing binary (T1 5250 K) with a photometrically-determined mass ratio of M2 / M1 = 0.80. Its spectral color type classifies it as a pre-contact W UMa Binary (PCWB). The Wilson-Devinney Mode 2 solutions show that the system has a detached binary configuration with fill-outs of 94% and 98% for the primary and secondary component, respectively. As expected, the light curve is asymmetric due to spot activity. Three times of minimum light were calculated, for two primary eclipses and one secondary eclipse, from our present observations. In total, some 26 times of minimum light covering nearly 20 years of observation were used to determine linear and quadratic ephemerides. It is noted that the light curve solution remained in a detached state for every iteration of the computer runs. The components are very similar with a computed temperature difference of only 4 K, and the flux of the primary component accounts for 53±55% of the system's light in B, V, Rc, and Ic. A 12-degree radius high latitude white spot (faculae) was iterated on the primary component.

E-cigarettes: Impact of E-Liquid Components and Device Characteristics on Nicotine Exposure.

PubMed

DeVito, Elise E; Krishnan-Sarin, Suchitra

2018-01-01

Electronic cigarette (e-cigarette) use has increased substantially in recent years. While e-cigarettes have been proposed as a potentially effective smoking cessation tool, dualuse in smokers is common and e-cigarettes are widely used by non-smokers, including youth and young-adult non-smokers. Nicotine, the primary addictive component in cigarettes, is present at varying levels in many e-liquids. E-cigarettes may lead to initiation of nicotine use in adult and youth non-smokers, re-initiation of nicotine dependence in ex-smokers or increased severity of nicotine dependence in dual-users of cigarettes and e-cigarettes. As such, there are important clinical and policy implications to understanding factors impacting nicotine exposure from e-cigarettes. However, the broad and rapidly changing range of e-liquid constituents and e-cigarette hardware which could impact nicotine exposure presents a challenge. Recent changes in regulatory oversight of e-cigarettes underscore the importance of synthesizing current knowledge on common factors which may impact nicotine exposure. This review focuses on factors which may impact nicotine exposure by changing e-cigarette use behavior, puff topography, altering the nicotine yield (amount of nicotine exiting the e-cigarette mouth piece including nicotine exhaled as vapor) or more directly by altering nicotine absorption and bioavailability. Topics reviewed include e-liquid components or characteristics including flavor additives (e.g., menthol), base e-liquid ingredients (propylene glycol, vegetable glycerin), components commonly used to dissolve flavorants (e.g., ethanol), and resulting properties of the e-liquid (e.g., pH), e-cigarette device characteristics (e.g., wattage, temperature, model) and user behavior (e.g., puff topography) which may impact nicotine exposure. E-liquid characteristics and components, e-cigarette hardware and settings, and user behavior can all contribute substantially to nicotine exposure from e-cigarettes. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Treating primary dysmenorrhoea with acupuncture: a narrative review of the relationship between acupuncture 'dose' and menstrual pain outcomes.

PubMed

Armour, Mike; Smith, Caroline A

2016-12-01

A number of randomised controlled trials have been performed to determine the effectiveness or efficacy of acupuncture in primary dysmenorrhoea. The objective of this review was to explore the relationship between the 'dose' of the acupuncture intervention and menstrual pain outcomes. Eight databases were systematically searched for trials examining penetrating body acupuncture for primary dysmenorrhoea published in English up to September 2015. Dose components for each trial were extracted, assessed by the two authors and categorised by neurophysiological dose (number of needles, retention time and mode of stimulation), cumulative dose (total number and frequency of treatments), needle location and treatment timing. Eleven trials were included. Components of acupuncture dose were well reported across all trials. The relationship between needle location and menstrual pain demonstrated conflicting results. Treatment before the menses appeared to produce greater reductions in pain than treatment starting at the onset of menses. A single needle during menses may provide greater pain reduction compared to multiple needles. Conversely, multiple needles before menses were superior to a single needle. Electroacupuncture may provide more rapid pain reduction compared to manual acupuncture but may not have a significantly different effect on overall menstrual pain. There appear to be relationships between treatment timing and mode of needle stimulation, and menstrual pain outcomes. Needle location, number of needles used and frequency of treatment show clear dose-response relationships with menstrual pain outcomes. Current research is insufficient to make definitive clinical recommendations regarding optimum dose parameters for treating primary dysmenorrhoea. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Primary prevention of cannabis use: a systematic review of randomized controlled trials.

PubMed

Norberg, Melissa M; Kezelman, Sarah; Lim-Howe, Nicholas

2013-01-01

A systematic review of primary prevention was conducted for cannabis use outcomes in youth and young adults. The aim of the review was to develop a comprehensive understanding of prevention programming by assessing universal, targeted, uni-modal, and multi-modal approaches as well as individual program characteristics. Twenty-eight articles, representing 25 unique studies, identified from eight electronic databases (EMBASE, MEDLINE, CINAHL, ERIC, PsycINFO, DRUG, EBM Reviews, and Project CORK), were eligible for inclusion. Results indicated that primary prevention programs can be effective in reducing cannabis use in youth populations, with statistically significant effect sizes ranging from trivial (0.07) to extremely large (5.26), with the majority of significant effect sizes being trivial to small. Given that the preponderance of significant effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent across program type and individual components, the effectiveness of primary prevention for cannabis use should be interpreted with caution. Universal multi-modal programs appeared to outperform other program types (i.e, universal uni-modal, targeted multi-modal, targeted unimodal). Specifically, universal multi-modal programs that targeted early adolescents (10-13 year olds), utilised non-teacher or multiple facilitators, were short in duration (10 sessions or less), and implemented boosters sessions were associated with large median effect sizes. While there were studies in these areas that contradicted these results, the results highlight the importance of assessing the interdependent relationship of program components and program types. Finally, results indicated that the overall quality of included studies was poor, with an average quality rating of 4.64 out of 9. Thus, further quality research and reporting and the development of new innovative programs are required.

Primary Prevention of Cannabis Use: A Systematic Review of Randomized Controlled Trials

PubMed Central

Norberg, Melissa M.; Kezelman, Sarah; Lim-Howe, Nicholas

2013-01-01

A systematic review of primary prevention was conducted for cannabis use outcomes in youth and young adults. The aim of the review was to develop a comprehensive understanding of prevention programming by assessing universal, targeted, uni-modal, and multi-modal approaches as well as individual program characteristics. Twenty-eight articles, representing 25 unique studies, identified from eight electronic databases (EMBASE, MEDLINE, CINAHL, ERIC, PsycINFO, DRUG, EBM Reviews, and Project CORK), were eligible for inclusion. Results indicated that primary prevention programs can be effective in reducing cannabis use in youth populations, with statistically significant effect sizes ranging from trivial (0.07) to extremely large (5.26), with the majority of significant effect sizes being trivial to small. Given that the preponderance of significant effect sizes were trivial to small and that percentages of statistically significant and non-statistically significant findings were often equivalent across program type and individual components, the effectiveness of primary prevention for cannabis use should be interpreted with caution. Universal multi-modal programs appeared to outperform other program types (i.e, universal uni-modal, targeted multi-modal, targeted unimodal). Specifically, universal multi-modal programs that targeted early adolescents (10–13 year olds), utilised non-teacher or multiple facilitators, were short in duration (10 sessions or less), and implemented boosters sessions were associated with large median effect sizes. While there were studies in these areas that contradicted these results, the results highlight the importance of assessing the interdependent relationship of program components and program types. Finally, results indicated that the overall quality of included studies was poor, with an average quality rating of 4.64 out of 9. Thus, further quality research and reporting and the development of new innovative programs are required. PMID:23326396

Genetically heterogeneous glioblastoma recurring with disappearance of 1p/19q losses: case report.

PubMed

Ito, Motokazu; Wakabayashi, Toshihiko; Natsume, Atsushi; Hatano, Hisashi; Fujii, Masazumi; Yoshida, Jun

2007-07-01

Intratumor heterogeneity is of great importance in many clinical aspects of glioma biology, including tumor grading, therapeutic response, and recurrence. Modifications in the genetic features of a specific primary tumor recurring after chemo- and radiotherapy are poorly understood. We report a recurrent glioblastoma case exhibiting loss of heterozygosity (LOH) on chromosome 10q, while the primary tumor exhibited heterogeneity in the LOH status of 1p, 19q, and 10q. To determine the relationship between such modifications and heterogeneous chemosensitivity, primary cultured cells heterogeneously showing 1p/19q/10q losses were established from a surgical specimen of oligoastrocytoma and were treated with chemotherapeutic agents. A 46-year-old woman with a 1-month history of headache and visual disturbances presented to our institution. A right temporoparietal craniotomy and gross total resection were performed. The pathological diagnosis was glioblastoma multiforme with oligodendroglial components. Whereas LOH on 10q was identified at all tumor sites, only the oligodendroglial components exhibited LOH on 1p and 19q. The tumor recurred 6 months after postoperative chemotherapy using interferon-beta and ranimustine, as well as a course of fractionated external-beam radiotherapy (total dose, 60 Gy). Gene analysis revealed no 1p/19q allelic losses but only 10q LOH. Intratumor heterogeneity might be explained by the presence of more than one subclone in the primary tumor. Here, the tumor cells exhibiting 1p/19q LOH with high chemosensitivity might have been killed by the adjuvant therapy and those exhibiting 10q LOH with chemoresistance recurred. This study and our preliminary laboratory findings might suggest an approach to brain tumor physiology, diagnosis, and therapy.

Preliminary assessment of the computer-based Taenia solium educational program 'The Vicious Worm' on knowledge uptake in primary school students in rural areas in eastern Zambia.

PubMed

Hobbs, Emma C; Mwape, Kabemba Evans; Van Damme, Inge; Berkvens, Dirk; Zulu, Gideon; Mambwe, Moses; Chembensofu, Mwelwa; Phiri, Isaac Khozozo; Masuku, Maxwell; Bottieau, Emmanuel; Devleesschauwer, Brecht; Speybroeck, Niko; Colston, Angela; Dorny, Pierre; Willingham, Arve Lee; Gabriël, Sarah

2018-03-01

The zoonotic helminth Taenia solium is endemic in Zambia, causing human (taeniasis and (neuro)cysticercosis) and pig (porcine cysticercosis) diseases with high health, social and economic burdens. We aimed to evaluate the impact of a health educational program intended to lead to powerful and cumulative improvements in knowledge, attitudes and practices that decrease parasite transmission and disease occurrence. Half-day health education workshops were conducted in three primary schools in the highly endemic Eastern Province of Zambia, using the computer-based T. solium educational program 'The Vicious Worm'. Questionnaires were administered before and after the educational component to determine the program's impact on knowledge uptake in primary school students. In total, 99 students participated: 38 males and 61 females, with a median age of 14 years (range 10-18 years). Baseline general knowledge of T. solium, including awareness of the different human and pig disease states, and disease diagnosis, treatment and prevention, was quite high (average score 62%) and consistent across all three study areas. Participants' knowledge had significantly increased after the educational component, particularly regarding parasite transmission and disease prevention. Preliminary assessment of 'The Vicious Worm' indicates it is an effective tool for the short-term T. solium education of primary school students in Zambia. Follow-up studies are planned to assess the longer term impact of the program on knowledge uptake in the study neighbourhoods. Inclusion of tailored 'The Vicious Worm' educational workshops should be considered in integrated cysticercosis control programs in endemic areas of sub-Saharan Africa. © 2018 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Proteome-wide changes in primary skin keratinocytes exposed to diesel particulate extract-A role for antioxidants in skin health.

PubMed

Rajagopalan, Pavithra; Jain, Ankit P; Nanjappa, Vishalakshi; Patel, Krishna; Mangalaparthi, Kiran K; Babu, Niraj; Cavusoglu, Nükhet; Roy, Nita; Soeur, Jeremie; Breton, Lionel; Pandey, Akhilesh; Gowda, Harsha; Chatterjee, Aditi; Misra, Namita

2018-05-21

Skin acts as a protective barrier against direct contact with pollutants but inhalation and systemic exposure have indirect effect on keratinocytes. Exposure to diesel exhaust has been linked to increased oxidative stress. To investigate global proteomic alterations in diesel particulate extract (DPE)/its vapor exposed skin keratinocytes. We employed Tandem Mass Tag (TMT)-based proteomics to study effect of DPE/DPE vapor on primary skin keratinocytes. We observed an increased expression of oxidative stress response protein NRF2, upon chronic exposure of primary keratinocytes to DPE/its vapor which includes volatile components such as polycyclic aromatic hydrocarbons (PAHs). Mass spectrometry-based quantitative proteomics led to identification 4490 proteins of which 201 and 374 proteins were significantly dysregulated (≥1.5 fold, p ≤ 0.05) in each condition, respectively. Proteins involved in cellular processes such as cornification (cornifin A), wound healing (antileukoproteinase) and differentiation (suprabasin) were significantly downregulated in primary keratinocytes exposed to DPE/DPE vapor. These results were corroborated in 3D skin models chronically exposed to DPE/DPE vapor. Bioinformatics analyses indicate that DPE and its vapor affect distinct molecular processes in skin keratinocytes. Components of mitochondrial oxidative phosphorylation machinery were seen to be exclusively overexpressed upon chronic DPE vapor exposure. In addition, treatment with an antioxidant like vitamin E partially restores expression of proteins altered upon exposure to DPE/DPE vapor. Our study highlights distinct adverse effects of chronic exposure to DPE/DPE vapor on skin keratinocytes and the potential role of vitamin E in alleviating adverse effects of environmental pollution. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

The influence of heart disease on characteristics, quality of life, use of health resources, and costs of COPD in primary care settings.

PubMed

de Miguel-Díez, Javier; Carrasco-Garrido, Pilar; Rejas-Gutierrez, Javier; Martín-Centeno, Antonio; Gobartt-Vázquez, Elena; Hernandez-Barrera, Valentín; de Miguel, Angel Gil; Jimenez-Garcia, Rodrigo

2010-02-18

To evaluate the influence of heart disease on clinical characteristics, quality of life, use of health resources, and costs of patients with COPD followed at primary care settings under common clinical practice conditions. Epidemiologic, observational, and descriptive study (EPIDEPOC study). Patients > or = 40 years of age with stable COPD attending primary care settings were included. Demographic, clinical characteristics, quality of life (SF-12), seriousness of the disease, and treatment data were collected. Results were compared between patients with or without associated heart disease. A total of 9,390 patients with COPD were examined of whom 1,770 (18.8%) had heart disease and 78% were males. When comparing both patient groups, significant differences were found in the socio-demographic characteristics, health profile, comorbidities, and severity of the airway obstruction, which was greater in patients with heart disease. Differences were also found in both components of quality of life, physical and mental, with lower scores among those patients with heart disease. Higher frequency of primary care and pneumologist visits, emergency-room visits and number of hospital admissions were observed among patients with heart diseases. The annual total cost per patient was significantly higher in patients with heart disease; 2,937 +/- 2,957 vs. 1,749 +/- 2,120, p < 0.05. Variables that were showed to be independently associated to COPD in subjects with hearth conditions were age, being inactive, ex-smokers, moderate physical exercise, body mass index, concomitant blood hypertension, diabetes, anxiety, the SF-12 physical and mental components and per patient per year total cost. Patients with COPD plus heart disease had greater disease severity and worse quality of life, used more healthcare resources and were associated with greater costs compared to COPD patients without known hearth disease.

Primary Cosmic-Ray Spectra in the Knee Region

NASA Astrophysics Data System (ADS)

Ter-Antonyan, Samvel V.; Biermann, P. L.

2003-07-01

Using EAS inverse approach and KASCADE EAS data the primary energy spectra for different primary nuclei at energies 1015 - 1017 eV are obtained in the framework of multi-comp onent model of primary cosmic ray origin and QGSJET and SIBYLL interaction models. The rigidity-dep endent behavior of spectra is the same for two interaction models. The extrap olation of the obtained primary spectra in a 1017 - 1018 eV energy range displays a presence of the extragalactic component of primary cosmic rays.

Characterization of an ntrX mutant of Neisseria gonorrhoeae reveals a response regulator that controls expression of respiratory enzymes in oxidase-positive proteobacteria.

PubMed

Atack, John M; Srikhanta, Yogitha N; Djoko, Karrera Y; Welch, Jessica P; Hasri, Norain H M; Steichen, Christopher T; Vanden Hoven, Rachel N; Grimmond, Sean M; Othman, Dk Seti Maimonah Pg; Kappler, Ulrike; Apicella, Michael A; Jennings, Michael P; Edwards, Jennifer L; McEwan, Alastair G

2013-06-01

NtrYX is a sensor-histidine kinase/response regulator two-component system that has had limited characterization in a small number of Alphaproteobacteria. Phylogenetic analysis of the response regulator NtrX showed that this two-component system is extensively distributed across the bacterial domain, and it is present in a variety of Betaproteobacteria, including the human pathogen Neisseria gonorrhoeae. Microarray analysis revealed that the expression of several components of the respiratory chain was reduced in an N. gonorrhoeae ntrX mutant compared to that in the isogenic wild-type (WT) strain 1291. These included the cytochrome c oxidase subunit (ccoP), nitrite reductase (aniA), and nitric oxide reductase (norB). Enzyme activity assays showed decreased cytochrome oxidase and nitrite reductase activities in the ntrX mutant, consistent with microarray data. N. gonorrhoeae ntrX mutants had reduced capacity to survive inside primary cervical cells compared to the wild type, and although they retained the ability to form a biofilm, they exhibited reduced survival within the biofilm compared to wild-type cells, as indicated by LIVE/DEAD staining. Analyses of an ntrX mutant in a representative alphaproteobacterium, Rhodobacter capsulatus, showed that cytochrome oxidase activity was also reduced compared to that in the wild-type strain SB1003. Taken together, these data provide evidence that the NtrYX two-component system may be a key regulator in the expression of respiratory enzymes and, in particular, cytochrome c oxidase, across a wide range of proteobacteria, including a variety of bacterial pathogens.

Improving the fitness and physical activity levels of primary school children: results of the Fit-4-Fun group randomized controlled trial.

PubMed

Eather, Narelle; Morgan, Philip J; Lubans, David R

2013-01-01

To evaluate the impact of a multi-component school-based physical activity intervention (Fit-4-Fun) on health-related fitness and objectively measured physical activity in primary school children. Four Hunter primary schools were recruited in April, 2011 and randomized by school into treatment or control conditions. Participants included 213 children (mean age = 10.72 years ± 0.6; 52.2% female) with the treatment group (n = 118) completing the 8-week Fit-4-Fun Program. Participants were assessed at baseline and 6-month follow-up, with a 91% retention rate. Cardio-respiratory fitness (CRF) (20 m shuttle run) was the primary outcome, and secondary outcomes included body composition (BMI, BMI(Z)), muscular fitness (7-stage sit-up test, push-up test, basketball throw test, Standing Jump), flexibility (sit and reach) and physical activity (7 days pedometry). After 6-months, significant treatment effects were found for CRF (adjusted mean difference, 1.14 levels, p < 0.001), body composition (BMI mean, -0.96 kg/m(2), p < 0.001 and BMI z-score mean -0.47 z-scores, p < 0.001), flexibility (sit and reach mean, 1.52 cm, p = 0.0013), muscular fitness (sit-ups) (mean 0.62 stages, p = 0.003) and physical activity (mean, 3253 steps/day, p < 0.001). There were no group by time effects for the other muscular fitness measures. A primary school-based intervention focusing on fitness education significantly improved health-related fitness and physical activity levels in children. Copyright © 2012 Elsevier Inc. All rights reserved.

Comprehensive process model of clinical information interaction in primary care: results of a "best-fit" framework synthesis.

PubMed

Veinot, Tiffany C; Senteio, Charles R; Hanauer, David; Lowery, Julie C

2018-06-01

To describe a new, comprehensive process model of clinical information interaction in primary care (Clinical Information Interaction Model, or CIIM) based on a systematic synthesis of published research. We used the "best fit" framework synthesis approach. Searches were performed in PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Library and Information Science Abstracts, Library, Information Science and Technology Abstracts, and Engineering Village. Two authors reviewed articles according to inclusion and exclusion criteria. Data abstraction and content analysis of 443 published papers were used to create a model in which every element was supported by empirical research. The CIIM documents how primary care clinicians interact with information as they make point-of-care clinical decisions. The model highlights 3 major process components: (1) context, (2) activity (usual and contingent), and (3) influence. Usual activities include information processing, source-user interaction, information evaluation, selection of information, information use, clinical reasoning, and clinical decisions. Clinician characteristics, patient behaviors, and other professionals influence the process. The CIIM depicts the complete process of information interaction, enabling a grasp of relationships previously difficult to discern. The CIIM suggests potentially helpful functionality for clinical decision support systems (CDSSs) to support primary care, including a greater focus on information processing and use. The CIIM also documents the role of influence in clinical information interaction; influencers may affect the success of CDSS implementations. The CIIM offers a new framework for achieving CDSS workflow integration and new directions for CDSS design that can support the work of diverse primary care clinicians.

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

Lin, Liyong, E-mail: linl@uphs.upenn.edu; Huang, Sheng; Kang, Minglei

Purpose: The purpose of this paper is to demonstrate the utility of a comprehensive test pattern in validating calculation models that include the halo component (low-dose tails) of proton pencil beam scanning (PBS) spots. Such a pattern has been used previously for quality assurance purposes to assess spot shape, position, and dose. Methods: In this study, a scintillation detector was used to measure the test pattern in air at isocenter for two proton beam energies (115 and 225 MeV) of two IBA universal nozzles (UN #1 and UN #2). Planar measurements were compared with calculated dose distributions based on themore » weighted superposition of location-independent (UN #1) or location-dependent (UN #2) spot profiles, previously measured using a pair-magnification method and between two nozzles. Results: Including the halo component below 1% of the central dose is shown to improve the gamma-map comparison between calculation and measurement from 94.9% to 98.4% using 2 mm/2% criteria for the 115 MeV proton beam of UN #1. In contrast, including the halo component below 1% of the central dose does not improve the gamma agreement for the 115 MeV proton beam of UN #2, due to the cutoff of the halo component at off-axis locations. When location-dependent spot profiles are used for calculation instead of spot profiles at central axis, the gamma agreement is improved from 98.0% to 99.5% using 2 mm/2% criteria. The two nozzles clearly have different characteristics, as a direct comparison of measured data shows a passing rate of 89.7% for the 115 MeV proton beam. At 225 MeV, the corresponding gamma comparisons agree better between measurement and calculation, and between measurements in the two nozzles. Conclusions: In addition to confirming the primary component of individual PBS spot profiles, a comprehensive test pattern is useful for the validation of the halo component at off-axis locations, especially for low energy protons.« less

SU-E-I-55: The Contribution to Skin Dose Due to Scatter From the Patient Table and the Head Holder During Fluoroscopy

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

Islam, N; Xiong, Z; Vijayan, S

2015-06-15

Purpose: To determine contributions to skin dose due to scatter from the table and head holder used during fluoroscopy, and also to explore alternative design material to reduce the scatter dose. Methods: Measurements were made of the primary and scatter components of the xray beam exiting the patient table and a cylindrical head holder used on a Toshiba Infinix c-arm unit as a function of kVp for the various beam filters on the machine and for various field sizes. The primary component of the beam was measured in air with the object placed close to the x-ray tube with anmore » air gap between it and a 6 cc parallel-plate ionization chamber and with the beam collimated to a size just larger than the chamber. The primary plus scatter radiation components were measured with the object moved to a position in the beam next to the chamber for larger field sizes. Both sets of measurements were preformed while keeping the source-to-chamber distance fixed. The scatter fraction was estimated by taking the ratio of the difference between the two measurements and the reading that included both primary and scatter. Similar measurements were also made for a 2.3 cm thick Styrofoam block which could substitute for the patient support. Results: The measured scatter fractions indicate that the patient table as well as the head holder contributes an additional 10–16% to the patient entrance dose depending on field size. Forward scatter was reduced with the Styrofoam block so that the scatter fraction was about 4–5%. Conclusion: The results of this investigation demonstrated that scatter from the table and head holder used in clinical fluoroscopy contribute substantially to the skin dose. The lower contribution of scatter from Styrofoam suggests that there is an opportunity to redesign patient support accessories to reduce the skin dose. Partial support from NIH grant R01EB002873 and Toshiba Medical Systems Corporation Equipment Grant.« less

A cost-effectiveness analysis of three components of a syndromic surveillance system for the early warning of epidemics in rural China.

PubMed

Ding, Yan; Sauerborn, Rainer; Xu, Biao; Shaofa, Nie; Yan, Weirong; Diwan, Vinod K; Dong, Hengjin

2015-11-14

Syndromic surveillance systems (SSSs) collect non-specific syndromes in early stages of disease outbreaks. This makes an SSS a promising tool for the early detection of epidemics. An Integrated Surveillance System in rural China (ISSC project), which added an SSS to the existing Chinese surveillance system for the early warning of epidemics, was implemented from April 2012 to March 2014 in Jiangxi and Hubei Provinces. This study aims to measure the costs and effectiveness of the three components of the SSS in the ISSC project. The central measures of the cost-effectiveness analysis of the three components of the syndromic surveillance system were: 1) the costs per reported event, respectively, at the health facilities, the primary schools and the pharmacies; and 2) the operating costs per surveillance unit per year, respectively, at the health facilities, the primary schools and the pharmacies. Effectiveness was expressed by reporting outputs which were numbers of reported events, numbers of raw signals, and numbers of verified signals. The reported events were tracked through an internal data base. Signal verification forms and epidemiological investigation reports were collected from local country centers for disease control and prevention. We adopted project managers' perspective for the cost analysis. Total costs included set-up costs (system development and training) and operating costs (data collection, quality control and signal verification). We used self-designed questionnaires to collect cost data and received, respectively, 369 and 477 facility and staff questionnaires through a cross-sectional survey with a purposive sampling following the ISSC project. All data were entered into Epidata 3.02 and exported to Stata for descriptive analysis. The number of daily reported events per unit was the highest at pharmacies, followed by health facilities and finally primary schools. Variances existed within the three groups and also between Jiangxi and Hubei. During a 15-month surveillance period, the number of raw signals for early warning in Jiangxi province (n = 36) was nine times of that in Hubei. Health facilities and primary schools had equal numbers of raw signals (n = 19), which was 9.5 times of that from pharmacies. Five signals were confirmed as outbreaks, of which two were influenza, two were chicken pox and one was mumps. The cost per reported event was the highest at primary schools, followed by health facilities and then pharmacies. The annual operating cost per surveillance unit was the highest at pharmacies, followed by health facilities and finally primary schools. Both the cost per reported event and the annual operating cost per surveillance unit in Jiangxi in each of the three groups were higher than their counterparts in Hubei. Health facilities and primary schools are better sources of syndromic surveillance data in the early warning of outbreaks. The annual operating costs of all the three components of the syndromic surveillance system in the ISSC Project were low compared to general government expenditures on health and average individual income in rural China.

White-Light Phase-Conjugate Mirrors as Distortion Correctors

NASA Technical Reports Server (NTRS)

Frazier, Donald; Smith, W. Scott; Abdeldayem, Hossin; Banerjee, Partha

2010-01-01

White-light phase-conjugate mirrors would be incorporated into some optical systems, according to a proposal, as means of correcting for wavefront distortions caused by imperfections in large optical components. The proposal was given impetus by a recent demonstration that white, incoherent light can be made to undergo phase conjugation, whereas previously, only coherent light was known to undergo phase conjugation. This proposal, which is potentially applicable to almost any optical system, was motivated by a need to correct optical aberrations of the primary mirror of the Hubble Space telescope. It is difficult to fabricate large optical components like the Hubble primary mirror and to ensure the high precision typically required of such components. In most cases, despite best efforts, the components as fabricated have small imperfections that introduce optical aberrations that adversely affect imaging quality. Correcting for such aberrations is difficult and costly. The proposed use of white-light phase conjugate mirrors offers a relatively simple and inexpensive solution of the aberration-correction problem. Indeed, it should be possible to simplify the entire approach to making large optical components because there would be no need to fabricate those components with extremely high precision in the first place: A white-light phase-conjugate mirror could correct for all the distortions and aberrations in an optical system. The use of white-light phase-conjugate mirrors would be essential for ensuring high performance in optical systems containing lightweight membrane mirrors, which are highly deformable. As used here, "phase-conjugate mirror" signifies, more specifically, an optical component in which incident light undergoes time-reversal phase conjugation. In practice, a phase-conjugate mirror would typically be implemented by use of a suitably positioned and oriented photorefractive crystal. In the case of a telescope comprising a primary and secondary mirror (see figure) white light from a distant source would not be brought to initial focus on one or more imaging scientific instrument(s) as in customary practice. Instead, the light would be brought to initial focus on a phase-conjugate mirror. The phase-conjugate mirror would send a phase-conjugate image back, along the path of the incoming light, to the primary mirror. A transparent, highly efficient diffractive thin film deposited on the primary mirror would direct the phase-conjugate image to the imaging instrument(s).

Process evaluation of the data-driven quality improvement in primary care (DQIP) trial: active and less active ingredients of a multi-component complex intervention to reduce high-risk primary care prescribing.

PubMed

Grant, Aileen; Dreischulte, Tobias; Guthrie, Bruce

2017-01-07

Two to 4% of emergency hospital admissions are caused by preventable adverse drug events. The estimated costs of such avoidable admissions in England were £530 million in 2015. The data-driven quality improvement in primary care (DQIP) intervention was designed to prompt review of patients vulnerable from currently prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and anti-platelets and was found to be effective at reducing this prescribing. A process evaluation was conducted parallel to the trial, and this paper reports the analysis which aimed to explore response to the intervention delivered to clusters in relation to participants' perceptions about which intervention elements were active in changing their practice. Data generation was by in-depth interview with key staff exploring participant's perceptions of the intervention components. Analysis was iterative using the framework technique and drawing on normalisation process theory. All the primary components of the intervention were perceived as active, but at different stages of implementation: financial incentives primarily supported recruitment; education motivated the GPs to initiate implementation; the informatics tool facilitated sustained implementation. Participants perceived the primary components as interdependent. Intervention subcomponents also varied in whether and when they were active. For example, run charts providing feedback of change in prescribing over time were ignored in the informatics tool, but were motivating in some practices in the regular e-mailed newsletter. The high-risk NSAID and anti-platelet prescribing targeted was accepted as important by all interviewees, and this shared understanding was a key wider context underlying intervention effectiveness. This was a novel use of process evaluation data which examined whether and how the individual intervention components were effective from the perspective of the professionals delivering changed care to patients. These findings are important for reproducibility and roll-out of the intervention. ClinicalTrials.gov, NCT01425502 .

49 CFR 237.131 - Design.

Code of Federal Regulations, 2010 CFR

2010-10-01

... modification which materially modifies the capacity of a bridge or the stresses in any primary load-carrying... materially modify the capacity of a bridge or the stresses in any primary load-carrying component of a bridge...

49 CFR 237.131 - Design.

Code of Federal Regulations, 2012 CFR

2012-10-01

... modification which materially modifies the capacity of a bridge or the stresses in any primary load-carrying... materially modify the capacity of a bridge or the stresses in any primary load-carrying component of a bridge...

KENNEDY SPACE CENTER, FLA. - The container with the Japanese Experiment Module (JEM)’s pressurized module is inside the Space Station Processing Facility. The National Space Development Agency of Japan (NASDA) developed the laboratory at the Tsukuba Space Center near Tokyo. The Pressurized Module is the first element of the JEM, named "Kibo" (Hope), to be delivered to KSC. The JEM is Japan's primary contribution to the Station. It will enhance the unique research capabilities of the orbiting complex by providing an additional environment for astronauts to conduct science experiments. The JEM also includes an exposed facility (platform) for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

NASA Image and Video Library

2003-06-06

KENNEDY SPACE CENTER, FLA. - The container with the Japanese Experiment Module (JEM)’s pressurized module is inside the Space Station Processing Facility. The National Space Development Agency of Japan (NASDA) developed the laboratory at the Tsukuba Space Center near Tokyo. The Pressurized Module is the first element of the JEM, named "Kibo" (Hope), to be delivered to KSC. The JEM is Japan's primary contribution to the Station. It will enhance the unique research capabilities of the orbiting complex by providing an additional environment for astronauts to conduct science experiments. The JEM also includes an exposed facility (platform) for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

KENNEDY SPACE CENTER, FLA. - The truck transporting the Pressurized Module of the Japanese Experiment Module (JEM) to KSC’s Space Station Processing Facility arrives on Center. The National Space Development Agency of Japan (NASDA) developed the laboratory at the Tsukuba Space Center near Tokyo. The Pressurized Module is the first element of the JEM, named "Kibo" (Hope), to be delivered to KSC. The JEM is Japan's primary contribution to the Station. It will enhance the unique research capabilities of the orbiting complex by providing an additional environment for astronauts to conduct science experiments. The JEM also includes an exposed facility (platform) for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

NASA Image and Video Library

2003-06-04

KENNEDY SPACE CENTER, FLA. - The truck transporting the Pressurized Module of the Japanese Experiment Module (JEM) to KSC’s Space Station Processing Facility arrives on Center. The National Space Development Agency of Japan (NASDA) developed the laboratory at the Tsukuba Space Center near Tokyo. The Pressurized Module is the first element of the JEM, named "Kibo" (Hope), to be delivered to KSC. The JEM is Japan's primary contribution to the Station. It will enhance the unique research capabilities of the orbiting complex by providing an additional environment for astronauts to conduct science experiments. The JEM also includes an exposed facility (platform) for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

KENNEDY SPACE CENTER, FLA. - The JEM Pressurized Module is seen in the hold of the ship that carried it from Japan. The National Space Development Agency of Japan (NASDA) built the laboratory at the Tsukuba Space Center near Tokyo. The Pressurized Module is the first element of the JEM, Japan’s primary contribution to the space station, to be delivered to KSC. It will enhance the unique research capabilities of the orbiting complex by providing an additional shirt-sleeve environment for astronauts to conduct science experiments. The JEM also includes two logistics modules, an exposed pallet for space environment experiments and a robotic manipulator system that are still under construction in Japan. The various JEM components will be assembled in space over the course of three space shuttle missions.

NASA Image and Video Library

2003-05-30

KENNEDY SPACE CENTER, FLA. - The JEM Pressurized Module is seen in the hold of the ship that carried it from Japan. The National Space Development Agency of Japan (NASDA) built the laboratory at the Tsukuba Space Center near Tokyo. The Pressurized Module is the first element of the JEM, Japan’s primary contribution to the space station, to be delivered to KSC. It will enhance the unique research capabilities of the orbiting complex by providing an additional shirt-sleeve environment for astronauts to conduct science experiments. The JEM also includes two logistics modules, an exposed pallet for space environment experiments and a robotic manipulator system that are still under construction in Japan. The various JEM components will be assembled in space over the course of three space shuttle missions.

Kneelike Structure in the Spectrum of the Heavy Component of Cosmic Rays Observed with KASCADE-Grande

NASA Astrophysics Data System (ADS)

Apel, W. D.; Arteaga-Velázquez, J. C.; Bekk, K.; Bertaina, M.; Blümer, J.; Bozdog, H.; Brancus, I. M.; Buchholz, P.; Cantoni, E.; Chiavassa, A.; Cossavella, F.; Daumiller, K.; de Souza, V.; di Pierro, F.; Doll, P.; Engel, R.; Engler, J.; Finger, M.; Fuhrmann, D.; Ghia, P. L.; Gils, H. J.; Glasstetter, R.; Grupen, C.; Haungs, A.; Heck, D.; Hörandel, J. R.; Huber, D.; Huege, T.; Isar, P. G.; Kampert, K.-H.; Kang, D.; Klages, H. O.; Link, K.; Łuczak, P.; Ludwig, M.; Mathes, H. J.; Mayer, H. J.; Melissas, M.; Milke, J.; Mitrica, B.; Morello, C.; Navarra, G.; Oehlschläger, J.; Ostapchenko, S.; Over, S.; Palmieri, N.; Petcu, M.; Pierog, T.; Rebel, H.; Roth, M.; Schieler, H.; Schröder, F. G.; Sima, O.; Toma, G.; Trinchero, G. C.; Ulrich, H.; Weindl, A.; Wochele, J.; Wommer, M.; Zabierowski, J.

2011-10-01

We report the observation of a steepening in the cosmic ray energy spectrum of heavy primary particles at about 8×1016eV. This structure is also seen in the all-particle energy spectrum, but is less significant. Whereas the “knee” of the cosmic ray spectrum at 3-5×1015eV was assigned to light primary masses by the KASCADE experiment, the new structure found by the KASCADE-Grande experiment is caused by heavy primaries. The result is obtained by independent measurements of the charged particle and muon components of the secondary particles of extensive air showers in the primary energy range of 1016 to 1018eV. The data are analyzed on a single-event basis taking into account also the correlation of the two observables.

ARTIE: An Integrated Environment for the Development of Affective Robot Tutors

PubMed Central

Imbernón Cuadrado, Luis-Eduardo; Manjarrés Riesco, Ángeles; De La Paz López, Félix

2016-01-01

Over the last decade robotics has attracted a great deal of interest from teachers and researchers as a valuable educational tool from preschool to highschool levels. The implementation of social-support behaviors in robot tutors, in particular in the emotional dimension, can make a significant contribution to learning efficiency. With the aim of contributing to the rising field of affective robot tutors we have developed ARTIE (Affective Robot Tutor Integrated Environment). We offer an architectural pattern which integrates any given educational software for primary school children with a component whose function is to identify the emotional state of the students who are interacting with the software, and with the driver of a robot tutor which provides personalized emotional pedagogical support to the students. In order to support the development of affective robot tutors according to the proposed architecture, we also provide a methodology which incorporates a technique for eliciting pedagogical knowledge from teachers, and a generic development platform. This platform contains a component for identiying emotional states by analysing keyboard and mouse interaction data, and a generic affective pedagogical support component which specifies the affective educational interventions (including facial expressions, body language, tone of voice,…) in terms of BML (a Behavior Model Language for virtual agent specification) files which are translated into actions of a robot tutor. The platform and the methodology are both adapted to primary school students. Finally, we illustrate the use of this platform to build a prototype implementation of the architecture, in which the educational software is instantiated with Scratch and the robot tutor with NAO. We also report on a user experiment we carried out to orient the development of the platform and of the prototype. We conclude from our work that, in the case of primary school students, it is possible to identify, without using intrusive and expensive identification methods, the emotions which most affect the character of educational interventions. Our work also demonstrates the feasibility of a general-purpose architecture of decoupled components, in which a wide range of educational software and robot tutors can be integrated and then used according to different educational criteria. PMID:27536230

ARTIE: An Integrated Environment for the Development of Affective Robot Tutors.

PubMed

Imbernón Cuadrado, Luis-Eduardo; Manjarrés Riesco, Ángeles; De La Paz López, Félix

2016-01-01

Over the last decade robotics has attracted a great deal of interest from teachers and researchers as a valuable educational tool from preschool to highschool levels. The implementation of social-support behaviors in robot tutors, in particular in the emotional dimension, can make a significant contribution to learning efficiency. With the aim of contributing to the rising field of affective robot tutors we have developed ARTIE (Affective Robot Tutor Integrated Environment). We offer an architectural pattern which integrates any given educational software for primary school children with a component whose function is to identify the emotional state of the students who are interacting with the software, and with the driver of a robot tutor which provides personalized emotional pedagogical support to the students. In order to support the development of affective robot tutors according to the proposed architecture, we also provide a methodology which incorporates a technique for eliciting pedagogical knowledge from teachers, and a generic development platform. This platform contains a component for identiying emotional states by analysing keyboard and mouse interaction data, and a generic affective pedagogical support component which specifies the affective educational interventions (including facial expressions, body language, tone of voice,…) in terms of BML (a Behavior Model Language for virtual agent specification) files which are translated into actions of a robot tutor. The platform and the methodology are both adapted to primary school students. Finally, we illustrate the use of this platform to build a prototype implementation of the architecture, in which the educational software is instantiated with Scratch and the robot tutor with NAO. We also report on a user experiment we carried out to orient the development of the platform and of the prototype. We conclude from our work that, in the case of primary school students, it is possible to identify, without using intrusive and expensive identification methods, the emotions which most affect the character of educational interventions. Our work also demonstrates the feasibility of a general-purpose architecture of decoupled components, in which a wide range of educational software and robot tutors can be integrated and then used according to different educational criteria.

Are V1 Simple Cells Optimized for Visual Occlusions? A Comparative Study

PubMed Central

Bornschein, Jörg; Henniges, Marc; Lücke, Jörg

2013-01-01

Simple cells in primary visual cortex were famously found to respond to low-level image components such as edges. Sparse coding and independent component analysis (ICA) emerged as the standard computational models for simple cell coding because they linked their receptive fields to the statistics of visual stimuli. However, a salient feature of image statistics, occlusions of image components, is not considered by these models. Here we ask if occlusions have an effect on the predicted shapes of simple cell receptive fields. We use a comparative approach to answer this question and investigate two models for simple cells: a standard linear model and an occlusive model. For both models we simultaneously estimate optimal receptive fields, sparsity and stimulus noise. The two models are identical except for their component superposition assumption. We find the image encoding and receptive fields predicted by the models to differ significantly. While both models predict many Gabor-like fields, the occlusive model predicts a much sparser encoding and high percentages of ‘globular’ receptive fields. This relatively new center-surround type of simple cell response is observed since reverse correlation is used in experimental studies. While high percentages of ‘globular’ fields can be obtained using specific choices of sparsity and overcompleteness in linear sparse coding, no or only low proportions are reported in the vast majority of studies on linear models (including all ICA models). Likewise, for the here investigated linear model and optimal sparsity, only low proportions of ‘globular’ fields are observed. In comparison, the occlusive model robustly infers high proportions and can match the experimentally observed high proportions of ‘globular’ fields well. Our computational study, therefore, suggests that ‘globular’ fields may be evidence for an optimal encoding of visual occlusions in primary visual cortex. PMID:23754938

Multi-Axis Thrust Measurements of the EO-1 Pulsed Plasma Thruster

NASA Technical Reports Server (NTRS)

Arrington, Lynn A.; Haag, Thomas W.

1999-01-01

Pulsed plasma thrusters are low thrust propulsive devices which have a high specific impulse at low power. A pulsed plasma thruster is currently scheduled to fly as an experiment on NASA's Earth Observing-1 satellite mission. The pulsed plasma thruster will be used to replace one of the reaction wheels. As part of the qualification testing of the thruster it is necessary to determine the nominal thrust as a function of charge energy. These data will be used to determine control algorithms. Testing was first completed on a breadboard pulsed plasma thruster to determine nominal or primary axis thrust and associated propellant mass consumption as a function of energy and then later to determine if any significant off-axis thrust component existed. On conclusion that there was a significant off-axis thrust component with the bread-board in the direction of the anode electrode, the test matrix was expanded on the flight hardware to include thrust measurements along all three orthogonal axes. Similar off-axis components were found with the flight unit.

An MCNP-based model of a medical linear accelerator x-ray photon beam.

PubMed

Ajaj, F A; Ghassal, N M

2003-09-01

The major components in the x-ray photon beam path of the treatment head of the VARIAN Clinac 2300 EX medical linear accelerator were modeled and simulated using the Monte Carlo N-Particle radiation transport computer code (MCNP). Simulated components include x-ray target, primary conical collimator, x-ray beam flattening filter and secondary collimators. X-ray photon energy spectra and angular distributions were calculated using the model. The x-ray beam emerging from the secondary collimators were scored by considering the total x-ray spectra from the target as the source of x-rays at the target position. The depth dose distribution and dose profiles at different depths and field sizes have been calculated at a nominal operating potential of 6 MV and found to be within acceptable limits. It is concluded that accurate specification of the component dimensions, composition and nominal accelerating potential gives a good assessment of the x-ray energy spectra.

Dynamic energy budget modeling reveals the potential of future growth and calcification for the coccolithophore Emiliania huxleyi in an acidified ocean.

PubMed

Muller, Erik B; Nisbet, Roger M

2014-06-01

Ocean acidification is likely to impact the calcification potential of marine organisms. In part due to the covarying nature of the ocean carbonate system components, including pH and CO2 and CO3(2-) levels, it remains largely unclear how each of these components may affect calcification rates quantitatively. We develop a process-based bioenergetic model that explains how several components of the ocean carbonate system collectively affect growth and calcification rates in Emiliania huxleyi, which plays a major role in marine primary production and biogeochemical carbon cycling. The model predicts that under the IPCC A2 emission scenario, its growth and calcification potential will have decreased by the end of the century, although those reductions are relatively modest. We anticipate that our model will be relevant for many other marine calcifying organisms, and that it can be used to improve our understanding of the impact of climate change on marine systems. © 2014 John Wiley & Sons Ltd.

[A network to promote health systems based on primary health care in the Region of the Americas].

PubMed

Herrera Vázquez, María Magdalena; Rodríguez Avila, Nuria; Nebot Adell, Carme; Montenegro, Hernán

2007-05-01

To identify the relational components of an international network of organizations that provide technical and financial assistance to promote the development of health systems based on primary health care in the countries of the Region of the Americas; to analyze the linkages that would allow the collaborating partners of the Pan American Health Organization (PAHO) to work together on health issues; and to determine the basic theoretical elements that can help to develop action strategies that support advocacy efforts by a network. This was a qualitative and quantitative cross-sectional study based on identifying key informants and on analyzing social networks. Ethnographic and relational information from 46 international organizations was collected through a self-administered semistructured questionnaire. From 46 international health cooperation organizations, 29 decision makers from 29 organizations participated (63.0% response rate). The structure and the strength of the network was evaluated in terms of density, closeness, clustering, and centralization. The statistical analysis was done using computer programs that included UCINET, Pajek, and Microsoft Access. We found a structurally centralized theoretical network, whose nodes were clustered into four central subgroups linked by a shared vision. The leadership, influence, and political interests reflected the formal and technical-cooperation linkages, the formal support for health systems based on primary health care, and the flow of resources being more often technical ones than financial ones. The interorganizational relational components and the social-action ties that were identified could help in the development and consolidation of a thematic network for advocacy and for the management of technical and financial assistance that supports primary health care in the Americas. The linkages for joint action that were identified could advance international cooperation in developing health systems based on primary health care, once PAHO formulates clear implementation strategies and takes a leadership position in mobilizing financial resources and in creating informal and interpersonal linkages for action.

Darapladib for preventing ischemic events in stable coronary heart disease.

PubMed

White, Harvey D; Held, Claes; Stewart, Ralph; Tarka, Elizabeth; Brown, Rebekkah; Davies, Richard Y; Budaj, Andrzej; Harrington, Robert A; Steg, P Gabriel; Ardissino, Diego; Armstrong, Paul W; Avezum, Alvaro; Aylward, Philip E; Bryce, Alfonso; Chen, Hong; Chen, Ming-Fong; Corbalan, Ramon; Dalby, Anthony J; Danchin, Nicolas; De Winter, Robbert J; Denchev, Stefan; Diaz, Rafael; Elisaf, Moses; Flather, Marcus D; Goudev, Assen R; Granger, Christopher B; Grinfeld, Liliana; Hochman, Judith S; Husted, Steen; Kim, Hyo-Soo; Koenig, Wolfgang; Linhart, Ales; Lonn, Eva; López-Sendón, José; Manolis, Athanasios J; Mohler, Emile R; Nicolau, José C; Pais, Prem; Parkhomenko, Alexander; Pedersen, Terje R; Pella, Daniel; Ramos-Corrales, Marco A; Ruda, Mikhail; Sereg, Mátyás; Siddique, Saulat; Sinnaeve, Peter; Smith, Peter; Sritara, Piyamitr; Swart, Henk P; Sy, Rody G; Teramoto, Tamio; Tse, Hung-Fat; Watson, David; Weaver, W Douglas; Weiss, Robert; Viigimaa, Margus; Vinereanu, Dragos; Zhu, Junren; Cannon, Christopher P; Wallentin, Lars

2014-05-01

Elevated lipoprotein-associated phospholipase A2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a selective oral inhibitor of lipoprotein-associated phospholipase A2. In a double-blind trial, we randomly assigned 15,828 patients with stable coronary heart disease to receive either once-daily darapladib (at a dose of 160 mg) or placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the components of the primary end point as well as major coronary events (death from coronary heart disease, myocardial infarction, or urgent coronary revascularization for myocardial ischemia) and total coronary events (death from coronary heart disease, myocardial infarction, hospitalization for unstable angina, or any coronary revascularization). During a median follow-up period of 3.7 years, the primary end point occurred in 769 of 7924 patients (9.7%) in the darapladib group and 819 of 7904 patients (10.4%) in the placebo group (hazard ratio in the darapladib group, 0.94; 95% confidence interval [CI], 0.85 to 1.03; P=0.20). There were also no significant between-group differences in the rates of the individual components of the primary end point or in all-cause mortality. Darapladib, as compared with placebo, reduced the rate of major coronary events (9.3% vs. 10.3%; hazard ratio, 0.90; 95% CI, 0.82 to 1.00; P=0.045) and total coronary events (14.6% vs. 16.1%; hazard ratio, 0.91; 95% CI, 0.84 to 0.98; P=0.02). In patients with stable coronary heart disease, darapladib did not significantly reduce the risk of the primary composite end point of cardiovascular death, myocardial infarction, or stroke. (Funded by GlaxoSmithKline; STABILITY ClinicalTrials.gov number, NCT00799903.).

HEARTBEAT STARS: SPECTROSCOPIC ORBITAL SOLUTIONS FOR SIX ECCENTRIC BINARY SYSTEMS

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

Smullen, Rachel A.; Kobulnicky, Henry A., E-mail: rsmullen@email.arizona.edu

2015-08-01

We present multi-epoch spectroscopy of “heartbeat stars,” eccentric binaries with dynamic tidal distortions and tidally induced pulsations originally discovered with the Kepler satellite. Optical spectra of six known heartbeat stars using the Wyoming Infrared Observatory 2.3 m telescope allow measurement of stellar effective temperatures and radial velocities from which we determine orbital parameters including the periods, eccentricities, approximate mass ratios, and component masses. These spectroscopic solutions confirm that the stars are members of eccentric binary systems with eccentricities e > 0.34 and periods P = 7–20 days, strengthening conclusions from prior works that utilized purely photometric methods. Heartbeat stars inmore » this sample have A- or F-type primary components. Constraints on orbital inclinations indicate that four of the six systems have minimum mass ratios q = 0.3–0.5, implying that most secondaries are probable M dwarfs or earlier. One system is an eclipsing, double-lined spectroscopic binary with roughly equal-mass mid-A components (q = 0.95), while another shows double-lined behavior only near periastron, indicating that the F0V primary has a G1V secondary (q = 0.65). This work constitutes the first measurements of the masses of secondaries in a statistical sample of heartbeat stars. The good agreement between our spectroscopic orbital elements and those derived using a photometric model support the idea that photometric data are sufficient to derive reliable orbital parameters for heartbeat stars.« less

Primary Cystic Lesions of the Retrorectal Space: MRI Evaluation and Clinical Assessment.

PubMed

Dwarkasing, Roy S; Verschuuren, Sylvia I; van Leenders, Geert J L H; Braun, Loes M M; Krestin, Gabriel P; Schouten, W Rudolph

2017-10-01

The purpose of this study was to assess the a priori chance that primary cystic lesions of the retrorectal space are malignant and to investigate MRI characteristics that indicate malignancy. Patients referred to a center for colorectal surgery were recruited from 2000 to 2014. Lesions were proven by clinical assessment and histopathology. MRI was performed at 1.5 T with examinations evaluated by two radiologists. Interobserver agreement was assessed (Cohen kappa) and differences between malignant and benign lesions calculated (Fisher exact test). Twenty-eight patients (22 women, six men; age range, 18-70 years) with 31 lesions were included. Lesions were categorized as tailgut cysts (n = 16, 52%), teratomas (n = 9, 29%), lesions of colorectal origin (n = 4, 13%), or neurogenic lesions (n = 2, 6%). Five patients (18%) had malignant lesions. Colorectal lesions had the highest percentage of malignancy (3/4, 75%). A solid tissue component was found in all five (100%) malignant lesions and two (8%) of the benign lesions, which were both teratomas (p < 0.05). Sensitivity and specificity for malignancy according to the presence of a solid tissue component was 100% (5/5) and 92% (24/26). For unilocularity, multilocularity, debris, septa, and wall thickening, differences were not significant. Interobserver agreement was excellent (κ = 1) for all characteristics except debris (κ = 0.795). The majority of retrorectal cystic lesions are benign. The presence of a solid tissue component should raise suspicion for malignancy.

Intraperitoneal chemotherapy for the initial management of primary epithelial ovarian cancer.

PubMed

Jaaback, Kenneth; Johnson, Nick; Lawrie, Theresa A

2011-11-09

Ovarian cancer tends to be chemosensitive and confine itself to the surface of the peritoneal cavity for much of its natural history. These features have made it an obvious target for intraperitoneal (IP) chemotherapy. Chemotherapy for ovarian cancer is usually given as an intravenous (IV) infusion repeatedly over five to eight cycles. Intraperitoneal chemotherapy is given by infusion of the chemotherapeutic agent directly into the peritoneal cavity. There are biological reasons why this might increase the anticancer effect and reduce some systemic adverse effects in comparison to IV therapy. To determine if adding a component of the chemotherapy regime into the peritoneal cavity affects overall survival, progression-free survival, quality of life (QOL) and toxicity in the primary treatment of epithelial ovarian cancer. We searched the Gynaecological Cancer Review Group's Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 2, 2011, MEDLINE (1951 to May 2011) and EMBASE (1974 to May 2011). We updated these searches in February 2007, August 2010 and May 2011. In addition, we handsearched and cascade searched the major gynaecological oncology journals. The analysis was restricted to randomised controlled trials (RCTs) assessing women with a new diagnosis of primary epithelial ovarian cancer, of any FIGO stage, following primary cytoreductive surgery. Standard IV chemotherapy was compared with chemotherapy that included a component of IP administration. We extracted data on overall survival, disease-free survival, adverse events and QOL and performed meta-analyses of hazard ratios (HR) for time-to-event variables and relative risks (RR) for dichotomous outcomes using RevMan software. Nine randomised trials studied 2119 women receiving primary treatment for ovarian cancer. We considered six trials to be of high quality. Women were less likely to die if they received an IP component to chemotherapy (eight studies, 2026 women; HR = 0.81; 95% confidence interval (CI): 0.72 to 0.90). Intraperitoneal component chemotherapy prolonged the disease-free interval (five studies, 1311 women; HR = 0.78; 95% CI: 0.70 to 0.86). There was greater serious toxicity with regard to gastrointestinal effects, pain, fever and infection but less ototoxicity with the IP than the IV route. Intraperitoneal chemotherapy increases overall survival and progression-free survival from advanced ovarian cancer. The results of this meta-analysis provide the most reliable estimates of the relative survival benefits of IP over IV therapy and should be used as part of the decision making process. However, the potential for catheter related complications and toxicity needs to be considered when deciding on the most appropriate treatment for each individual woman. The optimal dose, timing and mechanism of administration cannot be addressed from this meta-analysis. This needs to be addressed in the next phase of clinical trials.

A neural correlate of working memory in the monkey primary visual cortex.

PubMed

Supèr, H; Spekreijse, H; Lamme, V A

2001-07-06

The brain frequently needs to store information for short periods. In vision, this means that the perceptual correlate of a stimulus has to be maintained temporally once the stimulus has been removed from the visual scene. However, it is not known how the visual system transfers sensory information into a memory component. Here, we identify a neural correlate of working memory in the monkey primary visual cortex (V1). We propose that this component may link sensory activity with memory activity.

Characterizing spatiotemporal variations of chromophoric dissolved organic matter in headwater catchment of a key drinking water source in China.

PubMed

Chen, Yihan; Yu, Kaifeng; Zhou, Yongqiang; Ren, Longfei; Kirumba, George; Zhang, Bo; He, Yiliang

2017-12-01

Natural surface drinking water sources with the increasing chromophoric dissolved organic matter (CDOM) have profound influences on the aquatic environment and drinking water safety. Here, this study investigated the spatiotemporal variations of CDOM in Fengshuba Reservoir and its catchments in China. Twenty-four surface water samples, 45 water samples (including surface water, middle water, and bottom water), and 15 pore water samples were collected from rivers, reservoir, and sediment of the reservoir, respectively. Then, three fluorescent components, namely two humic-like components (C1 and C2) and a tryptophan-like component (C3), were identified from the excitation-emission matrix coupled with parallel factor analysis (EEM-PARAFAC) for all samples. For spatial distributions, the levels of CDOM and two humic-like components in the reservoir were significantly lower than those in the upstream rivers (p < 0.01), indicating that the reservoir may act as a reactor to partly reduce the levels of exogenous input including CDOM and humic-like matters from the surrounding catchment. For temporal variations, the mean levels of CDOM and three fluorescent components did not significantly change in rivers, suggesting that perennial anthropic activity maybe an important factor impacting the concentration and composition of river CDOM but not the precipitation and runoff. However, these mean values of CDOM for the bulk waters of the reservoir changed markedly along with seasonal variations, indicating that the hydrological processes in the reservoir could control the quality and quantity of CDOM. The different correlations between the fluorescent components and primary water parameters in the river, reservoir, and pore water samples further suggest that the reservoir is an important factor regulating the migration and transformation of FDOM along with the variations of different environmental gradients.

Modular femoral neck fracture after primary total hip arthroplasty.

PubMed

Sotereanos, Nicholas G; Sauber, Timothy J; Tupis, Todd T

2013-01-01

The use of modular femoral stems in primary total hip arthroplasty has increased considerably in recent years. These modular components offer the surgeon the ability to independently alter version, offset, and length of the femoral component of a hip arthroplasty. This increases the surgeon's ability to accurately recreate the relevant anatomy but increases the possibilities of corrosion and fracture. Multiple case reports have highlighted fractures of these modular components. We present a case of a fracture of a modular design that has had no previously reported modular neck fractures. The patient was informed that data concerning the case would be submitted, and he consented. Copyright © 2013 Elsevier Inc. All rights reserved.

NEW PRECISION ORBITS OF BRIGHT DOUBLE-LINED SPECTROSCOPIC BINARIES. V. THE AM STARS HD 434 AND 41 SEXTANTIS

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

Fekel, Francis C.; Williamson, Michael H., E-mail: fekel@evans.tsuniv.ed

We have detected the secondary component in two previously known spectroscopic binaries, HD 434 and 41 Sex, and for the first time determined double-lined orbits for them. Despite the relatively long period of 34.26 days and a moderate eccentricity of 0.32, combined with the components' rotationally broadened lines, measurement of the primary and secondary radial velocities of HD 434 has enabled us to obtain significantly improved orbital elements. While the 41 Sex system has a much shorter period of 6.167 days and a circular orbit, the estimated V mag difference of 3.2 between its components also makes this a challengingmore » system. The new orbital dimensions (a{sub 1} sin i and a{sub 2} sin i) and minimum masses (m{sub 1} sin{sup 3} i and m{sub 2} sin{sup 3} i) of HD 434 have accuracies of 0.8% or better, while the same quantities for 41 Sex are good to 0.5% or better. Both components of HD 434 are Am stars while the Am star primary of 41 Sex has a late-F or early-G companion. All four stars are on the main sequence. The two components of HD 434 are rotating much faster than their predicted pseudosynchronous velocities, while both components of 41 Sex are synchronously rotating. For the primary of 41 Sex, the spectrum line depth changes noted by Sreedhar Rao et al. were not detected.« less

Comparative effectiveness of intervention components for producing long-term abstinence from smoking: a factorial screening experiment.

PubMed

Schlam, Tanya R; Fiore, Michael C; Smith, Stevens S; Fraser, David; Bolt, Daniel M; Collins, Linda M; Mermelstein, Robin; Piper, Megan E; Cook, Jessica W; Jorenby, Douglas E; Loh, Wei-Yin; Baker, Timothy B

2016-01-01

To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. A 2 × 2 × 2 × 2 × 2 randomized factorial experiment. Eleven primary care clinics in Wisconsin, USA. A total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit. Five intervention components designed to help smokers attain and maintain abstinence: (1) extended medication (26 versus 8 weeks of nicotine patch + nicotine gum); (2) maintenance (phone) counseling versus none; (3) medication adherence counseling versus none; (4) automated (medication) adherence calls versus none; and (5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone. The primary outcome was 7-day self-reported point-prevalence abstinence 1 year after the target quit day. Only extended medication produced a main effect. Twenty-six versus 8 weeks of medication improved point-prevalence abstinence rates (43 versus 34% at 6 months; 34 versus 27% at 1 year; P = 0.01 for both). There were four interaction effects at 1 year, showing that an intervention component's effectiveness depended upon the components with which it was combined. Twenty-six weeks of nicotine patch + nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment. © 2015 Society for the Study of Addiction.

Studies in Mathematics Education, Volume 3. The Mathematical Education of Primary-School Teachers.

ERIC Educational Resources Information Center

Morris, Robert, Ed.

Recognizing that the teacher is the key to improving any mathematics program, this volume examines the responsibility of primary school teachers for the mathematics component of the curriculum and the implications thereof for teacher education. The first two chapters focus on the responsibilities of teachers of primary mathematics and contemporary…

An Introduction to Primary Physical Education

ERIC Educational Resources Information Center

Griggs, Gerald, Ed.

2012-01-01

Physical Education is a core component of the primary school curriculum. The primary years are perhaps the most significant period for motor development in children, a time during which basic movement competencies are developed and which offers the first opportunity for embedding physical activity as part of a healthy lifestyle. This is the first…

Development of Program to Enhance Team Building Leadership Skills of Primary School Administrators

ERIC Educational Resources Information Center

Sairam, Boonchauy; Sirisuthi, Chaiyuth; Wisetrinthong, Kanjana

2017-01-01

Team building leadership skills are important to understandings of how the primary school administrators might work towards creating more effective teamwork in the school. This research aimed 1) to study the components of team building leadership skills needed for primary school administrators, 2) to examine the current states and desirable…

Global Health and Primary Care: Increasing Burden of Chronic Diseases and Need for Integrated Training

PubMed Central

Truglio, Joseph; Graziano, Michelle; Vedanthan, Rajesh; Hahn, Sigrid; Rios, Carlos; Hendel-Paterson, Brett; Ripp, Jonathan

2015-01-01

Noncommunicable diseases, including cardiovascular disease, chronic respiratory disease, diabetes, cancer, and mental illness, are the leading causes of death and disability worldwide. These diseases are chronic and often mediated predominantly by social determinants of health. Currently there exists a global-health workforce crisis and a subsequent disparity in the distribution of providers able to manage chronic noncommunicable diseases. Clinical competency in global health and primary care could provide practitioners with the knowledge and skills needed to address the global rise of noncommunicable diseases through an emphasis on these social determinants. The past decade has seen substantial growth in the number and quality of US global-health and primary-care training programs, in both undergraduate and graduate medical education. Despite their overlapping competencies, these 2 complementary fields are most often presented as distinct disciplines. Furthermore, many global-health training programs suffer from a lack of a formalized curriculum. At present, there are only a few examples of well-integrated US global-health and primary-care training programs. We call for universal acceptance of global health as a core component of medical education and greater integration of global-health and primary-care training programs in order to improve the quality of each and increase a global workforce prepared to manage noncommunicable diseases and their social mediators. PMID:22786735

[Family Health Teams in Ontario: Ideas for Germany from a Canadian Primary Care Model].

PubMed

Ulrich, Lisa-R; Pham, Thuy-Nga Tia; Gerlach, Ferdinand M; Erler, Antje

2017-07-11

The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners. In 2014, the German Advisory Council on the Assessment of Developments in the Health Care System highlighted the importance of regional, integrated care with community-based primary care centres at its core, providing comprehensive, population-based, patient-centred primary care with adequate access to general practitioners for a given geographical area. Such centres exist already in Ontario, Canada; within Family Health Teams (FHT), family physicians work hand-in-hand with pharmacists, nurses, nurse practitioners, social workers, and other allied health professionals. In this article, the Canadian model of FHT will be introduced and we will discuss which components could be adapted to suit the German primary care system. © Georg Thieme Verlag KG Stuttgart · New York.

Water Impact Prediction Tool for Recoverable Rockets

NASA Technical Reports Server (NTRS)

Rooker, William; Glaese, John; Clayton, Joe

2011-01-01

Reusing components from a rocket launch can be cost saving. NASA's space shuttle system has reusable components that return to the Earth and impact the ocean. A primary example is the Space Shuttle Solid Rocket Booster (SRB) that descends on parachutes to the Earth after separation and impacts the ocean. Water impact generates significant structural loads that can damage the booster, so it is important to study this event in detail in the design of the recovery system. Some recent examples of damage due to water impact include the Ares I-X First Stage deformation as seen in Figure 1 and the loss of the SpaceX Falcon 9 First Stage.To ensure that a component can be recovered or that the design of the recovery system is adequate, an adequate set of structural loads is necessary for use in failure assessments. However, this task is difficult since there are many conditions that affect how a component impacts the water and the resulting structural loading that a component sees. These conditions include the angle of impact with respect to the water, the horizontal and vertical velocities, the rotation rate, the wave height and speed, and many others. There have been attempts to simulate water impact. One approach is to analyze water impact using explicit finite element techniques such as those employed by the LS-Dyna tool [1]. Though very detailed, this approach is time consuming and would not be suitable for running Monte Carlo or optimization analyses. The purpose of this paper is to describe a multi-body simulation tool that runs quickly and that captures the environments a component might see. The simulation incorporates the air and water interaction with the component, the component dynamics (i.e. modes and mode shapes), any applicable parachutes and lines, the interaction of winds and gusts, and the wave height and speed. It is capable of quickly conducting Monte Carlo studies to better capture the environments and genetic algorithm optimizations to reproduce a flight.

The Primary Care Behavioral Health (PCBH) Model: An Overview and Operational Definition.

PubMed

Reiter, Jeffrey T; Dobmeyer, Anne C; Hunter, Christopher L

2018-06-01

The Primary Care Behavioral Health (PCBH) model is a prominent approach to the integration of behavioral health services into primary care settings. Implementation of the PCBH model has grown over the past two decades, yet research and training efforts have been slowed by inconsistent terminology and lack of a concise, operationalized definition of the model and its key components. This article provides the first concise operationalized definition of the PCBH model, developed from examination of multiple published resources and consultation with nationally recognized PCBH model experts. The definition frames the model as a team-based approach to managing biopsychosocial issues that present in primary care, with the over-arching goal of improving primary care in general. The article provides a description of the key components and strategies used in the model, the rationale for those strategies, a brief comparison of this model to other integration approaches, a focused summary of PCBH model outcomes, and an overview of common challenges to implementing the model.

A Model-based Approach to Scaling GPP and NPP in Support of MODIS Land Product Validation

NASA Astrophysics Data System (ADS)

Turner, D. P.; Cohen, W. B.; Gower, S. T.; Ritts, W. D.

2003-12-01

Global products from the Earth-orbiting MODIS sensor include land cover, leaf area index (LAI), FPAR, 8-day gross primary production (GPP), and annual net primary production (NPP) at the 1 km spatial resolution. The BigFoot Project was designed specifically to validate MODIS land products, and has initiated ground measurements at 9 sites representing a wide array of vegetation types. An ecosystem process model (Biome-BGC) is used to generate estimates of GPP and NPP for each 5 km x 5 km BigFoot site. Model inputs include land cover and LAI (from Landsat ETM+), daily meteorological data (from a centrally located eddy covariance flux tower), and soil characteristics. Model derived outputs are validated against field-measured NPP and flux tower-derived GPP. The resulting GPP and NPP estimates are then aggregated to the 1 km resolution for direct spatial comparison with corresponding MODIS products. At the high latitude sites (tundra and boreal forest), the MODIS GPP phenology closely tracks the BigFoot GPP, but there is a high bias in the MODIS GPP. In the temperate zone sites, problems with the timing and magnitude of the MODIS FPAR introduce differences in MODIS GPP compared to the validation data at some sites. However, the MODIS LAI/FPAR data are currently being reprocessed (=Collection 4) and new comparisons will be made for 2002. The BigFoot scaling approach permits precise overlap in spatial and temporal resolution between the MODIS products and BigFoot products, and thus permits the evaluation of specific components of the MODIS NPP algorithm. These components include meteorological inputs from the NASA Data Assimilation Office, LAI and FPAR from other MODIS algorithms, and biome-specific parameters for base respiration rate and light use efficiency.

Source Characterization of Volatile Organic Compounds Affecting the Air Quality in a Coastal Urban Area of South Texas

PubMed Central

Sanchez, Marciano; Karnae, Saritha; John, Kuruvilla

2008-01-01

Selected Volatile Organic Compounds (VOC) emitted from various anthropogenic sources including industries and motor vehicles act as primary precursors of ozone, while some VOC are classified as air toxic compounds. Significantly large VOC emission sources impact the air quality in Corpus Christi, Texas. This urban area is located in a semi-arid region of South Texas and is home to several large petrochemical refineries and industrial facilities along a busy ship-channel. The Texas Commission on Environmental Quality has setup two continuous ambient monitoring stations (CAMS 633 and 634) along the ship channel to monitor VOC concentrations in the urban atmosphere. The hourly concentrations of 46 VOC compounds were acquired from TCEQ for a comprehensive source apportionment study. The primary objective of this study was to identify and quantify the sources affecting the ambient air quality within this urban airshed. Principal Component Analysis/Absolute Principal Component Scores (PCA/APCS) was applied to the dataset. PCA identified five possible sources accounting for 69% of the total variance affecting the VOC levels measured at CAMS 633 and six possible sources affecting CAMS 634 accounting for 75% of the total variance. APCS identified natural gas emissions to be the major source contributor at CAMS 633 and it accounted for 70% of the measured VOC concentrations. The other major sources identified at CAMS 633 included flare emissions (12%), fugitive gasoline emissions (9%), refinery operations (7%), and vehicle exhaust (2%). At CAMS 634, natural gas sources were identified as the major source category contributing to 31% of the observed VOC. The other sources affecting this site included: refinery operations (24%), flare emissions (22%), secondary industrial processes (12%), fugitive gasoline emissions (8%) and vehicle exhaust (3%). PMID:19139530

Convergence of an iterative procedure for large-scale static analysis of structural components

NASA Technical Reports Server (NTRS)

Austin, F.; Ojalvo, I. U.

1976-01-01

The paper proves convergence of an iterative procedure for calculating the deflections of built-up component structures which can be represented as consisting of a dominant, relatively stiff primary structure and a less stiff secondary structure, which may be composed of one or more substructures that are not connected to one another but are all connected to the primary structure. The iteration consists in estimating the deformation of the primary structure in the absence of the secondary structure on the assumption that all mechanical loads are applied directly to the primary structure. The j-th iterate primary structure deflections at the interface are imposed on the secondary structure, and the boundary loads required to produce these deflections are computed. The cycle is completed by applying the interface reaction to the primary structure and computing its updated deflections. It is shown that the mathematical condition for convergence of this procedure is that the maximum eigenvalue of the equation relating primary-structure deflection to imposed secondary-structure deflection be less than unity, which is shown to correspond with the physical requirement that the secondary structure be more flexible at the interface boundary.

Systematic chemical and molecular profiling of MLL-rearranged infant acute lymphoblastic leukemia reveals efficacy of romidepsin

PubMed Central

Cruickshank, M N; Ford, J; Cheung, L C; Heng, J; Singh, S; Wells, J; Failes, T W; Arndt, G M; Smithers, N; Prinjha, R K; Anderson, D; Carter, K W; Gout, A M; Lassmann, T; O'Reilly, J; Cole, C H; Kotecha, R S; Kees, U R

2017-01-01

To address the poor prognosis of mixed lineage leukemia (MLL)-rearranged infant acute lymphoblastic leukemia (iALL), we generated a panel of cell lines from primary patient samples and investigated cytotoxic responses to contemporary and novel Food and Drug Administration-approved chemotherapeutics. To characterize representation of primary disease within cell lines, molecular features were compared using RNA-sequencing and cytogenetics. High-throughput screening revealed variable efficacy of currently used drugs, however identified consistent efficacy of three novel drug classes: proteasome inhibitors, histone deacetylase inhibitors and cyclin-dependent kinase inhibitors. Gene expression of drug targets was highly reproducible comparing iALL cell lines to matched primary specimens. Histone deacetylase inhibitors, including romidepsin (ROM), enhanced the activity of a key component of iALL therapy, cytarabine (ARAC) in vitro and combined administration of ROM and ARAC to xenografted mice further reduced leukemia burden. Molecular studies showed that ROM reduces expression of cytidine deaminase, an enzyme involved in ARAC deactivation, and enhances the DNA damage–response to ARAC. In conclusion, we present a valuable resource for drug discovery, including the first systematic analysis of transcriptome reproducibility in vitro, and have identified ROM as a promising therapeutic for MLL-rearranged iALL. PMID:27443263

Dynamic System Simulation of the KRUSTY Experiment

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

Klein, Steven Karl; Kimpland, Robert Herbert

2016-05-09

The proposed KRUSTY experiment is a demonstration of a reactor operating at power. The planned experimental configuration includes a highly enriched uranium (HEU) reflected core, cooled by multiple heat pipes leading to Stirling engines for primary heat rejection. Operating power is expected to be approximately four (4) to five (5) kilowatts with a core temperature above 1,000 K. No data is available on any historical reactor employing HEU metal that operated over the temperature range required for the KRUSTY experiment. Further, no reactor has operated with heat pipes as the primary cooling mechanism. Historic power reactors have employed either naturalmore » or forced convection so data on their operation is not directly applicable to the KRUSTY experiment. The primary purpose of the system model once developed and refined by data from these component experiments, will be used to plan the KRUSTY experiment. This planning will include expected behavior of the reactor from start-up, through various transient conditions where cooling begins to become present and effective, and finally establishment of steady-state. In addition, the model can provide indicators of anticipated off-normal events and appropriate operator response to those conditions. This information can be used to develop specific experiment operating procedures and aids to guide the operators in conduct of the experiment.« less

The allocation of ecosystem net primary productivity in tropical forests

PubMed Central

Malhi, Yadvinder; Doughty, Christopher; Galbraith, David

2011-01-01

The allocation of the net primary productivity (NPP) of an ecosystem between canopy, woody tissue and fine roots is an important descriptor of the functioning of that ecosystem, and an important feature to correctly represent in terrestrial ecosystem models. Here, we collate and analyse a global dataset of NPP allocation in tropical forests, and compare this with the representation of NPP allocation in 13 terrestrial ecosystem models. On average, the data suggest an equal partitioning of allocation between all three main components (mean 34 ± 6% canopy, 39 ± 10% wood, 27 ± 11% fine roots), but there is substantial site-to-site variation in allocation to woody tissue versus allocation to fine roots. Allocation to canopy (leaves, flowers and fruit) shows much less variance. The mean allocation of the ecosystem models is close to the mean of the data, but the spread is much greater, with several models reporting allocation partitioning outside of the spread of the data. Where all main components of NPP cannot be measured, litterfall is a good predictor of overall NPP (r2 = 0.83 for linear fit forced through origin), stem growth is a moderate predictor and fine root production a poor predictor. Across sites the major component of variation of allocation is a shifting allocation between wood and fine roots, with allocation to the canopy being a relatively invariant component of total NPP. This suggests the dominant allocation trade-off is a ‘fine root versus wood’ trade-off, as opposed to the expected ‘root–shoot’ trade-off; such a trade-off has recently been posited on theoretical grounds for old-growth forest stands. We conclude by discussing the systematic biases in estimates of allocation introduced by missing NPP components, including herbivory, large leaf litter and root exudates production. These biases have a moderate effect on overall carbon allocation estimates, but are smaller than the observed range in allocation values across sites. PMID:22006964

Sequencing the Cortical Processing of Pitch-Evoking Stimuli using EEG Analysis and Source Estimation

PubMed Central

Butler, Blake E.; Trainor, Laurel J.

2012-01-01

Cues to pitch include spectral cues that arise from tonotopic organization and temporal cues that arise from firing patterns of auditory neurons. fMRI studies suggest a common pitch center is located just beyond primary auditory cortex along the lateral aspect of Heschl’s gyrus, but little work has examined the stages of processing for the integration of pitch cues. Using electroencephalography, we recorded cortical responses to high-pass filtered iterated rippled noise (IRN) and high-pass filtered complex harmonic stimuli, which differ in temporal and spectral content. The two stimulus types were matched for pitch saliency, and a mismatch negativity (MMN) response was elicited by infrequent pitch changes. The P1 and N1 components of event-related potentials (ERPs) are thought to arise from primary and secondary auditory areas, respectively, and to result from simple feature extraction. MMN is generated in secondary auditory cortex and is thought to act on feature-integrated auditory objects. We found that peak latencies of both P1 and N1 occur later in response to IRN stimuli than to complex harmonic stimuli, but found no latency differences between stimulus types for MMN. The location of each ERP component was estimated based on iterative fitting of regional sources in the auditory cortices. The sources of both the P1 and N1 components elicited by IRN stimuli were located dorsal to those elicited by complex harmonic stimuli, whereas no differences were observed for MMN sources across stimuli. Furthermore, the MMN component was located between the P1 and N1 components, consistent with fMRI studies indicating a common pitch region in lateral Heschl’s gyrus. These results suggest that while the spectral and temporal processing of different pitch-evoking stimuli involves different cortical areas during early processing, by the time the object-related MMN response is formed, these cues have been integrated into a common representation of pitch. PMID:22740836

Geographical and Temporal Body Size Variation in a Reptile: Roles of Sex, Ecology, Phylogeny and Ecology Structured in Phylogeny

PubMed Central

Aragón, Pedro; Fitze, Patrick S.

2014-01-01

Geographical body size variation has long interested evolutionary biologists, and a range of mechanisms have been proposed to explain the observed patterns. It is considered to be more puzzling in ectotherms than in endotherms, and integrative approaches are necessary for testing non-exclusive alternative mechanisms. Using lacertid lizards as a model, we adopted an integrative approach, testing different hypotheses for both sexes while incorporating temporal, spatial, and phylogenetic autocorrelation at the individual level. We used data on the Spanish Sand Racer species group from a field survey to disentangle different sources of body size variation through environmental and individual genetic data, while accounting for temporal and spatial autocorrelation. A variation partitioning method was applied to separate independent and shared components of ecology and phylogeny, and estimated their significance. Then, we fed-back our models by controlling for relevant independent components. The pattern was consistent with the geographical Bergmann's cline and the experimental temperature-size rule: adults were larger at lower temperatures (and/or higher elevations). This result was confirmed with additional multi-year independent data-set derived from the literature. Variation partitioning showed no sex differences in phylogenetic inertia but showed sex differences in the independent component of ecology; primarily due to growth differences. Interestingly, only after controlling for independent components did primary productivity also emerge as an important predictor explaining size variation in both sexes. This study highlights the importance of integrating individual-based genetic information, relevant ecological parameters, and temporal and spatial autocorrelation in sex-specific models to detect potentially important hidden effects. Our individual-based approach devoted to extract and control for independent components was useful to reveal hidden effects linked with alternative non-exclusive hypothesis, such as those of primary productivity. Also, including measurement date allowed disentangling and controlling for short-term temporal autocorrelation reflecting sex-specific growth plasticity. PMID:25090025

White matter damage in primary progressive aphasias: a diffusion tensor tractography study.

PubMed

Galantucci, Sebastiano; Tartaglia, Maria Carmela; Wilson, Stephen M; Henry, Maya L; Filippi, Massimo; Agosta, Federica; Dronkers, Nina F; Henry, Roland G; Ogar, Jennifer M; Miller, Bruce L; Gorno-Tempini, Maria Luisa

2011-10-01

Primary progressive aphasia is a clinical syndrome that encompasses three major phenotypes: non-fluent/agrammatic, semantic and logopenic. These clinical entities have been associated with characteristic patterns of focal grey matter atrophy in left posterior frontoinsular, anterior temporal and left temporoparietal regions, respectively. Recently, network-level dysfunction has been hypothesized but research to date has focused largely on studying grey matter damage. The aim of this study was to assess the integrity of white matter tracts in the different primary progressive aphasia subtypes. We used diffusion tensor imaging in 48 individuals: nine non-fluent, nine semantic, nine logopenic and 21 age-matched controls. Probabilistic tractography was used to identify bilateral inferior longitudinal (anterior, middle, posterior) and uncinate fasciculi (referred to as the ventral pathway); and the superior longitudinal fasciculus segmented into its frontosupramarginal, frontoangular, frontotemporal and temporoparietal components, (referred to as the dorsal pathway). We compared the tracts' mean fractional anisotropy, axial, radial and mean diffusivities for each tract in the different diagnostic categories. The most prominent white matter changes were found in the dorsal pathways in non-fluent patients, in the two ventral pathways and the temporal components of the dorsal pathways in semantic variant, and in the temporoparietal component of the dorsal bundles in logopenic patients. Each of the primary progressive aphasia variants showed different patterns of diffusion tensor metrics alterations: non-fluent patients showed the greatest changes in fractional anisotropy and radial and mean diffusivities; semantic variant patients had severe changes in all metrics; and logopenic patients had the least white matter damage, mainly involving diffusivity, with fractional anisotropy altered only in the temporoparietal component of the dorsal pathway. This study demonstrates that both careful dissection of the main language tracts and consideration of all diffusion tensor metrics are necessary to characterize the white matter changes that occur in the variants of primary progressive aphasia. These results highlight the potential value of diffusion tensor imaging as a new tool in the multimodal diagnostic evaluation of primary progressive aphasia.

Orbital Elements and Stellar Parameters of the Active Binary UX Arietis

NASA Astrophysics Data System (ADS)

Hummel, C. A.; Monnier, J. D.; Roettenbacher, R. M.; Torres, G.; Henry, G. W.; Korhonen, H.; Beasley, A.; Schaefer, G. H.; Turner, N. H.; Ten Brummelaar, T.; Farrington, C. D.; Sturmann, J.; Sturmann, L.; Baron, F.; Kraus, S.

2017-08-01

Stellar activity observed as large surface spots, radio flares, or emission lines is often found in binary systems. UX Arietis exhibits these signs of activity, originating on the K0 subgiant primary component. Our aim is to resolve the binary, measure the orbital motion, and provide accurate stellar parameters such as masses and luminosities to aid in the interpretation of the observed phenomena. Using the CHARA six-telescope optical long-baseline array on Mount Wilson, California, we obtained amplitudes and phases of the interferometric visibility on baselines up to 330 m in length, resolving the two components of the binary. We reanalyzed archival Center for Astrophysics spectra to disentangle the binary component spectra and the spectrum of the third component, which was resolved by speckle interferometry. We also obtained new spectra with the Nordic Optical Telescope, and we present new photometric data that we use to model stellar surface spot locations. Both interferometric visibilities and spectroscopic radial velocities are modeled with a spotted primary stellar surface using the Wilson-Devinney code. We fit the orbital elements to the apparent orbit and radial velocity data to derive the distance (52.1 ± 0.8 pc) and stellar masses ({M}{{P}}=1.30+/- 0.06 {M}⊙ , {M}{{S}}=1.14+/- 0.06 {M}⊙ ). The radius of the primary can be determined to be {R}{{P}}=5.6+/- 0.1 {R}⊙ and that of the secondary to be {R}{{S}}=1.6+/- 0.2 {R}⊙ . The equivalent spot coverage of the primary component was found to be 62% with an effective temperature 20% below that of the unspotted surface.

Drivers of nitrogen transfer in stream food webs across continents

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

Norman, Beth C.; Whiles, Matt R.; Collins, Sarah M.

Studies of trophic-level material and energy transfers are central to ecology. The use of isotopic tracers has now made it possible to measure trophic transfer efficiencies of important nutrients and to better understand how these materials move through food webs. We analyzed data from thirteen 15N-ammonium tracer addition experiments to quantify N transfer from basal resources to animals in headwater streams with varying physical, chemical, and biological features. N transfer efficiencies from primary uptake compartments (PUCs; heterotrophic microorganisms and primary producers) to primary consumers was lower (mean: 11.5%, range: <1%-43%) than N transfer efficiencies from primary consumers to predators (mean:more » 80%, range: 5%- >100%). Total N transferred (as a rate) was greater in streams with open compared to closed canopies and overall N transfer efficiency generally followed a similar pattern, although was not statistically significant. We used principal component analysis to condense a suite of site characteristics into two environmental components. Total N uptake rates among trophic levels were best predicted by the component that was correlated with latitude, DIN:SRP, GPP:ER, and % canopy cover. N transfer efficiency did not respond consistently to environmental variables. Here, our results suggest that canopy cover influences N movement through stream food webs because light availability and primary production facilitate N transfer to higher trophic levels.« less

Drivers of nitrogen transfer in stream food webs across continents

DOE PAGES

Norman, Beth C.; Whiles, Matt R.; Collins, Sarah M.; ...

2017-10-25

Studies of trophic-level material and energy transfers are central to ecology. The use of isotopic tracers has now made it possible to measure trophic transfer efficiencies of important nutrients and to better understand how these materials move through food webs. We analyzed data from thirteen 15N-ammonium tracer addition experiments to quantify N transfer from basal resources to animals in headwater streams with varying physical, chemical, and biological features. N transfer efficiencies from primary uptake compartments (PUCs; heterotrophic microorganisms and primary producers) to primary consumers was lower (mean: 11.5%, range: <1%-43%) than N transfer efficiencies from primary consumers to predators (mean:more » 80%, range: 5%- >100%). Total N transferred (as a rate) was greater in streams with open compared to closed canopies and overall N transfer efficiency generally followed a similar pattern, although was not statistically significant. We used principal component analysis to condense a suite of site characteristics into two environmental components. Total N uptake rates among trophic levels were best predicted by the component that was correlated with latitude, DIN:SRP, GPP:ER, and % canopy cover. N transfer efficiency did not respond consistently to environmental variables. Here, our results suggest that canopy cover influences N movement through stream food webs because light availability and primary production facilitate N transfer to higher trophic levels.« less

Drivers of nitrogen transfer in stream food webs across continents.

PubMed

Norman, Beth C; Whiles, Matt R; Collins, Sarah M; Flecker, Alexander S; Hamilton, Steve K; Johnson, Sherri L; Rosi, Emma J; Ashkenas, Linda R; Bowden, William B; Crenshaw, Chelsea L; Crowl, Todd; Dodds, Walter K; Hall, Robert O; El-Sabaawi, Rana; Griffiths, Natalie A; Marti, Eugènia; McDowell, William H; Peterson, Scot D; Rantala, Heidi M; Riis, Tenna; Simon, Kevin S; Tank, Jennifer L; Thomas, Steven A; von Schiller, Daniel; Webster, Jackson R

2017-12-01

Studies of trophic-level material and energy transfers are central to ecology. The use of isotopic tracers has now made it possible to measure trophic transfer efficiencies of important nutrients and to better understand how these materials move through food webs. We analyzed data from thirteen 15 N-ammonium tracer addition experiments to quantify N transfer from basal resources to animals in headwater streams with varying physical, chemical, and biological features. N transfer efficiencies from primary uptake compartments (PUCs; heterotrophic microorganisms and primary producers) to primary consumers was lower (mean 11.5%, range <1% to 43%) than N transfer efficiencies from primary consumers to predators (mean 80%, range 5% to >100%). Total N transferred (as a rate) was greater in streams with open compared to closed canopies and overall N transfer efficiency generally followed a similar pattern, although was not statistically significant. We used principal component analysis to condense a suite of site characteristics into two environmental components. Total N uptake rates among trophic levels were best predicted by the component that was correlated with latitude, DIN:SRP, GPP:ER, and percent canopy cover. N transfer efficiency did not respond consistently to environmental variables. Our results suggest that canopy cover influences N movement through stream food webs because light availability and primary production facilitate N transfer to higher trophic levels. © 2017 by the Ecological Society of America.

Star-spot distributions and chromospheric activity on the RS CVn type eclipsing binary SV Cam

NASA Astrophysics Data System (ADS)

Şenavcı, H. V.; Bahar, E.; Montes, D.; Zola, S.; Hussain, G. A. J.; Frasca, A.; Işık, E.; Yörükoǧlu, O.

2018-06-01

Using a time series of high-resolution spectra and high-quality multi-colour photometry, we reconstruct surface maps of the primary component of the RS CVn type rapidly rotating eclipsing binary, SV Cam (F9V + K4V). We measure a mass ratio, q, of 0.641(2) using our highest quality spectra and obtain surface brightness maps of the primary component, which exhibit predominantly high-latitude spots located between 60° - 70° latitudes with a mean filling factor of ˜35%. This is also indicated by the R-band light curve inversion, subjected to rigourous numerical tests. The spectral subtraction of the Hα line reveals strong activity of the secondary component. The excess Hα absorption detected near the secondary minimum hints to the presence of cool material partially obscuring the primary star. The flux ratios of Ca II IRT excess emission indicate that the contribution of chromospheric plage regions associated with star-spots is dominant, even during the passage of the filament-like absorption feature.

E-Enterprise for the Environment Conceptual Blueprint: Principles and Components

EPA Pesticide Factsheets

The State-EPA E-Enterprise Working Group commissioned a Conceptual Blueprint document to define the principles and primary components of E-Enterprise. This Blueprint is the first step in defining E-Enterprise.

Signal Frequency Spectra with Audacity®

ERIC Educational Resources Information Center

Gailey, Alycia

2015-01-01

The primary objective of the activity presented here is to allow students to explore the frequency components of various simple signals, with the ultimate goal of teaching them how to remove unwanted noise from a voice signal. Analysis of the frequency components of a signal allows students to design filters that remove unwanted components of a…

CARBON CONTAINING COMPONENT OF THE LOS ANGELES AEROSOL: SOURCE APPORTIONMENT AND CONTRIBUTIONS TO THE VISIBILITY BUDGET

EPA Science Inventory

Source resolution of the organic component of the fine fraction of the ambient aerosol (d(sub p) < 3.5 micrometers) has been carried out by combining source information from the organic component with thermal analysis and local emission inventories. The primary and secondary carb...

Lewis base-catalyzed three-component Strecker reaction on water. An efficient manifold for the direct alpha-cyanoamination of ketones and aldehydes.

PubMed

Cruz-Acosta, Fabio; Santos-Expósito, Alicia; de Armas, Pedro; García-Tellado, Fernando

2009-11-28

The first three-component organocatalyzed Strecker reaction operating on water has been developed. The manifold utilizes ketones (aldehydes) as the starting carbonyl component, aniline as the primary amine, acetyl cyanide as the cyanide source and N,N-dimethylcyclohexylamine as the catalyst.

Essential elements of professional nursing environments in Primary Care and their influence on the quality of care.

PubMed

Gea-Caballero, Vicente; Castro-Sánchez, Enrique; Júarez-Vela, Raúl; Díaz-Herrera, Miguel Ángel; de Miguel-Montoya, Isabel; Martínez-Riera, José Ramón

Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Behavioral interventions for office-based care: depressive disorders.

PubMed

James, Ernest; Larzelere, Michele McCarthy

2014-03-01

Depressive disorders commonly are diagnosed and managed in primary care settings, and many patients prefer a nonpharmacologic approach. Traditionally, symptom reduction through pharmacotherapy has been the primary focus of management, but there is a growing acknowledgment of the need to develop modalities that prevent subsequent relapse and recurrences. Psychotherapy, including cognitive behavioral and interpersonal therapies, can have enduring effects that reduce subsequent risk in ways that drugs cannot. Although most family physicians do not provide formal psychosocial interventions for depression, brief interventions and behavioral intervention technologies, such as those that deliver care via the Internet or mobile device, are key means of increasing access to psychotherapy. For children and adolescents with mild, uncomplicated depression, physician-provided social support, encouragement, and reinforcement of adaptive behavior patterns can be as effective as cognitive behavioral therapy. In addition, a primary care physician's involvement in parent education and safety planning for suicide prevention holds promise for risk reduction. Evidence also supports the use of problem-solving therapy and components of cognitive behavioral therapy and interpersonal psychotherapy provided by primary care physicians for patients with depression. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Provider and interpreter preferences among Somali women in a primary care setting.

PubMed

Odunukan, Olufunso W; Abdulai, Raolat M; Hagi Salaad, Misbil F; Lahr, Brian D; Flynn, Priscilla M; Wieland, Mark L

2015-04-01

Somali people are among the largest refugee populations to resettle in North America and Europe over the past 2 decades, and health disparities are well documented, including barriers to effective navigation of primary health care systems. Patient-provider gender discordance has been described as a barrier to health-seeking behaviors and effective communication by Somali women in past qualitative work. The objective of this study was to elucidate provider and interpreter preferences during clinical encounters according to gender and race among Somali women in the United States. Fifty Somali women empanelled to a large primary care practice completed pictorial surveys to elucidate preferences of Somali women for providers of different genders and race for different components of the clinical examination using a Likert-type scale. We found that Somali women generally preferred a female provider for conducting the physical examination, particularly for the pelvic, breast, and abdominal examinations. Likewise, Somali women strongly preferred female interpreters to be present during the physical examination. There was no stated preference for patient-provider racial concordance. These findings have implications for structural health care changes aimed at delivering culturally sensitive and effective primary care to Somali patients. © The Author(s) 2014.

Analysis of Dynamic Stiffness Effect of Primary Suspension Helical Springs on Railway Vehicle Vibration

NASA Astrophysics Data System (ADS)

Sun, W.; Thompson, D. J.; Zhou, J.; Gong, D.

2016-09-01

Helical springs within the primary suspension are critical components for isolating the whole vehicle system from vibration generated at the wheel/rail contact. As train speeds increase, the frequency region of excitation becomes larger, and a simplified static stiffness can no longer represent the real stiffness property in a vehicle dynamic model. Coil springs in particular exhibit strong internal resonances, which lead to high vibration amplitudes within the spring itself as well as degradation of the vibration isolation. In this paper, the dynamic stiffness matrix method is used to determine the dynamic stiffness of a helical spring from a vehicle primary suspension. Results are confirmed with a finite element analysis. Then the spring dynamic stiffness is included within a vehicle-track coupled dynamic model of a high speed train and the effect of the dynamic stiffening of the spring on the vehicle vibration is investigated. It is shown that, for frequencies above about 50 Hz, the dynamic stiffness of the helical spring changes sharply. Due to this effect, the vibration transmissibility increases considerably which results in poor vibration isolation of the primary suspension. Introducing a rubber layer in series with the coil spring can attenuate this effect.

In vitro FTIR microspectroscopy analysis of primary oral squamous carcinoma cells treated with cisplatin and 5-fluorouracil: a new spectroscopic approach for studying the drug-cell interaction.

PubMed

Giorgini, Elisabetta; Sabbatini, Simona; Rocchetti, Romina; Notarstefano, Valentina; Rubini, Corrado; Conti, Carla; Orilisi, Giulia; Mitri, Elisa; Bedolla, Diana E; Vaccari, Lisa

2018-06-22

In the present study, human primary oral squamous carcinoma cells treated with cisplatin and 5-fluorouracil were analyzed, for the first time, by in vitro FTIR Microspectroscopy (FTIRM), to improve the knowledge on the biochemical pathways activated by these two chemotherapy drugs. To date, most of the studies regarding FTIRM cellular analysis have been executed on fixed cells from immortalized cell lines. FTIRM analysis performed on primary tumor cells under controlled hydrated conditions provides more reliable information on the biochemical processes occurring in in vivo tumor cells. This spectroscopic analysis allows to get on the same sample and at the same time an overview of the composition and structure of the most remarkable cellular components. In vitro FTIRM analysis of primary oral squamous carcinoma cells evidenced a time-dependent drug-specific cellular response, also including apoptosis triggering. Furthermore, the univariate and multivariate analyses of IR data evidenced meaningful spectroscopic differences ascribable to alterations affecting cellular proteins, lipids and nucleic acids. These findings suggest for the two drugs different pathways and extents of cellular damage, not provided by conventional cell-based assays (MTT assay and image-based cytometry).

Prostheses and orthoses for the foot and ankle.

PubMed

Rubin, G; Cohen, E

1988-07-01

The general nature and function of the AFO has been presented. These devices encompass the foot and leg crossing the ankle joint. They may insert into the shoe or attach to the shoe. The more recent AFOs are made of polypropylene and were formerly composed of steel. The indications for an AFO are for a basically ambulatory patient with problems walking, including various pathologic gaits especially drop-foot and spastic equinus. Other primary indications include ankle arthritis, Charcot foot, fractures, and post-surgery. Given the basic employment of AFOs to treat problems directly related to the foot, it is hoped that this introduction has stimulated practitioners to begin using this essential tool as an integral component of their practice.

Liquid Rocket Propulsion Technology: An evaluation of NASA's program. [for space transportation systems

NASA Technical Reports Server (NTRS)

1981-01-01

The liquid rocket propulsion technology needs to support anticipated future space vehicles were examined including any special action needs to be taken to assure that an industrial base in substained. Propulsion system requirements of Earth-to-orbit vehicles, orbital transfer vehicles, and planetary missions were evaluated. Areas of the fundamental technology program undertaking these needs discussed include: pumps and pump drives; combustion heat transfer; nozzle aerodynamics; low gravity cryogenic fluid management; and component and system life reliability, and maintenance. The primary conclusion is that continued development of the shuttle main engine system to achieve design performance and life should be the highest priority in the rocket engine program.

Modeling of rolling element bearing mechanics

NASA Technical Reports Server (NTRS)

Greenhill, L. M.

1991-01-01

Roller element bearings provide the primary mechanical interface between rotating and nonrotating components in the high performance turbomachinery of the Space Shuttle Main Engine (SSME). Knowledge of bearing behavior under various loading and environmental conditions is essential to predicting and understanding the overall behavior of turbopumps, including rotordynamic stability, critical speeds and bearing life. The objective is to develop mathematical models and computer programs to describe the mechanical behavior of ball and cylinder roller bearings under the loading and environmental conditions encountered in the SSME and future high performance rocket engines. This includes characteristics such as nonlinear load/motion relationships, stiffness and damping, rolling element loads for life prediction, and roller and cage stability.

Hierarchical modularization of biochemical pathways using fuzzy-c means clustering.

PubMed

de Luis Balaguer, Maria A; Williams, Cranos M

2014-08-01

Biological systems that are representative of regulatory, metabolic, or signaling pathways can be highly complex. Mathematical models that describe such systems inherit this complexity. As a result, these models can often fail to provide a path toward the intuitive comprehension of these systems. More coarse information that allows a perceptive insight of the system is sometimes needed in combination with the model to understand control hierarchies or lower level functional relationships. In this paper, we present a method to identify relationships between components of dynamic models of biochemical pathways that reside in different functional groups. We find primary relationships and secondary relationships. The secondary relationships reveal connections that are present in the system, which current techniques that only identify primary relationships are unable to show. We also identify how relationships between components dynamically change over time. This results in a method that provides the hierarchy of the relationships among components, which can help us to understand the low level functional structure of the system and to elucidate potential hierarchical control. As a proof of concept, we apply the algorithm to the epidermal growth factor signal transduction pathway, and to the C3 photosynthesis pathway. We identify primary relationships among components that are in agreement with previous computational decomposition studies, and identify secondary relationships that uncover connections among components that current computational approaches were unable to reveal.

Physician-patient communication in the primary care office: a systematic review.

PubMed

Beck, Rainer S; Daughtridge, Rebecca; Sloane, Philip D

2002-01-01

The physician-patient interview is the key component of all health care, particularly of primary medical care. This review sought to evaluate existing primary-care-based research studies to determine which verbal and nonverbal behaviors on the part of the physician during the medical encounter have been linked in empirical studies with favorable patient outcomes. We reviewed the literature from 1975 to 2000 for studies of office interactions between primary care physicians and patients that evaluated these interactions empirically using neutral observers who coded observed encounters, videotapes, or audiotapes. Each study was reviewed for the quality of the methods and to find statistically significant relations between specific physician behaviors and patient outcomes. In examining nonverbal behaviors, because of a paucity of clinical outcome studies, outcomes were expanded to include associations with patient characteristics or subjective ratings of the interaction by observers. We found 14 studies of verbal communication and 8 studies of nonverbal communication that met inclusion criteria. Verbal behaviors positively associated with health outcomes included empathy, reassurance and support, various patient-centered questioning techniques, encounter length, history taking, explanations, both dominant and passive physician styles, positive reinforcement, humor, psychosocial talk, time in health education and information sharing, friendliness, courtesy, orienting the patient during examination, and summarization and clarification. Nonverbal behaviors positively associated with outcomes included head nodding, forward lean, direct body orientation, uncrossed legs and arms, arm symmetry, and less mutual gaze. Existing research is limited because of lack of consensus of what to measure, conflicting findings, and relative lack of empirical studies (especially of nonverbal behavior). Nonetheless, medical educators should focus on teaching and reinforcing behaviors known to be facilitative, and to continue to understand further how physician behavior can enhance favorable patient outcomes, such as understanding and adherence to medical regimens and overall satisfaction.

The association between radiographic severity and pre-operative function in patients undergoing primary knee replacement for osteoarthritis.

PubMed

Dowsey, Michelle M; Dieppe, Paul; Lohmander, Stefan; Castle, David; Liew, Danny; Choong, Peter F M

2012-12-01

To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement. Single centre study examining pre-operative outcomes in a consecutive series of 525 patients who underwent primary knee replacement for OA between January 2006 and December 2007. Pre-operative data included: demographics, American Society of Anaesthesiologists (ASA) status and OA in the contralateral knee. The International Knee Society (IKS) rating and Short Form-12 (SF-12) were recorded for each patient. Pre-operative radiographs were read by a single observer for Kellgren and Lawrence (K&L) grading and Osteoarthritis Research Society International (OARSI) atlas features. Multiple linear regression was used to assess the strength of associations between radiographic OA severity and function, adjusting for clinically relevant variables. Lateral tibiofemoral osteophyte grade was an independent predictor of pre-operative function as determined by the functional sub-scale of the IKS in patients undergoing primary knee replacement (coefficient=2.58, p=0.033). No associations were evident between pre-operative function and modified K&L, joint space narrowing, Ahlbäck attrition and coronal plane deformity. Other statistically significant predictors of poorer pre-operative function included: advancing age, female gender, knee pain and poorer SF-12 mental component summary scores which including osteophyte grade accounted for 24.6% of the variation in functional scores, (r=0.496). Osteophytes in the lateral compartment of the knee were associated with pre-operative function in patients with advanced knee OA. Further studies are required which examine individual radiographic features specifically in patients with advanced knee OA to determine their relationship to pre-operative pain and function. Copyright © 2012 Elsevier B.V. All rights reserved.

A mathematical model of a lithium/thionyl chloride primary cell

NASA Technical Reports Server (NTRS)

Evans, T. I.; Nguyen, T. V.; White, R. E.

1987-01-01

A 1-D mathematical model for the lithium/thionyl chloride primary cell was developed to investigate methods of improving its performance and safety. The model includes many of the components of a typical lithium/thionyl chloride cell such as the porous lithium chloride film which forms on the lithium anode surface. The governing equations are formulated from fundamental conservation laws using porous electrode theory and concentrated solution theory. The model is used to predict 1-D, time dependent profiles of concentration, porosity, current, and potential as well as cell temperature and voltage. When a certain discharge rate is required, the model can be used to determine the design criteria and operating variables which yield high cell capacities. Model predictions can be used to establish operational and design limits within which the thermal runaway problem, inherent in these cells, can be avoided.

Pilot, a balloon borne experiment underground tests

NASA Astrophysics Data System (ADS)

Engel, C.; Marty, C.; Mot, B.; Bernard, J.-Ph.; Ristorcelli, I.; Otrio, G.; Leriche, B.; Longval, Y.; Pajot, F.; Roudil, G.; Caillat, A.; Dubois, J. P.; Bouzit, M.; Buttice, V.; Camus, T.

2017-11-01

PILOT is a balloon borne experiment, which will measure the polarized emission of dust grains, in the interstellar medium, in the sub millimeter range (with two photometric channels centered at 240 and 550 μm). The primary and secondary mirror must be positioned with accuracies better than 0.6 mm and 0.06°. These tolerances include environmental conditions (mainly gravity and thermo-elastic effects), uncertainties on alignments, and uncertainties on the dilatation coefficient. In order to respect these tolerances, we need precise characterization of each optical component. The characterization of the primary mirror and the integrated instrument is performed using a dedicated submillimeter test bench. A brief description of the scientific objectives and instrumental concept is given in the first part. We present, in the second and in the third part, the status of these ground tests, first results and planned tests.

African Primary Care Research: Writing a research report

PubMed Central

Mash, Bob

2014-01-01

Abstract Presenting a research report is an important way of demonstrating one's ability to conduct research and is a requirement of most research-based degrees. Although known by various names across academic institutions, the structure required is mostly very similar, being based on the Introduction, Methods, Results, Discussion format of scientific articles. This article offers some guidance on the process of writing, aimed at helping readers to start and to continue their writing; and to assist them in presenting a report that is received positively by their readers, including examiners. It also details the typical components of the research report, providing some guidelines for each, as well as the pitfalls to avoid. This article is part of a series on African Primary Care Research that aims to build capacity for research particularly at a Master's level. PMID:26245441

Inability to Perform the Repeated Chair Stand Task Predicts Fall-Related Injury in Older Primary Care Patients.

PubMed

Shea, Cristina A; Ward, Rachel E; Welch, Sarah A; Kiely, Dan K; Goldstein, Richard; Bean, Jonathan F

2018-06-01

The aim of the study was to examine whether the chair stand component of the Short Physical Performance Battery predicts fall-related injury among older adult primary care patients. A 2-yr longitudinal cohort study of 430 Boston-area primary care patients aged ≥65 yrs screened to be at risk for mobility decline was conducted. The three components of the Short Physical Performance Battery (balance time, gait speed, and chair stand time) were measured at baseline. Participants reported incidence of fall-related injuries quarterly for 2 yrs. Complementary log-log discrete time hazard models were constructed to examine the hazard of fall-related injury across Short Physical Performance Battery scores, adjusting for age, sex, race, Digit Symbol Substitution Test score, and fall history. Participants were 68% female and 83% white, with a mean (SD) age of 76.6 (7.0). A total of 137 (32%) reported a fall-related injury during the follow-up period. Overall, inability to perform the chair stand task was a significant predictor of fall-related injury (hazard ratio = 2.11, 95% confidence interval = 1.23-3.62, P = 0.01). Total Short Physical Performance Battery score, gait component score, and balance component score were not predictive of fall-related injury. Inability to perform the repeated chair stand task was associated with increased hazard of an injurious fall for 2 yrs among a cohort of older adult primary care patients.

Histological heterogeneity in primary and metastatic classic combined hepatocellular-cholangiocarcinoma: a case series.

PubMed

De Vito, Claudio; Sarker, Debashis; Ross, Paul; Heaton, Nigel; Quaglia, Alberto

2017-11-01

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare and aggressive primary liver cancer with both hepatocellular and cholangiocellular differentiation. Due to its bi-phenotypic component, cHCC-CC is a heterogeneous tumour and histopathological analysis of metastatic deposits is poorly characterized. In this retrospective study, we describe four patients in whom the histology from resected specimens of both primary and recurrent and/or metastatic tumour was available for comparison and immunohistochemical characterization. Our study shows that recurrent or metastatic deposits replicate the heterogeneity of the primary cHCC-CC, that even originally small foci of divergent differentiation can become predominant later on and that hepatocellular and cholangiocellular components can show different tropism in distant organs. In our experience, the behaviour of recurrent/metastatic cHCC-CC is unpredictable and histological examination is necessary to guide treatment options at present.

Rationale and design of the STAR randomized controlled trial to accelerate adoption of childhood obesity comparative effectiveness research.

PubMed

Taveras, Elsie M; Marshall, Richard; Horan, Christine M; Gillman, Matthew W; Hacker, Karen; Kleinman, Ken P; Koziol, Renata; Price, Sarah; Simon, Steven R

2013-01-01

Comparative effectiveness research (CER) evidence on childhood obesity provides the basis for effective screening and management strategies in pediatric primary care. The uses of health information technology including decision support tools in the electronic health records (EHRs), as well as remote and mobile support to families, offer the potential to accelerate the adoption of childhood obesity CER evidence. The Study of Technology to Accelerate Research (STAR) is a three-arm, cluster-randomized controlled trial being conducted in 14 pediatric offices in Massachusetts designed to enroll 800, 6 to 12 year old children with a body mass index (BMI)≥ 95th percentile seen in primary care at those practices. We will examine the extent to which computerized decision support tools in the EHR delivered to primary care providers at the point of care, with or without direct-to-parent support and coaching, will increase adoption of CER evidence for management of obese children. Direct-to-parent intervention components include telephone coaching and twice-weekly text messages. Point-of-care outcomes include obesity diagnosis, nutrition and physical activity counseling, and referral to weight management. One-year child-level outcomes include changes in BMI and improvements in diet, physical activity, screen time, and sleep behaviors, as well as cost and cost-effectiveness. STAR will determine the extent to which decision support tools in EHRs with or without direct-to-parent support will increase adoption of evidence-based obesity management strategies in pediatric practice and improve childhood obesity-related outcomes. Copyright © 2012 Elsevier Inc. All rights reserved.

Applying GRADE-CERQual to qualitative evidence synthesis findings-paper 3: how to assess methodological limitations.

PubMed

Munthe-Kaas, Heather; Bohren, Meghan A; Glenton, Claire; Lewin, Simon; Noyes, Jane; Tunçalp, Özge; Booth, Andrew; Garside, Ruth; Colvin, Christopher J; Wainwright, Megan; Rashidian, Arash; Flottorp, Signe; Carlsen, Benedicte

2018-01-25

The GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) approach has been developed by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Working Group. The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. CERQual includes four components for assessing how much confidence to place in findings from reviews of qualitative research (also referred to as qualitative evidence syntheses): (1) methodological limitations, (2) coherence, (3) adequacy of data and (4) relevance. This paper is part of a series providing guidance on how to apply CERQual and focuses on CERQual's methodological limitations component. We developed the methodological limitations component by searching the literature for definitions, gathering feedback from relevant research communities and developing consensus through project group meetings. We tested the CERQual methodological limitations component within several qualitative evidence syntheses before agreeing on the current definition and principles for application. When applying CERQual, we define methodological limitations as the extent to which there are concerns about the design or conduct of the primary studies that contributed evidence to an individual review finding. In this paper, we describe the methodological limitations component and its rationale and offer guidance on how to assess methodological limitations of a review finding as part of the CERQual approach. This guidance outlines the information required to assess methodological limitations component, the steps that need to be taken to assess methodological limitations of data contributing to a review finding and examples of methodological limitation assessments. This paper provides guidance for review authors and others on undertaking an assessment of methodological limitations in the context of the CERQual approach. More work is needed to determine which criteria critical appraisal tools should include when assessing methodological limitations. We currently recommend that whichever tool is used, review authors provide a transparent description of their assessments of methodological limitations in a review finding. We expect the CERQual approach and its individual components to develop further as our experiences with the practical implementation of the approach increase.

Chromatography - mass spectrometry in aerospace industry

NASA Astrophysics Data System (ADS)

Buryak, A. K.; Serdyuk, T. M.

2013-01-01

The applications of chromatography - mass spectrometry in aerospace industry are considered. The primary attention is devoted to the development of physicochemical grounds of the use of various chromatography - mass spectrometry procedures to solve topical problems of this industry. Various methods for investigation of the composition of rocket fuels, surfaces of structural materials and environmental media affected by aerospace activities are compared. The application of chromatography - mass spectrometry for the development and evaluation of processes for decontaminations of equipment, industrial wastes and soils from rocket fuel components is substantiated. The bibliography includes 135 references.

An Analysis of Fuel Cell Options for an All-electric Unmanned Aerial Vehicle

NASA Technical Reports Server (NTRS)

Kohout, Lisa L.; Schmitz, Paul C.

2007-01-01

A study was conducted to assess the performance characteristics of both PEM and SOFC-based fuel cell systems for an all-electric high altitude, long endurance Unmanned Aerial Vehicle (UAV). Primary and hybrid systems were considered. Fuel options include methane, hydrogen, and jet fuel. Excel-based models were used to calculate component mass as a function of power level and mission duration. Total system mass and stored volume as a function of mission duration for an aircraft operating at 65 kft altitude were determined and compared.

Rheological Properties of Gels from Pyrene Based Low Molecular Weight Gelators

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

Leivo, Kimmo T.; Hahma, Arno P.

2008-07-07

Gels of pyrene derived low molecular weight organogelators (LMOGs) in primary alcohols have been characterized by rheometry and scanning electron microscopy. Total gelator concentration was 1-2.7 % w/w depending on the solvent and the gelator, including equimolar amounts of the gelator and 2,4,7-trinitrofluorenone (TNF), which is necessary for gelation. Thermoreversible and strongly shear thinning gels were achieved as the two components interact non-covalently to form a gel network. A qualitative correlation between the rheological properties and the nanoscale gel structure were found.

Rheological Properties of Gels from Pyrene Based Low Molecular Weight Gelators

NASA Astrophysics Data System (ADS)

Leivo, Kimmo T.; Hahma, Arno P.

2008-07-01

Gels of pyrene derived low molecular weight organogelators (LMOGs) in primary alcohols have been characterized by rheometry and scanning electron microscopy. Total gelator concentration was 1-2.7 % w/w depending on the solvent and the gelator, including equimolar amounts of the gelator and 2,4,7-trinitrofluorenone (TNF), which is necessary for gelation. Thermoreversible and strongly shear thinning gels were achieved as the two components interact non-covalently to form a gel network. A qualitative correlation between the rheological properties and the nanoscale gel structure were found.

The Development of a Primary Neural Crest Assay for Neuroblastoma Oncogenesis

DTIC Science & Technology

2015-09-01

NBL )  forms  from  immature  cells  of  the   sympathetic  nervous...system  (SNS).    A  prominent  category  of  high-­‐risk   NBL  is  MYCN   amplification  with  loss  of  heterozygosity...of   NBL  and  can   include  ARID1A,  a  component  of  the  SWI/SNF  chromatin-­‐remodeling  complex.    In  

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

Anderson, Katherine H.; Cutler, Dylan S.; Olis, Daniel R.

REopt is a techno-economic decision support model used to optimize energy systems for buildings, campuses, communities, and microgrids. The primary application of the model is for optimizing the integration and operation of behind-the-meter energy assets. This report provides an overview of the model, including its capabilities and typical applications; inputs and outputs; economic calculations; technology descriptions; and model parameters, variables, and equations. The model is highly flexible, and is continually evolving to meet the needs of each analysis. Therefore, this report is not an exhaustive description of all capabilities, but rather a summary of the core components of the model.

Keys to successful organ procurement: An experience-based review of clinical practices at a high-performing health-care organization

PubMed Central

Wojda, Thomas R.; Stawicki, Stanislaw P.; Yandle, Kathy P.; Bleil, Maria; Axelband, Jennifer; Wilde-Onia, Rebecca; Thomas, Peter G.; Cipolla, James; Hoff, William S.; Shultz, Jill

2017-01-01

Organ procurement (OP) from donors after brain death and circulatory death represents the primary source of transplanted organs. Despite favorable laws and regulations, OP continues to face challenges for a number of reasons, including institutional, personal, and societal barriers. This focused review presents some of the key components of a successful OP program at a large, high-performing regional health network. This review focuses on effective team approaches, aggressive resuscitative strategies, optimal communication, family support, and community outreach efforts. PMID:28660162

Does dental health of 6-year-olds reflect the reform of the Israeli dental care system?

PubMed

Natapov, Lena; Sasson, Avi; Zusman, Shlomo P

2016-01-01

The National health insurance law enacted in 1995 did not include dental care in its basket of services. Dental care for children was first included in 2010, initially up till 8 years of age. The eligibility age rose to 12 years in 2013. The dental survey of 6 year-olds in 2007 found that the average of decayed, missing and filled teeth index (dmft) was 3.31 and 35 % of children were caries free. The current cross sectional survey of dental health for 6 year-olds was conducted as a comparison to the pre-reform status. Twenty-three local authorities were randomly selected nationwide. Two Grade 1 classes were randomly chosen in each. The city of Jerusalem was also included in the survey because of its size. The children were examined according to the WHO Oral Health Survey Methods 4th ed protocol. The dental caries index for deciduous teeth (dmft: decayed, missing, filled teeth) was calculated. One thousand two hundred ten children were examined. 61.7 % of the children suffered from dental decay and only 38.3 % were caries free. The mean dmft was 2.56; d = 1.41 (teeth with untreated caries), f = 1.15 (teeth damaged by decay and restored), virtually none were missing due to caries. Dental caries prevalence was rather consistent, an average of over 2 teeth affected per child. Although there is no major change in comparison to former surveys, there is more treated than untreated disease. In the present survey the f component is higher than in the past, especially in the Jewish sector where it is the main component. It is still lower in the Arab sector. Although the level of dental disease remained rather constant, an increase in the treatment component was observed. In order to reduce caries prevalence, preventive measures such as school dental services and drinking water fluoridation should be extended and continued. Primary preventive dental services should be established for children from birth, with an emphasis on primary health care and educational settings, such as family health centers and kindergartens.

Creating a driving profile for older adults using GPS devices and naturalistic driving methodology

PubMed Central

Babulal, Ganesh M.; Traub, Cindy M.; Webb, Mollie; Stout, Sarah H.; Addison, Aaron; Carr, David B.; Ott, Brian R.; Morris, John C.; Roe, Catherine M.

2016-01-01

Background/Objectives: Road tests and driving simulators are most commonly used in research studies and clinical evaluations of older drivers. Our objective was to describe the process and associated challenges in adapting an existing, commercial, off-the-shelf (COTS), in-vehicle device for naturalistic, longitudinal research to better understand daily driving behavior in older drivers. Design: The Azuga G2 Tracking Device TM was installed in each participant’s vehicle, and we collected data over 5 months (speed, latitude/longitude) every 30-seconds when the vehicle was driven.  Setting: The Knight Alzheimer’s Disease Research Center at Washington University School of Medicine. Participants: Five individuals enrolled in a larger, longitudinal study assessing preclinical Alzheimer disease and driving performance.  Participants were aged 65+ years and had normal cognition. Measurements:  Spatial components included Primary Location(s), Driving Areas, Mean Centers and Unique Destinations.  Temporal components included number of trips taken during different times of the day.  Behavioral components included number of hard braking, speeding and sudden acceleration events. Methods:  Individual 30-second observations, each comprising one breadcrumb, and trip-level data were collected and analyzed in R and ArcGIS.  Results: Primary locations were confirmed to be 100% accurate when compared to known addresses.  Based on the locations of the breadcrumbs, we were able to successfully identify frequently visited locations and general travel patterns.  Based on the reported time from the breadcrumbs, we could assess number of trips driven in daylight vs. night.  Data on additional events while driving allowed us to compute the number of adverse driving alerts over the course of the 5-month period. Conclusions: Compared to cameras and highly instrumented vehicle in other naturalistic studies, the compact COTS device was quickly installed and transmitted high volumes of data. Driving Profiles for older adults can be created and compared month-to-month or year-to-year, allowing researchers to identify changes in driving patterns that are unavailable in controlled conditions. PMID:27990264

An overview of the NASA textile composites program

NASA Technical Reports Server (NTRS)

Dexter, H. Benson

1993-01-01

The NASA Langley Research Center is conducting and sponsoring research to explore the benefits of textile reinforced composites for civil transport aircraft primary structures. The objective of this program is to develop and demonstrate the potential of affordable textile reinforced composite materials to meet design properties and damage tolerance requirements of advanced aircraft structures. In addition to in-house research, the program includes major participation by the aircraft industry and aerospace textile companies. The major program elements include development of textile preforms, processing science, mechanics of materials, experimental characterization of materials, and development and evaluation of textile reinforced composite structural elements and subcomponents. The NASA Langley in-house research is focused on science-based understanding of resin transfer molding (RTM), development of powder-coated towpreg processes, analysis methodology, and development of a performance database on textile reinforced composites. The focus of the textile industry participation is on development of multidirectional, damage-tolerant preforms, and the aircraft industry participation is in the areas of innovative design concepts, cost-effective fabrication, and testing of textile reinforced composite structural elements and subcomponents. Textile processes such as 3-D weaving, 2-D and 3-D braiding, and knitting/stitching are being compared with conventional laminated tape processes for improved damage tolerance. Through-the-thickness reinforcements offer significant damage tolerance improvements. However, these gains must be weighed against potential loss in in-plane properties such as strength and stiffness. Analytical trade studies are underway to establish design guidelines for the application of textile material forms to meet specific loading requirements. Fabrication and testing of large structural components are required to establish the full potential of textile reinforced composite materials. The goals of the NASA Langley-sponsored research program are to demonstrate technology readiness with subscale composite components by 1995 and to verify the performance of full-scale composite primary aircraft structural components by 1997. The status of textile reinforced composite structural elements under development by Boeing, Douglas, Lockheed, and Grumman are presented. Included are braided frames and woven/stitched wing and fuselage panels.

PARduino: A Simple Device Measuring and Logging Photosynthetically Active Radiation

NASA Astrophysics Data System (ADS)

Barnard, H. R.; Findley, M. C.

2013-12-01

Photosynthetically Active Radiation (PAR, 400 to 700 nm) is one of the primary controls of forest carbon and water relations. In complex terrain, PAR has high spatial-variability. Given the high cost of commercial datalogging equipment, spatially-distributed measurements of PAR have been typically modeled using geographic coordinates and terrain indices. Here, we present a design for a low cost, field-deployable device for measuring and logging PAR built around an Arduino microcontroller (we named it PARduino). PARduino provides for widely distributed sensor arrays and tests the feasibility of using hobbyist-grade electronics for collecting scientific data. PARduino components include a LiCor quantum sensor, EME Systems signal converter/amplifier, and Sparkfun's Arduino Pro Mini microcontroller. Additional components include a real time clock, a microSD flash memory card, and a custom printed circuit board (PCB). We selected the components with an eye towards ease of assembly. Everything can be connected to the PCB using through-hole soldering techniques. Since the device will be deployed in remote research plots that lack easy access to line power, battery life was also a consideration in the design. Extended deployment is possible because PARduino's software keeps it in a low-power sleep mode until ready to make a measurement. PARduino will be open-source hardware for use and improvement by others.

Net primary productivity of subalpine meadows in Yosemite National Park in relation to climate variability

Treesearch

Peggy E. Moore; Jan W. van Wagtendonk; Julie L. Yee; Mitchel P. McClaran; David N. Cole; Neil K. McDougald; Matthew L. Brooks

2013-01-01

Subalpine meadows are some of the most ecologically important components of mountain landscapes, and primary productivity is important to the maintenance of meadow functions. Understanding how changes in primary productivity are associated with variability in moisture and temperature will become increasingly important with current and anticipated changes in climate....

Magnetization transfer studies of the fast and slow tissue water diffusion components in the human brain.

PubMed

Mulkern, Robert V; Vajapeyam, Sridhar; Haker, Steven J; Maier, Stephan E

2005-05-01

Magnetization transfer (MT) properties of the fast and slow diffusion components recently observed in the human brain were assessed experimentally. One set of experiments, performed at 1.5 T in healthy volunteers, was designed to determine whether the amplitudes of fast and slow diffusion components, differentiated on the basis of biexponential fits to signal decays over a wide range of b-factors, demonstrated a different or similar magnetization transfer ratio (MTR). Another set of experiments, performed at 3 T in healthy volunteers, was designed to determine whether MTRs differed when measured from high signal-to-noise images acquired with b-factor weightings of 350 vs 3500 s/mm2. The 3 T studies included measurements of MTR as a function of off-resonance frequency for the MT pulse at both low and high b-factors. The primary conclusion drawn from all the studies is that there appears to be no significant difference between the magnetization transfer properties of the fast and slow tissue water diffusion components. The conclusions do not lend support to a direct interpretation of the 'components' of the biexponential diffusion decay in terms of the 'compartments' associated with intra- and extracellular water. Copyright 2004 John Wiley & Sons, Ltd.

Engineering and Evolution of Molecular Chaperones and Protein Disaggregases with Enhanced Activity

PubMed Central

Mack, Korrie L.; Shorter, James

2016-01-01

Cells have evolved a sophisticated proteostasis network to ensure that proteins acquire and retain their native structure and function. Critical components of this network include molecular chaperones and protein disaggregases, which function to prevent and reverse deleterious protein misfolding. Nevertheless, proteostasis networks have limits, which when exceeded can have fatal consequences as in various neurodegenerative disorders, including Parkinson's disease and amyotrophic lateral sclerosis. A promising strategy is to engineer proteostasis networks to counter challenges presented by specific diseases or specific proteins. Here, we review efforts to enhance the activity of individual molecular chaperones or protein disaggregases via engineering and directed evolution. Remarkably, enhanced global activity or altered substrate specificity of various molecular chaperones, including GroEL, Hsp70, ClpX, and Spy, can be achieved by minor changes in primary sequence and often a single missense mutation. Likewise, small changes in the primary sequence of Hsp104 yield potentiated protein disaggregases that reverse the aggregation and buffer toxicity of various neurodegenerative disease proteins, including α-synuclein, TDP-43, and FUS. Collectively, these advances have revealed key mechanistic and functional insights into chaperone and disaggregase biology. They also suggest that enhanced chaperones and disaggregases could have important applications in treating human disease as well as in the purification of valuable proteins in the pharmaceutical sector. PMID:27014702

Psychosocial approaches to violence and aggression: contextually anchored and trauma-informed interventions.

PubMed

Horowitz, Deborah; Guyer, Margaret; Sanders, Kathy

2015-06-01

Psychosocial interventions are part of the complex understanding and treatment of violent behavior in our state mental health hospitals. A comprehensive assessment of violence and aggression includes attention to all 3 domains of prevention and assessment (primary-institutional, secondary-structural, and tertiary-direct). Trauma experiences and their consequences may include behavioral violence and aggression. The authors' premise is that trauma is a universal component in the individual assessment of violent behavior. Therapeutic interventions must include a trauma-informed formulation to be effective. Organizational commitment to trauma-informed, person-centered, recovery-oriented (TPR) care is crucial to the efficacy of any of the interventions discussed. Thus, the dynamic nature of the individual, interpersonal, environmental, and cultural factors associated with the daily operations of the inpatient unit need to be assessed through the lens of primary and secondary violence prevention, building on the recognition that the majority of persons served and staff have significant trauma histories. Once a compassionate, respectful, empathic, and empowering approach is embraced by leadership and staff, the work with individuals can proceed more effectively. Interventions used include a variety of cognitive-behavioral, interpersonal, and somatosensory therapies. These interventions, when effectively applied, result in more self-esteem, self-mastery, self-control for the person served, and diminished behavioral violence.

Nationwide review of mixed and non-mixed components from different manufacturers in total hip arthroplasty

PubMed Central

Peters, Rinne M; van Steenbergen, Liza N; Bulstra, Sjoerd K; Zeegers, Adelgunde V C M; Stewart, Roy E; Poolman, Rudolf W; Hosman, Anton H

2016-01-01

Background and purpose Combining components from different manufacturers in total hip arthroplasty (THA) is common practice worldwide. We determined the proportion of THAs used in the Netherlands that consist of components from different manufacturers, and compared the revision rates of these mixed THAs with those of non-mixed THAs. Patients and methods Data on primary and revision hip arthroplasty are recorded in the LROI, the nationwide population-based arthroplasty register in the Netherlands. We selected all 163,360 primary THAs that were performed in the period 2007–2014. Based on the manufacturers of the components, 4 groups were discerned: non-mixed THAs with components from the same manufacturer (n = 142,964); mixed stem-head THAs with different manufacturers for the femoral stem and head (n = 3,663); mixed head-cup THAs with different head and cup manufacturers (n = 12,960), and mixed stem-head-cup THAs with different femoral stem, head, and cup manufacturers (n = 1,773). Mixed prostheses were defined as THAs (stem, head, and cup) composed of components made by different manufacturers. Results 11% of THAs had mixed components (n = 18,396). The 6-year revision rates were similar for mixed and non-mixed THAs: 3.4% (95% CI: 3.1w–3.7) for mixed THAs and 3.5% (95% CI: 3.4–3.7) for non-mixed THAs. Revision of primary THAs due to loosening of the acetabulum was more common in mixed THAs (16% vs. 12%). Interpretation Over an 8-year period in the Netherlands, 11% of THAs had mixed components—with similar medium-term revision rates to those of non-mixed THAs. PMID:27348544

Characterization of mercury and its risk in Nelson's, Saltmarsh, and Seaside Sparrows.

PubMed

Winder, Virginia L

2012-01-01

Nelson's, Saltmarsh, and Seaside Sparrows (Ammodramus nelsoni, A. caudacutus, and A. maritimus, respectively) depend on marsh and wetland habitats--ecosystems in which mercury (Hg) bioavailability is notoriously high. The purpose of the present study was to address the potential impact of Hg on these species using first primary and breast feathers as non-destructive biomonitoring tools. Feathers were sampled from wintering sparrows in North Carolina salt marshes (2006-2010). Feather Hg data were used in three risk analysis components (1) Threshold Component--examined feather Hg with regard to published negative effects thresholds; (2) Hg Dynamics Component--examined Hg in sparrows captured multiple times; and (3) Capture Frequency and Survival Component--tested for links between Hg and return frequency and survival. Threshold Component analyses indicated that Hg concentrations in 42-77% of sampled individuals (breast feather n = 879; first primary feather n = 663) were within the range associated with decreased reproduction in other avian species. Hg Dynamics Component analyses demonstrated that Hg increased between first and second captures for Nelson's (n = 9) and Seaside Sparrows (n = 23). Capture Frequency and Survival Component analyses detected a negative relationship between Hg and capture frequency in Nelson's Sparrows (n = 315). However, MARK models detected no effect of Hg on apparent survival in any species. This study indicates that current Hg exposure places a considerable proportion of each population at risk. In particular, 52% of all sampled Saltmarsh Sparrows exhibited first primary feather Hg concentrations exceeding those associated with a >60% reduction in reproductive success in other species. This study reports evidence for net annual bioaccumulation, indicating an increased risk in older individuals. These data can be used to inform future population assessments and management for these species.

Prospective evaluation of PBC-specific health-related quality of life questionnaires in patients with primary sclerosing cholangitis.

PubMed

Raszeja-Wyszomirska, Joanna; Wunsch, Ewa; Krawczyk, Marek; Rigopoulou, Eirini I; Bogdanos, Dimitrios; Milkiewicz, Piotr

2015-06-01

Primary biliary cirrhosis and Primary sclerosing cholangitis are autoimmune cholestatic liver diseases sharing a lot in common, including a significant impairment of patients' health-related quality of life HRQoL HRQoL in PBC is assessed with disease-specific PBC-40 and PBC-27 questionnaires. A PSC-specific questionnaire has not been developed. Neither PBC-40 nor PBC-27s applicability for PSC has been evaluated. We applied these three questionnaires for HRQoL assessment in a large homogenous cohort of PSC patients. This cross-sectional study enrolled 102 Caucasian PSCs and 53 matched healthy controls and measured HRQoL using generic SF-36, and disease-specific (PBC-40/PBC-27) questionnaires. (i) SF-36. Most SF-36 domains were significantly lower in PSCs than controls. Physical Functioning and Mental Component Summary scores were significantly lower in female patients and correlated negatively with age but not with concurrent inflammatory bowel disease. Cirrhosis was associated with lower Physical Functioning, Role Physical, General Health, Vitality and Physical Component Summary. (ii) PBC-40 and PBC-27. Both tools showed similar HRQoL impairment scoring. Fatigue and Cognitive were impaired in female patients. Several correlations existed between HRQoL and laboratory parameters, including cholestatic tests and Itch. Cirrhosis correlated with Other symptoms and Fatigue PBC-40. (iii) PBC-40 vs PBC-27. Strong correlations among most domains of both questionnaires were seen, as well as between (iv) SF-36 vs PBC-40 or SF-36 vs PBC-27. This is the first study directly comparing PBC-40, PBC-27 and SF-36 in PSC. PSC patients, especially females, show HRQoL impairment. PBC-40 and PBC-27 questionnaires could be of potential use for HRQoL assessment in PSC. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Vehicle Weight Reduction Study

DOT National Transportation Integrated Search

1981-03-01

This report studies the potential for primary weight reduction of a 1979 Oldsmobile Omega X-body four-door sedan, by substituting aluminum components for iron and steel components where suitable. A secondary weight reduction is mentioned but is not d...

Cemented all-polyethylene and metal-backed polyethylene tibial components used for primary total knee arthroplasty: a systematic review of the literature and meta-analysis of randomized controlled trials involving 1798 primary total knee implants.

PubMed

Voigt, Jeffrey; Mosier, Michael

2011-10-05

The cost of the implant as part of a total knee arthroplasty accounts for a substantial portion of the costs for the overall procedure: all-polyethylene tibial components cost considerably less than cemented metal-backed tibial components. We performed a systematic review of the literature to determine whether the clinical results of lower-cost all-polyethylene tibial components were comparable with the results of a more expensive metal-backed tibial component. We searched The Cochrane Library, MEDLINE, EMBASE, EBSCO CINAHL, the bibliographies of identified articles, orthopaedic meeting abstracts, health technology assessment web sites, and important orthopaedic journals. This search was performed for the years 1990 to the present. No language restriction was applied. We restricted our search to Level-I studies involving participants who received either an all-polyethylene or a metal-backed tibial implant. The primary outcome measures were durability, function, and adverse events. Two reviewers independently screened the papers for inclusion, assessed trial quality, and extracted data. Effects estimates were pooled with use of fixed and random-effects models of risk ratios, calculated with 95% confidence intervals. Heterogeneity was assessed with the I2 statistic. Forest plots were also generated. Data on 1798 primary total knee implants from twelve studies were analyzed. In all studies, the median or mean age of the participants was greater than sixty-seven years, with a majority of the patients being female. There was no difference between patients managed with an all-polyethylene tibial component and those managed with a metal-backed tibial component in terms of adverse events. There was no significant difference between the two groups in terms of the durability of the implants at two, ten, and fifteen years postoperatively, regardless of the year or how durability was defined (revision or radiographic failure). Finally, with use of a variety of validated measures, there was no difference between the two groups in terms of functional status at two, eight, and ten years, regardless of the measure used. A less expensive all-polyethylene component as part of a total knee arthroplasty has results equivalent to those obtained with a cemented metal-backed tibial component. Using a total knee implant with a cemented all-polyethylene tibial component could save the healthcare system substantial money while obtaining equivalent results to more expensive cemented designs and materials.

Examining Primary Healthcare Performance through a Triple Aim Lens.

PubMed

Ryan, Bridget L; Brown, Judith Belle; Glazier, Richard H; Hutchison, Brian

2016-02-01

This study sought to apply a Triple Aim framework to the measurement and evaluation of primary healthcare (PHC) team performance. Triple Aim components were populated with 10 dimensions derived from survey and health administrative data for 17 Family Health Teams (FHTs) in Ontario, Canada. Bivariate analyses and rankings of sites examined the relationships among dimensions and among Triple Aim components. Readily available measures to fully populate the Triple Aim framework were lacking in FHTs. Within sites, there was little consistency in performance across the Triple Aim components (health, patient experience and cost). More and better measures are needed that can be readily used to examine the Triple Aim performance in PHC teams. FHTs, in this study, are partially achieving Triple Aim goals; however, there was a lack of consistency in performance. It is essential to collect appropriate measures and attend to performance across all components of the Triple Aim. Copyright © 2016 Longwoods Publishing.

Examining Primary Healthcare Performance through a Triple Aim Lens

PubMed Central

Ryan, Bridget L.; Brown, Judith Belle; Glazier, Richard H.; Hutchison, Brian

2016-01-01

Purpose: This study sought to apply a Triple Aim framework to the measurement and evaluation of primary healthcare (PHC) team performance. Methods: Triple Aim components were populated with 10 dimensions derived from survey and health administrative data for 17 Family Health Teams (FHTs) in Ontario, Canada. Bivariate analyses and rankings of sites examined the relationships among dimensions and among Triple Aim components. Results: Readily available measures to fully populate the Triple Aim framework were lacking in FHTs. Within sites, there was little consistency in performance across the Triple Aim components (health, patient experience and cost). Conclusions: More and better measures are needed that can be readily used to examine the Triple Aim performance in PHC teams. FHTs, in this study, are partially achieving Triple Aim goals; however, there was a lack of consistency in performance. It is essential to collect appropriate measures and attend to performance across all components of the Triple Aim. PMID:27027790

Detectors for the James Webb Space Telescope near-infrared spectrograph

NASA Astrophysics Data System (ADS)

Rauscher, Bernard J.; Figer, Donald F.; Regan, Michael W.; Boeker, Torsten; Garnett, James; Hill, Robert J.; Bagnasco, Giorgio; Balleza, Jesus; Barney, Richard; Bergeron, Louis E.; Brambora, Clifford; Connelly, Joe; Derro, Rebecca; DiPirro, Michael J.; Doria-Warner, Christina; Ericsson, Aprille; Glazer, Stuart D.; Greene, Charles; Hall, Donald N.; Jacobson, Shane; Jakobsen, Peter; Johnson, Eric; Johnson, Scott D.; Krebs, Carolyn; Krebs, Danny J.; Lambros, Scott D.; Likins, Blake; Manthripragada, Sridhar; Martineau, Robert J.; Morse, Ernie C.; Moseley, Samuel H.; Mott, D. Brent; Muench, Theo; Park, Hongwoo; Parker, Susan; Polidan, Elizabeth J.; Rashford, Robert; Shakoorzadeh, Kamdin; Sharma, Rajeev; Strada, Paolo; Waczynski, Augustyn; Wen, Yiting; Wong, Selmer; Yagelowich, John; Zuray, Monica

2004-10-01

The Near-Infrared Spectrograph (NIRSpec) is the James Webb Space Telescope"s primary near-infrared spectrograph. NASA is providing the NIRSpec detector subsystem, which consists of the focal plane array, focal plane electronics, cable harnesses, and software. The focal plane array comprises two closely-butted λco ~ 5 μm Rockwell HAWAII-2RG sensor chip assemblies. After briefly describing the NIRSpec instrument, we summarize some of the driving requirements for the detector subsystem, discuss the baseline architecture (and alternatives), and presents some recent detector test results including a description of a newly identified noise component that we have found in some archival JWST test data. We dub this new noise component, which appears to be similar to classical two-state popcorn noise in many aspects, "popcorn mesa noise." We close with the current status of the detector subsystem development effort.

Detectors for the James Webb Space Telescope Near-Infrared Spectrograph

NASA Technical Reports Server (NTRS)

Rauscher, Bernard J.; Figer, Donald F.; Regan, Michael W.; Boeker, Torsten; Garnett, James; Hill, Robert J.; Bagnasco, Georgio; Balleza, Jesus; Barney, Richard; Bergeron, Louis E.

2004-01-01

The Near-Infrared Spectrograph (NIRSpec) is the James Webb Space Telescope's primary near-infrared spectrograph. NASA is providing the NIRSpec detector subsystem, which consists of the focal plane array, focal plane electronics, cable harnesses, and software. The focal plane array comprises two closely-butted lambda (sub co) approximately 5 micrometer Rockwell HAWAII- 2RG sensor chip assemblies. After briefly describing the NIRSpec instrument, we summarize some of the driving requirements for the detector subsystem, discuss the baseline architecture (and alternatives), and presents some recent detector test results including a description of a newly identified noise component that we have found in some archival JWST test data. We dub this new noise component, which appears to be similar to classical two-state popcorn noise in many aspects, "popcorn mesa noise." We close with the current status of the detector subsystem development effort.

Micro-Logistics Analysis for Human Space Exploration

NASA Technical Reports Server (NTRS)

Cirillo, William; Stromgren, Chel; Galan, Ricardo

2008-01-01

Traditionally, logistics analysis for space missions has focused on the delivery of elements and goods to a destination. This type of logistics analysis can be referred to as "macro-logistics". While the delivery of goods is a critical component of mission analysis, it captures only a portion of the constraints that logistics planning may impose on a mission scenario. The other component of logistics analysis concerns the local handling of goods at the destination, including storage, usage, and disposal. This type of logistics analysis, referred to as "micro-logistics", may also be a primary driver in the viability of a human lunar exploration scenario. With the rigorous constraints that will be placed upon a human lunar outpost, it is necessary to accurately evaluate micro-logistics operations in order to develop exploration scenarios that will result in an acceptable level of system performance.

Developmental assessment of the Fort St. Vrain version of the Composite HTGR Analysis Program (CHAP-2)

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

Stroh, K.R.

1980-01-01

The Composite HTGR Analysis Program (CHAP) consists of a model-independent systems analysis mainframe named LASAN and model-dependent linked code modules, each representing a component, subsystem, or phenomenon of an HTGR plant. The Fort St. Vrain (FSV) version (CHAP-2) includes 21 coded modules that model the neutron kinetics and thermal response of the core; the thermal-hydraulics of the reactor primary coolant system, secondary steam supply system, and balance-of-plant; the actions of the control system and plant protection system; the response of the reactor building; and the relative hazard resulting from fuel particle failure. FSV steady-state and transient plant data are beingmore » used to partially verify the component modeling and dynamic smulation techniques used to predict plant response to postulated accident sequences.« less

E-ELT M1 test facility

NASA Astrophysics Data System (ADS)

Dimmler, M.; Marrero, J.; Leveque, S.; Barriga, P.; Sedghi, B.; Mueller, M.

2012-09-01

During the advanced design phase of the European Extremely Large Telescope (E-ELT) several critical components have been prototyped. During the last year some of them have been tested in dedicated test stands. In particular, a representative section of the E-ELT primary mirror has been assembled with 2 active and 2 passive segments. This test stand is equipped with complete prototype segment subunits, i.e. including support mechanisms, glass segments, edge sensors, position actuators as well as additional metrology for monitoring. The purpose is to test various procedures such as calibration, alignment and handling and to study control strategies. In addition the achievable component and subsystem performances are evaluated, and interface issues are identified. In this paper an overview of the activities related to the E-ELT M1 Test Facility will be given. Experiences and test results are presented.

THERMAL DESIGN OF THE ITER VACUUM VESSEL COOLING SYSTEM

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

Carbajo, Juan J; Yoder Jr, Graydon L; Kim, Seokho H

RELAP5-3D models of the ITER Vacuum Vessel (VV) Primary Heat Transfer System (PHTS) have been developed. The design of the cooling system is described in detail, and RELAP5 results are presented. Two parallel pump/heat exchanger trains comprise the design one train is for full-power operation and the other is for emergency operation or operation at decay heat levels. All the components are located inside the Tokamak building (a significant change from the original configurations). The results presented include operation at full power, decay heat operation, and baking operation. The RELAP5-3D results confirm that the design can operate satisfactorily during bothmore » normal pulsed power operation and decay heat operation. All the temperatures in the coolant and in the different system components are maintained within acceptable operating limits.« less

Total knee replacement-cementless tibial fixation with screws: 10-year results.

PubMed

Ersan, Önder; Öztürk, Alper; Çatma, Mehmet Faruk; Ünlü, Serhan; Akdoğan, Mutlu; Ateş, Yalım

2017-12-01

The aim of this study was to evaluate the long term clinical and radiological results of cementless total knee replacement. A total of 51 knees of 49 patients (33 female and 16 male; mean age: 61.6 years (range, 29-66 years)) who underwent TKR surgery with a posterior stabilized hydroxyapatite coated knee implant were included in this study. All of the tibial components were fixed with screws. The HSS scores were examined preoperatively and at the final follow-up. Radiological assessment was performed with Knee Society evaluating and scoring system. Kaplan-Meier survival analysis was performed to rule out the survival of the tibial component. The mean HSS scores were 45.8 (range 38-60) and 88.1 (range 61-93), preoperatively and at the final follow-up respectively. Complete radiological assessment was performed for 48 knees. Lucent lines at the tibial component were observed in 4 patients; one of these patients underwent a revision surgery due to the loosening of the tibial component. The 10-year survival rate of a tibial component was 98%. Cementless total knee replacement has satisfactory long term clinical results. Primary fixation of the tibial component with screws provides adequate stability even in elderly patients with good bone quality. Level IV, Therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Fifth Ovarian Cancer Consensus Conference of the Gynecologic Cancer InterGroup: first-line interventions.

PubMed

Karam, A; Ledermann, J A; Kim, J-W; Sehouli, J; Lu, K; Gourley, C; Katsumata, N; Burger, R A; Nam, B-H; Bacon, M; Ng, C; Pfisterer, J; Bekkers, R L M; Casado Herráez, A; Redondo, A; Fujiwara, H; Gleeson, N; Rosengarten, O; Scambia, G; Zhu, J; Okamoto, A; Stuart, G; Ochiai, K

2017-04-01

The consensus statements regarding first-line therapies in women with ovarian cancer, reached at the Fifth Ovarian Cancer Consensus Conference held in Tokyo, Japan, in November 2015 are reported. Three topics were reviewed and the following statements are recommended: (i) Surgery: the subgroups that should be considered in first-line ovarian cancer clinical trials should be (a) patients undergoing primary debulking surgery and (b) patients receiving neo-adjuvant chemotherapy. The amount of residual disease following surgery should further stratify patients into those with absent gross residual disease and others. (ii) Control arms for chemotherapy: for advanced stage ovarian cancer the standard is intravenous 3-weekly carboplatin and paclitaxel. Acceptable alternatives, which should be stratified variables in trials when more than one regimen is offered, include weekly paclitaxel plus 3-weekly carboplatin, the addition of bevacizumab to 3-weekly carboplatin and paclitaxel, and intraperitoneal therapy. (iii) Trial Endpoints: overall survival is the preferred primary endpoint for first-line clinical trials with or without a maintenance component. Progression-free survival (PFS) is an alternative primary endpoint, but if PFS is chosen overall survival must be measured as a secondary endpoint and PFS must be supported by additional endpoints, including predefined patient reported outcomes and time to first or second subsequent therapy. For neoadjuvant therapy, additional 'window of opportunity' endpoints should be included. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Lunar articulated remote transportation system

NASA Technical Reports Server (NTRS)

Beech, Geoffrey; Conley, Gerald; Diaz, Claudine; Dimella, Timothy; Dodson, Pete; Hykin, Jeff; Richards, Byron; Richardson, Kroy; Shetzer, Christie; Vandyke, Melissa

1990-01-01

A first generation lunar transportation vehicle was designed for use on the surface of the Moon between the years 2010 and 2020. Attention is focussed on specific design details on all components of the Lunar Articulated Remote Transportation System (Lunar ARTS). The Lunar ARTS will be a three cart, six-wheeled articulated vehicle. It's purpose will be for the transportation of astronauts and/or materials for excavation purposes at a short distance from the base (37.5 kilometers). The power system includes fuel cells for both the primary system and the back-up system. The vehicle has the option of being operated in a manned or unmanned mode. The unmanned mode includes stereo imaging with signal processing for navigation. For manned missions the display console is a digital readout displayed on the inside of the asronaut's helmet. A microprocessor is also on board the vehicle. Other components of the vehicle include: a double wishbone/flexible hemispherical wheel suspension; chassis; a steering system; motors; seat restraints, heat rejection systems; solar flare protection; dust protection; and meteoroid protection. A one-quarter scale dynamic model was built to study the dynamic behavior of the vehicle. The dynamic model closely captures the mechanical and electrical details of the total design.

Thermal Analysis of Iodine Satellite (iSAT) from Preliminary Design Review (PDR) to Critical Design Review (CDR)

NASA Technical Reports Server (NTRS)

Mauro, Stephanie

2016-01-01

The Iodine Satellite (iSAT) is a 12U cubesat with a primary mission to demonstrate the iodine fueled Hall Effect Thruster (HET) propulsion system. The spacecraft (SC) will operate throughout a one year mission in an effort to mature the propulsion system for use in future applications. The benefit of the HET is that it uses a propellant, iodine, which is easy to store and provides a high thrust-to-mass ratio. This paper will describe the thermal analysis and design of the SC between Preliminary Design Review (PDR) and Critical Design Review (CDR). The design of the satellite has undergone many changes due to a variety of challenges, both before PDR and during the time period discussed in this paper. Thermal challenges associated with the system include a high power density, small amounts of available radiative surface area, localized temperature requirements of the propulsion components, and unknown orbital parameters. The thermal control system is implemented to maintain component temperatures within their respective operational limits throughout the mission, while also maintaining propulsion components at the high temperatures needed to allow gaseous iodine propellant to flow. The design includes heaters, insulation, radiators, coatings, and thermal straps. Currently, the maximum temperatures for several components are near to their maximum operation limit, and the battery is close to its minimum operation limit. Mitigation strategies and planned work to solve these challenges will be discussed.

Endothelial glycocalyx: permeability barrier and mechanosensor.

PubMed

Curry, F E; Adamson, R H

2012-04-01

Endothelial cells are covered with a polysaccharide rich layer more than 400 nm thick, mechanical properties of which limit access of circulating plasma components to endothelial cell membranes. The barrier properties of this endothelial surface layer are deduced from the rate of tracer penetration into the layer and the mechanics of red and white cell movement through capillary microvessels. This review compares the mechanosensor and permeability properties of an inner layer (100-150 nm, close to the endothelial membrane) characterized as a quasi-periodic structure which accounts for key aspects of transvascular exchange and vascular permeability with those of the whole endothelial surface layers. We conclude that many of the barrier properties of the whole surface layer are not representative of the primary fiber matrix forming the molecular filter determining transvascular exchange. The differences between the properties of the whole layer and the inner glycocalyx structures likely reflect dynamic aspects of the endothelial surface layer including tracer binding to specific components, synthesis and degradation of key components, activation of signaling pathways in the endothelial cells when components of the surface layer are lost or degraded, and the spatial distribution of adhesion proteins in microdomains of the endothelial cell membrane.