Sample records for provide continuous day

  1. The influence of day/night cycles on biomass yield and composition of Neochloris oleoabundans.

    PubMed

    de Winter, Lenneke; Cabanelas, Iago Teles Dominguez; Martens, Dirk E; Wijffels, René H; Barbosa, Maria J

    2017-01-01

    Day/night cycles regulate the circadian clock of organisms to program daily activities. Many species of microalgae have a synchronized cell division when grown under a day/night cycle, and synchronization might influence biomass yield and composition. Therefore, the aim of this study was to study the influence of day/night cycle on biomass yield and composition of the green microalgae Neochloris oleoabundans . Hence, we compared continuous turbidostat cultures grown under continuous light with cultures grown under simulated day/night cycles. Under day/night cycles, cultures were synchronized as cell division was scheduled in the night, whereas under continuous light cell division occurred randomly synchronized cultures were able to use the light 10-15% more efficiently than non-synchronized cultures. Our results indicate that the efficiency of light use varies over the cell cycle and that synchronized cell division provides a fitness benefit to microalgae. Biomass composition under day/night cycles was similar to continuous light, with the exception of starch content. The starch content was higher in cultures under continuous light, most likely because the cells never had to respire starch to cover for maintenance during dark periods. Day/night cycles were provided in a 'block' (continuous light intensity during the light period) and in a 'sine' (using a sine function to simulate light intensities from sunrise to sunset). There were no differences in biomass yield or composition between these two ways of providing light (in a 'block' or in a 'sine'). The biomass yield and composition of N. oleoabundans were influenced by day/night cycles. These results are important to better understand the relations between research done under continuous light conditions and with day/night cycle conditions. Our findings also imply that more research should be done under day/night cycles.

  2. Dynamic allocation of same-day requests in multi-physician primary care practices in the presence of prescheduled appointments.

    PubMed

    Balasubramanian, Hari; Biehl, Sebastian; Dai, Longjie; Muriel, Ana

    2014-03-01

    Appointments in primary care are of two types: 1) prescheduled appointments, which are booked in advance of a given workday; and 2) same-day appointments, which are booked as calls come during the workday. The challenge for practices is to provide preferred time slots for prescheduled appointments and yet see as many same-day patients as possible during regular work hours. It is also important, to the extent possible, to match same-day patients with their own providers (so as to maximize continuity of care). In this paper, we present a mathematical framework (a stochastic dynamic program) for same-day patient allocation in multi-physician practices in which calls for same-day appointments come in dynamically over a workday. Allocation decisions have to be made in the presence of prescheduled appointments and without complete demand information. The objective is to maximize a weighted measure that includes the number of same-day patients seen during regular work hours as well as the continuity provided to these patients. Our experimental design is motivated by empirical data we collected at a 3-provider family medicine practice in Massachusetts. Our results show that the location of prescheduled appointments - i.e. where in the day these appointments are booked - has a significant impact on the number of same-day patients a practice can see during regular work hours, as well as the continuity the practice is able to provide. We find that a 2-Blocks policy which books prescheduled appointments in two clusters - early morning and early afternoon - works very well. We also provide a simple, easily implementable policy for schedulers to assign incoming same-day requests to appointment slots. Our results show that this policy provides near-optimal same-day assignments in a variety of settings.

  3. Continuing Vocational Training (CVT).

    ERIC Educational Resources Information Center

    Drogosz-Zablocka, Elzbieta; Izycka, Halina; Trzeciak, Wlodzimierz

    Polish continuing education (CE) includes education, further education, and professional development in and out of school; in day, evening, or weekend courses; and distance education. The state, workplaces, grants, and foreign assistance provide financing. A variety of organizations cooperate to provide continuing education. High-risk groups…

  4. Extending “Continuity of Care” to include the Contribution of Family Carers

    PubMed Central

    Parsons, John; Sheridan, Nicolette; Kenealy, Timothy; Peckham, Allie

    2017-01-01

    Background: Family carers, as a “shadow workforce”, are foundational to the day-to-day integration of health service delivery for older family members living with complex health needs. This paper utilises Haggerty’s model of continuity of care to explore the contribution of family carers’ to the provision of care and support for an older family member’s chronic condition within the context of health service delivery. Methods: We analysed data from interviews of 13 family carers in a case study of primary health care in New Zealand – a Maori Provider Organisation – to determine the alignment of family caregiving with the three levels of continuity of care (relational continuity, informational continuity, and management continuity). Results: We found alignment of family caregiving tasks, responsibilities, and relationships with the three levels of continuity of care. Family carers 1) partnered with providers to extend chronic care to the home; 2) transferred and contributed information from one provider/service to another; 3) supported consistent and flexible management of care. Discussion: The Maori Provider Organisation supported family carer-provider partnership enabled by shared Maori cultural values and social mandate of building family-centred wellbeing. Relational continuity was the most important level of continuity of care; it sets precedence for family carers and providers to establish the other levels – informational and management – continuity of care for their family member cared for. Family carers need to be considered as active partners working alongside responsive primary health care providers and organisation in the implementation of chronic care. PMID:28970752

  5. EVALUATION OF DIOXIN EMISSIONS MONITORING SYSTEMS

    EPA Science Inventory

    Continuous samplers and real or semi-real-time continuous monitors for polychlorinated dibenzodioxins and furans provide significant advantages relative to conventional methods of extractive sampling. Continuous samplers collect long term samples over a time period of days to wee...

  6. Taking an Antibiotic Time-out: Utilization and Usability of a Self-Stewardship Time-out Program for Renewal of Vancomycin and Piperacillin-Tazobactam.

    PubMed

    Graber, Christopher J; Jones, Makoto M; Glassman, Peter A; Weir, Charlene; Butler, Jorie; Nechodom, Kevin; Kay, Chad L; Furman, Amy E; Tran, Thuong T; Foltz, Christopher; Pollack, Lori A; Samore, Matthew H; Goetz, Matthew Bidwell

    2015-11-01

    Antibiotic time-outs can promote critical thinking and greater attention to reviewing indications for continuation. We pilot tested an antibiotic time-out program at a tertiary care teaching hospital where vancomycin and piperacillin-tazobactam continuation past day 3 had previously required infectious diseases service approval. The time-out program consisted of 3 components: (1) an electronic antimicrobial dashboard that aggregated infection-relevant clinical data; (2) a templated note in the electronic medical record that included a structured review of antibiotic indications and that provided automatic approval of continuation of therapy when indicated; and (3) an educational and social marketing campaign. In the first 6 months of program implementation, vancomycin was discontinued by day 5 in 93/145 (64%) courses where a time-out was performed on day 4 versus in 96/199 (48%) 1 year prior (P = .04). Seven vancomycin continuations via template (5% of time-outs) were guideline-discordant by retrospective chart review versus none 1 year prior (P = .002). Piperacillin-tazobactam was discontinued by day 5 in 70/105 (67%) courses versus 58/93 (62%) 1 year prior (P = .55); 9 continuations (9% of time-outs) were guideline-discordant versus two 1 year prior (P = .06). A usability survey completed by 32 physicians demonstrated modest satisfaction with the overall program, antimicrobial dashboard, and renewal templates. By providing practitioners with clinical informatics support and guidance, the intervention increased provider confidence in making decisions to de-escalate antimicrobial therapy in ambiguous circumstances wherein they previously sought authorization for continuation from an antimicrobial steward.

  7. 7 CFR 226.18 - Day care home provisions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF... approval to provide day care services to children. Day care homes which cannot obtain their license because... access to its meal service and records during its normal hours of child care operations. For day care...

  8. 7 CFR 226.18 - Day care home provisions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF... approval to provide day care services to children. Day care homes which cannot obtain their license because... access to its meal service and records during its normal hours of child care operations. For day care...

  9. Protein and calorie prescription for children and young adults receiving continuous renal replacement therapy: a report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group.

    PubMed

    Zappitelli, Michael; Goldstein, Stuart L; Symons, Jordan M; Somers, Michael J G; Baum, Michelle A; Brophy, Patrick D; Blowey, Douglas; Fortenberry, James D; Chua, Annabelle N; Flores, Francisco X; Benfield, Mark R; Alexander, Steven R; Askenazi, David; Hackbarth, Richard; Bunchman, Timothy E

    2008-12-01

    Few published reports describe nutrition provision for critically ill children and young adults with acute kidney injury receiving continuous renal replacement therapy. The goals of this study were to describe feeding practices in pediatric continuous renal replacement therapy and to evaluate factors associated with over- and under-prescription of protein and calories. Retrospective database study. Multicenter study in pediatric critical care units. Patients with acute kidney injury (estimated glomerular filtration rate < 75 mL/min/1.73 m at continuous renal replacement therapy initiation) enrolled in the Prospective Pediatric Continuous Renal Replacement Therapy Registry. None. Nutrition variables: initial and maximal protein (g/kg/day) and caloric (kcal/kg/day) prescription and predicted resting energy expenditure (kcal/kg/day). We determined factors predicting initial and maximal protein and caloric prescription by multivariate analysis. One hundred ninety-five patients (median [interquartile range] age = 8.1 [12.8] yrs, 56.9% men) were studied. Mean protein and caloric prescriptions at continuous renal replacement therapy initiation were 1.3 +/- 1.5 g/kg/day (median, 1.0; range, 0-10) and 37 +/- 27 kcal/kg/day (median, 32; range, 0-107). Mean maximal protein and caloric prescriptions during continuous renal replacement therapy were 2.0 +/- 1.5 g/kg/day (median, 1.7; range, 0-12) and 48 +/- 32 kcal/kg/day (median, 43; range, 0-117). Thirty-four percent of patients were initially prescribed < 1 g/kg/day protein; 23% never attained > 1 g/kg/day protein prescription. By continuous renal replacement therapy day 5, median protein prescribed was > 2 g/kg/day. Protein prescription practices differed substantially between medical centers with 5 of 10 centers achieving maximal protein prescription of > 2 g/kg/day in > or = 40% of patients. Caloric prescription exceeded predicted resting energy expenditure by 30%-100%. Factors independently associated with maximal protein and caloric prescription while on continuous renal replacement therapy were younger age, initial protein and caloric prescription and number of continuous renal replacement therapy treatment days (p < 0.05). Protein prescription in pediatric continuous renal replacement therapy may be inadequate. Inter-center variation exists with respect to nutrition prescription. Feeding practice standardization and research in pediatric acute kidney injury nutrition are essential to begin providing evidence-based feeding recommendations.

  10. Continuous metabolic and cardiovascular measurements on a monkey subject during a simulated 6-day Spacelab mission

    NASA Technical Reports Server (NTRS)

    Pace, N.; Rahlmann, D. F.; Mains, R. C.; Kodama, A. M.; Mccutcheon, E. P.

    1979-01-01

    A 10-kg male pig-tailed monkey (Macaca nemestrina) was selected as an optimal species for spaceflight studies on weightlessness. Three days before the simulated launch, the animal was placed in a fiberglass pod system to provide continuous measurement of respiratory gas exchange. Attention is given to examining the effects of weightlessness on several basic parameters of metabolic and cardiovascular function in an adult nonhuman primate. The 10.7-day total simulated-experiment period consisted of preflight 2.6 days, inflight 6.3 days, and postflight 1.8 days. Statistically significant diurnal variation was noted in oxygen consumption and CO2 production rates, body temperature and HR, but not in respiratory quotient or blood pressure. The high quality of the continuous data obtained demonstrates the feasibility of performing sound physiological experimentation on nonhuman primates in the Spacelab environment.

  11. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    PubMed

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P < .01), but reported similar experiences with routine access and continuity. Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  12. The true value and return on investment of business continuity.

    PubMed

    Phelps, Regina

    2018-01-01

    The phrase return on investment (ROI) is commonly heard when groups or organisations attempt to demonstrate the value of a particular activity. 'Is it good for us?', 'Is it worth the investment?' and 'Should we continue to fund the endeavour?' are all valid and important questions. The challenge for business continuity professionals is to address the question, 'What is the ROI of business continuity?' in ways that will be meaningful to the person wielding the budget stick. In the 'olden days', colleagues would point to their business impact analysis, with pie charts and bar graphs showing the cost of business downtime if an event occurred. They would sit back and say, 'See? We provide ROI because we addressed The Bad Thing!'. But is that really the best that continuity professionals can do? This paper peels back the question of ROI and addresses the value proposition of business continuity. The goal is to broaden the conversation, by instead of talking about how much money business continuity efforts will save the company, and instead to focus on the value that business continuity provides every day.

  13. Matrix and reservoir-type multipurpose vaginal rings for controlled release of dapivirine and levonorgestrel.

    PubMed

    Boyd, Peter; Fetherston, Susan M; McCoy, Clare F; Major, Ian; Murphy, Diarmaid J; Kumar, Sandeep; Holt, Jonathon; Brimer, Andrew; Blanda, Wendy; Devlin, Brid; Malcolm, R Karl

    2016-09-10

    A matrix-type silicone elastomer vaginal ring providing 28-day continuous release of dapivirine (DPV) - a lead candidate human immunodeficiency virus type 1 (HIV-1) microbicide compound - has recently demonstrated moderate levels of protection in two Phase III clinical studies. Here, next-generation matrix and reservoir-type silicone elastomer vaginal rings are reported for the first time offering simultaneous and continuous in vitro release of DPV and the contraceptive progestin levonorgestrel (LNG) over a period of between 60 and 180days. For matrix-type vaginal rings comprising initial drug loadings of 100, 150 or 200mg DPV and 0, 16 or 32mg LNG, Day 1 daily DPV release values were between 4132 and 6113μg while Day 60 values ranged from 284 to 454μg. Daily LNG release ranged from 129 to 684μg on Day 1 and 2-91μg on Day 60. Core-type rings comprising one or two drug-loaded cores provided extended duration of in vitro release out to 180days, and maintained daily drug release rates within much narrower windows (either 75-131μg/day or 37-66μg/day for DPV, and either 96-150μg/day or 37-57μg/day for LNG, depending on core ring configuration and ignoring initial lag release effect for LNG) compared with matrix-type rings. The data support the continued development of these devices as multi-purpose prevention technologies (MPTs) for HIV prevention and long-acting contraception. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

  15. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

  16. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...

  17. 77 FR 27758 - Kinder Morgan Texas Pipeline LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... day to 425 MMcf per day. The proposed amendment would allow KMTP to continue to provide Pemex-Gas Y Petroquimica Basica (Pemex) with increased gas supplies as Pemex finishes repairing a damaged pipeline in...

  18. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing adult day health care to eligible veterans in a...

  19. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing adult day health care to eligible veterans in a...

  20. 38 CFR 52.10 - Per diem based on recognition and certification.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Obtaining Per Diem for Adult Day Health Care in State Homes § 52.10 Per diem based on recognition and certification. VA will pay per diem to a State for providing adult day health care to eligible veterans in a...

  1. Ophthalmic Care of the Combat Casualty

    DTIC Science & Technology

    2003-01-01

    World War I and World War II made evident the need to maintain well-trained military ophthalmologists on continual active duty to provide care for...the military ( active and retired), their dependents, and selected civilians has continued to this day. Military conflicts, peacekeeping efforts, and... Philippines , tropical ophthalmology became very important. This made Fig. 1-8. Fort Seldon, Texas, 1865– 1892. Eye care could be provided at this

  2. 40 CFR 97.361 - EPA recordation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false EPA recordation. 97.361 Section 97.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX... § 97.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  3. 40 CFR 97.361 - EPA recordation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false EPA recordation. 97.361 Section 97.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX... § 97.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  4. 40 CFR 96.361 - EPA recordation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false EPA recordation. 96.361 Section 96.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Allowance Transfers § 96.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b...

  5. 40 CFR 97.361 - EPA recordation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false EPA recordation. 97.361 Section 97.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX... § 97.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  6. 40 CFR 96.361 - EPA recordation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false EPA recordation. 96.361 Section 96.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Allowance Transfers § 96.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b...

  7. 40 CFR 96.361 - EPA recordation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 21 2014-07-01 2014-07-01 false EPA recordation. 96.361 Section 96.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Allowance Transfers § 96.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b...

  8. 40 CFR 96.361 - EPA recordation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false EPA recordation. 96.361 Section 96.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Season Allowance Transfers § 96.361 EPA recordation. (a) Within 5 business days (except as provided in...

  9. 40 CFR 96.361 - EPA recordation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false EPA recordation. 96.361 Section 96.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Allowance Transfers § 96.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b...

  10. 40 CFR 97.361 - EPA recordation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 21 2014-07-01 2014-07-01 false EPA recordation. 97.361 Section 97.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX... § 97.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  11. 40 CFR 97.361 - EPA recordation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false EPA recordation. 97.361 Section 97.361 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) FEDERAL NOX... § 97.361 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  12. A smartphone application to support recovery from alcoholism: a randomized clinical trial.

    PubMed

    Gustafson, David H; McTavish, Fiona M; Chih, Ming-Yuan; Atwood, Amy K; Johnson, Roberta A; Boyle, Michael G; Levy, Michael S; Driscoll, Hilary; Chisholm, Steven M; Dillenburg, Lisa; Isham, Andrew; Shah, Dhavan

    2014-05-01

    Patients leaving residential treatment for alcohol use disorders are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. To determine whether patients leaving residential treatment for alcohol use disorders with a smartphone application to support recovery have fewer risky drinking days than control patients. An unmasked randomized clinical trial involving 3 residential programs operated by 1 nonprofit treatment organization in the Midwestern United States and 2 residential programs operated by 1 nonprofit organization in the Northeastern United States. In total, 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment were randomized to treatment as usual (n = 179) or treatment as usual plus a smartphone (n = 170) with the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an application designed to improve continuing care for alcohol use disorders. Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention and follow-up period lasted 8 and 4 months, respectively. Risky drinking days--the number of days during which a patient's drinking in a 2-hour period exceeded 4 standard drinks for men and 3 standard drinks for women, with standard drink defined as one that contains roughly 14 g of pure alcohol (12 oz of regular beer, 5 oz of wine, or 1.5 oz of distilled spirits). Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than did patients in the control group, with a mean of 1.39 vs 2.75 days (mean difference, 1.37; 95% CI, 0.46-2.27; P = .003). The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders. clinicaltrials.gov Identifier: NCT01003119.

  13. 29 CFR 825.115 - Continuing treatment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... condition, that also involves: (1) Treatment two or more times, within 30 days of the first day of... the health care provider. (3) The requirement in paragraphs (a)(1) and (2) of this section for... paragraph (a)(1) of this section means circumstances beyond the employee's control that prevent the follow...

  14. 40 CFR 96.161 - EPA recordation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 22 2012-07-01 2012-07-01 false EPA recordation. 96.161 Section 96.161 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Transfers § 96.161 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  15. 40 CFR 96.161 - EPA recordation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 21 2014-07-01 2014-07-01 false EPA recordation. 96.161 Section 96.161 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Transfers § 96.161 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  16. 40 CFR 96.161 - EPA recordation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 21 2011-07-01 2011-07-01 false EPA recordation. 96.161 Section 96.161 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Transfers § 96.161 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  17. 40 CFR 96.161 - EPA recordation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 22 2013-07-01 2013-07-01 false EPA recordation. 96.161 Section 96.161 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Transfers § 96.161 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  18. 40 CFR 96.161 - EPA recordation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false EPA recordation. 96.161 Section 96.161 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NOX BUDGET... Transfers § 96.161 EPA recordation. (a) Within 5 business days (except as provided in paragraph (b) of this...

  19. Growth and Your 1- to 2-Year-Old

    MedlinePlus

    ... doctor. Encourage activity and exploration by providing a safe environment that lets your child be active every day. ... the area of language. Continue to provide a safe and healthy environment to support your child's growth and development. Talk ...

  20. [Psychological Effects of Forest Therapy Program on Workers].

    PubMed

    Ikei, Harumi; Koizumi, Haruka; Song, Chorong; Kouzuki, Mitsunori; Teratani, Seiichiro; Sakuma, Takahiro; Miyazaki, Yoshifumi

    2015-01-01

    To examine the psychological effects of forest therapy program on workers. The subjective symptoms index, a shortened version of the profile of mood states (POMS), and a semantic differential (SD) method were used to measure the psychological effects. The evaluations were performed 3 days before, during, and 1, 3, and 5 days after the forest therapy. The following results were obtained: (1) the subjective symptoms improved before breakfast and continued for 5 days; (2) the mood evaluated using POMS improved before breakfast and continued for 3 days; and (3) “comfortable,” “relaxed,” and “natural” feelings evaluated using the SD method were enhanced before breakfast, lunch, and dinner during forest therapy. These results provided scientific evidence of the psychological effects of forest therapy program on workers.

  1. Open the Door...See the People. A Descriptive Report of the Second Year of the Community Family Day Care Project.

    ERIC Educational Resources Information Center

    Pacific Oaks Coll. and Children's School, Pasadena, CA.

    The second year of the Community Family Day Care Project, begun in August 1970, to test the belief that group day care is the best way to provide care for children of working parents is discussed. The tasks for the second year were to demonstrate the feasibility of improving quality, stability, continuity, and flexibility in an existing network of…

  2. 12 CFR 229.33 - Notice of nonpayment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Notice of nonpayment. 229.33 Section 229.33 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM... presented to the paying bank. If the day the paying bank is required to provide notice is not a banking day...

  3. 40 CFR 430.64 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... achievable (BAT). 430.64 Section 430.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... by the application of the best available technology economically achievable (BAT). Except as provided... achievable (BAT). Non-continuous dischargers shall not be subject to the maximum day mass limitations in kg...

  4. 40 CFR 430.64 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... achievable (BAT). 430.64 Section 430.64 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... by the application of the best available technology economically achievable (BAT). Except as provided... achievable (BAT). Non-continuous dischargers shall not be subject to the maximum day mass limitations in kg...

  5. Partnering with Industry to Deliver Continuing Education to Florida's Licensed Pesticide Applicators

    ERIC Educational Resources Information Center

    Fishel, Fred

    2014-01-01

    Partnering with private industry can empower Extension educators to enhance their educational outreach efforts. Since 2011, UF/IFAS has cooperated with the Florida Turfgrass Association in conducting a 1-day statewide Polycom® event for providing continuing education to licensed pesticide applicators employed primarily in the ornamental and…

  6. A smartphone application to support recovery from alcoholism: A randomized controlled trial

    PubMed Central

    Gustafson, David H.; McTavish, Fiona M.; Chih, Ming-Yuan; Atwood, Amy K.; A. Johnson, Roberta; G. Boyle, Michael; S. Levy, Michael; Driscoll, Hilary; M. Chisholm, Steven; Dillenburg, Lisa; Isham, Andrew; Shah, Dhavan

    2014-01-01

    Importance: Patients leaving treatment for alcohol-use disorders (AUDs) are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. Objective: To determine whether patients leaving residential treatment for AUDs with a smartphone application to support recovery have fewer risky drinking days than control-group patients. Design: An un-blinded randomized controlled trial. Patients were randomized to treatment as usual or treatment as usual plus a smartphone with A-CHESS, an application designed to improve continuing care for AUDs. “A-CHESS” stands for Addiction – Comprehensive Health Enhancement Support System. Setting: Three residential programs operated by one treatment organization in the Midwestern US and 2 residential programs operated by one organization in the Northeastern US. Participants: 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment. 179 were randomized to the control group and 170 to the treatment group. Intervention: Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention lasted 8 months and the follow-up period lasted 4 months. Main Outcome Measure: Risky drinking days—the number of days during which a patient’s drinking in a 2-hour period exceeded, for men, 4 standard drinks and for women, 3 standard drinks. Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. Results: For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than patients in the control group (M = 1.39 vs. 2.75, respectively; P = .003; 95% CI [.46, 2.27]). Conclusions and Relevance: The findings suggest that a multi-featured smartphone application may have significant benefit to patients in continuing care for AUDs. Trial registration: clinicaltrials.gov Identifier: NCT01003119 PMID:24671165

  7. COMPASS Final Report: Lunar Network Satellite-High Rate (LNS-HR)

    NASA Technical Reports Server (NTRS)

    oleson, Steven R.; McGuire, Melissa L.

    2012-01-01

    Two design options were explored to address the requirement to provide lunar piloted missions with continuous communications for outpost and sortie missions. Two unique orbits were assessed, along with the appropriate spacecraft (S/C) to address these requirements. Both constellations (with only two S/C each) provide full time coverage (24 hr/7 d) for a south polar base and also provide continuous 7 day coverage for sorties for specified sites and periodic windows. Thus a two-satellite system can provide full coverage for sorties for selected windows of opportunity without reconfiguring the constellation.

  8. Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings.

    PubMed

    Koenig, Christopher J; Maguen, Shira; Daley, Aaron; Cohen, Greg; Seal, Karen H

    2013-01-01

    Handoffs are communication processes that enact the transfer of responsibility between providers across clinical settings. Prior research on handoff communication has focused on inpatient settings between provider teams and has emphasized patient safety. This study examines handoff communication within multidisciplinary provider teams in two outpatient settings. To conduct an exploratory study that describes handoff communication among multidisciplinary providers, to develop a theory-driven descriptive framework for outpatient handoffs, and to evaluate the strengths and weaknesses of different handoff types. Qualitative, in-depth, semi-structured interviews with 31 primary care, mental health, and social work providers in two Department of Veterans Affairs (VA) Medical Center outpatient clinics. Audio-recorded interviews were transcribed and analyzed using Grounded Practical Theory to develop a theoretical model of and a descriptive framework for handoff communication among multidisciplinary providers. Multidisciplinary providers reported that handoff decisions across settings were made spontaneously and without clear guidelines. Two situated values, clinic efficiency and patient-centeredness, shaped multidisciplinary providers' handoff decisions. Providers reported three handoff techniques along a continuum: the electronic handoff, which was the most clinically efficient; the provider-to-provider handoff, which balanced clinic efficiency and patient-centeredness; and the collaborative handoff, which was the most patient-centered. Providers described handoff choice as a practical response to manage constituent features of clinic efficiency (time, space, medium of communication) and patient-centeredness (information continuity, management continuity, relational continuity, and social interaction). We present a theoretical and descriptive framework to help providers evaluate differential handoff use, reflect on situated values guiding clinic communication, and guide future research. Handoff communication reflected multidisciplinary providers' efforts to balance clinic efficiency with patient-centeredness within the constraints of day-to-day clinical practice. Evaluating the strengths and weaknesses among alternative handoff options may enhance multidisciplinary provider handoff decision-making and may contribute to increased coordination and continuity of care across outpatient settings.

  9. Continuing assessment of the 5 day sodium carbonate-ammonium nitrate extraction assay as an indicator test for silicon fertilizers

    USDA-ARS?s Scientific Manuscript database

    The five day sodium carbonate-ammonium nitrate extraction assay has been proposed by the AAFPCO as a standard test to identify fertilizers that provide plant-available Si. A single-lab validation test was previously performed; however, the analysis lacked any correlation to a grow-out study. To do...

  10. Contingency Management for Alcohol Use Reduction: A Pilot Study using a Transdermal Alcohol Sensor*

    PubMed Central

    Barnett, Nancy P.; Tidey, Jennifer; Murphy, James G.; Swift, Robert; Colby, Suzanne M.

    2011-01-01

    Background Contingency management (CM) has not been thoroughly evaluated as a treatment for alcohol abuse or dependence, in part because verification of alcohol use reduction requires frequent in-person breath tests. Transdermal alcohol sensors detect alcohol regularly throughout the day, providing remote monitoring and allowing for rapid reinforcement of reductions in use. Methods The purpose of this study was to evaluate the efficacy of CM for reduction in alcohol use, using a transdermal alcohol sensor to provide a continuous measure of alcohol use. Participants were 13 heavy drinking adults who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet for three weeks and provided reports of alcohol and drug use using daily web-based surveys. In Week 1, participants were asked to drink as usual; in Weeks 2 and 3, they were reinforced on an escalating schedule with values ranging from $5-$17 per day on days when alcohol use was not reported or detected by the SCRAM. Results Self-reports of percent days abstinent and drinks per week, and transdermal measures of average and peak transdermal alcohol concentration and area under the curve declined significantly in Weeks 2-3. A nonsignificant but large effect size for reduction in days of tobacco use also was found. An adjustment to the SCRAM criteria for detecting alcohol use provided an accurate but less conservative method for use with non-mandated clients. Conclusion Results support the efficacy of CM for alcohol use reductions and the feasibility of using transdermal monitoring of alcohol use for clinical purposes. PMID:21665385

  11. Contingency management for alcohol use reduction: a pilot study using a transdermal alcohol sensor.

    PubMed

    Barnett, Nancy P; Tidey, Jennifer; Murphy, James G; Swift, Robert; Colby, Suzanne M

    2011-11-01

    Contingency management (CM) has not been thoroughly evaluated as a treatment for alcohol abuse or dependence, in part because verification of alcohol use reduction requires frequent in-person breath tests. Transdermal alcohol sensors detect alcohol regularly throughout the day, providing remote monitoring and allowing for rapid reinforcement of reductions in use. The purpose of this study was to evaluate the efficacy of CM for reduction in alcohol use, using a transdermal alcohol sensor to provide a continuous measure of alcohol use. Participants were 13 heavy drinking adults who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet for three weeks and provided reports of alcohol and drug use using daily web-based surveys. In Week 1, participants were asked to drink as usual; in Weeks 2 and 3, they were reinforced on an escalating schedule with values ranging from $5 to $17 per day on days when alcohol use was not reported or detected by the SCRAM. Self-reports of percent days abstinent and drinks per week, and transdermal measures of average and peak transdermal alcohol concentration and area under the curve declined significantly in Weeks 2-3. A nonsignificant but large effect size for reduction in days of tobacco use also was found. An adjustment to the SCRAM criteria for detecting alcohol use provided an accurate but less conservative method for use with non-mandated clients. Results support the efficacy of CM for alcohol use reductions and the feasibility of using transdermal monitoring of alcohol use for clinical purposes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  12. Temporal variability of tidal and gravity waves during a record long 10-day continuous lidar sounding

    NASA Astrophysics Data System (ADS)

    Baumgarten, Kathrin; Gerding, Michael; Baumgarten, Gerd; Lübken, Franz-Josef

    2018-01-01

    Gravity waves (GWs) as well as solar tides are a key driving mechanism for the circulation in the Earth's atmosphere. The propagation of gravity waves is strongly affected by tidal waves as they modulate the mean background wind field and vice versa, which is not yet fully understood and not adequately implemented in many circulation models. The daylight-capable Rayleigh-Mie-Raman (RMR) lidar at Kühlungsborn (54° N, 12° E) typically provides temperature data to investigate both wave phenomena during one full day or several consecutive days in the middle atmosphere between 30 and 75 km altitude. Outstanding weather conditions in May 2016 allowed for an unprecedented 10-day continuous lidar measurement, which shows a large variability of gravity waves and tides on timescales of days. Using a one-dimensional spectral filtering technique, gravity and tidal waves are separated according to their specific periods or vertical wavelengths, and their temporal evolution is studied. During the measurement period a strong 24 h wave occurs only between 40 and 60 km and vanishes after a few days. The disappearance is related to an enhancement of gravity waves with periods of 4-8 h. Wind data provided by ECMWF are used to analyze the meteorological situation at our site. The local wind structure changes during the observation period, which leads to different propagation conditions for gravity waves in the last days of the measurement period and therefore a strong GW activity. The analysis indicates a further change in wave-wave interaction resulting in a minimum of the 24 h tide. The observed variability of tides and gravity waves on timescales of a few days clearly demonstrates the importance of continuous measurements with high temporal and spatial resolution to detect interaction phenomena, which can help to improve parametrization schemes of GWs in general circulation models.

  13. Creating an educationally minded schedule: one approach to minimize the impact of duty hour standards on intern continuity clinic experience.

    PubMed

    DeBlasio, Dominick; Kerrey, M Kathleen; Sucharew, Heidi; Klein, Melissa

    2014-11-01

    To determine if implementing an educationally minded schedule utilizing consecutive night shifts can moderate the impact of the 2011 duty hour standards on education and patient continuity of care in longitudinal primary care experience (continuity clinic). A 14-month pre-post study was performed in continuity clinic with one supervising physician group and two intern groups. Surveys to assess attitudes and education were distributed to the supervising physicians and interns before and after the changes in duty hour standards. Intern groups' schedules were reviewed for the number of regular and alternative day clinic (i.e. primary care experience on a different weekday) sessions and patient continuity of care. Fifteen supervising physicians and 51 interns participated (25 in 2011, 26 in 2012). Intern groups' comfort when discussing patient issues, educational needs and teamwork perception did not differ. Supervising physicians' understanding of learning needs and provision of feedback did not differ between groups. Supervising physicians indicated a greater ability to provide feedback and understand learning needs during regular continuity clinic sessions compared with alternative day clinics (all p < 0.05). No significant difference was detected between intern groups in the number of regularly scheduled continuity clinics, alternative day clinics or patient continuity of care. The 2011 duty hour standards required significant alterations to intern schedules, but educationally minded scheduling limited impact on education and patient continuity in care.

  14. 42 CFR 495.368 - Combating fraud and abuse.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE... identified as an overpayment regardless of recoupment from such providers, within 60 days of discovery of the...

  15. Low-flow frequency analyses for streams in west-central Florida

    USGS Publications Warehouse

    Hammett, K.M.

    1985-01-01

    The log-Pearson type III distribution was used for defining low-flow frequency at 116 continuous-record streamflow stations in west-central Florida. Frequency distributions were calculated for 1, 3, 7, 14, 30, 60, 90, 120, and 183 consecutive-day periods for recurrence intervals of 2, 5, 10, and 20 years. Discharge measurements at more than 100 low-flow partial-record stations and miscellaneous discharge-measurement stations were correlated with concurrent daily mean discharge at continuous-record stations. Estimates of the 7-day, 2-year; 7-day, 10-year; 30-day, 2-year; and 30-day, 10-year discharges were made for most of the low-flow partial-record and miscellaneous discharge-measurement stations based on those correlations. Multiple linear-regression analysis was used in an attempt to mathematically relate low-flow frequency data to basin characteristics. The resulting equations showed an apparent bias and were considered unsatisfactory for use in estimating low-flow characteristics. Maps of the 7-day, 10-year and 30-day, 10-year low flows are presented. Techniques that can be used to estimate low-flow characteristics at an ungaged site are also provided. (USGS)

  16. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.

    PubMed

    Panattoni, Laura; Stone, Ashley; Chung, Sukyung; Tai-Seale, Ming

    2015-03-01

    The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. The study included family medicine (n = 104) and internal medicine (n = 101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n = 12,688). Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third next-available appointment. Physician FTE was directly associated with better continuity of care received (0.172% per FTE, p < 0.001), better continuity of care provided (0.108% per FTE, p < 0.001), and better access to care (-0.033 days per FTE, p < 0.01), but worse patient satisfaction scores (-0.080% per FTE, p = 0.03). The continuity of care provided was a significant mediator (0.016% per FTE, p < 0.01) of the relationship between FTE and patient satisfaction; but overall, reduced clinical work hours were associated with better patient satisfaction (-0.053 % per FTE, p = 0.03). These results suggest that PCPs who choose to work fewer clinical hours may have worse continuity and access, but they may provide a better patient experience. Physician workforce planning should consider these care attributes when considering the role of part-time PCPs in practice redesign efforts and initiatives to meet the demand for primary care services.

  17. 40 CFR 92.706 - Approval of plan: Implementation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (CONTINUED) CONTROL OF AIR POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Recall Regulations § 92.706... days after the completion of such hearing, order the manufacturer or remanufacturer to provide prompt...

  18. The Role of Electronic Health Records in Structuring Nursing Handoff Communication and Maintaining Situation Awareness

    ERIC Educational Resources Information Center

    Alghenaimi, Said

    2012-01-01

    In healthcare institutions, work must continue 24 hours a day, 7 days a week. A team of nurses is needed to provide around-the-clock patient care, and this process requires transfer of patient care responsibilities, a process known as a "handoff." The present study explored the role of electronic health records in structuring handoff…

  19. Improving Genetics Education in Graduate and Continuing Health Professional Education: Workshop Summary

    ERIC Educational Resources Information Center

    Berger, Adam C.; Johnson, Samuel G.; Beachy, Sarah H.; Olson, Steve

    2015-01-01

    Many health care providers do not have either the knowledge or the tools they need in order to apply genetic information in their day-to-day practices. This lack of support is contributing to a substantial delay in the translation of genetic research findings, when appropriate, into improvement in patient outcomes within the health care system.…

  20. Space weather services: now and in the future

    NASA Astrophysics Data System (ADS)

    Kunches, J.; Murtagh, W.

    The NOAA Space Environment Center has provided continuous 24 hours per day 7 days per week space weather products and services to the United States and the international community via the International Space Environment Service for more than 30 years Over that time span an evolutionary process has occurred In the early days the products consisted of short text and coded messages to accommodate the communications technologies of the period The birth of the Internet made the sharing of graphical imagery and real-time data possible enabling service providers to communicate more information more quickly to the users Now in parallel with the advances in telecommunications the space weather user community has grown dramatically and is enunciating ever-stronger requirements back to the service providers The commercial airline community is probably the best example of an industry wanting more from space weather How are the users going to continue to change over the next 10-20 years and what services might they need How will they get this information and how might they use it This is the overall thrust of the presentation offering a look to the future and a challenge to the space weather community

  1. Hospital Patients Are Not Eating Their Full Meal: Results of the Canadian 2010-2011 nutritionDay Survey.

    PubMed

    Kent-Smith, Luiza; Eisenbraun, Corinne; Wile, Heather

    2016-03-01

    nutritionDay is a 1-day cross-sectional survey identifying how nutrition care is provided. This paper provides results of the first 2 Canadian nutritionDay surveys. In November 2010 and 2011, data from standardized questionnaires were collected from 193 units in Canadian hospitals consisting of unit demographics and patient information including weight history, health status, nutrition assessment, nutrition therapy, food intake and 30-day outcomes. Results indicated that overall, 46% of the 1905 patients reported weight loss in the previous 3 months, and in half of these it was greater than 5 kg. Only 50% of the units had nutrition teams and nutrition therapy was provided to less than 14% of patients. More than 50% of patients ate less than normal in the previous week and 57% ate less than half of their meal on nutritionDay. Within the next 30 days the majority of patients went home, 10% remained in hospital, and 6% were readmitted. In this study, nutritionDay provided relevant information on nutrition assessment, weight history, food intake, nutrition therapy, length of stay, and outcomes in participating Canadian institutions. Data from 2010 and 2011 can help to both reflect on current practices and define continuous improvements through benchmarking with the overall goal of mitigating suboptimal nutrition intake during hospitalization.

  2. Mapping the Riverscape of the Middle Fork John Day River with Structure-from-Motion

    NASA Astrophysics Data System (ADS)

    Dietrich, J. T.

    2014-12-01

    Aerial photography has proven an efficient method to collect a wide range of continuous variables for large sections of rivers. These data include variables such as the planimetric shape, low-flow and bank-full widths, bathymetry, and sediment sizes. Mapping these variables in a continuous manner allows us to explore the heterogeneity of the river and build a more complete picture of the holistic riverscape. To explore a low-cost option for aerial photography and riverscape mapping, I used the combination of a piloted helicopter and an off-the-shelf digital SLR camera to collect aerial imagery for a 32 km segment of the Middle Fork John Day River in eastern Oregon. This imagery was processed with Structure-from-Motion (SfM) photogrammetry to produce high-resolution 10 cm orthophotos and digital surface models that were used to extract riverscape variables. The Middle Fork John Day River is an important spawning river for anadromous Chinnook and Steelhead and has been the focus of widespread restoration and conservation activities in response to the legacies of extensive grazing and mining activity. By mapping the riverscape of the Middle Fork John Day, I explored downstream relationships between several geomorphic variables with hyperscale analysis. These riverscape data also provided an opportunity to make a continuous map of habitat suitability for migrating adult Chinook. Both the geomorphic and habitat suitability analysis provide an important assessment of the natural variation in the river and the impact of human modification, both positive and negative.

  3. 40 CFR 63.10021 - How do I demonstrate continuous compliance with the emission limitations, operating limits, and...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... need only provide a single pre- and post-tune-up value rather than continual values before and after...) Within 45 days of the exceedance or at the time of the annual compliance test, whichever comes first, conduct a PM emissions compliance test to determine compliance with the PM emissions limit and to verify...

  4. 40 CFR 63.10021 - How do I demonstrate continuous compliance with the emission limitations, operating limits, and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... need only provide a single pre- and post-tune-up value rather than continual values before and after...) Within 45 days of the exceedance or at the time of the annual compliance test, whichever comes first, conduct a PM emissions compliance test to determine compliance with the PM emissions limit and to verify...

  5. 78 FR 67956 - Rates for Interstate Inmate Calling Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ... facility employees. Our Order ensures that security features that are part of modern ICS continue to be...]iven modern-day technology, the costs for providing secure phone and video services to correctional...

  6. Tips for Living with Scleroderma

    MedlinePlus

    ... raw foods – about 50% of your diet – especially dark, leafy greens to provide chlorophyll and other nutrients. ... normal levels to dangerously high levels in a matter of days. If it continues without treatment, the ...

  7. Prescription duration and treatment episodes in oral glucocorticoid users: application of the parametric waiting time distribution.

    PubMed

    Laugesen, Kristina; Støvring, Henrik; Hallas, Jesper; Pottegård, Anton; Jørgensen, Jens Otto Lunde; Sørensen, Henrik Toft; Petersen, Irene

    2017-01-01

    Glucocorticoids are widely used medications. In many pharmacoepidemiological studies, duration of individual prescriptions and definition of treatment episodes are important issues. However, many data sources lack this information. We aimed to estimate duration of individual prescriptions for oral glucocorticoids and to describe continuous treatment episodes using the parametric waiting time distribution. We used Danish nationwide registries to identify all prescriptions for oral glucocorticoids during 1996-2014. We applied the parametric waiting time distribution to estimate duration of individual prescriptions each year by estimating the 80th, 90th, 95th and 99th percentiles for the interarrival distribution. These corresponded to the time since last prescription during which 80%, 90%, 95% and 99% of users presented a new prescription for redemption. We used the Kaplan-Meier survival function to estimate length of first continuous treatment episodes by assigning estimated prescription duration to each prescription and thereby create treatment episodes from overlapping prescriptions. We identified 5,691,985 prescriptions issued to 854,429 individuals of whom 351,202 (41%) only redeemed 1 prescription in the whole study period. The 80th percentile for prescription duration ranged from 87 to 120 days, the 90th percentile from 116 to 150 days, the 95th percentile from 147 to 181 days, and the 99th percentile from 228 to 259 days during 1996-2014. Based on the 80th, 90th, 95th and 99th percentiles of prescription duration, the median length of continuous treatment was 113, 141, 170 and 243 days, respectively. Our method and results may provide an important framework for future pharmacoepidemiological studies. The choice of which percentile of the interarrival distribution to apply as prescription duration has an impact on the level of misclassification. Use of the 80th percentile provides a measure of drug exposure that is specific, while the 99th percentile provides a sensitive measure.

  8. [Continuous drug infusion in terminal cancer].

    PubMed

    Ottesen, S; Manger, A T; Monrad, L

    1992-05-30

    Today's technology provides portable pumps which facilitate continuous infusion of drugs to relieve suffering in terminal disease. Subcutaneous and epidural infusion is now frequently used in our hospital. The most common indications are gastrointestinal obstruction, impaired absorption of drugs, refractory side effects of oral medication or poor compliance because good pain relief is no longer possible orally. During the last days of life, this method may be the only possible approach to good comfort and relief from terminal agitation and anxiety. Of the patients referred to the advisory group for seriously ill and dying in 1990, 64% received subcutaneous infusions and 15% epidural infusions during the last days or weeks of life. Continuous infusion of drugs from portable pumps has become an almost indispensible method of treatment in an ordinary clinic.

  9. 'For me it's about not feeling like I'm on a diet': a thematic analysis of women's experiences of an intermittent energy restricted diet to reduce breast cancer risk.

    PubMed

    Donnelly, L S; Shaw, R L; Pegington, M; Armitage, C J; Evans, D G; Howell, A; Harvie, M N

    2018-06-21

    Weight-loss programmes requiring intermittent energy restriction offer an alternative to continuous energy restriction programmes that typically have low adherence. We reported greater weight loss, better adherence and spontaneous reduced energy intake on healthy eating days with intermittent as opposed to continuous energy restriction. The present study aims to explore why intermittent energy restriction diets exert these positive effects. Semi-structured interviews were carried out with 13 women aged 39-62 years, who followed a 4-month intermittent energy restriction (2 days of low energy/low carbohydrate, 5 days of healthy eating). Nine of the 13 women successfully lost >5% of their total body weight. Data were analysed using thematic analysis. The intermittent regimen redefined the meaning of dieting and normal eating. Women reconceptualised dieting as only two low energy days per week, even though this often differed from their pre-diet eating patterns. Women reported that they could adhere more closely to the rules of the intermittent diet compared to previously attempted continuous diets. They found that the intermittent diet was less cognitively demanding because the restrictive and clear rules of the intermittent diet were easier to understand and easier to follow than with continuous dieting. Many participants found intermittent dieting preferable to previous experiences of continuous dieting. The findings provide some insight into the ways in which intermittent dieting is successful, and why it could be considered a viable alternative to continuous energy restriction for weight loss. © 2018 The British Dietetic Association Ltd.

  10. Differences in regional blood volume during a 28-day period of abstinence in chronic cannabis smokers.

    PubMed

    Sneider, Jennifer T; Pope, Harrison G; Silveri, Marisa M; Simpson, Norah S; Gruber, Staci A; Yurgelun-Todd, Deborah A

    2008-08-01

    Cerebral blood volume (CBV) studies have provided important insight into the effects of illicit substances such as cannabis. The present study examined changes in regional blood volume in the frontal and temporal lobe, and the cerebellum during 28 days of supervised abstinence from cannabis. Dynamic susceptibility contrast MRI (DSCMRI) data were collected on 15 current, long-term cannabis users between 6 and 36 h after the subjects' last reported cannabis use (Day 0), and again after 7 and 28 days of abstinence. Resting state CBV images were also acquired on 17 healthy comparison subjects. The present findings demonstrate that at Day 7, cannabis users continued to display increased blood volumes in the right frontal region, the left and right temporal regions, and the cerebellum. However, after 28 days of abstinence, only the left temporal area and cerebellum showed significantly increased CBV values in cannabis users. These findings suggest that while CBV levels begin to normalize with continued abstinence from cannabis, specifically in frontal areas, other temporal and cerebellar brain regions show slower CBV decreases.

  11. Continuous delivery of ropinirole reverses motor deficits without dyskinesia induction in MPTP-treated common marmosets.

    PubMed

    Stockwell, K A; Virley, D J; Perren, M; Iravani, M M; Jackson, M J; Rose, S; Jenner, P

    2008-05-01

    L-DOPA treatment of Parkinson's disease induces a high incidence of motor complications, notably dyskinesia. Longer acting dopamine agonists, e.g. ropinirole, are thought to produce more continuous dopaminergic stimulation and less severe dyskinesia. However, standard oral administration of dopamine agonists does not result in constant plasma drug levels, therefore, more continuous drug delivery may result in both prolonged reversal of motor deficits and reduced levels of dyskinesia. Therefore, we compared the effects of repeated oral administration of ropinirole to constant subcutaneous infusion in MPTP-treated common marmosets. Animals received oral administration (0.4 mg/kg, BID) or continuous infusion of ropinirole (0.8 mg/kg/day) via osmotic minipumps for 14 days (Phase I). The treatments were then switched and continued for a further 14 days (Phase II). In Phase I, locomotor activity was similar between treatment groups but reversal of motor disability was more pronounced in animals receiving continuous infusion. Dyskinesia intensity was low in both groups however there was a trend suggestive of less marked dyskinesia in those animals receiving continuous infusion. In Phase II, increased locomotor activity was maintained but animals switched from oral to continuous treatment showing an initial period of enhanced locomotor activity. The reversal of motor disability was maintained in both groups, however, motor disability tended towards greater improvement following continuous infusion. Importantly, dyskinesia remained low in both groups suggesting that constant delivery of ropinirole neither leads to priming nor expression of dyskinesia. These results suggest that a once-daily controlled-release formulation may provide improvements over existing benefits with standard oral ropinirole in Parkinson's disease patients.

  12. STS-95 Day 08 Highlights

    NASA Technical Reports Server (NTRS)

    1998-01-01

    On this eighth day of the STS-95 mission, the flight crew, Cmdr. Curtis L. Brown, Pilot Steven W. Lindsey, Mission Specialists Scott E. Parazynski, Stephen K. Robinson, and Pedro Duque, and Payload Specialists Chiaki Mukai and John H. Glenn, continue to perform microgravity experiments. Specialist John Glenn completes a back-pain questionnaire as part of a study of how the muscle, intervertebral discs and bone marrow change due to microgravity. The results will then be compared with data provided by astronauts during previous missions. Glenn continues blood sample analysis and blood processing that are part of the Protein Turnover (PTO) experiment, which is studying the muscle loss that occurs during space flight.

  13. Efficacy of a pressure-sensing mattress cover system for reducing interface pressure: study protocol for a randomized controlled trial.

    PubMed

    Wong, Holly; Kaufman, Jaime; Baylis, Barry; Conly, John M; Hogan, David B; Stelfox, Henry T; Southern, Danielle A; Ghali, William A; Ho, Chester H

    2015-09-29

    Interface pressure is a key risk factor in the development of pressure ulcers. Visual feedback of continuous interface pressure between the body and support surface could inform clinicians on repositioning strategies and play a key role in an overall strategy for the prevention and management of pressure ulcers. A parallel two-group randomized controlled clinical trial will be conducted to study the effect of continuous pressure imaging on reducing interface pressure and on the incidence of pressure ulcers in vulnerable hospital patients. A total of 678 eligible consenting inpatients at risk of pressure ulcer development in a tertiary acute care institution will be randomly allocated to either having the ForeSite PT™ system with the liquid-crystal display monitor turned on to provide visual feedback to the clinicians while also collecting continuous interface pressure data (intervention group) or to having the ForeSite PT™ system with monitor turned off (that is, not providing visual feedback) but still collecting continuous interface pressure data (control group), in a ratio of 1:1. Continuous interface pressure data will be collected in both groups for 3 days (72 h). Data collection will continue until discharge for a subset of approximately 60 patients. The primary outcome will be the differences in the two groups' interface pressure analysis. Interface pressure readings will be collected through hourly samplings of continuous interface pressure recordings. Secondary outcomes will be the differences between the two groups in pressure-related skin and soft tissue changes in areas at risk of pressure ulcer (obtained at baseline within 24 h of admission) and on the third day of the trial or at discharge and perceptions of the intervention by patients and clinicians (obtained on the third day or at discharge). This will be the first randomized controlled trial to investigate the effect of visual feedback with continuous interface pressure of vulnerable hospital patients across different care settings, and the association between interface pressure and development of pressure-related skin and soft tissue changes. The results could provide important information to guide clinical practice in the prevention and management of pressure ulcers. ClinicalTrials.gov NCT02325388 (date of registration: 24 December 2014).

  14. 75 FR 11508 - Revision of Land Management Plan for the Uwharrie National Forest

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ... economic benefits to local communities. The proposed action includes direction to provide well-maintained tourism-related infrastructure that would continue to attract visitors. Nature Hikes and Day Use More...

  15. The Air Force Fitness Program and the Challenge of Creating a More Fit Force

    DTIC Science & Technology

    2012-06-08

    their fitness habits. In the early 1990s the Air Force transitioned to the bike test. The Weight Management Program continued with little change. The...member reported that he had lost ten pounds and was walking every day. I along with my Chief Master Sergeant continued to monitor the progress of the... continually high standard. The study 12 will show that the current Air Force fitness program does provide a basic view of fitness, but it does

  16. Chronic intracerebroventricular infusion of nociceptin/orphanin FQ increases food and ethanol intake in alcohol-preferring rats.

    PubMed

    Cifani, Carlo; Guerrini, Remo; Massi, Maurizio; Polidori, Carlo

    2006-11-01

    Central administration of low doses of nociceptin/orphanin FQ (N/OFQ), the endogenous ligand of the opioid-like orphan receptor NOP, have been shown to reduce ethanol consumption, ethanol-induced conditioned place preference and stress-induced reinstatement of alcohol-seeking behavior in alcohol preferring rats. The present study evaluated the effect of continuous (7 days) lateral brain ventricle infusions of N/OFQ (0, 0.25, 1, 4, and 8 microg/h), by means of osmotic mini-pumps, on 10% ethanol intake in Marchigian-Sardinian alcohol-preferring (msP) rats provided 2h or 24h access to it. N/OFQ dose-dependently increased food intake in msP rats. On the other hand, in contrast to previous studies with acute injections, continuous lateral brain ventricle infusion of high doses of N/OFQ increased ethanol consumption when the ethanol solution was available for 24h/day or 2h/day. The present study demonstrates that continuous activation of the opioidergic N/OFQ receptor does not blunt the reinforcing effects of ethanol. Moreover, the data suggest that continuous activation of the opioidergic N/OFQ receptor is not a suitable way to reduce alcohol abuse.

  17. Fatal Hormonema dematioides Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis: Criteria for Organism Identification and Review of Other Known Fungal Etiologic Agents

    PubMed Central

    Shin, Jong Hee; Lee, Sang Ku; Suh, Soon Pal; Ryang, Dong Wook; Kim, Nam Ho; Rinaldi, Michael G.; Sutton, Deanna A.

    1998-01-01

    We report a fatal case a fungal peritonitis caused by the yeast-like dematiaceous mould Hormonema dematioides in a 45-year-old woman. The woman had a 13-year history of insulin-dependent diabetes mellitus and had been on continuous ambulatory peritoneal dialysis for chronic renal failure. H. dematioides was repeatedly isolated from the dialysate culture specimens collected on days 3, 9, 16, and 20 of her hospital stay. Preliminary culture reports on day 7 of the growth of a yeast-like fungus, a probable Candida species, prompted the administration of fluconazole (FLU). Intraperitoneal and intravenous FLU failed to eliminate the mould, and the patient expired on day 21 of her hospital stay. We use this case to present what appears to be the first report of fungal peritonitis due to H. dematioides, to provide laboratorians with criteria for differentiating this organism from the similar mould Aureobasidium pullulans and from various yeast genera, and to provide a review of known fungal taxa inciting peritonitis. PMID:9650991

  18. Continuous femoral nerve block using 0.125% bupivacaine does not prevent early ambulation after total knee arthroplasty.

    PubMed

    Beebe, Michael J; Allen, Rachel; Anderson, Mike B; Swenson, Jeffrey D; Peters, Christopher L

    2014-05-01

    Continuous femoral nerve block has been shown to decrease opioid use, improve postoperative pain scores, and decrease length of stay. However, several studies have raised the concern that continuous femoral nerve block may delay patient ambulation and increase the risk of falls during the postoperative period. This study sought to determine whether continuous femoral nerve block with a single-shot sciatic block prevented early ambulation after total knee arthroplasty (TKA) and whether the technique was associated with adverse effects. Between January 2011 and January 2013, 77 consecutive patients undergoing primary TKAs at an orthopaedic specialty hospital received a continuous femoral nerve block for perioperative analgesia. The femoral block was placed preoperatively with an initial bolus and 76 (99%) patients received a single-shot sciatic nerve block performed at the same time. Fifty-eight percent (n = 45) received an initial bolus of 0.125% bupivacaine and 42% (n = 32) received 0.25% bupivacaine. All 77 patients received 0.125% bupivacaine infusion postoperatively with the continuous femoral nerve block. All patients were provided a knee immobilizer that was worn while they were out of bed and was used until 24 hours after removal of the block. All patients also used a front-wheeled walker to assist with ambulation. All 77 patients had complete records for assessing the end points of interest in this retrospective case series, including distance ambulated each day and whether in-hospital complications could be attributed to the patients' nerve blocks. Thirty-five patients (45%) ambulated for a mean distance of 19 ± 22 feet on the day of surgery. On postoperative Days 1 and 2, all 77 patients successfully ambulated a mean of 160 ± 112 and 205 ± 123 feet, respectively. Forty-eight patients (62%) had documentation of ascending/descending stairs during their hospital stay. No patient fell during the postoperative period, required return to the operating room, or readmission within 90 days of surgery. One patient experienced a transient foot drop related to the sciatic nerve block, which resolved by postoperative Day 1. Continuous femoral nerve block with dilute bupivacaine (0.125%) can be successfully used after TKA without preventing early ambulation. By taking active steps to prevent in-hospital falls, including the use of a knee immobilizer for ambulation while the block is in effect, patients can benefit from the analgesia provided by the block and still ambulate early after TKA. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  19. Ammonia photolysis and the greenhouse effect in the primordial atmosphere of the earth

    NASA Technical Reports Server (NTRS)

    Kuhn, W. R.; Atreya, S. K.

    1979-01-01

    Photochemical calculations indicate that in the prebiotic atmosphere of earth ammonia would have been irreversibly converted to N2 in less than 40 years if the ammonia surface mixing ratio were no more than 0.0001. However, if a continuous outgassing of ammonia were maintained, radiative-equilibrium calculations indicate that a surface mixing ratio of ammonia of 0.0001 or greater would provide a sufficient greenhouse effect to keep the surface temperature above freezing. With a 0.0001 mixing ratio of ammonia, 60% to 70% of the present-day solar luminosity would be adequate to maintain surface temperatures above freezing. A lower limit to the time constant for accumulation of an amount of nitrogen equivalent to the present day value is 10 my if the outgassing were such as to provide a continuous surface mixing ratio of ammonia of at least 0.00001.

  20. A randomised controlled trial of flow driver and bubble continuous positive airway pressure in preterm infants in a resource-limited setting.

    PubMed

    Mazmanyan, P; Mellor, K; Doré, C J; Modi, N

    2016-01-01

    The variable-flow flow driver (FD; EME) and continuous-flow bubble (Fisher-Paykel) continuous positive airway pressure (CPAP) systems are widely used. As these differ in cost and technical requirements, determining comparative efficacy is important particularly where resources are limited. We performed a randomised, controlled, equivalence trial of CPAP systems. We specified the margin of equivalence as 2 days. We analysed binary variables by logistical regression adjusted for gestation, and log transformed continuous variables by multiple linear regression adjusted for gestation, sex and antenatal steroids. A neonatal unit with no blood gas analyser or surfactant availability and limited X-ray and laboratory facilities Neonates <37 weeks of gestation. We provided CPAP at delivery followed by randomisation to FD or bubble (B). Primary outcome included total days receiving CPAP; secondary outcomes included days receiving CPAP, supplemental oxygen, ventilation, death, pneumothorax and nasal excoriation. We randomised 125 infants (B 66, FD 59). Differences in infant outcomes on B and FD were not statistically significant. The median (range) for CPAP days for survivors was B 0.8 (0.04 to 17.5), FD 0.5 (0.04 to 5.3). B:FD (95% CI) ratios were CPAP days 1.3 (0.9 to 2.1), CPAP plus supplementary oxygen days 1.2 (0.7 to 1.9). B:FD (95% CI) ORs were death 2.3 (0.2 to 28), ventilation 2.1 (0.5 to 9), nasal excoriation 1.2 (0.2 to 8) and pneumothorax 2.4 (0.2 to 26). In a resource-limited setting we found B CPAP equivalent to FD CPAP in the total number of days receiving CPAP within a margin of 2 days. ISRCTN22578364. 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/

  1. Baseline Psychosocial Characteristics Predict Frequency of Continuous Glucose Monitoring in Youth with Type 1 Diabetes.

    PubMed

    McGill, Dayna E; Volkening, Lisa K; Butler, Deborah A; Harrington, Kara R; Katz, Michelle L; Laffel, Lori M

    2018-05-04

    Consistent use of continuous glucose monitoring (CGM) has been associated with improved glycemic control in youth with type 1 diabetes (T1D). There are many barriers to device uptake and continued use. There is a need to understand patient-specific characteristics when considering CGM. We evaluated patterns of CGM use and associations between baseline psychosocial measures and frequency of CGM use over 1 year. Youth with T1D (n = 120), ages 8-18 years, completed questionnaires at CGM initiation and after 6 and 12 months assessing depressive symptoms, diabetes burden, and diabetes-specific and generic quality of life (QOL). Youth (51% male and 95% white) had mean age 12.7 ± 2.7 years, diabetes duration 6.1 ± 3.6 years, and glycated hemoglobin (HbA 1c ) 8.0 ± 0.8%. Over 1 year, 35% of youth used CGM 6 to 7 days per week, 45% used CGM 3-5 days per week, and 20% used CGM only 0-2 days per week. Youth who used CGM 3-7 days per week over 12 months had lower HbA 1c at months 9 and 12 than youth who used CGM 0-2 days per week (9 months: 7.9 ± 0.9% vs. 8.5 ± 1.1%, P = 0.006 and 12 months: 8.0 ± 0.9% vs. 8.5 ± 1.1%, P = 0.02). Those using CGM 0-2 days per week had greater endorsement of depressive symptoms and diabetes burden and reported lower QOL at baseline compared with those using CGM 3-7 days per week. CGM use for 3 or more days per week over 12 months had a protective effect on HbA 1c . Providers should consider addressing psychosocial parameters when initiating CGM to maximize uptake and promote continued use in youth with T1D.

  2. GADEP Continuous PM2.5 mass concentration data, VIIRS Day Night Band SDR (SVDNB), MODIS Terra Level 2 water vapor profiles (infrared algorithm for atmospheric profiles for both day and night, NWS surface meteorological data

    EPA Pesticide Factsheets

    Data descriptions are provided at the following urls:GADEP Continuous PM2.5 mass concentration data - https://aqs.epa.gov/aqsweb/documents/data_mart_welcome.htmlhttps://www3.epa.gov/ttn/amtic/files/ambient/pm25/qa/QA-Handbook-Vol-II.pdfVIIRS Day Night Band SDR (SVDNB) http://www.class.ngdc.noaa.gov/saa/products/search?datatype_family=VIIRS_SDRMODIS Terra Level 2 water vapor profiles (infrared algorithm for atmospheric profiles for both day and night -MOD0&_L2; http://modis-atmos.gsfc.nasa.gov/MOD07_L2/index.html NWS surface meteorological data - https://www.ncdc.noaa.gov/isdThis dataset is associated with the following publication:Wang, J., C. Aegerter, and J. Szykman. Potential Application of VIIRS Day/Night Band for Monitoring Nighttime Surface PM2.5 Air Quality From Space. ATMOSPHERIC ENVIRONMENT. Elsevier Science Ltd, New York, NY, USA, 124(0): 55-63, (2016).

  3. Child-feeding practices and child overweight perceptions of family day care providers caring for preschool-aged children.

    PubMed

    Brann, Lynn S

    2010-01-01

    The purpose of this study was to evaluate the attitudes, feeding practices, and child overweight perceptions of family day-care providers caring for preschool-aged children and to examine whether child feeding practices differ based on child weight perceptions. One hundred twenty-three family day-care providers participated in this cross-sectional exploratory study and completed a self-administered survey measuring feeding attitudes and practices from the Child Feeding Questionnaire, demographic information, and self-reported height and weight. Participants selected a cut point to identify childhood overweight using male and female child figure drawings. Participants reported a high level of responsibility in feeding and monitoring of children's food intake. Differences were found in child feeding practices between family day-care providers based on their child weight perceptions for girls. Providers who selected the smaller girl figures as the cut point for overweight were more concerned about the children becoming overweight and used more restriction in child feeding compared with the providers who selected the larger girl figures. Health professionals should continue working with this population to promote positive feeding environments. Copyright 2010 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  4. A cost analysis of orthopedic foot surgery: can outpatient continuous regional analgesia provide the same standard of care for postoperative pain control at home without shifting costs?

    PubMed

    Saporito, Andrea; Calciolari, Stefano; Ortiz, Laura Gonzalez; Anselmi, Luciano; Borgeat, Alain; Aguirre, José

    2016-11-01

    Same-day surgery is common for foot surgery. Continuous regional anesthesia for outpatients has been shown effective but the economic impact on the perioperative process-related healthcare costs remains unclear. One hundred twenty consecutive patients were included in this assessor-blinded, prospective cohort study and allocated according to inclusion criteria in the day-care or in the in-patient group. Standardized continuous popliteal sciatic nerve block was performed in both groups for 48 h using an elastomeric pump delivering ropivacaine 0.2 % at a rate of 5 ml/h with an additional 5 ml bolus every 60 min. Outpatients were discharged the day of surgery and followed with standardized telephone interviews. The total direct health costs of both groups were compared. Moreover, the difference in treatment costs and the difference in terms of quality of care and effectiveness between the groups were compared. Total management costs were significantly reduced in the day-care group. There was no difference between the groups regarding pain at rest and with motion, persistent pain after catheter removal and the incidence of PONV. Persistent motor block and catheter inflammation/infection were comparable in both groups. There was neither a difference in the number of unscheduled ambulatory visits nor in the number of readmissions. Day-care continuous regional analgesia leads to an overall positive impact on costs by decreasing the incidence of unplanned ambulatory visits and unscheduled readmissions, without compromising on the quality of analgesia, patients' satisfaction, and safety.

  5. KSC-00pp0623

    NASA Image and Video Library

    2000-05-03

    The night sky is briefly turned bright as day with the launch of the Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  6. Feasibility of Continuous Frying System to Improve the Quality Indices of Palm Olein for the Production of Extruded Product.

    PubMed

    Ahmad Tarmizi, Azmil Haizam; Ahmad, Karimah

    2015-01-01

    Comparative frying studies on the processing of extruded product were conducted under intermittent and continuous frying conditions using two separate frying systems, i.e batch and pilot scale continuous fryers, respectively. Thermal resistance of palm olein were assessed for a total of 5 days of frying operation at 155°C - the unconventional frying temperature gave the product moisture content of 3% after intermittent and continuous frying for 2.5 min and 2 min, respectively. The formation of free fatty acid in palm olein in the case of intermittent frying was more than 2-fold higher compared to its counterpart (0.66%). Smoke point inversely evolved with oil acidity: the value dropped progressively from 215 to 177°C and from 219 to 188°C when extruded product was intermittently and continuously fried, respectively. In the light of induction period, repeated frying exhibited a gradual decrease in the value after 5 days of frying (12.2 h). Interestingly, continuous frying gave somewhat similar induction period, as demonstrated by fresh palm olein, across frying time. Frying at lower temperature, to some extent, provides opportunity for palm olein to retain 74% of its initial vitamin E during continuous frying. This benefit, however, is somehow denied when extruded product was processed under intermittent frying conditions--only 27% of vitamin E was remained at the end of frying session. Regardless of frying protocols, transient in polar compounds was minimal and hence comparable. The colour in the case of continuous frying appeared to be darker due to higher degree of oil utilisation for frying. The data obtained will provide useful information for food processors on how palm olein behaves when frying is undertaken under different frying protocols.

  7. Continuous, daily levonorgestrel/ethinyl estradiol vs. 21-day, cyclic levonorgestrel/ethinyl estradiol: efficacy, safety and bleeding in a randomized, open-label trial.

    PubMed

    Teichmann, Alexander; Apter, Dan; Emerich, Janusz; Greven, Klaus; Klasa-Mazurkiewicz, Dagmara; Melis, Giambi B; Spaczynski, Marek; Grubb, Gary S; Constantine, Ginger D; Spielmann, Daniele

    2009-12-01

    This Phase 3, randomized, open-label, multicenter study conducted at 44 sites in Europe evaluated the safety and efficacy of a continuous, daily regimen of levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg compared with a 21-day, cyclic LNG 100 mcg/EE 20 mcg regimen. Three hundred twenty-three healthy women were randomized to continuous LNG 90 mcg/EE 20 mcg and 318 subjects to cyclic LNG 100 mcg/EE 20 mcg for 1 year (13 pill packs). Pearl index, adverse event (AE) incidence and bleeding profiles were assessed. No pregnancies occurred with the continuous oral contraceptive (OC) (Pearl index=0.00). As the study progressed, the percentage of women who achieved amenorrhea during each 28-day pill pack increased: 40% at pill pack 7, 53% at pill pack 13. The percentage of women with no bleeding [with or without spotting (defined as not requiring sanitary protection)] was 50%, 69% and 79% at pill packs 3, 7 and 13, respectively. The incidence of AEs was similar to that of the cyclic OC (except for metrorrhagia and vaginal bleeding in the first 6 months). Continuous LNG 90 mcg/EE 20 mcg was shown to be a safe and effective OC in this direct comparison to a cyclic OC. Suppression of menses and the potential for no bleeding requiring sanitary protection may be provided by this continuous, low-dose OC.

  8. Streamflow, water quality, and constituent loads and yields, Scituate Reservoir Drainage Area, Rhode Island, water year 2015

    USGS Publications Warehouse

    Smith, Kirk P.

    2018-05-11

    Streamflow and concentrations of sodium and chloride estimated from records of specific conductance were used to calculate loads of sodium and chloride during water year (WY) 2015 (October 1, 2014, through September 30, 2015) for tributaries to the Scituate Reservoir, Rhode Island. Streamflow and water-quality data used in the study were collected by the U.S. Geological Survey and the Providence Water Supply Board. Streamflow was measured or estimated by the U.S. Geological Survey following standard methods at 23 streamgages; 14 of these streamgages are equipped with instrumentation capable of continuously monitoring water level, specific conductance, and water temperature. Water-quality samples were collected at 36 sampling stations by the Providence Water Supply Board and at 14 continuous-record streamgages by the U.S. Geological Survey during WY 2015 as part of a long-term sampling program; all stations are in the Scituate Reservoir drainage area. Water-quality data collected by the Providence Water Supply Board are summarized by using values of central tendency and are used, in combination with measured (or estimated) streamflows, to calculate loads and yields (loads per unit area) of selected water-quality constituents for WY 2015.The largest tributary to the reservoir (the Ponaganset River, which was monitored by the U.S. Geological Survey) contributed a mean streamflow of 25 cubic feet per second to the reservoir during WY 2015. For the same time period, annual mean streamflows measured (or estimated) for the other monitoring stations in this study ranged from about 0.38 to about 14 cubic feet per second. Together, tributaries (equipped with instrumentation capable of continuously monitoring specific conductance) transported about 1,500,000 kilograms of sodium and 2,400,000 kilograms of chloride to the Scituate Reservoir during WY 2015; sodium and chloride yields for the tributaries ranged from 8,000 to 54,000 kilograms per square mile and from 12,000 to 91,000 kilograms per square mile, respectively.At the stations where water-quality samples were collected by the Providence Water Supply Board, the medians of the median concentrations were the following: for chloride, 29.5 milligrams per liter; for nitrite, 0.002 milligrams per liter as nitrogen; for nitrate, 0.05 milligrams per liter as nitrogen; for orthophosphate, 0.08 milligrams per liter as phosphate; and for total coliform bacteria and Escherichia coli, 440 and 20 colony forming units per 100 milliliters, respectively. The medians of the median daily loads (and yields) of chloride, nitrite, nitrate, orthophosphate, and total coliform and Escherichia coli bacteria were 170 kilograms per day (79 kilograms per day per square mile), 14 grams per day (5.2 grams per day per square mile), 670 grams per day (190 grams per day per square mile), 640 grams per day (210 grams per day per square mile), 18,000 million colony forming units per day (7,600 million colony forming units per day per square mile), and 1,200 million colony forming units per day (810 million colony forming units per day per square mile), respectively.

  9. Streamflow, water quality and constituent loads and yields, Scituate Reservoir drainage area, Rhode Island, water year 2014

    USGS Publications Warehouse

    Smith, Kirk P.

    2016-05-03

    Streamflow and concentrations of sodium and chloride estimated from records of specific conductance were used to calculate loads of sodium and chloride during water year (WY) 2014 (October 1, 2013, through September 30, 2014) for tributaries to the Scituate Reservoir, Rhode Island. Streamflow and water-quality data used in the study were collected by the U.S. Geological Survey and the Providence Water Supply Board in the cooperative study. Streamflow was measured or estimated by the U.S. Geological Survey following standard methods at 23 streamgages; 14 of these streamgages are equipped with instrumentation capable of continuously monitoring water level, specific conductance, and water temperature. Water-quality samples were collected at 37 sampling stations by the Providence Water Supply Board and at 14 continuous-record streamgages by the U.S. Geological Survey during WY 2014 as part of a long-term sampling program; all stations are in the Scituate Reservoir drainage area. Water-quality data collected by the Providence Water Supply Board are summarized by using values of central tendency and are used, in combination with measured (or estimated) streamflows, to calculate loads and yields (loads per unit area) of selected water-quality constituents for WY 2014.The largest tributary to the reservoir (the Ponaganset River, which was monitored by the U.S. Geological Survey) contributed a mean streamflow of 23 cubic feet per second to the reservoir during WY 2014. For the same time period, annual mean streamflows measured (or estimated) for the other monitoring stations in this study ranged from about 0.35 to about 14 cubic feet per second. Together, tributaries (equipped with instrumentation capable of continuously monitoring specific conductance) transported about 1,200,000 kilograms of sodium and 2,100,000 kilograms of chloride to the Scituate Reservoir during WY 2014; sodium and chloride yields for the tributaries ranged from 7,700 to 45,000 kilograms per year per square mile and from 12,000 to 75,000 kilograms per year per square mile, respectively.At the stations where water-quality samples were collected by the Providence Water Supply Board, the median of the median chloride concentrations was 24 milligrams per liter, median nitrite concentration was 0.002 milligrams per liter as nitrogen (N), median nitrate concentration was 0.01 milligrams per liter as N, median orthophosphate concentration was 0.07 milligrams per liter as phosphate, and median concentrations of total coliform bacteria and Escherichia coli were 320 and 20 colony forming units per 100 milliliters, respectively. The medians of the median daily loads (and yields) of chloride, nitrite, nitrate, orthophosphate, and total coliform and Escherichia coli bacteria were 62 kilograms per day (42 kilograms per day per square mile), 19 grams per day (6.1 grams per day per square mile), 79 grams per day (36 grams per day per square mile), 380 grams per day (150 grams per day per square mile), 13,000 million colony forming units per day (8,300 million colony forming units per day per square mile), and 1,000 million colony forming units per day (470 million colony forming units per day per square mile), respectively.

  10. Lifetime testing UV LEDs for use in the LISA charge management system

    NASA Astrophysics Data System (ADS)

    Hollington, D.; Baird, J. T.; Sumner, T. J.; Wass, P. J.

    2017-10-01

    As a future charge management light source, UV light-emitting diodes (UV LEDs) offer far superior performance in a range of metrics compared to the mercury lamps used in the past. As part of a qualification program a number of short wavelength UV LEDs have been subjected to a series of lifetime tests for potential use on the laser interferometer space antenna (LISA) mission. These tests were performed at realistic output levels for both fast and continuous discharging in either a DC or pulsed mode of operation and included a DC fast discharge test spanning 50 days, a temperature dependent pulsed fast discharge test spanning 21 days and a pulsed continuous discharge test spanning 507 days. Two types of UV LED have demonstrated lifetimes equivalent to over 25 years of realistic mission usage with one type providing a baseline for LISA and the other offering a backup solution.

  11. Labor Day and the war on workers.

    PubMed Central

    Rosner, D; Markowitz, G

    1999-01-01

    We celebrate Labor Day every year with barbecues and picnics, rarely remembering that the holiday was born in the midst of tremendous labor struggles to improve working conditions. In the last century, 16-hour workdays and 6- and 7-day workweeks led to terribly high injury rates in the nation's mines and mills. Thousands upon thousands of workers died, caught in the grinding machinery of our growing industries. Today, despite improvements, thousands of workers still die in what has been described as a form of war on the American workforce. This commentary reminds us of the historical toll in lives and limbs that workers have paid to provide us with our modern prosperity. It also reminds us that the continuing toll is far too high and that workers who died and continue to die in order to produce our wealth deserve to be remembered and honored on this national holiday. PMID:10474546

  12. The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada

    PubMed Central

    Leddin, Desmond; Armstrong, David; Borgaonkar, Mark; Bridges, Ronald J; Fallone, Carlo A; Telford, Jennifer J; Chen, Ying; Colacino, Palma; Sinclair, Paul

    2013-01-01

    BACKGROUND: Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time. METHODS: During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005. RESULTS: Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (P<0.05); the wait time to same-day consultation and procedure was shorter in 2012 than in 2008 (78 days versus 101 days; P<0.05), but continued to be longer than in 2005 (P<0.05). The total wait time remained longest for screening colonoscopy, increasing from 201 days in 2008 to 279 days in 2012 (P<0.05). DISCUSSION: Wait times for gastroenterology services continue to exceed recommended targets, remain unchanged since 2008 and exceed wait times reported in 2005. PMID:23472243

  13. From Prime to Extended Mission: Evolution of the MER Tactical Uplink Process

    NASA Technical Reports Server (NTRS)

    Mishkin, Andrew H.; Laubach, Sharon

    2006-01-01

    To support a 90-day surface mission for two robotic rovers, the Mars Exploration Rover mission designed and implemented an intensive tactical operations process, enabling daily commanding of each rover. Using a combination of new processes, custom software tools, a Mars-time staffing schedule, and seven-day-a-week operations, the MER team was able to compress the traditional weeks-long command-turnaround for a deep space robotic mission to about 18 hours. However, the pace of this process was never intended to be continued indefinitely. Even before the end of the three-month prime mission, MER operations began evolving towards greater sustainability. A combination of continued software tool development, increasing team experience, and availability of reusable sequences first reduced the mean process duration to approximately 11 hours. The number of workshifts required to perform the process dropped, and the team returned to a modified 'Earth-time' schedule. Additional process and tool adaptation eventually provided the option of planning multiple Martian days of activity within a single workshift, making 5-day-a-week operations possible. The vast majority of the science team returned to their home institutions, continuing to participate fully in the tactical operations process remotely. MER has continued to operate for over two Earth-years as many of its key personnel have moved on to other projects, the operations team and budget have shrunk, and the rovers have begun to exhibit symptoms of aging.

  14. Measuring Stability and Security in Iraq

    DTIC Science & Technology

    2009-06-01

    preventing judges from receiving registered firearms. The U.S. Marshal Service continues to provide handguns to judges and their security details and...in the South, a trend expected to continue throughout 2010. Overall, crude oil production peaked at 2.54 million barrels per day (mbpd) in...the best way to utilize MoI human and material resources. The result of this commission was the MoI 2009 training plan, which addresses the issue of

  15. Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval.

    PubMed

    Nappi, Rossella E; Lobo Abascal, Paloma; Hsieh, Jennifer; Micheletti, Marie-Christine

    2017-01-01

    To evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI). This post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy. Subjects recorded bleeding and spotting episodes daily using electronic diaries. Logistic regression analyses are reported as ORs with 95% CIs. There was a 10% increase (OR =1.102; 95% CI: 1.006-1.206) in the likelihood of reporting no scheduled bleeding for each additional 91-day cycle completed. From the third 91-day cycle, more than one fifth of women reported no scheduled bleeding (third cycle =23% [121/533]; fourth cycle =22% [97/446]). Among women who reported no scheduled bleeding at Cycle 1 (136/758 [18%]), ≥45% showed sustained lack of scheduled bleeding in later cycles. There were increases of 53% (OR =1.531; 95% CI: 1.393-1.683) and 31% (OR =1.307; 95% CI: 1.205-1.418) in the likelihood of reporting 0 to ≤6 days vs >6 days of unscheduled bleeding and spotting, respectively, for each additional 91-day cycle. By Cycle 2, more than 80% of women reported no unscheduled bleeding or ≤6 days of unscheduled bleeding during each 91-day cycle. Improved cycle control with decreased bleeding over time was shown during extended-regimen COC with 30 µg EE/150 µg LNG for 84 days and continuous low-dose EE instead of the traditional 7-day HFI. Women considering this regimen should be informed that those who complete at least one 91-day COC cycle will likely experience less bleeding/spotting in future cycles.

  16. Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval

    PubMed Central

    Nappi, Rossella E; Lobo Abascal, Paloma; Hsieh, Jennifer; Micheletti, Marie-Christine

    2017-01-01

    Purpose To evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI). Patients and methods This post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy. Subjects recorded bleeding and spotting episodes daily using electronic diaries. Logistic regression analyses are reported as ORs with 95% CIs. Results There was a 10% increase (OR =1.102; 95% CI: 1.006–1.206) in the likelihood of reporting no scheduled bleeding for each additional 91-day cycle completed. From the third 91-day cycle, more than one fifth of women reported no scheduled bleeding (third cycle =23% [121/533]; fourth cycle =22% [97/446]). Among women who reported no scheduled bleeding at Cycle 1 (136/758 [18%]), ≥45% showed sustained lack of scheduled bleeding in later cycles. There were increases of 53% (OR =1.531; 95% CI: 1.393–1.683) and 31% (OR =1.307; 95% CI: 1.205–1.418) in the likelihood of reporting 0 to ≤6 days vs >6 days of unscheduled bleeding and spotting, respectively, for each additional 91-day cycle. By Cycle 2, more than 80% of women reported no unscheduled bleeding or ≤6 days of unscheduled bleeding during each 91-day cycle. Conclusion Improved cycle control with decreased bleeding over time was shown during extended-regimen COC with 30 µg EE/150 µg LNG for 84 days and continuous low-dose EE instead of the traditional 7-day HFI. Women considering this regimen should be informed that those who complete at least one 91-day COC cycle will likely experience less bleeding/spotting in future cycles. PMID:29042818

  17. The 7-day contraceptive hormone-free interval should be consigned to history.

    PubMed

    MacGregor, E Anne; Guillebaud, John

    2018-06-26

    This review summarises the available data on the disadvantages of the 7-day contraceptive-free interval (CFI) of combined oral contraceptives (COCs), in contrast to shorter CFIs or continuous use - including flexible regimens - and provides recommendations for practice. Relevant papers were identified by Medline and PubMed. The final reference list was generated on the basis of relevance to the review, with priority given to systematic reviews and randomised controlled trials. There is considerable inter- and intra-individual variation in the absorption and metabolism of COCs. Even with perfect use, the loss of endocrine suppression during the standard 7-day CFI allows follicular development with the risk of escape ovulation in a vulnerable minority. This risk increases in typical users whenever the CFI is prolonged: late restarts are a common reason for pill omissions. Shortening or eliminating the CFI improves contraceptive efficacy using the lowest doses available, without evidence to date of compromised safety. There is no scientific evidence to support a 7-day CFI and it should be replaced either by a continuous flexible regimen, or extended regimens with a shortened CFI, prescribed first-line. In women preferring a monthly 'bleed', a 4-day CFI similarly provides a greater safety margin when pills are omitted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 μg/levonorgestrel 100 μg + ethinyl estradiol 10 μg.

    PubMed

    Krishnan, Sheila; Kiley, Jessica

    2010-08-10

    Extended-cycle oral contraceptives (OCs) are increasing in popularity in the United States. A new extended-cycle OC that contains the lowest doses of ethinyl estradiol (EE) and levonorgestrel (LNG) + continuous EE throughout the cycle is now available. It provides 84 days of a low-dose, combined active pill containing levonorgestrel 100 μg and ethinyl estradiol 20 μg. Instead of 7 days of placebo following the active pills, the regimen delivers 7 days of ethinyl estradiol 10 μg. Existing studies reveal a similar efficacy and adverse effect profile compared with other extended-regimen OCs. Specifically, the unscheduled bleeding profile is similar to other extended-cycle OCs and improves with the increase in the duration of use. Although lower daily doses of hormonal exposure have potential benefit, to our knowledge, there are no published studies indicating that this specific regimen offers a lower incidence of hormone-related side effects or adverse events. In summary, this new extended-cycle OC provides patients a low-dose, extended-regimen OC option without sacrificing efficacy or tolerability.

  19. Treatment of severe cancer pain by low-dose continuous subcutaneous morphine.

    PubMed

    Drexel, H; Dzien, A; Spiegel, R W; Lang, A H; Breier, C; Abbrederis, K; Patsch, J R; Braunsteiner, H

    1989-02-01

    In a prospective and intraindividually controlled trial, we have compared the efficacy and safety of a continuous subcutaneous morphine infusion with conventional intermittent oral or subcutaneous morphine application. Twenty-eight in-patients with cancer pain received a short-term infusion lasting 2-42 days, and 8 out-patients underwent long-term infusion from 49 to 197 days during the terminal stage of their disease. Continuous subcutaneous morphine infusion significantly (P less than 0.001) improved both pain and quality of life when compared to conventional morphine application. With continuous infusion, 5-48 mg (median 19 mg) of morphine was required daily, significantly (P less than 0.001) less than the 10-90 mg (median 50 mg) necessary with conventional use. As a result of lower dosage, side effects under continuous infusion were infrequent and mild. Constipation occurred in 3 of the 36 patients and was always controlled by the addition of laxatives; no nausea, sedation or respiratory depression were observed. Signs of tolerance developed in 2 patients on long-term infusion, but the use of continuous subcutaneous methadone for 2 weeks reversed the tolerance. The study presented indicates that low-dose continuous subcutaneous morphine provides a valuable treatment modality for severe terminal cancer pain exhibiting a high degree of both efficacy and safety.

  20. 1997 News Releases | NREL

    Science.gov Websites

    Continues Day 8 - St. Francis, Kan. to Limon, Color. - (6/26/97) Sunrayce 97 Continues Day 7 - Smith Center to St. Francis - (6/25/97) Sunrayce 97 Continues Day 6 - Manhattan to Smith Center - (6/24/97

  1. Photovoltaic dryer with dual packed beds for drying medical herb

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

    Abdel-Rehim, Z.S.; Fahmy, F.H.

    1998-03-01

    This work presents design and optimization of a cylindrical photovoltaic dryer with dual packed beds thermal energy storage for drying medical herb. The dryer is provided with electrical heater where the electrical energy is generated by using photovoltaic system. The electrical heater is designed and sized to realize continuous drying (day and night) to minimize the drying time. Two packed beds are used to fix the drying temperature in dryer during day and night. The main packed bed thermal energy storage is charged during the sunlight hours directly, to realize continued drying after sunset. An efficient PV dryer is devisedmore » to work under forced air created by air blower and heated by the electrical coils.« less

  2. Preservation of chromosomal integrity in murine spermatozoa derived from gonocytes and spermatogonial stem cells surviving prenatal and postnatal exposure to γ-rays in mice.

    PubMed

    Watanabe, Hiroyuki; Kohda, Atsushi; Komura, Jun-Ichiro; Tateno, Hiroyuki

    2017-07-01

    Pre- and postnatal male mice were acutely (659-690 mGy/min) and continuously (0.303 mGy/min) exposed to 2 Gy γ-rays to evaluate spermatogenic potential and chromosome damage in their germ cells as adults. Acute irradiation on Days 15.5, 16.5, and 17.5 post-coitus affected testicular development, as a result of massive quiescent gonocyte loss; the majority of the seminiferous tubules in these testes were devoid of germ cells. Acute irradiation on Days 18.5 and 19.5 post-coitus had less effect on testicular development and spermatogenesis, even though germ cells were quiescent gonocytes on these days. Adverse effects on testicular development and spermatogenesis were observed following continuous irradiation between Days 14.5 and 19.5 post-coitus. Exposure to acute and continuous postnatal irradiation after the differentiation of spermatogonial stem cells and spermatogonia resulted in nearly all of the seminiferous tubules exhibiting spermatogenesis. Neither acute nor continuous irradiation was responsible for the increased number of multivalent chromosomes in primary-spermatocyte descendents of the exposed gonocytes. In contrast, a significant increase in cells with multivalent chromosomes was observed following acute irradiation on Days 4 and 11 post-partum. No significant increases in unstable structural chromosomal aberrations or aneuploidy in spermatozoa were observed, regardless of cell stage at irradiation or the radiation dose-rate. Thus, murine germ cells that survive prenatal and postnatal irradiation can restore spermatogenesis and produce viable spermatozoa without chromosome damage. These findings may provide a better understanding of reproductive potential following accidental, environmental, or therapeutic irradiation during the prenatal and postnatal periods in humans. © 2017 Wiley Periodicals, Inc.

  3. Calcium-Alginate Hydrogel-Encapsulated Fibroblasts Provide Sustained Release of Vascular Endothelial Growth Factor

    PubMed Central

    Hunt, Nicola C.; Shelton, Richard M.; Henderson, Deborah J.

    2013-01-01

    Vascularization of engineered or damaged tissues is essential to maintain cell viability and proper tissue function. Revascularization of the left ventricle (LV) of the heart after myocardial infarction is particularly important, since hypoxia can give rise to chronic heart failure due to inappropriate remodeling of the LV after death of cardiomyocytes (CMs). Fibroblasts can express vascular endothelial growth factor (VEGF), which plays a major role in angiogenesis and also acts as a chemoattractant and survival factor for CMs and cardiac progenitors. In this in vitro model study, mouse NIH 3T3 fibroblasts encapsulated in 2% w/v Ca-alginate were shown to remain viable for 150 days. Semiquantitative reverse transcription–polymerase chain reaction and immunohistochemistry demonstrated that over 21 days of encapsulation, fibroblasts continued to express VEGF, while enzyme-linked immunosorbent assay showed that there was sustained release of VEGF from the Ca-alginate during this period. The scaffold degraded gradually over the 21 days, without reduction in volume. Cells released from the Ca-alginate at 7 and 21 days as a result of scaffold degradation were shown to retain viability, to adhere to fibronectin in a normal manner, and continue to express VEGF, demonstrating their potential to further contribute to maintenance of cardiac function after scaffold degradation. This model in vitro study therefore demonstrates that fibroblasts encapsulated in Ca-alginate provide sustained release of VEGF. PMID:23082964

  4. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select; TRICARE Dental Program; Early Eligibility for TRICARE for Certain Reserve Component Members. Final rule.

    PubMed

    2015-09-15

    TRICARE Reserve Select (TRS) is a premium-based TRICARE health plan available for purchase worldwide by qualified members of the Ready Reserve and by qualified survivors of TRS members. TRICARE Dental Program (TDP) is a premium-based TRICARE dental plan available for purchase worldwide by qualified Service members. This final rule revises requirements and procedures for the TRS program to specify the appropriate actuarial basis for calculating premiums in addition to making other minor clarifying administrative changes. For a member who is involuntarily separated from the Selected Reserve under other than adverse conditions this final rule provides a time-limited exception that allows TRS coverage in effect to continue for up to 180 days after the date on which the member is separated from the Selected Reserve and TDP coverage in effect to continue for no less than 180 days after the separation date. It also expands early TRICARE eligibility for certain Reserve Component members from a maximum of 90 days to a maximum of 180 days prior to activation in support of a contingency operation for more than 30 days.

  5. Quantifying tetracycline resistance genes in swine waste anaerobic digester over a period of 100 days

    USDA-ARS?s Scientific Manuscript database

    Unregulated use of growth promoting antibiotics like Tetracyclines in agricultural feeds is becoming an increasing problem in antibiotic resistance. Undigested antibiotics leads to significant concentrations in livestock waste. These concentrations provide continuous selection pressure for the devel...

  6. Poor agreement between continuous measurements of energy expenditure and routinely used prediction equations in intensive care unit patients.

    PubMed

    Reid, Clare L

    2007-10-01

    A wide variation in 24h energy expenditure has been demonstrated previously in intensive care unit (ICU) patients. The accuracy of equations used to predict energy expenditure in critically ill patients is frequently compared with single or short-duration indirect calorimetry measurements, which may not represent the total energy expenditure (TEE) of these patients. To take into account this variability in energy expenditure, estimates have been compared with continuous indirect calorimetry measurements. Continuous (24h/day for 5 days) indirect calorimetry measurements were made in patients requiring mechanical ventilation for 5 days. The Harris-Benedict, Schofield and Ireton-Jones equations and the American College of Chest Physicians recommendation of 25 kcal/kg/day were used to estimate energy requirements. A total of 192 days of measurements, in 27 patients, were available for comparison with the different equations. Agreement between the equations and measured values was poor. The Harris-Benedict, Schofield and ACCP equations provided more estimates (66%, 66% and 65%, respectively) within 80% and 110% of TEE values. However, each of these equations would have resulted in clinically significant underfeeding (<80% of TEE) in 16%, 15% and 22% of patients, respectively, and overfeeding (>110% of TEE) in 18%, 19% and 13% of patients, respectively. Limits of agreement between the different equations and TEE values were unacceptably wide. Prediction equations may result in significant under or overfeeding in the clinical setting.

  7. Automated Continuous Distraction Osteogenesis May Allow Faster Distraction Rates: A Preliminary Study

    PubMed Central

    Peacock, Zachary S.; Tricomi, Brad; Murphy, Brian; Magill, John; Kaban, Leonard B.; Troulis, Maria

    2013-01-01

    Purpose To determine if automated continuous distraction osteogenesis at rates > 1mm/day would result in clinical and radiographic bone formation in a minipig model. Materials and Methods An automated, continuous, curvilinear distraction device was placed across a mandibular osteotomy in 10 minipigs. After 12 mm of distraction and 24 days fixation, animals were sacrificed and bone healing evaluated. The continuous distraction rates were 1.5 (n=5) and 3 mm/day (n=5). A semiquantitative scale was used to assess ex-vivo clinical appearance of the distraction gap (3= osteotomy not visible; 2= <50%; 1= >50%; 0= 100% visible); stability (3 = no mobility; 2 and 1 = mobility in 2 or 1 plane respectively; 0= mobility in 3 planes); radiographic density (4 = 100% gap opaque, 3= >75%, 2 = 50% – 75%, 1= <50%, or 0 = radiolucent). Groups of 4 minipigs distracted discontinuously at 1, 2, and 4 mm/day served as controls. Results The continuous DO 1.5 mm/day group had significantly higher scores for appearance and radiographic density compared to the discontinuous 4 mm/day group. The continuous DO 3mm/day group had significantly higher scores for appearance and radiographic density compared to the discontinuous 4 mm/day group, and higher stability compared to the discontinuous 2 and 4 mm/day groups. Conclusions Results of this preliminary study indicate that continuous DO at rates of 1.5 and 3.0 mm/day produces better bone formation when compared to discontinuous DO at rates faster than 1mm/day. PMID:23499159

  8. LANL continuity of operations plan

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

    Senutovitch, Diane M

    2010-12-22

    The Los Alamos National Laboratory (LANL) is a premier national security research institution, delivering scientific and engineering solutions for the nation's most crucial and complex problems. Our primary responsibility is to ensure the safety, security, and reliability of the nation's nuclear stockpile. LANL emphasizes worker safety, effective operational safeguards and security, and environmental stewardship, outstanding science remains the foundation of work at the Laboratory. In addition to supporting the Laboratory's core national security mission, our work advances bioscience, chemistry, computer science, earth and environmental sciences, materials science, and physics disciplines. To accomplish LANL's mission, we must ensure that the Laboratorymore » EFs continue to be performed during a continuity event, including localized acts of nature, accidents, technological or attack-related emergencies, and pandemic or epidemic events. The LANL Continuity of Operations (COOP) Plan documents the overall LANL COOP Program and provides the operational framework to implement continuity policies, requirements, and responsibilities at LANL, as required by DOE 0 150.1, Continuity Programs, May 2008. LANL must maintain its ability to perform the nation's PMEFs, which are: (1) maintain the safety and security of nuclear materials in the DOE Complex at fixed sites and in transit; (2) respond to a nuclear incident, both domestically and internationally, caused by terrorist activity, natural disaster, or accident, including mobilizing the resources to support these efforts; and (3) support the nation's energy infrastructure. This plan supports Continuity of Operations for Los Alamos National Laboratory (LANL). This plan issues LANL policy as directed by the DOE 0 150.1, Continuity Programs, and provides direction for the orderly continuation of LANL EFs for 30 days of closure or 60 days for a pandemic/epidemic event. Initiation of COOP operations may be required to support an allhazards event, including a national security emergency, major fire, catastrophic natural disaster, man-made disaster, terrorism event, or technological disaster by rendering LANL buildings, infrastructure, or Technical Areas unsafe, temporarily unusable, or inaccessible.« less

  9. Recent Trends in the Dispensing of 90-Day-Supply Prescriptions at Retail Pharmacies: Implications for Improved Convenience and Access

    PubMed Central

    Liberman, Joshua N.; Girdish, Charmaine

    2011-01-01

    Background Mail-service pharmacies offer consumers the convenience of prescriptions filled with a 90-day supply of medication. Unlike mail-service pharmacies, retail pharmacies traditionally dispensed maintenance medication prescriptions with a 30-day supply. However, the retail landscape changed in May 2008 with Walmart's announcement of an extension of its $4 Prescription Program to include 90-day-supply prescriptions. Objective To evaluate recent changes in access to and use of 90-day-supply maintenance medications dispensed via retail pharmacy. Summary As of the first quarter of 2007, the proportion of retail-dispensed maintenance medications with a 90-day supply (compared with all maintenance prescriptions dispensed) among Medicare Part D plans, self-insured employers, and private health plans was 5.1%, 5.1%, and 5.0%, respectively. As of December 2009, this ratio had risen to 8.0% for Medicare plans and 8.1% for commercial health plans; the ratio among employers had risen more modestly to 6.1%. Of particular interest and importance, the proportion increased similarly for brand and for generic medications. Conclusion There has been substantial growth in 90-day prescriptions dispensed via retail pharmacy, a trend that is likely to continue as more insurance providers adopt compatible benefit designs. It is important to continue monitoring these trends and to identify opportunities to rigorously evaluate their impact on medication adherence and healthcare costs. PMID:25126341

  10. Recent trends in the dispensing of 90-day-supply prescriptions at retail pharmacies: implications for improved convenience and access.

    PubMed

    Liberman, Joshua N; Girdish, Charmaine

    2011-03-01

    Mail-service pharmacies offer consumers the convenience of prescriptions filled with a 90-day supply of medication. Unlike mail-service pharmacies, retail pharmacies traditionally dispensed maintenance medication prescriptions with a 30-day supply. However, the retail landscape changed in May 2008 with Walmart's announcement of an extension of its $4 Prescription Program to include 90-day-supply prescriptions. To evaluate recent changes in access to and use of 90-day-supply maintenance medications dispensed via retail pharmacy. As of the first quarter of 2007, the proportion of retail-dispensed maintenance medications with a 90-day supply (compared with all maintenance prescriptions dispensed) among Medicare Part D plans, self-insured employers, and private health plans was 5.1%, 5.1%, and 5.0%, respectively. As of December 2009, this ratio had risen to 8.0% for Medicare plans and 8.1% for commercial health plans; the ratio among employers had risen more modestly to 6.1%. Of particular interest and importance, the proportion increased similarly for brand and for generic medications. There has been substantial growth in 90-day prescriptions dispensed via retail pharmacy, a trend that is likely to continue as more insurance providers adopt compatible benefit designs. It is important to continue monitoring these trends and to identify opportunities to rigorously evaluate their impact on medication adherence and healthcare costs.

  11. Lunar Outpost Life Support Trade Studies

    NASA Technical Reports Server (NTRS)

    Lange, Kevin E.; Anderson, Molly S.; Ewert, Michael K.; Barta, Daniel J.

    2008-01-01

    Engineering trade-off studies of life support system architecture and technology options were conducted for potential lunar surface mission scenarios within NASA's Constellation Program. The scenarios investigated are based largely on results of the NASA Lunar Architecture Team (LAT) Phase II study. In particular, the possibility of Hosted Sortie missions, the high cost of power during eclipse periods, and the potential to reduce life support consumables through scavenging, in-situ resources, and alternative EVA technologies were all examined. These trade studies were performed within the Systems Integration, Modeling and Analysis (SIMA) element of NASA's Exploration Life Support (ELS) technology development project. The tools and methodology used in the study are described briefly, followed by a discussion of mission scenarios, life support technology options and results presented in terms of equivalent system mass for various regenerative life support technologies and architectures. Three classes of repeated or extended lunar surface missions were investigated in this study along with several life support resource scenarios for each mission class. Individual mission durations of 14 days, 90 days and 180 days were considered with 10 missions assumed for each at a rate of 2 missions per year. The 14-day missions represent a class of Hosted Sortie missions where a pre-deployed and potentially mobile habitat provides life support for multiple crews at one or more locations. The 90-day and 180-day missions represent lunar outpost expeditions with a larger fixed habitat. The 180-day missions assume continuous human presence and must provide life support through eclipse periods of up to 122 hours while the 90-day missions are planned for best-case periods of nearly continuous sunlight. This paper investigates system optimization within the assumptions of each scenario and addresses how the scenario selected drives the life support system to different designs. Subsequently, these analysis results can be used to determine which technologies may be good choices throughout a broad range of architectures.

  12. Frequency and management of breakthrough bleeding with continuous use of the transvaginal contraceptive ring: a randomized controlled trial.

    PubMed

    Sulak, Patricia J; Smith, Virginia; Coffee, Andrea; Witt, Iris; Kuehl, Alicia L; Kuehl, Thomas J

    2008-09-01

    To assess bleeding patterns with continuous use of the transvaginal contraceptive ring. We did a prospective analysis of daily menstrual flow during a 21/7 cycle followed by 6 months of continuous use and institution of a randomized protocol to manage breakthrough bleeding/spotting. Seventy-four women completed the baseline 21/7 phase and were randomized equally into two groups during the continuous phase. Group 1 was instructed to replace the ring monthly on the same calendar day with no ring-free days. Group 2 was instructed to use the same process, but if breakthrough bleeding/spotting occurred for 5 days or more, they were to remove the ring for 4 days, store it, and then reinsert that ring. Sixty-five women completed the continuous phase with reduced average flow scores in the continuous phase compared with the 21/7 phase (P<.02). Most patients had no to minimal bleeding during continuous use, with group 2 experiencing a statistically greater percentage of days without breakthrough bleeding or spotting (95%) compared with group 1 (89%) (P=.016). Instituting a 4-day hormone-free interval was more (P<.001) effective in resolving breakthrough bleeding/spotting than continuing ring use. A reduction in bleeding occurred during continuous use with replacement of the transvaginal ring compared with baseline 21/7 use. Continuous vaginal ring use resulted in an acceptable bleeding profile in most patients, reduction in flow, reduction in pelvic pain, and a high continuation rate.

  13. Continuous wind measurement in the tropical Pacific using VHF radars

    NASA Technical Reports Server (NTRS)

    Balsley, B. B.; Ecklund, W. L.; Carter, D. A.

    1986-01-01

    Very High Frequency (VHF) Radar Wind Profilers are being installed on Ponape, East Caroline Islands and Christmas Island, Republic of Kiribati to continuously monitor winds aloft. The purpose of this experiment is to study wind fluctuations on time scales between minutes and days, to determine the longitudinal character of these fluctuations, and to examine their relationship to climate variability. Six-hourly wind profiles will be provided via satellite to the scientific community for Project TOGA (Tropical Ocean Global Atmosphere).

  14. National Symposium: Surface Navy Leading the Way (5th) Held at Washington, DC on 26-29 October 1992

    DTIC Science & Technology

    1992-10-29

    nation. We all hope that in the days and years ahead a grateful nation continues to be grateful, and will not forget the price we paid for this... skimming threats. The Outlaw Bandit Program will continue. This program reduces the radar cross section of combatants significantly and increases the...Weapon Systems to provide a precision, multi-mode strike Cruise missile with an imaging seeker and hard target penetrator warhead. 22 With the

  15. An Electronic Pillbox for Continuous Monitoring of Medication Adherence

    PubMed Central

    Hayes, Tamara. L.; Hunt, John M.; Adami, Andre; Kaye, Jeffrey A.

    2010-01-01

    We have developed an instrumented pillbox, called a MedTracker, which allows monitoring of medication adherence on a continuous basis. This device improves on existing systems by providing mobility, frequent and automatic data collection, more detailed information about nonadherence and medication errors, and the familiar interface of a 7-day drug store pillbox. We report on the design of the MedTracker, and on the results of a field trial in 39 homes to evaluate the device. PMID:17946369

  16. Amount of kinematic feedback affects learning of speech motor skills.

    PubMed

    Ballard, Kirrie J; Smith, Heather D; Paramatmuni, Divija; McCabe, Patricia; Theodoros, Deborah G; Murdoch, Bruce E

    2012-01-01

    Knowledge of Performance (KP) feedback, such as biofeedback or kinematic feedback, is used to provide information on the nature and quality of movement responses for the purpose of guiding active learning or rehabilitation of motor skills. It has been proposed that KP feedback may interfere with long-term learning when provided throughout training. Here, twelve healthy English-speaking adults were trained to produce a trilled Russian [r] in words with KP kinematic feedback using electropalatography (EPG) and without KP (noKP). Five one-hour training sessions were provided over one week with testing pretraining and one day and one week posttraining. No group differences were found at pretraining or one day post training for production accuracy. A group by time interaction supported the hypothesis that providing kinematic feedback continually during skill acquisition interferes with retention.

  17. Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center.

    PubMed

    Salta, L; Buick, W P

    1989-01-01

    The authors evaluated two indices of services for 349 outpatients who requested an initial appointment for screening and evaluation at a community mental health center over a one-month period in April of 1981, 1984, and 1988. Intake waiting time after initial screening and evaluation was 15.2 treatment days in 1981, 15.4 treatment days in 1984 and reduced to 2.7 treatment days in 1988. For patients who were referred for continued outpatient treatment, the dropout rates were reduced from 54.3 percent in 1981, to 28.51 percent in 1984 and further reduced to 19.19 percent in 1988. A divisional structure was designed with the purpose of reducing organizational barriers in order to provide greater access to services and to enhance continuity of care to patients. These results suggest that systematic organizational changes and the implementation of clearly defined clinical and administrative policies and procedures can impact favorably upon the intake, referral and treatment of outpatients.

  18. Using an Electronic Medication Refill System to Improve Provider Productivity in an Accountable Care Setting.

    PubMed

    Schoenhaus, Robert; Lustig, Adam; Rivas, Silvia; Monrreal, Victor; Westrich, Kimberly D; Dubois, Robert W

    2016-03-01

    Even within fully integrated health care systems, primary care providers (PCPs) often lack support for medication management. Because challenges with conducting medication reconciliation, improving adherence, and achieving optimal patient outcomes continue to be prevalent nationally, it is critical that PCPs are provided the resources and support they need to provide high-quality, patient-centered care in an accountable care environment. Sharp Rees-Stealy Medical Group uses a fully electronic medication refill system that allows for a centralized team to manage all incoming requests. Over time, 16 disease-specific protocols were created that allowed the pharmacy team to absorb approximately 80% of incoming refill requests for all enrolled PCPs. The refill clinic assessed all clinic information that a PCP would normally review in order to approve a refill. Tasks performed by the clinical pharmacists included medication reconciliation, dosage adjustment, and coordination of distribution from external mail order and retail pharmacies. In 2014, the number of tasks related to refill management reviewed by the refill/medication therapy management service totaled 302,592, resulting in 140,350 refill authorizations and multiple interventions related to medication use. Physicians have estimated that the service provides between 20 and 30 minutes of time savings per day. Assuming an annual PCP salary of around $200,000, 20 to 30 minutes per day would amount to $33 to $50 saved per day per physician. The savings is even higher when time savings from other clinical staff is included. The development of this electronic medication refill service has provided the following important lessons: (a) organizations rely on a leader or champion to push through process reforms--this program started with reluctant physicians first to determine best practices; (b) the lack of clinical pharmacist profiles within electronic health records (EHR) is a serious concern, since the creation of these profiles may not be easy or timely; and (c) PCPs working within an EHR environment will quickly embrace the idea of a service that can save them up to 30 minutes per day. With PCPs continuing to take on additional population health management tasks in accountable care organizations, pharmacists can provide workload offsets by meaningfully contributing to medication-related care.

  19. Support needs of breast-feeding women: views of Australian midwives and health nurses.

    PubMed

    McLelland, Gayle; Hall, Helen; Gilmour, Carole; Cant, Robyn

    2015-01-01

    to explore the views of midwives and maternal-child health nurses regarding factors that influence breast feeding initiation and continuation, focusing on how support for women could be improved to increase breast feeding duration. a focus group study. hospital or domiciliary (home-visiting) midwives and community-based maternal and child health (MCH) nurses in one region of Victoria, Australia. twelve MCH nurses and five midwives who provided supportive services to women in the immediate postnatal period attended one of three audio-recorded focus groups. Thematic findings were identified. four key themes were: 'Guiding women over breast-feeding hurdles', 'Timing, and time to care'; 'Continuity of women's care' and 'Imparting professional knowledge'. Given the a pattern of hospital discharge of mother and infant on day one or day two after birth, participants thought the timing of immediate postnatal breast-feeding support was critical to enable women to initiate and continue breast feeding. Community-based MCH nurses reported time gaps in uptake of new mother referrals and time-pressured face-to-face consultations. Both groups perceived barriers to continuity of women's care. health services subscribe to the Baby Friendly Health Initiative and government policies which support breast feeding, however providers described time pressures and a lack of continuity of women's care, including during transition from hospital to community services. there is a need to examine administration of service delivery and how domiciliary and community nurses can collaborate to establish and maintain supportive relationships with breast feeding women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. 10 CFR 609.9 - Closing on the Loan Guarantee Agreement.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Closing on the Loan Guarantee Agreement. 609.9 Section 609.9 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS LOAN GUARANTEES FOR PROJECTS THAT... 30 days prior to the closing date, the Applicant must provide in writing updated project financing...

  1. 10 CFR 609.9 - Closing on the Loan Guarantee Agreement.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Closing on the Loan Guarantee Agreement. 609.9 Section 609.9 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS LOAN GUARANTEES FOR PROJECTS THAT... 30 days prior to the closing date, the Applicant must provide in writing updated project financing...

  2. 10 CFR 609.9 - Closing on the Loan Guarantee Agreement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Closing on the Loan Guarantee Agreement. 609.9 Section 609.9 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS LOAN GUARANTEES FOR PROJECTS THAT... 30 days prior to the closing date, the Applicant must provide in writing updated project financing...

  3. Podcasts as a Learning Tool: German Language and Culture Every Day

    ERIC Educational Resources Information Center

    Schmidt, Johannes

    2008-01-01

    Podcasts provide a straightforward opportunity to stay connected with language, culture, and recent events of German-speaking countries. Podcasts offer clearly articulated, authentic material that can be automatically and regularly delivered to your computer and classrooms; continuously exposing students and teachers to German. This article…

  4. 40 CFR 144.86 - What are the definitions I need to know?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... systems that provide water to schools, day care centers, government/military installations, manufacturers... 40 Protection of Environment 22 2010-07-01 2010-07-01 false What are the definitions I need to know? 144.86 Section 144.86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER...

  5. Accountability Pillar Results for Annual Education Results Report (AERR)

    ERIC Educational Resources Information Center

    Alberta Education, 2008

    2008-01-01

    Alberta has developed an innovative new way of measuring performance to ensure we continue to provide the best possible education opportunities for all of our students. This accountability framework, called the Accountability Pillar, recognizes and respects the outstanding work seen in our school authorities every day. It ensures school…

  6. 10 CFR 61.9a - Completeness and accuracy of information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Completeness and accuracy of information. 61.9a Section 61.9a Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  7. 10 CFR 71.7 - Completeness and accuracy of information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Completeness and accuracy of information. 71.7 Section 71.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE.... Notification must be provided to the Administrator of the appropriate Regional Office within 2 working days of...

  8. 10 CFR 61.9a - Completeness and accuracy of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Completeness and accuracy of information. 61.9a Section 61.9a Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  9. 10 CFR 61.9a - Completeness and accuracy of information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Completeness and accuracy of information. 61.9a Section 61.9a Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  10. 10 CFR 60.10 - Completeness and accuracy of information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Completeness and accuracy of information. 60.10 Section 60.10 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  11. 10 CFR 71.7 - Completeness and accuracy of information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Completeness and accuracy of information. 71.7 Section 71.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE.... Notification must be provided to the Administrator of the appropriate Regional Office within 2 working days of...

  12. 10 CFR 60.10 - Completeness and accuracy of information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Completeness and accuracy of information. 60.10 Section 60.10 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  13. 10 CFR 60.10 - Completeness and accuracy of information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Completeness and accuracy of information. 60.10 Section 60.10 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  14. 10 CFR 71.7 - Completeness and accuracy of information.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Completeness and accuracy of information. 71.7 Section 71.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE.... Notification must be provided to the Administrator of the appropriate Regional Office within 2 working days of...

  15. 10 CFR 61.9a - Completeness and accuracy of information.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 2 2013-01-01 2013-01-01 false Completeness and accuracy of information. 61.9a Section 61.9a Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  16. 10 CFR 71.7 - Completeness and accuracy of information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Completeness and accuracy of information. 71.7 Section 71.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE.... Notification must be provided to the Administrator of the appropriate Regional Office within 2 working days of...

  17. 10 CFR 61.9a - Completeness and accuracy of information.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 2 2011-01-01 2011-01-01 false Completeness and accuracy of information. 61.9a Section 61.9a Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  18. 10 CFR 71.7 - Completeness and accuracy of information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Completeness and accuracy of information. 71.7 Section 71.7 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE.... Notification must be provided to the Administrator of the appropriate Regional Office within 2 working days of...

  19. 10 CFR 60.10 - Completeness and accuracy of information.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 2 2014-01-01 2014-01-01 false Completeness and accuracy of information. 60.10 Section 60.10 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN... provided to the Administrator of the appropriate Regional Office within two working days of identifying the...

  20. 29 CFR 1650.203 - Notification of intent to collect.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....203 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION DEBT... intent to collect. EEOC's notification of intent to collect by tax refund offset shall provide: (a) The amount of the debt; (b) That unless the debt is repaid within 60 days from the date of EEOC's...

  1. 29 CFR 1650.203 - Notification of intent to collect.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....203 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION DEBT... intent to collect. EEOC's notification of intent to collect by tax refund offset shall provide: (a) The amount of the debt; (b) That unless the debt is repaid within 60 days from the date of EEOC's...

  2. 29 CFR 1650.203 - Notification of intent to collect.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....203 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION DEBT... intent to collect. EEOC's notification of intent to collect by tax refund offset shall provide: (a) The amount of the debt; (b) That unless the debt is repaid within 60 days from the date of EEOC's...

  3. 29 CFR 1650.203 - Notification of intent to collect.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....203 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION DEBT... intent to collect. EEOC's notification of intent to collect by tax refund offset shall provide: (a) The amount of the debt; (b) That unless the debt is repaid within 60 days from the date of EEOC's...

  4. 29 CFR 1650.203 - Notification of intent to collect.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....203 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION DEBT... intent to collect. EEOC's notification of intent to collect by tax refund offset shall provide: (a) The amount of the debt; (b) That unless the debt is repaid within 60 days from the date of EEOC's...

  5. Long continuous bridge deck evaluation : John Day River Bridge, Clatsop County, Bridge No. 1827B : final report.

    DOT National Transportation Integrated Search

    1995-06-01

    The John Day River Bridge, near Astoria, Oregon was built with a continuous deck length of 1,105 ft. (340 m). The rationale for designing the John Day River Bridge with an unusually long continuous deck is in part based on the site's very mild climat...

  6. Diels–Alder reactions of myrcene using intensified continuous-flow reactors

    PubMed Central

    Álvarez-Diéguez, Miguel Á; Kohl, Thomas M; Tsanaktsidis, John

    2017-01-01

    This work describes the Diels–Alder reaction of the naturally occurring substituted butadiene, myrcene, with a range of different naturally occurring and synthetic dienophiles. The synthesis of the Diels–Alder adduct from myrcene and acrylic acid, containing surfactant properties, was scaled-up in a plate-type continuous-flow reactor with a volume of 105 mL to a throughput of 2.79 kg of the final product per day. This continuous-flow approach provides a facile alternative scale-up route to conventional batch processing, and it helps to intensify the synthesis protocol by applying higher reaction temperatures and shorter reaction times. PMID:28228853

  7. Continuous IV Crotalidae Polyvalent Immune Fab (Ovine) (FabAV) for selected North American rattlesnake bite patients.

    PubMed

    Bush, Sean P; Seifert, Steven A; Oakes, Jennifer; Smith, Susan D; Phan, Tammy H; Pearl, Sarah R; Reibling, Ellen T

    2013-07-01

    In patients bitten by North American rattlesnakes and treated with Crotalidae Polyvalent Immune Fab (Ovine) (FabAV), late hematologic abnormalities-persistent, recurrent, or late, new onset of hypofibrinogenemia, prolonged PT/INR, prolonged PTT, and/or thrombocytopenia beyond 48 h post-envenomation-are common, difficult to manage, and may result in morbidity and mortality are common, difficult to manage, and may result in morbidity and mortality. The optimal management of late hematologic abnormalities, particularly the use of further treatment with antivenom, has not been well defined. The current FabAV treatment regimen is to give antivenom as a bolus dose over a one-hour period. We describe our experience using a continuous intravenous infusion of FabAV for late hematologic effects and/or associated bleeding complications in rattlesnake envenomation. This is a retrospective, observational case series of patients envenomated by North American rattlesnakes at three medical centers managed with a continuous intravenous infusion of FabAV for late hematologic abnormalities and/or associated bleeding complications. Indications, dilution and infusion protocols, and duration of therapy were individualized. Five cases were identified between July 2010 and September 2011. All patients had profound late hematologic abnormalities and/or were associated with bleeding complications. Several patients had received repeat bolus infusions of FabAV, with or without human blood products, with either inadequate or only transient beneficial response. All patients were then managed with a continuous intravenous infusion of FabAV and all appeared to respond to the continuous intravenous infusion of FabAV, titrated to effect, with cessation of progression and, in most cases, improvement in hematologic abnormalities. Rates of infusion varied from 2 to 4 vials per 24 h (mean = 3.1 ± 0.4 vials/day). The termination of FabAV infusion was between day 6 and day 14 from the time of envenomation (mean = 10 ± 3 days), after which hematologic values were normalized or were normalizing in all patients and continued to do so. The use of FabAV as a continuous intravenous infusion, particularly after the acute phase of envenomation has passed, provides a continuous source of circulating antibodies to neutralize venom components reaching circulation from tissue stores and allows natural replenishment of hematologic factors such as platelets and/or fibrinogen. This method is an efficient use of FabAV, avoiding the wasteful excess of a bolus dose, may be more effective, eliminating the potential for destruction of hematologic factors when protective antivenom levels are lost between bolus FabAV doses, and appears to be safe. Further assessments of the stability and sterility of the product during infusion are needed. The need to continue hospitalization is the major drawback, but continued observation and inpatient care may be needed for other indications (e.g. bleeding) in this subset of patients. A continuous intravenous infusion of FabAV between 2 and 4 vials per day, titrated to effect, and continued for 6-14 days post-envenomation appeared to be associated with reversal of late hematologic effects of rattlesnake envenomation and, when combined with indicated human blood products, control of significant bleeding. Continuous intravenous infusion of FabAV may be safer, more efficacious, and more cost-effective than observation without FabAV treatment or as-needed bolus dosing in selected patients with late hematologic abnormalities. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Subjective health complaints, functional ability, fear avoidance beliefs, and days on sickness benefits after work rehabilitation - a mediation model.

    PubMed

    Øyeflaten, Irene; Opsahl, Jon; Eriksen, Hege R; Braathen, Tore Norendal; Lie, Stein Atle; Brage, Søren; Ihlebæk, Camilla M; Breivik, Kyrre

    2016-05-23

    Long-term sick leave and withdrawal from working life is a concern in western countries. In Norway, comprehensive inpatient work rehabilitation may be offered to sick listed individuals at risk of long-term absence from work. Knowledge about prognostic factors for work outcomes after long-term sick leave and work rehabilitation is still limited. The aim of this study was to test a mediation model for various hypothesized biopsychosocial predictors of continued sick leave after inpatient work rehabilitation. One thousand one hundred fifty-five participants on long-term sick leave from eight different work rehabilitation clinics answered comprehensive questionnaires at arrival to the clinic, and were followed with official register data on sickness benefits for 3 years. Structural equation models were conducted, with days on sickness benefits after work rehabilitation as the outcome. Fear avoidance beliefs for work mediated the relation between both musculoskeletal complaints and education on days on sickness benefits after work rehabilitation. The relation between musculoskeletal complaints and fear avoidance beliefs for work was furthermore fully mediated by poor physical function. Previous sick leave had a strong independent effect on continued sick leave after work rehabilitation. Fear avoidance beliefs for work did not mediate the small effect of pseudoneurological complaints on continued sick leave. Poor coping/interaction ability was neither related to continued sick leave nor fear avoidance beliefs for work. The mediation model was partly supported by the data, and provides some possible new insight into how fear avoidance beliefs for work and functional ability may intervene with subjective health complaints and days on sickness benefits after work rehabilitation.

  9. Relationship Between Attention-Deficit/Hyperactivity Disorder Care and Medication Continuity.

    PubMed

    Brinkman, William B; Baum, Rebecca; Kelleher, Kelly J; Peugh, James; Gardner, William; Lichtenstein, Phil; Langberg, Joshua; Epstein, Jeffery N

    2016-04-01

    To describe the relationships between attention-deficit/hyperactivity disorder (ADHD) care practices and subsequent medication use. A retrospective cohort from a random sample of medical records in 50 pediatric practices with 188 providers, including 1,352 children who started ADHD medication, was studied. Independent variables included physician behaviors related to medication titration and monitoring of treatment response. Primary outcomes were number of days covered with ADHD medication during the first year of treatment and time from starting medicine to the first 30-day gap in medication supply. Multilevel modeling and Cox proportional hazards regression models were conducted. Children had an average medication supply of 217 days in the first year. Half experienced a 30-day gap in medication supply in the first 3 months. Nearly three-fourths had a medication adjustment in the first year with the first adjustment usually being a dosage change. The average time to the first medication adjustment was over 3 months. Physician's first contact with parents occurred in the first month of treatment for less than half, with the average time being over 2 months. Little variation related to ADHD care quality was accounted for at the physician level. Early titration and early contact were related to greater medication supply and continuity of treatment. Earlier physician-delivered ADHD care (e.g., contact with parent after starting medication and medication adjustment) is related to greater medication supply and continuity. It remains to be determined whether interventions that improve the quality of titration and monitoring practices for children with ADHD would also improve medication continuity. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Effects of the 2017 Solar Eclipse on HF Radio Propagation and the D-Region Ionosphere: Citizen Science Investigation

    NASA Technical Reports Server (NTRS)

    Fry, C. D.; Rawlins, L.; Krause, L. H.; Suggs, R. M.; McTernan, J. K.; Adams, M. L.; Gallagher, D. L.; Anderson, Scott; Allsbrooks, Robert IV

    2017-01-01

    August 21, 2017 provided a unique opportunity to investigate the effects of the total solar eclipse on high frequency (HF) radio propagation and ionospheric variability. In Marshall Space Flight Center's partnership with the US Space and Rocket Center (USSRC) and Austin Peay State University (APSU), we engaged students and citizen scientists in an investigation of the eclipse effects on the mid-latitude ionosphere. Activities included implementing and configuring software, monitoring the HF Amateur Radio frequency bands and collecting radio transmission data on days before, the day of, and days after the eclipse to build a continuous record of changing propagation conditions as the moon's shadow marched across the United States. Post-eclipse radio propagation analysis provided insights into ionospheric variability due to the eclipse. We report on results, interpretation, and conclusions of these investigations.

  11. The costs of fluid overload in the adult intensive care unit: is a small-volume infusion model a proactive solution?

    PubMed Central

    Child, Debra L; Cao, Zhun; Seiberlich, Laura E; Brown, Harold; Greenberg, Jordan; Swanson, Anne; Sewall, Martha R; Robinson, Scott B

    2015-01-01

    Purpose Fluid overload (FO) in critically ill patients remains a challenging clinical dilemma, and many continuous intravenous (IV) medications in the US are being delivered as a dilute solution, adding significantly to a patient’s daily intake. This study describes the costs and outcomes of FO in patients receiving multiple continuous infusions. Materials and methods A retrospective study was conducted using a hospital administrative database covering >500 US hospitals. An FO cohort included adult intensive care unit (ICU) patients with a central line receiving IV loop diuretics and 2+ continuous IV infusions on 50%+ of their ICU days; a directly matched non-FO cohort included patients without IV diuretic use. The primary outcome of the study was total hospitalization costs per visit. Additional outcomes were ICU costs, mortality, total and ICU length of stay (LOS), 30-day readmission rates, and ventilator use. Unadjusted descriptive analysis was performed using chi-squared or paired t-tests to compare outcomes between the two cohorts. Results A total of 63,974 patients were identified in each cohort. The total hospitalization cost per visit for the FO cohort was US$15,344 higher than the non-FO cohort (US$42,386 vs US$27,042), and the ICU cost for the FO cohort was US$5,243 higher than the non-FO cohort (US$10,902 vs US$5,659). FO patients had higher mortality (20% vs 16.8%), prolonged LOS (11.5 vs 8.0 days), longer ICU LOS (6.2 vs 3.6 days), higher risk of 30-day readmission (21.8% vs 21.3%), and ventilator usage (47.7% vs 28.3%) than the non-FO cohort (all P<0.05). Conclusion In patients receiving multiple continuous infusions, FO is associated with increased health care resources and costs. Maximally concentrating medications and proactively providing continuous medications in small-volume infusions (SVI) could be a potential solution to prevent iatrogenic FO in critically ill patients. Further prospective research is warranted to assess the impact of the SVI dispensing model on patient outcomes and health care costs. PMID:25548524

  12. Day Care Facts.

    ERIC Educational Resources Information Center

    Hart, Annie L.; And Others

    The need for child care will continue to increase in the decade ahead because of: (1) a growing number of children aged five and younger, (2) the accelerating trend in employment of mothers, (3) increased emphasis on providing child care services for welfare mothers who desire to work, and (4) widespread awareness that a child's early years are of…

  13. 40 CFR 410.23 - Effluent limitation representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... achievable (BAT). 410.23 Section 410.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... available technology economically achievable (BAT). (a) Except as provided in 40 CFR 125.30 through 125.32... economically achievable (BAT): Pollutant or pollutant property BAT limitation Maximum for any 1 day Average of...

  14. 40 CFR 420.83 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... achievable (BAT). 420.83 Section 420.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... and plate. Subpart H Pollutant or pollutant property BAT effluent limitations Maximum for any 1 day...

  15. 40 CFR 420.83 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... achievable (BAT). 420.83 Section 420.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... and plate. Subpart H Pollutant or pollutant property BAT effluent limitations Maximum for any 1 day...

  16. 40 CFR 410.23 - Effluent limitation representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... achievable (BAT). 410.23 Section 410.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... available technology economically achievable (BAT). (a) Except as provided in 40 CFR 125.30 through 125.32... economically achievable (BAT): Pollutant or pollutant property BAT limitation Maximum for any 1 day Average of...

  17. 40 CFR 433.14 - Effluent limitations representing the degree of effluent reduction attainable by applying the...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (BAT). 433.14 Section 433.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... the best available technology economically achievable (BAT). (a) Except as provided in 40 CFR 125.30... economically achievable (BAT): BAT Effluent Limitations Pollutant or pollutant property Maximum for any 1 day...

  18. 40 CFR 410.23 - Effluent limitation representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... achievable (BAT). 410.23 Section 410.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... available technology economically achievable (BAT). (a) Except as provided in 40 CFR 125.30 through 125.32... economically achievable (BAT): Pollutant or pollutant property BAT limitation Maximum for any 1 day Average of...

  19. 40 CFR 420.83 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... achievable (BAT). 420.83 Section 420.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... and plate. Subpart H Pollutant or pollutant property BAT effluent limitations Maximum for any 1 day...

  20. 40 CFR 410.23 - Effluent limitation representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... achievable (BAT). 410.23 Section 410.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... available technology economically achievable (BAT). (a) Except as provided in 40 CFR 125.30 through 125.32... economically achievable (BAT): Pollutant or pollutant property BAT limitation Maximum for any 1 day Average of...

  1. 40 CFR 420.33 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... achievable (BAT). 420.33 Section 420.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... pollutant property BAT effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive...

  2. 40 CFR 420.33 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... achievable (BAT). 420.33 Section 420.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... pollutant property BAT effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive...

  3. 40 CFR 430.104 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... achievable (BAT). 430.104 Section 430.104 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... (BAT). Except as provided in 40 CFR 125.30 through 125.32, any existing point source subject to this... economically achievable (BAT). Non-continuous dischargers shall not be subject to the maximum day mass...

  4. 40 CFR 430.104 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... achievable (BAT). 430.104 Section 430.104 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... (BAT). Except as provided in 40 CFR 125.30 through 125.32, any existing point source subject to this... economically achievable (BAT). Non-continuous dischargers shall not be subject to the maximum day mass...

  5. 40 CFR 420.33 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... achievable (BAT). 420.33 Section 420.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... pollutant property BAT effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive...

  6. 40 CFR 420.33 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... achievable (BAT). 420.33 Section 420.33 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... pollutant property BAT effluent limitations Maximum for any 1 day Average of daily values for 30 consecutive...

  7. 40 CFR 420.83 - Effluent limitations representing the degree of effluent reduction attainable by the application...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... achievable (BAT). 420.83 Section 420.83 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... application of the best available technology economically achievable (BAT). Except as provided in 40 CFR 125... and plate. Subpart H Pollutant or pollutant property BAT effluent limitations Maximum for any 1 day...

  8. 40 CFR 433.14 - Effluent limitations representing the degree of effluent reduction attainable by applying the...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (BAT). 433.14 Section 433.14 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... the best available technology economically achievable (BAT). (a) Except as provided in 40 CFR 125.30... economically achievable (BAT): BAT Effluent Limitations Pollutant or pollutant property Maximum for any 1 day...

  9. Think "E" for Engagement: Use Technology Tools to Design Personalized Professional E-Learning

    ERIC Educational Resources Information Center

    Farris, Shari

    2015-01-01

    As faculty chair of early childhood education at Vanguard University of Southern California, the author was challenged each day by questions: How to provide high-impact online professional learning to adult continuing education students? What barriers exist for adult learners seeking meaningful professional learning? How does practice as a…

  10. Estimation of Unreimbursed Patient Education Costs at a Large Group Practice

    ERIC Educational Resources Information Center

    Williams, Arthur R.; McDougall, John C.; Bruggeman, Sandra K.; Erwin, Patricia J.; Kroshus, Margo E.; Naessens, James M.

    2004-01-01

    Introduction: A search of the literature on the cost of patient education found that provider education time per patient per day was rarely reported and usually not derivable from published reports. Costs of continuing education needed by health professionals to support patient education also were not given. Without this information, it is…

  11. Effect of continuous oral suctioning on the development of ventilator-associated pneumonia: a pilot randomized controlled trial.

    PubMed

    Chow, Meyrick C M; Kwok, Shu-Man; Luk, Hing-Wah; Law, Jenny W H; Leung, Bartholomew P K

    2012-11-01

    Both continuous and intermittent aspiration of subglottic secretions by means of specially designed endotracheal tubes containing a separate dorsal lumen that opens into the subglottic region have been shown to be useful in reducing ventilator-associated pneumonia (VAP). However, the high cost of these tubes restricts their use. The aim of this pilot randomized controlled trial was to test the effect of a low-cost device (saliva ejector) for continuous oral suctioning (COS) on the incidence of VAP in patients receiving mechanical ventilation. The study was conducted in the six-bed medical-surgical ICU of a hospital with over 400 beds that provides comprehensive medical services to the public. The design of this study was a parallel-group randomized controlled trial. While both the experimental and control groups used the conventional endotracheal tube, the saliva ejector was only applied to patients assigned to the experimental group. The device was put between the patient's cheek and teeth, and then connected to 100mmHg of suction for the continuous drainage of saliva. Fourteen patients were randomized to receive COS and 13 patients were randomized to the control group. The two groups were similar in demographics, reasons for intubation, co-morbidity, and risk factors for acquiring VAP. VAP was found in 3 patients (23.1%; 71 episodes of VAP per 1000 ventilation days) receiving COS and in 10 patients (83.3%; 141 episodes of VAP per 1000 ventilation days) in the control group (relative risk, 0.28; 95% confidence interval, 0.10-0.77; p=0.003). The duration of mechanical ventilation in the experimental group was 3.2 days (SD 1.3), while that in the control group was 5.9 days (SD 2.8) (p=0.009); and the length of ICU stay was 4.8 days (SD 1.6) versus 9.8 days (SD 6.3) for the experimental and control groups, respectively (p=0.019). Continuous clearance of oral secretion by the saliva ejector may have an important role to play in reducing the rate of VAP, decreasing the duration of mechanical ventilation, and shortening the length of stay of patients in the ICU. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Daily rhythms of food intake and feces reingestion in the degu, an herbivorous Chilean rodent: optimizing digestion through coprophagy.

    PubMed

    Kenagy, G J; Veloso, C; Bozinovic, F

    1999-01-01

    Animals must match their foraging and digestion to seasonal changes in availability and quality of food. When these parameters decline, the animal's performance limits for extracting energy and nutrients may be challenged. In the laboratory, we investigated daily patterns of food processing on a low-quality (high-fiber) diet of alfalfa in an herbivorous, day-active rodent, the degu (Octodon degus), which inhabits semiarid central Chile. We manipulated timing of food availability, from continuous availability down to as little as 5 h/d. Degus maintained weight while digesting only 53% of dry-matter consumption. With food continuously available in a metabolic cage, the animals ate more food and deposited about twice as much feces in the day as at night. Continuous 24-h behavioral observation revealed that degus were actually defecating at the same rate both night and day but then ingesting most of the feces they produced at night. Further experimental treatments challenged animals with limited periods of food availability that matched natural foraging patterns. With either 11 h of daytime food availability or only 5 h (in morning and afternoon periods of 2.5 h each), degus consumed as much food as those with 24-h food availability. Continuous 24-h behavioral observations revealed in the 11-h group that nearly all feces produced at night were reingested and nearly none were reingested in the day, whereas the 5-h group resorted to further coprophagy during the 6-h midday interval with no food. Despite these differences in timing of food intake and coprophagy in response to the three experimental treatments, the degus were defecating at the same rate both night and day, which indicated a constant rate of output from the colon. This suggests a range of adjustments of digestive physiology to the timing of gut function by balancing coprophagy with ingestion of food. Overall, 38% of 24-h feces production was reingested, and 87% of this coprophagy occurred at night. The ingestion of feces during parts of the day when food is unavailable provides for continued intake into the digestive tract and appears to represent an increase in overall efficiency of gut use.

  13. Business continuity after catastrophic medical events: the Joplin medical business continuity report.

    PubMed

    Carlton, Paul K; Bringle, Dottie

    2012-01-01

    On May 22, 2011, The St Johns Mercy Medical Center in Joplin, MO, was destroyed by an F-5 tornado. There were 183 patients in the building at that time in this 367-bed Medical Center. The preparation and response were superbly done and resulted in many lives saved. This report is focused on the reconstitution phase of this disaster response, which includes how to restore business continuity. As 95 percent of our medical capacity resides in the private sector in the United States, we must have a proper plan for how to restore business continuity or face the reality of the medical business failing and not providing critical medical services to the community. A tornado in 2007 destroyed a medical center in Sumter County, GA, and it took more than 365 days to restore business continuity at a cost of $18M. The plan executed by the Mercy Medical System after the disaster in Joplin restored business continuity in 88 days and cost a total of $6.6M, with all assets being reusable. The recommendation from these lessons learned is that every county, state, and Federal Emergency Management Agency region has a plan on the shelf to restore business continuity and the means to be able to do so. The hard work that the State of Missouri and the Mercy Medical System did after this disaster can serve as a model for the nation in how to quickly recover from any loss of medical capability.

  14. Low-flow characteristics of Virginia streams

    USGS Publications Warehouse

    Austin, Samuel H.; Krstolic, Jennifer L.; Wiegand, Ute

    2011-01-01

    Low-flow annual non-exceedance probabilities (ANEP), called probability-percent chance (P-percent chance) flow estimates, regional regression equations, and transfer methods are provided describing the low-flow characteristics of Virginia streams. Statistical methods are used to evaluate streamflow data. Analysis of Virginia streamflow data collected from 1895 through 2007 is summarized. Methods are provided for estimating low-flow characteristics of gaged and ungaged streams. The 1-, 4-, 7-, and 30-day average streamgaging station low-flow characteristics for 290 long-term, continuous-record, streamgaging stations are determined, adjusted for instances of zero flow using a conditional probability adjustment method, and presented for non-exceedance probabilities of 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.05, 0.02, 0.01, and 0.005. Stream basin characteristics computed using spatial data and a geographic information system are used as explanatory variables in regional regression equations to estimate annual non-exceedance probabilities at gaged and ungaged sites and are summarized for 290 long-term, continuous-record streamgaging stations, 136 short-term, continuous-record streamgaging stations, and 613 partial-record streamgaging stations. Regional regression equations for six physiographic regions use basin characteristics to estimate 1-, 4-, 7-, and 30-day average low-flow annual non-exceedance probabilities at gaged and ungaged sites. Weighted low-flow values that combine computed streamgaging station low-flow characteristics and annual non-exceedance probabilities from regional regression equations provide improved low-flow estimates. Regression equations developed using the Maintenance of Variance with Extension (MOVE.1) method describe the line of organic correlation (LOC) with an appropriate index site for low-flow characteristics at 136 short-term, continuous-record streamgaging stations and 613 partial-record streamgaging stations. Monthly streamflow statistics computed on the individual daily mean streamflows of selected continuous-record streamgaging stations and curves describing flow-duration are presented. Text, figures, and lists are provided summarizing low-flow estimates, selected low-flow sites, delineated physiographic regions, basin characteristics, regression equations, error estimates, definitions, and data sources. This study supersedes previous studies of low flows in Virginia.

  15. Improved rooting of western white pine shoots from tissue cultures

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

    Amerson, H.V.; Mott, R.L.

    1982-01-01

    Adventitious shoots of Pinus monticola obtained from embryonic tissue were exposed to 4 combinations of growth regulators (6-benzylaminopurine/NAA/IAA/IBA), either continuously for 6 weeks or by pulse treatment for 7 days, followed by 5 weeks culture without growth regulators. After 6 weeks of continuous exposure, rooting of shoots varied between 0 and 20%. Pulse treatment resulted in 40-64% rooting. In paired comparisons pulse treatments always provided better rooting percentages than did constant exposure treatments. Pulse treatments also produced longer (less than 2 mm) roots and more multiple roots.

  16. CQI proiect Every other day nocturnal HHD - An alternative approach to reduce burden.

    PubMed

    2016-08-01

    More frequent dialysis, typically performed five to six times per week at home, has been associated with a num- ber of clinical, cardiovascular, and health-related quality of life (HRQOL) benefits. Daily therapy often results in a burden for patients and care partners. A continuous qual- ity improvement (CQI) initiative was conducted to evaluate if an alternate day, longer duration therapy (3.5 treatments with six to 10 hour treatments per week) would provide a viable alternative for home hemodialysis (HHD). This initia- tive demonstrated that every other day (EOD) nocturnal HD is a feasible alternative option to daily HHD and should be considered to individualize home dialysis therapy.

  17. Blastocyst utilization rates after continuous culture in two commercial single-step media: a prospective randomized study with sibling oocytes.

    PubMed

    Sfontouris, Ioannis A; Kolibianakis, Efstratios M; Lainas, George T; Venetis, Christos A; Petsas, George K; Tarlatzis, Basil C; Lainas, Tryfon G

    2017-10-01

    The aim of this study is to determine whether blastocyst utilization rates are different after continuous culture in two different commercial single-step media. This is a paired randomized controlled trial with sibling oocytes conducted in infertility patients, aged ≤40 years with ≥10 oocytes retrieved assigned to blastocyst culture and transfer. Retrieved oocytes were randomly allocated to continuous culture in either Sage one-step medium (Origio) or Continuous Single Culture (CSC) medium (Irvine Scientific) without medium renewal up to day 5 post oocyte retrieval. Main outcome measure was the proportion of embryos suitable for clinical use (utilization rate). A total of 502 oocytes from 33 women were randomly allocated to continuous culture in either Sage one-step medium (n = 250) or CSC medium (n = 252). Fertilization was performed by either in vitro fertilization or intracytoplasmic sperm injection, and embryo transfers were performed on day 5. Two patients had all blastocysts frozen due to the occurrence of severe ovarian hyperstimulation syndrome. Fertilization and cleavage rates, as well as embryo quality on day 3, were similar in the two media. Blastocyst utilization rates (%, 95% CI) [55.4% (46.4-64.1) vs 54.7% (44.9-64.6), p = 0.717], blastocyst formation rates [53.6% (44.6-62.5) vs 51.9 (42.2-61.6), p = 0.755], and proportion of good quality blastocysts [36.8% (28.1-45.4) vs 36.1% (27.2-45.0), p = 0.850] were similar in Sage one-step and CSC media, respectively. Continuous culture of embryos in Sage one-step and CSC media is associated with similar blastocyst development and utilization rates. Both single-step media appear to provide adequate support during in vitro preimplantation embryo development. Whether these observations are also valid for other continuous single medium protocols remains to be determined. NCT02302638.

  18. Community based kangaroo mother care for low birth weight babies: A pilot study

    PubMed Central

    Rasaily, Reeta; Ganguly, K. K.; Roy, M.; Vani, S. N.; Kharood, N.; Kulkarni, R.; Chauhan, S.; Swain, S.; Kanugo, L.

    2017-01-01

    Background & objectives: Kangaroo mother care (KMC - early continuous skin-to-skin contact between mother and infants) has been recommended as an alternative care for low birth weight infants. There is limited evidence in our country on KMC initiated at home. The present study was undertaken to study acceptability of KMC in different community settings. Methods: A community-based pilot study was carried out at three sites in the States of Odisha, Gujarat and Maharashtra covering rural, urban and rural tribal population, respectively. Trained health workers provided IEC (information, education and communication) on KMC during antenatal period along with essential newborn care messages. These messages were reinforced during the postnatal period. Outcome measures were the proportion of women accepting KMC, duration of KMC/day and total number of days continuing KMC. Focus group discussions and in-depth interviews were also carried out. Results: KMC was provided to 101 infants weighing 1500-2000 g; 57.4 per cent were preterm. Overall, 80.2 per cent mothers received health education on KMC during antenatal period, family members (68.3%) also attended KMC sessions along with pregnant women and 55.4 per cent of the women initiated KMC within 72 h of birth. KMC was provided on an average for five hours per day. Qualitative survey data indicated that the method was acceptable to mothers and family members; living in nuclear family, household work, twin pregnancy, hot weather, etc., were cited as reasons for not being able to practice KMC for a longer duration. Interpretation & conclusions: It was feasible to provide KMC using existing infrastructure, and the method was acceptable to most mothers of low birth infants. PMID:28574014

  19. Community based kangaroo mother care for low birth weight babies: A pilot study.

    PubMed

    Rasaily, Reeta; Ganguly, K K; Roy, M; Vani, S N; Kharood, N; Kulkarni, R; Chauhan, S; Swain, S; Kanugo, L

    2017-01-01

    Kangaroo mother care (KMC - early continuous skin-to-skin contact between mother and infants) has been recommended as an alternative care for low birth weight infants. There is limited evidence in our country on KMC initiated at home. The present study was undertaken to study acceptability of KMC in different community settings. A community-based pilot study was carried out at three sites in the States of Odisha, Gujarat and Maharashtra covering rural, urban and rural tribal population, respectively. Trained health workers provided IEC (information, education and communication) on KMC during antenatal period along with essential newborn care messages. These messages were reinforced during the postnatal period. Outcome measures were the proportion of women accepting KMC, duration of KMC/day and total number of days continuing KMC. Focus group discussions and in-depth interviews were also carried out. KMC was provided to 101 infants weighing 1500-2000 g; 57.4 per cent were preterm. Overall, 80.2 per cent mothers received health education on KMC during antenatal period, family members (68.3%) also attended KMC sessions along with pregnant women and 55.4 per cent of the women initiated KMC within 72 h of birth. KMC was provided on an average for five hours per day. Qualitative survey data indicated that the method was acceptable to mothers and family members; living in nuclear family, household work, twin pregnancy, hot weather, etc., were cited as reasons for not being able to practice KMC for a longer duration. It was feasible to provide KMC using existing infrastructure, and the method was acceptable to most mothers of low birth infants.

  20. Modifications of a Device for Maintenance of the Rumen Microbial Population in Continuous Culture

    PubMed Central

    Slyter, L. L.; Nelson, W. O.; Wolin, M. J.

    1964-01-01

    An improved and simplified apparatus for maintaining the rumen microbial population in continuous culture was constructed. All components were easily obtained from commercial sources or were simple to construct. Mechanical difficulties were minimal, and little attention was needed on the part of the operator. The deoxyribonucleic acid (DNA) content of the cultures (100 to 150 μg/ml) varied little during 7 days of continuous culture, and protozoal concentration decreased from 105 per ml to a steady-state level of 2 × 103 per ml in 4 days. Volatile fatty acid and methane production followed the normal in vivo pattern for 7 days of continuous culture. DNA, protozoal concentrations, and fermentation patterns did not significantly change between 4 and 21 days of continuous culture. PMID:14201093

  1. Day surgery nurses' selection of patient preoperative information.

    PubMed

    Mitchell, Mark

    2017-01-01

    To determine selection and delivery of preoperative verbal information deemed important by nurses to relay to patients immediately prior to day surgery. Elective day-case surgery is expanding, patient turnover is high and nurse-patient contact limited. In the brief time-frame available, nurses must select and precisely deliver information to patients, provide answers to questions and gain compliance to ensure a sustained, co-ordinated patient throughput. Concise information selection is therefore necessary especially given continued day surgery expansion. Electronic questionnaire. A survey investigating nurses' choice of patient information prior to surgery was distributed throughout the UK via email addresses listed on the British Association of Day Surgery member's website (January 2015-April 2015). Participants were requested to undertake the survey within 2-3 weeks, with 137 participants completing the survey giving a 44% response rate. Verbal information deemed most important by nurses preoperatively was checking fasting time, information about procedure/operation, checking medication, ensuring presence of medical records/test results and concluding medical investigations checks. To a lesser extent was theatre environment information, procedure/operation start time and possible time to discharge. Significant differences were established between perceived importance of information and information delivery concerning the procedure/operation and anaesthesia details. Nurses working with competing demands and frequent interruptions, prioritised patient safety information. Although providing technical details during time-limited encounters, efforts were made to individualise provision. A more formal plan of verbal information provision could help ease nurses' cognitive workload and enhance patient satisfaction. This study provides evidence that verbal information provided immediately prior to day surgery may vary with experience. Nurse educators and managers may need to provide greater guidance for such complex care settings as delivery of increasingly technical details during brief encounters is gaining increasing priority. © 2016 John Wiley & Sons Ltd.

  2. U.S. Geological Survey continuous monitoring workshop—Workshop summary report

    USGS Publications Warehouse

    Sullivan, Daniel J.; Joiner, John K.; Caslow, Kerry A.; Landers, Mark N.; Pellerin, Brian A.; Rasmussen, Patrick P.; Sheets, Rodney A.

    2018-04-20

    Executive SummaryThe collection of high-frequency (in other words, “continuous”) water data has been made easier over the years because of advances in technologies to measure, transmit, store, and query large, temporally dense datasets. Commercially available, in-situ sensors and data-collection platforms—together with new techniques for data analysis—provide an opportunity to monitor water quantity and quality at time scales during which meaningful changes occur. The U.S. Geological Survey (USGS) Continuous Monitoring Workshop was held to build stronger collaboration within the Water Mission Area on the collection, interpretation, and application of continuous monitoring data; share technical approaches for the collection and management of continuous data that improves consistency and efficiency across the USGS; and explore techniques and tools for the interpretation of continuous monitoring data, which increases the value to cooperators and the public. The workshop was organized into three major themes: Collecting Continuous Data, Understanding and Using Continuous Data, and Observing and Delivering Continuous Data in the Future. Presentations each day covered a variety of related topics, with a special session at the end of each day designed to bring discussion and problem solving to the forefront.The workshop brought together more than 70 USGS scientists and managers from across the Water Mission Area and Water Science Centers. Tools to manage, assure, control quality, and explore large streams of continuous water data are being developed by the USGS and other organizations and will be critical to making full use of these high-frequency data for research and monitoring. Disseminating continuous monitoring data and findings relevant to critical cooperator and societal issues is central to advancing the USGS networks and mission. Several important outcomes emerged from the presentations and breakout sessions.

  3. Unscheduled bleeding with continuous oral contraceptive pills: a comparison of progestin dose.

    PubMed

    Kaneshiro, Bliss; Edelman, Alison; Carlson, Nichole E; Nichols, Mark; Jensen, Jeffrey

    2012-07-01

    Although the use of continuous oral contraceptive pills (OCPs) eliminates scheduled uterine bleeding, unscheduled bleeding is common. The objective of this study was to determine whether progestin dose influences bleeding with use of continuous OCPs. This was a secondary data analysis of two other studies of continuous OCPs. Women were eligible if they were switching from a cyclic hormonal contraceptive to a continuous OCP. Women took a 20-mcg ethinyl estradiol (EE)/100-mcg levonorgestrel (LNG) pill or a 20-mcg EE/90-mcg LNG pill for 112 days. The number of bleeding/spotting days was compared between groups using a t test. Sample size was adequate to detect a difference of 8 days of bleeding/spotting over the 112 day study period (β=0.80, α=0.05). Sixty-six subjects were enrolled, 33 in each group. There were no differences in baseline characteristic, missed OCPs or side effects. There were no differences in the mean number of bleeding/spotting days in the first 84 days of the study (90 mcg LNG mean 20.8 (SE 3.6) days versus 100 mcg LNG 17.8 (SE 2.3) days, p=.48), nor was there a difference in the time to amenorrhea (p=.35). Our results do not support the use of one LNG dose over another to decrease the amount of unscheduled bleeding women experience when initiating a continuous OCP. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Landsat: Planning the Next 20 Years of Earth Observation and Science

    NASA Astrophysics Data System (ADS)

    Ryker, S. J.; Larsen, M. C.; Newman, T. R.

    2013-12-01

    The Landsat series of Earth-observing satellites began 41 years ago as a partnership between the U.S. Department of the Interior (DOI) and NASA. The U.S. Geological Survey (USGS), as DOI's Earth science agency, provides Landsat's ground systems and data and develops value-added science products and applications. In 2013 the Administration committed to continue the Landsat program for the long term, and directed NASA and USGS to develop a series of spaceborne systems to provide global, continuous Landsat-quality multispectral and thermal infrared measurements for at least 20 years beyond Landsat 9. The Administration also directed the USGS to develop the program's long-term science directions, with special emphasis on making Landsat data more easily used in a wide variety of disciplines and fields of practice. With Landsats 7 and 8 on orbit, the USGS provides data every eight days for any location on the Earth's land masses. Given eight-day data collection and Landsat's 41-year historical archive, researchers and decision-makers can assess phenomena occurring at weekly to decadal time scales. With this in mind, the USGS has identified a set of Landsat-based science products that will improve applications used by natural resource managers and will contribute to the international and interagency climate monitoring community's initiative to develop consistent climate data records (CDRs) and essential climate variables (ECVs). Key Landsat-derived CDRs include surface reflectance and surface temperature, and ECV products will include measures of fire disturbance, snow covered area, surface water extent, land cover, and above-ground green biomass. These interpretive products will provide an authoritative basis for regional to continental scale identification of historical change, monitoring of current conditions, and predicting future conditions. The Administration has also assigned USGS the responsibility to analyze Landsat users' needs to inform future operational directions. For example, according to 2012 surveys, two-thirds of Landsat applications studied required eight-day data collection (i.e. multiple satellites on orbit), and applications increasingly rely on the 41-year archive (not only current data). These findings support the need for a near-term replacement for Landsat 7, which has only a few years of fuel left; and the need for Landsat 9 data to be highly compatible with previous Landsat data. In addition to eight-day repeat data collection and continuity, current themes in users' recommendations range from more frequent data collection for commodity estimates and resource management, to exploring the potential of new imaging instruments, for example by launching future Landsats with prototypes of new sensors on board. USGS continues to work with NASA to examine these options. USGS is also collaborating with commercial and foreign Earth observing institutions to explore alternate means to meet these user needs. For example, the European Commission in 2013 made strides toward a free data policy for the Sentinel-2 program. This and other relationships will augment what Landsat provides to scientists, decision-makers, and the commercial sector.

  5. Continuing Day Treatment Programs Promote Recovery in Schizophrenia

    PubMed Central

    2009-01-01

    Continuing day treatment programs focus on community stabilization through comprehensive individualized rehabilitation. They promote recovery through a variety of practical clinical therapeutic interventions. This empirically based report describes a continuing day treatment program’s rehabilitation of four clients with schizophrenia, chronic type in a western New York mental health clinic who were in each of the specialty services: a two-phase program, a program for seniors, and a program for co-occurring substance dependence. Some particularly difficult psychiatric symptoms of schizophrenia were successfully treated in this continuing day treatment program. Each of these clients showed improvements in their symptoms and overall community adjustment that may well have been unobtainable with less intensive outpatient treatment. PMID:19724730

  6. Predictors of attrition for a sexual assault forensic examiner (SAFE) blended learning training program.

    PubMed

    Patterson, Debra; Resko, Stella

    2015-01-01

    Participant attrition is a major concern for online continuing education health care courses. The current study sought to understand what factors predicted health care professionals completing the online component of a sexual assault forensic examiner (SAFE) blended learning training program (12-week online course and 2-day in-person clinical skills workshop). The study used a Web-based survey to examine participant characteristics, motivation, and external barriers that may influence training completion. Hierarchical logistic regression was utilized to examine the predictors of training completion, while the Cox proportional hazards (Cox PH) regression model helped determine the factors associated with the timing of participant attrition. Results show that 79.3% of the enrolled professionals completed the online component. The study also found that clinicians who work in rural communities and those who were interested in a 2-day clinical skills workshop were more likely to complete the online course. In terms of when attrition occurred, we found that participants who were motivated by the 2-day clinical workshop, those who worked in a rural community, and participants interested in the training program because of its online nature were more likely to complete more of the online course. Blending an online course with a brief in-person clinical component may serve as a motivator for completing an online course because it provides the opportunity to develop clinical skills while receiving immediate feedback. Participant attrition appears to be less of a concern for rural clinicians because this modality can reduce their barriers to accessing continuing education. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  7. Improving Our Odds: Success through Continuous Risk Management

    NASA Technical Reports Server (NTRS)

    Greenhalgh, Phillip O.

    2009-01-01

    Launching a rocket, running a business, driving to work and even day-to-day living all involve some degree of risk. Risk is ever present yet not always recognized, adequately assessed and appropriately mitigated. Identification, assessment and mitigation of risk are elements of the risk management component of the "continuous improvement" way of life that has become a hallmark of successful and progressive enterprises. While the application of risk management techniques to provide continuous improvement may be detailed and extensive, the philosophy, ideals and tools can be beneficially applied to all situations. Experiences with the use of risk identification, assessment and mitigation techniques for complex systems and processes are described. System safety efforts and tools used to examine potential risks of the Ares I First Stage of NASA s new Constellation Crew Launch Vehicle (CLV) presently being designed are noted as examples. Recommendations from lessons learned are provided for the application of risk management during the development of new systems as well as for the improvement of existing systems. Lessons learned and suggestions given are also examined for applicability to simple systems, uncomplicated processes and routine personal daily tasks. This paper informs the reader of varied uses of risk management efforts and techniques to identify, assess and mitigate risk for improvement of products, success of business, protection of people and enhancement of personal life.

  8. 18 CFR 376.209 - Procedures during periods of emergency requiring activation of the Continuity of Operations Plan.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... major wire services, industry press, and appropriate metropolitan area radio stations announcing that... Internet Web site, the Transmission Provide may, for 30 days, also delay compliance with the requirements of § 358.4(a)(2) of this chapter to post this information on the OASIS or Internet Web site, as...

  9. Providing Post-Compulsory Education Options through "Newlook" Rural Partnerships

    ERIC Educational Resources Information Center

    Mlcek, Susan

    2009-01-01

    The tree change phenomenon started around Australia from about 2003 and continues to this day, even into places like the Western Plains area of New South Wales. Relocating from the city to rural areas for a lifestyle change is attributed to this phenomenon. An ever-growing interest in post-compulsory education solutions that run parallel to this…

  10. Million Dollar Busing: Saving Money through Privatization

    ERIC Educational Resources Information Center

    Crates, Cheryl

    2009-01-01

    The economic crisis has had--and will continue to have--a dramatic effect on tax revenue and education spending throughout the United States and beyond. Yet children still show up for school every day in need of an education. In times like these, educators and school business managers must be as committed as ever to providing it. The economic…

  11. Teaching Introductory Business Statistics Using the DCOVA Framework

    ERIC Educational Resources Information Center

    Levine, David M.; Stephan, David F.

    2011-01-01

    Introductory business statistics students often receive little guidance on how to apply the methods they learn to further business objectives they may one day face. And those students may fail to see the continuity among the topics taught in an introductory course if they learn those methods outside a context that provides a unifying framework.…

  12. Continuous Glucose Monitoring in Female NOD Mice Reveals Daily Rhythms and a Negative Correlation With Body Temperature.

    PubMed

    Korstanje, Ron; Ryan, Jennifer L; Savage, Holly S; Lyons, Bonnie L; Kane, Kevin G; Sukoff Rizzo, Stacey J

    2017-09-01

    Previous studies with continuous glucose monitoring in mice have been limited to several days or weeks, with the mouse's physical attachment to the equipment affecting behavior and measurements. In the current study, we measured blood glucose and body temperature at 10-second intervals for 12 weeks in a cohort of NOD/ShiLtJ female mice using wireless telemetry. This allowed us to obtain a high-resolution profile of the circadian rhythm of these two parameters and the onset of hyperglycemic development in real time. The most striking observations were the elevated nocturnal concentrations of glucose into the diabetic range days before elevations in diurnal glucose (when glucose concentrations are historically measured) and the strong, negative correlation between elevated blood glucose concentrations and body temperature with a steady decline of the body temperature with diabetes development. Taken together, this technological advancement provides improved resolution in the study of the disease trajectory of diabetes in mouse models, including relevant translatability to the current technologies of continuous glucose monitoring now regularly used in patients. Copyright © 2017 Endocrine Society.

  13. Continuous fermentation of food waste leachate for the production of volatile fatty acids and potential as a denitrification carbon source.

    PubMed

    Kim, Hakchan; Kim, Jaai; Shin, Seung Gu; Hwang, Seokhwan; Lee, Changsoo

    2016-05-01

    This study investigated the simultaneous effects of hydraulic retention time (HRT) and pH on the continuous production of VFAs from food waste leachate using response surface analysis. The response surface approximations (R(2)=0.895, p<0.05) revealed that pH has a dominant effect on the specific VFA production (PTVFA) within the explored space (1-4-day HRT, pH 4.5-6.5). The estimated maximum PTVFA was 0.26g total VFAs/g CODf at 2.14-day HRT and pH 6.44, and the approximation was experimentally validated by running triplicate reactors under the estimated optimum conditions. The mixture of the filtrates recovered from these reactors was tested as a denitrification carbon source and demonstrated superior performance in terms of reaction rate and lag length relative to other chemicals, including acetate and methanol. The overall results provide helpful information for better design and control of continuous fermentation for producing waste-derived VFAs, an alternative carbon source for denitrification. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Building enterprise-wide resilience by integrating business continuity capability into day-to-day business culture and technology.

    PubMed

    Alesi, Patrick

    2008-04-01

    This paper follows the development of the business continuity planning (BCP) programme at Lehman Brothers following the events of September 11th. Previous attempts to implement a `traditional' form of BCP had been ineffective, but following the events, the firm began to look at BCP in a new light. This paper deals with three main themes: creating a culture of resiliency, leveraging technology, and building flexible plans. Distributing accountability for BCP to business line managers, integrating BCP change management into the normal course of business, and providing every employee with personalised BCP information breeds a culture of resiliency where people are empowered to react to events without burdensome, hierarchical response and recovery procedures. Building a strong relationship with one's application development community can result in novel, customised BCP solutions; existing systems and data structures can be used to enhance an existing BCP. Even the best plans are often challenged by events; understanding that flexibility is essential to effective incident response is a critical element in the development of a proper business continuity plan.

  15. International AGN Watch: Continuous Monitoring of NGC 4151

    NASA Technical Reports Server (NTRS)

    Crenshaw, D. M.

    1995-01-01

    The nucleus of NGC 4151 was observed continuously with the International Ultraviolet Explorer (IUE) for 9.3 days, yielding a pair of LWP and SWP spectra every 70 minutes, and during four-hour periods for 4 days prior to and 5 days after the continuous monitoring period. The sampling frequency of the observations is an order of magnitude higher than that of any previous UV monitoring campaign on a Seyfert galaxy.

  16. Effects of Cardiopulmonary Support with a Novel Pediatric Pump-Lung (PediPL) in a Thirty-Day Ovine Animal Model

    PubMed Central

    Liu, Yang; Sanchez, Pablo G; Wei, Xufeng; Watkins, Amelia C; Niu, Shuqiong; Wu, Zhongjun J; Griffith, Bartley P

    2016-01-01

    The scarcity of donor organs has led to the development of devices that provide optimal long-term respiratory or cardiopulmonary support to bridge recipients as they wait for lung and/or heart transplantation. This study was designed to evaluate the 30-day in-vivo performance of the newly developed pediatric pump-lung (PediPL) for cardiopulmonary support using a juvenile sheep model. The PediPL device was placed surgically between the right atrium and descending aorta in eight sheep (25.4 to 31.2kg) and evaluated for 30 days. Anticoagulation was maintained with continuous heparin infusion (ACT 150–200 sec). The flow rate was measured continually and gas transfer was measured daily. Plasma free hemoglobin, platelet activation, hematologic data, and blood biochemistry were assessed twice a week. Sheep were euthanized after 30 days. The explanted devices were examined for gross thrombosis. Six sheep survived for 30 to 32 days. During the study, the oxygen transfer rate of the devices was 54.9 ± 13.2mL/min at a mean flow rate of 1.14 ± 0.46 L/min with blood oxygen saturation of 95.4% ± 1.7%. Plasma free hemoglobin was 8.2 ± 3.7 mg/dL. Platelet activation was 5.35 ± 2.65%. The animals had normal organ chemistries except for surgery-related transient alterations in kidney and liver function. Although we found some scattered thrombi on the membrane surfaces of some explanted devices during the necropsy, the device function and performance did not degrade. The PediPL device was capable of providing cardiopulmonary with long-term reliability and good biocompatibility over the 30 day duration and offering the potential option for bridging to heart and/or lung transplant pediatric patients with end-stage heart or lung disease. PMID:25921361

  17. Muscle protein metabolism in neonatal alloxan-administered rats: effects of continuous and intermittent swimming training

    PubMed Central

    2012-01-01

    Background This study aimed to examine the effects of intermittent and continuous swimming training on muscle protein metabolism in neonatal alloxan-administered rats. Methods Wistar rats were used and divided into six groups: sedentary alloxan (SA), sedentary control (SC), continuous trained alloxan (CA), intermittent trained alloxan (IA), continuous trained control (CC) and intermittent trained control (IC). Alloxan (250 mg/kg body weight) was injected into newborn rats at 6 days of age. The continuous training protocol consisted of 12 weeks of swimming training in individual cylinder tanks while supporting a load that was 5% of body weight; uninterrupted swimming for 1 h/day, five days a week. The intermittent training protocol consisted of 12 weeks of swimming training in individual cylinder tanks while supporting a load that was 15% of body weight; 30 s of activity interrupted by 30 s of rest for a total of 20 min/day, five days a week. Results At 28 days, the alloxan animals displayed higher glycemia after glucose overload than the control animals. No differences in insulinemia among the groups were detected. At 120 days, no differences in serum albumin and total protein among the groups were observed. Compared to the other groups, DNA concentrations were higher in the alloxan animals that were subjected to continuous training, whereas the DNA/protein ratio was higher in the alloxan animals that were subjected to intermittent training. Conclusion It was concluded that continuous and intermittent training sessions were effective in altering muscle growth by hyperplasia and hypertrophy, respectively, in alloxan-administered animals. PMID:22309804

  18. TDRS-L Media Day

    NASA Image and Video Library

    2014-01-03

    TITUSVILLE, Fla. – Inside the Astrotech payload processing facility in Titusville, members of the news media are given an opportunity for an up-close look at the payload fairing that will encapsulate the Tracking and Data Relay Satellite, or TDRS-L, spacecraft. Journalists visited Astrotech as part of TDRS-L Media Day to conduct interviews and photograph the satellite that will be a part of the second of three next-generation spacecraft designed to ensure vital operational continuity for the NASA Space Network. It is scheduled to launch from Cape Canaveral's Space Launch Complex 41 atop an Atlas V rocket in January 2014. The current Tracking and Data Relay Satellite system consists of eight in-orbit satellites distributed to provide near continuous information relay contact with orbiting spacecraft ranging from the International Space Station and Hubble Space Telescope to the array of scientific observatories. For more information, visit: http://www.nasa.gov/mission_pages/tdrs/home/index.html

  19. Antarctica Day: An International Celebration

    NASA Astrophysics Data System (ADS)

    Pope, A.; Hambrook Berkman, J.; Berkman, P. A.

    2013-12-01

    For more than half a century, the 1959 Antarctic Treaty continues to shine as a rare beacon of international cooperation. To celebrate this milestone of peace in our civilization with hope and inspiration for future generations, Antarctica Day is celebrated each year on December 1st , the anniversary of the Antarctic Treaty signing. As an annual event - initiated by the Foundation for the Good Governance of International Spaces (www.internationalspaces.org/) in collaboration with the Association of Polar Early Carer Scientists (www.apecs.is) - Antarctica Day encourages participation from around the world. The Antarctic Treaty set aside 10% of the earth, 'forever to be used exclusively for peaceful purposes in the interest of mankind.' It was the first nuclear arms agreement and the first institution to govern all human activities in an international region beyond sovereign jurisdictions. In this spirit, Antarctica Day aims to: - Demonstrate how diverse nations can work together peacefully, using science as a global language of cooperation for decision making beyond national boundaries, - Provide strategies for students learning about Antarctica through art, science and history at all school levels, - Increase collaboration and communication between classrooms, communities, researchers and government officials around the world, and - Provide a focus for polar educators to build on each year. Through close collaboration with a number of partners. Antarctica Day activities have included: a Polar Film Festival convened by The Explorers Club; live sessions connecting classrooms with scientists in Antarctica thanks to PolarTREC and ARCUS; an international activity that involved children from 13 countries who created over 600 flags which exemplify Antarctica Day (these were actually flown in Antarctica with signed certificates then returned to the classes); a map where Antarctica Day participants all over the world could share what they were doing; an Antarctic bird count involving the International Association of Antarctic Tour Operators; and public lectures and online videos (including a notable submission from Polar Educators International). Antarctica Day was initiated as a legacy of the 2009 Antarctic Treaty Summit (www.atsumit50.aq), which was convened at the Smithsonian Institution with 40 sponsoring institutions from around the world as part of the International Polar Year. Antarctic Day involved participants from 14 nations in 2010. 28 nations in 2011, and 26 nations in 2012 with representatives from all 7 continents. Antarctica Day 2013 will have recently taken place before the AGU Fall Meeting 2013, and we will present updates at that time. Our aim is to continue expanding Antarctica Day as a globally-accessible platform to share, interpret and cherish the values associated with Antarctica for the benefit of present and future generations. We look forward to the discussion and sharing that this session will provide.

  20. A study on delay in treatment of kala-azar patients in Bangladesh.

    PubMed

    Arif, Syed M; Basher, Ariful; Rahman, Mohammad R; Faiz, Mohammad A

    2012-01-01

    Visceral leishmaniasis (kala-azar) continues to be a major rural public health problem in Bangladesh. A cross-sectional study was carried out in two subdistricts of Mymensingh district from January 2006 to June 2007 to evaluate the delay kala-azar treatment. Suspected patients who attended to out patient department (OPD) were subjected to a dipstick test (RK39) for kala-azar. Sixty five from Bhaluka and 60 positive patients from Gafargaon subdistrict were enrolled. Most of the patients (80%) first visited nonqualified private practitioners, while only 15.2% consulted registered doctors. Fifty per cent were referred to the Upazilla health complex (UZHC) by the family members or relatives. About 49% and 43% patients required third and second health-care providers for kala-azar treatment, respectively. Patient delay ranged from 2 to 30 days; median 4 (IQR 3 to 7 days), the system delay ranged from 0 days to 225 days; median 54 (IQR 40-66 days). Residential status (p value <0.05) had impact on patient delay. Educational status and number of treatment providers had impact on system delay (p<0.05). System delay rather than patient delay is the important weakness of the kala-azar control programme in Bangladesh. Residence in rural areas, low educational background and treatment providers are associated with these delays. A proper educational programme may reduce the delay.

  1. CONT14: Preparation and Prospects

    NASA Astrophysics Data System (ADS)

    Behrend, Dirk; Thomas, Cynthia; Himwich, Ed; MacMillan, Dan

    2014-12-01

    In May 2014, a network of seventeen stations at sixteen sites will observe the next continuous VLBI campaign named CONT14. From May 6 through May 20, ten northern hemisphere and seven southern hemisphere stations will record S/X VLBI data for fifteen continuous UT days at a rate of 512 Mbps. This campaign is the continuation of similar campaigns loosely organized every three years. We discuss the preparation work such as allocation of station, media, and correlator resources and the observational procedure that will ensure that the best possible S/X VLBI data set be recorded. With a network size of seventeen stations, CONT14 is a precursor of continuous VGOS-type observing but with the S/X system. In the next several years, continuous VGOS observing on the broadband system will become a reality. With this in mind, we provide an outlook on future prospects of CONT campaigns.

  2. Microwave and continuous flow technologies in drug discovery.

    PubMed

    Sadler, Sara; Moeller, Alexander R; Jones, Graham B

    2012-12-01

    Microwave and continuous flow microreactors have become mainstream heating sources in contemporary pharmaceutical company laboratories. Such technologies will continue to benefit from design and engineering improvements, and now play a key role in the drug discovery process. The authors review the applications of flow- and microwave-mediated heating in library, combinatorial, solid-phase, metal-assisted, and protein chemistries. Additionally, the authors provide a description of the combination of microwave and continuous flow platforms, with applications in the preparation of radiopharmaceuticals and in drug candidate development. Literature reviewed is chiefly 2000 - 2012, plus key citations from earlier reports. With the advent of microwave irradiation, reactions that normally took days to complete can now be performed in a matter of minutes. Coupled with the introduction of continuous flow microreactors, pharmaceutical companies have an easy way to improve the greenness and efficiency of many synthetic operations. The combined force of these technologies offers the potential to revolutionize discovery and manufacturing processes.

  3. Day Care Centers for Seniors in Singapore: Looking Back and Looking Ahead.

    PubMed

    Liu, Germaine; Yap, Philip; Wong, Gabriel H Z; Wei, Heng Xiao; Hua, Ee Chye

    2015-07-01

    The burden of care for frail elderly persons on families and the society is ever real as our population ages. Given the dual-income nature of many working families, day care centers offer a strong alternative to nursing homes for families wishing to provide custodial care and meaningful engagement for seniors while continuing to uphold their filial duties. Recognizing this, several initiatives, such as SPICE (Singapore Programme for Integrated Care for the Elderly) and Weekend Respite Care, have been launched to enhance the services of Singapore's day care centers. This article traces the evolution of this process, distills current challenges, and offers policy recommendations to improve Singapore's day care services for seniors. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  4. Recovery of resources for advanced life support space applications: effect of retention time on biodegradation of two crop residues in a fed-batch, continuous stirred tank reactor.

    PubMed

    Strayer, R F; Finger, B W; Alazraki, M P; Cook, K; Garland, J L

    2002-09-01

    Bioreactor retention time is a key process variable that will influence costs that are relevant to long distance space travel or long duration space habitation. However. little is known about the effects of this parameter on the microbiological treatment options that are being proposed for Advanced Life Support (ALS) systems. Two bioreactor studies were designed to examine this variable. In the first one, six retention times ranging from 1.3 to 21.3 days--were run in duplicate, 81 working-volume continuous stirred tank reactors (CSTR) that were fed ALS wheat residues. Ash-free dry weight loss, carbon mineralization, soluble TOC reduction, changes in fiber content (cellulose, hemicellulose, and lignin), bacterial numbers, and mineral recoveries were monitored. At short retention times--1.33 days--biodegradation was poor (total: 16-20%, cellulose - 12%, hemicellulose - 28%) but soluble TOC was decreased by 75-80% and recovery of major crop inorganic nutrients was adequate, except for phosphorus. A high proportion of the total bacteria (ca. 83%) was actively respiring. At the longest retention time tested, 21.3 days, biodegradation was good (total: 55-60%, cellulose ca. 70%, hemicellulose - ca. 55%) and soluble TOC was decreased by 80%. Recovery of major nutrients, except phosphorus, remained adequate. A very low proportion of total bacteria was actively respiring (ca. 16%). The second bioreactor study used potato residue to determine if even shorter retention times could be used (range 0.25-2.0 days). Although overall biodegradation deteriorated, the degradation of soluble TOC continued to be ca. 75%. We conclude that if the goal of ALS bioprocessing is maximal degradation of crop residues, including cellulose, then retention times of 10 days or longer will be needed. If the goal is to provide inorganic nutrients with the smallest volume/weight bioreactor possible, then a retention time of 1 day (or less) is sufficient.

  5. Recovery of resources for advanced life support space applications: effect of retention time on biodegradation of two crop residues in a fed-batch, continuous stirred tank reactor

    NASA Technical Reports Server (NTRS)

    Strayer, R. F.; Finger, B. W.; Alazraki, M. P.; Cook, K.; Garland, J. L.

    2002-01-01

    Bioreactor retention time is a key process variable that will influence costs that are relevant to long distance space travel or long duration space habitation. However. little is known about the effects of this parameter on the microbiological treatment options that are being proposed for Advanced Life Support (ALS) systems. Two bioreactor studies were designed to examine this variable. In the first one, six retention times ranging from 1.3 to 21.3 days--were run in duplicate, 81 working-volume continuous stirred tank reactors (CSTR) that were fed ALS wheat residues. Ash-free dry weight loss, carbon mineralization, soluble TOC reduction, changes in fiber content (cellulose, hemicellulose, and lignin), bacterial numbers, and mineral recoveries were monitored. At short retention times--1.33 days--biodegradation was poor (total: 16-20%, cellulose - 12%, hemicellulose - 28%) but soluble TOC was decreased by 75-80% and recovery of major crop inorganic nutrients was adequate, except for phosphorus. A high proportion of the total bacteria (ca. 83%) was actively respiring. At the longest retention time tested, 21.3 days, biodegradation was good (total: 55-60%, cellulose ca. 70%, hemicellulose - ca. 55%) and soluble TOC was decreased by 80%. Recovery of major nutrients, except phosphorus, remained adequate. A very low proportion of total bacteria was actively respiring (ca. 16%). The second bioreactor study used potato residue to determine if even shorter retention times could be used (range 0.25-2.0 days). Although overall biodegradation deteriorated, the degradation of soluble TOC continued to be ca. 75%. We conclude that if the goal of ALS bioprocessing is maximal degradation of crop residues, including cellulose, then retention times of 10 days or longer will be needed. If the goal is to provide inorganic nutrients with the smallest volume/weight bioreactor possible, then a retention time of 1 day (or less) is sufficient.

  6. A randomized controlled trial of subantimicrobial-dose doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use.

    PubMed

    Kaneshiro, Bliss; Edelman, Alison; Carlson, Nichole E; Nichols, Mark; Forbes, Marci Messerle; Jensen, Jeffrey

    2012-04-01

    Unscheduled bleeding is the main side effect of continuous oral contraceptive pills (OCPs) and has been correlated with the up-regulation of matrix metalloprotineases (MMPs). The study objective was to determine if prophylactic administration of doxycycline (an MMP inhibitor at low subantimicrobial doses) would prevent unscheduled bleeding during the initiation of a continuous OCP. Subjects using cyclic hormonal contraceptives (combined OCPs, patch or ring) without unscheduled bleeding were switched to continuous OCPs (20 mcg ethinyl estradiol/100 mcg levonorgestrel). They were randomized to receive daily doxycycline [sustained-release subantimicrobial dose (40 mg daily)] or placebo for the first 84 days and then observed for an additional 28 days on the continuous OCP alone. The number of bleeding/spotting days and the time in days it took to achieve amenorrhea were compared using a t test. Sixty-five subjects were randomized. Although the use of doxycycline did not significantly decrease the number of mean bleeding/spotting days in the first 84 days of the study [doxycycline 14.75 (SE 2.30), placebo 17.78 (2.31), p=.36], women who received doxycycline had a significantly earlier onset of amenorrhea [mean last day of bleeding/spotting doxycycline 61.7 (7.7), placebo 85.2 (6.7), p=.03]. The coadministration of subantimicrobial-dose doxycycline during initiation of continuous OCPs results in a significant reduction in the length of time needed to achieve amenorrhea. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. A randomized controlled trial of subantimicrobial-dose doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use☆

    PubMed Central

    Kaneshiro, Bliss; Edelman, Alison; Carlson, Nichole E.; Nichols, Mark; Forbes, Marci Messerle; Jensen, Jeffrey

    2016-01-01

    Background Unscheduled bleeding is the main side effect of continuous oral contraceptive pills (OCPs) and has been correlated with the up-regulation of matrix metalloprotineases (MMPs). The study objective was to determine if prophylactic administration of doxycycline (an MMP inhibitor at low subantimicrobial doses) would prevent unscheduled bleeding during the initiation of a continuous OCP. Study Design Subjects using cyclic hormonal contraceptives (combined OCPs, patch or ring) without unscheduled bleeding were switched to continuous OCPs (20 mcg ethinyl estradiol/100 mcg levonorgestrel). They were randomized to receive daily doxycycline [sustained-release subantimicrobial dose (40 mg daily)] or placebo for the first 84 days and then observed for an additional 28 days on the continuous OCP alone. The number of bleeding/spotting days and the time in days it took to achieve amenorrhea were compared using a t test. Results Sixty-five subjects were randomized. Although the use of doxycycline did not significantly decrease the number of mean bleeding/spotting days in the first 84 days of the study [doxycycline 14.75 (SE 2.30), placebo 17.78 (2.31), p=.36], women who received doxycycline had a significantly earlier onset of amenorrhea [mean last day of bleeding/spotting doxycycline 61.7 (7.7), placebo 85.2 (6.7), p=.03]. Conclusion The coadministration of subantimicrobial-dose doxycycline during initiation of continuous OCPs results in a significant reduction in the length of time needed to achieve amenorrhea. PMID:22067758

  8. Anaerobic glycolysis and specific gravity of the red blood cells of rats exposed to pure oxygen at 600 torr.

    NASA Technical Reports Server (NTRS)

    Sabine, J. C.; Leon, H. A.

    1971-01-01

    Rats were exposed to 100% oxygen at 600 torr for up to 8 days. Highly significant increases in RBC anaerobic glycolysis occurred during the first 4 days of exposure and then subsided. Two significant peaks were found, one on days 1 and 2 and one on day 4. The first peak is attributed to reticulocytosis, which was maximal after 90 minutes and had disappeared by day 3. A second mechanism must account for the peak on day 4. An interpretation of the second peak is provided by existing evidence that selective removal of older RBCs occurs during the first few days of exposure to hypobaric oxygen, with maximum effect on day 4. Results in splenectomized, sham-operated and intact animals were indistinguishable from each other. A significant decrease in RBC specific gravity was found in exposed animals with spleens intact, but not in splenectomized animals. Theoretical aspects of age-related parameters as an aid to continuous detection and evaluation of changes in RBC populations are discussed.

  9. Alternative Energy for Defense Conference

    DTIC Science & Technology

    2011-10-26

    Actuated Cooling and Cogeneration Systems Beginning TRL 3/4; End Goal TRL 5 METRICS: COP 0.7, 45 kg/ton US Army CERDEC Applications Portable Power NOW...Provided Power – Not Gov’t owned/operated, commercial grade, capacities vary • Rules of thumb: – 3 kW/person/day (bases with 5 to 3,500 population) – 4 kW...provide CONTINUOUS RATED POWER at these conditions: – 0.8 power factor (pf), lagging – Ambient temperatures up to 52°C (125°F) [-3% for each

  10. A Rotating Bioreactor for Scalable Culture and Differentiation of Respiratory Epithelium

    PubMed Central

    Raredon, Micha Sam Brickman; Ghaedi, Mahboobe; Calle, Elizabeth A.; Niklason, Laura E.

    2015-01-01

    Respiratory epithelium is difficult to grow in vitro, as it requires a well-maintained polarizing air–liquid interface (ALI) to maintain differentiation. Traditional methods rely on permeable membrane culture inserts, which are difficult to work with and are ill-suited for the production of large numbers of cells, such as the quantities required for cell-based clinical therapies. Herein, we investigate an alternative form of culture in which the cells are placed on a porous substrate that is continuously rolled, such that the monolayer of cells is alternately submerged in media or apically exposed to air. Our prototype bioreactor is reliable for up to 21 days of continuous culture and is designed for scale-up for large-scale cell culture with continuous medium and gas exchange. Normal human bronchial epithelial (NHBE) cells were cultured on an absorbent substrate in the reactor for periods of 7, 14, and 21 days and were compared to static controls that were submerged in media. Quantification by immunohistochemistry and quantitative PCR of markers specific to differentiated respiratory epithelium indicated increased cilia, mucous production, and tight junction formation in the rolled cultures, compared to static. Together with scanning electron microscopy and paraffin histology, the data indicate that the intermittent ALI provided by the rolling bioreactor promotes a polarized epithelial phenotype over a period of 21 days. PMID:26858899

  11. Continuous Subcutaneous Insulin Infusion in Children: A Pilot Study Validating a Protocol to Avoid Hypoglycemia at Initiation.

    PubMed

    Manousaki, Despoina; Deladoëy, Johnny; Geoffroy, Louis; Olivier, Patricia

    2017-01-01

    The occurrence of hypoglycemia and hyperglycemia during the first days after transition to continuous subcutaneous insulin infusion (CSII) in patients with type 1 diabetes has not been systematically studied in children. The aim of this prospective study was to demonstrate that the protocol applied in our diabetes clinic is safe at CSII initiation in children. We assessed 22 pediatric patients with type 1 diabetes, using continuous glucose monitoring (CGM) before and after CSII initiation (±3 days). After CSII initiation, there was no difference in the rates of hypoglycemic events expressed as relative rates (RRs) per person-reading (RR = 0.85, p  = 0.52, 95% CI 0.52-1.39), as well as in the number of prolonged hypoglycemic events (>1 h) per day (RR = 1.12, p  = 0.56, 95% CI 0.75-1.68). We observed only a trend toward prolonged episodes of hyperglycemia after pump initiation (RR = 1.52, p  = 0.06, 95% CI 0.97-2.35). Our study is the first to assess, through CGM and in a prospective way, the impact of a CSII initiation protocol on glycemic values. Our protocol provides a safe model to avoid hypoglycemia at CSII initiation in children. www.ClinicalTrials.gov, identifier NCT01840358.

  12. Plasma volume methodology: Evans blue, hemoglobin-hematocrit, and mass density transformations

    NASA Technical Reports Server (NTRS)

    Greenleaf, J. E.; Hinghofer-Szalkay, H.

    1985-01-01

    Methods for measuring absolute levels and changes in plasma volume are presented along with derivations of pertinent equations. Reduction in variability of the Evans blue dye dilution technique using chromatographic column purification suggests that the day-to-day variability in the plasma volume in humans is less than + or - 20 m1. Mass density determination using the mechanical-oscillator technique provides a method for measuring vascular fluid shifts continuously for assessing the density of the filtrate, and for quantifying movements of protein across microvascular walls. Equations for the calculation of volume and density of shifted fluid are presented.

  13. ELF/VLF Waves Generated by an Artificially-Modulated Auroral Electrojet Above the HAARP HF Transmitter

    NASA Astrophysics Data System (ADS)

    Moore, R. C.; Inan, U. S.; Bell, T. F.

    2004-12-01

    Naturally-forming, global-scale currents, such as the polar electrojet current and the mid-latitude dynamo, have been used as current sources to generate electromagnetic waves in the Extremely Low Frequency (ELF) and Very Low Frequency (VLF) bands since the 1970's. While many short-duration experiments have been performed, no continuous multi-week campaign data sets have been published providing reliable statistics for ELF/VLF wave generation. In this paper, we summarize the experimental data resulting from multiple ELF/VLF wave generation campaigns conducted at the High-frequency Active Auroral Research Project (HAARP) HF transmitter in Gakona, Alaska. For one 14-day period in March, 2002, and one 24-day period in November, 2002, the HAARP HF transmitter broadcast ELF/VLF wave generation sequences for 10 hours per day, between 0400 and 1400 UT. Five different modulation frequencies broadcast separately using two HF carrier frequencies are examined at receivers located 36, 44, 147, and 155 km from the HAARP facility. Additionally, a continuous 24-hour transmission period is analyzed to compare day-time wave generation to night-time wave generation. Lastly, a power-ramping scheme was employed to investigate possible thresholding effects at the wave-generating altitude. Wave generation statistics are presented along with source-region property calculations performed using a simple model.

  14. Statistics of AUV's Missions for Operational Ocean Observation at the South Brazilian Bight.

    NASA Astrophysics Data System (ADS)

    dos Santos, F. A.; São Tiago, P. M.; Oliveira, A. L. S. C.; Barmak, R. B.; Miranda, T. C.; Guerra, L. A. A.

    2016-02-01

    The high costs and logistics limitations of ship-based data collection represent an obstacle for a persistent in-situ data collection. Satellite-operated Autonomous Underwater Vehicles (AUV's) or gliders (as these AUV's are generally known by the scientific community) are presented as an inexpensive and reliable alternative to perform long-term and real-time ocean monitoring of important parameters such as temperature, salinity, water-quality and acoustics. This work is focused on the performance statistics and the reliability for continuous operation of a fleet of seven gliders navigating in Santos Basin - Brazil, since March 2013. The gliders performance were evaluated by the number of standby days versus the number of operating days, the number of interrupted missions due to (1) equipment failure, (2) weather, (3) accident versus the number of successful missions and the amount and quality of data collected. From the start of the operations in March 2013 to the preparation of this work (July 2015), a total of 16 glider missions were accomplished, operating during 728 of the 729 days passed since then. From this total, 11 missions were successful, 3 missions were interrupted due to equipment failure and 2 gliders were lost. Most of the identified issues were observed in the communication with the glider (when recovery was necessary) or the optode sensors (when remote settings solved the problem). The average duration of a successful mission was 103 days while interrupted ones ended on average in 7 days. The longest mission lasted for 139 days, performing 859 continuous profiles and covering a distance of 2734 Km. The 2 projects performed together 6856 dives, providing an average of 9,5 profiles per day or one profile every 2,5 hours each day during 2 consecutive years.

  15. Why continuous simulation? The role of antecedent moisture in design flood estimation

    NASA Astrophysics Data System (ADS)

    Pathiraja, S.; Westra, S.; Sharma, A.

    2012-06-01

    Continuous simulation for design flood estimation is increasingly becoming a viable alternative to traditional event-based methods. The advantage of continuous simulation approaches is that the catchment moisture state prior to the flood-producing rainfall event is implicitly incorporated within the modeling framework, provided the model has been calibrated and validated to produce reasonable simulations. This contrasts with event-based models in which both information about the expected sequence of rainfall and evaporation preceding the flood-producing rainfall event, as well as catchment storage and infiltration properties, are commonly pooled together into a single set of "loss" parameters which require adjustment through the process of calibration. To identify the importance of accounting for antecedent moisture in flood modeling, this paper uses a continuous rainfall-runoff model calibrated to 45 catchments in the Murray-Darling Basin in Australia. Flood peaks derived using the historical daily rainfall record are compared with those derived using resampled daily rainfall, for which the sequencing of wet and dry days preceding the heavy rainfall event is removed. The analysis shows that there is a consistent underestimation of the design flood events when antecedent moisture is not properly simulated, which can be as much as 30% when only 1 or 2 days of antecedent rainfall are considered, compared to 5% when this is extended to 60 days of prior rainfall. These results show that, in general, it is necessary to consider both short-term memory in rainfall associated with synoptic scale dependence, as well as longer-term memory at seasonal or longer time scale variability in order to obtain accurate design flood estimates.

  16. Long-term use of nerve block catheters in paediatric patients with cancer related pathologic fractures

    PubMed Central

    BURGOYNE, L. L.; PEREIRAS, L. A.; BERTANI, L. A.; KADDOUM, R. N.; NEEL, M.; FAUGHNAN, L. G.; ANGHELESCU, D. L.

    2013-01-01

    SUMMARY We report three cases of children with osteosarcoma and pathologic fractures treated with long-term continuous nerve blocks for preoperative pain control. One patient with a left distal femoral diaphysis fracture had a femoral continuous nerve block catheter for 41 days without complications. Another with a fractured left proximal femoral shaft had three femoral continuous nerve block catheters for 33, 26 and 22 days respectively. The third patient, whose right proximal humerus was fractured, had a brachial plexus continuous nerve block catheter for 36 days without complication. In our experience, prolonged use of continuous nerve block is safe and effective in children with pathologic fractures for preoperative pain control. PMID:22813501

  17. Variability in and agreement between modeled and personal continuously measured black carbon levels using novel smartphone and sensor technologies.

    PubMed

    Nieuwenhuijsen, Mark J; Donaire-Gonzalez, David; Rivas, Ioar; de Castro, Montserrat; Cirach, Marta; Hoek, Gerard; Seto, Edmund; Jerrett, Michael; Sunyer, Jordi

    2015-03-03

    Novel technologies, such as smartphones and small personal continuous air pollution sensors, can now facilitate better personal estimates of air pollution in relation to location. Such information can provide us with a better understanding about whether and how personal exposures relate to residential air pollution estimates, which are normally used in epidemiological studies. The aims of this study were to examine (1) the variability in personal air pollution levels during the day and (2) the relationship between modeled home and school estimates and continuously measured personal air pollution exposure levels in different microenvironments (e.g., home, school, and commute). We focused on black carbon as an indicator of traffic-related air pollution. We recruited 54 school children (aged 7-11) from 29 different schools around Barcelona as part of the BREATHE study, an epidemiological study of the relation between air pollution and brain development. For 2 typical week days during 2012-2013, the children were given a smartphone with CalFit software to obtain information on their location and physical activity level and a small sensor, the micro-aethalometer model AE51, to measure their black carbon levels simultaneously and continuously. We estimated their home and school exposure to PM2.5 filter absorbance, which is well-correlated with black carbon, using a temporally adjusted PM2.5 absorbance land use regression (LUR) model. We found considerable variation in the black carbon levels during the day, with the highest levels measured during commuting periods (geometric mean = 2.8 μg/m(3)) and the lowest levels at home (geometric mean = 1.3 μg/m(3)). Hourly temporally adjusted LUR model estimates for the home and school showed moderate to good correlation with measured personal black carbon levels at home and school (r = 0.59 and 0.68, respectively) and lower correlation with commuting trips (r = 0.32 and 0.21, respectively). The correlation between modeled home estimates and overall personal black carbon levels was 0.62. Personal black carbon levels vary substantially during the day. The correlation between modeled and measured black carbon levels was generally good, with the exception of commuting times. In conclusion, novel technologies, such as smartphones and sensors, provide insights in personal exposure to air pollution.

  18. Cologne Consensus Conference: providers in accredited CME/CPD 11–12 September 2015, Cologne, Germany

    PubMed Central

    Simper, Julie

    2016-01-01

    On 11–12 September 2015, the fourth annual Cologne Consensus Conference (CCC) was held in Cologne, Germany. The 2-day educational event was organised by the European Cardiology Section Foundation (ECSF) and the European Board for Accreditation in Cardiology (EBAC), a specialty continuing medical education–continuing professional development (CME—CPD) accreditation board of the European Union of Medical Specialists (UEMS). The conference was again planned in cooperation with an impressive group of international organisations and faculty members representing leading European and North American institutions. Each year, the CCC is organised around a specific topic area. For the conference's fourth iteration, the providers in accredited CME/CPD were the focus. The CCC 2015 set out to share ideas, discuss concepts, and increase collaborations amongst the various groups. This report provides a summary of the presentations and discussions from the educational event. PMID:29644122

  19. STRESS - STEREO TRansiting Exoplanet and Stellar Survey

    NASA Astrophysics Data System (ADS)

    Sangaralingam, Vinothini; Stevens, Ian R.; Spreckley, Steve; Debosscher, Jonas

    2010-02-01

    The Heliospheric Imager (HI) instruments on board the two STEREO (Solar TErrestrial RElations Observatory) spacecraft provides an excellent opportunity for space based stellar photometry. The HI instruments provide a wide area coverage (20° × 20° for the two HI-1 instruments and 70° × 70° for the two HI-2 instruments) and long continuous periods of observations (20 days and 70 days respectively). Using HI-1A which has a pass band of 6500Å to 7500Å and a cadence of 40 minutes, we have gathered photometric information for more than a million stars brighter than 12th magnitude for a period of two years. Here we present some early results from this study on a range of variable stars and the future prospects for the data.

  20. Newton's Investigation of the Resistance to Moving Bodies in Continuous Fluids and the Nature of "Frontier Science"

    ERIC Educational Resources Information Center

    Gauld, Colin F.

    2010-01-01

    Newton's experiments into the resistance which fluids offer to moving bodies provide some insight into the way he related theory and experiment. His theory demonstrates a way of thought typical of 17th century physics and his experiments are simple enough to be replicated by present day students. Newton's investigations using pendulums were…

  1. 31 CFR 375.22 - Will I receive confirmations and, if I am submitting offers for others, do I have to provide...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Will I receive confirmations and, if... and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT... by the close of the business day of the redemption operation. (b) Confirmation of customer offers. If...

  2. 26 CFR 54.4980B-7 - Duration of COBRA continuation coverage.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... day for which timely payment is not made to the plan with respect to the qualified beneficiary (see Q... provide any group health plan (including successor plans) to any employee; (4) The date, after the date of... plan, as described in Q&A-2 of this section; (5) The date, after the date of the election, upon which...

  3. Family Policy and Practice in Early Child Care. Advances in Early Education and Day Care.

    ERIC Educational Resources Information Center

    Reifel, Stuart, Ed.; Dunst, Carl J., Ed.; Wolery, Mark, Ed.

    Family issues are an abiding concern for members of the profession of early education, and debate regarding government policies about families and child care continues to be timely. This volume provides a foundation for understanding programs, families, and the current social context, as well as particular areas of concern for families and child…

  4. Treating Wisely: The Surgeon's Role in Antibiotic Stewardship.

    PubMed

    Leeds, Ira L; Fabrizio, Anne; Cosgrove, Sara E; Wick, Elizabeth C

    2017-05-01

    : Antibiotic resistance continues to receive national attention as a leading public health threat. In 2015, President Barack Obama proposed a National Action Plan to Combat Antibiotic-Resistant Bacteria to curb the rise of "superbugs," bacteria resistant to antibiotics of last resort. Whereas many antibiotics are prescribed appropriately to treat infections, there continue to be a large number of inappropriately prescribed antibiotics. Although much of the national attention with regards to stewardship has focused on primary care providers, there is a significant opportunity for surgeons to embrace this national imperative and improve our practices. Local quality improvement efforts suggest that antibiotic misuse for surgical disease is common. Opportunities exist as part of day-to-day surgical care as well as through surgeons' interactions with nonsurgeon colleagues and policy experts. This article discusses the scope of the antibiotic misuse in surgery for surgical patients, and provides immediate practice improvements and also advocacy efforts surgeons can take to address the threat. We believe that surgical antibiotic prescribing patterns frequently do not adhere to evidence-based practices; surgeons are in a position to mitigate their ill effects; and antibiotic stewardship should be a part of every surgeons' practice.

  5. The Large Ring Laser G for Continuous Earth Rotation Monitoring

    NASA Astrophysics Data System (ADS)

    Schreiber, K. U.; Klügel, T.; Velikoseltsev, A.; Schlüter, W.; Stedman, G. E.; Wells, J.-P. R.

    2009-09-01

    Ring Laser gyroscopes exploit the Sagnac effect and measure rotations absolute. They do not require an external reference frame and therefore provide an independent method to monitor Earth rotation. Large-scale versions of these gyroscopes promise to eventually provide a similar high resolution for the measurement of the variations in the Earth rotation rate as the established methods based on VLBI and GNSS. This would open the door to a continuous monitoring of LOD (Length of Day) and polar motion, which is not yet available today. Another advantage is the access to the sub-daily frequency regime of Earth rotation. The ring laser “G” (Grossring), located at the Geodetic Observatory Wettzell (Germany) is the most advanced realization of such a large gyroscope. This paper outlines the current sensor design and properties.

  6. Predictors of Medication Continuity in Children With ADHD.

    PubMed

    Brinkman, William B; Sucharew, Heidi; Majcher, Jessica Hartl; Epstein, Jeffery N

    2018-06-01

    To identify predictors of attention-deficit/hyperactivity disorder (ADHD) medication continuity, hypothesizing greater continuity among children with (1) greater child acceptance of treatment, (2) parent belief in longer time course for ADHD, (3) positive differential between parent-perceived need for and concerns about medication, and (4) greater parent-perceived alliance with their child's doctor. We conducted a prospective longitudinal cohort of 89 children aged 6 to 10 years old newly treated for ADHD by 1 of 44 pediatricians in 11 practices. Parents completed validated surveys on their beliefs about ADHD and medicine. We audited charts and obtained pharmacy dispensing records. In our analyses, we examined the relationship between predictor variables (eg, sociodemographic and clinical characteristics, quality of care, and belief measures) and short-term (first 90 days after starting medication) and long-term (91-450 days) medication continuity as defined by the number of days covered with medication. Children had a median of 81% of days covered over 0 to 90 days and 54% of days covered over 91 to 450 days after starting medicine. In the first 90 days, medication coverage related to child age, satisfaction with information about medicine, medication titration, symptom reduction, parent beliefs about control over symptoms, uncertainty about treating with medicine, and working alliance. Long-term medication continuity related to child acceptance of treatment and differential between parent-perceived need for and concerns about medication at 3 months, not baseline factors. Adherence is a process that can change over time in response to experiences with treatment. Interventions are needed to promote productive interactions between pediatricians and families in support of continuity. Copyright © 2018 by the American Academy of Pediatrics.

  7. Continuity of Landsat observations: Short term considerations

    USGS Publications Warehouse

    Wulder, Michael A.; White, Joanne C.; Masek, Jeffery G.; Dwyer, John L.; Roy, David P.

    2011-01-01

    As of writing in mid-2010, both Landsat-5 and -7 continue to function, with sufficient fuel to enable data collection until the launch of the Landsat Data Continuity Mission (LDCM) scheduled for December of 2012. Failure of one or both of Landsat-5 or -7 may result in a lack of Landsat data for a period of time until the 2012 launch. Although the potential risk of a component failure increases the longer the sensor's design life is exceeded, the possible gap in Landsat data acquisition is reduced with each passing day and the risk of Landsat imagery being unavailable diminishes for all except a handful of applications that are particularly data demanding. Advances in Landsat data compositing and fusion are providing opportunities to address issues associated with Landsat-7 SLC-off imagery and to mitigate a potential acquisition gap through the integration of imagery from different sensors. The latter will likely also provide short-term, regional solutions to application-specific needs for the continuity of Landsat-like observations. Our goal in this communication is not to minimize the community's concerns regarding a gap in Landsat observations, but rather to clarify how the current situation has evolved and provide an up-to-date understanding of the circumstances, implications, and mitigation options related to a potential gap in the Landsat data record.

  8. The 2012 Chitranjan Ranawat award: intraarticular analgesia after TKA reduces pain: a randomized, double-blinded, placebo-controlled, prospective study.

    PubMed

    Goyal, Nitin; McKenzie, James; Sharkey, Peter F; Parvizi, Javad; Hozack, William J; Austin, Matthew S

    2013-01-01

    Postoperative pain after total knee arthroplasty remains one of the most important challenges facing patients undergoing this surgery. Providing a balance of adequate analgesia while limiting the functional impact of regional anesthesia and minimizing opioid side effects is critical to minimize adverse events and improve patient satisfaction. We asked whether bupivacaine delivered through an elastomeric device decreases the (1) patients' perception of pain after TKA; (2) narcotic consumption; and (3) narcotic-related side effects as compared with a placebo. In this prospective, double-blind, placebo-controlled study, all patients received standardized regional anesthesia, a preemptive and multimodal analgesic protocol, and a continuous intraarticular infusion at 5 mL/hour through an elastomeric infusion pump. The patients were randomized to receive either an infusion pump filled with (1) 300 mL of 0.5% bupivacaine, the experimental group (n = 75); or (2) 300 mL of 0.9% normal saline solution, the control group (n = 75). Data concerning postoperative pain levels through a visual analog scale, postoperative opioid consumption, opioid-related side effects, and complications were collected and analyzed. Patients in the experimental group receiving the bupivacaine reported a reduction in pain levels in highest, lowest, and current visual analog scale scores compared with the placebo group on the first postoperative day and highest visual analog scale score on postoperative Day 2 along with a 33% reduction in opioid consumption on postoperative Day 2 and a 54% reduction on postoperative Day 3. In patients undergoing TKA, continuous intraarticular analgesia provided an effective adjunct for pain relief in the immediate postoperative period without the disadvantages encountered with other analgesic methods.

  9. Mesoscale variability of free tropospheric humidity near San Nicolas Island during FIRE

    NASA Technical Reports Server (NTRS)

    White, A. B.; Fairall, C. W.; Thomson, D. W.

    1990-01-01

    Humidity variability at the top of the marine boundary layer (MBL) and in the free troposphere was examined using a variety of measurements taken on and around San Nicolas Island (SNI) during the FIRE IFO in July, 1987. Doppler wind profiler reflectivity recorded at two minute time resolution has provided the most continuous record and detail of small scale humidity fluctuations. Rawinsonde data were available from both an island site and the research vessel Point Sur. The information extractable from these sources is somewhat limited due to the frequency of launches (3 to 4/day at SNI and 6/day on the Point Sur). Some additional data were available from instrumented aircraft although scheduling flights in the neighborhood of the island was difficult due to restrictions on the air space. Other relevant data were collected at SNI near the radar and rawinsonde launch sites. A continuous record of cloud base altitude was logged by a ceilometer. Doppler acoustic sounder (sodar) reflectivity data provided a good record of inversion height. The sodar also monitored turbulent temperature fluctuations in the MBL. A small ground station recorded hourly averages of solar irradiance and downward longwave irradiance. The analysis in progress of the various data sets for two adjacent two day periods from 11 July to 14 July is described. The earlier period was chosen because the marine inversion was unusually high and there was increased frequency of rawinsonde launches at SNI. The later period was chosen because of the significant descent with time of an elevated inversion indicated by the radar data. Throughout the four day period, but especially in the first half, the turbulent humidity structure calculated from Doppler radar reflectivity shows excellent agreement with humidity profiles evaluated from rawinsonde data.

  10. Tray service generates more food waste in dining areas of a continuing-care retirement community.

    PubMed

    Hackes, B L; Shanklin, C W; Kim, T; Su, A Y

    1997-08-01

    To determine if the type of service system affects the amount of service food waste (SFW) generated in dining areas of a continuing-care retirement community. A waste stream analysis was conducted for 7 days to determine quantity of SFW generated in three service systems: health care tray service, health care dining room with wait-staff service, and ambulatory dining room with family-style service. Weight and volume were determined. Health care tray service and wait-staff service were provided to 70 residents in a health care unit. Family-style service was provided as an optional service for 130 residents in independent-living units. An average of 229 meals were served per day. Analysis of variance and a multiple comparison method were used to compare mean weight and volume of SFW on a per meal, per day, and per week basis. During the 7-day period, 482.8 lb, or 83 gal, of SFW was disposed of Health care tray service generated more SFW by weight for all three meals than either family-style service or wait-staff service, and it generated the greatest total volume of service waste. Residents eating in the dining room with family-style service disposed of significantly less SFW by weight at lunch and dinner than those receiving the other two service styles. Changing the style of service can affect not only quantity of solid waste generated and associated disposal costs but also food and supply costs, meal acceptability, and quantity of natural resources required. The systems approach should be used to assess the feasibility of changing service system so that all costs are considered.

  11. Aspirin mono-therapy continuation does not result in more bleeding after knee arthroplasty.

    PubMed

    Schwab, Pierre-Emmanuel; Lavand'homme, Patricia; Yombi, JeanCyr; Thienpont, Emmanuel

    2017-08-01

    Current clinical practice guidelines sometimes still recommend stopping aspirin five to seven days before knee arthroplasty surgery. Literature regarding multimodal blood management and continuation of anti-platelet therapy in this type of surgery is scant. The study hypothesis was that knee arthroplasty under low-dose aspirin mono-therapy continuation does not cause more total blood loss than knee arthroplasty performed without aspirin. Blood loss would be measured by haemoglobin (Hb) and haematocrit (HTC) levels drop at day 2 or day 4 for patients who benefit from multimodal bleeding control measures. A database of all patients undergoing knee arthroplasty between 2006 and 2014 was analysed. Demographic, surgical and complete blood workup data were collected. A retrospective comparison study analysed both groups in terms of blood loss, by mean calculated blood loss as haemoglobin or haematocrit drop between the preoperative Nadir value and the postoperative day 2 and 4 value. A group of 198 (44 UKA and 154 TKA) patients underwent surgery without interrupting their aspirin therapy for cardiovascular prevention. Mean (SD) age was 71 (8) and the mean (SD) BMI was 29 (5.5) kg/m 2 . The control group consisted of 403 (102 UKA and 301 TKA) patients who were not under aspirin, or any other anti-platelet agent. Mean (SD) age was 65 (10) (p < 0.05) and the mean (SD) BMI was 29 (5.0) kg/m 2 (n.s.). All patients in the control group were randomly selected. There were no differences in terms of visible (early) or hidden (late) blood loss as measured by Hb drop in between both groups. There is no difference in transfusion rates. Modern multimodal blood management provides sufficient blood loss prevention during and after knee arthroplasty to allow physicians to continue low-dose aspirin mono-therapy for cardiovascular prevention. III.

  12. Handling of Diskus dry powder inhaler in Chinese chronic obstructive pulmonary disease patients.

    PubMed

    Li, Huaidong; Chen, Yuanyuan; Zhang, Zhaorui; Dong, Xiaoxuan; Zhang, Guogang; Zhang, Hui

    2014-06-01

    The incorrect handling of Diskus inhalers in Chinese patients with chronic obstructive pulmonary disease (COPD) is not well documented. The present study was conducted to evaluate in detail the handling errors related to the Diskus device, and to elucidate the importance of educating COPD patients on the proper use of the device. A total of 384 COPD patients from a pulmonary clinic in China over a period of 5 years were included in the study. The compliance of COPD patients to the 13 discrete steps of Diskus usage were scored and analyzed by three measures: (1) On day 0, patients were given only a package insert on Diskus, and the handling error rate was assessed. Then the patients were given instruction on the 13-step Diskus procedure until they could demonstrate the proper technique. (2) On days 1, 2, and 3, the observation group was continuously educated on a 13-step procedure, and the percentage of patients who scored 100% for each step was recorded. The control group had no such training. (3) On days 10, 20, and 30, the percentage of all subjects correctly performing the Diskus 13-step inhalation procedure was assessed. Incorrect handling techniques on Diskus usage were widely distributed among Chinese COPD patients. Step 8 ("Inhale forcefully from the beginning, slowly, deeply, and uniformly during the inspiratory phase until the lungs are full") was the most commonly mishandled step (93.8%). The total score and individual step scores of the patients from the observation group were significantly improved during 3-day continuous education. There was also a significantly higher percentage of correctly performed steps in the observation group than in the control group upon assessment on day 10 (96.24% vs. 85.63%, respectively; p<0.01), day 20 (97.31% vs. 86.09%, respectively; p<0.01), and day 30 (98.19% vs. 87.39%, respectively; p<0.01). Handling errors of the Diskus 13-step inhalation procedure were commonly observed in Chinese COPD patients. Continuous educational interventions and regular supervision by health-care providers are therefore crucial for the optimum use of the Diskus inhaler.

  13. Continuous interscalene brachial plexus blockade provides good analgesia at home after major shoulder surgery-report of four cases.

    PubMed

    Nielsen, Karen C; Greengrass, Roy A; Pietrobon, Ricardo; Klein, Stephen M; Steele, Susan M

    2003-01-01

    Continuous interscalene brachial plexus blockade (CIBPB) in a hospital setting can provide excellent surgical conditions and postoperative analgesia for major shoulder surgery. This is a case report of four patients on the efficacy and advantages of CIBPB for postoperative analgesia at home. Four patients scheduled for rotator cuff repair under CIBPB were discharged home the day of surgery with an interscalene catheter connected to an automated infusion pump administering 0.2% ropivacaine at 10 mL x hr(-1) for 72 hr. Prior to discharge, patients and their attendant were given verbal and written instructions concerning local anesthetic toxicity and explicit contact information for an anesthesiologist or nurse. Outcomes were measured pre- and postoperatively, including verbal analogue pain scores (pain VAS), verbal analogue nausea scores (nausea VAS), side effects, cognitive function (mini-mental state questionnaire), sleep (hours/night), and patient satisfaction (Likert scale). Postoperative VAS scores over three days were very low. Two patients reported only one episode of nausea. There were no complications associated with local anesthetic toxicity or catheter use. Cognitive function improved over three days. Sleep increased from a mean of five hours before surgery to seven hours over the next three nights. Patient satisfaction with care was high. Significant cost savings were documented. The use of CIBPB for 72 hr in patients undergoing major ambulatory shoulder surgery can result in good analgesia with minimal opioid requirement, cost savings and possibly improvement in outcome measures.

  14. Global communication using a constellation of low earth meridian orbits

    NASA Astrophysics Data System (ADS)

    Oli, P. V. S.; Nagarajan, N.; Rayan, H. R.

    1993-07-01

    The concept of 'meridian orbits' is briefly reviewed. It is shown that, if a satellite in the meridian orbit makes an odd number of revolutions per day, then the satellite passes over the same set of meridians twice a day. Satellites in such orbits pass over the same portion of the sky twice a day and every day. This enables a user to adopt a programmed mode of tracking, thereby avoiding a computational facility for orbit prediction, look angle generation, and auto tracking. A constellation of 38 or more satellites placed in a 1200 km altitude circular orbit is favorable for global communications due to various factors. It is shown that appropriate phasing in right ascension of the ascending node and mean anomaly results in a constellation, wherein each satellite appears over the user's horizon one satellite after another. Visibility and coverage plots are provided to verify the continuous coverage.

  15. The Helioviewer Project: Solar Data Visualization and Exploration

    NASA Astrophysics Data System (ADS)

    Hughitt, V. Keith; Ireland, J.; Müller, D.; García Ortiz, J.; Dimitoglou, G.; Fleck, B.

    2011-05-01

    SDO has only been operating a little over a year, but in that short time it has already transmitted hundreds of terabytes of data, making it impossible for data providers to maintain a complete archive of data online. By storing an extremely efficiently compressed subset of the data, however, the Helioviewer project has been able to maintain a continuous record of high-quality SDO images starting from soon after the commissioning phase. The Helioviewer project was not designed to deal with SDO alone, however, and continues to add support for new types of data, the most recent of which are STEREO EUVI and COR1/COR2 images. In addition to adding support for new types of data, improvements have been made to both the server-side and client-side products that are part of the project. A new open-source JPEG2000 (JPIP) streaming server has been developed offering a vastly more flexible and reliable backend for the Java/OpenGL application JHelioviewer. Meanwhile the web front-end, Helioviewer.org, has also made great strides both in improving reliability, and also in adding new features such as the ability to create and share movies on YouTube. Helioviewer users are creating nearly two thousand movies a day from the over six million images that are available to them, and that number continues to grow each day. We provide an overview of recent progress with the various Helioviewer Project components and discuss plans for future development.

  16. Add-On Aliskiren Elicits Stronger Renoprotection Than High-Dose Valsartan in Type 2 Diabetic KKAy Mice That Do Not Respond to Low-Dose Valsartan

    PubMed Central

    Lei, Bai; Nakano, Daisuke; Fan, Yu-Yan; Kitada, Kento; Hitomi, Hirofumi; Kobori, Hiroyuki; Mori, Hirohito; Masaki, Tsutomu; Nishiyama, Akira

    2012-01-01

    We hypothesized that aliskiren provides renoprotection in diabetic animals that did not receive sufficient renoprotection by AT1-receptor antagonist treatment. Type 2 diabetic KKAy mice were treated with group 1: vehicle or group 2: valsartan (15 mg/kg per day) from 12 to 16 weeks of age. The mice were subsequently divided into 4 groups and treated with the following combinations of drugs for another 6 weeks: 1: group 1 kept receiving vehicle, 2: group 2 continuously received 15 mg/kg per day of valsartan (Val-Val15), 3: group 2 received 50 mg/kg per day of valsartan (Val-Val50), 4: group 2 continuously received 15 mg/kg per day of valsartan with 25 mg/kg per day of aliskiren (Val-Val+Ali). Aliskiren exerted significant anti-albuminuric effects, whereas valsartan failed to ameliorate the albuminuria in the first four weeks. Surprisingly, the increasing dosage of valsartan in the Val-Val50 group showed non-significant tendencies to attenuate the albuminuria compared with vehicle infusion. Val-Val+Ali significantly suppressed the development of albuminuria and podocyte injury. Val-Val50 and Val-Val+Ali showed similar suppression of angiotensin II contents in the kidney of KKAy mice. In conclusion, the anti-albuminuric effect that was observed in the type 2 diabetic mice showing no anti-albuminuric effect by valsartan can be attributed to the add-on aliskiren. PMID:22673148

  17. Analgesic Effects of Tramadol, Tramadol–Gabapentin, and Buprenorphine in an Incisional Model of Pain in Rats (Rattus norvegicus)

    PubMed Central

    McKeon, Gabriel P; Pacharinsak, Cholawat; Long, Charles T; Howard, Antwain M; Jampachaisri, Katechan; Yeomans, David C; Felt, Stephen A

    2011-01-01

    Postoperative pain management in laboratory animals relies heavily on a limited number of drug classes, such as opioids and nonsteroidal antiinflammatory drugs. Here we evaluated the effects of saline, tramadol, tramadol with gabapentin, and buprenorphine (n = 6 per group) in a rat model of incisional pain by examining thermal hyperalgesia and weight-bearing daily for 6 d after surgery. All drugs were administered preemptively and continued for 2 consecutive days after surgery. Rats treated with saline or with tramadol only showed thermal hyperalgesia on days 1 through 4 and 1 through 3 after surgery, respectively. In contrast, buprenorphine-treated rats showed no thermal hyperalgesia on days 1 and 2 after surgery, and rats given tramadol with gabapentin showed reduced thermal hyperalgesia on days 2 and 4. For tests of weight-bearing, rats treated with saline or with tramadol only showed significantly less ipsilateral weight-bearing on day 1 after surgery, whereas rats given either buprenorphine or tramadol with gabapentin showed no significant change in ipsilateral weight-bearing after surgery. These data suggest that tramadol alone provides insufficient analgesia in this model of incisional pain; buprenorphine and, to a lesser extent, tramadol with gabapentin provide relief of thermal hyperalgesia and normalize weight-bearing. PMID:21439212

  18. Two phase I, pharmacokinetic, and pharmacodynamic studies of DFP-10917, a novel nucleoside analog with 14-day and 7-day continuous infusion schedules.

    PubMed

    Sankhala, Kamalesh; Takimoto, Chris H; Mita, Alain C; Xiong, Henry; Rodón, Jordi; Mehrvarz Sarshekeh, Amir; Burns, K; Iizuka, Kenzo; Kopetz, Scott

    2018-04-18

    Purpose DFP-10917 is a novel deoxycytidine analog with a unique mechanism of action. Brief exposure to high concentrations of DFP-10917 inhibits DNA polymerase resulting in S-phase arrest, while prolonged exposure to DFP-10917 at low concentration causes DNA fragmentation, G2/M-phase arrest, and apoptosis. DFP-10917 demonstrated activity in tumor xenografts resistant to other deoxycytidine analogs. Experimental design Two phase I studies assessed the safety, pharmacokinetic, pharmacodynamic and preliminary efficacy of DFP-10917. Patients with refractory solid tumors received DFP-10917 continuous infusion 14-day on/7-day off and 7-day on/7-day off. Enrollment required age > 18 years, ECOG Performance Status 0-2 and adequate organ function. Results 29 patients were dosed in both studies. In 14-day infusion, dose-limiting toxicities (DLT) consisting of febrile neutropenia and thrombocytopenia occurred at 4.0 mg/m 2 /day. At 3.0 mg/m 2 /day, 3 patients experienced neutropenia in cycle 2. The dose of 2.0 mg/m 2 /day was well tolerated in 6 patients. In 7-day infusion, grade 4 neutropenia was DLT at 4.0 mg/m 2 /day. The maximum tolerated dose was 3 mg/m 2 /day. Other toxicities included nausea, vomiting, diarrhea, neutropenia, and alopecia. Eight patients had stable disease for >12 weeks. Paired comet assays performed for 7 patients showed an increase in DNA strand breaks at day 8. Pharmacokinetic data showed dose-proportionality for steady-state concentration and AUC of DFP-10917 and its primary metabolite. Conclusion Continuous infusion of DFP-10917 is feasible and well tolerated with myelosuppression as main DLT. The recommended doses are 2.0 mg/m 2 /day and 3.0 mg/m 2 /day on the 14-day and 7-day continuous infusion schedules, respectively. Preliminary activity was suggested. Pharmacodynamic data demonstrate biological activity at the tested doses.

  19. Evaluation of Biomarkers of Exposure in Smokers Switching to a Carbon-Heated Tobacco Product: A Controlled, Randomized, Open-Label 5-Day Exposure Study

    PubMed Central

    Haziza, Christelle; Weitkunat, Rolf; Magnette, John

    2016-01-01

    Introduction: Tobacco harm reduction aims to provide reduced risk alternatives to adult smokers who would otherwise continue smoking combustible cigarettes (CCs). This randomized, open-label, three-arm, parallel-group, single-center, short-term confinement study aimed to investigate the effects of exposure to selected harmful and potentially harmful constituents (HPHCs) of cigarette smoke in adult smokers who switched to a carbon-heated tobacco product (CHTP) compared with adult smokers who continued to smoke CCs and those who abstained from smoking for 5 days. Methods: Biomarkers of exposure to HPHCs, including nicotine and urinary excretion of mutagenic material, were measured in 24-hour urine and blood samples in 112 male and female Caucasian smokers switching from CCs to the CHTP ad libitum use. Puffing topography was assessed during product use. Results: Switching to the CHTP or smoking abstinence (SA) resulted in marked decreases from baseline to Day 5 in all biomarkers of exposure measured, including carboxyhemoglobin (43% and 55% decrease in the CHTP and SA groups, respectively). The urinary excretion of mutagenic material was also markedly decreased on Day 5 compared with baseline (89% and 87% decrease in the CHTP and SA groups, respectively). No changes in biomarkers of exposure to HPHCs or urinary mutagenic material were observed between baseline and Day 5 in the CC group. Conclusions: Our results provide clear evidence supporting a reduction in the level of exposure to HPHCs of tobacco smoke in smokers who switch to CHTP under controlled conditions, similar to that observed in SA. Implications: The reductions observed in biomarkers of exposure to HPHCs of tobacco smoke in this short-term study could potentially also reduce the incidence of cancer, cardiovascular and respiratory diseases in those smokers who switch to a heated tobacco product. PMID:26817490

  20. VizieR Online Data Catalog: Broadband photometry of Neptune from K2 (Rowe+, 2017)

    NASA Astrophysics Data System (ADS)

    Rowe, J. F.; Gaulme, P.; Lissauer, J. J.; Marley, M. S.; Simon, A. A.; Hammel, H. B.; Silva Aguirre, V.; Barclay, T.; Benomar, O.; Boumier, P.; Caldwell, D. A.; Casewell, S. L.; Chaplin, W. J.; Colon, K. D.; Corsaro, E.; Davies, G. R.; Fortney, J. J.; Garcia, R. A.; Gizis, J. E.; Haas, M. R.; Mosser, B.; Schmider, F.-X.

    2017-08-01

    The K2 C3 field provided the first opportunity to observe the planet Neptune for up to 80 days with short-cadence (1 minute) sampling (the C3 campaign had an actual duration of 69.2 days, limited by on-board data storage). We were awarded sufficient pixel allocation from Guest Observer Programs GO3060 (PI: Rowe) and GO3057 (PI: Gaulme) to continuously monitor Neptune for 49 days. Short-cadence target pixel files were obtained from Mikulski Archive for Space Telescopes (MAST). The Neptune short-cadence subraster was spread across 161 FITS files. Each file contained 1 column of time-series pixel data. Each target pixel file contains observations starting on 2014 November 15 and finishing on 2015 January 18. (1 data file).

  1. Electronic diary evidence on energy erosion in clinical burnout.

    PubMed

    Sonnenschein, Mieke; Sorbi, Marjolijn J; van Doornen, Lorenz J P; Schaufeli, Wilmar B; Maas, Cora J M

    2007-10-01

    Burnout is generally defined as a state of severe exhaustion. So far, research has predominantly focused on relatively mild burnout in employees able to work despite their complaints. This study examines energy depletion in clinical burnout (e.g., the severest cases on extended sick leave) by comparing the diurnal patterns of fatigue and exhaustion with those of healthy individuals. Sixty clinically burned-out and 40 healthy participants kept an electronic diary for 14 days, 7 times a day, yielding a total of 8,116 diary entries. This study shows that burned-out individuals typically suffer continuously from a severe fatigue throughout the day. The resulting flattened diurnal cycles mark a stable exhaustion that is uncommon in healthy persons. The current results provide novel support for the existence of severe energy erosion in clinical burnout.

  2. 31 CFR 375.22 - Will I receive confirmations and, if I am submitting offers for others, do I have to provide...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Will I receive confirmations and, if I... Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE... of the business day of the redemption operation. (b) Confirmation of customer offers. If you submit a...

  3. 77 FR 42038 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-17

    ... market in 60% of the non-adjusted option series \\4\\ of each registered class that have a time to... time series Classes C2 (current rule) 99 of the time........ 60 Class-by-class. NOM 90 of a trading day... required to provide continuous quotes for the same amount of time in the same percentage of series as...

  4. Combined carboplatin plus ifosfamide and cisplatin in patients with advanced ovarian carcinoma. A phase I-II study. GOCS (Gynecological Oncology Cooperative Study).

    PubMed

    Lorusso, V; Leone, B; Di Vagno, G; Manzione, L; Palmeri, S; Vallejo, C; Machiavelli, M; Nacci, G; Bilancia, D; Leonardi, V; Catino, A; Gargano, G; Loverro, G; Selvaggi, L; De Lena, M

    1998-02-01

    Because of the relative lack of overlapping toxicity, carboplatin (PPL) and cisplatin (CDDP) can be easily combined for treatment of ovarian cancer to increase total platinum dose intensity. Ifosfamide (IFO), one of the most effective single agents in ovarian cancer, has a low hematological toxicity when administered in continuous infusion. From January 1991 to December 1993, 34 patients with advanced ovarian cancer, previously untreated with chemo- or radiotherapy, were enrolled in a phase I-II study with the aim of determining the maximum tolerated dose (MTD) of CDDP (on day 8 of a 28-day cycle) in combination with PPL (300 mg/m2 on day 1) and IFO (4,000 mg/m2/24 h by continuous infusion on day 1). The initial dose level of CDDP was 40 mg/m2, which was continuously increased by 10 mg/m2 up to the MTD defined as one dose level below that inducing dose-limiting toxicity (DLT) in at least two-thirds of treated patients; no dose escalation was allowed in the same patient. Grade 3-4 leukopenia and thrombocytopenia were observed in 54 and 49% of patients, respectively. The DLT was reached at 70 mg/m2 and therefore the dose recommended for the phase II study was 60 mg/m2. Complete (CR) plus partial response was observed in 88% of patients with a 21% pathological CR. With a minimum follow-up of 32 months (median 40 months), median progression-free survival and overall survival were 21 and 39 months, respectively. In conclusion, the combination of CDDP, PPL, and IFO provides an effective regimen for ovarian cancer with an acceptable toxicity profile.

  5. Continuous Activity Monitoring During Concurrent Chemoradiotherapy

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

    Ohri, Nitin, E-mail: ohri.nitin@gmail.com; Kabarriti, Rafi; Bodner, William R.

    Purpose: To perform a prospective trial testing the feasibility and utility of acquiring activity data as a measure of health status during concurrent chemoradiotherapy. Methods and Materials: Ambulatory patients who were planned for treatment with concurrent chemoradiotherapy with curative intent for cancers of the head and neck, lung, or gastrointestinal tract were provided with activity monitors before treatment initiation. Patients were asked to wear the devices continuously throughout the radiation therapy course. Step count data were downloaded weekly during radiation therapy and 2 and 4 weeks after radiation therapy completion. The primary objective was to demonstrate feasibility, defined as collection ofmore » step counts for 80% of the days during study subjects' radiation therapy courses. Secondary objectives included establishing step count as a dynamic predictor of unplanned hospitalization risk. Results: Thirty-eight enrolled patients were treated with concurrent chemoradiotherapy. Primary diagnoses included head and neck cancer (n=11), lung cancer (n=13), and a variety of gastrointestinal cancers (n=14). Step data were collected for 1524 of 1613 days (94%) during patients' radiation therapy courses. Fourteen patients were hospitalized during radiation therapy or within 4 weeks of radiation therapy completion. Cox regression modeling demonstrated a significant association between recent step counts (3-day average) and hospitalization risk, with a 38% reduction in the risk of hospitalization for every 1000 steps taken each day (hazard ratio 0.62, 95% confidence interval 0.46-0.83, P=.002). Inferior quality of life scores and impaired performance status were not associated with increased hospitalization risk. Conclusion: Continuous activity monitoring during concurrent chemoradiotherapy is feasible and well-tolerated. Step counts may serve as powerful, objective, and dynamic indicators of hospitalization risk.« less

  6. Concordance with a STOPP (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions) Criterion in Nova Scotia, Canada: Benzodiazepine and Zoplicone Prescription Claims by Older Adults with Fall-related Hospitalizaions.

    PubMed

    Hill-Taylor, B; Sketris, I S; Gardner, D M; Thompson, K

    2016-01-01

    Optimization of prescribing in older adults is needed. The STOPP criteria provide a systematic way of identifying potentially inappropriate prescribing in this population. Previous research indicates poor concordance between benzodiazepine prescribing and STOPP. To determine the extent and predictors of benzodiazepine and zopiclone (BZD-Z) pharmacy dispensations in older adults with a history of a recent fall, in concordance with STOPP. Prescription claims data from the Nova Scotia Seniors' Phamacare Program were linked with fall-related injury data from the CIHI Discharge Abstract Database. Adults aged ≥ 66 years making a claim for a BZD-Z in the 100 days prior to fall-related hospitalization were identified. Their BZD-Z claims in the 100 days following discharge were also identified. Descriptive statistics, trend tests and logistical regression modelling were performed to examine predictors for continued use of BZD-Z post-fall. Over 5 years, from a pool of 8,271 older adults discharged following a fall-related hospitalization, 1,789 (21.6%) had made a claim for a BZD-Z in the 100 days prior to admission. Of these, 82% were women. Younger age and female sex were predictors of continuing BZD-Z dispensations post-fall. In the 100 days following discharge, 74.2% (n=1327) made a claim for at least one BZD-Z. BZD-Z use continued in 74% of patients following discharge from a fall-related hospitalization, representing limited concordance with the STOPP criterion. Such hospitalizations and follow-up care present an opportunity to address an ongoing modifiable risk factor.

  7. The effect of fixed-dose combination of valsartan and amlodipine on nighttime blood pressure in patients with non-dipper hypertension.

    PubMed

    Erdoğan, Doğan; İçli, Atilla; Aksoy, Fatih; Akçay, Salaheddin; Yücel, Habil; Ersoy, İbrahim; Özaydın, Mehmet

    2016-07-01

    Failure to decrease blood pressure (BP) during the night is associated with higher cardiovascular (CV) morbidity and mortality. There is strong evidence that fixed-dose combinations (FDCs) of antihypertensive agents are associated with significant improvement and non-significant adverse effects. The aim of the present study was to evaluate whether FDC affected nocturnal BP favorably in patients with uncontrolled, non-dipper hypertension (HT). All non-dipper hypertensives were either newly diagnosed with stage 2-3 HT or had HT uncontrolled with monotherapy. Patients (n=195) were consecutively assigned to 4 treatment groups: FDC of valsartan/amlodipine (160/5 mg), free-drug combination of valsartan 160 mg and amlodipine 5 mg, amlodipine 10 mg, and valsartan 320 mg. Ambulatory blood pressure monitoring (ABPM) was repeated at 4th and 8th week. Average 24-h (24-hour) and nocturnal BP were similar among the groups at baseline evaluation, and had significantly decreased by the fourth week of treatment. However, BP continued to decrease only slightly between the 4th and 8th weeks in the valsartan and amlodipine monotherapy groups, but continued to decrease significantly in both combination groups. After 4 weeks, day-night BP difference and day-night BP % change were significantly elevated in the combination and valsartan groups. Between the 4th and 8th weeks, however, day-night BP difference and day-night BP % change continued to rise only in the FDC group, nearly reducing to baseline levels in the free-drug combination and valsartan groups. An additional 2.2 mmHg decrease was observed in the FDC group, compared to the free-drug combination group. In non-dipper HT, FDC of valsartan and amlodipine improved diurnal-nocturnal ratio of BP and provided 24-h coverage.

  8. Continuous full-time occlusion of the sound eye vs full-time occlusion of the sound eye periodically alternating with occlusion of the amblyopic eye in treatment of amblyopia: a prospective randomized study.

    PubMed

    Stanković, B; Milenković, S

    2007-01-01

    To compare continuous full-time (24 hours per day) occlusion of the sound eye with full-time occlusion (24 hours per day) of the sound eye 1 day more than the years of age periodically alternating with occlusion of the amblyopic eye for 1 day, as treatments for profound strabismic amblyopia in children older than 5 years. A total of 53 patients with visual acuity (VA) of 0.4 and less in the amblyopic eye (tested by crowded Landolt Cs) after previously being provided optimal optical correction were randomly assigned to receive either of the two patching regimens. VA and pattern reversal visual evoked potentials (PVEP) were recorded prospectively at 1-month intervals. Improvement in VA and the reduction in crowding difficulties (CD) were the main outcome measures of the treatment efficiency. Both treatment modalities were equally effective. Of the 51 subjects who completed the study, 21 (41.2%) were cured whereas 32 (62.7%) attained satisfactory improvement. Recovery of VA was related to age, with cure being obtained in 23.5% (4/17) and satisfactory improvement in 52.9% (9/17) of patients older than 9 years. Larger gain in VA influenced the stability of the vision over time. It can be concluded that in clinically monitored parameters both treatment modalities were equally effective without any statistical or clinical significance in the observed groups of patients. However, events like the "trade-off" effect, occurrence of occlusion amblyopia, or prolongation of PVEP latency of the sound eye indicate that full-time continuous occlusion possibly presents a more effective form of treatment.

  9. 78 FR 61408 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... continues for a period of 30 consecutive business days. Upon such failure, the Company shall be notified.... Compliance can be achieved by meeting the applicable standard for a minimum of 10 consecutive business days... the deficiency continues for a period of 30 consecutive business days. Upon such failure, the Company...

  10. A Two-Day Continuous Nicotine Infusion Is Sufficient to Demonstrate Nicotine Withdrawal in Rats as Measured Using Intracranial Self-Stimulation.

    PubMed

    Muelken, Peter; Schmidt, Clare E; Shelley, David; Tally, Laura; Harris, Andrew C

    2015-01-01

    Avoidance of the negative affective (emotional) symptoms of nicotine withdrawal (e.g., anhedonia, anxiety) contributes to tobacco addiction. Establishing the minimal nicotine exposure conditions required to demonstrate negative affective withdrawal signs in animals, as well as understanding moderators of these conditions, could inform tobacco addiction-related research, treatment, and policy. The goal of this study was to determine the minimal duration of continuous nicotine infusion required to demonstrate nicotine withdrawal in rats as measured by elevations in intracranial self-stimulation (ICSS) thresholds (anhedonia-like behavior). Administration of the nicotinic acetylcholine receptor antagonist mecamylamine (3.0 mg/kg, s.c.) on alternate test days throughout the course of a 2-week continuous nicotine infusion (3.2 mg/kg/day via osmotic minipump) elicited elevations in ICSS thresholds beginning on the second day of infusion. Magnitude of antagonist-precipitated withdrawal did not change with further nicotine exposure and mecamylamine injections, and was similar to that observed in a positive control group receiving mecamylamine following a 14-day nicotine infusion. Expression of a significant withdrawal effect was delayed in nicotine-infused rats receiving mecamylamine on all test days rather than on alternate test days. In a separate study, rats exhibited a transient increase in ICSS thresholds following cessation of a 2-day continuous nicotine infusion (3.2 mg/kg/day). Magnitude of this spontaneous withdrawal effect was similar to that observed in rats receiving a 9-day nicotine infusion. Our findings demonstrate that rats exhibit antagonist-precipitated and spontaneous nicotine withdrawal following a 2-day continuous nicotine infusion, at least under the experimental conditions studied here. Magnitude of these effects were similar to those observed in traditional models involving more prolonged nicotine exposure. Further development of these models, including evaluation of more clinically relevant nicotine dosing regimens and other measures of nicotine withdrawal (e.g., anxiety-like behavior, somatic signs), may be useful for understanding the development of the nicotine withdrawal syndrome.

  11. A Two-Day Continuous Nicotine Infusion Is Sufficient to Demonstrate Nicotine Withdrawal in Rats as Measured Using Intracranial Self-Stimulation

    PubMed Central

    Muelken, Peter; Schmidt, Clare E.; Shelley, David; Tally, Laura; Harris, Andrew C.

    2015-01-01

    Avoidance of the negative affective (emotional) symptoms of nicotine withdrawal (e.g., anhedonia, anxiety) contributes to tobacco addiction. Establishing the minimal nicotine exposure conditions required to demonstrate negative affective withdrawal signs in animals, as well as understanding moderators of these conditions, could inform tobacco addiction-related research, treatment, and policy. The goal of this study was to determine the minimal duration of continuous nicotine infusion required to demonstrate nicotine withdrawal in rats as measured by elevations in intracranial self-stimulation (ICSS) thresholds (anhedonia-like behavior). Administration of the nicotinic acetylcholine receptor antagonist mecamylamine (3.0 mg/kg, s.c.) on alternate test days throughout the course of a 2-week continuous nicotine infusion (3.2 mg/kg/day via osmotic minipump) elicited elevations in ICSS thresholds beginning on the second day of infusion. Magnitude of antagonist-precipitated withdrawal did not change with further nicotine exposure and mecamylamine injections, and was similar to that observed in a positive control group receiving mecamylamine following a 14-day nicotine infusion. Expression of a significant withdrawal effect was delayed in nicotine-infused rats receiving mecamylamine on all test days rather than on alternate test days. In a separate study, rats exhibited a transient increase in ICSS thresholds following cessation of a 2-day continuous nicotine infusion (3.2 mg/kg/day). Magnitude of this spontaneous withdrawal effect was similar to that observed in rats receiving a 9-day nicotine infusion. Our findings demonstrate that rats exhibit antagonist-precipitated and spontaneous nicotine withdrawal following a 2-day continuous nicotine infusion, at least under the experimental conditions studied here. Magnitude of these effects were similar to those observed in traditional models involving more prolonged nicotine exposure. Further development of these models, including evaluation of more clinically relevant nicotine dosing regimens and other measures of nicotine withdrawal (e.g., anxiety-like behavior, somatic signs), may be useful for understanding the development of the nicotine withdrawal syndrome. PMID:26658557

  12. Continuity planning for workplace infectious diseases.

    PubMed

    Welch, Nancy; Miller, Pamela Blair; Engle, Lisa

    2016-01-01

    Traditionally, business continuity plans prepare for worst-case scenarios; people plan for the exception rather than the common. Plans focus on infrastructure damage and recovery wrought by such disasters as hurricanes, terrorist events or tornadoes. Yet, another very real threat looms present every day, every season and can strike without warning, wreaking havoc on the major asset -- human capital. Each year, millions of dollars are lost in productivity, healthcare costs, absenteeism and services due to infectious, communicable diseases. Sound preventive risk management and recovery strategies can avert this annual decimation of staff and ensure continuous business operation. This paper will present a strong economic justification for the recognition, prevention and mitigation of communicable diseases as a routine part of continuity planning for every business. Recommendations will also be provided for environmental/engineering controls as well as personnel policies that address employee and customer protection, supply chain contacts and potential legal issues.

  13. Computed tomography scan in supine and prone positions: an alternative method to detect intramural gas in emphysematous cystitis and to evaluate efficacy after adjuvant continuous intravesical irrigation treatment.

    PubMed

    Cortés-González, Jeff R; Ortiz-Lara, Gerardo E; Salinas, Matías; Hernández-Galván, Fernando; Gómez-Guerra, Lauro S

    2013-04-01

    To evaluate the efficacy of continuous intravesical irrigation with saline plus amikacin as adjuvant therapy and to evaluate the computed tomography (CT) scan in supine and prone positions (CystoCT scan) as an alternative diagnostic and evaluation method of intramural gas in emphysematous cystitis (EC) before and after treatment. Consecutive patients with a diagnosis of EC who were hospitalized between March 2006 and January 2011 were investigated. The diagnosis was made by CystoCT scan. Treatment consisted of intravenous antibiotics, control of concomitant diseases, and placement of a 3-way urinary catheter for continuous irrigation of 500 mg of amikacin diluted in 1 l of saline given on days 0, 3, and 7. Treatment was considered successful when there was an absence of gas in the bladder wall, the urine culture was negative, there was clinical improvement, and there was an absence of toxicity. Eleven patients were hospitalized with a diagnosis of EC during the study period. Four were excluded from the study, 2 due to the lack of confirmation of the diagnosis with the CystoCT scan. Treatment was successful in all patients; for 6 (86%) this was achieved in 3 days and for 1 (14%) in 7 days. No toxicity was reported. Continuous intravesical irrigation with saline plus amikacin as adjuvant treatment of EC is an inexpensive, effective, and safe tool that might help conventional treatment and provide a rapid recovery. The CystoCT scan is an alternative method to diagnose and evaluate intramural gas in EC patients. These findings should be challenged in a randomized, multi-centre, placebo-controlled clinical trial.

  14. Design and evaluation of a payload to support plant growth onboard COMET 1

    NASA Technical Reports Server (NTRS)

    Hoehn, A.; Kliss, M. H.; Luttges, M. W.; Robinson, M. C.; Stodieck, L. S.

    1992-01-01

    The paper describes the design and the operation principles of the Plant Module for Autonomous Space Support (P-MASS), designed to provide life support for a variety of plants, algae, and bacteria in low earth orbit during the maiden flight of COMET-1, scheduled for 1993. During flight (scheduled to continue for 30 days), both color video images and collected environmental data (including light intensity, temperature, relative humidity, CO2 and O2 concentrations, soil moisture, and nutrients released) will be downlinked to earth several times a day. These data will also be stored within the payload and retrieved from it after reentry and recovery.

  15. Layered virus protection for the operations and administrative messaging system

    NASA Technical Reports Server (NTRS)

    Cortez, R. H.

    2002-01-01

    NASA's Deep Space Network (DSN) is critical in supporting the wide variety of operating and plannedunmanned flight projects. For day-to-day operations it relies on email communication between the three Deep Space Communication Complexes (Canberra, Goldstone, Madrid) and NASA's Jet Propulsion Laboratory. The Operations & Administrative Messaging system, based on the Microsoft Windows NTand Exchange platform, provides the infrastructure that is required for reliable, mission-critical messaging. The reliability of this system, however, is threatened by the proliferation of email viruses that continue to spread at alarming rates. A layered approach to email security has been implemented across the DSN to protect against this threat.

  16. Geosynchronous SAR for Terrain & Atmosphere with short Revisit (GeoSTARe)

    NASA Astrophysics Data System (ADS)

    Monti-Guarnieri, Andrea; Recchia, Andrea; Rocca, Fabio; Bombaci, Ornella; Germani, Chiara; Broquetas, Antoni; Wadge, Geoff; Hobbs, Steve

    2016-08-01

    GeoSTARe would be a mission combining the continuous view capabilities from geostationary orbits of super-continental areas with the all-day, all-weather imaging capabilities of Synthetic Aperture Radar. It would complement Copernicus Sentinel-1 bringing the repeat time from days down to hours.In that, it would provide novel and unique observations. The well proven potentials of Radar in sensing roughness, deformations, and moisture, combined with the short time to get any image, from minutes to an hour, and the immediate data download and exploitation (thanks to the geostationary orbit) makes GeoSTARe a game changer in those fields where hourly-to-daily monitoring is a must.

  17. An automatic 14-day paste diet feeder for animals

    NASA Technical Reports Server (NTRS)

    Vasques, Marilyn; Mulenburg, Jerry; Gundo, Dan; Griffith, Jon

    1994-01-01

    During a centrifuge experiment, any interruption that requires stopping the centrifuge may influence the results. Centrifuges often must be stopped for animal maintenance (food, water and waste removal), especially in cases of timed feedings. To eliminate the need for stopping the centrifuge while still providing timed feeding, an automatic paste diet feeder was developed. The feeder is based on a constant volume concept and can deliver a predetermined amount of paste diet at specified time intervals. This unit was supported by water delivery and waste collection systems. The entire system performed reliably and maintained the animals well for a continuous centrifugation experiment of 14 days.

  18. Education of staff--a key factor for a safe environment in day care.

    PubMed

    Sellström, E; Bremberg, S

    2000-05-01

    In order to create a safe environment in day-care settings, an understanding of factors within the organization of day care, factors which influence safety, is essential. Day-care directors in 83 daycare centres completed a mail-in survey that contained questions about professional experience, the day-care centre's organization of child safety measures and a battery of questions designed to evaluate the directors' perceptions and beliefs about child safety. The day-care directors also carried out a safety inspection at their centre. The results were analysed using the multivariate logistic regression technique. The existence of a continuing plan for continued staff education in child safety was shown to be the strongest predictor of few safety hazards in day-care centres. The day-care directors' perceptions and beliefs about injury prevention were of less importance. This study indicates that in order to promote safety in day-care settings, an on-going plan for continued staff education in child safety should be a matter of routine. The introduction of such a plan should be the concern of the individual day-care directors, policy-makers and managers at the local and national level, and health professionals working in this field.

  19. Estimated reductions in provider-initiated preterm births and hospital length of stay under a universal acetylsalicylic acid prophylaxis strategy: a retrospective cohort study

    PubMed Central

    Ray, Joel G.; Bartsch, Emily; Park, Alison L.; Shah, Prakesh S.; Dzakpasu, Susie

    2017-01-01

    Background: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. Methods: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the corresponding mean maternal and newborn hospital length of stay. We projected the potential number of cases reduced and corresponding hospital length of stay if ASA prophylaxis lowered cases of preeclampsia and intrauterine growth restriction by a relative risk reduction (RRR) of 10% (lowest) or 53% (highest), as suggested by randomized clinical trials. Results: Of the 269 303 singleton live births and stillbirths in our cohort, 4495 (1.7%) were provider-initiated preterm births. Of the 4495, 1512 (33.6%) had a diagnosis of preeclampsia and/or intrauterine growth restriction. The mean maternal length of stay was 2.0 (95% confidence interval [CI] 2.0-2.0) days among term births unaffected by either condition and 7.3 (95% CI 6.1-8.6) days among provider-initiated preterm births with both conditions. The corresponding values for mean newborn length of stay were 1.9 (95% CI 1.8-1.9) days and 21.8 (95% CI 17.4-26.2) days. If ASA conferred a 53% RRR against preeclampsia and/or intrauterine growth restriction, 3365 maternal and 11 591 newborn days in hospital would be averted. If ASA conferred a 10% RRR, 635 maternal and 2187 newborn days in hospital would be averted. Interpretation: A universal ASA prophylaxis strategy could substantially reduce the burden of long maternal and newborn hospital stays associated with provider-initiated preterm birth. However, until there is compelling evidence that administration of ASA to all, or most, pregnant women reduces the risk of preeclampsia and/or intrauterine growth restriction, clinicians should continue to follow current clinical practice guidelines. PMID:28646095

  20. Delayed extubation to nasal continuous positive airway pressure in the immature baboon model of bronchopulmonary dysplasia: lung clinical and pathological findings.

    PubMed

    Thomson, Merran A; Yoder, Bradley A; Winter, Vicki T; Giavedoni, Luis; Chang, Ling Yi; Coalson, Jacqueline J

    2006-11-01

    Using the 125-day baboon model of bronchopulmonary dysplasia treated with prenatal steroid and exogenous surfactant, we hypothesized that a delay of extubation from low tidal volume positive pressure ventilation to nasal continuous positive airway pressure at 5 days (delayed nasal continuous positive airway pressure group) would not induce more lung injury when compared with baboons aggressively weaned to nasal continuous positive airway pressure at 24 hours (early nasal continuous positive airway pressure group), because both received positive pressure ventilation. After delivery by cesarean section at 125 days (term: 185 days), infants received 2 doses of Curosurf (Chiesi Farmaceutica S.p.A., Parma, Italy) and daily caffeine citrate. The delay in extubation to 5 days resulted in baboons in the delayed nasal continuous positive airway pressure group having a lower arterial to alveolar oxygen ratio, high PaCO2, and worse respiratory function. The animals in the delayed nasal continuous positive airway pressure group exhibited a poor respiratory drive that contributed to more reintubations and time on mechanical ventilation. A few animals in both groups developed necrotizing enterocolitis and/or sepsis, but infectious pneumonias were not documented. Cellular bronchiolitis and peribronchiolar alveolar wall thickening were more frequently seen in the delayed nasal continuous positive airway pressure group. Bronchoalveolar lavage levels of interleukin-6, interleukin-8, monocyte chemotactic protein-1, macrophage inflammatory protein-1 alpha, and growth-regulated oncogene-alpha were significantly increased in the delayed nasal continuous positive airway pressure group. Standard and digital morphometric analyses showed no significant differences in internal surface area and nodal measurements between the groups. Platelet endothelial cell adhesion molecule vascular staining was not significantly different between the 2 nasal continuous positive airway pressure groups. Volutrauma and/or low-grade colonization of airways secondary to increased reintubations and ventilation times are speculated to play causative roles in the delayed nasal continuous positive airway pressure group findings.

  1. Physiological responses of three deciduous conifers (Metasequoia glyptostroboides, Taxodium distichum and Larix laricina) to continuous light: adaptive implications for the early Tertiary polar summer.

    PubMed

    Equiza, M Alejandra; Day, Michael E; Jagels, Richard

    2006-03-01

    Polar regions were covered with extensive forests during the Cretaceous and early Tertiary, and supported trees comparable in size and productivity to those of present-day temperate forests. With a winter of total or near darkness and a summer of continuous, low-angle illumination, these temperate, high-latitude forests were characterized by a light regime without a contemporary counterpart. Although maximum irradiances were much lower than at mid-latitudes, the 24-h photoperiod provided similar integrated light flux. Taxodium, Larix and Metasequoia, three genera of deciduous conifers that occurred in paleoarctic wet forests, have extant, closely related descendents. However, the contemporary relative abundance of these genera differs greatly from that in the paleoarctic. To provide insight into attributes that favor competitive success in a continuous-light environment, we subjected saplings of these genera to a natural photoperiod or a 24-h photoperiod and measured gas exchange, chlorophyll fluorescence, non-structural carbohydrate concentrations, biomass production and carbon allocation. Exposure to continuous light significantly decreased photosynthetic capacity and quantum efficiency of photosystem II in Taxodium and Larix, but had minimal influence in Metasequoia. In midsummer, foliar starch concentration substantially increased in both Taxodium and Larix saplings grown in continuous light, which may have contributed to end-product down-regulation of photosynthetic capacity. In contrast, Metasequoia allocated photosynthate to continuous production of new foliar biomass. This difference in carbon allocation may have provided Metasequoia with a two fold advantage in the paleoarctic by minimizing depression of photosynthetic capacity and increasing photosynthetic surface.

  2. Enteral nutrients potentiate glucagon-like peptide-2 action and reduce dependence on parenteral nutrition in a rat model of human intestinal failure

    PubMed Central

    Brinkman, Adam S.; Murali, Sangita G.; Hitt, Stacy; Solverson, Patrick M.; Holst, Jens J.

    2012-01-01

    Glucagon-like peptide-2 (GLP-2) is a nutrient-dependent, proglucagon-derived gut hormone that shows promise for the treatment of short bowel syndrome (SBS). Our objective was to investigate how combination GLP-2 + enteral nutrients (EN) affects intestinal adaption in a rat model that mimics severe human SBS and requires parenteral nutrition (PN). Male Sprague-Dawley rats were assigned to one of five groups and maintained with PN for 18 days: total parenteral nutrition (TPN) alone, TPN + GLP-2 (100 μg·kg−1·day−1), PN + EN + GLP-2(7 days), PN + EN + GLP-2(18 days), and a nonsurgical oral reference group. Animals underwent massive distal bowel resection followed by jejunocolic anastomosis and placement of jugular catheters. Starting on postoperative day 4, rats in the EN groups were allowed ad libitum access to EN. Groups provided PN + EN + GLP-2 had their rate of PN reduced by 0.25 ml/day starting on postoperative day 6. Groups provided PN + EN + GLP-2 demonstrated significantly greater body weight gain with similar energy intake and a safe 80% reduction in PN compared with TPN ± GLP-2. Groups provided PN + EN + GLP-2 for 7 or 18 days showed similar body weight gain, residual jejunal length, and digestive capacity. Groups provided PN + EN + GLP-2 showed increased jejunal GLP-2 receptor (GLP-2R), insulin-like growth factor-I (IGF-I), and IGF-binding protein-5 (IGFBP-5) expression. Treatment with TPN + GLP-2 demonstrated increased jejunal expression of epidermal growth factor. Cessation of GLP-2 after 7 days with continued EN sustained the majority of intestinal adaption and significantly increased expression of colonic proglucagon compared with PN + EN + GLP-2 for 18 days, and increased plasma GLP-2 concentrations compared with TPN alone. In summary, EN potentiate the intestinotrophic actions of GLP-2 by improving body weight gain allowing for a safe 80% reduction in PN with increased jejunal expression of GLP-2R, IGF-I, and IGFBP-5 following distal bowel resection in the rat. PMID:22744334

  3. Colonization and Gut Flora Modulation of Lactobacillus kefiranofaciens ZW3 in the Intestinal Tract of Mice.

    PubMed

    Xing, Zhuqing; Tang, Wei; Yang, Ying; Geng, Weitao; Rehman, Rizwan Ur; Wang, Yanping

    2018-06-01

    This study evaluated the distribution and colonization of Lactobacillus kefiranofaciens ZW3 and determined its capacity to modulate the gut microbiota in an animal model. Based on (1) fluorescence imaging, (2) flow cytometry, and (3) qPCR, we found that ZW3 successfully adhered to mouse mucous tissue and colonized the mouse ileum. Gut microbiota profiling was performed using high-throughput sequencing. After continuous intubation with ZW3 for 1 week, the proportion of Lachnospiraceae, a family of butyric acid-producing bacteria, increased at day 7 (11.9% at day 0 versus 18.4% at day 7). In addition, Lactobacillaceae showed an increasing trend (4% at day 0 versus 13% at day 7) that was accompanied by an observable decline in the Rikenellaceae family (1.58% at day 7, 0.14% at day 14, and 0.75% at day 21) in the tested mouse. The results demonstrate that ZW3 could successfully adhere to and colonize the mouse gut throughout the course of the experiment. The profiling analysis of the gut microbiota also provided evidence supporting the function of ZW3 in improving the intestinal flora of mice.

  4. New-generation diabetes management: glucose sensor-augmented insulin pump therapy

    PubMed Central

    Cengiz, Eda; Sherr, Jennifer L; Weinzimer, Stuart A; Tamborlane, William V

    2011-01-01

    Diabetes is one of the most common chronic disorders with an increasing incidence worldwide. Technologic advances in the field of diabetes have provided new tools for clinicians to manage this challenging disease. For example, the development of continuous subcutaneous insulin infusion systems have allowed for refinement in the delivery of insulin, while continuous glucose monitors provide patients and clinicians with a better understanding of the minute to minute glucose variability, leading to the titration of insulin delivery based on this variability when applicable. Merging of these devices has resulted in sensor-augmented insulin pump therapy, which became a major building block upon which the artificial pancreas (closed-loop systems) can be developed. This article summarizes the evolution of sensor-augmented insulin pump therapy until present day and its future applications in new-generation diabetes management. PMID:21728731

  5. New-generation diabetes management: glucose sensor-augmented insulin pump therapy.

    PubMed

    Cengiz, Eda; Sherr, Jennifer L; Weinzimer, Stuart A; Tamborlane, William V

    2011-07-01

    Diabetes is one of the most common chronic disorders with an increasing incidence worldwide. Technologic advances in the field of diabetes have provided new tools for clinicians to manage this challenging disease. For example, the development of continuous subcutaneous insulin infusion systems have allowed for refinement in the delivery of insulin, while continuous glucose monitors provide patients and clinicians with a better understanding of the minute to minute glucose variability, leading to the titration of insulin delivery based on this variability when applicable. Merging of these devices has resulted in sensor-augmented insulin pump therapy, which became a major building block upon which the artificial pancreas (closed-loop systems) can be developed. This article summarizes the evolution of sensor-augmented insulin pump therapy until present day and its future applications in new-generation diabetes management.

  6. Private duty home care: what it means to real people across the nation.

    PubMed

    2011-04-01

    Private duty home care is growing rapidly to accommodate the needs of more and more seniors, disabled persons, and those with chronic conditions as these populations themselves are fast expanding and projected to continue to do so in the coming years and decades. The services that private duty/privately paid home care providers deliver each day to individuals across the United States can be absolutely essential to allowing them to remain in their own homes and communities leading as active and healthy lives as possible and continuing to contribute in the work force and to society as they are able. Requirements vary from state to state, and while most private duty agencies provide nonmedical companionship, homemaker, and personal care services--often described as assistance with activities of daily living--some incorporate licensed medical care as well.

  7. Comparative evaluation of continuous intercostal nerve block or epidural analgesia on the rate of respiratory complications, intensive care unit, and hospital stay following traumatic rib fractures: a retrospective review.

    PubMed

    Britt, Todd; Sturm, Ryan; Ricardi, Rick; Labond, Virginia

    2015-01-01

    Thoracic trauma accounts for 10%-15% of all trauma admissions. Rib fractures are the most common injury following blunt thoracic trauma. Epidural analgesia improves patient outcomes but is not without problems. The use of continuous intercostal nerve blockade (CINB) may offer superior pain control with fewer side effects. This study's objective was to compare the rate of pulmonary complications when traumatic rib fractures were treated with CINB vs epidurals. A hospital trauma registry provided retrospective data from 2008 to 2013 for patients with 2 or more traumatic rib fractures. All subjects were admitted and were treated with either an epidural or a subcutaneously placed catheter for continuous intercostal nerve blockade. Our primary outcome was a composite of either pneumonia or respiratory failure. Secondary outcomes included total hospital days, total ICU days, and days on the ventilator. 12.5% (N=8) of the CINB group developed pneumonia or had respiratory failure compared to 16.3% (N=7) in the epidural group. No statistical difference (P=0.58) in the incidence of pneumonia or vent dependent respiratory failure was observed. There was a significant reduction (P=0.05) in hospital days from 9.72 (SD 9.98) in the epidural compared to 6.98 (SD 4.67) in the CINB group. The rest of our secondary outcomes showed no significant difference. This study did not show a difference in the rate of pneumonia or ventilator-dependent respiratory failure in the CINB vs epidural groups. It was not sufficiently powered. Our data supports a reduction in hospital days when CINB is used vs epidural. CINB may have advantages over epidurals such as fewer complications, fewer contraindications, and a shorter time to placement. Further studies are needed to confirm these statements.

  8. Are we chained to our desks? Describing desk-based sitting using a novel measure of occupational sitting.

    PubMed

    Ryde, Gemma Cathrine; Brown, Helen Elizabeth; Gilson, Nicholas David; Brown, Wendy J

    2014-09-01

    Prolonged occupational sitting is related to poor health outcomes. Detailed data on sitting time at desks are required to understand and effectively influence occupational sitting habits. Full-time office employees were recruited (n = 105; mean age 40.9 ± 11.5 years; BMI 26.1 ± 3.9, 65% women). Sitting at the desk and in other work contexts was measured using a sitting pad and ActivPAL for an entire working week. Employees used a diary to record work hours. Time spent at work, sitting at work and at the desk; number of sit to stand transitions at the desk; and number of bouts of continuous sitting at the desk < 20 and > 60 minutes, were calculated. Average time spent at work was 8.7 ± 0.8 hours/day with 67% spent sitting at the desk (5.8 ± 1.2 hours/day), and 4% in other workplace settings. On average, employees got up from their desks 3 times/hour (29 ± 13/day). Sitting for more than 60 consecutive minutes occurred infrequently (0.69 ± 0.62 times/day), with most sit to stands (80%; 23 ± 14) occurring before 20 minutes of continual sitting. The findings provide highly detailed insights into desk-based sitting habits, highlighting large proportions of time spent sitting at desks, but with frequent interruptions.

  9. First clinical evaluation of a new percutaneous optical fiber glucose sensor for continuous glucose monitoring in diabetes.

    PubMed

    Müller, Achim Josef; Knuth, Monika; Nikolaus, Katharina Sibylle; Krivánek, Roland; Küster, Frank; Hasslacher, Christoph

    2013-01-01

    This article describes a new fiber-coupled, percutaneous fluorescent continuous glucose monitoring (CGM) system that has shown 14 days of functionality in a human clinical trial. The new optical CGM system (FiberSense) consists of a transdermal polymer optical fiber containing a biochemical glucose sensor and a small fluorescence photometer optically coupled to the fiber. The glucose-sensitive optical fiber was implanted in abdominal and upper-arm subcutaneous tissue of six diabetes patients and remained there for up to 14 days. The performance of the system was monitored during six visits to the study center during the trial. Blood glucose changes were induced by oral carbohydrate intake and insulin injections, and capillary blood glucose samples were obtained from the finger tip. The data were analyzed using linear regression and the consensus error grid analysis. The FiberSense worn at the upper arm exhibited excellent results during 14 wearing days, with an overall mean absolute relative difference (MARD) of 8.3% and 94.6% of the data in zone A of the consensus error grid. At the abdominal application site, FiberSense resulted in a MARD of 11.4 %, with 93.8% of the data in zone A. The FiberSense CGM system provided consistent, reliable measurements of subcutaneous glucose levels in human clinical trial patients with diabetes for up to 14 days. © 2013 Diabetes Technology Society.

  10. TDRS-L Media Day

    NASA Image and Video Library

    2014-01-03

    TITUSVILLE, Fla. – Members of the news media are given an up-close look at the Tracking and Data Relay Satellite, or TDRS-L, spacecraft undergoing preflight processing inside the Astrotech payload processing facility in Titusville. TDRS-L is being prepared for encapsulation inside its payload fairing prior to being transported to Launch Complex 41 at Cape Canaveral Air Force Station. Journalists visited Astrotech as part of TDRS-L Media Day to conduct interviews and photograph the satellite that will be a part of the second of three next-generation spacecraft designed to ensure vital operational continuity for the NASA Space Network. It is scheduled to launch from Cape Canaveral's Space Launch Complex 41 atop an Atlas V rocket in January 2014. The current Tracking and Data Relay Satellite system consists of eight in-orbit satellites distributed to provide near continuous information relay contact with orbiting spacecraft ranging from the International Space Station and Hubble Space Telescope to the array of scientific observatories. For more information, visit: http://www.nasa.gov/mission_pages/tdrs/home/index.html

  11. A new way of setting rFSH deposit: a case of severe injection error in IVF/ICSI cycle ending with live birth.

    PubMed

    Mayer, Richard Bernhard; Ebner, Thomas; Shebl, Omar; Tews, Gernot

    2012-01-01

    a 25- year old woman with secondary infertility caused by a male factor was enrolled in our IVF/ICSI-ET program. Stimulation was performed in a long- protocol and ovarian stimulation, using rFSH follitropin beta, starting on the third day of the menstrual cycle. The rFSH dose per day was 900 IU-0 IU-0 IU-0 IU. Due to normal ovarian response and follicle growth, stimulation was continued and there was no detriment in oocyte quality and no symptoms of OHSS. Following blastocyte transfer cesarean section was unpreventable at 37+5 weeks of gestation due to an impacted transverse lie. Different stimulation protocols are needed for appropriate treatment of various patients provided that the administration of treatment was done correctly. In the case of injection errors, continuing stimulation protocol seems to be achievable in certain cases considering hormone levels and the process of follicle growth.

  12. A new way of setting rFSH deposit: a case of severe injection error in IVF/ICSI cycle ending with live birth

    PubMed Central

    Mayer, Richard Bernhard; Ebner, Thomas; Shebl, Omar; Tews, Gernot

    2012-01-01

    We present a case with a severe injection error: a 25- year old woman with secondary infertility caused by a male factor was enrolled in our IVF/ICSI-ET program. Stimulation was performed in a long- protocol and ovarian stimulation, using rFSH follitropin beta, starting on the third day of the menstrual cycle. The rFSH dose per day was 900 IU-0 IU-0 IU-0 IU. Due to normal ovarian response and follicle growth, stimulation was continued and there was no detriment in oocyte quality and no symptoms of OHSS. Following blastocyte transfer cesarean section was unpreventable at 37+5 weeks of gestation due to an impacted transverse lie. Different stimulation protocols are needed for appropriate treatment of various patients provided that the administration of treatment was done correctly. In the case of injection errors, continuing stimulation protocol seems to be achievable in certain cases considering hormone levels and the process of follicle growth. PMID:24592042

  13. Scale-up potential of cultivating Chlorella zofingiensis in piggery wastewater for biodiesel production.

    PubMed

    Yuan, Zhenhong; Wang, Zhongming; Takala, Josu; Hiltunen, Erkki; Qin, Lei; Xu, Zhongbin; Qin, Xiaoxi; Zhu, Liandong

    2013-06-01

    Scale-up potential of cultivating Chlorella zofingiensis in piggery wastewater for simultaneous wastewater treatment and biodiesel production was tested. The cultivation of C. zofingiensis with autoclaved wastewater and NaClO-pretreated wastewater, cultivation of algae indoors and outdoors, and stability of semi-continuous feeding operation were examined. The results showed that C. zofingiensis cultivated in piggery wastewater pretreated by autoclaving and NaClO had no evident difference in the performance of nutrient removal, algal growth and biodiesel production. The outdoor cultivation experiments indicated that C. zofingiensis was able to adapt and grow well outdoors. The semi-continuous feeding operation by replacing 50% of algae culture with fresh wastewater every 1.5 days could provide a stable net biomass productivity of 1.314 g L(-1) day(-1). These findings in this study can prove that it is greatly possible to amplify the cultivation of C. zofingiensis in piggery wastewater for nutrient removal and biodiesel production. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Daily steps among Finnish adults: variation by age, sex, and socioeconomic position.

    PubMed

    Hirvensalo, Mirja; Telama, Risto; Schmidt, Michael D; Tammelin, Tuija H; Xiaolin Yang; Magnussen, Costan G; Vkari, Jorma S A; Raitakari, Olli T

    2011-11-01

    The aim of this study was to provide descriptive population-based pedometer data from adults aged 30-45 years in Finland, and to compare daily step counts with evidence-based indices. The data was collected from 1853 participants in 7 consecutive days in winter 2007-08 in part of 27-year follow up of the Cardiovascular Risk in Young Finns study. The participants took (mean±standard deviation) 7499 ± 2908 steps/day. Step counts included 1925 ± 2052 aerobic steps/day gathered in bouts of at least 10 min continuous ambulatory activity. Women had more total steps than men ((7824 ± 2925 vs. 7089 ± 2774; p < 0.001). Although participants had higher mean total steps on weekdays than on weekend days, they took more aerobic steps on weekend days than weekdays (p < 0.001). High-level non-manual work, and unemployment were associated with having fewer total steps, but high-level non-manual workers had more aerobic steps than other occupation groups. According to pedometer thresholds proposed by Tudor-Locke and Basset, 26% of men and 16% of women could be classified as inactive (<5000 steps/day) and 20% of women and 15% of men would be classified as active (>10,000 steps/day). We conclude that about one-quarter of men and one-fifth of women are considered as inactive, based on the number of daily total steps. Our results suggest that total steps may provide a very different picture of activity from aerobic steps; important differences are evident by socioeconomic position and day of the week.

  15. Effects of Cardiopulmonary Support With a Novel Pediatric Pump-Lung in a 30-Day Ovine Animal Model.

    PubMed

    Liu, Yang; Sanchez, Pablo G; Wei, Xufeng; Watkins, Amelia C; Niu, Shuqiong; Wu, Zhongjun J; Griffith, Bartley P

    2015-12-01

    The scarcity of donor organs has led to the development of devices that provide optimal long-term respiratory or cardiopulmonary support to bridge recipients as they wait for lung and/or heart transplantation. This study was designed to evaluate the 30-day in vivo performance of the newly developed pediatric pump-lung (PediPL) for cardiopulmonary support using a juvenile sheep model. The PediPL device was placed surgically between the right atrium and descending aorta in eight sheep (25.4-31.2 kg) and evaluated for 30 days. Anticoagulation was maintained with continuous heparin infusion (activated clotting time 150-200 s). The flow rate was measured continually, and gas transfer was measured daily. Plasma free hemoglobin, platelet activation, hematologic data, and blood biochemistry were assessed twice a week. Sheep were euthanized after 30 days. The explanted devices were examined for gross thrombosis. Six sheep survived for 30-32 days. During the study, the oxygen transfer rate of the devices was 54.9 ± 13.2 mL/min at a mean flow rate of 1.14 ± 0.46 L/min with blood oxygen saturation of 95.4% ± 1.7%. Plasma free hemoglobin was 8.2 ± 3.7 mg/dL. Platelet activation was 5.35 ± 2.65%. The animals had normal organ chemistries except for surgery-related transient alterations in kidney and liver function. Although we found some scattered thrombi on the membrane surfaces of some explanted devices during the necropsy, the device function and performance did not degrade. The PediPL device was capable of providing cardiopulmonary support with long-term reliability and good biocompatibility over the 30-day duration and offers the potential option for bridging pediatric patients with end-stage heart or lung disease to heart and/or lung transplantation. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  16. Intermittent episodes of bright light suppress myopia in the chicken more than continuous bright light.

    PubMed

    Lan, Weizhong; Feldkaemper, Marita; Schaeffel, Frank

    2014-01-01

    Bright light has been shown a powerful inhibitor of myopia development in animal models. We studied which temporal patterns of bright light are the most potent in suppressing deprivation myopia in chickens. Eight-day-old chickens wore diffusers over one eye to induce deprivation myopia. A reference group (n = 8) was kept under office-like illuminance (500 lux) at a 10:14 light:dark cycle. Episodes of bright light (15 000 lux) were super-imposed on this background as follows. Paradigm I: exposure to constant bright light for either 1 hour (n = 5), 2 hours (n = 5), 5 hours (n = 4) or 10 hours (n = 4). Paradigm II: exposure to repeated cycles of bright light with 50% duty cycle and either 60 minutes (n = 7), 30 minutes (n = 8), 15 minutes (n = 6), 7 minutes (n = 7) or 1 minute (n = 7) periods, provided for 10 hours. Refraction and axial length were measured prior to and immediately after the 5-day experiment. Relative changes were analyzed by paired t-tests, and differences among groups were tested by one-way ANOVA. Compared with the reference group, exposure to continuous bright light for 1 or 2 hours every day had no significant protective effect against deprivation myopia. Inhibition of myopia became significant after 5 hours of bright light exposure but extending the duration to 10 hours did not offer an additional benefit. In comparison, repeated cycles of 1:1 or 7:7 minutes of bright light enhanced the protective effect against myopia and could fully suppress its development. The protective effect of bright light depends on the exposure duration and, to the intermittent form, the frequency cycle. Compared to the saturation effect of continuous bright light, low frequency cycles of bright light (1:1 min) provided the strongest inhibition effect. However, our quantitative results probably might not be directly translated into humans, but rather need further amendments in clinical studies.

  17. Infrared Sky Imager (IRSI) Instrument Handbook

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

    Morris, Victor R.

    2016-04-01

    The Infrared Sky Imager (IRSI) deployed at the Atmospheric Radiation Measurement (ARM) Climate Research Facility is a Solmirus Corp. All Sky Infrared Visible Analyzer. The IRSI is an automatic, continuously operating, digital imaging and software system designed to capture hemispheric sky images and provide time series retrievals of fractional sky cover during both the day and night. The instrument provides diurnal, radiometrically calibrated sky imagery in the mid-infrared atmospheric window and imagery in the visible wavelengths for cloud retrievals during daylight hours. The software automatically identifies cloudy and clear regions at user-defined intervals and calculates fractional sky cover, providing amore » real-time display of sky conditions.« less

  18. 'Palliative sedation'? A retrospective cohort study on the use and labelling of continuously administered sedatives on a palliative care unit.

    PubMed

    Schildmann, Eva; Pörnbacher, Sebastian; Kalies, Helen; Bausewein, Claudia

    2018-03-01

    Sedatives are frequently used towards the end of life. However, there is scarce information when their use is labelled as 'palliative sedation'. To assess the use and labelling of 'continuous administration of sedatives within the last 7 days of life', based on objective operational criteria, on a palliative care unit. Retrospective cohort study, using medical records. Explorative statistical analysis (SPSS 23). Patients who died on a palliative care unit from August 2014 to July 2015. Sedatives recorded were benzodiazepines, levomepromazine, haloperidol ⩾5 mg/day and propofol. Of the 192 patients, 149 (78%) patients received continuous sedatives within the last week of life. The prevalence of delirium/agitation was significantly higher in patients with continuous sedatives compared to those without continuous sedatives at admission to the unit (35% vs 16%, p = 0.02) and on the day before death (58% vs 40%, p = 0.04). The term '(palliative) sedation' was used in the records for 22 of 149 (15%) patients with continuous sedatives. These patients had significantly higher total daily midazolam doses 2 days before death (median (range), 15.0 (6.0-185.0) mg vs 11.5 (1.0-70.0) mg, p = 0.04) and on the day of death (median (range), 19.5 (7.5-240.0) mg vs 12.5 (2.0-65.0) mg, p = 0.01). The dose range was large in both groups. The prevalence of delirium/agitation was associated with the administration of continuous sedatives. There was no consistent pattern regarding labelling the use of continuous sedatives as '(palliative) sedation'. Multicentre mixed-methods research is needed for a better characterization of sedation practices in palliative care.

  19. The Ellsworth Mountains: critical and enduringly enigmatic

    USGS Publications Warehouse

    Dalziel, I.W.D.

    2007-01-01

    The elevation (~5000m) is high for an early Mesozoic fold belt. Thermal uplift could have been initiated during Jurassic-Cretaceous block rotation and Weddell Sea opening and continued into the Cenozoic. The history of glaciation provides input for models of ice loading and unloading. Measurements of present-day uplift test these models and help assess change in the mass of the ice sheet and hence in global sea level.

  20. How Should the History of Education Be Written? Some Reflections about the Nature of the Discipline from the Perspective of the Reception of Our Work

    ERIC Educational Resources Information Center

    Depaepe, Marc

    2004-01-01

    How should history of education be written? To put the question is far more easier than to provide a concrete answer. In contemporary research, there continue to be pedagogistic complaints about finding answers to present-day educational problems via history. In our view, such an ahistorical utilitarianism as well as the legitimizing and/or…

  1. Language Use, Language Ability, and Language Development: Abstracts of Doctoral Dissertations Published in "Dissertation Abstracts International," July through December 1985 (Vol. 46 Nos. 1 through 6).

    ERIC Educational Resources Information Center

    ERIC Clearinghouse on Reading and Communication Skills, Urbana, IL.

    This collection of abstracts is part of a continuing series providing information on recent doctoral dissertations. The 34 titles deal with a variety of topics, including the following: (1) object conservation and receptive language in day care center infants; (2) the syntactic incorporation of linguistic units; (3) implicit theories of meaning in…

  2. Effects of different aerobic exercise frequencies on streptozotocin-nicotinamide-induced type 2 diabetic rats: Continuous versus short bouts and weekend warrior exercises.

    PubMed

    Alaca, Nuray; Uslu, Serap; Gulec Suyen, Guldal; Ince, Umit; Serteser, Mustafa; Kurtel, Hızır

    2018-01-01

    Exercise training is known to have multiple beneficial effects on type 2 diabetes mellitus (T2DM). The aim of this study was to explore the effects of aerobic exercise frequency on diabetic parameters, the histopathological structure of skeletal muscle, diabetic myopathy, and mitochondrial enzyme activity in an experimental model of T2DM. Sprague-Dawley rats (n = 35) were rendered diabetic by injection of nicotinamide (110 mg/kg) and streptozotocin (65 mg/kg). Rats with blood glucose concentrations between 7 and 17 mmol/L were used. Diabetic rats were randomly allocated to one of the following groups: (i) control sedentary; (ii) diabetic sedentary; (iii) diabetic with continuous exercise (30 min/day, 5 days/week); (iv) diabetic with short bouts of exercise (3 × 10 min/day, 5 days/week); and (v) diabetic rats as "weekend warriors" (35 + 40 min/day, 2 days/week). After 6 weeks swimming exercise (total duration 150 min/week), biochemical tests were performed to measure insulin, glucose, cytokines, serum and muscle myeloperoxidase (MPO), and malondialdehyde (MDA) levels. Histologic analysis (histomorphometric and mitochondrial enzyme analysis) was also performed. Compared with diabetic sedentary rats, significant improvements were observed in all exercise groups in terms of glucose levels, weight loss, tissue MPO and MDA levels, muscular connective tissue, muscle atrophy, mitochondrial enzyme, and all histomorphometric analyses. The results of the study emphasize the effects of training on inflammation, increased oxidative stress, myopathy, and mitochondrial damage in a rat model of T2DM, and demonstrate that there is no major difference between exercise modalities provided that the total duration of exercise remains the same. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  3. 3 CFR 8413 - Proclamation 8413 of September 10, 2009. Patriot Day and National Day of Service and Remembrance...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... lives we lost 8 years ago. On a bright September day, innocent men, women, and children boarded planes... brave men and women in uniform who continue to protect our country at home and abroad. In April, I was... next great chapter in our Nation’s history and ensure that future generations continue to enjoy the...

  4. Evaluation of the North Country on the Job Network: a model of facilitated care for injured workers in rural upstate New York.

    PubMed

    Lipscomb, Hester J; Moon, Samuel D; Li, Leiming; Pompeii, Lisa; Kennedy, Margaret Q

    2002-03-01

    We describe the evaluation of a community-based program designed to facilitate access to care and return to work for injured workers in a rural, medically underserved area in upstate New York. Providers are recruited to provide easily accessible care and are oriented to concepts of transitional duty and rapid return to work as medically appropriate; companies are recruited with the agreement to provide transitional work for injured employees. Registered nurses, hired by the local hospital, serve as case coordinators to facilitate care and coordinate communications among all parties. Over 3000 injured workers received care through the program in the first 56 months, with a decline in the number of transitional days over time. The number of days that the cases remain open has steadily declined, and the number of return-to-work cases has increased. The success of this initiative provides an excellent background for continued improvement in delivery of care to injured workers and proactive efforts at improving workplace safety and health in a rural area.

  5. Appetite, appetite hormone and energy intake responses to two consecutive days of aerobic exercise in healthy young men.

    PubMed

    Douglas, Jessica A; King, James A; McFarlane, Ewan; Baker, Luke; Bradley, Chloe; Crouch, Nicole; Hill, David; Stensel, David J

    2015-09-01

    Single bouts of exercise do not cause compensatory changes in appetite, food intake or appetite regulatory hormones on the day that exercise is performed. It remains possible that such changes occur over an extended period or in response to a higher level of energy expenditure. This study sought to test this possibility by examining appetite, food intake and appetite regulatory hormones (acylated ghrelin, total peptide-YY, leptin and insulin) over two days, with acute bouts of exercise performed on each morning. Within a controlled laboratory setting, 15 healthy males completed two, 2-day long (09:00-16:00) experimental trials (exercise and control) in a randomised order. On the exercise trial participants performed 60 min of continuous moderate-high intensity treadmill running (day one: 70.1 ± 2.5% VO2peak, day two: 70.0 ± 3.2% VO2max (mean ± SD)) at the beginning of days one and two. Across each day appetite perceptions were assessed using visual analogue scales and appetite regulatory hormones were measured from venous blood samples. Ad libitum energy and macronutrient intakes were determined from meals provided two and six hours into each day and from a snack bag provided in-between trial days. Exercise elicited a high level of energy expenditure (total = 7566 ± 635 kJ across the two days) but did not produce compensatory changes in appetite or energy intake over two days (control: 29,217 ± 4006 kJ; exercise: 28,532 ± 3899 kJ, P > 0.050). Two-way repeated measures ANOVA did not reveal any main effects for acylated ghrelin or leptin (all P > 0.050). However a significant main effect of trial (P = 0.029) for PYY indicated higher concentrations on the exercise vs. control trial. These findings suggest that across a two day period, high volume exercise does not stimulate compensatory appetite regulatory changes. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Recruitment Into a Pediatric Continuous Glucose Monitoring RCT.

    PubMed

    Volkening, Lisa K; Gaffney, Kaitlin C; Katz, Michelle L; Laffel, Lori M

    2017-01-01

    The purpose was to identify patient/family characteristics and recruitment process characteristics associated with the decision to participate in a 2-year continuous glucose monitoring (CGM) RCT for youth with type 1 diabetes and their families. Study staff approached patients who were conditionally eligible according to medical record review or referred by a provider. We categorized families according to participation decision (agree vs decline) and timing of decision (day of approach vs later ["thinkers"]). Over 18 months, we approached 456 eligible patients; 19% agreed on the day of approach, 10% agreed later, 42% declined on the day of approach, and 30% declined later. Agreers were younger ( P = .002), had shorter diabetes duration ( P = .0003), had a lower insulin dose ( P = .02), checked blood glucose levels more often ( P = .002), and were more likely to use pump therapy ( P = .009) than decliners. Patients/families were more likely to agree in fall/winter (41%) than spring/summer (19%, P < .0001). Of decliners, 50% cited no interest in CGM as the reason for nonparticipation. Among thinkers, 49% of patients who made a decision within 2 weeks of being approached agreed; only 15% of thinkers who made a decision >2 weeks after being approached agreed to participate ( P < .0001). Recruitment is a critical and often challenging phase of clinical trials. Recruitment to pediatric CGM studies may be especially challenging due to youths' reluctance to use CGM. These data provide an opportunity to better understand and possibly optimize recruitment into future pediatric CGM studies and other studies of advanced diabetes technologies.

  7. Widespread suppression of huntingtin with convection-enhanced delivery of siRNA.

    PubMed

    Stiles, David K; Zhang, Zhiming; Ge, Pei; Nelson, Brian; Grondin, Richard; Ai, Yi; Hardy, Peter; Nelson, Peter T; Guzaev, Andrei P; Butt, Mark T; Charisse, Klaus; Kosovrasti, Verbena; Tchangov, Lubomir; Meys, Michael; Maier, Martin; Nechev, Lubomir; Manoharan, Muthiah; Kaemmerer, William F; Gwost, Douglas; Stewart, Gregory R; Gash, Don M; Sah, Dinah W Y

    2012-01-01

    Huntington's disease is an autosomal dominant neurodegenerative disease caused by a toxic gain of function mutation in the huntingtin gene (Htt). Silencing of Htt with RNA interference using direct CNS delivery in rodent models of Huntington's disease has been shown to reduce pathology and promote neuronal recovery. A key translational step for this approach is extension to the larger non-human primate brain, achieving sufficient distribution of small interfering RNA targeting Htt (siHtt) and levels of Htt suppression that may have therapeutic benefit. We evaluated the potential for convection enhanced delivery (CED) of siHtt to provide widespread and robust suppression of Htt in nonhuman primates. siHtt was infused continuously for 7 or 28 days into the nonhuman primate putamen to analyze effects of infusion rate and drug concentration on the volume of effective suppression. Distribution of radiolabeled siHtt and Htt suppression were quantified by autoradiography and PCR, respectively, in tissue punches. Histopathology was evaluated and Htt suppression was also visualized in animals treated for 28 days. Seven days of CED led to widespread distribution of siHtt and significant Htt silencing throughout the nonhuman primate striatum in an infusion rate and dose dependent manner. Htt suppression at therapeutic dose levels was well tolerated by the brain. A model developed from these results predicts that continuous CED of siHtt can achieve significant coverage of the striatum of Huntington's disease patients. These findings suggest that this approach may provide an important therapeutic strategy for treating Huntington's disease. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Partial nitrification using aerobic granules in continuous-flow reactor: rapid startup.

    PubMed

    Wan, Chunli; Sun, Supu; Lee, Duu-Jong; Liu, Xiang; Wang, Li; Yang, Xue; Pan, Xiangliang

    2013-08-01

    This study applied a novel strategy to rapid startup of partial nitrification in continuous-flow reactor using aerobic granules. Mature aerobic granules were first cultivated in a sequencing batch reactor at high chemical oxygen demand in 16 days. The strains including the Pseudoxanthomonas mexicana strain were enriched in cultivated granules to enhance their structural stability. Then the cultivated granules were incubated in a continuous-flow reactor with influent chemical oxygen deamnad being stepped decreased from 1,500 ± 100 (0-19 days) to 750 ± 50 (20-30 days), and then to 350 ± 50 mg l(-1) (31-50 days); while in the final stage 350 mg l(-1) bicarbonate was also supplied. Using this strategy the ammonia-oxidizing bacterium, Nitrosomonas europaea, was enriched in the incubated granules to achieve partial nitrification efficiency of 85-90% since 36 days and onwards. The partial nitrification granules were successfully harvested after 52 days, a period much shorter than those reported in literature. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. [Introduction of Shimane University's outside funded support project for female researchers and healthcare staff].

    PubMed

    Tsumori, Toshiko

    2013-09-01

    Shimane University has started to provide facilities and services to female researchers and healthcare staff who have worked for the university or its hospital after 2007. This initiative had been supported by grants from the Japanese Ministry of Education, Culture, Sports, Science and Technology until 2010. Over time, it has become clear that these efforts, including a day-and-night nursery, day-care for sick children, temporary day-care, after-school programs, and research support system have effectively sustained female researchers and staff in maintaining a balance between private life and work. It is essential that the university devote part of its budget along with outside funding for continued childcare, which has so motivated these female employees. Moreover, it is expected that these efforts will become an effective recruitment tool for excellent young teachers and researchers.

  10. Defibrotide for the treatment of sinusoidal obstruction syndrome: evaluation of response to therapy and patient outcomes.

    PubMed

    Coutsouvelis, John; Avery, Sharon; Dooley, Michael; Kirkpatrick, Carl; Spencer, Andrew

    2018-03-01

    Defibrotide is an agent used to treat sinusoidal obstruction syndrome (SOS/VOD) in patients undergoing haemopoietic stem cell transplantation. The aim of this study was to evaluate the effectiveness of defibrotide used within institutional guidelines for the treatment of SOS/VOD in patients undergoing haemopoietic stem cell transplantation (HSCT). Data for 23 patients was retrospectively reviewed to evaluate the effectiveness of defibrotide and the utility of response criteria to direct therapy as specified within institution guidelines. Patients met institutional criteria for a diagnosis of SOS/VOD based on predominantly Baltimore criteria and received defibrotide. Stabilisation or improvement in symptoms and biochemical markers was required for continuation of therapy with defibrotide. Overall, 14 patients responded to therapy. Survival at day 100 post HSCT was 70%. Median serum (total) bilirubin concentrations in all evaluable patients had decreased at days 5 and 10 (p < 0.001). There was a proportional reduction in median weight of 4% by day 5 and 6.6% by day 10 (p < 0.001). On cessation of defibrotide, there was a decrease in the proportion of patients exhibiting hepatomegaly (p = 0.02), ascites (p < 0.01) and requiring oxygen supplementation (p < 0.01), with 70% survival at day 100 post HSCT. Defibrotide to treat SOS/VOD and continued based on attainment of early response was effective management of this condition. Defibrotide should be considered in any consensus protocol providing guidance on the management of SOS/VOD, with future studies considered to assess appropriate time points for response to therapy during treatment.

  11. An Introduction to the Tibet cGPS pilot project: TigiCAS

    NASA Astrophysics Data System (ADS)

    Zhang, Z.; Liu, J.; Galetzka, J.; Avouac, J.; Tapponnier, P.; Zeng, L.; Gan, W.; Shen, Z.; Wang, M.

    2007-12-01

    The convergence between India and Eurasia is the¡¡prototype of continental collision in action. Compared¡¡to geological history and fault kinematics studies, the present-day, regional pattern of strain-partitioning¡¡is still inadequately known. Among limited geodetic¡¡efforts in the past decade or two, most have been focused¡¡on refining measurements of the current crustal¡¡shortening rate across the Himalaya. The vast region¡¡immediately to the north is sparsely instrumented, with only one continuous GPS station (Lhasa) within¡¡the plateau proper. Campaign stations are few and¡¡ill-positioned, mostly along major roads, providing¡¡poor constraints on present-day slip-rates on individual¡¡active faults. The extant GPS network configuration is thus still insufficient to discriminate between block vs continuum deformation. In November 2006, the¡¡Chinese Academy of Sciences led a pilot program and¡¡installed 6 continuous GPS stations in southern Tibet, crossing the NS-trending normal fault systems and¡¡complementing the Nepal cGPS profiles. We present¡¡here the new sites, preliminary data processing results, and the spatial relationship with ongoing or planned¡¡continuous GPS sites from a couple of other projects. Together with such projects, TigiCAS will provide¡¡a substantial increase in geodetic data in the¡¡Himalayan-Tibet convergent belt in the next few¡¡years, and lead to a better understanding of¡¡contemporary deformation of the region.

  12. Effects of heroin on rat prosocial behavior.

    PubMed

    Tomek, Seven E; Stegmann, Gabriela M; Olive, M Foster

    2018-05-04

    Opioid use disorders are characterized in part by impairments in social functioning. Previous research indicates that laboratory rats, which are frequently used as animal models of addiction-related behaviors, are capable of prosocial behavior. For example, under normal conditions, when a 'free' rat is placed in the vicinity of rat trapped in a plastic restrainer, the rat will release or 'rescue' the other rat from confinement. The present study was conducted to determine the effects of heroin on prosocial behavior in rats. For 2 weeks, rats were given the opportunity to rescue their cagemate from confinement, and the occurrence of and latency to free the confined rat was recorded. After baseline rescuing behavior was established, rats were randomly selected to self-administer heroin (0.06 mg/kg/infusion i.v.) or sucrose pellets (orally) for 14 days. Next, rats were retested for rescuing behavior once daily for 3 days, during which they were provided with a choice between freeing the trapped cagemate and continuing to self-administer their respective reinforcer. Our results indicate that rats self-administering sucrose continued to rescue their cagemate, whereas heroin rats chose to self-administer heroin and not rescue their cagemate. These findings suggest that rats with a history of heroin self-administration show deficits in prosocial behavior, consistent with specific diagnostic criteria for opioid use disorder. Behavioral paradigms providing a choice between engaging in prosocial behavior and continuing drug use may be useful in modeling and investigating the neural basis of social functioning deficits in opioid addiction. © 2018 Society for the Study of Addiction.

  13. A novel antiproliferative drug coating for glaucoma drainage devices.

    PubMed

    Ponnusamy, Thiruselvam; Yu, Haini; John, Vijay T; Ayyala, Ramesh S; Blake, Diane A

    2014-01-01

    The implantation of a glaucoma drainage device (GDD) is often necessary for intractable cases of glaucoma. Currently, the success rate of GDD implants is relatively low because fibrosis that develops during the wound-healing process ultimately blocks fluid drainage. We describe herein a novel porous coating for Ahmed glaucoma valves based on biodegradable poly(lactic-co-glycolic acid) (PLGA). Thin films of PLGA were fabricated using a spin-coating technique. The procedure led to an asymmetric pore structure that was exploited to control the rate of dissolution. Double-layered porous films were constructed to achieve continuous drug release. A cell culture system was used to test the efficacy of these coatings. Double-layered films were manufactured to provide a burst of mitomycin C (MMC) release followed by a slow release of 5-fluorouracil (5-FU), which together prevented fibrosis over the most active period of postoperative wound healing (0 to 28 d). Double-layered films containing 5-FU only in the bottom layer showed a 3- to 5-day delay in drug release, followed by a sharp increase that continued for ~28 days. MMC was stable only when surface-loaded, and this drug was therefore surface-loaded onto the top PLGA layer to provide a continuous release of antifibrotics over the wound-healing period. The combined use of both MMC and 5-FU in a biodegradable device inhibits cell proliferation in a tissue culture model and has the potential to reduce fibrosis and increase the success rate of GDD implants. The design is simple and can be scaled for commercial production.

  14. Long-term variability in bright hard X-ray sources: 5+ years of BATSE data

    NASA Technical Reports Server (NTRS)

    Robinson, C. R.; Harmon, B. A.; McCollough, M. L.; Paciesas, W. S.; Sahi, M.; Scott, D. M.; Wilson, C. A.; Zhang, S. N.; Deal, K. J.

    1997-01-01

    The operation of the Compton Gamma Ray Observatory (CGRO)/burst and transient source experiment (BATSE) continues to provide data for inclusion into a data base for the analysis of long term variability in bright, hard X-ray sources. The all-sky capability of BATSE provides up to 30 flux measurements/day for each source. The long baseline and the various rising and setting occultation flux measurements allow searches for periodic and quasi-periodic signals with periods of between several hours to hundreds of days to be conducted. The preliminary results from an analysis of the hard X-ray variability in 24 of the brightest BATSE sources are presented. Power density spectra are computed for each source and profiles are presented of the hard X-ray orbital modulations in some X-ray binaries, together with amplitude modulations and variations in outburst durations and intensities in recurrent X-ray transients.

  15. Hardware description ADSP-21020 40-bit floating point DSP as designed in a remotely controlled digital CW Doppler radar

    NASA Astrophysics Data System (ADS)

    Morrison, R. E.; Robinson, S. H.

    A continuous wave Doppler radar system has been designed which is portable, easily deployed, and remotely controlled. The heart of this system is a DSP/control board using Analog Devices ADSP-21020 40-bit floating point digital signal processor (DSP) microprocessor. Two 18-bit audio A/D converters provide digital input to the DSP/controller board for near real time target detection. Program memory for the DSP is dual ported with an Intel 87C51 microcontroller allowing DSP code to be up-loaded or down-loaded from a central controlling computer. The 87C51 provides overall system control for the remote radar and includes a time-of-day/day-of-year real time clock, system identification (ID) switches, and input/output (I/O) expansion by an Intel 82C55 I/O expander.

  16. Design of a home-based adaptive mixed reality rehabilitation system for stroke survivors.

    PubMed

    Baran, Michael; Lehrer, Nicole; Siwiak, Diana; Chen, Yinpeng; Duff, Margaret; Ingalls, Todd; Rikakis, Thanassis

    2011-01-01

    This paper presents the design of a home-based adaptive mixed reality system (HAMRR) for upper extremity stroke rehabilitation. The goal of HAMRR is to help restore motor function to chronic stroke survivors by providing an engaging long-term reaching task therapy at home. The system uses an intelligent adaptation scheme to create a continuously challenging and unique multi-year therapy experience. The therapy is overseen by a physical therapist, but day-to-day use of the system can be independently set up and completed by a stroke survivor. The HAMMR system tracks movement of the wrist and torso and provides real-time, post-trial, and post-set feedback to encourage the stroke survivor to self-assess his or her movement and engage in active learning of new movement strategies. The HAMRR system consists of a custom table, chair, and media center, and is designed to easily integrate into any home.

  17. Home therapy with continuous infusion of factor VIII after minor surgery or serious haemorrhage.

    PubMed

    Varon, D; Schulman, S; Bashari, D; Martinowitz, U

    1996-10-01

    Administration of factor VIII (F VIII) concentrates by continuous infusion is now routinely used at several haemophilia centers but almost exclusively for hospitalized patients. We evaluated various aspects of home therapy with continuous infusion of an immunoaffinity purified F VIII concentrate (Monoclate P®, Armour) in patients who would normally have been treated with high doses in bolus injections or with continuous infusion as in-patients. Twenty haemophilia A patients, eight after minor surgery and 12 for serious haemorrhage, received continuous infusion with undiluted F VIII by a minipump for a mean of 0.9 days in the hospital, followed by 3.3 days at home. Infusion bags were exchanged every 2.5 days. No haemorrhagic complications occurred, and five haemorrhages that had been resistant to treatment with bolus injections responded promptly to the continuous infusion. There were no technical problems and patient compliance and acceptance was good. We find this mode of therapy safe, efficacious and convenient for the patients as well as for the staff.

  18. Daily menus can result in suboptimal nutrient intakes, especially calcium, of adolescents living in dormitories.

    PubMed

    Kresić, Greta; Simundić, Borislav; Mandić, Milena L; Kendel, Gordana; Zezelj, Sandra Pavicić

    2008-03-01

    The aims of this study were to evaluate daily menus in Croatian dormitories and to assess the overall intake of dairy products among resident adolescents. For this purpose, 168 daily menus were chosen for nutritional evaluation by random sampling. In addition, 227 adolescents (133 girls and 94 boys) participated in a questionnaire focused on food intake in addition to the meals supplied in dormitories with the aim to assess the amount and the type of dairy products consumed. The results showed that only 35% of the daily menus were nutritionally balanced. Most of the menus provided an excess of energy, protein, carbohydrate, saturated fat, phosphorus, riboflavin, and vitamin A. The levels of calcium and magnesium in the menus were suboptimal. The menus offered to adolescents provided approximately 2 servings of dairy products per day. Milk was the most often supplied dairy product (1.1 servings per day), whereas yogurt had the lowest frequency of serving (0.2 servings per day). The most preferred dairy-based snack for both sexes was milk. Dairy-based snacks provided about 1 serving per day for both sexes and contributed to about 30% of the recommended dietary allowances for calcium. Adolescents who regularly consumed dairy-based snacks meet the recommendations (3.2 servings of dairy products per day and about 98% recommended dietary allowances for calcium). We conclude that the institutional menu planning should be improved because the intake of dairy snacks will continue to be a problem for achieving a healthy diet in adolescences.

  19. 7 CFR 989.104 - Lot.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN IN... form), processed in any continuous production of one calendar day and packaged in one size and style of... necessarily processed in one continuous production or during one calendar day, identifiable and offered for...

  20. 7 CFR 989.104 - Lot.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN IN... form), processed in any continuous production of one calendar day and packaged in one size and style of... necessarily processed in one continuous production or during one calendar day, identifiable and offered for...

  1. 7 CFR 989.104 - Lot.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE RAISINS PRODUCED FROM GRAPES GROWN IN... form), processed in any continuous production of one calendar day and packaged in one size and style of... necessarily processed in one continuous production or during one calendar day, identifiable and offered for...

  2. Treatment of unscheduled bleeding in continuous oral contraceptive users with doxycycline: a randomized controlled trial.

    PubMed

    Kaneshiro, Bliss; Edelman, Alison; Carlson, Nichole; Morgan, Kristin; Nichols, Mark; Jensen, Jeffrey

    2010-06-01

    To estimate whether doxycycline, a matrix metalloproteinase inhibitor, would decrease unscheduled bleeding associated with initiation of a continuous oral contraceptive pill. Participants initiating a continuous oral contraceptive pill (20 micrograms of ethinyl estradiol/90 micrograms of levonorgestrel) were randomly assigned to receive either doxycycline (100 mg orally twice daily) or placebo taken for 5 days at the onset of each bleeding or spotting episode during the first 84 days of the study period. For the final 28 days of the study, participants were observed on the oral contraceptive pill alone. The primary outcome was the number of bleeding and spotting days. A sample size of 66 (33 in each arm) was calculated to detect a 50% reduction in bleeding (beta=0.80, alpha=0.05) and accounted for a 30% dropout rate. Sixty-six women were randomly assinged (33 in each study group). There were no significant differences during the 84-day treatment in bleeding or spotting days (doxycycline [mean {standard error}, placebo, P=.32) or the length of the longest bleeding or spotting episode (doxycycline, placebo, P=.70) between study groups. Similarly, no significant differences in bleeding patterns existed between groups during the final 28 days. Doxycycline, administered once bleeding has started, does not decrease unscheduled bleeding or shorten episodes of unscheduled bleeding in continuous oral contraceptive pill users. I.

  3. Urbanization and industrialization effects on haze in China: take Jinagsu for example

    NASA Astrophysics Data System (ADS)

    Liu, Duanyang; Wei, Jiansu; Kang, Zhiming; Yan, Wenlian; Cao, Lu; Chen, Hao

    2017-04-01

    Since the policy of ''Reform and Open to the Outside World'' was implemented from 1978, urbanization and industrialization have been rapid in China, leading to the expansion of urban areas, industrial district and population synchronous with swift advances in economy. With urban industrialization development underway, the urban heat island (UHI) and air pollution are being enhanced, together with vegetation coverage and relative humidity on the decrease. Based on the surface meteorological data of Jiangsu Province during 1980-2012, the climatic characteristics and the trends of haze were analyzed. The results indicated that during 1980-2012 haze days increased; in particular, severe and moderate haze days significantly increased. In the northern and coastal cities of Jiangsu Province China, haze days showed a significant increase. Haze often appeared in fall and winter, and rare in summer in the study area. It also occurred more often inland, and less along the coast. Haze occurred more often in June due to straw burning in the harvest time. The haze day increased during the 1990's over southern and southwestern Jiangsu Province; in central and northern Jiangsu, haze day increased after 2000. The continuous, regional and regional continuous haze days all showed increasing trends. As the urban area expanded each year, industrial emissions, coal consumption and car ownership increased accordingly, resulting in regional temperature increase and relative humidity decrease, which formed the urban heat island and dry island effects. Hence, haze formation and maintenance conditions became more favorable for more haze days, which led to the increase of haze days, and the significant increases of continuous, regional and regional continuous haze days.

  4. Monitoring InBaskets With Feedback to Providers Enhances the Timeliness of Patient Care.

    PubMed

    Trant, Amelia A; Strait, Michael; Kaplan, Rory; Dest, Vanna; Roshka, Adam; Lyons, Catherine A; Vest, Kevin A; Steffen, Tessa; Chiang, Anne; Adelson, Kerin B

    2018-05-01

    Electronic health records have changed providers' workflow. Epic's InBasket supplants traditional communication and is a central hub for clinical information. Failure to promptly complete records impairs communication and revenue collection. By tracking providers' InBasket activities and offering feedback, we hoped to improve InBasket management and interdisciplinary communication. We created a report to track 273 providers' InBasket activities, including ambulatory transcriptions, chart cosignatures, order cosignatures, patient calls, results, and billable encounters. The report showed how often and for how long each activity was delinquent. We completed three Plan-Do-Study-Act cycles. During cycle 1 (November to December 2015), we sent all providers automated e-mails with their monthly results. During cycle 2 (January to April 2016), we focused solely on billable encounter closure and sent targeted e-mails to providers with > 50 delinquent encounters. The e-mails stated that providers had 30 days to complete encounters or their practices would be closed to new patients; at 30 days, noncompliant providers had 60 days before practice suspension. During cycle 3 (May to September 2016), we continued to monitor and send targeted e-mails to providers who accumulated > 50 encounters. We modeled the financial impact of the intervention using net closure data, the report's aging function, and billing logs. InBasket monitoring with structured feedback decreased open encounters by 53.43%. We did not see improvements in the other metrics that the report tracked. We estimate that $231,724 was saved as a result of the intervention and $349,179 was lost to filing deadlines. Automated e-mails did not reduce open encounters; targeted e-mails to providers improved InBasket management.

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

    Kim, Joyce Jihyun; Yin, Rongxin; Kiliccote, Sila

    Open Automated Demand Response (OpenADR), an XML-based information exchange model, is used to facilitate continuous price-responsive operation and demand response participation for large commercial buildings in New York who are subject to the default day-ahead hourly pricing. We summarize the existing demand response programs in New York and discuss OpenADR communication, prioritization of demand response signals, and control methods. Building energy simulation models are developed and field tests are conducted to evaluate continuous energy management and demand response capabilities of two commercial buildings in New York City. Preliminary results reveal that providing machine-readable prices to commercial buildings can facilitate bothmore » demand response participation and continuous energy cost savings. Hence, efforts should be made to develop more sophisticated algorithms for building control systems to minimize customer's utility bill based on price and reliability information from the electricity grid.« less

  6. A unique approach to mental health services in an HMO: indemnity benefit and service program.

    PubMed

    Craig, T J; Patterson, D Y

    1981-02-01

    Three years' experience with a unique combination of an indemnity benefit plus an in-house service program in a prepaid group practice plan's psychiatric department demonstrates enhanced accessibility and increased utilization among formerly unserved segments of the membership plus the flexibility of freedom of choice in choosing service provider and the ability to tailor treatment to patient needs. Overall costs were similar to those reported for other prepaid plans despite the addition of benefits for long-term therapy outside the plan. Flexible use of inpatient and day hospital services enabled the program to migrate, to a large extent, major increases in hospital charges while providing greater continuity of care. This combination of benefits offers the advantages of both an indemnity benefit (Freedom of choice in treatment) and an in-house service program (greater continuity of care, more flexible use of resources, reduction of reliance on hospital care).

  7. Virtual day of the midwife: a global 'pyjama party'.

    PubMed

    Stewart, Sarah

    2014-06-01

    The Virtual International Day of the Midwife (VIDM) (www.vidm.org) is an annual online conference designed to break down traditional barriers to continuing professional development (CPD); provide online opportunities for international midwifery networking; and model open access communication and collaboration practices. Whilst the VIDM is designed to reach midwives all around the world, issues of access to the Internet, language and cultural differences prevent some midwives from attending, especially those who live in resource-poor countries. Nevertheless, the VIDM has successfully demonstrated how CPD can be delivered to midwives in a flexible and cost-effective way, as well as bring them together in a truly global open and collaborative environment.

  8. Relative Advantage: Strength for Favorable Conflict Resolution

    DTIC Science & Technology

    2014-05-22

    Director, School of Advanced Military Studies Henry A. Arnold III, COL, IN Accepted this 22nd day of May 2014 by...refused to continue negotiations, led to a decision by President Nixon to conduct a 12- day strategic bombing campaign focused on Hanoi and North...Vietnamese garrisons for a period of twelve days starting December 18, 1972. Anxiety continued to rise as the United States deduced that “if Hanoi did

  9. Is Fly in/Fly out (FIFO) a viable interim solution to address remote medical workforce shortages?

    PubMed

    Margolis, Stephen A

    2012-01-01

    Geographically remote regions of Australia experience a higher degree of socioeconomic inequality and health inequity, amid poor resourcing and extreme climatic conditions, when compared with their more urban counterparts. Doctors with the knowledge, skills and interest in remote work remain a scarce resource, with only 58 practitioners per 100,000 people versus 196/100,000 in metropolitan areas. Pending the arrival of the full complement of long-term remote medical workforce, an alternative solution that has so far received little attention but could provide near equivalence to resident doctors is the 'fly in/fly out' (FIFO) model. Specifically, where one doctor has a continuous relationship with one town or community, albeit spending their rostered time off away from this location, rather than continuity of service with different doctors each time. In this model, doctors spend a fixed number of days at work geographically remote from their home and families, with logistical support (eg housing, transport) provided, followed by a fixed number of days back at home not working. This provides a the doctor with the benefits of remote clinical work plus guaranteed time off at home, a more acceptable roster than in many remote locations at present. This also avoids the complex issue of experienced doctors having to leave remote areas mid-career for the well-documented reasons of spouse employment and children's education, as well as providing easier access to professional development activities. The author followed this path and remains a FIFO doctor after 7 years of continuous service. For FIFO to be effective, there needs to be a commitment from the sponsoring organisation for short, balanced, flexible, family friendly rosters and a positive organizational structure with effective communication between management and front line staff. Evidence shows that families and children with healthy family functioning, who are able to balance separateness and togetherness and are able to readily adjust when circumstances move from stability through change, and have strong communication skills, cope well with FIFO work. The author's employer actively supports his FIFO work arrangements. Although FIFO presents challenges and is not for everyone, it may be time for organisations providing medical care to remote Australia to further consider this option. Allowing mid-career doctors experienced in remote medicine to continue remote clinical practice when they move to the city for family reasons would provide an immediate benefit to remote communities. Notwithstanding the challenges, perhaps it is time to consider the option of FIFO to address ongoing workforce shortages?

  10. β-Blocker Continuation After Noncardiac Surgery

    PubMed Central

    Kwon, Steve; Thompson, Rachel; Florence, Michael; Maier, Ronald; McIntyre, Lisa; Rogers, Terry; Farrohki, Ellen; Whiteford, Mark; Flum, David R.

    2014-01-01

    Background Despite limited evidence of effect, β-blocker continuation has become a national quality improvement metric. Objective To determine the effect of β-blocker continuation on outcomes in patients undergoing elective noncardiac surgery. Design, Setting, and Patients The Surgical Care and Outcomes Assessment Program is a Washington quality improvement benchmarking initiative based on clinical data from more than 55 hospitals. Linking Surgical Care and Outcomes Assessment Program data to Washington’s hospital admission and vital status registries, we studied patients undergoing elective colorectal and bariatric surgical procedures at 38 hospitals between January 1, 2008, and December 31, 2009. Main Outcome Measures Mortality, cardiac events, and the combined adverse event of cardiac events and/or mortality. Results Of 8431 patients, 23.5% were taking β-blockers prior to surgery (mean [SD] age, 61.9 [13.7] years; 63.1% were women). Treatment with β-blockers was continued on the day of surgery and during the postoperative period in 66.0% of patients. Continuation of β-blockers both on the day of surgery and postoperatively improved from 57.2% in the first quarter of 2008 to 71.3% in the fourth quarter of 2009 (P value <.001). After adjusting for risk characteristics, failure to continue β-blocker treatment was associated with a nearly 2-fold risk of 90-day combined adverse event (odds ratio, 1.97; 95% CI, 1.19-3.26). The odds were even greater among patients with higher cardiac risk (odds ratio, 5.91; 95% CI, 1.40-25.00). The odds of combined adverse events continued to be elevated 1 year postoperatively (odds ratio, 1.66; 95% CI, 1.08-2.55). Conclusions β-Blocker continuation on the day of and after surgery was associated with fewer cardiac events and lower 90-day mortality. A focus on β-blocker continuation is a worthwhile quality improvement target and should improve patient outcomes. PMID:22249847

  11. Alteration in amyloid β42, phosphorylated tau protein, interleukin 6, and acetylcholine during diabetes-accelerated memory dysfunction in diabetic rats: correlation of amyloid β42 with changes in glucose metabolism.

    PubMed

    Zhou, You; Zhao, Ying; Xie, Hailong; Wang, Yan; Liu, Lin; Yan, Xinjia

    2015-08-14

    Diabetes accelerates memory dysfunction in a continuous, slowly pathological process. Studies suggest that the time course of certain biomarkers can characterize the pathological course of the disease to provide information for early intervention. Thus, there is an urgent need for validated biomarkers to characterize the cognitive impairment induced by DM. We aimed to detect changes in cerebrospinal fluid biomarkers such as amyloid β42, phosphorylated tau protein, interleukin 6, and acetylcholine in diabetic rats over time, and to analyse the relationship between diabetes and cognitive impairment. Rats were injected once intraperitoneally with 1% of streptozotocin to establish a diabetic model. Index changes were investigated longitudinally and all were measured at the end of the experiment at day 75. Aβ42, P-tau, IL-6, and ACh levels in CSF, insulin levels in plasma, and Aβ42 levels in plasma and brain tissue were measured by ELISA. Compared with control, the diabetic model showed ACh in CSF to be decreased by day 15, continuing lower out to day 75. Aβ42 changes in brain and blood showed the same trends but exhibited minima at different time points: day 30 in CSF and day 15 in plasma. After the minimum, Aβ42 in cerebrospinal fluid rose and levelled off lower than in the control group, whereas Aβ42 in plasma rose and went above the controls at day 30, slowly trending upwards for the remainder of the experiment. P-tau protein in CSF in diabetic rats showed an increasing trend, becoming significantly different from the controls at day 60 and day 75. Aβ42 in CSF was strongly negatively correlated with blood glucose at day 15 and was negatively correlated with insulin in serum, particularly at day 45. Our longitudinal research model suggest that changes in the measured biomarkers appear before learning and memory impairments do. Aβ42 and ACh in the diabetes model group clearly changed from day 0 to day 45, and then P-tau and IL-6 varied significantly from day 45 to day 75. The reduced ACh levels observed possibly correlated with the factors common to changes in Aβ42, P-tau, and IL-6.

  12. 30 CFR 75.832 - Frequency of examinations; recordkeeping.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... machine examination. At least once every 7 days, a qualified person must examine each high-voltage continuous mining machine to verify that electrical protection, equipment grounding, permissibility, cable... least once every 7 days, and prior to tramming the high-voltage continuous mining machine, a qualified...

  13. Correlation between sexual maturation and induction of persistent estrus by continuous illumination.

    PubMed

    Takeo, Y; Shirama, K; Shimizu, K; Maekawa, K

    1975-10-01

    The rats brought up under continuous illumination from the neonatal day persist in the rhythmic estrous cycle for long time and do not easily reveal so-called continuous vaginal estrus. On the contrary, immature rats at about 30 days of age show the persistent estrus soon after exposure to continuous illumination as well as adult rats. The purpose of this paper was to examine the relation of the age placed under continuous illumination and the time required to reach the persistent estrus. As the results, it was found that the younger rats need proportionally the longer time to reach the persistent estrus; the rats which were transferred into continuously illuminated environment at 0 (group A), 5 (group B), 10 (group C), 15-16 (group D) and 30 (group E) days of age required a mean time of 132.1 +/- 8.4, 126.8 +/- 8.9, 89.7 +/- 6.2, 91.5 +/- 3.8 and 70.3 +/- 3.0 days after birth to reach the persistent estrus, respectively. In the present data, a significant difference was seen between group B and C. Though all rats were killed after the same length of persistently estrous periods, actual endocrine level appeared to differ among the groups; the rats required longer time to reach the persistent estrus had smaller ovaries and adrenals.

  14. Identifying microbial carbon sources during ethanol and toluene biodegradation in a pilot-scale experimental aquifer system using isotopic analysis

    NASA Astrophysics Data System (ADS)

    Clay, S.; McLeod, H.; Smith, J. E.; Roy, J. W.; Slater, G. F.

    2013-12-01

    Combining ethanol with gasoline has become increasingly common in order to create more environmentally conscience transportation fuels. These blended fuels are favourable alternatives since ethanol is a non-toxic and highly labile renewable biomass-based resource which is an effective fuel oxygenate that reduces air pollution. Recent research however, has indicated that upon accidental release into groundwater systems, the preferential microbial metabolism of ethanol can cause progressively reducing conditions leading to slower biodegradation of petroleum hydrocarbons. Therefore, the presence of ethanol can result in greater persistence of BTEX compounds and longer hydrocarbon plumes in groundwater systems. Microbial biodegradation and community carbon sources coupled to aqueous geochemistry were monitored in a pilot-scale laboratory tank (80cm x 525cm x 175cm) simulating an unconfined sand aquifer. Dissolved ethanol and toluene were continuously injected into the aquifer at a controlled rate over 330 days. Carbon isotope analyses were performed on phospholipid fatty acid (PLFA) samples collected from 4 different locations along the aquifer. Initial stable carbon isotope values measured over days 160-185 in the bacterial PLFA ranged from δ13C = -10 to -21‰, which is indicative of dominant ethanol incorporation by the micro-organisms based on the isotopic signature of ethanol derived from corn, a C4 plant. A negative shift to δ13C = -10 to -30‰ observed over days 185-200, suggests a change in microbial metabolisms associated with less ethanol incorporation. This generally corresponds to a decrease in ethanol concentrations from day 40 to full attenuation at approximately day 160, and the onset of toluene depletion observed on day 120 and continuing thereafter. In addition, aqueous methane concentrations first detected on day 115 continued to rise to 0.38-0.70 mmol/L at all monitoring locations, demonstrating a significant redox shift to low energy methanogenic metabolisms. On-going archaeal lipid analyses are expected to capture the establishment of methanogenic communities and provide insight into carbon use by these communities. Furthermore, radiocarbon analysis will aid in tracking the biodegradation of ethanol and toluene. Ultimately this research aims to illustrate the preferential biodegradation of ethanol in a gasoline mixture, and identify the carbon sources utilized by an evolving microbial community using isotopic analyses to improve assessments and remediation strategies at sites contaminated with ethanol-blended fuels.

  15. A Severe Accident Caused by an Ocellate River Stingray (Potamotrygon motoro) in Central Brazil: How Well Do We Really Understand Stingray Venom Chemistry, Envenomation, and Therapeutics?

    PubMed

    da Silva, Nelson Jorge; Ferreira, Kalley Ricardo Clementino; Pinto, Raimundo Nonato Leite; Aird, Steven Douglas

    2015-06-18

    Freshwater stingrays cause many serious human injuries, but identification of the offending species is uncommon. The present case involved a large freshwater stingray, Potamotrygon motoro (Chondrichthyes: Potamotrygonidae), in the Araguaia River in Tocantins, Brazil. Appropriate first aid was administered within ~15 min, except that an ice pack was applied. Analgesics provided no pain relief, although hot compresses did. Ciprofloxacin therapy commenced after ~18 h and continued seven days. Then antibiotic was suspended; however, after two more days and additional tests, cephalosporin therapy was initiated, and proved successful. Pain worsened despite increasingly powerful analgesics, until debridement of the wound was performed after one month. The wound finally closed ~70 days after the accident, but the patient continued to have problems wearing shoes even eight months later. Chemistry and pharmacology of Potamotrygon venom and mucus, and clinical management of freshwater stingray envenomations are reviewed in light of the present case. Bacterial infections of stingray puncture wounds may account for more long-term morbidity than stingray venom. Simultaneous prophylactic use of multiple antibiotics is recommended for all but the most superficial stingray wounds. Distinguishing relative contributions of venom, mucus, and bacteria will require careful genomic and transcriptomic investigations of stingray tissues and contaminating bacteria.

  16. Landsat Data Continuity Mission, now Landsat-8: six months on-orbit

    USGS Publications Warehouse

    Markham, Brian L.; Storey, James C.; Irons, James R.

    2013-01-01

    The Landsat Data Continuity Mission (LDCM) with two pushbroom Earth-imaging sensors, the Operational Land Imager (OLI) and the Thermal InfraRed Sensor (TIRS), was launched on February 11, 2013. Its on-orbit check out period or commissioning phase lasted about 90 days. During this phase the spacecraft and its instruments were activated, operationally tested and their performance verified. In addition, during this period, the spacecraft was temporarily placed in an intermediary orbit where it drifted relative to the Landsat-7 spacecraft, providing near simultaneous imaging for about 3 days, allowing data comparison and cross calibration. After this tandem-imaging period, LDCM was raised to its final altitude and placed in the position formerly occupied by Landsat-5, i.e., 8 days out of phase with Landsat-7, with about a 10:10 AM equatorial crossing time. At the end of commissioning, the satellite was transferred to the United States Geological Survey (USGS), officially renamed Landsat-8 and declared operational. Data were made available to the public beginning May 31, 2013. The performance of the satellite and two instruments has generally been excellent as evidenced in the quality of the distributed data products. © (2013) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

  17. A Severe Accident Caused by an Ocellate River Stingray (Potamotrygon motoro) in Central Brazil: How Well Do We Really Understand Stingray Venom Chemistry, Envenomation, and Therapeutics?

    PubMed Central

    da Silva, Nelson Jorge; Clementino Ferreira, Kalley Ricardo; Leite Pinto, Raimundo Nonato; Aird, Steven Douglas

    2015-01-01

    Freshwater stingrays cause many serious human injuries, but identification of the offending species is uncommon. The present case involved a large freshwater stingray, Potamotrygon motoro (Chondrichthyes: Potamotrygonidae), in the Araguaia River in Tocantins, Brazil. Appropriate first aid was administered within ~15 min, except that an ice pack was applied. Analgesics provided no pain relief, although hot compresses did. Ciprofloxacin therapy commenced after ~18 h and continued seven days. Then antibiotic was suspended; however, after two more days and additional tests, cephalosporin therapy was initiated, and proved successful. Pain worsened despite increasingly powerful analgesics, until debridement of the wound was performed after one month. The wound finally closed ~70 days after the accident, but the patient continued to have problems wearing shoes even eight months later. Chemistry and pharmacology of Potamotrygon venom and mucus, and clinical management of freshwater stingray envenomations are reviewed in light of the present case. Bacterial infections of stingray puncture wounds may account for more long-term morbidity than stingray venom. Simultaneous prophylactic use of multiple antibiotics is recommended for all but the most superficial stingray wounds. Distinguishing relative contributions of venom, mucus, and bacteria will require careful genomic and transcriptomic investigations of stingray tissues and contaminating bacteria. PMID:26094699

  18. Continuous versus intermittent endotracheal cuff pressure control for the prevention of ventilator-associated respiratory infections in Vietnam: study protocol for a randomised controlled trial.

    PubMed

    Dat, Vu Quoc; Geskus, Ronald B; Wolbers, Marcel; Loan, Huynh Thi; Yen, Lam Minh; Binh, Nguyen Thien; Chien, Le Thanh; Mai, Nguyen Thi Hoang; Phu, Nguyen Hoan; Lan, Nguyen Phu Huong; Hao, Nguyen Van; Long, Hoang Bao; Thuy, Tran Phuong; Kinh, Nguyen Van; Trung, Nguyen Vu; Phu, Vu Dinh; Cap, Nguyen Trung; Trinh, Dao Tuyet; Campbell, James; Kestelyn, Evelyne; Wertheim, Heiman F L; Wyncoll, Duncan; Thwaites, Guy Edward; van Doorn, H Rogier; Thwaites, C Louise; Nadjm, Behzad

    2018-04-04

    Ventilator-associated respiratory infection (VARI) comprises ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). Although their diagnostic criteria vary, together these are the most common hospital-acquired infections in intensive care units (ICUs) worldwide, responsible for a large proportion of antibiotic use within ICUs. Evidence-based strategies for the prevention of VARI in resource-limited settings are lacking. Preventing the leakage of oropharyngeal secretions into the lung using continuous endotracheal cuff pressure control is a promising strategy. The aim of this study is to investigate the efficacy of automated, continuous endotracheal cuff pressure control in preventing the development of VARI and reducing antibiotic use in ICUs in Vietnam. This is an open-label randomised controlled multicentre trial. We will enrol 600 adult patients intubated for ≤ 24 h at the time of enrolment. Eligible patients will be stratified according to admission diagnosis (180 tetanus, 420 non-tetanus) and site and will be randomised in a 1:1 ratio to receive either (1) automated, continuous control of endotracheal cuff pressure or (2) intermittent measurement and control of endotracheal cuff pressure using a manual cuff pressure meter. The primary outcome is the occurrence of VARI, defined as either VAP or VAT during the ICU admission up to a maximum of 90 days after randomisation. Patients in both groups who are at risk for VARI will receive a standardised battery of investigations if their treating physician feels a new infection has occurred, the results of which will be used by an endpoint review committee, blinded to the allocated arm and independent of patient care, to determine the primary outcome. All enrolled patients will be followed for mortality and endotracheal tube cuff-related complications at 28 days and 90 days after randomisation. Other secondary outcomes include antibiotic use; days ventilated, in ICU and in hospital; inpatient mortality; costs of antibiotics in ICU; duration of ICU stay; and duration of hospital stay. This study will provide high-quality evidence concerning the use of continuous endotracheal cuff pressure control as a method to reduce VARI, antibiotic use and hospitalisation costs and to shorten stay. ClinicalTrials.gov, NCT02966392 . Registered on November 9, 2016. Protocol version: 2.0; issue date March 3, 2017.

  19. Continuous monitoring of intracranial pressure after endoscopic third ventriculostomy in the management of CSF shunt failure.

    PubMed

    Elgamal, E A

    2010-04-01

    The effectiveness of continuous intracranial pressure (ICP) monitoring in the adaptation period, after endoscopic third ventriculostomy (ETV), and removal of the failed shunt in the management of CSF shunt failure is assessed. Nine patients with active hydrocephalus presenting with CSF shunt obstruction or infection were managed by ETV, removal of the shunt and insertion of an external ventricular drain (EVD) containing an ICP sensor for the purpose of postoperative monitoring of the ICP, and intermittent drainage of CSF. Patient ages ranged from 8 months to 24 years, and six of them were females. Hydrocephalus was obstructive in seven patients, and multiloculated in two. Six patients had an ventriculoperitoneal shunt (VPS), one with a bilateral VPS, one patient had a ventriculoatrial shunt, and one had a VPS and cystoperitoneal shunt (CPS). Shunt failure was caused by obstruction in six patients and infection in three. The post-operative ICP monitoring period ranged from 1-7 days. Intracranial hypertension was persistent in the first day after ETV in 3 patients, and up to 110 mL of CSF were drained to improve its symptoms. ETV was successful in six patients and 3 had permanent VPS. Post-operative continuous ICP monitoring and EVD insertion were very useful in the treatment of CSF shunt failure with ETV. This procedure allowed intermittent CSF drainage, relieving symptoms of elevated ICP, and provided accurate assessment of the success of the ETV and patency of the stoma in the early postoperative days by CT ventriculography and can also be used to install antibiotics in cases of infection.

  20. Continuous detection and decoding of dexterous finger flexions with implantable myoelectric sensors.

    PubMed

    Baker, Justin J; Scheme, Erik; Englehart, Kevin; Hutchinson, Douglas T; Greger, Bradley

    2010-08-01

    A rhesus monkey was trained to perform individuated and combined finger flexions of the thumb, index, and middle finger. Nine implantable myoelectric sensors (IMES) were then surgically implanted into the finger muscles of the monkey's forearm, without any adverse effects over two years postimplantation. Using an inductive link, EMG was wirelessly recorded from the IMES as the monkey performed a finger flexion task. The EMG from the different IMES implants showed very little cross correlation. An offline parallel linear discriminant analysis (LDA) based algorithm was used to decode finger activity based on features extracted from continuously presented frames of recorded EMG. The offline parallel LDA was run on intraday sessions as well as on sessions where the algorithm was trained on one day and tested on following days. The performance of the algorithm was evaluated continuously by comparing classification output by the algorithm to the current state of the finger switches. The algorithm detected and classified seven different finger movements, including individual and combined finger flexions, and a no-movement state (chance performance = 12.5%) . When the algorithm was trained and tested on data collected the same day, the average performance was 43.8+/-3.6% n=10. When the training-testing separation period was five months, the average performance of the algorithm was 46.5+/-3.4% n=8. These results demonstrated that using EMG recorded and wirelessly transmitted by IMES offers a promising approach for providing intuitive, dexterous control of artificial limbs where human patients have sufficient, functional residual muscle following amputation.

  1. Towards universal Kangaroo Mother Care: recommendations and report from the First European conference and Seventh International Workshop on Kangaroo Mother Care.

    PubMed

    Nyqvist, K H; Anderson, G C; Bergman, N; Cattaneo, A; Charpak, N; Davanzo, R; Ewald, U; Ibe, O; Ludington-Hoe, S; Mendoza, S; Pallás-Allonso, C; Ruiz Peláez, J G; Sizun, J; Widström, A-M

    2010-06-01

    The hallmark of Kangaroo Mother Care (KMC) is the kangaroo position: the infant is cared for skin-to-skin vertically between the mother's breasts and below her clothes, 24 h/day, with father/substitute(s) participating as KMC providers. Intermittent KMC (for short periods once or a few times per day, for a variable number of days) is commonly employed in high-tech neonatal intensive care units. These two modalities should be regarded as a progressive adaptation of the mother-infant dyad, ideally towards continuous KMC, starting gradually and progressively with intermittent KMC. The other components in KMC are exclusive breastfeeding (ideally) and early discharge in kangaroo position with strict follow-up. Current evidence allows the following general statements about KMC in affluent and low-income settings: KMC enhances bonding and attachment; reduces maternal postpartum depression symptoms; enhances infant physiologic stability and reduces pain, increases parental sensitivity to infant cues; contributes to the establishment and longer duration of breastfeeding and has positive effects on infant development and infant/parent interaction. Therefore, intrapartum and postnatal care in all types of settings should adhere to a paradigm of nonseparation of infants and their mothers/families. Preterm/low-birth-weight infants should be regarded as extero-gestational foetuses needing skin-to-skin contact to promote maturation. Kangaroo Mother Care should begin as soon as possible after birth, be applied as continuous skin-to-skin contact to the extent that this is possible and appropriate and continue for as long as appropriate.

  2. KSC00pp0621

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L lifts off at 3:07 a.m. EDT from Pad A at Complex 36 on Cape Canaveral Air Force Station. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  3. KSC00pp0618

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L launches toward space from Pad A at Complex 36 on Cape Canaveral Air Force Station. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  4. KSC-00pp0621

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L lifts off at 3:07 a.m. EDT from Pad A at Complex 36 on Cape Canaveral Air Force Station. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  5. KSC-00pp0618

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L launches toward space from Pad A at Complex 36 on Cape Canaveral Air Force Station. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  6. KSC00pp0619

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L lifts off at 3:07 a.m. EDT from Pad A at Complex 36 on Cape Canaveral Air Force Station. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  7. KSC-00pp0619

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L lifts off at 3:07 a.m. EDT from Pad A at Complex 36 on Cape Canaveral Air Force Station. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  8. LifeSat - A satellite for space biological research

    NASA Technical Reports Server (NTRS)

    Halstead, Thora W.; Morey-Holton, Emily R.

    1990-01-01

    The LifeSat Program addresses the need for continuing access by biological scientists to space experimentation by accommodating a wide range of experiments involving animals and plants for durations up to 60 days in an unmanned satellite. The program will encourage interdisciplinary and international cooperation at both the agency and scientist levels, and will provide a recoverable, reusable facility for low-cost missions addressing key scientific issues that can only be answered by space experimentation. It will provide opportunities for research in gravitational biology and on the effects of cosmic radiation on life systems. The scientific aspects of LifeSat are addressed here.

  9. Lightning mapper sensor design study

    NASA Technical Reports Server (NTRS)

    Eaton, L. R.; Poon, C. W.; Shelton, J. C.; Laverty, N. P.; Cook, R. D.

    1983-01-01

    World-wide continuous measurement of lightning location, intensity, and time during both day and night is to be provided by the Lightning Mapper (LITMAP) instrument. A technology assessment to determine if the LITMAP requirements can be met using existing sensor and electronic technologies is presented. The baseline concept discussed in this report is a compromise among a number of opposing requirements (e.g., ground resolution versus array size; large field of view versus narrow bandpass filter). The concept provides coverage for more than 80 percent of the lightning events as based on recent above-cloud NASA/U2 lightning measurements.

  10. Hubble space telescope six-battery test bed

    NASA Technical Reports Server (NTRS)

    Pajak, J. A.; Bush, J. R., Jr.; Lanier, J. R., Jr.

    1990-01-01

    A test bed for a large space power system breadboard for the Hubble Space Telescope (HST) was designed and built to test the system under simulated orbital conditions. A discussion of the data acquisition and control subsystems designed to provide for continuous 24 hr per day operation and a general overview of the test bed is presented. The data acquisition and control subsystems provided the necessary monitoring and protection to assure safe shutdown with protection of test articles in case of loss of power or equipment failure over the life of the test (up to 5 years).

  11. The Correlation Radiometer - A New Application in MM-Wave Total Power Radiometry

    NASA Technical Reports Server (NTRS)

    Gaier, Todd; Tanner, Alan; Kangaslahti, Pekka; Lim, Boon

    2013-01-01

    We describe the design and performance of a 180 GHz correlation radiometer suitable for remote sensing. The radiometer provides continuous comparisons between a the observed signal and a reference load to provide stable radiometric baselines. The radiometer was assembled and tested using parts from the GeoSTAR-II instrument and is fully compatible with operation in a synthetic aperture radiometer or as a standalone technology for use in microwave sounding and imaging. This new radiometer was tested over several days easily demonstrating the required 6 hour stability requirement for observations of mean brightness temperature for a geostationary instrument.

  12. Applying a managerial approach to day surgery.

    PubMed

    Onetti, Alberto

    2008-01-01

    The present article explores the day surgery topic assuming a managerial perspective. If we assume such a perspective, day surgery can be considered as a business model decision care and not just a surgical procedure alternative to the traditional ones requiring patient hospitalization. In this article we highlight the main steps required to develop a strategic approach [Cotta Ramusino E, Onetti A. Strategia d'Impresa. Milano; Il Sole 24 Ore; Second Edition, 2007] at hospital level (Onetti A, Greulich A. Strategic management in hospitals: the balanced scorecard approach. Milano: Giuffé; 2003) and to make day surgery part of it. It means understanding: - how and when day surgery can improve the health care providers' overall performance both in terms of clinical effectiveness and financial results, and, - how to organize and integrate it with the other hospital activities in order to make it work. Approaching day surgery as a business model decision requires to address in advance a list of potential issues and necessitates of continued audit to verify the results. If it does happen, day surgery can be both safe and cost effective and impact positively on surgical patient satisfaction. We propose a sort of "check-up list" useful to hospital managers and doctors that are evaluating the option of introducing day surgery or are trying to optimize it.

  13. Use of the PiCCO system in critically ill patients with septic shock and acute respiratory distress syndrome: a study protocol for a randomized controlled trial.

    PubMed

    Zhang, Zhongheng; Xu, Xiao; Yao, Min; Chen, Huilan; Ni, Hongying; Fan, Haozhe

    2013-02-01

    Hemodynamic monitoring is very important in critically ill patients with shock or acute respiratory distress syndrome(ARDS). The PiCCO (Pulse index Contour Continuous Cardiac Output, Pulsion Medical Systems, Germany) system has been developed and used in critical care settings for several years. However, its impact on clinical outcomes remains unknown. The study is a randomized controlled multi-center trial. A total of 708 patients with ARDS, septic shock or both will be included from January 2012 to January 2014. Subjects will be randomized to receive PiCCO monitoring or not. Our primary end point is 30-day mortality, and secondary outcome measures include ICU length of stay, days on mechanical ventilation, days of vasoactive agent support, ICU-free survival days during a 30-day period, mechanical-ventilation-free survival days during a 30-day period, and maximum SOFA score during the first 7 days. We investigate whether the use of PiCCO monitoring will improve patient outcomes in critically ill patients with ARDS or septic shock. This will provide additional data on hemodynamic monitoring and help clinicians to make decisions on the use of PiCCO. http://www.clinicaltrials.gov NCT01526382.

  14. Maximizing the production of butyric acid from food waste as a precursor for ABE-fermentation.

    PubMed

    Stein, Ullrich Heinz; Wimmer, B; Ortner, M; Fuchs, W; Bochmann, G

    2017-11-15

    The current study reports on the maximization of butyric acid production from food waste using a mixed microbial fermentation. In semi-continuous fermentations the effect of three different pH values (5.5, 7.0 and 9.0), three different temperatures (37°C, 55°C and 70°C) and two levels of hydraulic retention time (HRT, 2days and 6days) on the formation of butyric acid as well as total volatile fatty acid production (tVFA) were investigated. Overall, pH5.5 provided the lowest butyric acid concentrations regardless of the temperature and the HRT. At mesophilic temperature (37°C) alkaline conditions (pH9.0) lead to a strong incline of tVFA as well as butyric acid concentration probably due to a decreased solubilization of the substrate. However, most efficient in terms of butyric acid production was the fermentation conducted at 55°C and pH7 where a butyric acid concentrations of 10.55g/L (HRT 2days) and 13.00g/L (HRT 6days) were achieved. Additional experiments at 70°C showed declining butyric acid production. Increase of the HRT from 2days to 6days provided an increment of butyric acid concentration throughout almost all experimental settings. However, regarding volumetric productivity the increase in concentration does not compensate for the bigger reactor volume required to establish a higher HRT. At pH7 and 55°C the resulting volumetric production rates were 5.27g/L∗d at a HRT 2days and only 2.17g/L∗d at a HRT of 6days. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Effect of Continued Medical Therapy on Productivity Costs for Refractory Chronic Rhinosinusitis.

    PubMed

    Rudmik, Luke; Soler, Zachary M; Smith, Timothy L; Mace, Jess C; Schlosser, Rodney J; DeConde, Adam S

    2015-11-01

    It is estimated that lost productivity related to chronic rhinosinusitis (CRS) costs society in excess of $13 billion per year in the United States. Given this tremendous cost to society, it is important to evaluate the effect of current interventions on improving this productivity loss. To define the change in productivity costs in patients with refractory CRS who select continued medical therapy. Observational cohort study. Thirty-eight patients with a guideline-based diagnosis of CRS whose initial appropriate medical therapy failed were enrolled from 4 tertiary-level rhinology clinics. The study was conducted from December 6, 2010, to April 23, 2013, and data analysis was performed from December 6, 2010, to June 1, 2015. Continued medical therapy for CRS. The human capital approach was applied to quantify productivity costs. Absenteeism, presenteeism, and lost leisure time were quantified to define annual lost productive time, which was measured at enrollment (baseline) and at a minimum of 6 months after treatment. Lost productive time was monetized using the annual daily wage rates obtained from the 2012 US National Census and the 2013 US Department of Labor statistics. Thirty-eight patients with refractory CRS who selected continued medical therapy had a mean (SD) baseline annual productivity cost of $3464 ($4900) per patient. After continued medical therapy for a mean of 12.8 (4.8) months, productivity costs were $2730 ($3720) (before vs after continued medical therapy productivity cost, P = .74). Mean annual absenteeism was reduced from 5 (12) days to 2 (8) days (P = .02). Mean annual presenteeism (17 [27] days reduced to 15 [23] days; P = .93) and mean annual household days lost (7 [7] days reduced to 6 [6] days; P = .51) were maintained at baseline levels. There were no significant differences in productivity outcomes based on endoscopy, the 22-item Sinonasal Outcome Test score, age, or polyp status (all P ≥ .11). Patients with refractory CRS often make treatment decisions based on the degree of quality-of-life and productivity impairment. Outcomes from this study suggest that productivity in patients with refractory CRS who have minor reductions in baseline productivity can remain stable with continued medical therapy. Physicians can use this information to inform appropriate patients with CRS of their expected outcomes from continued medical therapy.

  16. Impact of a breastfeeding-friendly workplace on an employed mother's intention to continue breastfeeding after returning to work.

    PubMed

    Tsai, Su-Ying

    2013-04-01

    Ever-increasing populations of women in their childbearing years are choosing to become employed. Breastfeeding provides unique health advantages to both the infant and mother. A breastfeeding-friendly workplace might be an important factor for predicting breastfeeding rates among working women. To explore the impact of breastfeeding-friendly support on the intention of working mothers to continue breastfeeding, we conducted a survey at a female labor-intensive electronics manufacturer in Taiwan. A structured questionnaire survey was administered to 715 working mothers employed in an electronics manufacturing plant in Tainan Science Park in Southern Taiwan. Questionnaire content included female employee demographics, employment characteristics, continued breastfeeding behavior after returning to work, access to lactation rooms, and employee perception of the breastfeeding policy and support when raising their most recently born child. A higher education level (odds ratio [OR]=2.66), lower work load (8 work hours/day) (OR=2.66), lactation room with dedicated space (OR=2.38), use of breast pumping breaks (OR=61.6), and encouragement from colleagues (OR=2.78) and supervisors (OR=2.44) to use breast pumping breaks were significant predictors of continued breastfeeding for more than 6 months after returning to work. The findings of the present study suggest that to encourage and increase the rate of continued breastfeeding, workplaces should establish dedicated breastfeeding rooms and maintain a comfortable and clean environment. Furthermore, employers should provide encouragement and support for working mothers to continue breastfeeding after returning to work.

  17. NASA/JPL CLIMATE DAY: Middle and High School Students Get the Facts about Global Climate Change

    NASA Astrophysics Data System (ADS)

    Richardson, Annie; Callery, Susan; Srinivasan, Margaret

    2013-04-01

    In 2007, NASA Headquarters requested that Earth Science outreach teams brainstorm new education and public outreach activities that would focus on the topic of global climate change. At the Jet Propulsion Laboratory (JPL), Annie Richardson, outreach lead for the Ocean Surface Topography missions came up with the idea of a "Climate Day", capitalizing on the popular Earth Day name and events held annually throughout the world. JPL Climate Day would be an education and public outreach event whose objectives are to provide the latest scientific facts about global climate change - including the role the ocean plays in it, the contributions that NASA/JPL satellites and scientists make to the body of knowledge on the topic, and what we as individuals can do to promote global sustainability. The primary goal is that participants get this information in a fun and exciting environment, and walk away feeling empowered and capable of confidently engaging in the global climate debate. In March 2008, JPL and its partners held the first Climate Day event. 950 students from seven school districts heard from five scientists; visited exhibits, and participated in hands-on-activities. Pleased with the outcome, we organized JPL Climate Day 2010 at the Pasadena Convention Center in Pasadena, California, reaching more than 1700 students, teachers, and members of the general public over two days. Taking note of this successful model, NASA funded a multi-center, NASA Climate Day proposal in 2010 to expand Climate Day nation-wide. The NASA Climate Day proposal is a three-pronged project consisting of a cadre of Earth Ambassadors selected from among NASA-affiliated informal educators; a "Climate Day Kit" consisting of climate-related electronic resources available to the Earth Ambassadors; and NASA Climate Day events to be held in Earth Ambassador communities across the United States. NASA/JPL continues to host the original Climate Day event and in 2012 held its 4th event, at the Pasadena Convention Center in Pasadena, California. Although our goals and objectives remain the same, we continue to improve the event, which now includes student staff and student exhibitors. Our poster will give an overview and highlights of the November 16, 2012 event.

  18. Vegetation Continuous Fields--Transitioning from MODIS to VIIRS

    NASA Astrophysics Data System (ADS)

    DiMiceli, C.; Townshend, J. R.; Sohlberg, R. A.; Kim, D. H.; Kelly, M.

    2015-12-01

    Measurements of fractional vegetation cover are critical for accurate and consistent monitoring of global deforestation rates. They also provide important parameters for land surface, climate and carbon models and vital background data for research into fire, hydrological and ecosystem processes. MODIS Vegetation Continuous Fields (VCF) products provide four complementary layers of fractional cover: tree cover, non-tree vegetation, bare ground, and surface water. MODIS VCF products are currently produced globally and annually at 250m resolution for 2000 to the present. Additionally, annual VCF products at 1/20° resolution derived from AVHRR and MODIS Long-Term Data Records are in development to provide Earth System Data Records of fractional vegetation cover for 1982 to the present. In order to provide continuity of these valuable products, we are extending the VCF algorithms to create Suomi NPP/VIIRS VCF products. This presentation will highlight the first VIIRS fractional cover product: global percent tree cover at 1 km resolution. To create this product, phenological and physiological metrics were derived from each complete year of VIIRS 8-day surface reflectance products. A supervised regression tree method was applied to the metrics, using training derived from Landsat data supplemented by high-resolution data from Ikonos, RapidEye and QuickBird. The regression tree model was then applied globally to produce fractional tree cover. In our presentation we will detail our methods for creating the VIIRS VCF product. We will compare the new VIIRS VCF product to our current MODIS VCF products and demonstrate continuity between instruments. Finally, we will outline future VIIRS VCF development plans.

  19. Multi-parameter vital sign database to assist in alarm optimization for general care units.

    PubMed

    Welch, James; Kanter, Benjamin; Skora, Brooke; McCombie, Scott; Henry, Isaac; McCombie, Devin; Kennedy, Rosemary; Soller, Babs

    2016-12-01

    Continual vital sign assessment on the general care, medical-surgical floor is expected to provide early indication of patient deterioration and increase the effectiveness of rapid response teams. However, there is concern that continual, multi-parameter vital sign monitoring will produce alarm fatigue. The objective of this study was the development of a methodology to help care teams optimize alarm settings. An on-body wireless monitoring system was used to continually assess heart rate, respiratory rate, SpO 2 and noninvasive blood pressure in the general ward of ten hospitals between April 1, 2014 and January 19, 2015. These data, 94,575 h for 3430 patients are contained in a large database, accessible with cloud computing tools. Simulation scenarios assessed the total alarm rate as a function of threshold and annunciation delay (s). The total alarm rate of ten alarms/patient/day predicted from the cloud-hosted database was the same as the total alarm rate for a 10 day evaluation (1550 h for 36 patients) in an independent hospital. Plots of vital sign distributions in the cloud-hosted database were similar to other large databases published by different authors. The cloud-hosted database can be used to run simulations for various alarm thresholds and annunciation delays to predict the total alarm burden experienced by nursing staff. This methodology might, in the future, be used to help reduce alarm fatigue without sacrificing the ability to continually monitor all vital signs.

  20. [Motivation and satisfaction of residents in urology].

    PubMed

    Enzmann, T; Buxel, H; Benzing, F

    2010-08-01

    To address the increasing shortage of qualified residents, which leads to further discontent and additional on-call rotations for the remaining physicians, an analysis of the current situation was performed. Stress in the daily working routine, not enough free time, too little pay, or too little compensatory time off for overtime as well as inadequate options for continuing education were reported to be the main elements of dissatisfaction. The economic pressure of day-to-day work continues to define the physician's role and places demands on the medical staff by burdening them with nonmedical and administrative tasks.The major causes mentioned were staff shortage and lack of support provided by supervisors and the administration. For this reason, human resource development should be considered a strategic and central goal. This requires a normative, cross-functional approach at all levels of management and inclusion of personnel departments in the strategic processes of the hospital. The most important aspects for resident satisfaction were the work environment, acceptable work-life balance and remuneration, compensation for overtime, and quality of available continuing education, which is often rated as being insufficient.Effective strategies to improve the motivation of residents comprise offering opportunities for structured continuing education, optimizing the everyday work processes, and involving employees in social networks. The establishment of feedback strategies, including recognition of residents' achievements, will help to ensure their loyalty and identification with their clinic. This can serve as a preventive measure to offset any potential willingness to change jobs.

  1. Validity of Questionnaire and Representativeness of Objective Methods for Measurements of Mechanical Exposures in Construction and Health Care Work.

    PubMed

    Koch, Markus; Lunde, Lars-Kristian; Gjulem, Tonje; Knardahl, Stein; Veiersted, Kaj Bo

    2016-01-01

    To determine the criterion validity of a questionnaire on physical exposures compared to objective measurements at construction and health care sites and to examine exposure variation over several working days. Five hundred ninety-four construction and health care workers answered a baseline questionnaire. The daily activities (standing, moving, sitting, number of steps), postures (inclination of the arm and the trunk), and relative heart rate of 125 participants were recorded continuously over 3-4 working days. At the end of the first measurement day, the participants answered a second questionnaire (workday questionnaire). All objective activity measurements had significant correlations to their respective questions. Among health care workers, there were no correlations between postures and relative heart rate and the baseline questionnaire. The questionnaires overestimated the exposure durations. The highest explained variance in the adjusted models with self-reported variables were found for objectively measured sitting (R2 = 0.559) and arm inclination > 60° (R2 = 0.420). Objective measurements over several days showed a higher reliability compared to single day measurements. Questionnaires cannot provide an accurate description of mechanical exposures. Objective measurements over several days are recommended in occupations with varying tasks.

  2. Tying It All Together

    ERIC Educational Resources Information Center

    Hirsh, Stephanie; Crow, Tracy

    2017-01-01

    The learning team cycle as described in "Becoming a Learning Team: A Guide to a Teacher-Led Cycle of Continuous Improvement" by Stephanie Hirsh and Tracy Crow was created to support teams of teachers working on particular lessons and instructional challenges within classrooms. Even as the day-to-day work of classroom teaching continues,…

  3. 5 CFR 841.109 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL... computing a period of time for filing documents, the day of the action or event after which the designated... Saturday, a Sunday, or a legal holiday; in this event, the period runs until the end of the next day which...

  4. 29 CFR 1990.147 - Final action.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Final action. 1990.147 Section 1990.147 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED... Occupational Carcinogens § 1990.147 Final action. (a) Within one hundred twenty (120) days from the last day of...

  5. Bioreactor culture duration of engineered constructs influences bone formation by mesenchymal stem cells.

    PubMed

    Mitra, Debika; Whitehead, Jacklyn; Yasui, Osamu W; Leach, J Kent

    2017-11-01

    Perfusion culture of mesenchymal stem cells (MSCs) seeded in biomaterial scaffolds provides nutrients for cell survival, enhances extracellular matrix deposition, and increases osteogenic cell differentiation. However, there is no consensus on the appropriate perfusion duration of cellular constructs in vitro to boost their bone forming capacity in vivo. We investigated this phenomenon by culturing human MSCs in macroporous composite scaffolds in a direct perfusion bioreactor and compared their response to scaffolds in continuous dynamic culture conditions on an XYZ shaker. Cell seeding in continuous perfusion bioreactors resulted in more uniform MSC distribution than static seeding. We observed similar calcium deposition in all composite scaffolds over 21 days of bioreactor culture, regardless of pore size. Compared to scaffolds in dynamic culture, perfused scaffolds exhibited increased DNA content and expression of osteogenic markers up to 14 days in culture that plateaued thereafter. We then evaluated the effect of perfusion culture duration on bone formation when MSC-seeded scaffolds were implanted in a murine ectopic site. Human MSCs persisted in all scaffolds at 2 weeks in vivo, and we observed increased neovascularization in constructs cultured under perfusion for 7 days relative to those cultured for 1 day within each gender. At 8 weeks post-implantation, we observed greater bone volume fraction, bone mineral density, tissue ingrowth, collagen density, and osteoblastic markers in bioreactor constructs cultured for 14 days compared to those cultured for 1 or 7 days, and acellular constructs. Taken together, these data demonstrate that culturing MSCs under perfusion culture for at least 14 days in vitro improves the quantity and quality of bone formation in vivo. This study highlights the need for optimizing in vitro bioreactor culture duration of engineered constructs to achieve the desired level of bone formation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. A New Paradigm of Technology-Enabled ‘Vital Signs’ for Early Detection of Health Change for Older Adults.

    PubMed

    Rantz, Marilyn J; Skubic, Marjorie; Popescu, Mihail; Galambos, Colleen; Koopman, Richelle J; Alexander, Gregory L; Phillips, Lorraine J; Musterman, Katy; Back, Jessica; Miller, Steven J

    2015-01-01

    Environmentally embedded (nonwearable) sensor technology is in continuous use in elder housing to monitor a new set of ‘vital signs' that continuously measure the functional status of older adults, detect potential changes in health or functional status, and alert healthcare providers for early recognition and treatment of those changes. Older adult participants' respiration, pulse, and restlessness are monitored as they sleep. Gait speed, stride length, and stride time are calculated daily, and automatically assess for increasing fall risk. Activity levels are summarized and graphically displayed for easy interpretation. Falls are detected when they occur and alerts are sent immediately to healthcare providers, so time to rescue may be reduced. Automated health alerts are sent to healthcare staff, based on continuously running algorithms applied to the sensor data, days and weeks before typical signs or symptoms are detected by the person, family members, or healthcare providers. Discovering these new functional status ‘vital signs', developing automated methods for interpreting them, and alerting others when changes occur have the potential to transform chronic illness management and facilitate aging in place through the end of life. Key findings of research in progress at the University of Missouri are discussed in this viewpoint article, as well as obstacles to widespread adoption.

  7. Semi-continuous methane production from undiluted brown algae using a halophilic marine microbial community.

    PubMed

    Miura, Toyokazu; Kita, Akihisa; Okamura, Yoshiko; Aki, Tsunehiro; Matsumura, Yukihiko; Tajima, Takahisa; Kato, Junichi; Nakashimada, Yutaka

    2016-01-01

    Acclimated marine sediment-derived culture was used for semi-continuous methane production from materials equivalent to raw brown algae, without dilution of salinity and without nutrient supply, under 3 consecutive conditions of varying organic loading rates (OLRs) and hydraulic retention time (HRT). Methane production was stable at 2.0gVS/kg/day (39-day HRT); however, it became unstable at 2.9gVS/kg/day (28-day HRT) due to acetate and propionate accumulation. OLR subsequently decreased to 1.7gVS/kg/day (46-day HRT), stabilizing methane production beyond steady state. Methane yield was above 300mL/g VS at all OLRs. These results indicated that the acclimated marine sediment culture was able to produce methane semi-continuously from raw brown algae without dilution and nutrient supply under steady state. Microbial community analysis suggested that hydrogenotrophic methanogens predominated among archaea during unstable methane production, implying a partial shift of the methanogenic pathway from acetoclastic methanogenesis to acetate oxidation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Continuous light after a long-day treatment is equivalent to melatonin implants to stimulate testosterone secretion in Alpine male goats.

    PubMed

    Delgadillo, J A; Vélez, L I; Flores, J A

    2016-04-01

    In rams, artificial long days followed by continuous light stimulate testosterone secretion during the non-breeding season. The objective of this study was to determine whether artificial long days followed by continuous light could stimulate testosterone secretion in Alpine bucks as well as in those exposed to long days followed by a melatonin treatment. All bucks were kept in shaded open pens. Control males were exposed to natural photoperiod conditions (n=5). Males of the two experimental groups were exposed to 2.5 months of long days from 1 December (n=5 each). On 16 February, one group of males was exposed to 24 h of light per day until 30 June; the other group was exposed to natural variations of photoperiod and received two s.c. melatonin implants. Testicular weight was determined every 2 weeks, and the plasma testosterone concentrations once a week. In the control and the two photoperiodic-treated groups, a treatment×time interaction was detected for testicular weight and plasma testosterone concentrations (P<0.001). In control bucks, testicular weight increased from January and peaked in June, whereas in both photoperiodic-treated groups, this variable increased from January, but peaked in April, when the values were higher than in controls (P<0.05). In the control group, plasma testosterone concentrations remained low from January to June, whereas in both photoperiodic-treated groups, this variable remained low from January to March; thereafter, these levels increased in both photoperiodic-treated groups, and were higher than controls in April and May (P<0.05). We conclude that continuous light after a long-day treatment stimulate testosterone secretion in Alpine male goats during the non-breeding season as well as the long days followed by a melatonin treatment. Therefore, continuous light could replace the implants of melatonin.

  9. Extended observations of higher than 7-keV X-rays from Centaurus X-3 by the OSO-7 satellite

    NASA Technical Reports Server (NTRS)

    Baity, W. A.; Ulmer, M. P.; Wheaton, W. A.; Peterson, L. E.

    1974-01-01

    The UCSD X-ray telescope on board OSO-7 provided 43 days of continuous coverage of the variable X-ray source Cen X-3 at energies above 7 keV during December 1971 and January 1972. We detected the 4.8-sec pulsation period, the 2.087-day eclipse cycle, and an apparently nonperiodic, low-intensity state lasting more than 12 days. Spectra obtained over the 7-30 keV range during noneclipsed high-intensity states are steeper than those previously reported. Large changes, which may be characterized by a number spectral index alpha varying between 3.0 plus or minus 0.2 and 2.0 plus or minus 0.3, or by exponential spectra with kT varying from 6 plus or minus 2 to 13 plus or minus 3 keV, occur at different high-intensity states.

  10. Antietam: Aspects of Medicine, Nursing and the Civil War

    PubMed Central

    Tooker, John

    2007-01-01

    Robert E. Lee's Army of Northern Virginia met the Army of the Potomac under George B. McClellan at Antietam Creek near Sharpsburg, Maryland on September 17, 1862. Before the day was done, nearly 23,000 men were killed, wounded, or missing, memorializing Antietam as the bloodiest single day in American military history. Dr. Jonathan Letterman, the Medical Director of the Army of the Potomac, Clara Barton, the “Angel of the Battlefield,” and Dr. Hunter McGuire, Chief Surgeon to and Medical Director of General Stonewall Jackson's Corps, were among the nursing and medical personnel engaged on that historic day. These three individuals provided medical and nursing care to the casualties at Antietam (and other Civil War battles), but perhaps more importantly, developed systems of casualty management that brought order and humanity to the battlefield. These models of care continue today in modern military medicine. PMID:18528505

  11. World TB Day 2018: The Challenge of Drug Resistant Tuberculosis.

    PubMed

    Gupta-Wright, Ankur; Tomlinson, Gillian S; Rangaka, Molebogeng X; Fletcher, Helen A

    2018-01-01

    On 24th March, the world commemorates the day in 1882 when Dr Robert Koch announced his discovery of Mycobacterium tuberculosis (MTB). Over 130 years later, tuberculosis (TB) continues to affect individuals, communities, and entire health systems and economies. Koch unsuccessfully tried to 'cure' TB, and despite major advances in other areas of medicine, control of TB remains elusive- in 2016 TB was the leading infectious cause of death. The STOP TB partnership and World Health Organization (WHO) have announced their theme for World TB Day 2018 "Wanted: Leaders for a TB-Free World. You can make history. End TB." This theme recognizes that TB is much larger than any one person, institute or discipline of research, and provides an opportunity for us to reflect on the major challenges and consider how we, as a scientific community, can work together and take the lead to address the global crisis of drug-resistant TB (DR-TB).

  12. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...

  13. The immediate effects of the severe acute respiratory syndrome (SARS) epidemic on childbirth in Taiwan.

    PubMed

    Lee, Cheng-Hua; Huang, Nicole; Chang, Hong-Jen; Hsu, Yea-Jen; Wang, Mei-Chu; Chou, Yiing-Jenq

    2005-04-04

    When an emerging infectious disease like severe acute respiratory syndrome (SARS) strikes suddenly, many wonder the public's overwhelming fears of SARS may deterred patients from seeking routine care from hospitals and/or interrupt patient's continuity of care. In this study, we sought to estimate the influence of pregnant women's fears of severe acute respiratory syndrome (SARS) on their choice of provider, mode of childbirth, and length of stay (LOS) for the delivery during and after the SARS epidemic in Taiwan. The National Health Insurance data from January 01, 2002 to December 31, 2003 were used. A population-based descriptive analysis was conducted to assess the changes in volume, market share, cesarean rate, and average LOS for each of the 4 provider levels, before, during and after the SARS epidemic. Compared to the pre-SARS period, medical centers and regional hospitals dropped 5.2% and 4.1% in market share for childbirth services during the peak SARS period, while district hospitals and clinics increased 2.1% and 7.1%, respectively. For changes in cesarean rates, only a significantly larger increase was observed in medical centers (2.2%) during the peak SARS period. In terms of LOS, significant reductions in average LOS were observed in all hospital levels except for clinics. Average LOS was shortened by 0.21 days in medical centers (5.6%), 0.21 days in regional hospitals (5.8%), and 0.13 days in district hospitals (3.8%). The large amount of patients shifting from the maternity wards of more advanced hospitals to those of less advanced hospitals, coupled with the substantial reduction in their length of maternity stay due to their fears of SARS could also lead to serious concerns for quality of care, especially regarding a patient's accessibility to quality providers and continuity of care.

  14. The immediate effects of the severe acute respiratory syndrome (SARS) epidemic on childbirth in Taiwan

    PubMed Central

    Lee, Cheng-Hua; Huang, Nicole; Chang, Hong-Jen; Hsu, Yea-Jen; Wang, Mei-Chu; Chou, Yiing-Jenq

    2005-01-01

    Background When an emerging infectious disease like severe acute respiratory syndrome (SARS) strikes suddenly, many wonder the public's overwhelming fears of SARS may deterred patients from seeking routine care from hospitals and/or interrupt patient's continuity of care. In this study, we sought to estimate the influence of pregnant women's fears of severe acute respiratory syndrome (SARS) on their choice of provider, mode of childbirth, and length of stay (LOS) for the delivery during and after the SARS epidemic in Taiwan. Methods The National Health Insurance data from January 01, 2002 to December 31, 2003 were used. A population-based descriptive analysis was conducted to assess the changes in volume, market share, cesarean rate, and average LOS for each of the 4 provider levels, before, during and after the SARS epidemic. Results Compared to the pre-SARS period, medical centers and regional hospitals dropped 5.2% and 4.1% in market share for childbirth services during the peak SARS period, while district hospitals and clinics increased 2.1% and 7.1%, respectively. For changes in cesarean rates, only a significantly larger increase was observed in medical centers (2.2%) during the peak SARS period. In terms of LOS, significant reductions in average LOS were observed in all hospital levels except for clinics. Average LOS was shortened by 0.21 days in medical centers (5.6%), 0.21 days in regional hospitals (5.8%), and 0.13 days in district hospitals (3.8%). Conclusion The large amount of patients shifting from the maternity wards of more advanced hospitals to those of less advanced hospitals, coupled with the substantial reduction in their length of maternity stay due to their fears of SARS could also lead to serious concerns for quality of care, especially regarding a patient's accessibility to quality providers and continuity of care. PMID:15804368

  15. Does suckling offer protection to the lamb against Teladorsagia circumcincta infection?

    PubMed

    Iposu, S O; McAnulty, R W; Greer, A W; Xie, H L; Green, R S; Stankiewicz, M; Sykes, A R

    2008-05-31

    This study tested the hypothesis that milk has a direct effect on the establishment of infection with Teladorsagia circumcincta, and provides information on the effects of suckling on resilience to infection in young lambs. Of 46 six-week-old twin-born lambs, one from each twin was allowed to continue suckling (S-) and its twin-weaned (W-) while both were concurrently infected with an average of either 0 (-0; n=7/group), 250 (-250; n=8/group) or 1000 (-1000; n=8/group) third stage infective larvae (L3) of T. circumcincta per day, providing six treatment groups. All groups grazed minimally contaminated pasture, and after 42 days were slaughtered for necropsy. Low pasture larval contamination was confirmed in W0 and S0 lambs by faecal egg counts (FEC) of less than 30 eggs per gram (EPG) and burdens of less than 140 worms. There was no difference in FEC between weaned and suckled lambs. Within infection regime, total worm burdens were 55-60% greater in the weaned compared with their suckled counterparts (P=0.05), and represented 27 and 17%, respectively, net establishment of larvae. The greater worm burdens of both groups of weaned animals, which compared with their suckled counterparts, and of those infected with 1000 compared with 250 larvae per day, were associated with shorter female adults that had fewer eggs in utero, perhaps indicating intra-worm population regulation, but highlighting the limitation of FEC in assessing nematode burdens of such young lambs. There was no effect of infection on live weight gain of either weaned or suckled groups and the possibility was raised that, in such young lambs, immune unresponsiveness may be responsible. The major benefit of continued milk consumption appears to lie more in providing nutrients for enhanced growth rather than in improving resilience of the lambs to infection.

  16. Effects of Long-Term Daily Administration of Prostaglandin-E2 on Maintaining Elevated Proximal Tibial Metaphyseal Cancellous Bone Mass in Male Rats

    NASA Technical Reports Server (NTRS)

    Ke, Hua Zhu; Jee, Webster S. S.; Mori, Satoshi; Li, Xiao Jian; Kimmel, Donald B.

    1992-01-01

    The effects of long-term prostaglandin E(sub 2) (PGE(sub 2)) on cancellous bone in proximal tibial metaphysis were studied in 7 month old male Sprague-Dawley rats given daily subcutaneous injections of 0, 1, 3, and 6 mg PGE(sub 2)/kg/day and sacrificed after 60, 120, and 180 days. Histomorphometric analyses were performed on double fluorescent-labeled undecalcified bone specimens. After 60 days of treatment, PGE(sub 2) produced diffusely labeled trabecular bone area, increased trabecular bone area, eroded and labeled trabecular perimeter, mineral apposition rate, and bone formation rate at all dose levels when compared with age-matched controls. In rats given PGE(sub 2) for longer time periods (120 and 180 days), trabecular bone area, diffusely labeled trabecular bone area, labeled perimeter, mineral apposition, and bone formation rates were sustained at the elevated levels achieved earlier at 60-day treatment. The eroded perimeter continued to increase until 120 days, then plateau. The observation that continuous systemic PGE(sub 2) administration to adult male rats elevated metaphyseal cancellous bone mass to 3.5-fold of the control level within 60 days and maintained it for another 120 days indicates that the powerful skeletal anabolic effects of PGE2 can be sustained with continuous administration .

  17. Effect of core body temperature, time of day, and climate conditions on behavioral patterns of lactating dairy cows experiencing mild to moderate heat stress.

    PubMed

    Allen, J D; Hall, L W; Collier, R J; Smith, J F

    2015-01-01

    Cattle show several responses to heat load, including spending more time standing. Little is known about what benefit this may provide for the animals. Data from 3 separate cooling management trials were analyzed to investigate the relationship between behavioral patterns in lactating dairy cows experiencing mild to moderate heat stress and their body temperature. Cows (n=157) were each fitted with a leg data logger that measured position and an intravaginal data logger that measures core body temperature (CBT). Ambient conditions were also collected. All data were standardized to 5-min intervals, and information was divided into several categories: when standing and lying bouts were initiated and the continuance of each bout (7,963 lying and 6,276 standing bouts). In one location, cows were continuously subjected to heat-stress levels according to temperature-humidity index (THI) range (THI≥72). The THI range for the other 2 locations was below and above a heat-stress threshold of 72 THI. Overall and regardless of period of day, cows stood up at greater CBT compared with continuing to stand or switching to a lying position. In contrast, cows lay down at lower CBT compared with continuing to lie or switching to a standing position, and lying bouts lasted longer when cows had lower CBT. Standing bouts also lasted longer when cattle had greater CBT, and they were less likely to lie down (less than 50% of lying bouts initiated) when their body temperature was over 38.8°C. Also, cow standing behavior was affected once THI reached 68. Increasing CBT decreased lying duration and increased standing duration. A CBT of 38.93°C marked a 50% likelihood a cow would be standing. This is the first physiological evidence that standing may help cool cows and provides insight into a communally observed behavioral response to heat. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  18. Growth and lipid accumulation characteristics of Scenedesmus obliquus in semi-continuous cultivation outdoors for biodiesel feedstock production.

    PubMed

    Feng, Pingzhong; Yang, Kang; Xu, Zhongbin; Wang, Zhongming; Fan, Lu; Qin, Lei; Zhu, Shunni; Shang, Changhua; Chai, Peng; Yuan, Zhenhong; Hu, Lei

    2014-12-01

    In an effort to identify suitable microalgal species for biodiesel production, seven species were isolated from various habitats and their growth characteristics were compared. The results demonstrated that a green alga Scenedesmus obliquus could grow more rapidly and synthesize more lipids than other six microalgal strains. S. obliquus grew well both indoors and outdoors, and reached higher μmax indoors than that outdoors. However, the cells achieved higher dry weight (4.36 g L(-1)), lipid content (49.6%) and productivity (183 mg L(-1) day(-1)) outdoors than in indoor cultures. During the 61 days semi-continuous cultivation outdoors, high biomass productivities (450-550 mg L(-1) day(-1)) and μmax (1.05-1.44 day(-1)) were obtained. The cells could also achieve high lipid productivities (151-193 mg L(-1) day(-1)). These results indicated that S. obliquus was promising for lipids production in semi-continuous cultivation outdoors. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. BLOND, a building-level office environment dataset of typical electrical appliances.

    PubMed

    Kriechbaumer, Thomas; Jacobsen, Hans-Arno

    2018-03-27

    Energy metering has gained popularity as conventional meters are replaced by electronic smart meters that promise energy savings and higher comfort levels for occupants. Achieving these goals requires a deeper understanding of consumption patterns to reduce the energy footprint: load profile forecasting, power disaggregation, appliance identification, startup event detection, etc. Publicly available datasets are used to test, verify, and benchmark possible solutions to these problems. For this purpose, we present the BLOND dataset: continuous energy measurements of a typical office environment at high sampling rates with common appliances and load profiles. We provide voltage and current readings for aggregated circuits and matching fully-labeled ground truth data (individual appliance measurements). The dataset contains 53 appliances (16 classes) in a 3-phase power grid. BLOND-50 contains 213 days of measurements sampled at 50kSps (aggregate) and 6.4kSps (individual appliances). BLOND-250 consists of the same setup: 50 days, 250kSps (aggregate), 50kSps (individual appliances). These are the longest continuous measurements at such high sampling rates and fully-labeled ground truth we are aware of.

  20. TDRS-L Media Day

    NASA Image and Video Library

    2014-01-03

    TITUSVILLE, Fla. – Members of the news media are given an opportunity for an up-close look at the Tracking and Data Relay Satellite, or TDRS-L, spacecraft undergoing preflight processing inside the Astrotech payload processing facility in Titusville. TDRS-L is being prepared for encapsulation inside its payload fairing prior to being transported to Launch Complex 41 at Cape Canaveral Air Force Station. Journalists visited Astrotech as part of TDRS-L Media Day to conduct interviews and photograph the satellite that will be a part of the second of three next-generation spacecraft designed to ensure vital operational continuity for the NASA Space Network. It is scheduled to launch from Cape Canaveral's Space Launch Complex 41 atop an Atlas V rocket in January 2014. The current Tracking and Data Relay Satellite system consists of eight in-orbit satellites distributed to provide near continuous information relay contact with orbiting spacecraft ranging from the International Space Station and Hubble Space Telescope to the array of scientific observatories. For more information, visit: http://www.nasa.gov/mission_pages/tdrs/home/index.html

  1. BLOND, a building-level office environment dataset of typical electrical appliances

    NASA Astrophysics Data System (ADS)

    Kriechbaumer, Thomas; Jacobsen, Hans-Arno

    2018-03-01

    Energy metering has gained popularity as conventional meters are replaced by electronic smart meters that promise energy savings and higher comfort levels for occupants. Achieving these goals requires a deeper understanding of consumption patterns to reduce the energy footprint: load profile forecasting, power disaggregation, appliance identification, startup event detection, etc. Publicly available datasets are used to test, verify, and benchmark possible solutions to these problems. For this purpose, we present the BLOND dataset: continuous energy measurements of a typical office environment at high sampling rates with common appliances and load profiles. We provide voltage and current readings for aggregated circuits and matching fully-labeled ground truth data (individual appliance measurements). The dataset contains 53 appliances (16 classes) in a 3-phase power grid. BLOND-50 contains 213 days of measurements sampled at 50kSps (aggregate) and 6.4kSps (individual appliances). BLOND-250 consists of the same setup: 50 days, 250kSps (aggregate), 50kSps (individual appliances). These are the longest continuous measurements at such high sampling rates and fully-labeled ground truth we are aware of.

  2. Performance of High Resolution Satellite InSAR in Detection of Dangerous Subsidence in Case of Brno Urban Area

    NASA Astrophysics Data System (ADS)

    Lazecky, Milan; Rapant, Petr; Blaha, Pavel; Perissin, Daniele

    2016-08-01

    For the work, we have achieved 20 Radarsat-2 acquisitions in fine beam mode within ESA project C1P.21629 - Evaluation of Potential Threats to Stability of Linear Structures using InSAR Technology. These acquisitions show deformations in Brno city between August 2014 and October 2015 with a regular step of 24 days temporal difference. Also, we have additionally achieved a series of 75 Cosmo SkyMed images with temporal step every 16 days in average, for dates between June 2011 and July 2014. The Cosmo SkyMed dataset partially overlaps with the reference measurements of tilt and height changes. After the end of the intensive measurements, the PS InSAR time series can deliver knowledge about continuation of movement and depict the date of final stabilization of the area. The accuracy can be validated using the limited number of the continuing warranty levelling mission. We have realized that the available dataset can be used also for monitoring of other events. We provide an example of potential detection of a cavity under a house in Brno-Bystrc.

  3. BLOND, a building-level office environment dataset of typical electrical appliances

    PubMed Central

    Kriechbaumer, Thomas; Jacobsen, Hans-Arno

    2018-01-01

    Energy metering has gained popularity as conventional meters are replaced by electronic smart meters that promise energy savings and higher comfort levels for occupants. Achieving these goals requires a deeper understanding of consumption patterns to reduce the energy footprint: load profile forecasting, power disaggregation, appliance identification, startup event detection, etc. Publicly available datasets are used to test, verify, and benchmark possible solutions to these problems. For this purpose, we present the BLOND dataset: continuous energy measurements of a typical office environment at high sampling rates with common appliances and load profiles. We provide voltage and current readings for aggregated circuits and matching fully-labeled ground truth data (individual appliance measurements). The dataset contains 53 appliances (16 classes) in a 3-phase power grid. BLOND-50 contains 213 days of measurements sampled at 50kSps (aggregate) and 6.4kSps (individual appliances). BLOND-250 consists of the same setup: 50 days, 250kSps (aggregate), 50kSps (individual appliances). These are the longest continuous measurements at such high sampling rates and fully-labeled ground truth we are aware of. PMID:29583141

  4. Continuous metabolic and cardiovascular measurements on a monkey subject during a simulated 6-day Spacelab mission

    NASA Technical Reports Server (NTRS)

    Pace, N.; Rahlmann, D. F.; Mains, R. C.; Kodama, A. M.; Mccutcheon, E. P.

    1978-01-01

    An adult male pig-tailed monkey (Macaca nemestrina) with surgically implanted biotelemetry unit was inserted into a fiberglass pod system which was installed in a Spacelab mock-up to simulate a 6-day mission during which extensive physiological measurements were obtained. The purpose of the pod was to make possible the study of respiratory gas exchange. Body temperature and selected cardiovascular parameters were recorded continuously for 2.6 days prior to 'launch', 6.3 days during 'flight', and 1.8 days after 'landing'. The results are surveyed, and it is concluded that it is feasible to perform sound physiological experiments on nonhuman primates in the Spacelab environment

  5. Ongoing right ventricular hemodynamics in heart failure: clinical value of measurements derived from an implantable monitoring system.

    PubMed

    Adamson, Philip B; Magalski, Anthony; Braunschweig, Frieder; Böhm, Michael; Reynolds, Dwight; Steinhaus, David; Luby, Allyson; Linde, Cecilia; Ryden, Lars; Cremers, Bodo; Takle, Teri; Bennett, Tom

    2003-02-19

    This study examined the characteristics of continuously measured right ventricular (RV) hemodynamic information derived from an implantable hemodynamic monitor (IHM) in heart failure patients. Hemodynamic monitoring might improve the day-to-day management of patients with chronic heart failure (CHF). Little is known about the characteristics of long-term hemodynamic information in patients with CHF or how such information relates to meaningful clinical events. Thirty-two patients with CHF received a permanent RV IHM system similar to a single-lead pacemaker. Right ventricular systolic and diastolic pressures, heart rate, and pressure derivatives were continuously measured for nine months without using the data for clinical decision-making or management of patients. Data were then made available to clinical providers, and the patients were followed up for 17 months. Pressure characteristics during optimal volume, clinically determined volume-overload exacerbations, and volume depletion events were examined. The effect of IHM on hospitalizations was examined using the patients' historical controls. Long-term RV pressure measurements had either marked variability or minimal time-related changes. During 36 volume-overload events, RV systolic pressures increased by 25 +/- 4% (p < 0.05) and heart rate increased by 11 +/- 2% (p < 0.05). Pressure increases occurred in 9 of 12 events 4 +/- 2 days before the exacerbations requiring hospitalization. Hospitalizations before using IHM data for clinical management averaged 1.08 per patient year and decreased to 0.47 per patient-year (57% reduction, p < 0.01) after hemodynamic data were used. Long-term ambulatory pressure measurements from an IHM may be helpful in guiding day-to-day clinical management, with a potentially favorable impact on CHF hospitalizations.

  6. Adjunct Ketamine Use in the Management of Severe Ethanol Withdrawal.

    PubMed

    Pizon, Anthony F; Lynch, Michael J; Benedict, Neal J; Yanta, Joseph H; Frisch, Adam; Menke, Nathan B; Swartzentruber, Greg S; King, Andrew M; Abesamis, Michael G; Kane-Gill, Sandra L

    2018-05-08

    Ketamine offers a plausible mechanism with favorable kinetics in treatment of severe ethanol withdrawal. The purpose of this study is to determine if a treatment guideline using an adjunctive ketamine infusion improves outcomes in patients suffering from severe ethanol withdrawal. Retrospective observational cohort study. Academic tertiary care hospital. Patients admitted to the ICU and diagnosed with delirium tremens by Diagnostic and Statistical Manual of Mental Disorders V criteria. Pre and post guideline, all patients were treated in a symptom-triggered fashion with benzodiazepines and/or phenobarbital. Postguideline, standard symptom-triggered dosing continued as preguideline, plus, the patient was initiated on an IV ketamine infusion at 0.15-0.3 mg/kg/hr continuously until delirium resolved. Based upon withdrawal severity and degree of agitation, a ketamine bolus (0.3 mg/kg) was provided prior to continuous infusion in some patients. A total of 63 patients were included (29 preguideline; 34 postguideline). Patients treated with ketamine were less likely to be intubated (odds ratio, 0.14; p < 0.01; 95% CI, 0.04-0.49) and had a decreased ICU stay by 2.83 days (95% CI, -5.58 to -0.089; p = 0.043). For ICU days outcome, correlation coefficients were significant for alcohol level and total benzodiazepine dosing. For hospital days outcome, correlation coefficients were significant for patient age, aspartate aminotransferase, and alanine aminotransferase level. Regression revealed the use of ketamine was associated with a nonsignificant decrease in hospital stay by 3.66 days (95% CI, -8.40 to 1.08; p = 0.13). Mechanistically, adjunctive therapy with ketamine may attenuate the demonstrated neuroexcitatory contribution of N-methyl-D-aspartate receptor stimulation in severe ethanol withdrawal, reduce the need for excessive gamma-aminobutyric acid agonist mediated-sedation, and limit associated morbidity. A ketamine infusion in patients with delirium tremens was associated with reduced gamma-aminobutyric acid agonist requirements, shorter ICU length of stay, lower likelihood of intubation, and a trend toward a shorter hospitalization.

  7. ADHD, depression, and motor vehicle crashes: A prospective cohort study of continuously-monitored, real-world driving.

    PubMed

    Aduen, Paula A; Kofler, Michael J; Sarver, Dustin E; Wells, Erica L; Soto, Elia F; Cox, Daniel J

    2018-06-01

    ADHD is associated with automobile crashes, traffic fatalities, and serious road trauma, but it is unclear whether this risk is (a) driven by ADHD symptoms specifically, and (b) unique to ADHD or transdiagnostic across psychiatric disabilities, such as depression, that also have concentration problems as core symptoms. The current study provides the first prospective, continuously-monitored evaluation of crash risk related to ADHD symptoms, including the first on-road comparison of ADHD with another high-prevalence psychiatric disability (depression). A probability-based sample of 3226 drivers from six U.S. sites, including subsamples with self-reported ADHD (n = 274) and depression (n = 251), consented to have their vehicles outfitted with sophisticated data acquisition technologies to continuously monitor real-world, day-to-day driving from 'engine-on to engine-off' for 1-2 years (Mean = 440 consecutive days/driver, Mean = 9528 miles/driver). Crashes and near-crashes were objectively identified via software-based algorithms and double-coded manual validation (blinded to clinical status). Miles driven, days monitored, age, gender, education, and marital status were controlled. ADHD symptoms portended 5% increased crash risk per increase in symptom severity score (IRR = 1.05). This risk corresponded to approximately 1 biennial crash and 1 annual near-crash per driver with ADHD; crash risk doubled for drivers reporting ADHD symptom severity near the sample's maximum. Analyses based on self-reported clinical status indicated similarly elevated rates for ADHD (IRR = 1.46) and depression (IRR = 1.34) that may be related, in part, to both groups' inattention/concentration symptoms. Risk was not attenuated by ADHD usual treatment, but varied according to antidepressant medication status. Previous studies have significantly underestimated the risk for traffic crashes conveyed by ADHD and depression. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Work Systems Package/Pontoon Implacement Vehicle Operational Testing at San Clemente Island, 1979. Demonstration of a Technology for Remotely Controlled Deep-Water Recovery of Objects up to 5 Tons from Depths to 20000 Feet.

    DTIC Science & Technology

    1980-06-06

    classes of objects, a basic inventory of hardware can be established to provide a remote recovery capabilily. Although these tests were performed in...decided to continue the operatio , ihe following day. Friday, 10 Aug 0600 Task team arrives at YD197. 0830 Dive team to lift module for inspection. The

  9. Species Profiles: Life Histories and Environmental Requirements of Coastal Fishes and Invertebrates (Pacific Southwest).

    DTIC Science & Technology

    1988-02-01

    Ophiodon successive life history events (range, A elongatus), as well as for waterfowl, optimum) are 2.6-28.7 ppt and 27-28 sea lions , and whales (Hart...days (Hay 1985; Rabin and Barnhart is assumed to require continuous 1986). In California adult herring movement and replacement of return to sea ...major fodder animals of the 1973). In British Columbia waters, sea , providing food for salmon, salinities associated with these sharks, and lingcod

  10. Developing Non-Somatotopic Phantom Finger Sensation to Comparable Levels of Somatotopic Sensation through User Training With Electrotactile Stimulation.

    PubMed

    Chai, Guohong; Zhang, Dingguo; Zhu, Xiangyang

    2017-05-01

    Cutaneous electrical stimulation can provide tactile feedback for upper-limb amputees through somatotopic feedback (SF) or non-somatotopic feedback (NF). The SF delivers electrotactile stimulus to projection finger maps (PFMs) on the stumps of amputees, which outperforms NF that transfers stimulus to other human intact skin areas in general. However, the SF areas on stumps are very limited and often occupied by electromyography (EMG) sensors in application of myoelectric prosthesis. This work aims at improving NF performance on human upper arms through user training with electrotactile stimulation. The experiments were conducted over seven consecutive days on nine able-bodied subjects and two forearm amputees. The performance measures of NF/SF included the correct identification rates (CIR s ), the response time and the NASA-TLX questionnaire. The between-day CIR s on NF sites increased logarithmically with a mean course of 3-day rapid-improving phase and plateaued in the relative-steady phase. The response time and NASA-TLX scores could also rapidly reduce to the comparable levels of the SF areas during the same mean period of 3-day rapid-improving phase, respectively. These results indicated that the performance of NF could be highly improved to the equivalent level as that of SF through 3-day electrotactile training, which we named as "3-day effect". It provides important insights that intact skin areas without phantom sensations can effectively replace SF sites to transfer tactile feedback after continuous user training, which validates effectiveness of non-invasive interfaces of tactile feedback for upper-limb amputees in practice.

  11. The time-varying association between perceived stress and hunger within and between days

    PubMed Central

    Huh, Jimi; Shiyko, Mariya; Keller, Stefen; Dunton, Genevieve; Schembre, Susan M.

    2015-01-01

    Objective Examine the association between perceived stress and hunger continuously over a week in free-living individuals. Methods Forty five young adults (70% women, 30% overweight/obese) ages 18 to 24 years (Mean = 20.7, SD = 1.5), with BMI between 17.4 and 36.3 kg/m2 (Mean = 23.6, SD = 4.0) provided between 513 and 577 concurrent ratings of perceived stress and hunger for 7 days via hourly, text messaging assessments and real-time eating records. Time-varying effect modeling was used to explore whether the within-day fluctuations in stress are related to perceived hunger assessed on a momentary basis. Results A generally positive stress–hunger relationship was confirmed, but we found that the strength of the relationship was not linear. Rather, the magnitude of the association between perceived stress and hunger changed throughout the day such that only during specific time intervals were stress and hunger significantly related. Specifically, the strength of the positive association peaked during late afternoon hours on weekdays (β = 0.31, p < .05) and it peaked during evening hours on weekend days (β = 0.56, p < .05). Conclusion This is the first empirical study to demonstrate potentially maladaptive, nonlinear stress–hunger associations that peak in the afternoon or evening hours. While we are unable to infer causality from these analyses, our findings provide empirical evidence for a potentially high-risk time of day for stress-induced eating. Replication of these findings in larger, more diverse samples will aid with the design and implementation of real-time intervention studies aimed at reducing stress-eating. PMID:25666299

  12. Lower glycemic load meals reduce diurnal glycemic oscillations in women with risk factors for gestational diabetes

    PubMed Central

    Kizirian, Nathalie V; Goletzke, Janina; Brodie, Shannon; Atkinson, Fiona S; Markovic, Tania P; Ross, Glynis P; Buyken, Anette; Brand-Miller, Jennie C

    2017-01-01

    Objective Maternal glycemia plays a key role in fetal growth. We hypothesized that lower glycemic load (GL) meals (lower glycemic index, modestly lower carbohydrate) would substantially reduce day-long glucose variability in women at risk of gestational diabetes mellitus (GDM). Research design and methods A crossover study of 17 women (mean±SD age 34.8±4 years; gestational weeks 29.3±1.3; body mass index 23.8±4.7 kg/m2) who consumed a low GL or a high GL diet in random order, 1-day each, over 2 consecutive days. Diets were energy-matched and fiber-matched with 5 meals per 24 hours. All food was provided. Continuous glucose monitoring was used to assess diurnal glycemia. Results Maternal glucose levels were 51% lower on the low GL day with lower incremental area under the curve (iAUC±SEM 549±109 vs 1120±198 mmol/L min, p=0.015). Glycemic variability was significantly lower on the low GL day, as demonstrated by a lower average SD (0.7±0.1 vs 0.9±0.1, p<0.001) and lower mean amplitude of glycemic excursions (2.1±0.2 vs 2.7±0.2 mmol/L, p<0.001). Conclusions A lower GL meal plan in pregnancy acutely halves day-long maternal glucose levels and reduces glucose variability, providing further evidence to support the utility of a low GL diet in pregnancy. PMID:28405345

  13. 75 FR 39787 - Airworthiness Directives; Bombardier, Inc. Model DHC-8-400 Series Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-13

    ... Limitations section (ALS) of the Instructions for Continued Airworthiness, replacing the upper bearing on... AD. (1) Within 60 days after the effective date of this AD: Revise the ALS of the Instructions for... days after the effective date of this AD: Revise the ALS of the Instructions for Continued...

  14. Transition from Long Day Care to Kindergarten: Continuity or Not?

    ERIC Educational Resources Information Center

    Barblett, Lennie; Barratt-Pugh, Caroline; Kilgallon, Pam; Maloney, Carmel

    2011-01-01

    Transition practices that ensure continuity between early childhood settings have been shown to be important in assisting children's short-term and long-term growth and development (Vogler, Cravello & Woodhead, 2008). In Western Australia many young children move from and between long day care (LDC) settings to kindergarten. In that state,…

  15. Continuous intercostal nerve blockade for rib fractures: ready for primetime?

    PubMed

    Truitt, Michael S; Murry, Jason; Amos, Joseph; Lorenzo, Manuel; Mangram, Alicia; Dunn, Ernest; Moore, Ernest E

    2011-12-01

    Providing analgesia for patients with rib fractures continues to be a management challenge. The objective of this study was to examine our experience with the use of a continuous intercostal nerve block (CINB). Although this technique is being used, little data have been published documenting its use and efficacy. We hypothesized that a CINB would provide excellent analgesia, improve pulmonary function, and decrease length of stay (LOS). Consecutive adult blunt trauma patients with three or more unilateral rib fractures were prospectively studied over 24 months. The catheters were placed at the bedside in the extrathoracic, paravertebral location, and 0.2% ropivacaine was infused. Respiratory rate, preplacement (PRE) numeric pain scale (NPS) scores, and sustained maximal inspiration (SMI) lung volumes were determined at rest and after coughing. Parameters were repeated 60 minutes after catheter placement (POST). Hospital LOS comparison was made with historical controls using epidural analgesia. Over the study period, 102 patients met inclusion criteria. Mean age was 69 (21-96) years, mean injury severity score was 14 (9-16), and the mean number of rib fractures was 5.8 (3-10). Mean NPS improved significantly (PRE NPS at rest = 7.5 vs. POST NPS at rest = 2.6, p < 0.05, PRE NPS after cough = 9.4, POST after cough = 3.6, p < 0.05) which was associated with an increase in the SMI (PRE SMI = 0.4 L and POST SMI = 1.3 L, p < 0.05). Respiratory rate decreased significantly (p < 0.05) and only 2 of 102 required mechanical ventilation. Average LOS for the study population was 2.9 days compared with 5.9 days in the historical control. No procedural or drug-related complications occurred. Utilization of CINB significantly improved pulmonary function, pain control, and shortens LOS in patients with rib fractures.

  16. Evidence for a QPO structure in the TeV and X-ray light curve during the 1997 high state γ emission of Mkn 501

    NASA Astrophysics Data System (ADS)

    Kranich, D.

    1999-08-01

    The BL Lac Object Mkn 501 was in a state of high activity in the TeV range in 1997. During this time Mkn 501 was observed by all Cherenkov-Telescopes of the HEGRA-Collaboration. Part of the data were also taken during moonshine thus providing a nearly continuous coverage for this object in the TeV-range. We have carried out a QPO analysis and found evidence for a 23 day periodicity. We applied the same analysis on the 'data by dwell' x-ray lightcurve from the RXTE/ASM database and found also evidence for the 23 day periodicity. The combined probability was -.

  17. Does daily kangaroo care provide sustained pain and stress relief in preterm infants?

    PubMed

    Mitchell, A J; Yates, C C; Williams, D K; Chang, J Y; Hall, R Whit

    2013-01-01

    1. Determine whether stress in preterm infants, measured with salivary cortisol, decreases after five days of Kangaroo Care (KC) compared to five days of Standard Care (SC). 2. To determine whether kangaroo care provides sustainable pain relief beyond the period of skin-to-skin holding. Preterm infants (n = 38) born at 27-30 weeks gestational age were randomized to either the KC or the SC group and received the allocated intervention starting on day of life (DOL) five and continuing for five days. Salivary cortisol was collected on DOL five and again on DOL ten. Differences were analyzed using repeated measures ANOVA and t tests. Pain during nasal suctioning over five days was assessed using the Premature Infant Pain Profile (PIPP). 1. Adequate saliva samples for salivary cortisol were collected for 13 KC infants and 11 SC infants. There was no main effect of group (p = 0.49), but there was a significant main effect of age (DOL five versus DOL ten), with salivary cortisol levels decreasing in both groups (p = 0.02). 2. Pain scores for both groups (n = 38) indicted mild to moderate pain during suctioning, with no significant difference in pain scores between groups. 1. KC did not affect salivary cortisol levels in preterm neonates, but levels in both the KC and SC groups decreased over time from DOL five to ten. Salivary cortisol may vary with age of infant. 2. Infants experience pain during routine suctioning and may require pain management.

  18. Utilization of potatoes in bioregenerative life support systems

    NASA Astrophysics Data System (ADS)

    Tibbitts, T. W.; Wheeler, R. M.

    Data on the tuberization, harvest index, and morphology of 2 cvs of white potato (Solanum tuberosum L.) grown at 12, 16, 20, 24 and 28°C, 250, 400 and 550 μmol s-1 m-2 photosynthetic photon flux (PPF), 350, 1000 and 1600 μ1 1-1 CO2 will be presented. A productivity of 21.9 g m-2 day-1 of edible tubers from a solid stand of potatoes grown for 15 weeks with continuous irradiation at 400 μmol s-1 m-2, 16°C and 1000 μ1 1-1 CO2 has been obtained. This equates to an area of 34.3 m2 being required to provide 2800 kcal of pototoes per day for a human diet. Separated plants receiving side lighting have produced 32.8 g m-2 day-1 which equates to an area of 23.6 m2 to provide 2800 kcal. Studies with side lighting indicate that productivities in this range should be realized from potatoes. Glycoalkaloid levels in tubers of controlled-environment-grown plants are within the range of levels found in tubers of field grown plants. The use and limitation of recirculating solution cultures for potato growth is discussed.

  19. Utilization of potatoes in bioregenerative life support systems

    NASA Technical Reports Server (NTRS)

    Tibbitts, T. W.; Wheeler, R. M.

    1987-01-01

    Data on the tuberization, harvest index, and morphology of 2 cvs of white potato (Solanum tuberosum L.) grown at 12, 16, 20, 24 and 28 C, 250, 400 and 550 micromol/s/m photosynthetic photon flux (PPF), 350, 1000 and 1600 microliter 1 sup -1 CO2 is presented. A productivity of 21.9 g/m day sup -1 of edible tubers from a solid stand of potatoes grown for 15 weeks with continuous irradiation at 400 micromol/s/m, 16 C and 1000 microliter 1 sup -1 CO2 was obtained. This equates to an area of 34.3 sq m being required to provide 2800 kcal of potatoes per day for a human diet. Separated plants receiving side lighting have produced 32.8 g/m day sup -1 which equates to an area of 23.6 sq m to provide 2800 kcal. Studies with side lighting indicate that productivities in this range should be realized from potatoes. Glycoalkaloid levels in tubers of controlled environment grown plants are within the range of levels found in tubers of field grown plants. The use and limitation of recirculating solution cultures for potato growth is discussed.

  20. Continuous production of monoclonal antibody in a packed-bed bioreactor.

    PubMed

    Golmakany, Naghmeh; Rasaee, Mohammad Javad; Furouzandeh, Mehdi; Shojaosadati, Seyed Abbas; Kashanian, Soheila; Omidfar, Kobra

    2005-06-01

    In the present study the growth and MAb (monoclonal antibody) production of a mouse x mouse hybridoma cell producing anti-digoxin MAb was evaluated. The hybridoma cells entrapped within the support matrix Fibra-Cel were cultured in batch and continuous mode following special protocols. Cell-culture studies were performed in a 1-litre spinner basket containing 3 g.litre-1 support matrix. Batch culture was operated with the cell density of 42x10(6) cells. During the 7 days of culture, the medium was sampled daily in order to assess glucose and MAb concentrations and the lactate dehydrogenase released into the culture medium. After a culture period of 72 h, the cell density and MAb concentration were found to be 10.4x10(7) cells/3 g of NWPF (non-woven polyester fibre) discs and 250 microg/ml respectively. This yield gradually decreased to 0.55x10(6) cells/3 g of packaging material and 60 microg/ml respectively at the end of the batch culture. In the continuous-culture studies, the batch culture was initially operated for 64.5 h and then continuous flow was started at the dilution rates of 0.15, 0.2, 0.25 and 0.3 day-1 and finally stabilized at 0.25 day-1 within 288 h (12 days). The MAb concentration at steady state was found to be 116-120 microg/day per ml, and the yield of operation was 62.5 mg/day per ml, which was 3.5 times higher than that of batch culture. In conclusion, a packed-bed bioreactor with the support matrix Fibra-Cel, operated in continuous-feeding mode, is more efficient for large-scale MAb production than a batch culture. On the other hand, by using a continuous-culture system, a better supply of nutrients and removal of inhibitory metabolites and proteolytic enzymes was obtained.

  1. Intensity of continuous renal-replacement therapy in critically ill patients.

    PubMed

    Bellomo, Rinaldo; Cass, Alan; Cole, Louise; Finfer, Simon; Gallagher, Martin; Lo, Serigne; McArthur, Colin; McGuinness, Shay; Myburgh, John; Norton, Robyn; Scheinkestel, Carlos; Su, Steve

    2009-10-22

    The optimal intensity of continuous renal-replacement therapy remains unclear. We conducted a multicenter, randomized trial to compare the effect of this therapy, delivered at two different levels of intensity, on 90-day mortality among critically ill patients with acute kidney injury. We randomly assigned critically ill adults with acute kidney injury to continuous renal-replacement therapy in the form of postdilution continuous venovenous hemodiafiltration with an effluent flow of either 40 ml per kilogram of body weight per hour (higher intensity) or 25 ml per kilogram per hour (lower intensity). The primary outcome measure was death within 90 days after randomization. Of the 1508 enrolled patients, 747 were randomly assigned to higher-intensity therapy, and 761 to lower-intensity therapy with continuous venovenous hemodiafiltration. Data on primary outcomes were available for 1464 patients (97.1%): 721 in the higher-intensity group and 743 in the lower-intensity group. The two study groups had similar baseline characteristics and received the study treatment for an average of 6.3 and 5.9 days, respectively (P=0.35). At 90 days after randomization, 322 deaths had occurred in the higher-intensity group and 332 deaths in the lower-intensity group, for a mortality of 44.7% in each group (odds ratio, 1.00; 95% confidence interval [CI], 0.81 to 1.23; P=0.99). At 90 days, 6.8% of survivors in the higher-intensity group (27 of 399), as compared with 4.4% of survivors in the lower-intensity group (18 of 411), were still receiving renal-replacement therapy (odds ratio, 1.59; 95% CI, 0.86 to 2.92; P=0.14). Hypophosphatemia was more common in the higher-intensity group than in the lower-intensity group (65% vs. 54%, P<0.001). In critically ill patients with acute kidney injury, treatment with higher-intensity continuous renal-replacement therapy did not reduce mortality at 90 days. (ClinicalTrials.gov number, NCT00221013.) 2009 Massachusetts Medical Society

  2. Day-to-day care in palliative sedation: survey of nurses' experiences with decision-making and performance.

    PubMed

    Arevalo, Jimmy J; Rietjens, Judith A; Swart, Siebe J; Perez, Roberto S G M; van der Heide, Agnes

    2013-05-01

    Continuous palliative sedation has been the focus of extensive international debates in the field of end-of-life decision making. Although nurses may be important participants in the performance of continuous palliative sedation, research has focused primarily on the role and experience of physicians. Nurses' experiences differ from that of physicians; they more often describe that continuous palliative sedation is used with the intention of hastening death and to have experienced serious emotional burden. Therefore, it is important to understand the experience of nurses in continuous palliative sedation. To describe nurses' experiences with the decision-making and performance of continuous palliative sedation in terminally ill patients. Cross-sectional study. In 2008, a structured questionnaire was sent to 576 nurses in six professional home care organizations, ten units for palliative care in nursing homes and in-patient hospices and seven hospitals in the western region of the Netherlands. Respondents provided information about the last patient receiving continuous palliative sedation whom they had cared for. Two-hundred seventy-seven questionnaires were returned and 199 (71.84%) reported a case of continuous palliative sedation. Nurses felt involved in the decision to use sedation in 84% of cases, albeit to a lesser extent in home care (68.75%, p=0.002). They agreed with the performance of continuous palliative sedation in 95.97% of cases and they proposed the use of continuous palliative sedation in 16.16%. Nurses were present at the start of sedation in 81.40% of cases and reported physicians to be present in 45.22%. In 72.77%, arrangements had been made among caregivers about the coordination of health care regarding the sedation. Nurses seem to play an important role in the use of continuous sedation. This role is mainly supportive toward physicians and patients during the decision-making process, but shifts to an active performance of sedation, particularly in settings where they explicitly participate as members of a team. Nurses could develop the practice of palliative sedation by anticipating procedural obstacles in the performance of continuous palliative sedation. We recommend them to become more active participants in the decision-making to improve the care of patients receiving continuous palliative sedation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Monitoring intensity and patterns of off-highway vehicle (OHV) use in remote areas of the western USA

    USGS Publications Warehouse

    Ouren, Douglas S.; Coffin, Alisa W.

    2013-01-01

    The continued growth of off-highway vehicle (OHV) activities – demonstrated by the dramatic increase in OHV sales, number of users, and areas experiencing OHV use – has elevated concerns about their ecological effects, the impacts on wildlife, and the sustainability of OHV use on secondary and tertiary road networks. Conflicts between visitors and wildlife are raising concerns about system resiliency and sustainable management. In order to quantify the spatial and temporal impacts of OHV use it is imperative to know about the timing and patterns of vehicle use. This study tested and used multiple vehicle-counter types to study vehicular OHV use patterns and volume throughout a mountainous road network in western Colorado. OHV counts were analyzed by time of day, day of week, season, and year. While daily use peaked within a two to three hour range for all sites, the overall volume of use varied among sites on an annual basis. The data also showed that there are at least two distinct patterns of OHV use: one dominated by a majority of use on weekends, and the other with continuous use throughout the week. This project provided important, but rarely captured, metrics about patterns of OHV use in a remote, mountainous region of Colorado. The techniques described here can provide land managers with a quantitative evaluation of OHV use across the landscape, an essential foundation for travel management planning. They also provide researchers with robust tools to further investigate the impacts of OHV use.

  4. Effect of a continuous regimen of contraceptive combination of ethinylestradiol and drospirenone on lipid, carbohydrate and coagulation profiles.

    PubMed

    Machado, Rogério Bonassi; de Melo, Nilson Roberto; Maia, Hugo; Cruz, Achilles Machado

    2010-02-01

    The objective of this study was to evaluate the effects of a contraceptive pill containing ethinylestradiol (30 mcg) and drospirenone (3 mg) in a continuous regimen on lipid, carbohydrate and coagulation parameters. This open, prospective, randomized study included 78 participants (mean age 27.8 years) who were randomized into two groups to use the pill continuously for 168 days or for six 28-day cycles with a 7-day hormone-free interval between cycles. Markers of lipid, carbohydrate and coagulation profiles were measured prior to initiation and after the 6 months of pill use. No statistically significant differences were found between the two contraceptive regimens with respect to carbohydrate or lipid profiles or in the parameters related to coagulation. The contraceptive combination of ethinylestradiol and drospirenone used in a continuous regimen was associated with metabolic alterations similar to those found during the traditional cyclic regimen of oral contraceptive use.

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

    Reiter, R.; Kanter, H. J.; Sladkovic, R.

    Studies of the stratospheric-tropospheric exchange were continued. Continuous data of the concentration of cosmogenic radionuclides /sup 7/Be, /sup 32/P, /sup 33/P, as well as of fallout and daily means of ozone concentrations, measured at 3000 m ASL are presented for the reporting period. Installation of two additional ozone measuring stations at 1800 and 740 m ASL provided the means for getting insight into the balance of the tropospheric ozone. First results of routine monitoring of the stratospheric aerosol with a high resolution lidar are shown. Accuracy of the method is discussed. Control of the stratospheric-tropospheric exchange by solar activity ismore » examined with the aid of the key day method using an 8-year measuring sequence. Relevant literature available on the subject is reviewed.« less

  6. Treatment of a retroperitoneal abscess by omentalization in an orangutan (Pongo pygmaeus pygmaeus).

    PubMed

    Chai, Norin; Hazan, Thierry; Wedlarski, Rudy; Rigoulet, Jacques

    2009-06-01

    A 38-yr-old orangutan (Pongo pygmaeus pygmaeus) presented with chronic lethargy and difficulty in locomotion that progressed to weakness, anorexia, and permanent dorsal and/or lateral recumbency. The orangutan was immobilized with ketamine. Abdominal ultrasonography revealed a mass in the caudal portion of the abdomen. Exploratory surgery was performed, but the mass could not be resected. Instead, the mass was drained and omentalized in an attempt to establish continuous drainage after surgery. The only complication was a wound infection that was treated locally with a disinfectant and installation of a drain that was changed every 2 days under anesthesia. Omentalization was successful in providing continuous fluid drainage for this retroperitoneal abscess and required minimal postoperative handling of the animal.

  7. High-dose continuous infusion beta-lactam antibiotics for the treatment of resistant Pseudomonas aeruginosa infections in immunocompromised patients.

    PubMed

    Moriyama, Brad; Henning, Stacey A; Childs, Richard; Holland, Steven M; Anderson, Victoria L; Morris, John C; Wilson, Wyndham H; Drusano, George L; Walsh, Thomas J

    2010-05-01

    To report a case series of high-dose continuous infusion beta-lactam antibiotics for the treatment of resistant Pseudomonas aeruginosa infections. Continuous infusion ceftazidime or aztreonam was administered to achieve target drug concentrations at or above the minimum inhibitory concentration, when possible, in 3 patients with P. aeruginosa infections. The maximal calculated target drug concentration was 100 mg/L. In the first patient, with primary immunodeficiency, neutropenia, and aggressive cutaneous T-cell lymphoma/leukemia, continuous infusion ceftazidime (6.5-9.6 g/day) was used to successfully treat multidrug-resistant P. aeruginosa bacteremia. In the second patient, with leukocyte adhesion deficiency type 1, continuous infusion aztreonam (8.4 g/day) was used to successfully treat multidrug-resistant P. aeruginosa wound infections. In the third patient, with severe aplastic anemia, continuous infusion ceftazidime (7-16.8 g/day) was used to treat P. aeruginosa pneumonia and bacteremia. In each patient, bacteremia cleared, infected wounds healed, and pneumonia improved in response to continuous infusion ceftazidime or aztreonam. Treatment strategies for multidrug-resistant P. aeruginosa infections are limited. A novel treatment strategy, when no other options are available, is the continuous infusion of existing beta-lactam antibiotics to maximize their pharmacodynamic activity. High-dose continuous infusion ceftazidime or aztreonam was used for the successful treatment of resistant systemic P. aeruginosa infections in 3 chronically immunocompromised patients. Continuous infusion beta-lactam antibiotics are a potentially useful treatment strategy for resistant P. aeruginosa infections in immunocompromised patients.

  8. Intermittent Episodes of Bright Light Suppress Myopia in the Chicken More than Continuous Bright Light

    PubMed Central

    Lan, Weizhong; Feldkaemper, Marita; Schaeffel, Frank

    2014-01-01

    Purpose Bright light has been shown a powerful inhibitor of myopia development in animal models. We studied which temporal patterns of bright light are the most potent in suppressing deprivation myopia in chickens. Methods Eight-day-old chickens wore diffusers over one eye to induce deprivation myopia. A reference group (n = 8) was kept under office-like illuminance (500 lux) at a 10∶14 light∶dark cycle. Episodes of bright light (15 000 lux) were super-imposed on this background as follows. Paradigm I: exposure to constant bright light for either 1 hour (n = 5), 2 hours (n = 5), 5 hours (n = 4) or 10 hours (n = 4). Paradigm II: exposure to repeated cycles of bright light with 50% duty cycle and either 60 minutes (n = 7), 30 minutes (n = 8), 15 minutes (n = 6), 7 minutes (n = 7) or 1 minute (n = 7) periods, provided for 10 hours. Refraction and axial length were measured prior to and immediately after the 5-day experiment. Relative changes were analyzed by paired t-tests, and differences among groups were tested by one-way ANOVA. Results Compared with the reference group, exposure to continuous bright light for 1 or 2 hours every day had no significant protective effect against deprivation myopia. Inhibition of myopia became significant after 5 hours of bright light exposure but extending the duration to 10 hours did not offer an additional benefit. In comparison, repeated cycles of 1∶1 or 7∶7 minutes of bright light enhanced the protective effect against myopia and could fully suppress its development. Conclusions The protective effect of bright light depends on the exposure duration and, to the intermittent form, the frequency cycle. Compared to the saturation effect of continuous bright light, low frequency cycles of bright light (1∶1 min) provided the strongest inhibition effect. However, our quantitative results probably might not be directly translated into humans, but rather need further amendments in clinical studies. PMID:25360635

  9. Protocol for a randomised crossover trial to evaluate patient and nurse satisfaction with electronic and elastomeric portable infusion pumps for the continuous administration of antibiotic therapy in the home: the Comparing Home Infusion Devices (CHID) study

    PubMed Central

    Ryan, Melissa K; Ritchie, Brett; Sluggett, Janet K; Sluggett, Andrew J; Ralton, Lucy; Reynolds, Karen J

    2017-01-01

    Introduction Previous studies comparing satisfaction with electronic and elastomeric infusion pumps are limited, and improvements in size and usability of electronic pumps have since occurred. The Comparing Home Infusion Devices (CHID) study plans to assess patient and nurse satisfaction with an elastomeric and electronic pump for delivering intravenous antibiotic treatment in the home. Secondary objectives are to determine pump-related complications and actual antibiotic dose administered, evaluate temperature variation and compare pump operating costs. Methods and analysis The CHID study will be a randomised, crossover trial. A trained research nurse will recruit patients with infectious disease aged ≥18 years and prescribed ≥8 days of continuous intravenous antibiotic therapy from the Royal Adelaide Hospital (RAH) (Adelaide, Australia). Patients will be randomised to receive treatment at home via an elastomeric (Baxter Infusor) or an electronic (ambIT Continuous) infusion pump for 4–7 days, followed by the other for a further 4–7 days. Patient satisfaction will be assessed by a 10-item survey to be completed at the end of each arm. Nurse satisfaction will be assessed by a single 24-item survey. Patient logbooks and case notes from clinic visits will be screened to identify complications. Pumps/infusion bags will be weighed to estimate the volume of solution delivered. Temperature sensors will record skin and ambient temperatures during storage and use of the pumps throughout the infusion period. Costs relating to pumps, consumables, antibiotics and servicing will be determined. Descriptive statistics will summarise study data. Ethics and dissemination This study has been approved by the RAH Human Research Ethics Committee (HREC/16/RAH/133 R20160420, version 6.0, 5 September 2016). Study results will be disseminated through peer-reviewed publications and conference presentations. The CHID study will provide key insights into patient and provider satisfaction with elastomeric and electronic infusion pumps and inform future device selection. Trial registration number ACTRN12617000251325; Pre-results. PMID:28760798

  10. Protocol for a randomised crossover trial to evaluate patient and nurse satisfaction with electronic and elastomeric portable infusion pumps for the continuous administration of antibiotic therapy in the home: the Comparing Home Infusion Devices (CHID) study.

    PubMed

    Hobbs, Jodie G; Ryan, Melissa K; Ritchie, Brett; Sluggett, Janet K; Sluggett, Andrew J; Ralton, Lucy; Reynolds, Karen J

    2017-07-31

    Previous studies comparing satisfaction with electronic and elastomeric infusion pumps are limited, and improvements in size and usability of electronic pumps have since occurred. The Comparing Home Infusion Devices (CHID) study plans to assess patient and nurse satisfaction with an elastomeric and electronic pump for delivering intravenous antibiotic treatment in the home. Secondary objectives are to determine pump-related complications and actual antibiotic dose administered, evaluate temperature variation and compare pump operating costs. The CHID study will be a randomised, crossover trial. A trained research nurse will recruit patients with infectious disease aged ≥18 years and prescribed ≥8 days of continuous intravenous antibiotic therapy from the Royal Adelaide Hospital (RAH) (Adelaide, Australia). Patients will be randomised to receive treatment at home via an elastomeric (Baxter Infusor) or an electronic (ambIT Continuous) infusion pump for 4-7 days, followed by the other for a further 4-7 days. Patient satisfaction will be assessed by a 10-item survey to be completed at the end of each arm. Nurse satisfaction will be assessed by a single 24-item survey. Patient logbooks and case notes from clinic visits will be screened to identify complications. Pumps/infusion bags will be weighed to estimate the volume of solution delivered. Temperature sensors will record skin and ambient temperatures during storage and use of the pumps throughout the infusion period. Costs relating to pumps, consumables, antibiotics and servicing will be determined. Descriptive statistics will summarise study data. This study has been approved by the RAH Human Research Ethics Committee (HREC/16/RAH/133 R20160420, version 6.0, 5 September 2016). Study results will be disseminated through peer-reviewed publications and conference presentations. The CHID study will provide key insights into patient and provider satisfaction with elastomeric and electronic infusion pumps and inform future device selection. ACTRN12617000251325; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. The 4P's Plus screen for substance use in pregnancy: clinical application and outcomes.

    PubMed

    Chasnoff, Ira J; McGourty, Richard F; Bailey, Gregory W; Hutchins, Ellen; Lightfoot, Saundra O; Pawson, Leslie Lynn; Fahey, Cynthia; May, Barbara; Brodie, Paula; McCulley, Larry; Campbell, Jan

    2005-06-01

    Determine the prevalence of substance use among pregnant women in five diverse communities utilizing the 4P's Plus screen for alcohol, tobacco, and other drug use. Pregnant women enrolled in prenatal care clinics in five communities were screened for substance use with the 4P's Plus. Those women with a positive screen underwent an assessment for substance use through a follow-up structured clinical interview conducted at the same prenatal visit. Among 7818 women in five communities, 2555 (32.7%) had a positive screen for substance use in pregnancy. Four of the communities conducted a follow-up assessment on all women with a positive screen (n = 1548). Among these women, 717 (15% of the total population) had continued use after learning of the pregnancy. Overall, 21% of the pregnant women used alcohol prior to recognition of the pregnancy, and 11% continued use after knowledge of the pregnancy. Among the 512 women who continued to use alcohol, 2% were drinking daily, 7% were drinking 3 to 6 days per week, 27% were drinking 1 to 2 days per week, and 63% were drinking less than 1 day per week. The rates of marijuana use and other illicit drug use among the women were 7 and 2%, respectively, prior to knowledge of pregnancy and dropped to 3 and 1% after learning of the pregnancy. The 4P's Plus identifies not only those pregnant women whose drinking or drug use is at a high enough level to impair daily functioning, but provides an opportunity for early intervention for the much larger group of women whose pregnancies are at risk from relatively small amounts of substance use.

  12. Continuous Monitoring of Essential Tremor Using a Portable System Based on Smartwatch.

    PubMed

    Zheng, Xiaochen; Vieira Campos, Alba; Ordieres-Meré, Joaquín; Balseiro, Jose; Labrador Marcos, Sergio; Aladro, Yolanda

    2017-01-01

    Essential tremor (ET) shows amplitude fluctuations throughout the day, presenting challenges in both clinical and treatment monitoring. Tremor severity is currently evaluated by validated rating scales, which only provide a timely and subjective assessment during a clinical visit. Motor sensors have shown favorable performances in quantifying tremor objectively. A new highly portable system was used to monitor tremor continuously during daily lives. It consists of a smartwatch with a triaxial accelerometer, a smartphone, and a remote server. An experiment was conducted involving eight ET patients. The average effective data collection time per patient was 26 (±6.05) hours. Fahn-Tolosa-Marin Tremor Rating Scale (FTMTRS) was adopted as the gold standard to classify tremor and to validate the performance of the system. Quantitative analysis of tremor severity on different time scales is validated. Significant correlations were observed between neurologist's FTMTRS and patient's FTMTRS auto-assessment scores ( r  = 0.84; p  = 0.009), between the device quantitative measures and the scores from the standardized assessments of neurologists ( r  = 0.80; p  = 0.005) and patient's auto-evaluation ( r  = 0.97; p  = 0.032), and between patient's FTMTRS auto-assessment scores day-to-day ( r  = 0.87; p  < 0.001). A graphical representation of four patients with different degrees of tremor was presented, and a representative system is proposed to summarize the tremor scoring at different time scales. This study demonstrates the feasibility of prolonged and continuous monitoring of tremor severity during daily activities by a highly portable non-restrictive system, a useful tool to analyze efficacy and effectiveness of treatment.

  13. Frequent Oxygen Desaturation During Sleep on the Day of Bronchoscopy Evaluated by Continuous Pulse Oximeter Monitoring.

    PubMed

    Chojin, Yasuo; Ishimoto, Hiroshi; Noguchi, Shingo; Kawanami, Toshinori; Kato, Tatsuji; Mukae, Hiroshi; Yatera, Kazuhiro

    To perform a bronchoscopy safely, it is very important to make a risk assessment before and after the procedure. There have been no reports of hypoxemia during sleep on the day after a bronchoscopic examination; therefore, we evaluated the oxygen saturation status during sleep on the days before and after bronchoscopy. Thirty patients that underwent bronchoscopy were studied. Continuous pulse oximetry monitoring was performed on the day before bronchoscopy and the day when the bronchoscopy was performed. The average oxygen saturation levels and the oxygen desaturation index (ODI) were evaluated. There was a significant increase (P < 0.05) in the ODI-3% during sleep on the day of the bronchoscopy compared to the day before the bronchoscopy. Clinicians should pay careful attention to hypoxia not only during bronchoscopy, but also during sleep on the night following the procedure.

  14. KSC00pp0622

    NASA Image and Video Library

    2000-05-03

    Seconds after liftoff, the Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L hurtles into space from Pad A at Complex 36 on Cape Canaveral Air Force Station. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  15. KSC00pp0620

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L casts a luminescent glow as it starts to clear the tower at Pad A, Complex 36, Cape Canaveral Air Force Station. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  16. KSC-00pp0622

    NASA Image and Video Library

    2000-05-03

    Seconds after liftoff, the Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L hurtles into space from Pad A at Complex 36 on Cape Canaveral Air Force Station. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  17. KSC-00pp0620

    NASA Image and Video Library

    2000-05-03

    The Atlas II/Centaur rocket carrying the NASA/NOAA weather satellite GOES-L casts a luminescent glow as it starts to clear the tower at Pad A, Complex 36, Cape Canaveral Air Force Station. Liftoff occurred at 3:07 a.m. EDT. The primary objective of the GOES-L is to provide a full capability satellite in an on-orbit storage condition, in order to assure NOAA continuity in services from a two-satellite constellation. Launch services are being provided by the 45th Space Wing. Once in orbit, the spacecraft is to be designated GOES-11 and will complete its 90-day checkout in time for availability during the 2000 hurricane season

  18. Efficacy and tolerability of transdermal granisetron for the control of chemotherapy-induced nausea and vomiting associated with moderately and highly emetogenic multi-day chemotherapy: a randomized, double-blind, phase III study.

    PubMed

    Boccia, Ralph V; Gordan, Lucio N; Clark, Gemma; Howell, Julian D; Grunberg, Steven M

    2011-10-01

    A novel transdermal formulation of granisetron (the granisetron transdermal delivery system (GTDS)) has been developed to deliver granisetron continuously over 7 days. This double-blind, phase III, non-inferiority study compared the efficacy and tolerability of the GTDS to daily oral granisetron for the control of chemotherapy-induced nausea and vomiting (CINV). Six hundred forty-one patients were randomized to oral (2 mg/day, 3-5 days) or transdermal granisetron (one GTDS patch, 7 days), before receiving multi-day chemotherapy. The primary endpoint was complete control of CINV (no vomiting/retching, no more than mild nausea, no rescue medication) from chemotherapy initiation until 24 h after final administration. The prespecified non-inferiority margin was 15%. Five hundred eighty-two patients were included in the per protocol analysis. The GTDS displayed non-inferiority to oral granisetron: complete control was achieved by 60% of patients in the GTDS group, and 65% in the oral granisetron group (treatment difference, -5%; 95% confidence interval, -13-3). Both treatments were well tolerated, the most common adverse event being constipation. The GTDS provides effective, well-tolerated control of CINV associated with moderately or highly emetogenic multi-day chemotherapy. It offers a convenient alternative route for delivering granisetron for up to 7 days that is as effective as oral granisetron.

  19. Impact of a Breastfeeding-Friendly Workplace on an Employed Mother's Intention to Continue Breastfeeding After Returning to Work

    PubMed Central

    2013-01-01

    Abstract Background Ever-increasing populations of women in their childbearing years are choosing to become employed. Breastfeeding provides unique health advantages to both the infant and mother. A breastfeeding-friendly workplace might be an important factor for predicting breastfeeding rates among working women. To explore the impact of breastfeeding-friendly support on the intention of working mothers to continue breastfeeding, we conducted a survey at a female labor-intensive electronics manufacturer in Taiwan. Subjects and Methods A structured questionnaire survey was administered to 715 working mothers employed in an electronics manufacturing plant in Tainan Science Park in Southern Taiwan. Questionnaire content included female employee demographics, employment characteristics, continued breastfeeding behavior after returning to work, access to lactation rooms, and employee perception of the breastfeeding policy and support when raising their most recently born child. Results A higher education level (odds ratio [OR]=2.66), lower work load (8 work hours/day) (OR=2.66), lactation room with dedicated space (OR=2.38), use of breast pumping breaks (OR=61.6), and encouragement from colleagues (OR=2.78) and supervisors (OR=2.44) to use breast pumping breaks were significant predictors of continued breastfeeding for more than 6 months after returning to work. Conclusions The findings of the present study suggest that to encourage and increase the rate of continued breastfeeding, workplaces should establish dedicated breastfeeding rooms and maintain a comfortable and clean environment. Furthermore, employers should provide encouragement and support for working mothers to continue breastfeeding after returning to work. PMID:23390987

  20. APDS: the autonomous pathogen detection system.

    PubMed

    Hindson, Benjamin J; Makarewicz, Anthony J; Setlur, Ujwal S; Henderer, Bruce D; McBride, Mary T; Dzenitis, John M

    2005-04-15

    We have developed and tested a fully autonomous pathogen detection system (APDS) capable of continuously monitoring the environment for airborne biological threat agents. The system was developed to provide early warning to civilians in the event of a bioterrorism incident and can be used at high profile events for short-term, intensive monitoring or in major public buildings or transportation nodes for long-term monitoring. The APDS is completely automated, offering continuous aerosol sampling, in-line sample preparation fluidics, multiplexed detection and identification immunoassays, and nucleic acid-based polymerase chain reaction (PCR) amplification and detection. Highly multiplexed antibody-based and duplex nucleic acid-based assays are combined to reduce false positives to a very low level, lower reagent costs, and significantly expand the detection capabilities of this biosensor. This article provides an overview of the current design and operation of the APDS. Certain sub-components of the ADPS are described in detail, including the aerosol collector, the automated sample preparation module that performs multiplexed immunoassays with confirmatory PCR, and the data monitoring and communications system. Data obtained from an APDS that operated continuously for 7 days in a major U.S. transportation hub is reported.

  1. Astrobites: Four Years of Astro-blogging

    NASA Astrophysics Data System (ADS)

    Faesi, Christopher; Newton, Elisabeth R.; Drout, Maria; Rawls, Meredith L.; Montet, Benjamin; Sanders, Nathan; Astrobites Collaboration

    2015-01-01

    Astrobites (astrobites.com) is now entering its fifth year publishing readable and accessible blog posts summarizing recent research in astrophysics and serving as an online hub for science communication. We continue to focus on our primary goal of making active research accessible to undergraduates by helping to break down technical descriptions and define jargon. However, our readership includes not only undergraduates, but also graduate students and professionals within astronomy, astronomy enthusiasts, and educators. With an average of more than 1000 page views per day, Astrobites reaches a large and diverse audience. We provide not only paper summaries, but also career guidance, practical 'how-to' articles, reports on attending conferences (such as this one), and astronomy news. Astrobites continues to be authored, operated, and led exclusively by a graduate students in astronomy, with our author list spanning the United States and beyond. We reflect on the first four years of Astrobites, including our emphasis on providing both graduate students and undergraduates with opportunities to write about their research for broad audiences, and present results from our latest readership survey. We also look forward at our continued involvement in broader science communication efforts, including ComSciCon (comscicon.com), the series of science communication workshops for graduate students.

  2. Next Day Building Load Predictions based on Limited Input Features Using an On-Line Laterally Primed Adaptive Resonance Theory Artificial Neural Network.

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

    Jones, Christian Birk; Robinson, Matt; Yasaei, Yasser

    Optimal integration of thermal energy storage within commercial building applications requires accurate load predictions. Several methods exist that provide an estimate of a buildings future needs. Methods include component-based models and data-driven algorithms. This work implemented a previously untested algorithm for this application that is called a Laterally Primed Adaptive Resonance Theory (LAPART) artificial neural network (ANN). The LAPART algorithm provided accurate results over a two month period where minimal historical data and a small amount of input types were available. These results are significant, because common practice has often overlooked the implementation of an ANN. ANN have often beenmore » perceived to be too complex and require large amounts of data to provide accurate results. The LAPART neural network was implemented in an on-line learning manner. On-line learning refers to the continuous updating of training data as time occurs. For this experiment, training began with a singe day and grew to two months of data. This approach provides a platform for immediate implementation that requires minimal time and effort. The results from the LAPART algorithm were compared with statistical regression and a component-based model. The comparison was based on the predictions linear relationship with the measured data, mean squared error, mean bias error, and cost savings achieved by the respective prediction techniques. The results show that the LAPART algorithm provided a reliable and cost effective means to predict the building load for the next day.« less

  3. Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial.

    PubMed

    McKay, James R; Gustafson, David H; Ivey, Megan; McTavish, Fiona; Pe-Romashko, Klaren; Curtis, Brenda; Oslin, David A; Polsky, Daniel; Quanbeck, Andrew; Lynch, Kevin G

    2018-01-30

    New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. To address this question, the study will feature a 2 × 2 design (A-CHESS for 12 months [yes/no] × TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile automated recovery support and counselor contact. ClinicalTrials.gov, NCT02681406 . Registered on 2 September 2016.

  4. Accuracy of a Factory-Calibrated, Real-Time Continuous Glucose Monitoring System During 10 Days of Use in Youth and Adults with Diabetes.

    PubMed

    Wadwa, R Paul; Laffel, Lori M; Shah, Viral N; Garg, Satish K

    2018-06-01

    Frequent use of continuous glucose monitoring (CGM) systems is associated with improved glycemic outcomes in persons with diabetes, but the need for calibrations and sensor insertions are often barriers to adoption. In this study, we evaluated the performance of G6, a sixth-generation, factory-calibrated CGM system specified for 10-day wear. The study enrolled participants of ages 6 years and up with type 1 diabetes or insulin-treated type 2 diabetes at 11 sites in the United States. Participation involved one sensor wear period of up to 10 days. Adults wore the system on the abdomen; youth of ages 6-17 years could choose to wear it on the abdomen or upper buttocks. Clinic sessions for frequent comparison with reference blood glucose measurements took place on days 1, 4-5, 7, and/or 10. Participants of ages 13 years and up underwent purposeful supervised glucose manipulation during in-clinic sessions. During the study, participants calibrated the systems once daily. However, analysis was performed on glucose values that were derived from reprocessed raw sensor data, independently of self-monitored blood glucose values used for calibration. Reprocessing used assigned sensor codes and a factory-calibration algorithm. Performance evaluation included the proportion of CGM values that were within ±20% of reference glucose values >100 mg/dL or within ±20 mg/dL of reference glucose values ≤100 mg/dL (%20/20), the analogous %15/15, and the mean absolute relative difference (MARD, expressed as a percentage) between temporally matched CGM and reference values. Data from 262 study participants (21,569 matched CGM reference pairs) were analyzed. The overall %15/15, %20/20, and MARD were 82.4%, 92.3%, and 10.0%, respectively. Matched pairs from 134 adults and 128 youth of ages 6-17 years were similar with respect to %20/20 (92.4% and 91.9%) and MARD (9.9% and 10.1%). Overall %20/20 values on days 1 and 10 of sensor wear were 88.6% and 90.6%, respectively. The system's "Urgent Low Soon" (predictive of hypoglycemia within 20 min) hypoglycemia alert was correctly provided 84% of the time within 30 min before impending biochemical hypoglycemia (<70 mg/dL). The 10-day sensor survival rate was 87%. The new factory-calibrated G6 real-time CGM system provides accurate readings for 10 days and removes several clinical barriers to broader CGM adoption.

  5. Data, exergy, and energy analysis of a vertical-bore, ground-source heat pump to for domestic water heating under simulated occupancy conditions

    DOE PAGES

    Ally, Moonis Raza; Munk, Jeffrey D.; Baxter, Van D.; ...

    2015-05-27

    Evidence is provided to support the view that greater than two-thirds of energy required to produce domestic hot water may be extracted from the ground which serves as renewable energy resource. The case refers to a 345 m2 research house located in Oak Ridge, Tennessee, 36.01 N 84.26 W in a mixed-humid climate with HDD of 2218 C-days (3993 F-days) and CDD of 723 C-days (1301 F-days). The house is operated under simulated occupancy conditions in which the hot water use protocol is based on the Building America Research Benchmark Definition (Hendron 2008; Hendron and Engebrecht 2010) which captures themore » water consumption lifestyles of the average family in the United States. The 5.275 (1.5-ton) water-to-water ground source heat pump (WW-GSHP) shared the same vertical bore with a 7.56 KW water-to-air ground source heat pump for space conditioning the same house. Energy and exergy analysis of data collected continuously over a twelve month period provide performance metrics and sources of inherent systemic inefficiencies. Data and analyses are vital to better understand how WW-GSHPs may be further improved to enable the ground to be used as a renewable energy resource.« less

  6. A phase 1 randomized placebo-controlled safety and pharmacokinetic trial of a tenofovir disoproxil fumarate vaginal ring.

    PubMed

    Keller, Marla J; Mesquita, Pedro M; Marzinke, Mark A; Teller, Ryan; Espinoza, Lilia; Atrio, Jessica M; Lo, Yungtai; Frank, Bruce; Srinivasan, Sujatha; Fredricks, David N; Rabe, Lorna; Anderson, Peter L; Hendrix, Craig W; Kiser, Patrick F; Herold, Betsy C

    2016-03-13

    Tenofovir disoproxil fumarate (TDF), a prodrug of tenofovir (TFV), may be ideal for topical HIV preexposure prophylaxis because it has higher tissue and cell permeability than TFV; is not adversely impacted by seminal proteins; and its active metabolite, TFV-diphosphate (TFV-DP), has a long intracellular half-life. We engineered a TDF eluting polyurethane reservoir intravaginal ring (IVR) to provide near constant mucosal antiretroviral concentrations. A first-in-human randomized placebo-controlled trial was conducted to assess the safety and pharmacokinetics of the TDF IVR in healthy, sexually abstinent women (15 TDF and 15 placebo). Drug concentrations were measured in cervicovaginal fluid (CVF) obtained by swab, cervical tissue, plasma, and dried blood spots (DBS) over 14 days of continuous ring use. There were 43 total, 23 reproductive tract, and eight product-related grade 1 adverse events. Steady-state CVF TFV concentrations were achieved proximal (vagina, ectocervix) and distal (introitus) to the TDF IVR 1 day after ring insertion. Median tissue TFV-DP concentrations 14 days after TDF IVR placement were 120 fmol/mg (interquartile range 90, 550). CVF collected from the cervix 1 week and 2 weeks after TDF IVR insertion provided significant protection against ex-vivo HIV challenge. Eleven of 14 (78%) participants had detectable TFV-DP DBS concentrations 14 days after TDF IVR placement, suggesting that DBS may provide a surrogate marker of adherence in future clinical trials. A TDF IVR is safe, well tolerated, and results in mucosal TFV concentrations that exceed those associated with HIV protection. The findings support further clinical evaluation of this TDF IVR.

  7. BAD knockout provides metabolic seizure resistance in a genetic model of epilepsy with sudden unexplained death in epilepsy.

    PubMed

    Foley, Jeannine; Burnham, Veronica; Tedoldi, Meghan; Danial, Nika N; Yellen, Gary

    2018-01-01

    Metabolic alteration, either through the ketogenic diet (KD) or by genetic alteration of the BAD protein, can produce seizure protection in acute chemoconvulsant models of epilepsy. To assess the seizure-protective role of knocking out (KO) the Bad gene in a chronic epilepsy model, we used the Kcna1 -/- model of epilepsy, which displays progressively increased seizure severity and recapitulates the early death seen in sudden unexplained death in epilepsy (SUDEP). Beginning on postnatal day 24 (P24), we continuously video monitored Kcna1 -/- and Kcna1 -/- Bad -/- double knockout mice to assess survival and seizure severity. We found that Kcna1 -/- Bad -/- mice outlived Kcna1 -/- mice by approximately 2 weeks. Kcna1 -/- Bad -/- mice also spent significantly less time in seizure than Kcna1 -/- mice on P24 and the day of death, showing that BadKO provides seizure resistance in a genetic model of chronic epilepsy. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  8. Future development of the PLATO Observatory for Antarctic science

    NASA Astrophysics Data System (ADS)

    Ashley, Michael C. B.; Bonner, Colin S.; Everett, Jon R.; Lawrence, Jon S.; Luong-Van, Daniel; McDaid, Scott; McLaren, Campbell; Storey, John W. V.

    2010-07-01

    PLATO is a self-contained robotic observatory built into two 10-foot shipping containers. It has been successfully deployed at Dome A on the Antarctic plateau since January 2008, and has accumulated over 730 days of uptime at the time of writing. PLATO provides 0.5{1kW of continuous electrical power for a year from diesel engines running on Jet-A1, supplemented during the summertime with solar panels. One of the 10-foot shipping containers houses the power system and fuel, the other provides a warm environment for instruments. Two Iridium satellite modems allow 45 MB/day of data to be transferred across the internet. Future enhancements to PLATO, currently in development, include a more modular design, using lithium iron-phosphate batteries, higher power output, and a light-weight low-power version for eld deployment from a Twin Otter aircraft. Technologies used in PLATO include a CAN (Controller Area Network) bus, high-reliability PC/104 com- puters, ultracapacitors for starting the engines, and fault-tolerant redundant design.

  9. 47 CFR 1.80 - Forfeiture proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Unauthorized substantial transfer of control 8,000 Violation of children's television commercialization or.... 223(b) Dial-a-Porn 75,000/day. Sec. 227(e) 10,000/violation.30,000/day for each day of continuing...

  10. Long-term safety and efficacy of sapropterin: the PKUDOS registry experience.

    PubMed

    Longo, Nicola; Arnold, Georgianne L; Pridjian, Gabriella; Enns, Gregory M; Ficicioglu, Can; Parker, Susan; Cohen-Pfeffer, Jessica L

    2015-04-01

    The Phenylketonuria (PKU) Demographics, Outcomes and Safety (PKUDOS) registry is designed to provide longitudinal safety and efficacy data on subjects with PKU who are (or have been) treated with sapropterin dihydrochloride. The PKUDOS population consists of 1189 subjects with PKU: N = 504 who were continuously exposed to sapropterin from date of registry enrollment, N = 211 who had intermittent exposure to the drug, and N = 474 with some other duration of exposure. Subjects continuously exposed to sapropterin showed an average 34% decrease in blood phenylalanine (Phe)--from 591 ± 382 μmol/L at baseline to 392 ± 239 μmol/L (p = 0.0009) after 5 years. This drop in blood Phe was associated with an increase in dietary Phe tolerance [from 1000 ± 959 mg/day (pre-sapropterin baseline) to 1539 ± 840 mg/day after 6 years]. Drug-related adverse events (AEs) were reported in 6% of subjects, were mostly considered non-serious, and were identified in the gastrointestinal, respiratory, and nervous systems. Serious drug-related AEs were reported in ≤ 1% of subjects. Similar safety and efficacy data were observed for children<4 years. Long-term data from the PKUDOS registry suggest that sapropterin has a tolerable safety profile and that continuous use is associated with a significant and persistent decrease in blood Phe and improvements in dietary Phe tolerance. Copyright © 2015. Published by Elsevier Inc.

  11. Pharmacy claims data versus patient self-report to measure contraceptive method continuation.

    PubMed

    Triebwasser, Jourdan E; Higgins, Stephanie; Secura, Gina M; Zhao, Qiuhong; Peipert, Jeffrey F

    2015-07-01

    To compare self-reported 12-month continuation of oral contraceptive pills (OCPs), patch, and ring versus continuation by pharmacy claims data. Women in the Contraceptive CHOICE Project who chose OCPs, the patch, or the ring as their initial method were included. Continuation was assessed by periodic telephone survey and by obtaining prescription claims data. Continuation was defined as no gap of more than 30 days. Kaplan-Meier survival functions were used to estimate continuation rates and cumulative unintended pregnancy rates. Kappa statistic assessed the level of agreement between self-report and claims data. We analyzed 1510 women who initiated use by 3 months and provided information on discontinuation. Of OCP users, 59% continued their method at 12 months by self-report versus 38% by pharmacy claims. Patch and ring users had self-reported/pharmacy continuation of 45%/28% and 57%/37%, respectively. Kappa coefficients and their 95% confidence intervals between the two measurements were 0.46 (0.40, 0.52), 0.54 (0.39, 0.68), and 0.54 (0.47, 0.61) for OCP, patch, and ring, respectively. Among women who self-reported continuation, unintended pregnancy rates were 0.4% in those who continued by pharmacy claims versus 4.9% in those who discontinued according to claims data. Contraceptive continuation rates differ by self-report versus pharmacy claims with women overestimating their continuation by self-report. This article directly compares contraception continuation rates by self-report and by pharmacy claims data. The study suggests that previously reported continuation rates from survey data overestimate specific method use. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Redundancy in Glucose Sensing: Enhanced Accuracy and Reliability of an Electrochemical Redundant Sensor for Continuous Glucose Monitoring.

    PubMed

    Sharifi, Amin; Varsavsky, Andrea; Ulloa, Johanna; Horsburgh, Jodie C; McAuley, Sybil A; Krishnamurthy, Balasubramanian; Jenkins, Alicia J; Colman, Peter G; Ward, Glenn M; MacIsaac, Richard J; Shah, Rajiv; O'Neal, David N

    2016-05-01

    Current electrochemical glucose sensors use a single electrode. Multiple electrodes (redundancy) may enhance sensor performance. We evaluated an electrochemical redundant sensor (ERS) incorporating two working electrodes (WE1 and WE2) onto a single subcutaneous insertion platform with a processing algorithm providing a single real-time continuous glucose measure. Twenty-three adults with type 1 diabetes each wore two ERSs concurrently for 168 hours. Post-insertion a frequent sampling test (FST) was performed with ERS benchmarked against a glucose meter (Bayer Contour Link). Day 4 and 7 FSTs were performed with a standard meal and venous blood collected for reference glucose measurements (YSI and meter). Between visits, ERS was worn with capillary blood glucose testing ≥8 times/day. Sensor glucose data were processed prospectively. Mean absolute relative deviation (MARD) for ERS day 1-7 (3,297 paired points with glucose meter) was (mean [SD]) 10.1 [11.5]% versus 11.4 [11.9]% for WE1 and 12.0 [11.9]% for WE2; P < .0001. ERS Clarke A and A+B were 90.2% and 99.8%, respectively. ERS day 4 plus day 7 MARD (1,237 pairs with YSI) was 9.4 [9.5]% versus 9.6 [9.7]% for WE1 and 9.9 [9.7]% for WE2; P = ns. ERS day 1-7 precision absolute relative deviation (PARD) was 9.9 [3.6]% versus 11.5 [6.2]% for WE1 and 10.1 [4.4]% for WE2; P = ns. ERS sensor display time was 97.8 [6.0]% versus 91.0 [22.3]% for WE1 and 94.1 [14.3]% for WE2; P < .05. Electrochemical redundancy enhances glucose sensor accuracy and display time compared with each individual sensing element alone. ERS performance compares favorably with 'best-in-class' of non-redundant sensors. © 2015 Diabetes Technology Society.

  13. A prospective, within-patient, crossover study of continuous intravenous and subcutaneous morphine for chronic cancer pain.

    PubMed

    Nelson, K A; Glare, P A; Walsh, D; Groh, E S

    1997-05-01

    The dose, efficacy, and side effects of continuous intravenous infusion (CIVI) of morphine were compared with continuous subcutaneous infusion (CSCI) of morphine in patients with chronic cancer pain. Eligible patients were referred to the Palliative Care Program and were receiving a stable dose of CIVI of morphine. The design was a within-patient, one-way crossover; in which each patient provided data before and after a switch from CIVI to CSCI of morphine. "Rescue" doses were 50% of the hourly dose given every 2 hours as needed. Morphine was infused intravenously (i.v.) and subcutaneously (s.c.) via a McGaw/AccuPro Volumetric Infusion Pump. After baseline data, including side effects and pain assessment, were obtained, patients were evaluated twice daily for toxicity and analgesic efficacy. Those who had a stable CIVI dose for 48 consecutive hr were crossed over to the CSCI at the same dose as the intravenous (i.v.) phase. A stable dose was defined as no dose change, four or less rescue doses in the previous 24 hr, and a pain rating of none or mild. CIVI was considered equal to CSCI if these criteria were maintained for 96 consecutive hr. Fifty-seven patients were entered, and 40 were evaluable (15 women and 25 men). The median age was 67 (range 30-83 years). All 40 participants, after maintaining a stable dose throughout the i.v. phase, crossed to the s.c. phase and remained on s.c. for at least 48 hr. Thirty-two patients maintained a stable dose throughout the i.v. and s.c. phases. The mean stable i.v. dose (day 2) was 5.05 mg/hr, and the mean stable s.c. dose (day 4) was 5.7 mg/hr (P = 0.01). The mean number of rescue doses on day 2 was 0.83 per 24 hr versus 0.80 per 24 hours on day 4 (P = 0.6). The mean categorical pain score on day 2 was 0.83, and on day 4, 0.85 (P = 0.7). The mean visual analogue scale (VAS) on day 2 was 22.9 mm versus 17.6 mm on day 4 (P = 0.1). The mean incidence of side effects on day 2 was 1.7, and on day 4, 2.0 (P = 0.2). No patient was withdrawn or had a dose reduction due to unacceptable toxicity. There were two reports of local toxicity (mild erythema) at the SC needle insertion point, which required a site change. All of our 40 patients had adequate pain control with CIVI and CSCI morphine. Of the eight participants who were not maintained on the same i.v. and s.c. dose, all had adequate pain control and a similar side-effect profile on a higher s.c. morphine dose. These data suggest that the i.v. and s.c. routes are equianalgesic for most patients when administered as a continuous infusion. Pain control and side-effect profiles are quite similar and acceptable. s.c. morphine is an excellent alternative to i.v. morphine in both inpatients and outpatients requiring parenteral morphine for pain.

  14. Use of Negative-Pressure Wound Therapy in Orthopaedic Trauma

    DTIC Science & Technology

    2012-09-01

    sponge, and continuous suction is applied at −50 mm Hg. NPWT is discontinued after 2 to 5 days. Split-thickness Skin Graft When placing a NPWT dressing...over a split-thickness skin graft (STSG), we apply a single sheet of nonadher- ent dressing to the wound to provide a barrier between the STSG and the...trauma, including surgical incisions at increased risk of breakdown or in- fection, skin grafts , and infected wounds.21,22 Wounds With Associated Soft

  15. The effect of random voice hand hygiene messages delivered by medical, nursing, and infection control staff on hand hygiene compliance in intensive care.

    PubMed

    McGuckin, Maryanne; Shubin, Arlene; McBride, Patricia; Lane, Stephen; Strauss, Kevin; Butler, Donna; Pitman, Andrew

    2006-12-01

    Hand hygiene (HH) compliance in the intensive care unit has been studied extensively, with short-term, nonsustained compliance often because of lack of ongoing reinforcement. HH messages delivered by health care workers responsible for overseeing staff in the intensive care unit provided continuous reinforcement of HH. Compliance measured through product usage and reported as HH/bed-days increased by 60% for soap and sanitizer combined and 25% for sanitizer usage (P < 001).

  16. A brief history of Legg-Calvé-Perthes disease.

    PubMed

    Wenger, Dennis R; Pandya, Nirav K

    2011-09-01

    Legg-Calvé-Perthes (LCP) disease has an extensive history that has provided an ongoing intellectual challenge for the orthopaedic community. Debate around etiology and treatment of LCP disease continues even after its initial description in the early 1900 s. In order for modern day clinicians to have a full understanding of the condition, one must be a scholar of its development. The purpose of our review will be to discuss the scientific communities' understanding of presentation, etiology, and treatment of LCP disease over time.

  17. Abandoned coal mine stores gas for Colorado peak-day demands

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

    Brown, L.W.

    1978-09-01

    Since 1961, the Leyden Mine, from which 6 million tons of coal had been removed to leave a 150 million cu ft void, has been used for gas storage at 250 psig max pressure, after the hoisting and ventilation shafts had been sealed with concrete, rock, sand, and mud. Following several withdrawal expansions, a design for maximum delivery of 230 million cu ft/day for five days with a pressure drop in the cavern down to 100 psig was developed to satisfy customer requirements for peak shaving. This required redesigning the gathering system by looping large existing lines, eliminating inefficient ones,more » and drilling additional wells; installing three lightweight 3500-hp Centaur turbine/compressor units from Solar Turbines International to provide the minimum 200 psig compressor discharge pressure needed for gas distribution on peak usage days; and installing Donaldson Co. engine air-inlet silencers on the turbine inlets to reduce noise levels below the public code requirement. In the 1977-78 heating season, the Leyden facility produced 196 million cu ft/day of gas; with continued load growth and well drilling to reduce pressure loss, the maximum design flow rate will be attained.« less

  18. Comparison of clinical efficacy between 3-day combined clavulanate/amoxicillin preparation treatment and 10-day amoxicillin treatment in children with pharyngolaryngitis or tonsillitis.

    PubMed

    Kuroki, Haruo; Ishiwada, Naruhiko; Inoue, Nobue; Ishikawa, Nobuyasu; Suzuki, Hiroshi; Himi, Kyoko; Kurosaki, Tomomichi

    2013-02-01

    The efficacy of 3-day treatment with a combined clavulanate/amoxicillin preparation (Clavamox combination dry syrup for pediatric cases) and 10-day treatment with amoxicillin against pediatric pharyngolaryngitis and tonsillitis caused by Group A β-hemolytic Streptococcus was compared. Among the patients included in the efficacy evaluation (54 from the clavulanate/amoxicillin group and 43 from the amoxicillin group), the clinical response rate on completion of treatment was 98.1 % in the clavulanate/amoxicillin group and 92.9 % in the amoxicillin group, thus supporting the equivalent efficacy of these two therapies. The Group A β-hemolytic Streptococcus eradication rate at approximately 1-2 weeks after completion/discontinuation of treatment was 65.4 % in the clavulanate/amoxicillin group and 85.4 % in the amoxicillin group. Even in cases from which the pathogen continued to be isolated, relapse/recurrence of clinical symptoms was seldom seen. Urinalysis, conducted to assess the presence or absence of acute glomerulonephritis, revealed no abnormality in any patient. These results suggest that 3-day treatment with this clavulanate/amoxicillin preparation is expected to provide a valid means of treating pediatric pharyngolaryngitis and tonsillitis caused by Group A β-hemolytic Streptococcus.

  19. Insights into shallow magmatic processes at Kīlauea Volcano, Hawaíi, from a multiyear continuous gravity time series

    NASA Astrophysics Data System (ADS)

    Poland, Michael P.; Carbone, Daniele

    2016-07-01

    Continuous gravity data collected near the summit eruptive vent at Kīlauea Volcano, Hawaíi, during 2011-2015 show a strong correlation with summit-area surface deformation and the level of the lava lake within the vent over periods of days to weeks, suggesting that changes in gravity reflect variations in volcanic activity. Joint analysis of gravity and lava level time series data indicates that over the entire time period studied, the average density of the lava within the upper tens to hundreds of meters of the summit eruptive vent remained low—approximately 1000-1500 kg/m3. The ratio of gravity change (adjusted for Earth tides and instrumental drift) to lava level change measured over 15 day windows rose gradually over the course of 2011-2015, probably reflecting either (1) a small increase in the density of lava within the eruptive vent or (2) an increase in the volume of lava within the vent due to gradual vent enlargement. Superimposed on the overall time series were transient spikes of mass change associated with inflation and deflation of Kīlauea's summit and coincident changes in lava level. The unexpectedly strong mass variations during these episodes suggest magma flux to and from the shallow magmatic system without commensurate deformation, perhaps indicating magma accumulation within, and withdrawal from, void space—a process that might not otherwise be apparent from lava level and deformation data alone. Continuous gravity data thus provide unique insights into magmatic processes, arguing for continued application of the method at other frequently active volcanoes.

  20. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  1. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  2. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  3. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  4. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be a...

  5. First description of the breeding biology and natural history of the ochre-breasted brush finch atlapetes semirufus in venezuela

    USGS Publications Warehouse

    Biancucci, L.; Martin, T.E.

    2008-01-01

    We provide the first description of the eggs, breeding biology, and natural history of the Ochre-breasted Brush Finch (Atlapetes semirufus). We found 37 nests over four breeding seasons (2004-2007) in Yacamb?? National Park, Venezuela. Nesting activity started in late April and continued until early June suggesting single-brooded behavior despite a typical tropical clutch size of two eggs (x?? = 1.89) that were laid on consecutive days. Egg mass averaged 3.38 g and 11.6% of adult female mass. The incubation and nestling periods averaged 14.9 and 10.5 days, respectively. Only females incubated and the percent time they spent incubating did not change between early and late incubation. Females brooded 42.7% of the time when nestlings were 2 days of age and 20.5% when 9 days of age. Both parents provisioned young at a low rate (3.9 trips/hr) and nestling growth rate (k = 0.45) was also slow. Nest predation rates were relatively high with daily mortality rates of 0.058 and 0.067 during incubation and nestling stages, respectively.

  6. Implementation of a 'lean' cytopathology service: towards routine same-day reporting.

    PubMed

    Hewer, Ekkehard; Hammer, Caroline; Fricke-Vetsch, Daniela; Baumann, Cinzia; Perren, Aurel; Schmitt, Anja M

    2018-05-01

    To systematically assess the effects of a Lean management intervention in an academic cytopathology service. We monitored outcomes including specimen turnaround times during stepwise implementation of a lean cytopathology workflow for gynaecological and non-gynaecological cytology. The intervention resulted in a major reduction of turnaround times for both gynaecological (3rd quartile 4.1 vs 2.3 working days) and non-gynaecological cytology (3rd quartile 1.9 vs. 1.2 working days). Introduction of fully electronic reporting had additional effect over continuous staining of slides alone. The rate of non-gynaecological specimens reported the same day increased from 4.5% to 56.5% of specimens received before noon. Lean management principles provide a useful framework for organization of a cytopathology workflow. Stepwise implementation beginning with a simplified gynaecological cytology workflow allowed involved staff to monitor the effects of individual changes and allowed for a smooth transition. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Stopping the effective non-fluoroquinolone antibiotics at day 7 vs continuing until day 14 in adults with acute pyelonephritis requiring hospitalization: A randomized non-inferiority trial.

    PubMed

    Rudrabhatla, Pavankumar; Deepanjali, Surendran; Mandal, Jharna; Swaminathan, Rathinam Palamalai; Kadhiravan, Tamilarasu

    2018-01-01

    To evaluate whether stopping the effective antibiotic treatment following clinical improvement at Day 7 (Truncated treatment) would be non-inferior to continued treatment until Day 14 (Continued treatment) in patients with acute pyelonephritis (APN) requiring hospitalization treated with non-fluoroquinolone (non-FQ) antibiotics. Hospitalized adult men and non-pregnant women with culture-confirmed APN were eligible for participation after they had clinically improved following empirical or culture-guided treatment with intravenous non-FQ antibiotic(s). We excluded patients with severe sepsis, abscesses, prostatitis, recurrent or catheter-associated urinary tract infection, or urinary tract obstruction. We randomized eligible patients on Day 7 of effective treatment and assessed them at Weeks 1 and 6 after treatment completion. The primary outcome was retreatment for recurrent urinary tract infection. The prespecified non-inferiority margin was 15%. Between March 17, 2015 and August 22, 2016, we randomly allocated 54 patients-27 patients in each arm. Twenty-four (44%) patients were male, and 26 (48%) had diabetes mellitus. Escherichia coli was the most common urinary isolate (47 [87%] patients); 36 (78%) were resistant to ciprofloxacin. In all, 41 (76%) patients received amikacin-based treatment. At the end of 6 weeks, no patient in the truncated treatment arm required retreatment, whereas 1 patient in the continued treatment arm was retreated. Difference (90% CI) in retreatment was -3.7% (-15.01% to 6.15%). Upper bound of the difference (6.15%) was below the prespecified limit, establishing non-inferiority of truncated treatment. Asymptomatic bacteriuria at Week 6 was similar between the two arms (3/24 vs. 3/26; P = 1.0). Patients in the truncated treatment arm had significantly shorter hospital stay (8 [7-10] vs. 14 [14-15] days; P < 0.001) and less antibiotic consumption per patient (8.4 ± 2.8 vs. 17.4 ± 8.3 DDDs; P < 0.001). Stopping the effective non-FQ antibiotics following clinical improvement at Day 7 is non-inferior to continued treatment until Day 14 in selected patients with APN requiring hospitalization. Clinical Trials Registry-India; CTRI/2016/04/006810.

  8. Maintenance of cytosolic calcium is crucial to extend l-arginine therapeutic benefits during continuous dosing.

    PubMed

    Mohan, Srinidi; Harding, Lisa

    2016-10-01

    The therapeutic benefits associated with short-term l-arginine supplementation are lost during continuous dosing. AMP-activated protein kinase (AMPK) functional modulation has been correlated with l-arginine therapeutic effectiveness, and with tolerance development during continuous supplementation. However, the metabolic link that is responsible for AMPK functional modulation during continuous l-arginine exposure is currently not known. To explore this, we incubated HUVECs for 7 days with 100 μmol/L l-arginine, in the presence or absence of other agents; and monitored their effects for eNOS function, and on tolerance sparing effects (viz, cellular glucose accumulation, and oxidative stress). HUVEC co-incubation with 100 μmol/L l-arginine and ≤1200 mg/mL calcium (Ca 2+ ) for 7 days avoided tolerance development, with an at least 1-fold increase in the eNOS and AMPK functional activity; and an 1-fold increase in overall cellular glucose uptake. The overall cellular cytosolic Ca 2+ was below 200 nmol/L, with no change in cellular glucose and superoxide/peroxynitrite (O 2 •- /ONOO - ) level from control. However, tolerance sparing effects of at least 70% decrease in eNOS and AMPK functional response, with an 1-fold reduction in glucose uptake, and at least 2-fold increase in O 2 •- /ONOO - were observed in cells exposed for 7 days to 100 μmol/L l-arginine at Ca 2+ co-incubation concentration of >1200 mg/mL. The >1200 mg/mL Ca2+ co-incubation condition, also improved the overall cellular Ca 2+ to >200 nmol/L. Similar tolerance response was observed in cells co-treated with 100 μmol/L l-arginine and ≤1200 mg/mL Ca 2+ in the presence of Ca 2+ influx inhibitor (20 μmol/L 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetra acetic acid), or eNOS activity inhibitor (30 μmol/L l-N G -nitroarginine methyl ester). No tolerance response was seen in cells incubated for 7 days with 100 μmol/L l-arginine and ≤1200 mg/mL Ca 2+ ; even in the presence of the inhibitor for cellular glucose induction (30 μmol/L 5-chloro-2-(n-(2,5-dichlorobenzenesulfonamide))-benzoxazole). The present study thus provides the first definitive evidence that shows the need to maintain cytosolic Ca 2+ within a threshold limit of less than 200 nmol/L to extend l-arginine therapeutic efficacy during continuous dosing, without any potential tolerance development. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Frequency of Hand Decontamination of Intraoperative Providers and Reduction of Postoperative Healthcare-Associated Infections: A Randomized Clinical Trial of a Novel Hand Hygiene System.

    PubMed

    Koff, Matthew D; Brown, Jeremiah R; Marshall, Emily J; O'Malley, A James; Jensen, Jens T; Heard, Stephen O; Longtine, Karen; O'Neill, Melissa; Longtine, Jaclyn; Houston, Donna; Robison, Cindy; Moulton, Eric; Patel, Hetal M; Loftus, Randy W

    2016-08-01

    BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.

  10. 5 CFR 890.303 - Continuation of enrollment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Section 890.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Enrollment § 890.303 Continuation of... moves from one employing office to another, without a break in service of more than 3 days, whether the...

  11. 5 CFR 890.303 - Continuation of enrollment.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Section 890.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Enrollment § 890.303 Continuation of... moves from one employing office to another, without a break in service of more than 3 days, whether the...

  12. Optogenetic feedback control of neural activity

    PubMed Central

    Newman, Jonathan P; Fong, Ming-fai; Millard, Daniel C; Whitmire, Clarissa J; Stanley, Garrett B; Potter, Steve M

    2015-01-01

    Optogenetic techniques enable precise excitation and inhibition of firing in specified neuronal populations and artifact-free recording of firing activity. Several studies have suggested that optical stimulation provides the precision and dynamic range requisite for closed-loop neuronal control, but no approach yet permits feedback control of neuronal firing. Here we present the ‘optoclamp’, a feedback control technology that provides continuous, real-time adjustments of bidirectional optical stimulation in order to lock spiking activity at specified targets over timescales ranging from seconds to days. We demonstrate how this system can be used to decouple neuronal firing levels from ongoing changes in network excitability due to multi-hour periods of glutamatergic or GABAergic neurotransmission blockade in vitro as well as impinging vibrissal sensory drive in vivo. This technology enables continuous, precise optical control of firing in neuronal populations in order to disentangle causally related variables of circuit activation in a physiologically and ethologically relevant manner. DOI: http://dx.doi.org/10.7554/eLife.07192.001 PMID:26140329

  13. Post-hit dynamics of price limit hits in the Chinese stock markets

    NASA Astrophysics Data System (ADS)

    Wu, Ting; Wang, Yue; Li, Ming-Xia

    2017-01-01

    Price limit trading rules are useful to cool off traders short-term trading mania on individual stocks. The price dynamics approaching the limit boards are known as the magnet effect. However, the price dynamics after opening price limit hits are not well investigated. Here, we provide a detailed analysis on the price dynamics after the hits of up-limit or down-limit is open based on all A-share stocks traded in the Chinese stock markets. A "W" shape is found in the expected return, which reveals high probability of a continuous price limit hit on the following day. We also find that price dynamics after opening limit hits are dependent on the market trends. The time span of continuously hitting the price limit is found to an influence factor of the expected profit after the limit hit is open. Our analysis provides a better understanding of the price dynamics around the limit boards and contributes potential practical values for investors.

  14. Observational Signatures of Magnetic Reconnection in the Extended Corona

    NASA Technical Reports Server (NTRS)

    Savage, Sabrina; West, Matthew J.; Seaton, Daniel B.; Kobelski, Adam

    2016-01-01

    Observational signatures of reconnection have been studied extensively in the lower corona for decades, successfully providing insight into energy release mechanisms in the region above post-flare arcade loops and below 1.5 solar radii. During large eruptive events, however, energy release continues to occur well beyond the presence of reconnection signatures at these low heights. Supra-Arcade Downflows (SADs) and Supra-Arcade Downflowing Loops (SADLs) are particularly useful measures of continual reconnection in the corona as they may indicate the presence and path of retracting post-reconnection loops. SADs and SADLs have been faintly observed up to 18 hours beyond the passage of coronas mass ejections through the SOHO/LASCO field of view, but a recent event from 2014 October 14 associated with giant arches provides very clear observations of these downflows for days after the initial eruption. We report on this unique event and compare these findings with observational signatures of magnetic reconnection in the extended corona for more typical eruptions.

  15. Observational Signatures of Magnetic Reconnection in the Extended Corona

    NASA Technical Reports Server (NTRS)

    Savage, Sabrina; West, Matthew J.; Seaton, Danial B.; Kobelski, Adam

    2016-01-01

    Observational signatures of reconnection have been studied extensively in the lower corona for decades, successfully providing insight into energy release mechanisms in the region above post-flare arcade loops and below 1.5 solar radii. During large eruptive events, however, energy release continues to occur well beyond the presence of reconnection signatures at these low heights. Supra-Arcade Downflows (SADs) and Supra-Arcade Downflowing Loops (SADLs) are particularly useful measures of continual reconnection in the corona as they may indicate the presence and path of retracting post-reconnection loops. SADs and SADLs have been faintly observed up to 18 hours beyond the passage of corona mass ejections through the SOHO/LASCO field of view, but a recent event from 2014 October 14 associated with giant arches provides very clear observations of these downflows for days after the initial eruption. We report on this unique event and compare these findings with observational signatures of magnetic reconnection in the extended corona for more typical eruptions.

  16. Observational Signatures of Magnetic Reconnection in the Extended Corona

    NASA Technical Reports Server (NTRS)

    Savage, Sabrina; West, Matthew J.; Seaton, Daniel B.; Kobelski, Adam

    2017-01-01

    Observational signatures of reconnection have been studied extensively in the lower corona for decades, successfully providing insight into energy release mechanisms in the region above post-flare arcade loops and below 1.5 solar radii. During large eruptive events, however, energy release continues to occur well beyond the presence of reconnection signatures at these low heights. Supra-Arcade Downflows (SADs) and Supra-Arcade Downflowing Loops (SADLs) are particularly useful measures of continual reconnection in the corona as they may indicate the presence and path of retracting post-reconnection loops. SADs and SADLs have been faintly observed up to 18 hours beyond the passage of corona mass ejections through the SOHO/LASCO field of view, but a recent event from 2014 October 14 associated with giant arches provides very clear observations of these downflows for days after the initial eruption. We report on this unique event and compare these findings with observational signatures of magnetic reconnection in the extended corona for more typical eruptions.

  17. 42 CFR 456.234 - Subsequent continued stay review dates.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... least every 90 days each time it decides under § 456.236 that the continued stay is needed; and (c) The...

  18. Microbial changes in conjunctival flora with 30-day continuous-wear silicone hydrogel contact lenses.

    PubMed

    Iskeleli, Güzin; Bahar, Hrisi; Eroglu, Ebru; Torun, Muzeyyen Mamal; Ozkan, Sehirbay

    2005-05-01

    To determine the effect of 30-day continuous-wear silicone hydrogel contact lenses on the conjunctival flora in asymptomatic wearers. The authors studied 29 eyes of 15 patients wearing Focus NIGHT & DAY silicone hydrogel contact lenses for up to 30 nights of continuous wear. The average age of the patients was 25.54 +/- 8.98 years. Cultures of the inferior cul-de-sac were taken bilaterally from all eyes, before and after lens wear in asymptomatic patients. The isolation and identification of bacteria were made by standard clinical laboratory methods. The number of eyes whose conjunctival cultures were sterile before using the lenses significantly decreased (P = 0.0005), and the number of eyes with a growth of coagulase-negative staphylococci and diphtheroid rods in their conjunctival cultures significantly increased after using these lenses (P = 0.001 and P = 0.031, respectively). Conversely, a statistically significant difference was not found in the number of eyes that carried Propionibacterium acnes and Fusobacterium nucleatum in their conjunctival cultures before and after using the 30-day continuous-wear silicone hydrogel lenses (P = 0.998 and P = 0.488, respectively). The results suggest that the sterility of the conjunctiva significantly decreased after using 30-day continuous-wear silicone hydrogel contact lenses. In addition, the number of bacteria of the normal conjunctival flora significantly increased after the use of these lenses. Contamination by the bacteria of the eyelids may be a possible colonization factor in this study group. Therefore, it is appropriate to examine the patients who wear these lenses more frequently.

  19. Effect of acid hydrolysis on morphology, structure and digestion property of starch from Cynanchum auriculatum Royle ex Wight.

    PubMed

    Wang, Xingchi; Wen, Fanting; Zhang, Shurong; Shen, Ruru; Jiang, Wei; Liu, Jun

    2017-03-01

    Effect of acid hydrolysis on the morphology, structure and digestion property of starch from Cynanchum auriculatum Royle ex Wight was investigated in this study. The hydrolysis degree of C. auriculatum starch rapidly increased to 63.69% after 4days and reached 78.67% at the end of 9days. Morphology observation showed that the starch granules remained intact during the first 4days of hydrolysis. However, serious erosion phenomenon was observed after 5days and starch granules completely fell into pieces after 7days. During acid hydrolysis process, the crystal type of hydrolyzed starch changed from original C B -type to final A-type. Small-angle X-ray scattering patterns showed the semi-crystalline growth rings started to be hydrolyzed after 4days. The proportions of single helix and amorphous components as well as amylose content in starch gradually decreased, whereas the proportion of double helix components continuously increased during acid hydrolysis. However, the contents of rapidly digestible starch, slowly digestible starch and resistant starch were almost constant during acid hydrolysis process, indicating the in vitro digestion property of C. auriculatum starch was not affected by acid hydrolysis. Our results provided novel information on the inner structure of C. auriculatum starch granules. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. The Association between Physical Activity During the Day and Long-Term Memory Stability.

    PubMed

    Pontifex, Matthew B; Gwizdala, Kathryn L; Parks, Andrew C; Pfeiffer, Karin A; Fenn, Kimberly M

    2016-12-02

    Despite positive associations between chronic physical activity and memory; we have little understanding of how best to incorporate physical activity during the day to facilitate the consolidation of information into memory, nor even how time spent physically active during the day relates to memory processes. The purpose of this investigation was to examine the relation between physical activity during the day and long-term memory. Ninety-two young adults learned a list of paired-associate items and were tested on the items after a 12-hour interval during which heart rate was recorded continuously. Although the percentage of time spent active during the day was unrelated to memory, two critical physical activity periods were identified as relating to the maintenance of long-term memory. Engaging in physical activity during the period 1 to 2-hours following the encoding of information was observed to be detrimental to the maintenance of information in long-term memory. In contrast, physical activity during the period 1-hour prior to memory retrieval was associated with superior memory performance, likely due to enhanced retrieval processing. These findings provide initial evidence to suggest that long-term memory may be enhanced by more carefully attending to the relative timing of physical activity incorporated during the day.

  1. Leucine Supplementation Improves Skeletal Muscle Regeneration after Cryolesion in Rats

    PubMed Central

    Pereira, Marcelo G.; Baptista, Igor L.; Carlassara, Eduardo O. C.; Moriscot, Anselmo S.; Aoki, Marcelo S.; Miyabara, Elen H.

    2014-01-01

    This study was undertaken in order to provide further insight into the role of leucine supplementation in the skeletal muscle regeneration process, focusing on myofiber size and strength recovery. Young (2-month-old) rats were subjected or not to leucine supplementation (1.35 g/kg per day) started 3 days prior to cryolesion. Then, soleus muscles were cryolesioned and continued receiving leucine supplementation until 1, 3 and 10 days later. Soleus muscles from leucine-supplemented animals displayed an increase in myofiber size and a reduction in collagen type III expression on post-cryolesion day 10. Leucine was also effective in reducing FOXO3a activation and ubiquitinated protein accumulation in muscles at post-cryolesion days 3 and 10. In addition, leucine supplementation minimized the cryolesion-induced decrease in tetanic strength and increase in fatigue in regenerating muscles at post-cryolesion day 10. These beneficial effects of leucine were not accompanied by activation of any elements of the phosphoinositide 3-kinase/Akt/mechanistic target of rapamycin signalling pathway in the regenerating muscles. Our results show that leucine improves myofiber size gain and strength recovery in regenerating soleus muscles through attenuation of protein ubiquitination. In addition, leucine might have therapeutic effects for muscle recovery following injury and in some muscle diseases. PMID:24416379

  2. Validity of Questionnaire and Representativeness of Objective Methods for Measurements of Mechanical Exposures in Construction and Health Care Work

    PubMed Central

    Koch, Markus; Lunde, Lars-Kristian; Gjulem, Tonje; Knardahl, Stein; Veiersted, Kaj Bo

    2016-01-01

    Objectives To determine the criterion validity of a questionnaire on physical exposures compared to objective measurements at construction and health care sites and to examine exposure variation over several working days. Methods Five hundred ninety-four construction and health care workers answered a baseline questionnaire. The daily activities (standing, moving, sitting, number of steps), postures (inclination of the arm and the trunk), and relative heart rate of 125 participants were recorded continuously over 3–4 working days. At the end of the first measurement day, the participants answered a second questionnaire (workday questionnaire). Results All objective activity measurements had significant correlations to their respective questions. Among health care workers, there were no correlations between postures and relative heart rate and the baseline questionnaire. The questionnaires overestimated the exposure durations. The highest explained variance in the adjusted models with self-reported variables were found for objectively measured sitting (R2 = 0.559) and arm inclination > 60° (R2 = 0.420). Objective measurements over several days showed a higher reliability compared to single day measurements. Conclusions Questionnaires cannot provide an accurate description of mechanical exposures. Objective measurements over several days are recommended in occupations with varying tasks. PMID:27649499

  3. Safety and Benefit of Discontinuing Statin Therapy in the Setting of Advanced, Life-Limiting Illness

    PubMed Central

    Kutner, Jean S.; Blatchford, Patrick J.; Taylor, Don H.; Ritchie, Christine S.; Bull, Janet H.; Fairclough, Diane L.; Hanson, Laura C.; LeBlanc, Thomas W.; Samsa, Greg P.; Wolf, Steven; Aziz, Noreen M.; Currow, David C.; Ferrell, Betty; Wagner-Johnston, Nina; Zafar, S. Yousuf; Cleary, James F.; Dev, Sandesh; Goode, Patricia S.; Kamal, Arif H.; Kassner, Cordt; Kvale, Elizabeth A.; McCallum, Janelle G.; Ogunseitan, Adeboye B.; Pantilat, Steven Z.; Portenoy, Russell K.; Prince-Paul, Maryjo; Sloan, Jeff A.; Swetz, Keith M.; Von Gunten, Charles F.; Abernethy, Amy P.

    2015-01-01

    IMPORTANCE For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy. OBJECTIVE To evaluate the safety, clinical, and cost impact of discontinuing statin medications for patients in the palliative care setting. DESIGN, SETTING, AND PARTICIPANTS This was a multicenter, parallel-group, unblinded, pragmatic clinical trial. Eligibility included adults with an estimated life expectancy of between 1 month and 1 year, statin therapy for 3 months or more for primary or secondary prevention of cardiovascular disease, recent deterioration in functional status, and no recent active cardiovascular disease. Participants were randomized to either discontinue or continue statin therapy and were monitored monthly for up to 1 year. The study was conducted from June 3, 2011, to May 2, 2013. All analyses were performed using an intent-to-treat approach. INTERVENTIONS Statin therapy was withdrawn from eligible patients who were randomized to the discontinuation group. Patients in the continuation group continued to receive statins. MAIN OUTCOMES AND MEASURES Outcomes included death within 60 days (primary outcome), survival, cardiovascular events, performance status, quality of life (QOL), symptoms, number of nonstatin medications, and cost savings. RESULTS A total of 381 patients were enrolled; 189 of these were randomized to discontinue statins, and 192 were randomized to continue therapy. Mean (SD) age was 74.1 (11.6) years, 22.0% of the participants were cognitively impaired, and 48.8% had cancer. The proportion of participants in the discontinuation vs continuation groups who died within 60 days was not significantly different (23.8% vs 20.3%; 90% CI, −3.5% to 10.5%; P = .36) and did not meet the noninferiority end point. Total QOL was better for the group discontinuing statin therapy (mean McGill QOL score, 7.11 vs 6.85; P = .04). Few participants experienced cardiovascular events (13 in the discontinuation group vs 11 in the continuation group). Mean cost savings were $3.37 per day and $716 per patient. CONCLUSIONS AND RELEVANCE This pragmatic trial suggests that stopping statin medication therapy is safe and may be associated with benefits including improved QOL, use of fewer nonstatin medications, and a corresponding reduction in medication costs. Thoughtful patient-provider discussions regarding the uncertain benefit and potential decrement in QOL associated with statin continuation in this setting are warranted. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01415934 PMID:25798575

  4. Automated Status Notification System

    NASA Technical Reports Server (NTRS)

    2005-01-01

    NASA Lewis Research Center's Automated Status Notification System (ASNS) was born out of need. To prevent "hacker attacks," Lewis' telephone system needed to monitor communications activities 24 hr a day, 7 days a week. With decreasing staff resources, this continuous monitoring had to be automated. By utilizing existing communications hardware, a UNIX workstation, and NAWK (a pattern scanning and processing language), we implemented a continuous monitoring system.

  5. Assessment of VIIRS daily BRDF/Albedo product using in situ measurement of SURFRAD sites and MODIS V006 daily BRDF/Albedo product

    NASA Astrophysics Data System (ADS)

    Liu, Y.; Wang, Z.; Sun, Q.; Schaaf, C.; Roman, M. O.

    2014-12-01

    Surface albedo is defined as the ratio of upwelling to downwelling radiative flux. It's important for understanding the global energy budget. Remote sensing albedo products provide global time continuous coverage to help capture global energy variability and change. The Visible Infrared Imaging Radiometer Suite (VIIRS) on the Suomi-NPP satellite, launched on October 28, 2011, is aiming to provide continues data record with the MODerate resolution Imaging Spectroradiometer (MODIS), which has been providing Bidirectional Reflectance Distribution Function (BRDF)/Albedo product since 2000. By utilizing the same approach that was used for the most recently V006 daily MODIS BRDF/Albedo product, VIIRS has the ability to keep providing products for research and operational users. Validating albedo product of VIIRS using in situmeasured albedo can assure the quality for land surface climate and biosphere models, and comparing with MODIS product can assure time continues of BRDF/albedo product. The daily BRDF/Albedo product still uses 16-day period multispectral, cloud-cleared, atmospherically-corrected surface reflectances to fit the Ross-Thick/Li-Sparse-Reciprocal semi-empirical BRDF model. But the multiday observations are also weighted based on proximity to the production date in order to emphasis on that individual day. Surface Radiation Budget Network (SURFRAD) was established in 1993 through the support of NOAA's Office of Global Programs. In situ albedo was driven from downwelling and upwelling radiative flux measured from the towers. Fraction of diffuse sky light was calculated using the direct and diffuse solar recorded in the data. It was further used to translate VIIRS, MODIS black sky and white sky albedos into actual albedo at local solar noon. Results show that VIIRS, MODIS and in situ albedo agree well at SURFARD spatially representative sites. While the VIIRS surface reflectance, snow, and cloud algorithms are still undergoing revision, the result shows that VIIRS can provide comparable albedo products with MODIS. The accuracy of both products can meet the requirement for climate and biosphere models. In situ albedo also can be gained from Baseline Surface Radiation Network (BSRN), FLUXNET and Long Term Ecological Research network (LTER) etc., which will be used in future validation work.

  6. Comparison of tofogliflozin 20 mg and ipragliflozin 50 mg used together with insulin glargine 300 U/mL using continuous glucose monitoring (CGM): A randomized crossover study.

    PubMed

    Takeishi, Soichi; Tsuboi, Hiroki; Takekoshi, Shodo

    2017-10-28

    To investigate whether sodium glucose co-transporter 2 inhibitors (SGLT2i), tofogliflozin or ipragliflozin, achieve optimal glycemic variability, when used together with insulin glargine 300 U/mL (Glargine 300). Thirty patients with type 2 diabetes were randomly allocated to 2 groups. For the first group: After admission, tofogliflozin 20 mg was administered; Fasting plasma glucose (FPG) levels were titrated using an algorithm and stabilized at 80 mg/dL level with Glargine 300 for 5 days; Next, glucose levels were continuously monitored for 2 days using continuous glucose monitoring (CGM); Tofogliflozin was then washed out over 5 days; Subsequently, ipragliflozin 50 mg was administered; FPG levels were titrated using the same algorithm and stabilized at 80 mg/dL level with Glargine 300 for 5 days; Next, glucose levels were continuously monitored for 2 days using CGM. For the second group, ipragliflozin was administered prior to tofogliflozin, and the same regimen was maintained. Glargine 300 and SGLT2i were administered at 8:00 AM. Data collected on the second day of measurement (mean amplitude of glycemic excursion [MAGE], average daily risk range [ADRR]; on all days of measurement) were analyzed. Area over the glucose curve (<70 mg/dL; 0:00 to 6:00, 24-h), M value, standard deviation, MAGE, ADRR, and mean glucose levels (24-h, 8:00 to 24:00) were significantly lower in patients on tofogliflozin than in those on ipragliflozin. Tofogliflozin, which reduces glycemic variability by preventing nocturnal hypoglycemia and decreasing postprandial glucose levels, is an ideal SGLT2i when used together with Glargine 300 during basal insulin therapy.

  7. The Challenge of Providing Safe Water with an Intermittently Supplied Piped Water Distribution System

    NASA Astrophysics Data System (ADS)

    Kumpel, E.; Nelson, K. L.

    2012-12-01

    An increasing number of urban residents in low- and middle-income countries have access to piped water; however, this water is often not available continuously. 84% of reporting utilities in low-income countries provide piped water for fewer than 24 hours per day (van den Berg and Danilenko, 2010), while no major city in India has continuous piped water supply. Intermittent water supply leaves pipes vulnerable to contamination and forces households to store water or rely on alternative unsafe sources, posing a health threat to consumers. In these systems, pipes are empty for long periods of time and experience low or negative pressure even when water is being supplied, leaving them susceptible to intrusion from sewage, soil, or groundwater. Households with a non-continuous supply must collect and store water, presenting more opportunities for recontamination. Upgrading to a continuous water supply, while an obvious solution to these challenges, is currently out of reach for many resource-constrained utilities. Despite its widespread prevalence, there are few data on the mechanisms causing contamination in an intermittent supply and the frequency with which it occurs. Understanding the impact of intermittent operation on water quality can lead to strategies to improve access to safe piped water for the millions of people currently served by these systems. We collected over 100 hours of continuous measurements of pressure and physico-chemical water quality indicators and tested over 1,000 grab samples for indicator bacteria over 14 months throughout the distribution system in Hubli-Dharwad, India. This data set is used to explore and explain the mechanisms influencing water quality when piped water is provided for a few hours every 3-5 days. These data indicate that contamination occurs along the distribution system as water travels from the treatment plant to reservoirs and through intermittently supplied pipes to household storage containers, while real-time measurements document variability in water quality throughout the 2-8 hour supply period. Our results show that piped water is not always safe water, but that safe water can be achieved in an intermittent supply under certain physical and operational conditions. Intermittent piped water supply is an important constraint on access to safe water in towns and cities in low-income countries, and strategies that improve these existing systems can help urban residents gain access to safe water. References van den Berg, C., and Danilenko, A. (2010). "The IBNET Water Supply and Sanitation Performance Blue Book: The International Benchmarking Network for Water and Sanitation Utilities Databook." World Bank Washington, DC.

  8. Magnitude and frequency of low flows in the Suwannee River Water Management District, Florida

    USGS Publications Warehouse

    Giese, G.L.; Franklin, M.A.

    1996-01-01

    Low-flow frequency statistics for 20 gaging stations having at least 10 years of continuous record and 31 other stations having less than 10 years of continu ous record or a series of at least two low- flow measurements are presented for unregulated streams in the Suwannee River Water Management District in north-central Florida. Statistics for the 20 continuous-record stations included are the annual and monthly minimum consecutive-day average low- flow magnitudes for 1, 3, 7, 14, and 30 consecutive days for recurrence intervals of 2, 5, 10, 20, and, for some long-term stations, 50 years, based on records available through the 1994 climatic year.Only theannual statistics are given for the 31 other stations; these are for the 7- and 30-consecutive day periods only and for recurrence intervals of 2 and 10 years only. Annual low-flow frequency statistics range from zero for many small streams to 5,500 cubic feet per second for the annual 30- consecutive-day average flow with a recurrenceinterval of 2 years for the Suwannee River near Wilcox (station 02323500). Monthly low-flow frequency statistics range from zero for many small streams to 13,800 cubic feet per second for the minimum 30-consecutive-day average flow with a 2-year recurrence interval for the month of March for the same station. Generally, low-flow characteristics of streams in the Suwannee River Water Management District are controlled by climatic, topographic, and geologic fac tors. The carbonate Floridan aquifer system underlies, or is at the surface of, the entire District. The terrane's karstic nature results in manysinkholes and springs. In some places, springs may contribute greatly to low streamflow and the contributing areas of such springs may include areasoutside the presumed surface drainage area of the springs. In other places, water may enter sinkholes within a drainage basin, then reappear in springs downstream from a gage. Many of the smaller streams in the District go dry or have no flow forseveral months in many years. In addition to the low-flow statistics, four synoptic low-flow measurement surveys were conducted on 161 sites during 1990, 1995, and 1996. Themeasurements were made to provide "snapshots" of flow conditions of streams throughout the Suwannee River Water Management District. Magnitudes of low flows during the 1990 series of measurements were in the range associated withminimum 7-consecutive-day 50-year recurrence interval to the minimum 7-consecutive-day 20-year recurrence interval, except in Taylor and Dixie Counties, where the magnitudes ranged from the minimum 7-consecutive-day 5-year flow level to the7-consecutive-day 2-year flow level. The magnitudes were all greater than the minimum 7- consecutive-day 2-year flow level during 1995 and 1996. Observations of no flow were recorded at many of the sites for all four series of measurements.

  9. High-Dose Continuous Infusion Beta-lactam Antibiotics for the Treatment of Resistant Pseudomonas aeruginosa Infections in Immunocompromised Patients

    PubMed Central

    Moriyama, Brad; Henning, Stacey A.; Childs, Richard; Holland, Steven M.; Anderson, Victoria L.; Morris, John C.; Wilson, Wyndham H.; Drusano, George L.; Walsh, Thomas J.

    2011-01-01

    OBJECTIVE To report a case series of high-dose continuous infusion beta-lactam antibiotics for the treatment of resistant Pseudomonas aeruginosa infections. CASE SUMMARY Continuous infusion ceftazidime or aztreonam was administered to achieve target drug levels at or above the MIC when possible in three patients with P. aeruginosa infections. The maximal calculated target drug level was 100 mg/L. In the first patient with primary immunodeficiency, neutropenia, and aggressive cutaneous T cell lymphoma/leukemia, continuous infusion ceftazidime (6.5 to 9.6 g/day) was used to successfully treat multidrug-resistant P. aeruginosa bacteremia. In the second patient with leukocyte adhesion deficiency type 1, continuous infusion aztreonam (8.4 g/day) was used to successfully treat multidrug-resistant P. aeruginosa wound infections. In the third patient with severe aplastic anemia, continuous infusion ceftazidime (7 to 16.8 g/day) was used to treat P. aeruginosa pneumonia and bacteremia. In each patient, the bacteremia cleared, infected wounds healed, and pneumonia improved in response to continuous infusion ceftazidime or aztreonam. DISCUSSION Treatment strategies for multidrug-resistant P. aeruginosa infections are limited. A novel treatment strategy when no other options are available is the administration of existing beta-lactam antibiotics by continuous infusion in order to maximize their pharmacodynamic activity. High-dose continuous infusion ceftazidime or aztreonam was used for the successful treatment of resistant systemic P. aeruginosa infections in three chronically immunocompromised patients. CONCLUSION Continuous infusion beta-lactam antibiotics are a potentially useful treatment strategy for resistant P. aeruginosa infections in immunocompromised patients. PMID:20371747

  10. Ovarian activity and safety of a novel levonorgestrel/ethinyl estradiol continuous oral contraceptive regimen.

    PubMed

    Archer, David F; Kovalevsky, George; Ballagh, Susan A; Grubb, Gary S

    2009-09-01

    A continuous regimen of oral levonorgestrel (LNG) 90 mcg/ethinyl estradiol (EE) 20 mcg was evaluated for inhibition of ovulation, time to return to ovulation after stopping treatment and safety. This open-label study was conducted in healthy women aged 18-35 years. Ovulation was documented before treatment, and then participants received oral tablets containing LNG 90 mcg/EE 20 mcg to be taken continuously for three 28-day intervals. Ovarian activity was assessed three times per week during the treatment period with transvaginal ultrasound scans and measurements of serum 17beta-estradiol, progesterone, follicle-stimulating hormone and luteinizing hormone concentrations. Safety assessments included physical examinations, laboratory evaluations and adverse event records. Thirty-seven of the 58 subjects who received treatment met predefined criteria for efficacy analysis. No on-treatment ovulations occurred in the efficacy or intent-to-treat population. There was evidence of ovulation within 37 days of stopping treatment for 46 (98%) of 47 subjects evaluated posttreatment. The final subject with a history of polycystic ovarian syndrome ovulated by Day 66. The safety profile observed during this 84-day continuous regimen was similar to that seen with other low-dose oral contraceptives administered in a cyclic regimen. The continuous LNG/EE regimen completely inhibited ovulation, with little evidence of follicular development and with rapid return of ovulatory capacity after stopping treatment.

  11. Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease.

    PubMed

    Nitawaki, Tatsuya; Sakata, Yoshihiko; Kawamura, Kodai; Ichikado, Kazuya

    2017-12-06

    Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is a key drug for ALK rearranged lung adenocarcinoma. Interstitial lung disease (ILD) is an important adverse effect of alectinib, which generally requires termination of treatment. However, we treated two patients with drug-induced ILD who continued to receive alectinib. Patient 1 was a 57-year-old male with an ALK-rearranged Stage IV lung adenocarcinoma who was administered alectinib as first-line therapy. Computed tomography (CT) detected asymptomatic ground-glass opacity (GGO) on day 33 of treatment. Alectinib therapy was therefore discontinued for 7 days and then restarted. GGO disappeared, and the progression of ILD ceased. Patient 2 was a 64-year-old woman with an ALK-positive lung adenocarcinoma who was administered alectinib as third-line therapy. One year later, CT detected GGO; and she had a slight, nonproductive cough. Alectinib therapy was continued in the absence of other symptoms, and GGO slightly diminished after 7 days. Two months later, CT detected increased GGO, and alectinib therapy was continued. GGO diminished again after 7 days. The patient has taken alectinib for more than 2 years without progression of ILD. Certain patients with alectinib-induced ILD Grade 2 or less may continue alectinib therapy if they are closely managed.

  12. Surface-Water Conditions in Georgia, Water Year 2005

    USGS Publications Warehouse

    Painter, Jaime A.; Landers, Mark N.

    2007-01-01

    INTRODUCTION The U.S. Geological Survey (USGS) Georgia Water Science Center-in cooperation with Federal, State, and local agencies-collected surface-water streamflow, water-quality, and ecological data during the 2005 Water Year (October 1, 2004-September 30, 2005). These data were compiled into layers of an interactive ArcReaderTM published map document (pmf). ArcReaderTM is a product of Environmental Systems Research Institute, Inc (ESRI?). Datasets represented on the interactive map are * continuous daily mean streamflow * continuous daily mean water levels * continuous daily total precipitation * continuous daily water quality (water temperature, specific conductance dissolved oxygen, pH, and turbidity) * noncontinuous peak streamflow * miscellaneous streamflow measurements * lake or reservoir elevation * periodic surface-water quality * periodic ecological data * historical continuous daily mean streamflow discontinued prior to the 2005 water year The map interface provides the ability to identify a station in spatial reference to the political boundaries of the State of Georgia and other features-such as major streams, major roads, and other collection stations. Each station is hyperlinked to a station summary showing seasonal and annual stream characteristics for the current year and for the period of record. For continuous discharge stations, the station summary includes a one page graphical summary page containing five graphs, a station map, and a photograph of the station. The graphs provide a quick overview of the current and period-of-record hydrologic conditions of the station by providing a daily mean discharge graph for the water year, monthly statistics graph for the water year and period of record, an annual mean streamflow graph for the period of record, an annual minimum 7-day average streamflow graph for the period of record, and an annual peak streamflow graph for the period of record. Additionally, data can be accessed through the layer's link to the National Water Inventory System Web (NWISWeb) Interface.

  13. Southeast Ecological Observatory Network (SEEON) Workshop on Ecological Sensors and Information Technology. Report on Second SEEON Workshop

    NASA Technical Reports Server (NTRS)

    Jones, Lori N.; Binford, Michael; Hinkle, Ross C.

    2004-01-01

    A fundamental goal of the new National Science Foundation (NSF) initiative National Ecological Observatory Network (NEON) is to provide timely and broad access to the ecological data collected at NEON sites. Information management and data collection will be critical components to achieving this goal and a successful NEON implementation. The Southeast Ecological Observatory Network (SEEON) working group recognized the importance of information management and sensor technology in its first planning workshop and recommended that interested parties in the region come together to discuss these subjects in the context of the needs and capabilities of a southeast regional ecological observatory network. In February 2004, 28 participants from 14 organizations including academic institutions, state and federal agencies, private and non-profit entities convened at the Space Life Sciences Laboratory (SLSL) at the Kennedy Space Center, Florida for two days of presentations and discussions on ecological sensors and information management. Some of the participants were previously involved in the first SEEON workshop or other meetings concerned with NEON, but many were somewhat new to the NEON community. Each day focused on a different technical component, i.e. ecological sensors the first day and cyber-infrastructure the second day, and were structured in a similar manner. The mornings were devoted to presentations by experts to help stimulate discussions on aspects of the focal topic held in the afternoon. The formal and informal discussions held during the workshop succeeded in validating some concerns and needs identified in the first SEEON workshop, but also served to bring to light other questions or issues that will need to be addressed as the NEON planning and design stages move forward. While the expansion of the SEEON community meant that some of the presentation and discussion time was needed to help bring the newcomers up to speed on the goals, objectives and current status of the various NEON efforts, the additional perspectives and technical expertise included in this workshop helped fuel some valuable interdisciplinary discussions that will need to continue to bring SEEON and NEON to fruition. Participants agreed that continued discussions of SEEON are needed , to keep up the momentum and that the southeast region must continue to be represented at the national level. It is vital that the all'the regions continue to push things forward for NEON to succeed.

  14. WIC-based interventions to promote breastfeeding among African-American Women in Baltimore: effects on breastfeeding initiation and continuation.

    PubMed

    Caulfield, L E; Gross, S M; Bentley, M E; Bronner, Y; Kessler, L; Jensen, J; Weathers, B; Paige, D M

    1998-03-01

    We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

  15. COMPOSE: Using temporal patterns for interpreting wearable sensor data with computer interpretable guidelines.

    PubMed

    Urovi, V; Jimenez-Del-Toro, O; Dubosson, F; Ruiz Torres, A; Schumacher, M I

    2017-02-01

    This paper describes a novel temporal logic-based framework for reasoning with continuous data collected from wearable sensors. The work is motivated by the Metabolic Syndrome, a cluster of conditions which are linked to obesity and unhealthy lifestyle. We assume that, by interpreting the physiological parameters of continuous monitoring, we can identify which patients have a higher risk of Metabolic Syndrome. We define temporal patterns for reasoning with continuous data and specify the coordination mechanisms for combining different sets of clinical guidelines that relate to this condition. The proposed solution is tested with data provided by twenty subjects, which used sensors for four days of continuous monitoring. The results are compared to the gold standard. The novelty of the framework stands in extending a temporal logic formalism, namely the Event Calculus, with temporal patterns. These patterns are helpful to specify the rules for reasoning with continuous data and in combining new knowledge into one consistent outcome that is tailored to the patient's profile. The overall approach opens new possibilities for delivering patient-tailored interventions and educational material before the patients present the symptoms of the disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. The time-varying association between perceived stress and hunger within and between days.

    PubMed

    Huh, Jimi; Shiyko, Mariya; Keller, Stefan; Dunton, Genevieve; Schembre, Susan M

    2015-06-01

    Examine the association between perceived stress and hunger continuously over a week in free-living individuals. Forty five young adults (70% women, 30% overweight/obese) ages 18 to 24 years (Mean = 20.7, SD = 1.5), with BMI between 17.4 and 36.3 kg/m(2) (Mean = 23.6, SD = 4.0) provided between 513 and 577 concurrent ratings of perceived stress and hunger for 7 days via hourly, text messaging assessments and real-time eating records. Time-varying effect modeling was used to explore whether the within-day fluctuations in stress are related to perceived hunger assessed on a momentary basis. A generally positive stress-hunger relationship was confirmed, but we found that the strength of the relationship was not linear. Rather, the magnitude of the association between perceived stress and hunger changed throughout the day such that only during specific time intervals were stress and hunger significantly related. Specifically, the strength of the positive association peaked during late afternoon hours on weekdays (β = 0.31, p < .05) and it peaked during evening hours on weekend days (β = 0.56, p < .05). This is the first empirical study to demonstrate potentially maladaptive, nonlinear stress-hunger associations that peak in the afternoon or evening hours. While we are unable to infer causality from these analyses, our findings provide empirical evidence for a potentially high-risk time of day for stress-induced eating. Replication of these findings in larger, more diverse samples will aid with the design and implementation of real-time intervention studies aimed at reducing stress-eating. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Mid-latitude ionospheric irregularity spectral density as determined by ground-based GPS receiver networks

    DOE PAGES

    Lay, Erin H.; Parker, Peter A.; Light, Max; ...

    2018-05-22

    In this paper, we present a new technique to experimentally measure the spatial spectrum of ionospheric disturbances in the spatial scale regime of 40 – 200 km. This technique produces a 2-dimensional (2-D) spectrum for each time snapshot over two dense GPS receiver networks (GEONET in Japan and PBO in the Western U.S.). Because this technique created the spectrum from an instantaneous time snapshot, no assumptions are needed about the speed of ionospheric irregularities. We examine spectra from three days: one with an intense geomagnetic storm, one with significant lightning activity, and one quiet day. Radial slices along the 2-Dmore » spectra provide 1-dimensional spectra that can be fit to a power law to quantify the steepness of the fall-off in the spatial scale sizes. Continuous data of this type in a stationary location allows monitoring the variability in the 2-D spectrum over the course of a day and comparing between days, as shown here, or even over a year or many years. We find that the spectra are highly variable over the course of a day and between the two selected regions of Japan and the Western U.S. When strong travelling ionospheric disturbances (TIDs) are present, the 2-D spectra provide information about the direction of propagation of the TIDs. We compare the TID propagation direction with horizontal wind directions from the Horizontal Wind Model. Finally, TID direction is correlated with the horizontal wind direction on all days, strongly indicating that the primary source of the TIDs measured by this technique is tropospheric.« less

  18. Predictors of Long-Term Survival Following Coronary Artery Bypass Grafting Surgery: Results from The Society of Thoracic Surgeons Adult Cardiac Surgery Database (The ASCERT Study)

    PubMed Central

    Shahian, David M.; O'Brien, Sean M.; Sheng, Shubin; Grover, Frederick L.; Mayer, John E.; Jacobs, Jeffrey P.; Weiss, Jocelyn M.; DeLong, Elizabeth R.; Peterson, Eric D.; Weintraub, William S.; Grau-Sepulveda, Maria V.; Klein, Lloyd W.; Shaw, Richard E.; Garratt, Kirk; Moussa, Issam; Shewan, Cynthia M.; Dangas, George D.; Edwards, Fred H.

    2012-01-01

    Background Most survival prediction models for coronary artery bypass grafting surgery (CABG) are limited to in-hospital or 30-day endpoints. We estimate a long-term survival model using data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database and Centers for Medicare and Medicaid Services (CMS). Methods and Results The final study cohort included 348,341 isolated CABG patients ≥ 65 years of age, discharged between January 1, 2002 and December 31, 2007 from 917 STS-participating hospitals, randomly divided into training (n = 174,506) and validation (n = 173,835) samples. Through linkage with CMS claims data, we ascertained vital status from date of surgery through December 31, 2008 (1 – 6 year follow-up). Because the proportional hazards assumption was violated, we fit four Cox regression models conditional on being alive at the beginning of the following intervals: 0 –30 days, 31 – 180 days, 181 days – 2 years, > 2 years. Kaplan-Meier estimated mortality was 3.2% at 30 days, 6.4% at 180 days, 8.1% at one-year, and 23.3% at 3 years of follow-up. Harrell's C statistic for predicting overall survival time was 0.732. Some risk factors (e.g., emergency status, shock, reoperation) were strong predictors of short-term outcome but, for early survivors, became non-significant within 2 years. The adverse impact of some other risk factors (e.g., dialysis-dependent renal failure, insulin-dependent diabetes) continued to increase. Conclusions Using clinical registry data and longitudinal claims data, we developed a long-term survival prediction model for isolated CABG. This provides valuable information for shared decision-making, comparative effectiveness research, quality improvement, and provider profiling. PMID:22361330

  19. Protective effects of high-potency FMDV O1 Manisa monovalent vaccine in cattle challenged with FMDV O/SKR/2010 at 7 or 4 days post vaccination.

    PubMed

    Horsington, Jacquelyn; Perez, Claudia Beascoechea; Maradei, Eduardo; Novo, Sabrina Galdo; Gonzales, Jose L; Singanallur, Nagendrakumar B; Bonastre, Paula; Vosloo, Wilna

    2017-09-12

    Serotype O foot-and-mouth disease (FMD) virus belonging to the SEA topotype continues to be a significant problem in the Eastern Asia region, with outbreaks in Japan and South Korea resulting in the culling of over 3.5 million cattle and pigs in recent years. High-potency O1 Manisa vaccine was previously shown to provide protection in cattle 21days post vaccination (dpv) following challenge with a representative virus, O/SKR/2010. This study tested the ability of the O1 Manisa vaccine to protect cattle from infection and disease with the O/SKR/2010 virus within just 4 or 7days post vaccination. The vaccine protected 50% of cattle from clinical disease when administered 7days prior to challenge, but was not protective with just 4days between vaccination and challenge. Viraemia was significantly reduced in animals challenged 7 dpv but not 4 dpv, compared to unvaccinated controls, however, there were no effects on the level of virus detected in nasal and oral secretions regardless of vaccination time. The level of neutralising antibodies detected in cattle challenged 7 dpv correlated with protection from clinical disease. All animals seroconverted to FMDV non-structural proteins, suggesting no sterile protection. An equal number of animals became persistently infected in both vaccine groups. The results indicated that high-potency O1 Manisa vaccine administered just 7days prior to challenge should provide partial protection of cattle if an outbreak of O/SKR/2010, or related viruses, occurs, and would be useful to limit spread of FMDV when used in conjunction with other control measures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Mid-latitude ionospheric irregularity spectral density as determined by ground-based GPS receiver networks

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

    Lay, Erin H.; Parker, Peter A.; Light, Max

    In this paper, we present a new technique to experimentally measure the spatial spectrum of ionospheric disturbances in the spatial scale regime of 40 – 200 km. This technique produces a 2-dimensional (2-D) spectrum for each time snapshot over two dense GPS receiver networks (GEONET in Japan and PBO in the Western U.S.). Because this technique created the spectrum from an instantaneous time snapshot, no assumptions are needed about the speed of ionospheric irregularities. We examine spectra from three days: one with an intense geomagnetic storm, one with significant lightning activity, and one quiet day. Radial slices along the 2-Dmore » spectra provide 1-dimensional spectra that can be fit to a power law to quantify the steepness of the fall-off in the spatial scale sizes. Continuous data of this type in a stationary location allows monitoring the variability in the 2-D spectrum over the course of a day and comparing between days, as shown here, or even over a year or many years. We find that the spectra are highly variable over the course of a day and between the two selected regions of Japan and the Western U.S. When strong travelling ionospheric disturbances (TIDs) are present, the 2-D spectra provide information about the direction of propagation of the TIDs. We compare the TID propagation direction with horizontal wind directions from the Horizontal Wind Model. Finally, TID direction is correlated with the horizontal wind direction on all days, strongly indicating that the primary source of the TIDs measured by this technique is tropospheric.« less

  1. Science-practice nexus for landslide surveying: technical training for local government units in Indonesia

    NASA Astrophysics Data System (ADS)

    Alam, A. L.; Hespiantoro, S.; Dyar, D.; Balzer, D.; Kuhn, D.; Torizin, J.; Fuchs, M.; Kastl, S.; Anhorn, J.

    2017-02-01

    The Indonesian archipelago is prone to various geological hazards on an almost day to day basis. In order to mitigate disaster risk and reduce losses, the government uses its unique setup of ministerial training institutions. The Centre for Development of Human Resources in Geology, Mineral and Coal offers different level of technical training to local governments in order to provide them with the necessary means to understand geological hazards, mitigate risks, and hence close the gap between local and national governments. One key factor has been the continuous incorporation of new scientific knowledge into their training curricula. The paper presents benefits and challenges of this science-practice nexus using the standardised landslide survey as one example where mobile technology has been introduced to the training just recently.

  2. Towards sustainable e-health networks: does modeling support efficient management and operation?

    PubMed

    Staemmler, Martin

    2007-01-01

    e-Health Networks require cost-effective approaches for routine operation to achieve long-lasting sustainability. By using a model to represent (i) the network's enterprise functions, (ii) the applications used and (iii) the physical implementations, the tasks of management, adapting to changes and providing continued maintenance can be effectively supported. The paper discusses approaches for modeling, assesses their usefulness for the above tasks and decides on the use of the 3LGM meta model. Based on this concept, three ways for modeling the specific properties of an e-Health network are presented, leading to the decision to represent the hospitals involved in only one layer. As a result the model derived is presented, assessed and proved to support strategic management, day-to-day maintenance and documentation.

  3. Simulating spatial and temporal variation of corn canopy temperature during an irrigation cycle

    NASA Technical Reports Server (NTRS)

    Choudhury, B. J.; Federer, C. A.

    1983-01-01

    The canopy air temperature difference (delta T) which provides an index for scheduling irrigation was examined. The Monteith transpiration equation was combined with both uptake from a single layered root zone and change in internal storage of the plant and the continuity equation for water flux in the soil plant atmosphere system was solved. The model indicates that both daily total transpiration and soil induced depression of plant water potential may be inferred from mid-day delta T. It is suggested that for the soil plant weather data used in the simulation, either a mid day spatial variability of about 0.8K in canopy temperatures or a field averaged delta T of 2 to 4K may be a suitable criterion for irrigation scheduling.

  4. Induced bioelectrochemical metabolism for bioremediation of petroleum refinery wastewater: Optimization of applied potential and flow of wastewater.

    PubMed

    Mohanakrishna, Gunda; Al-Raoush, Riyadh I; Abu-Reesh, Ibrahim M

    2018-07-01

    Hybrid based bioelectrochemical system (BES) configured with embedded anode and cathode electrodes in soil was tested for the bioelectrochemical degradation of petroleum refinery wastewater (PRW). Four applied potentials were studied to optimize under batch mode operation, among which 2 V resulted in higher COD degradation (69.2%) and power density (725 mW/m 2 ) during 7 days of operation. Further studies with continuous mode of operation at optimized potential (2 V) showed that hydraulic retention time (HRT) of 19 h achieved the highest COD removal (37%) and highest power density (561 mW/m 2 ). BES function with respect to treatment efficiencies of other pollutants of PRW was also identified with respect to oil and grease (batch mode, 91%; continuous mode, 34%), total dissolved salts (batch mode, 53%; continuous mode, 24%) and sulfates (batch mode, 59%; continuous mode, 42%). Soil microenvironment in association with BES forms complex processes, providing suitable conditions for efficient treatment of PRW. Copyright © 2018 Elsevier Ltd. All rights reserved.

  5. A 360 degrees evaluation of a night-float system for general surgery: a response to mandated work-hours reduction.

    PubMed

    Goldstein, Michael J; Kim, Eugene; Widmann, Warren D; Hardy, Mark A

    2004-01-01

    New York State Code 405 and societal/political pressure have led the RRC and ACGME to mandate strict limitations on resident work hours. In an attempt to meet these limitations, we have switched from the previous Q3 call schedule to a specialized night float (NF) system, the continuity-care system (CCS). The purpose of this CCS is to maximize resident duty time spent on direct patient care, operative experience, and outpatient clinics, while reducing duty hours spent on performing routine tasks and call coverage. The implementation of the CCS is the fundamental step in the restructuring of our residency program. In addition to a change in the call system, we added physician assistants to aid in performing some service tasks. We performed a 360 degrees evaluation of this work in progress. In May 2002, the standard Q3 call system was abolished on the general surgery services at the New York Presbyterian Hospital, Columbia campus. Two dedicated teams were created to provide day and night coverage, a day continuity-care team (DCT) and a night continuity-care team (NCT). The DCTs, consisting of PGY1-5 residents, provide daily in-house coverage from 6 AM to 5 PM with no regular weekday night-call responsibilities. The DCT residents provide Friday night, Saturday, and daytime Sunday call coverage 3 to 4 days per month. The NCT, consisting of 5 PGY1-5 residents, provides nightly continuous care, 5 PM to 6 AM, Sunday through Thursday, with no other weekend call responsibilities. This system creates a schedule with less than 80 duty hours per week, on average, with one 24-hour period off a week, one complete weekend off per month, and no more than 24 hours of consecutive duty time. After 1 year of use, the system was evaluated by a 360 degrees method in which residents, residents' spouses, nurses, and faculty were surveyed using a Likert-type scale. Statistical significance was calculated using the Student t-test. Patient satisfaction was measured both by internal review of a patient complaint database as well as by the Press Ganey patient satisfaction surveys. Twenty-one residents, 10 residents' spouses, 11 general surgery faculty, and 16 nurses were surveyed. Statistically significant findings included reduced resident fatigue noted by all groups (residents, p = 0.01; resident spouses, p = 0.05; faculty, p < 0.0001; nurses, p < 0.0001). Further, residents reported more time for sleep at home (p = 0.0005) and more time for independent reading (p = 0.01). Residents' spouses reported increased availability for family events (p = 0.01). Nurses reported increased availability of residents (p = 0.0002), shorter times to physician identification of patient problems (p = 0.0086), improved resident-nursing communications (p = 0.0096), and increased ease of nursing duties (p < 0.0001). Faculty were the only responders who felt that continuity of patient care suffered with the new system (p = 0.02). The Press Ganey review showed improvement in the quality of care rendered as perceived by patients. The institution of a specialized NF or CCS for in-house coverage of general surgical services in a large metropolitan university hospital has had initial success in meeting the mandated changes in resident work hours. The CCS reduced resident fatigue, improved quality of resident life, and improved patient care as judged by patients and nurse.

  6. Catecholaminergic effects of prolonged head-down bed rest

    NASA Technical Reports Server (NTRS)

    Goldstein, D. S.; Vernikos, J.; Holmes, C.; Convertino, V. A.

    1995-01-01

    Prolonged head-down bed rest (HDBR) provides a model for examining responses to chronic weightlessness in humans. Eight healthy volunteers underwent HDBR for 2 wk. Antecubital venous blood was sampled for plasma levels of catechols [norepinephrine (NE), epinephrine, dopamine, dihydroxyphenylalanine, dihydroxyphenylglycol, and dihydroxyphenylacetic acid] after supine rest on a control (C) day and after 4 h and 7 and 14 days of HDBR. Urine was collected after 2 h of supine rest during day C, 2 h before HDBR, and during the intervals 1-4, 4-24, 144-168 (day 7), and 312-336 h (day 14) of HDBR. All subjects had decreased plasma and blood volumes (mean 16%), atriopeptin levels (31%), and peripheral venous pressure (26%) after HDBR. NE excretion on day 14 of HDBR was decreased by 35% from that on day C, without further trends as HDBR continued, whereas plasma levels were only variably and nonsignificantly decreased. Excretion rates of dihydroxyphenylglycol and dihydroxyphenylalanine decreased slightly during HDBR; excretion rates of epinephrine, dopamine, and dihydroxyphenylacetic acid and plasma levels of catechols were unchanged. The results suggest that HDBR produces sustained inhibition of sympathoneural release, turnover, and synthesis of NE without affecting adrenomedullary secretion or renal dopamine production. Concurrent hypovolemia probably interferes with detection of sympathoinhibition by plasma levels of NE and other catechols in this setting. Sympathoinhibition, despite decreased blood volume, may help to explain orthostatic intolerance in astronauts returning from spaceflights.

  7. 31 CFR 800.201 - Business day.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Business day. 800.201 Section 800.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF INVESTMENT... FOREIGN PERSONS Definitions § 800.201 Business day. The term business day means Monday through Friday...

  8. 31 CFR 800.201 - Business day.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Business day. 800.201 Section 800.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF INVESTMENT... FOREIGN PERSONS Definitions § 800.201 Business day. The term business day means Monday through Friday...

  9. 31 CFR 800.201 - Business day.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Business day. 800.201 Section 800.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF INVESTMENT... FOREIGN PERSONS Definitions § 800.201 Business day. The term business day means Monday through Friday...

  10. 31 CFR 800.201 - Business day.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Business day. 800.201 Section 800.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF INVESTMENT... FOREIGN PERSONS Definitions § 800.201 Business day. The term business day means Monday through Friday...

  11. Music intervention during daily weaning trials-A 6 day prospective randomized crossover trial.

    PubMed

    Liang, Zhan; Ren, Dianxu; Choi, JiYeon; Happ, Mary Beth; Hravnak, Marylyn; Hoffman, Leslie A

    2016-12-01

    To examine the effect of patient-selected music intervention during daily weaning trials for patients on prolonged mechanical ventilation. Using a crossover repeated measures design, patients were randomized to music vs no music on the first intervention day. Provision of music was alternated for 6 days, resulting in 3 music and 3 no music days. During weaning trials on music days, data were obtained for 30min prior to music listening and continued for 60min while patients listened to selected music (total 90min). On no music days, data were collected for 90min. Outcome measures were heart rate (HR), respiratory rate (RR), oxygen saturation (SpO 2 ), blood pressure (BP), dyspnea and anxiety assessed with a visual analog scale (VAS-D, VAS-A) and weaning duration (meanh per day on music and non-music days). Of 31 patients randomized, 23 completed the 6-day intervention. When comparisons were made between the 3 music and 3 no music days, there were significant decreases in RR and VAS-D and a significant increase in daily weaning duration on music days (p<0.05). A multivariate mixed-effects model analysis that included patients who completed ≥2 days of the intervention (n=28) demonstrated significant decreases in HR, RR, VAS-A, and VAS-D and a significant increase in daily weaning duration on music days (p<0.05). Providing patient selected music during daily weaning trials is a simple, low-cost, potentially beneficial intervention for patients on prolonged mechanical ventilation. Further study is indicated to test ability of this intervention to promote weaning success and benefits earlier in the weaning process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Multisite Study of an Implanted Continuous Glucose Sensor Over 90 Days in Patients With Diabetes Mellitus.

    PubMed

    Dehennis, Andrew; Mortellaro, Mark A; Ioacara, Sorin

    2015-07-29

    Continuous glucose monitoring (CGM), which enables real-time glucose display and trend information as well as real-time alarms, can improve glycemic control and quality of life in patients with diabetes mellitus. Previous reports have described strategies to extend the useable lifetime of a single sensor from 1-2 weeks to 28 days. The present multisite study describes the characterization of a sensing platform achieving 90 days of continuous use for a single, fully implanted sensor. The Senseonics CGM system is composed of a long-term implantable glucose sensor and a wearable smart transmitter. Study subjects underwent subcutaneous implantation of sensors in the upper arm. Eight-hour clinic sessions were performed every 14 days, during which sensor glucose values were compared against venous blood lab reference measurements collected every 15 minutes using mean absolute relative differences (MARDs). All subjects (mean ± standard deviation age: 43.5 ± 11.0 years; with 10 sensors inserted in men and 14 in women) had type 1 diabetes mellitus. Most (22 of 24) sensors reported glucose values for the entire 90 days. The MARD value was 11.4 ± 2.7% (range, 8.1-19.5%) for reference glucose values between 40-400 mg/dl. There was no significant difference in MARD throughout the 90-day study (P = .31). No serious adverse events were noted. The Senseonics CGM, composed of an implantable sensor, external smart transmitter, and smartphone app, is the first system that uses a single sensor for continuous display of accurate glucose values for 3 months. © 2015 Diabetes Technology Society.

  13. [Continuing training plan in a clinical management unit].

    PubMed

    Gamboa Antiñolo, Fernando Miguel; Bayol Serradilla, Elia; Gómez Camacho, Eduardo

    2011-01-01

    Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Continuous flow, explosives vapor generator and sensor chamber.

    PubMed

    Collins, Greg E; Giordano, Braden C; Sivaprakasam, Vasanthi; Ananth, Ramagopal; Hammond, Mark; Merritt, Charles D; Tucker, John E; Malito, Michael; Eversole, Jay D; Rose-Pehrsson, Susan

    2014-05-01

    A novel liquid injection vapor generator (LIVG) is demonstrated that is amenable to low vapor pressure explosives, 2,4,6-trinitrotoluene and hexahydro-1,3,5-trinitro-1,3,5-triazine. The LIVG operates in a continuous manner, providing a constant and stable vapor output over a period of days and whose concentration can be extended over as much as three orders of magnitude. In addition, a large test atmosphere chamber attached to the LIVG is described, which enables the generation of a stable test atmosphere with controllable humidity and temperature. The size of the chamber allows for the complete insertion of testing instruments or arrays of materials into a uniform test atmosphere, and various electrical feedthroughs, insertion ports, and sealed doors permit simple and effective access to the sample chamber and its vapor.

  15. Quick and continuous improvement through kaizen blitz.

    PubMed

    McNichols, T; Hassinger, R; Bapst, G W

    1999-05-01

    It is our objective to provide you with a step-by-step approach to conducting a kaizen blitz within two days and describe how to achieve dramatic performance improvement with employee buy-in through this process. Kaizen blitz has been used dozens of times by the authors, and in some instances the same area has been blitzed as many as four times, with significant improvements each and every time. Employees have even taken it on themselves to conduct informal blitzes as a continuing improvement effort after a formal blitz has been conducted in their area. Blitzes can succeed in a variety of environments. The morning after the employees of one company attended this presentation, they self initiated a mini-blitz and discovered opportunities for improvement that they enthusiastically presented to management.

  16. Establishment of an immortal turkey turbinate cell line suitable for avian metapneumovirus propagation.

    PubMed

    Kong, Byung-Whi; Foster, Linda K; Foster, Douglas N

    2007-07-01

    Until recently, there has not been a homologous avian cellular substrate which could continuously produce high titer avian metapneumovirus (AMPV); development of such a cell line should provide an excellent model system for studying AMPV infection. We have established a non-tumorigenic immortal turkey turbinate cell line (TT-1) to propagate sufficiently high AMPV titers. Currently, immortal TT-1 cells are growing continuously at 1.2-1.4 population doublings per day and are at passage 160. Kinetic analysis suggests that AMPV can infect and replicate more rapidly in TT-1 compared to Vero cells, although both cell types undergo apoptosis upon infection. The non-tumorigenic, reverse transcriptase negative TT-1 cell line can serve as an excellent homologous cellular substrate for virus propagation.

  17. Variance in direct exposure measures of typing force and wrist kinematics across hours and days among office computer workers.

    PubMed

    Asundi, Krishna; Johnson, Peter W; Dennerlein, Jack T

    2012-01-01

    To determine the number of direct measurements needed to obtain a representative estimate of typing force and wrist kinematics, continuous measures of keyboard reaction force and wrist joint angle were collected at the workstation of 22 office workers while they completed their own work over three days, six hours per day. Typing force and wrist kinematics during keyboard, mouse and idle activities were calculated for each hour of measurement along with variance in measurements between subjects and between day and hour within subjects. Variance in measurements between subjects was significantly greater than variance in measurements between days and hours within subjects. Therefore, we concluded a single, one-hour period of continuous measures is sufficient to identify differences in typing force and wrist kinematics between subjects. Within subjects, day and hour of measurement had a significant effect on some measures and thus should be accounted for when comparing measures within a subject. The dose response relationship between exposure to computer related biomechanical risk factors and musculoskeletal disorders is poorly understood due to the difficulty and cost of direct measures. This study demonstrates a single hour of direct continuous measures is sufficient to identify differences in wrist kinematics and typing force between individuals.

  18. Aerosolized Red Tide Toxins (Brevetoxins) and Asthma: Continued health effects after 1 hour beach exposure.

    PubMed

    Kirkpatrick, Barbara; Fleming, Lora E; Bean, Judy A; Nierenberg, Kate; Backer, Lorraine C; Cheng, Yung Sung; Pierce, Richard; Reich, Andrew; Naar, Jerome; Wanner, Adam; Abraham, William M; Zhou, Yue; Hollenbeck, Julie; Baden, Daniel G

    2011-01-01

    Blooms of the toxic dinoflagellate, Karenia brevis, produce potent neurotoxins in marine aerosols. Recent studies have demonstrated acute changes in both symptoms and pulmonary function in asthmatics after only 1 hour of beach exposure to these aerosols. This study investigated if there were latent and/or sustained effects in asthmatics in the days following the initial beach exposure during periods with and without an active Florida red tide.Symptom data and spirometry data were collected before and after 1 hour of beach exposure. Subjects kept daily symptom diaries and measured their peak flow each morning for 5 days following beach exposure. During non-exposure periods, there were no significant changes in symptoms or pulmonary function either acutely or over 5 days of follow-up. After the beach exposure during an active Florida red tide, subjects had elevated mean symptoms which did not return to the pre-exposure baseline for at least 4 days. The peak flow measurements decreased after the initial beach exposure, decreased further within 24 hours, and continued to be suppressed even after 5 days. Asthmatics may continue to have increased symptoms and delayed respiratory function suppression for several days after 1 hour of exposure to the Florida red tide toxin aerosols.

  19. Aerosolized Red Tide Toxins (Brevetoxins) and Asthma: Continued health effects after 1 hour beach exposure

    PubMed Central

    Kirkpatrick, Barbara; Fleming, Lora E; Bean, Judy A; Nierenberg, Kate; Backer, Lorraine C; Cheng, Yung Sung; Pierce, Richard; Reich, Andrew; Naar, Jerome; Wanner, Adam; Abraham, William M; Zhou, Yue; Hollenbeck, Julie; Baden, Daniel G

    2010-01-01

    Blooms of the toxic dinoflagellate, Karenia brevis, produce potent neurotoxins in marine aerosols. Recent studies have demonstrated acute changes in both symptoms and pulmonary function in asthmatics after only 1 hour of beach exposure to these aerosols. This study investigated if there were latent and/or sustained effects in asthmatics in the days following the initial beach exposure during periods with and without an active Florida red tide. Symptom data and spirometry data were collected before and after 1 hour of beach exposure. Subjects kept daily symptom diaries and measured their peak flow each morning for 5 days following beach exposure. During non-exposure periods, there were no significant changes in symptoms or pulmonary function either acutely or over 5 days of follow-up. After the beach exposure during an active Florida red tide, subjects had elevated mean symptoms which did not return to the pre-exposure baseline for at least 4 days. The peak flow measurements decreased after the initial beach exposure, decreased further within 24 hours, and continued to be suppressed even after 5 days. Asthmatics may continue to have increased symptoms and delayed respiratory function suppression for several days after 1 hour of exposure to the Florida red tide toxin aerosols. PMID:21499552

  20. Medical Monitoring during Short Radius Centrifugation in Bed-rested Subjects

    NASA Technical Reports Server (NTRS)

    Reinertson, Randal; Nelson, Victor; Aunon, Serena; Schlegel, Todd; Paloski, William

    2007-01-01

    The artificial gravity pilot project was designed to investigate the efficacy of daily exposure to a Gz acceleration gradient for counteracting the physiologic decrements induced by prolonged bed rest. A short radius centrifuge was used to produce a Gz gradient such that 1 g was applied at the level of the subject s heart and 2.5 g at the feet. For inclusion in the study, subjects were required to complete a 75-minute screening spin on the centrifuge. During the study, each active treatment subject was scheduled for a 60-minute spin each day for 20 consecutive days. During centrifugation, subjects were continuously monitored by a physician for signs and symptoms of pre-syncope, motion sickness, arrhythmias, joint/muscle pain and any other unanticipated problems. The physician was also present to provide emergency care in the case of a medical emergency. Cameras mounted on the centrifuge were used to provide a means of observing the subject s face and torso. Audio communication was continuously maintained. Other monitoring tools included two-lead EKG tracings, pulse oximetry, intermittent sphygmomanometer readings, lights in the peripheral visual field, and continuous blood pressure readout from a tonometry device. Thirty screening runs were attempted using twenty-seven subjects. Seven of these runs were terminated early for symptoms of pre-syncope, motion sickness, or GI distress. A total of eight subjects completed the active treatment arm of the study. Of the 160 centrifuge runs that were scheduled for these eight treatment subjects, 152 were completed, seven were terminated early, and one was not attempted. Of the seven early terminations, four were related to symptoms of pre-syncope, one to leg pain, one to GI discomfort, and one to equipment failure. Three terminations for adverse symptoms occurred on the first treatment day. Three terminations occurred on day nineteen of treatment and within 24 hours after scheduled soleus and quadriceps muscle biopsies. We have summarized the relative usefulness of the information obtained by the various monitoring modalities in making a decision to terminate a centrifuge run. The video and audio communication information was essential to the decision-making process. Heart rate and EKG tracings are considered valuable, even though no spins were terminated due to significant arrhythmias. The tonometer device was generally not reliable in this application. Our observations suggest that subjects may be less tolerant of centrifugation just after starting bed rest and after invasive procedures.

  1. Mandibular distraction osteogenesis with newly designed electromechanical distractor.

    PubMed

    Aykan, Andac; Ugurlutan, Rifat; Zor, Fatih; Ozturk, Serdar

    2014-07-01

    The purposes of this study were to design a fully automatic electromechanical distractor for continuous mandibular distraction osteogenesis and to investigate the efficacy of this newly developed distractor on sheep mandible model. Five sheep underwent unilateral mandibular osteotomy, and the mechanical component of electromechanical distractor was fixed on both sides of the osteotomy site using pins. After a 5-day latency period, the electromechanical distractor was activated at a rate of 0.30 mm per 8 hours using an electronic control unit. The bone was lengthened for 20 days without any intervention to the electromechanical distractor. The animals were killed on the sixth week of the consolidation period, and 5 distracted mandibles were examined through macroscopic observation and computed tomography. Distracted bone length was measured through computed tomography on sagittal slices. The device was tolerated by the distraction process without complications in all animals. New callus formation was observed on the distraction gap. Radiologic evaluation showed new callus formation in the distraction gap. New callus length was found to be, in average, 18.28 mm. In this preliminary study, a newly designed electromechanical distractor was successfully used for mandible distraction, which mainly provided a continuous lengthening during activation period spontaneously without any intervention. We think that the clinical application of this electromechanic distractor may provide patient comfort during distraction. Moreover, electromechanical distractor has the potential for high-resolution movement capacity when compared with annual distraction. The promising results from this prototype are encouraging to further investigations for human applications.

  2. Partial Nephrogenic Diabetes Insipidus in a Burned Patient Receiving Sevoflurane Sedation With an Anesthetic Conserving Device-A Case Report.

    PubMed

    Muyldermans, Marie; Jennes, Serge; Morrison, Stuart; Soete, Olivier; François, Pierre-Michel; Keersebilck, Elkana; Rose, Thomas; Pantet, Olivier

    2016-12-01

    To describe a case of partial nephrogenic diabetes insipidus in a burned patient after prolonged delivery of low inspired concentrations of sevoflurane via an Anesthetic Conserving Device. Clinical observation. Case report. Relevant clinical information. A 34-year-old man was admitted with burns covering 52% of his total body surface area. Mechanical ventilation was provided during sedation with continuous infusions of sufentanil and midazolam. Sedation became increasingly difficult, and in order to limit administration of IV agents, sevoflurane was added to the inspiratory gas flow. This was provided using an Anesthetic Conserving Device and continued for 8 days. The patient rapidly developed polyuria and hypernatremia with an inappropriate decrease in urinary osmolality. Administration of desmopressin resulted in only a modest effect on renal concentrating ability. After cessation of sevoflurane, all variables returned to normal within 5 days. The results of further investigations (cerebral computed tomographic scan, cerebral magnetic resonance imaging, and serum arginine vasopressin concentration) were compatible with a diagnosis of partial nephrogenic diabetes insipidus. The temporal sequence of clinical findings in relation to sevoflurane administration suggests that the sevoflurane was the probable underlying cause. Clinicians should be aware of the possibility of sevoflurane-induced diabetes insipidus not only during general anesthesia but also in the intensive care setting of sedation in critically ill patients. This is especially important in patients, such as those with severe burns, in whom preserved renal concentrating ability is important to ensure compensation for extrarenal fluid losses.

  3. Designing an Alternate Mission Operations Control Room

    NASA Technical Reports Server (NTRS)

    Montgomery, Patty; Reeves, A. Scott

    2014-01-01

    The Huntsville Operations Support Center (HOSC) is a multi-project facility that is responsible for 24x7 real-time International Space Station (ISS) payload operations management, integration, and control and has the capability to support small satellite projects and will provide real-time support for SLS launches. The HOSC is a service-oriented/ highly available operations center for ISS payloads-directly supporting science teams across the world responsible for the payloads. The HOSC is required to endure an annual 2-day power outage event for facility preventive maintenance and safety inspection of the core electro-mechanical systems. While complete system shut-downs are against the grain of a highly available sub-system, the entire facility must be powered down for a weekend for environmental and safety purposes. The consequence of this ground system outage is far reaching: any science performed on ISS during this outage weekend is lost. Engineering efforts were focused to maximize the ISS investment by engineering a suitable solution capable of continuing HOSC services while supporting safety requirements. The HOSC Power Outage Contingency (HPOC) System is a physically diversified compliment of systems capable of providing identified real-time services for the duration of a planned power outage condition from an alternate control room. HPOC was designed to maintain ISS payload operations for approximately three continuous days during planned HOSC power outages and support a local Payload Operations Team, International Partners, as well as remote users from the alternate control room located in another building.

  4. Calibration and use of continuous heat-type automated seepage meters for submarine groundwater discharge measurements

    USGS Publications Warehouse

    Mwashote, B.M.; Burnett, W.C.; Chanton, J.; Santos, I.R.; Dimova, N.; Swarzenski, P.W.

    2010-01-01

    Submarine groundwater discharge (SGD) assessments were conducted both in the laboratory and at a field site in the northeastern Gulf of Mexico, using a continuous heat-type automated seepage meter (seepmeter). The functioning of the seepmeter is based on measurements of a temperature gradient in the water between downstream and upstream positions in its flow pipe. The device has the potential of providing long-term, high-resolution measurements of SGD. Using a simple inexpensive laboratory set-up, we have shown that connecting an extension cable to the seepmeter has a negligible effect on its measuring capability. Similarly, the observed influence of very low temperature (???3 ??C) on seepmeter measurements can be accounted for by conducting calibrations at such temperatures prior to field deployments. Compared to manual volumetric measurements, calibration experiments showed that at higher water flow rates (>28 cm day-1 or cm3 cm-2 day-1) an analog flowmeter overestimated flow rates by ???7%. This was apparently due to flow resistance, turbulence and formation of air bubbles in the seepmeter water flow tubes. Salinity had no significant effect on the performance of the seepmeter. Calibration results from fresh water and sea water showed close agreement at a 95% confidence level significance between the data sets from the two media (R2 = 0.98). Comparatively, the seepmeter SGD measurements provided data that are comparable to manually-operated seepage meters, the radon geochemical tracer approach, and an electromagnetic (EM) seepage meter. ?? 2009 Elsevier Ltd.

  5. Update on perioperative care of the cardiac patient for noncardiac surgery.

    PubMed

    Ghadimi, Kamrouz; Thompson, Annemarie

    2015-06-01

    The current review will address key topics and recommendations of the recent 2014 update of the American College of Cardiology and American Heart Association clinical practice guideline for the perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery. The completely rewritten guideline provides a stepwise approach for the identification and management of patients at highest risk for major adverse cardiac events and discusses new or updated recommendations. For example, β-blockers should be continued perioperatively but treatment should not be initiated within 24 h of noncardiac surgery. Angiotensin-converting enzyme inhibitors should be continued, but if held, may be restarted as soon as feasible. Routine aspirin therapy is not recommended without previous coronary stent implantation or risk assessment for myocardial ischemia. Elective noncardiac surgery should not be performed within 30 days of bare metal stent or 12 months of drug-eluting stent implantation because of in-stent thrombosis as well as bleeding risk from dual antiplatelet therapy during surgery. Noncardiac surgery may be considered, however, in patients on antiplatelet agents 180 days after drug-eluting stent placement if risk of surgical delay exceeds risk of stent thrombosis from cessation of antiplatelet therapy. In conclusion, this review will discuss the important topics from the 2014 American College of Cardiology/American Heart Association guideline in order to provide the perioperative physician with the most recent evidence necessary to minimize major adverse cardiac events in patients undergoing noncardiac surgery.

  6. Sedimentary Evidence of Environmental Degradation in Sanliqi Lake, Daye City (A Typical Mining City, Central China).

    PubMed

    Zeng, Linghan; Ning, Dongliang; Xu, Lei; Mao, Xin; Chen, Xu

    2015-09-01

    To reconstruct the history of environmental degradation in Sanliqi Lake (Daye City, central China), multiple proxies were analyzed in a sedimentary core which was dated using (137)Cs and spheroidal carbonaceous particles (SCPs). The results show that Sanliqi Lake has experienced serious degradation during the past 60 years, resulting from a large influx of metals and nutrients. Expansion of agricultural and industrial activities between 1945 and 1993 enhanced nutrient and metal enrichment, indicated by increases in metals, SCPs, magnetic susceptibility, total phosphorus, total nitrogen and total organic carbon. Further enrichment of Zn, Cd, Ni and Cr after 1993 was linked to a recent intensification of mining activities. Decreases in Cu and Pb after 2006 probably resulted from recent environmental remediation. This study verified the coupling between lake sediment pollution and human activities in Daye City during the past 60 years. The reconstructed history of lake pollution can provide reference information for continued restoration of Sanliqi Lake and other similar heavily polluted lakes in the developing regions.

  7. The end of an era? Midwifery conferences.

    PubMed

    Vilain, Annette Dalsgaard; Stewart, Sarah

    2012-12-01

    It has long been accepted that conferences are a useful mode of continuous professional development (CPD) (Russell 2010). Midwives welcome the chance to learn about recent practice developments, and the opportunity to network with each other in a face to face environment. However, barriers such as geographical isolation, time and financial constraints restrict midwives' ability to attend conferences (McIntosh 2007; Patterson and Davis 2007). At the same time, the effectiveness of conferences for CPD has been questioned (Guskey 2000). In these days of financial retrenchment, CPD has to be innovative and creative, offering ongoing support and learning in communities of practice that meet individual learning needs. The Virtual International Day of the Midwife (VIDM) is one such innovation. It is an annual 24 hour international synchronous online conference that celebrates the International Day of the Midwife on 5th May, and is freely open to all. Using the VIDM as a case study, this article discusses how online conferences may support and provide CPD for midwives.

  8. Effect of 14 days of bed rest on urine metabolite excretion and plasma enzyme levels

    NASA Technical Reports Server (NTRS)

    Pace, N.; Grunbaum, B. W.; Kodama, A. M.; Rahlmann, D. F.; Newsom, B. D.

    1974-01-01

    After 1 week of ambulatory base-line measurement, a group of 8 men 19-26 years of age remained continuously recumbent for 14 days. Studies were continued for 1 week following the prolonged recumbency. Urine excretion rates for a number of constituents were determined 2 days before bed rest, on day 14 of bed rest, and day 6 after bed rest. Blood plasma samples were also obtained at these times, and analyzed for several enzymes. On day 14 of bed rest significant increases were observed in urine excretion of total osmotically-active substances, magnesium, calcium, phosphate, creatinine, hydroxyproline, and 17-OH corticosteroids. A decrease occurred in urinary glucose excretion. Plasma levels of alkaline phosphatase and LDH-3 were depressed, while plasma GPT was elevated. Many of these changes persisted on day 6 after bed rest, and are interpreted as concomitants of the disuse atrophy of the musculoskeletal system that characterizes prolonged bed rest and weightlessness.

  9. Racial Differences in Tobacco Cessation and Treatment Usage After Lung Screening: An Examination of the National Lung Screening Trial.

    PubMed

    Kumar, Pallavi; Gareen, Ilana F; Lathan, Christopher; Sicks, JoRean D; Perez, Giselle K; Hyland, Kelly A; Park, Elyse R

    2016-01-01

    Black smokers have demonstrated greater lung cancer disease burden and poorer smoking cessation outcomes compared with whites. Lung cancer screening represents a unique opportunity to promote cessation among smokers; however, little is known about the differential impact of screening on smoking behaviors among black and white smokers. Using data from the National Lung Screening Trial (NLST), we examined the racial differences in smoking behaviors after screening. We examined racial differences in smoking behavior and cessation activity among 6,316 white and 497 black (median age, 60 and 59 years, respectively) NLST participants who were current smokers at screening using a follow-up survey on 24-hour and 7-day quit attempts, 6-month continuous abstinence, and the use of smoking cessation programs and aids at 12 months after screening. Using multiple regression analyses, we examined the predictors of 24-hour and 7-day quit attempts and 6-month continuous abstinence. At 12 months after screening, blacks were more likely to report a 24-hour (52.7% vs. 41.2%, p < .0001) or 7-day (33.6% vs. 27.2%, p = .002) quit attempt. However, no significant racial differences were found in 6-month continuous abstinence (5.6% blacks vs. 7.2% whites). In multiple regression, black race was predictive of a higher likelihood of a 24-hour (odds ratio [OR], 1.6, 95% confidence interval [CI], 1.2-2.0) and 7-day (OR, 1.5, 95% CI, 1.1-1.8) quit attempt; however, race was not associated with 6-month continuous abstinence. Only a positive screening result for lung cancer was significantly predictive of successful 6-month continuous abstinence (OR, 2.3, 95% CI, 1.8-2.9). Although blacks were more likely than whites to have 24-hour and 7-day quit attempts, the rates of 6-month continuous abstinence did not differ. Targeted interventions are needed at the time of lung cancer screening to promote abstinence among all smokers. Among smokers undergoing screening for lung cancer, blacks were more likely than whites to have 24-hour and 7-day quit attempts; however, these attempts did not translate to increased rates of 6-month continuous abstinence among black smokers. Targeted interventions are needed at the time of lung cancer screening to convert quit attempts to sustained smoking cessation among all smokers. ©AlphaMed Press.

  10. Financial incentives to promote extended smoking abstinence in opioid-maintained patients: a randomized trial.

    PubMed

    Sigmon, Stacey C; Miller, Mollie E; Meyer, Andrew C; Saulsgiver, Kathryn; Badger, Gary J; Heil, Sarah H; Higgins, Stephen T

    2016-05-01

    Prior studies by our group demonstrated the efficacy of a brief but intensive behavioral intervention for producing initial smoking abstinence among opioid-dependent patients. In the present study, our aim was to promote longer-duration abstinence in this population. Following an initial 2-week incentive intervention for smoking abstinence, we examined whether a 10-week maintenance arm involving continuation of contingent reinforcement will produce greater smoking abstinence than a similar duration of noncontingent reinforcement. Randomized, 12-week, parallel-group study. Out-patient research clinic in Burlington, Vermont, USA. Opioid-maintained smokers (n = 88) who provided breath carbon monoxide and urinary cotinine specimens and received contingent reinforcement for smoking abstinence during weeks 1-2 (phase 1), with 63 randomized on day 14 to an extended contingent (EC; n = 31) or extended noncontingent (EN; n = 32) experimental condition for weeks 3-12 (phase 2). The EC condition consisted of voucher values that escalated across consecutive negative samples until they reached $30, after which they remained at $30 per negative sample. A positive or a missing sample resulted in no vouchers for that day and reset the value of the next negative same to $9. Two consecutive negatives returned the schedule to the pre-reset value. The EN control condition consisted of vouchers delivered for providing scheduled samples, but independent of smoking status. The primary outcome was percentage of biochemically abstinent samples during phase 2. Secondary measures included abstinence status at final study visit, complete abstinence, participants' longest duration of continuous abstinence, cotinine and carbon monoxide (CO) levels and self-reported cigarettes per day. EC participants achieved greater smoking abstinence during phase 2 than EN participants [46.7 versus 23.5% negative samples, respectively; odds ratio (OR) = 2.98, 95% confidence interval (CI) = 1.16-7.65, χ(2) 1  (=)  5.0, P = 0.02]. When longest duration of continuous abstinence was compared between experimental groups, EC participants achieved twice the mean duration of continuous abstinence compared with EN participants (3.31 versus 1.68 weeks; t61  = 1.83, P = 0.07). An effect of experimental condition was also seen on mean cotinine levels (42.5 versus 210.6 ng/ml, respectively; F1,61 =5.9, P = 0.02). Among opioid-maintained smokers receiving an initial period of daily contingent incentives, a contingent reinforcement intervention appears to be more effective at extending smoking abstinence than noncontingent reinforcement over 10 weeks. © 2015 Society for the Study of Addiction.

  11. Improving operational plume forecasts

    NASA Astrophysics Data System (ADS)

    Balcerak, Ernie

    2012-04-01

    Forecasting how plumes of particles, such as radioactive particles from a nuclear disaster, will be transported and dispersed in the atmosphere is an important but computationally challenging task. During the Fukushima nuclear disaster in Japan, operational plume forecasts were produced each day, but as the emissions continued, previous emissions were not included in the simulations used for forecasts because it became impractical to rerun the simulations each day from the beginning of the accident. Draxler and Rolph examine whether it is possible to improve plume simulation speed and flexibility as conditions and input data change. The authors use a method known as a transfer coefficient matrix approach that allows them to simulate many radionuclides using only a few generic species for the computation. Their simulations work faster by dividing the computation into separate independent segments in such a way that the most computationally time consuming pieces of the calculation need to be done only once. This makes it possible to provide real-time operational plume forecasts by continuously updating the previous simulations as new data become available. They tested their method using data from the Fukushima incident to show that it performed well. (Journal of Geophysical Research-Atmospheres, doi:10.1029/2011JD017205, 2012)

  12. Performance enhancement in a semi-autonomous confined microsociety

    NASA Technical Reports Server (NTRS)

    Brady, J. V.; Bernstein, D. J.; Foltin, R. W.; Nellis, M. J.

    1988-01-01

    Research in a continuously programmed human experimental laboratory has been directed toward identifying, defining, and expanding generalized knowledge concerning motivational factors within the structure of human behavioral repertoires that maintain and enhance performance. Participants (in groups of three) engaged in a series of repetitive work activities (e.g., word sorting and rug-hooking) for extended periods each day, while living continuously in a residential laboratory. Other parts of the day were spent either interacting socially with other participants or engaging in individual recreational activities. The percentage of time devoted to the various work tasks provided the basis for selecting one activity that occurred with high frequency and one with low frequency. Performance of the low-frequency activity was then required in order to gain access to the high-frequency activity. Under such contingencies, time devoted to the original low-frequency activity increased greatly, and the participants consistently did more than the required amount of the low-frequency work than was necessary to restore access to the restricted work activity. The theoretical significance of these findings resides in the clear demonstration that a time-based model of value applies as well to the enhancement of work-like performance as it does to voluntarily selected or preferred recreational activities.

  13. Social media for lifelong learning.

    PubMed

    Kind, Terry; Evans, Yolanda

    2015-04-01

    Learning is ongoing, and can be considered a social activity. In this paper we aim to provide a review of the use of social media for lifelong learning. We start by defining lifelong learning, drawing upon principles of continuous professional development and adult learning theory. We searched Embase and MEDLINE from 2004-2014 for search terms relevant to social media and learning. We describe examples of lifelong learners using social media in medical education and healthcare that have been reported in the peer-reviewed literature. Medical or other health professions students may have qualities consistent with being a lifelong learner, yet once individuals move beyond structured learning environments they will need to recognize their own gaps in knowledge and skills over time and be motivated to fill them, thereby incorporating lifelong learning principles into their day-to-day practice. Engagement with social media can parallel engagement in the learning process over time, to the extent that online social networking fosters feedback and collaboration. The use of social media and online networking platforms are a key way to continuously learn in today's information sharing society. Additional research is needed, particularly rigorous studies that extend beyond learner satisfaction to knowledge, behaviour change, and outcomes.

  14. Impact of interprofessional activities on health professions students' knowledge of community pharmacists' role and services.

    PubMed

    Vrontos, Emily B; Kuhn, Catherine H; Brittain, Kristy L

    2011-10-10

    To determine the impact of health professions students' participation in interprofessional activities on their knowledge of the roles of community pharmacists and community pharmacist-provided services. Students at the Medical University of South Carolina were surveyed via a self-administered online survey tool to determine their participation in interprofessional activities as well as their knowledge of the role of community pharmacists and community pharmacist-provided services. Over 600 students completed the survey instrument. Nonpharmacy students who attended the university-sponsored Interprofessional Day were more knowledgeable of pharmacist-provided services. Previous interaction with a pharmacist increased nonpharmacy students' awareness of the services that pharmacists provide. Participation in interprofessional activities increased health professions students' awareness of the role of pharmacists. Continued education among healthcare professions about the role of and services provided by pharmacists is needed to ensure that pharmacists have the greatest possible impact on patient care.

  15. Randomized comparison of bleeding patterns in women using a combined contraceptive vaginal ring or a low-dose combined oral contraceptive on a menstrually signaled regimen.

    PubMed

    Weisberg, Edith; Merki-Feld, Gabriele S; McGeechan, Kevin; Fraser, Ian S

    2015-02-01

    To compare bleeding patterns for 12 months continuous use of a contraceptive ring [contraceptive vaginal ring (CVR)] and pill [combined oral contraceptive (COC)] on a menstrually signaled regimen and the effectiveness of 4 days "treatment withdrawal" to stop bleeding. Women, 66 to each group, were randomized to continuous use of a CVR (15 mcg ethinyl estradiol/150 mcg etonogestrel) or a low-dose pill (20 mcg ethinyl estradiol/100 mcg levonorgestrel) for 360 days on a menstrually signaled regimen. Bleeding/spotting days, daily use of ring or pill, was recorded. Endpoint was the total number of bleeding/spotting days for each method over four 90-day reference periods (RP) plus the analysis of bleeding patterns using modified World Health Organization criteria. There was a reduction in the mean (±S.D.) number of bleeding/spotting days from RP1 (CVR 14.2±10; pill 16.6±10.9) to RP4 (CVR 8.8±9.6; pill 8.8±9.1). Fifteen percent of CVR and 4% COC users experienced amenorrhea or infrequent bleeding throughout the study. Amenorrhea increased over time (RP1 vs. RP4: CVR 10% vs. 21% and COC 2% vs. 30%). Compliance with the menstrually signaled regimen was poor. Ceasing hormones for 4 days stopped a bleeding episode within 5 days in the majority of episodes and many stopped spontaneously. Bleeding patterns with continuous use of the CVR and COC are similar and improve over 1 year of use. The unpredictability, but short duration, of bleeding episodes should be stressed during counseling. This information for clinicians and women about breakthrough bleeding patterns with use of a CVR or combined pill over 12 months using a menstrually signaled regimen will give women an indication of what to expect with continuous use. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Development of an Experimental Model to Study the Relationship Between Day-to-Day Variability in Blood Pressure and Aortic Stiffness

    PubMed Central

    Bouissou-Schurtz, Camille; Lindesay, Georges; Regnault, Véronique; Renet, Sophie; Safar, Michel E.; Molinie, Vincent; Dabire, Hubert; Bezie, Yvonnick

    2015-01-01

    We aimed to develop an animal model of long-term blood pressure variability (BPV) and to investigate its consequences on aortic damage. We hypothesized that day-to-day BPV produced by discontinuous treatment of spontaneously hypertensive rats (SHR) by valsartan may increase arterial stiffness. For that purpose, rats were discontinuously treated, 2 days a week, or continuously treated by valsartan (30 mg/kg/d in chow) or placebo. Telemetered BP was recorded during 2 min every 15 min, 3 days a week during 8 weeks to cover the full BP variations in response to the treatment schedule. Pulse wave velocity (PWV) and aortic structure evaluated by immunohistochemistry were investigated in a second set of rats treated under the same conditions. Continuous treatment with valsartan reduced systolic BP (SBP) and reversed the aortic structural alterations observed in placebo treated SHR (decrease of medial cross-sectional area). Discontinuous treatment with valsartan decreased SBP to a similar extent but increased the day-to-day BPV, short term BPV, diastolic blood pressure (DBP), and PWV as compared with continuous treatment. Despite no modifications in the elastin/collagen ratio and aortic thickness, an increase in PWV was observed following discontinuous treatment and was associated with a specific accumulation of fibronectin and its αv-integrin receptor compared with both groups of rats. Taken together the present results indicate that a discontinuous treatment with valsartan is able to induce a significant increase in day-to-day BPV coupled to an aortic phenotype close to that observed in hypertension. This experimental model should pave the way for future experimental and clinical studies aimed at assessing how long-term BPV increases aortic stiffness. PMID:26696902

  17. Continuous hydroponic wheat production using a recirculating system

    NASA Technical Reports Server (NTRS)

    Mackowiak, C. L.; Owens, L. P.; Hinkle, C. R.; Prince, R. P.

    1989-01-01

    Continuous crop production, where plants of various ages are growing simultaneously in a single recirculating nutrient solution, is a possible alternative to batch production in a Controlled Ecological Life Support System. A study was conducted at John F. Kennedy Space Center where 8 trays (0.24 sq m per tray) of Triticum aestivum L. Yecora Rojo were grown simultaneously in a growth chamber at 23 C, 65 percent relative humidity, 1000 ppm CO2, continuous light, with a continuous flow, thin film nutrient delivery system. The same modified Hoagland nutrient solution was recirculated through the plant trays from an 80 L reservoir throughout the study. It was maintained by periodic addition of water and nutrients based on chemical analyses of the solution. The study was conducted for 216 days, during which 24 trays of wheat were consecutively planted (one every 9 days), 16 of which were grown to maturity and harvested. The remaining 8 trays were harvested on day 216. Grain yields averaged 520 g m(exp -2), and had an average edible biomass of 32 percent. Consecutive yields were unaffected by nutrient solution age. It was concluded that continual wheat production will work in this system over an extended period of time. Certain micronutrient deficiencies and toxicities posed problems and must be addressed in future continuous production systems.

  18. Reasons for Trying E-cigarettes and Risk of Continued Use

    PubMed Central

    Kong, Grace; Cavallo, Dana A.; Camenga, Deepa R.; Krishnan-Sarin, Suchitra

    2016-01-01

    BACKGROUND: Longitudinal research is needed to identify predictors of continued electronic cigarette (e-cigarette) use among youth. We expected that certain reasons for first trying e-cigarettes would predict continued use over time (eg, good flavors, friends use), whereas other reasons would not predict continued use (eg, curiosity). METHODS: Longitudinal surveys from middle and high school students from fall 2013 (wave 1) and spring 2014 (wave 2) were used to examine reasons for trying e-cigarettes as predictors of continued e-cigarette use over time. Ever e-cigarette users (n = 340) at wave 1 were categorized into those using or not using e-cigarettes at wave 2. Among those who continued using e-cigarettes, reasons for trying e-cigarettes were examined as predictors of use frequency, measured as the number of days using e-cigarettes in the past 30 days at wave 2. Covariates included age, sex, race, and smoking of traditional cigarettes. RESULTS: Several reasons for first trying e-cigarettes predicted continued use, including low cost, the ability to use e-cigarettes anywhere, and to quit smoking regular cigarettes. Trying e-cigarettes because of low cost also predicted more days of e-cigarette use at wave 2. Being younger or a current smoker of traditional cigarettes also predicted continued use and more frequent use over time. CONCLUSIONS: Regulatory strategies such as increasing cost or prohibiting e-cigarette use in certain places may be important for preventing continued use in youth. In addition, interventions targeting current cigarette smokers and younger students may also be needed. PMID:27503349

  19. Reasons for Trying E-cigarettes and Risk of Continued Use.

    PubMed

    Bold, Krysten W; Kong, Grace; Cavallo, Dana A; Camenga, Deepa R; Krishnan-Sarin, Suchitra

    2016-09-01

    Longitudinal research is needed to identify predictors of continued electronic cigarette (e-cigarette) use among youth. We expected that certain reasons for first trying e-cigarettes would predict continued use over time (eg, good flavors, friends use), whereas other reasons would not predict continued use (eg, curiosity). Longitudinal surveys from middle and high school students from fall 2013 (wave 1) and spring 2014 (wave 2) were used to examine reasons for trying e-cigarettes as predictors of continued e-cigarette use over time. Ever e-cigarette users (n = 340) at wave 1 were categorized into those using or not using e-cigarettes at wave 2. Among those who continued using e-cigarettes, reasons for trying e-cigarettes were examined as predictors of use frequency, measured as the number of days using e-cigarettes in the past 30 days at wave 2. Covariates included age, sex, race, and smoking of traditional cigarettes. Several reasons for first trying e-cigarettes predicted continued use, including low cost, the ability to use e-cigarettes anywhere, and to quit smoking regular cigarettes. Trying e-cigarettes because of low cost also predicted more days of e-cigarette use at wave 2. Being younger or a current smoker of traditional cigarettes also predicted continued use and more frequent use over time. Regulatory strategies such as increasing cost or prohibiting e-cigarette use in certain places may be important for preventing continued use in youth. In addition, interventions targeting current cigarette smokers and younger students may also be needed. Copyright © 2016 by the American Academy of Pediatrics.

  20. Survival and growth of newly transformed Lampsilis cardium and Lampsilis siliquoidea in a flow-through, continuous feeding test system

    USGS Publications Warehouse

    Meinertz, Jeffery R.; Schreier, Theresa M.; Hess, Karina R.; Bartsch, Michelle

    2011-01-01

    A test system was evaluated for assessing chronic toxicity of waterborne chemicals with early life stage mussels. To determine if the test system could result in ≥80% survival in a control (unexposed) group, fat mucket mussels (Lampsilis siliquoidea Barnes, 1823) and plain pocketbook mussels (L. cardium Rafinesque, 1820) 1 day post transformation were stocked into test chambers (250 mL beakers, water volume, 200 mL, 21 °C, 40 mussels of 1 species per chamber) within a test system constructed for conducting chronic, continuous exposure, flow-through toxicity tests. The test system contained 60 chambers containing silica sand, 30 chambers with L. siliquoidea, and 30 with L. cardium. Each chamber in the continuous feeding system received 1 of 6 food types prepared with concentrated algal products. After 28 days, mussels were harvested from chambers to assess survival and growth. For L. siliquoidea, mean survival ranged from 34 to 80% and mean shell length ranged from 464 to 643 µm. For L. cardium, mean survival ranged from 12 to 66% and mean shell length ranged from 437 to 612 µm. The maximum mean growth rate for L. siliquoidea was 12.7 µm/d and for L. cardium was 11.8 µm/d. When offered a continuous diet of Nannochloropsis, Tetraselmis, and Chlorella for 28 days in the test system, the survival of 1 day post transformation L. siliquoidea was 80%. The test system can be easily enhanced with a pumping system continuously delivering test chemical to the test system's flow stream allowing for chronic toxicity tests with 1 day post transformation mussels.

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