Key Attributes of a Successful Physician Order Entry System Implementation in a Multi-hospital Environment

PubMed Central

Ahmad, Asif; Teater, Phyllis; Bentley, Thomas D.; Kuehn, Lynn; Kumar, Rajee R.; Thomas, Andrew; Mekhjian, Hagop S.

2002-01-01

The benefits of computerized physician order entry have been widely recognized, although few institutions have successfully installed these systems. Obstacles to successful implementation are organizational as well as technical. In the spring of 2000, following a 4-year period of planning and customization, a 9-month pilot project, and a 14-month hiatus for year 2000, the Ohio State University Health System extensively implemented physician order entry across inpatient units. Implementation for specialty and community services is targeted for completion in 2002. On implemented units, all orders are processed through the system, with 80 percent being entered by physicians and the rest by nursing or other licensed care providers. The system is deployable across diverse clinical environments, focused on physicians as the primary users, and accepted by clinicians. These are the three criteria by which the authors measured the success of their implementation. They believe that the availability of specialty-specific order sets, the engagement of physician leadership, and a large-scale system implementation were key strategic factors that enabled physician-users to accept a physician order entry system despite significant changes in workflow. PMID:11751800

Power User Interface

NASA Technical Reports Server (NTRS)

Pfister, Robin; McMahon, Joe

2006-01-01

Power User Interface 5.0 (PUI) is a system of middleware, written for expert users in the Earth-science community, PUI enables expedited ordering of data granules on the basis of specific granule-identifying information that the users already know or can assemble. PUI also enables expert users to perform quick searches for orderablegranule information for use in preparing orders. PUI 5.0 is available in two versions (note: PUI 6.0 has command-line mode only): a Web-based application program and a UNIX command-line- mode client program. Both versions include modules that perform data-granule-ordering functions in conjunction with external systems. The Web-based version works with Earth Observing System Clearing House (ECHO) metadata catalog and order-entry services and with an open-source order-service broker server component, called the Mercury Shopping Cart, that is provided separately by Oak Ridge National Laboratory through the Department of Energy. The command-line version works with the ECHO metadata and order-entry process service. Both versions of PUI ultimately use ECHO to process an order to be sent to a data provider. Ordered data are provided through means outside the PUI software system.

Orion Entry Monitor

NASA Technical Reports Server (NTRS)

Smith, Kelly M.

2016-01-01

NASA is scheduled to launch the Orion spacecraft atop the Space Launch System on Exploration Mission 1 in late 2018. When Orion returns from its lunar sortie, it will encounter Earth's atmosphere with speeds in excess of 11 kilometers per second, and Orion will attempt its first precision-guided skip entry. A suite of flight software algorithms collectively called the Entry Monitor has been developed in order to enhance crew situational awareness and enable high levels of onboard autonomy. The Entry Monitor determines the vehicle capability footprint in real-time, provides manual piloting cues, evaluates landing target feasibility, predicts the ballistic instantaneous impact point, and provides intelligent recommendations for alternative landing sites if the primary landing site is not achievable. The primary engineering challenges of the Entry Monitor is in the algorithmic implementation in making a highly reliable, efficient set of algorithms suitable for onboard applications.

Aerodynamic and Aerothermal TPS Instrumentation Reference Guide

NASA Technical Reports Server (NTRS)

Woollard, Bryce A.; Braun, Robert D.; Bose, Deepack

2016-01-01

The hypersonic regime of planetary entry combines the most severe environments that an entry vehicle will encounter with the greatest amount of uncertainty as to the events unfolding during that time period. This combination generally leads to conservatism in the design of an entry vehicle, specifically that of the thermal protection system (TPS). Each planetary entry provides a valuable aerodynamic and aerothermal testing opportunity; the utilization of this opportunity is paramount in better understanding how a specific entry vehicle responds to the demands of the hypersonic entry environment. Previous efforts have been made to instrument entry vehicles in order to collect data during the entry period and reconstruct the corresponding vehicle response. The purpose of this paper is to cumulatively document past TPS instrumentation designs for applicable planetary missions, as well as to list pertinent results and any explainable shortcomings.

Outpatient CPOE orders discontinued due to 'erroneous entry': prospective survey of prescribers' explanations for errors.

PubMed

Hickman, Thu-Trang T; Quist, Arbor Jessica Lauren; Salazar, Alejandra; Amato, Mary G; Wright, Adam; Volk, Lynn A; Bates, David W; Schiff, Gordon

2018-04-01

Computerised prescriber order entry (CPOE) systems users often discontinue medications because the initial order was erroneous. To elucidate error types by querying prescribers about their reasons for discontinuing outpatient medication orders that they had self-identified as erroneous. During a nearly 3 year retrospective data collection period, we identified 57 972 drugs discontinued with the reason 'Error (erroneous entry)." Because chart reviews revealed limited information about these errors, we prospectively studied consecutive, discontinued erroneous orders by querying prescribers in near-real-time to learn more about the erroneous orders. From January 2014 to April 2014, we prospectively emailed prescribers about outpatient drug orders that they had discontinued due to erroneous initial order entry. Of 2 50 806 medication orders in these 4 months, 1133 (0.45%) of these were discontinued due to error. From these 1133, we emailed 542 unique prescribers to ask about their reason(s) for discontinuing these mediation orders in error. We received 312 responses (58% response rate). We categorised these responses using a previously published taxonomy. The top reasons for these discontinued erroneous orders included: medication ordered for wrong patient (27.8%, n=60); wrong drug ordered (18.5%, n=40); and duplicate order placed (14.4%, n=31). Other common discontinued erroneous orders related to drug dosage and formulation (eg, extended release versus not). Oxycodone (3%) was the most frequent drug discontinued error. Drugs are not infrequently discontinued 'in error.' Wrong patient and wrong drug errors constitute the leading types of erroneous prescriptions recognised and discontinued by prescribers. Data regarding erroneous medication entries represent an important source of intelligence about how CPOE systems are functioning and malfunctioning, providing important insights regarding areas for designing CPOE more safely in the future. © 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.

A programmable rules engine to provide clinical decision support using HTML forms.

PubMed

Heusinkveld, J; Geissbuhler, A; Sheshelidze, D; Miller, R

1999-01-01

The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser.

Study of advanced atmospheric entry systems for Mars

NASA Technical Reports Server (NTRS)

1978-01-01

Entry system designs are described for various advanced Mars missions including sample return, hard lander, and Mars airplane. The Mars exploration systems for sample return and the hard lander require decleration from direct approach entry velocities of about 6 km/s to terminal velocities consistent with surface landing requirements. The Mars airplane entry system is decelerated from orbit at 4.6 km/s to deployment near the surface. Mass performance characteristics of major elements of the Mass performance characteristics are estimated for the major elements of the required entry systems using Viking technology or logical extensions of technology in order to provide a common basis of comparison for the three entry modes mission mode approaches. The entry systems, although not optimized, are based on Viking designs and reflect current hardware performance capability and realistic mass relationships.

Implementation of a simple electronic transfusion alert system decreases inappropriate ordering of packed red blood cells and plasma in a multi-hospital health care system.

PubMed

Smith, Matthew; Triulzi, Darrell J; Yazer, Mark H; Rollins-Raval, Marian A; Waters, Jonathan H; Raval, Jay S

2014-12-01

Prescriber adherence to institutional blood component ordering guidelines can be low. The goal of this study was to decrease red blood cell (RBC) and plasma orders that did not meet institutional transfusion guidelines by using data within the laboratory information system to trigger alerts in the computerized order entry (CPOE) system at the time of order entry. At 10 hospitals within a regional health care system, discernment rules were created for RBC and plasma orders utilizing transfusion triggers of hemoglobin <8 gm/dl and INR >1.6, respectively, with subsequent alert generation that appears within the CPOE system when a prescriber attempts to order RBCs or plasma on a patient whose antecedent laboratory values do not suggest that a transfusion is indicated. Orders and subsequent alerts were tracked for RBCs and plasma over evaluation periods of 15 and 10 months, respectively, along with the hospital credentials of the ordering health care providers (physician or nurse). Alerts triggered which were heeded remained steady and averaged 11.3% for RBCs and 19.6% for plasma over the evaluation periods. Overall, nurses and physicians canceled statistically identical percentages of alerted RBC (10.9% vs. 11.5%; p = 0.78) and plasma (21.3% vs. 18.7%; p = 0.22) orders. Implementing a simple evidence-based transfusion alert system at the time of order entry decreased non-evidence based transfusion orders by both nurse and physician providers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ada Quality and Style: Guidelines for Professional Programmers

DTIC Science & Technology

1991-01-01

occured because entry queues are serviced in FIFO order, not by priority. There is another situation referred to as a race condition. A program like the...the value of ’COUNT. A task can be removed from an entry queue due to execution of an abort statement as well as expiration of a timed entry call. The...is not defined by the language and may vary from time sliced to preemptive priority. Some implementations (e.g., VAX Ada) provide several choices

Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units.

PubMed

Hoonakker, Peter L T; Carayon, Pascale; Brown, Roger L; Cartmill, Randi S; Wetterneck, Tosha B; Walker, James M

2013-01-01

Implementation of Computerized Provider Order Entry (CPOE) has many potential advantages. Despite the potential benefits of CPOE, several attempts to implement CPOE systems have failed or met with high levels of user resistance. Implementation of CPOE can fail or meet high levels of user resistance for a variety of reasons, including lack of attention to users' needs and the significant workflow changes required by CPOE. User satisfaction is a critical factor in information technology implementation. Little is known about how end-user satisfaction with CPOE changes over time. To examine ordering provider and nurse satisfaction with CPOE implementation over time. We conducted a repeated cross-sectional questionnaire survey in four intensive care units of a large hospital. We analyzed the questionnaire data as well as the responses to two open-ended questions about advantages and disadvantages of CPOE. Users were moderately satisfied with CPOE and there were interesting differences between user groups: ordering providers and nurses. User satisfaction with CPOE did not change over time for providers, but it did improve significantly for nurses. Results also show that nurses and providers are satisfied with different aspects of CPOE.

An organizational field approach to resource environments in healthcare: comparing entries of hospitals and home health agencies in the San Francisco Bay region.

PubMed

Ruef, M; Mendel, P; Scott, W R

1998-02-01

To draw together insights from three perspectives (health economics, organizational ecology, and institutional theory) in order to clarify the factors that influence entries of providers into healthcare markets. A model centered on the concept of an organizational field is advanced as the level of analysis best suited to examining the assortment and interdependence of organizational populations and the institutional forces that shape this co-evolution. In particular, the model argues that: (1) different populations of healthcare providers partition fiscal, geographic, and demographic resource environments in order to ameliorate competition and introduce service complementarities; and (2) competitive barriers to entry within populations of providers vary systematically with regulatory regimens. County-level entries of hospitals and home health agencies in the San Francisco Bay Area using data from the American Hospital Association (1945-1991) and California's Office of Statewide Health Planning and Development (1976-1991). Characteristics of the resource environment are derived from the Area Resource File (ARF) and selected government censuses. A comparative design is applied to contrast influences on hospital and home health agency entries during the post-World War II period. Empirical estimates are obtained using Poisson and negative binomial regression models. Hospital and HHA markets are partitioned primarily by the age and education of consumers and, to a lesser extent, by urbanization levels and public funding expenditures. Such resource partitioning allows independent HHAs to exist comfortably in concentrated hospital markets. For both hospitals and HHAs, the barriers to entry once generated by oligopolistic concentration have declined noticeably with the market-oriented reforms of the past 15 years. A field-level perspective demonstrates that characteristics of local resource environments interact with interdependencies of provider populations and broader regulatory regimes to affect significantly the types of provider organizations likely to enter a given healthcare market.

An organizational field approach to resource environments in healthcare: comparing entries of hospitals and home health agencies in the San Francisco Bay region.

PubMed Central

Ruef, M; Mendel, P; Scott, W R

1998-01-01

OBJECTIVE: To draw together insights from three perspectives (health economics, organizational ecology, and institutional theory) in order to clarify the factors that influence entries of providers into healthcare markets. A model centered on the concept of an organizational field is advanced as the level of analysis best suited to examining the assortment and interdependence of organizational populations and the institutional forces that shape this co-evolution. In particular, the model argues that: (1) different populations of healthcare providers partition fiscal, geographic, and demographic resource environments in order to ameliorate competition and introduce service complementarities; and (2) competitive barriers to entry within populations of providers vary systematically with regulatory regimens. DATA SOURCES: County-level entries of hospitals and home health agencies in the San Francisco Bay Area using data from the American Hospital Association (1945-1991) and California's Office of Statewide Health Planning and Development (1976-1991). Characteristics of the resource environment are derived from the Area Resource File (ARF) and selected government censuses. METHODS OF ANALYSIS: A comparative design is applied to contrast influences on hospital and home health agency entries during the post-World War II period. Empirical estimates are obtained using Poisson and negative binomial regression models. RESULTS: Hospital and HHA markets are partitioned primarily by the age and education of consumers and, to a lesser extent, by urbanization levels and public funding expenditures. Such resource partitioning allows independent HHAs to exist comfortably in concentrated hospital markets. For both hospitals and HHAs, the barriers to entry once generated by oligopolistic concentration have declined noticeably with the market-oriented reforms of the past 15 years. CONCLUSION: A field-level perspective demonstrates that characteristics of local resource environments interact with interdependencies of provider populations and broader regulatory regimes to affect significantly the types of provider organizations likely to enter a given healthcare market. PMID:9460486

Computerised pathology test order entry reduces laboratory turnaround times and influences tests ordered by hospital clinicians: a controlled before and after study

PubMed Central

Westbrook, J I; Georgiou, A; Dimos, A; Germanos, T

2006-01-01

Objective To assess the impact of a computerised pathology order entry system on laboratory turnaround times and test ordering within a teaching hospital. Methods A controlled before and after study compared test assays ordered from 11 wards two months before (n = 97 851) and after (n = 113 762) the implementation of a computerised pathology order entry system (Cerner Millennium Powerchart). Comparisons were made of laboratory turnaround times, frequency of tests ordered and specimens taken, proportions of patients having tests, average number per patient, and percentage of gentamicin and vancomycin specimens labelled as random. Results Intervention wards experienced an average decrease in turnaround of 15.5 minutes/test assay (range 73.8 to 58.3 minutes; p<0.001). Reductions were significant for prioritised and non‐prioritised tests, and for those done within and outside business hours. There was no significant change in the average number of tests (p = 0.228), or specimens per patient (p = 0.324), and no change in turnaround time for the control ward (p = 0.218). Use of structured order screens enhanced data provided to laboratories. Removing three test assays from the liver function order set resulted in significantly fewer of these tests being done. Conclusions Computerised order entry systems are an important element in achieving faster test results. These systems can influence test ordering patterns through structured order screens, manipulation of order sets, and analysis of real time data to assess the impact of such changes, not possible with paper based systems. The extent to which improvements translate into improved patient outcomes remains to be determined. A potentially limiting factor is clinicians' capacity to respond to, and make use of, faster test results. PMID:16461564

A programmable rules engine to provide clinical decision support using HTML forms.

PubMed Central

Heusinkveld, J.; Geissbuhler, A.; Sheshelidze, D.; Miller, R.

1999-01-01

The authors have developed a simple method for specifying rules to be applied to information on HTML forms. This approach allows clinical experts, who lack the programming expertise needed to write CGI scripts, to construct and maintain domain-specific knowledge and ordering capabilities within WizOrder, the order-entry and decision support system used at Vanderbilt Hospital. The clinical knowledge base maintainers use HTML editors to create forms and spreadsheet programs for rule entry. A test environment has been developed which uses Netscape to display forms; the production environment displays forms using an embedded browser. Images Figure 1 PMID:10566470

Using intranet-based order sets to standardize clinical care and prepare for computerized physician order entry.

PubMed

Heffner, John E; Brower, Kathleen; Ellis, Rosemary; Brown, Shirley

2004-07-01

The high cost of computerized physician order entry (CPOE) and physician resistance to standardized care have delayed implementation. An intranet-based order set system can provide some of CPOE's benefits and offer opportunities to acculturate physicians toward standardized care. INTRANET CLINICIAN ORDER FORMS (COF): The COF system at the Medical University of South Carolina (MUSC) allows caregivers to enter and print orders through the intranet at points of care and to access decision support resources. Work on COF began in March 2000 with transfer of 25 MUSC paper-based order set forms to an intranet site. Physician groups developed additional order sets, which number more than 200. Web traffic increased progressively during a 24-month period, peaking at more than 6,400 hits per month to COF. Decision support tools improved compliance with Centers for Medicare & Medicaid Services core indicators. Clinicians demonstrated a willingness to develop and use order sets and decision support tools posted on the COF site. COF provides a low-cost method for preparing caregivers and institutions to adopt CPOE and standardization of care. The educational resources, relevant links to external resources, and communication alerts will all link to CPOE, thereby providing a head start in CPOE implementation.

77 FR 28647 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-15

... calculating the ratio between (i) entered orders, weighted by the distance of the order from the national best... with an ``Order Entry Ratio'' of more than 100. The Order Entry Ratio is calculated, and the Excess Order Fee imposed, on a monthly basis. For each MPID, the Order Entry Ratio is the ratio of (i) the MPID...

Impact of a Commercially Available Clinical Decision Support Program on Provider Ordering Habits.

PubMed

Huber, Timothy C; Krishnaraj, Arun; Patrie, James; Gaskin, Cree M

2018-05-18

Clinical decision support (CDS) software designed around the ACR Appropriateness Criteria assists health care providers in choosing appropriate imaging studies at the time of order entry. The goal of this study was to determine the impact of commercially available CDS on the ordering habits of inpatient and emergency providers. In 2014, ACR Select was integrated into our electronic health record, though without displaying appropriateness scores in a "silent" mode for 6 months. Then, feedback regarding examination appropriateness was "turned on" at order entry for adult patients in the emergency and inpatient settings for 24 months. We retrospectively compared the appropriateness scores of imaging tests before and after displaying feedback at order entry and evaluated these data by modality and attending versus trainee status. The commercially available CDS-generated scores for 34% and 20.4% of pre- and postintervention studies, respectively. After feedback, the relative frequency of low utility studies decreased to 5.4% from 11%, and the relative frequency of indicated studies increased to 82% from 64.5%. This was most pronounced in trainees for whom the percentage of low utility studies decreased from 10.8% (95% confidence interval [CI]: 10.0%, 11.7%) to 4.8% (95% CI: 4.4%, 5.2%) and the percentage of indicated studies increased from 65.6% (95% CI: 64.3%, 66.9%) to 83.7% (83.0%, 84.3%). After implementation of a commercially available decision support tool integrated into the electronic health record, there was a significant improvement in imaging study appropriateness scores, more pronounced in studies ordered by trainees. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events?

PubMed

Charles, Krista; Cannon, Margaret; Hall, Robert; Coustasse, Alberto

2014-01-01

Computerized provider order entry (CPOE) systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology. This study followed a methodology using the basic principles of a systematic review and referenced 50 sources. CPOE systems in hospitals were found to be capable of reducing medical errors and ADEs, especially when CPOE systems are bundled with clinical decision support systems designed to alert physicians and other healthcare providers of pending lab or medical errors. However, CPOE systems face major barriers associated with adoption in a hospital system, mainly high implementation costs and physicians' resistance to change.

HL7 Structured Product Labeling - electronic prescribing information for provider order entry decision support.

PubMed

Schadow, Gunther

2005-01-01

Prescribing errors are an important cause of adverse events, and lack of knowledge of the drug is a root cause for prescribing errors. The FDA is issuing new regulations that will make the drug labels much more useful not only to physicians, but also to computerized order entry systems that support physicians to practice safe prescribing. For this purpose, FDA works with HL7 to create the Structured Product Label (SPL) standard that includes a document format as well as a drug knowledge representation, this poster introduces the basic concepts of SPL.

75 FR 36132 - Self-Regulatory Organizations; NASDAQ OMX PHLX, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... Change The Exchange proposes to clarify the definition of ``Directed Order'' in Rule 1080(l)(i)(A) by... ``Order Flow Provider'' is proposed to be made in Rule 1080(l)(i)(B). Second, amendments to Rule 1080(b)(i... opening orders to the list of eligible orders in Rule 1080(b)(i), as order types eligible for entry into...

75 FR 72855 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

... . NASDAQ has safeguards in place to protect the market from inadvertent entry of large orders. Each member that requests connectivity through an order entry port is required to specify the maximum order size... and procedures in place to ensure the proper entry and monitoring of orders entered into NASDAQ...

Mixed results in the safety performance of computerized physician order entry.

PubMed

Metzger, Jane; Welebob, Emily; Bates, David W; Lipsitz, Stuart; Classen, David C

2010-04-01

Computerized physician order entry is a required feature for hospitals seeking to demonstrate meaningful use of electronic medical record systems and qualify for federal financial incentives. A national sample of sixty-two hospitals voluntarily used a simulation tool designed to assess how well safety decision support worked when applied to medication orders in computerized order entry. The simulation detected only 53 percent of the medication orders that would have resulted in fatalities and 10-82 percent of the test orders that would have caused serious adverse drug events. It is important to ascertain whether actual implementations of computerized physician order entry are achieving goals such as improved patient safety.

Entry, Descent and Landing Systems Analysis: Exploration Class Simulation Overview and Results

NASA Technical Reports Server (NTRS)

DwyerCianciolo, Alicia M.; Davis, Jody L.; Shidner, Jeremy D.; Powell, Richard W.

2010-01-01

NASA senior management commissioned the Entry, Descent and Landing Systems Analysis (EDL-SA) Study in 2008 to identify and roadmap the Entry, Descent and Landing (EDL) technology investments that the agency needed to make in order to successfully land large payloads at Mars for both robotic and exploration or human-scale missions. The year one exploration class mission activity considered technologies capable of delivering a 40-mt payload. This paper provides an overview of the exploration class mission study, including technologies considered, models developed and initial simulation results from the EDL-SA year one effort.

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

Evaluation and implementation of chemotherapy regimen validation in an electronic health record.

PubMed

Diaz, Amber H; Bubalo, Joseph S

2014-12-01

Computerized provider order entry of chemotherapy regimens is quickly becoming the standard for prescribing chemotherapy in both inpatient and ambulatory settings. One of the difficulties with implementation of chemotherapy regimen computerized provider order entry lies in verifying the accuracy and completeness of all regimens built in the system library. Our goal was to develop, implement, and evaluate a process for validating chemotherapy regimens in an electronic health record. We describe our experience developing and implementing a process for validating chemotherapy regimens in the setting of a standard, commercially available computerized provider order entry system. The pilot project focused on validating chemotherapy regimens in the adult inpatient oncology setting and adult ambulatory hematologic malignancy setting. A chemotherapy regimen validation process was defined as a result of the pilot project. Over a 27-week pilot period, 32 chemotherapy regimens were validated using the process we developed. Results of the study suggest that by validating chemotherapy regimens, the amount of time spent by pharmacists in daily chemotherapy review was decreased. In addition, the number of pharmacist modifications required to make regimens complete and accurate were decreased. Both physician and pharmacy disciplines showed improved satisfaction and confidence levels with chemotherapy regimens after implementation of the validation system. Chemotherapy regimen validation required a considerable amount of planning and time but resulted in increased pharmacist efficiency and improved provider confidence and satisfaction. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

System Level Aerothermal Testing for the Adaptive Deployable Entry and Placement Technology (ADEPT)

NASA Technical Reports Server (NTRS)

Cassell, Alan; Gorbunov, Sergey; Yount, Bryan; Prabhu, Dinesh; de Jong, Maxim; Boghozian, Tane; Hui, Frank; Chen, Y.-K.; Kruger, Carl; Poteet, Carl;

A framework for analyzing the cognitive complexity of computer-assisted clinical ordering.

PubMed

Horsky, Jan; Kaufman, David R; Oppenheim, Michael I; Patel, Vimla L

2003-01-01

Computer-assisted provider order entry is a technology that is designed to expedite medical ordering and to reduce the frequency of preventable errors. This paper presents a multifaceted cognitive methodology for the characterization of cognitive demands of a medical information system. Our investigation was informed by the distributed resources (DR) model, a novel approach designed to describe the dimensions of user interfaces that introduce unnecessary cognitive complexity. This method evaluates the relative distribution of external (system) and internal (user) representations embodied in system interaction. We conducted an expert walkthrough evaluation of a commercial order entry system, followed by a simulated clinical ordering task performed by seven clinicians. The DR model was employed to explain variation in user performance and to characterize the relationship of resource distribution and ordering errors. The analysis revealed that the configuration of resources in this ordering application placed unnecessarily heavy cognitive demands on the user, especially on those who lacked a robust conceptual model of the system. The resources model also provided some insight into clinicians' interactive strategies and patterns of associated errors. Implications for user training and interface design based on the principles of human-computer interaction in the medical domain are discussed.

Knowledge Translation of the PERC Rule for Suspected Pulmonary Embolism: A Blueprint for Reducing the Number of CT Pulmonary Angiograms.

PubMed

Drescher, Michael J; Fried, Jeremy; Brass, Ryan; Medoro, Amanda; Murphy, Timothy; Delgado, João

2017-10-01

Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction). Patient characteristics were similar for both periods. Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.

17 CFR 10.7 - Date of entry of orders.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Date of entry of orders. 10.7 Section 10.7 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES OF PRACTICE General Provisions § 10.7 Date of entry of orders. In computing any period of time involving the date of...

Dynamic Oligomerization of Integrase Orchestrates HIV Nuclear Entry.

PubMed

Borrenberghs, Doortje; Dirix, Lieve; De Wit, Flore; Rocha, Susana; Blokken, Jolien; De Houwer, Stéphanie; Gijsbers, Rik; Christ, Frauke; Hofkens, Johan; Hendrix, Jelle; Debyser, Zeger

2016-11-10

Nuclear entry is a selective, dynamic process granting the HIV-1 pre-integration complex (PIC) access to the chromatin. Classical analysis of nuclear entry of heterogeneous viral particles only yields averaged information. We now have employed single-virus fluorescence methods to follow the fate of single viral pre-integration complexes (PICs) during infection by visualizing HIV-1 integrase (IN). Nuclear entry is associated with a reduction in the number of IN molecules in the complexes while the interaction with LEDGF/p75 enhances IN oligomerization in the nucleus. Addition of LEDGINs, small molecule inhibitors of the IN-LEDGF/p75 interaction, during virus production, prematurely stabilizes a higher-order IN multimeric state, resulting in stable IN multimers resistant to a reduction in IN content and defective for nuclear entry. This suggests that a stringent size restriction determines nuclear pore entry. Taken together, this work demonstrates the power of single-virus imaging providing crucial insights in HIV replication and enabling mechanism-of-action studies.

Ordering the Senses in a Monolingual Dictionary Entry.

ERIC Educational Resources Information Center

Gold, David L.

1986-01-01

Reviews issues to be considered in determining the order of meanings for a lexeme in a dictionary entry and compares techniques for deciding order. Types of ordering include importance, frequency, logical ordering, dominant meaning, syntactic, and historical. (MSE)

Learning analytics: Dataset for empirical evaluation of entry requirements into engineering undergraduate programs in a Nigerian university.

PubMed

Odukoya, Jonathan A; Popoola, Segun I; Atayero, Aderemi A; Omole, David O; Badejo, Joke A; John, Temitope M; Olowo, Olalekan O

2018-04-01

In Nigerian universities, enrolment into any engineering undergraduate program requires that the minimum entry criteria established by the National Universities Commission (NUC) must be satisfied. Candidates seeking admission to study engineering discipline must have reached a predetermined entry age and met the cut-off marks set for Senior School Certificate Examination (SSCE), Unified Tertiary Matriculation Examination (UTME), and the post-UTME screening. However, limited effort has been made to show that these entry requirements eventually guarantee successful academic performance in engineering programs because the data required for such validation are not readily available. In this data article, a comprehensive dataset for empirical evaluation of entry requirements into engineering undergraduate programs in a Nigerian university is presented and carefully analyzed. A total sample of 1445 undergraduates that were admitted between 2005 and 2009 to study Chemical Engineering (CHE), Civil Engineering (CVE), Computer Engineering (CEN), Electrical and Electronics Engineering (EEE), Information and Communication Engineering (ICE), Mechanical Engineering (MEE), and Petroleum Engineering (PET) at Covenant University, Nigeria were randomly selected. Entry age, SSCE aggregate, UTME score, Covenant University Scholastic Aptitude Screening (CUSAS) score, and the Cumulative Grade Point Average (CGPA) of the undergraduates were obtained from the Student Records and Academic Affairs unit. In order to facilitate evidence-based evaluation, the robust dataset is made publicly available in a Microsoft Excel spreadsheet file. On yearly basis, first-order descriptive statistics of the dataset are presented in tables. Box plot representations, frequency distribution plots, and scatter plots of the dataset are provided to enrich its value. Furthermore, correlation and linear regression analyses are performed to understand the relationship between the entry requirements and the corresponding academic performance in engineering programs. The data provided in this article will help Nigerian universities, the NUC, engineering regulatory bodies, and relevant stakeholders to objectively evaluate and subsequently improve the quality of engineering education in the country.

Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System

PubMed Central

Beccaro, M. A. Del; Villanueva, R.; Knudson, K. M.; Harvey, E. M.; Langle, J. M.; Paul, W.

2010-01-01

Objective We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. Design Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy alerts from our electronic medical record. During seven sampling periods (each two weeks long) between April 2006 and October 2008 all alerts in these categories were analyzed. Another audit was performed of all DRC alerts by ordering provider role from November 2008 through January 2009. Medication ordering error counts were obtained from a voluntary error reporting system. Measurement/Results Between April 2006 and October 2008 the percent of medication orders that triggered a dose range alert decreased from 23.9% to 7.4%. The relative risk (RR) for getting an alert was higher at the start of the interventions versus later (RR= 2.40, 95% CI 2.28-2.52; p< 0.0001). The percentage of medication orders that triggered alerts for drug-drug interactions also decreased from 13.5% to 4.8%. The RR for getting a drug interaction alert at the start was 1.63, 95% CI 1.60-1.66; p< 0.0001. Alerts decreased in all clinical areas without an increase in reported medication errors. Conclusion We reduced the quantity of decision support alerts in CPOE using a systematic approach without an increase in reported medication errors PMID:23616845

Thermal Testing of Woven TPS Materials in Extreme Entry Environments

NASA Technical Reports Server (NTRS)

Gonzales, G.; Stackpoole, M.

2014-01-01

NASAs future robotic missions to Venus and outer planets, namely, Saturn, Uranus, Neptune, result in extremely high entry conditions that exceed the capabilities of current mid density ablators (PICA or Avcoat). Therefore mission planners assume the use of a fully dense carbon phenolic heatshield similar to what was flown on Pioneer Venus and Galileo. Carbon phenolic (CP) is a robust TPS however its high density and thermal conductivity constrain mission planners to steep entries, high heat fluxes, high pressures and short entry durations, in order for CP to be feasible from a mass perspective. In 2012 the Game Changing Development Program in NASAs Space Technology Mission Directorate funded NASA ARC to investigate the feasibility of a Woven Thermal Protection System to meet the needs of NASAs most challenging entry missions. The high entry conditions pose certification challenges in existing ground based test facilities. Recent updates to NASAs IHF and AEDCs H3 high temperature arcjet test facilities enable higher heatflux (2000 Wcm2) and high pressure (5 atm) testing of TPS. Some recent thermal tests of woven TPS will be discussed in this paper. These upgrades have provided a way to test higher entry conditions of potential outer planet and Venus missions and provided a baseline against carbon phenolic material. The results of these tests have given preliminary insight to sample configuration and physical recession profile characteristics.

Care provider order entry (CPOE): a perspective on factors leading to success or to failure.

PubMed

Ozdas, A; Miller, R A

2007-01-01

Authors provide a perspective on factors leading to successful care provider order entry (CPOE) implementations. Viewpoint of authors supported by background literature review. Authors review both benefits and challenges related to CPOE implementation using three guiding principles: (1) a clinical approach to clinical systems, which claims that CPOE implementation is analogous to a "good" clinician delivering care to a patient; (2) a commitment to quality, which advocates that no compromises should be made in implementing system functionality and clinical system content - the highest objective for CPOE implementation is to provide better quality of care and increased safety for patients; (3) a commitment to fairness, as evidenced by respect for individuals and support of local autonomy, which advocates for minimizing disruptions to clinician-users' workflows, and adequate local control over CPOE system design and evolution, including clinical content management. Past experiences with CPOE implementation can inform future installation attempts. Sociocultural factors dominate in determining the success of implementation, and should govern technical factors.

Increased appropriateness of customized alert acknowledgement reasons for overridden medication alerts in a computerized provider order entry system.

PubMed

Dekarske, Brian M; Zimmerman, Christopher R; Chang, Robert; Grant, Paul J; Chaffee, Bruce W

2015-12-01

Computerized provider order entry systems commonly contain alerting mechanisms for patient allergies, incorrect doses, or drug-drug interactions when ordering medications. Providers have the option to override (bypass) these alerts and continue with the order unchanged. This study examines the effect of customizing medication alert override options on the appropriateness of override selection related to patient allergies, drug dosing, and drug-drug interactions when ordering medications in an electronic medical record. In this prospective, randomized crossover study, providers were randomized into cohorts that required a reason for overriding a medication alert from a customized or non-customized list of override reasons and/or by free-text entry. The primary outcome was to compare override responses that appropriately correlate with the alert type between the customized and non-customized configurations. The appropriateness of a subset of free-text responses that represented an affirmative and active acknowledgement of the alert without further explanation was classified as "indeterminate." Results were analyzed in three different ways by classifying indeterminate answers as either appropriate, inappropriate, or excluded entirely. Secondary outcomes included the appropriateness of override reasons when comparing cohorts and individual providers, reason selection based on order within the override list, and the determination of the frequency of free-text use, nonsensical responses, and multiple selection responses. Twenty-two clinicians were randomized into 2 cohorts and a total of 1829 alerts with a required response were generated during the study period. The customized configuration had a higher rate of appropriateness when compared to the non-customized configuration regardless of how indeterminate responses were classified (p<0.001). When comparing cohorts, appropriateness was significantly higher in the customized configuration regardless of the classification of indeterminate responses (p<0.001) with one exception: when indeterminate responses were considered inappropriate for the cohort of providers that were first exposed to the non-customized list (p=0.103). Free-text use was higher in the customized configuration overall (p<0.001), and there was no difference in nonsensical response between configurations (p=0.39). There is a benefit realized by using a customized list for medication override reasons. Poor application design or configuration can negatively affect provider behavior when responding to important medication alerts. Copyright © 2015. Published by Elsevier Ireland Ltd.

Aerothermodynamics of Blunt Body Entry Vehicles. Chapter 3

NASA Technical Reports Server (NTRS)

Hollis, Brian R.; Borrelli, Salvatore

2011-01-01

In this chapter, the aerothermodynamic phenomena of blunt body entry vehicles are discussed. Four topics will be considered that present challenges to current computational modeling techniques for blunt body environments: turbulent flow, non-equilibrium flow, rarefied flow, and radiation transport. Examples of comparisons between computational tools to ground and flight-test data will be presented in order to illustrate the challenges existing in the numerical modeling of each of these phenomena and to provide test cases for evaluation of Computational Fluid Dynamics (CFD) code predictions.

Aerothermodynamics of blunt body entry vehicles

NASA Astrophysics Data System (ADS)

Hollis, Brian R.; Borrelli, Salvatore

2012-01-01

In this chapter, the aerothermodynamic phenomena of blunt body entry vehicles are discussed. Four topics will be considered that present challenges to current computational modeling techniques for blunt body environments: turbulent flow, non-equilibrium flow, rarefied flow, and radiation transport. Examples of comparisons between computational tools to ground and flight-test data will be presented in order to illustrate the challenges existing in the numerical modeling of each of these phenomena and to provide test cases for evaluation of computational fluid dynamics (CFD) code predictions.

19 CFR 143.35 - Procedure for electronic entry summary.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Procedure for electronic entry summary. 143.35...; DEPARTMENT OF THE TREASURY (CONTINUED) SPECIAL ENTRY PROCEDURES Electronic Entry Filing § 143.35 Procedure for electronic entry summary. In order to obtain entry summary processing electronically, the filer...

19 CFR 143.35 - Procedure for electronic entry summary.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Procedure for electronic entry summary. 143.35...; DEPARTMENT OF THE TREASURY (CONTINUED) SPECIAL ENTRY PROCEDURES Electronic Entry Filing § 143.35 Procedure for electronic entry summary. In order to obtain entry summary processing electronically, the filer...

19 CFR 143.35 - Procedure for electronic entry summary.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Procedure for electronic entry summary. 143.35...; DEPARTMENT OF THE TREASURY (CONTINUED) SPECIAL ENTRY PROCEDURES Electronic Entry Filing § 143.35 Procedure for electronic entry summary. In order to obtain entry summary processing electronically, the filer...

SAKURA-viewer: intelligent order history viewer based on two-viewpoint architecture.

PubMed

Toyoda, Shuichi; Niki, Noboru; Nishitani, Hiromu

2007-03-01

We propose a new intelligent order history viewer applied to consolidating and visualizing data. SAKURA-viewer is a highly effective tool, as: 1) it visualizes both the semantic viewpoint and the temporal viewpoint of patient records simultaneously; 2) it promotes awareness of contextual information among the daily data; and 3) it implements patient-centric data entry methods. This viewer contributes to decrease the user's workload in an order entry system. This viewer is now incorporated into an order entry system being run on an experimental basis. We describe the evaluation of this system using results of a user satisfaction survey, analysis of information consolidation within the database, and analysis of the frequency of use of data entry methods.

Entry-level dietitians' salaries and benefits: comparisons with those of other selected health care professionals.

PubMed

Loushine, S K; Vaden, A G

1985-10-01

Data on salaries and fringe benefits of entry-level hospital dietitians were provided by surveys sent to personnel administrators in seven Midwestern states. In September 1982, the annual mean salary offered to dietitians awaiting registration was +16,472, whereas that for entry-level registered dietitians (R.D.s) was +17,250. In the smallest hospitals, annual mean salaries for R.D.s were lowest; non-metropolitan salaries were 2.8% lower than the metropolitan salaries. The salaries of entry-level R.D.s increased 54% from 1977 to 1982, while the Consumer Price Index (CPl), North Central, increased 59.7%. Salaries for selected entry-level health professionals ranked in decreasing order as follows: pharmacist, physical therapist, occupational therapist, social worker, staff nurse, dietitian, medical technologist, and respiratory therapist. Nationally, the entry-level dietitian's mean annual salary was +630 higher than that of the Midwestern dietitian. The increase in the national CPl from 1977 to 1982 was 57%, while the increase in the dietitian's salary was 48%. Leave time generally included 12 sick days, 2 weeks' vacation, 6 holidays, and 3 personal days per year. Employers contribute various amounts to life, health, and dental insurance costs. Discounts often were permitted on various hospital services. More than 80% of the hospitals surveyed provided some reimbursement for continuing education, and 74% permitted educational leaves of absence.

76 FR 30417 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

... Change Amending Rule 7.31(h)(5) To Reduce the Minimum Order Entry Size of a Mid-Point Passive Liquidity... order entry size of a Mid-Point Passive Liquidity Order (``MPL Order'') from 100 shares to one share...

Regenstrief Institute's Medical Gopher: a next-generation homegrown electronic medical record system.

PubMed

Duke, Jon D; Morea, Justin; Mamlin, Burke; Martin, Douglas K; Simonaitis, Linas; Takesue, Blaine Y; Dixon, Brian E; Dexter, Paul R

2014-03-01

Regenstrief Institute developed one of the seminal computerized order entry systems, the Medical Gopher, for implementation at Wishard Hospital nearly three decades ago. Wishard Hospital and Regenstrief remain committed to homegrown software development, and over the past 4 years we have fully rebuilt Gopher with an emphasis on usability, safety, leveraging open source technologies, and the advancement of biomedical informatics research. Our objective in this paper is to summarize the functionality of this new system and highlight its novel features. Applying a user-centered design process, the new Gopher was built upon a rich-internet application framework using an agile development process. The system incorporates order entry, clinical documentation, result viewing, decision support, and clinical workflow. We have customized its use for the outpatient, inpatient, and emergency department settings. The new Gopher is now in use by over 1100 users a day, including an average of 433 physicians caring for over 3600 patients daily. The system includes a wizard-like clinical workflow, dynamic multimedia alerts, and a familiar 'e-commerce'-based interface for order entry. Clinical documentation is enhanced by real-time natural language processing and data review is supported by a rapid chart search feature. As one of the few remaining academically developed order entry systems, the Gopher has been designed both to improve patient care and to support next-generation informatics research. It has achieved rapid adoption within our health system and suggests continued viability for homegrown systems in settings of close collaboration between developers and providers. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Computer-based physician order entry: the state of the art.

PubMed Central

Sittig, D F; Stead, W W

1994-01-01

Direct computer-based physician order entry has been the subject of debate for over 20 years. Many sites have implemented systems successfully. Others have failed outright or flirted with disaster, incurring substantial delays, cost overruns, and threatened work actions. The rationale for physician order entry includes process improvement, support of cost-conscious decision making, clinical decision support, and optimization of physicians' time. Barriers to physician order entry result from the changes required in practice patterns, roles within the care team, teaching patterns, and institutional policies. Key ingredients for successful implementation include: the system must be fast and easy to use, the user interface must behave consistently in all situations, the institution must have broad and committed involvement and direction by clinicians prior to implementation, the top leadership of the organization must be committed to the project, and a group of problem solvers and users must meet regularly to work out procedural issues. This article reviews the peer-reviewed scientific literature to present the current state of the art of computer-based physician order entry. PMID:7719793

An Analysis of the External Environmental and Internal Organizational Factors Associated with Adoption of the Electronic Health Record

ERIC Educational Resources Information Center

Kruse, Clemens Scott

2013-01-01

Despite a Presidential Order in 2004 that launched national incentives for the use of health information technology, specifically the Electronic Health Record (EHR), adoption of the EHR has been slow. This study attempts to quantify factors associated with adoption of the EHR and Computerized Provider Order Entry (CPOE) by combining multiple…

Computerized provider order entry systems.

PubMed

2001-01-01

Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

34 CFR 403.170 - What activities does the Secretary support under the Business-Labor-Education Partnership for...

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Providing vocational education to individuals in order to assist their entry into, or advancement in, high-technology occupations or to meet the technological need of other industries or businesses. (Authority: 20 U...

34 CFR 403.170 - What activities does the Secretary support under the Business-Labor-Education Partnership for...

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Providing vocational education to individuals in order to assist their entry into, or advancement in, high-technology occupations or to meet the technological need of other industries or businesses. (Authority: 20 U...

34 CFR 403.170 - What activities does the Secretary support under the Business-Labor-Education Partnership for...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Providing vocational education to individuals in order to assist their entry into, or advancement in, high-technology occupations or to meet the technological need of other industries or businesses. (Authority: 20 U...

34 CFR 403.170 - What activities does the Secretary support under the Business-Labor-Education Partnership for...

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Providing vocational education to individuals in order to assist their entry into, or advancement in, high-technology occupations or to meet the technological need of other industries or businesses. (Authority: 20 U...

CPOE in Iran--a viable prospect? Physicians' opinions on using CPOE in an Iranian teaching hospital.

PubMed

Kazemi, Alireza; Ellenius, Johan; Tofighi, Shahram; Salehi, Aref; Eghbalian, Fatemeh; Fors, Uno G

2009-03-01

In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems provide significant benefits. A pilot study in a limited setting and a comprehensive analysis of health outcomes and economic indicators should be performed, to assess the merits of introducing Computerised Physician Order Entry with decision support capabilities in Iran.

Implementation of a pharmacy automation system (robotics) to ensure medication safety at Norwalk hospital.

PubMed

Bepko, Robert J; Moore, John R; Coleman, John R

2009-01-01

This article reports an intervention to improve the quality and safety of hospital patient care by introducing the use of pharmacy robotics into the medication distribution process. Medication safety is vitally important. The integration of pharmacy robotics with computerized practitioner order entry and bedside medication bar coding produces a significant reduction in medication errors. The creation of a safe medication-from initial ordering to bedside administration-provides enormous benefits to patients, to health care providers, and to the organization as well.

Sensor Fusion of Gaussian Mixtures for Ballistic Target Tracking in the Re-Entry Phase

PubMed Central

Lu, Kelin; Zhou, Rui

2016-01-01

A sensor fusion methodology for the Gaussian mixtures model is proposed for ballistic target tracking with unknown ballistic coefficients. To improve the estimation accuracy, a track-to-track fusion architecture is proposed to fuse tracks provided by the local interacting multiple model filters. During the fusion process, the duplicate information is removed by considering the first order redundant information between the local tracks. With extensive simulations, we show that the proposed algorithm improves the tracking accuracy in ballistic target tracking in the re-entry phase applications. PMID:27537883

Sensor Fusion of Gaussian Mixtures for Ballistic Target Tracking in the Re-Entry Phase.

PubMed

Lu, Kelin; Zhou, Rui

2016-08-15

A sensor fusion methodology for the Gaussian mixtures model is proposed for ballistic target tracking with unknown ballistic coefficients. To improve the estimation accuracy, a track-to-track fusion architecture is proposed to fuse tracks provided by the local interacting multiple model filters. During the fusion process, the duplicate information is removed by considering the first order redundant information between the local tracks. With extensive simulations, we show that the proposed algorithm improves the tracking accuracy in ballistic target tracking in the re-entry phase applications.

Considerations for setting up an order entry system for nuclear medicine tests.

PubMed

Hara, Narihiro; Onoguchi, Masahisa; Nishida, Toshihiko; Honda, Minoru; Houjou, Osamu; Yuhi, Masaru; Takayama, Teruhiko; Ueda, Jun

2007-12-01

Integrating the Healthcare Enterprise-Japan (IHE-J) was established in Japan in 2001 and has been working to standardize health information and make it accessible on the basis of the fundamental Integrating Healthcare Enterprise (IHE) specifications. However, because specialized operations are used in nuclear medicine tests, online sharing of patient information and test order information from the order entry system as shown by the scheduled workflow (SWF) is difficult, making information inconsistent throughout the facility and uniform management of patient information impossible. Therefore, we examined the basic design (subsystem design) for order entry systems, which are considered an important aspect of information management for nuclear medicine tests and needs to be consistent with the system used throughout the rest of the facility. There are many items that are required by the subsystem when setting up an order entry system for nuclear medicine tests. Among these items, those that are the most important in the order entry system are constructed using exclusion settings, because of differences in the conditions for using radiopharmaceuticals and contrast agents and appointment frame settings for differences in the imaging method and test items. To establish uniform management of patient information for nuclear medicine tests throughout the facility, it is necessary to develop an order entry system with exclusion settings and appointment frames as standard features. Thereby, integration of health information with the Radiology Information System (RIS) or Picture Archiving Communication System (PACS) based on Digital Imaging Communications in Medicine (DICOM) standards and real-time health care assistance can be attained, achieving the IHE agenda of improving health care service and efficiently sharing information.

Usability Evaluation at the Point-of-Care: A Method to Identify User Information Needs in CPOE Applications

PubMed Central

Washburn, Jeff; Fiol, Guilherme Del; Rocha, Roberto A.

2006-01-01

Point of care usability evaluation may help identify information needs that occur during the process of providing care. We describe the process of using usability-specific recording software to record Computerized Physician Order Entry (CPOE) ordering sessions on admitted adult and pediatric patients at two urban tertiary hospitals in the Intermountain Healthcare system of hospitals. PMID:17238756

78 FR 16731 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... International Securities Exchange offers PRECISE TRADE as a means for users to enter orders and Chicago Board... users to develop their own internal front-end order entry systems and may provide savings to users in.../NASDAQOMXPHLXTools/PlatformViewer.asp?selectednode=chp%5F1%5F4&manual=%2Fnasdaqomxphlx%2Fphlx%2Fphlx%2Drulesbrd%2F...

77 FR 60917 - Trinexapac-ethyl; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

... ``hog, meat by-products'' in order to correct inadvertent errors in the final rule tolerance table for...'' is revised to ``hog, meat by-products.'' V. Statutory and Executive Order Reviews This final rule... alphabetical order an entry for ``Hog, meat by-products''. 0 iii. Revising the entries for ``Wheat, forage...

The Lilongwe Central Hospital Patient Management Information System: A Success in Computer-Based Order Entry Where One Might Least Expect It

PubMed Central

GP, Douglas; RA, Deula; SE, Connor

2003-01-01

Computer-based order entry is a powerful tool for enhancing patient care. A pilot project in the pediatric department of the Lilongwe Central Hospital (LCH) in Malawi, Africa has demonstrated that computer-based order entry (COE): 1) can be successfully deployed and adopted in resource-poor settings, 2) can be built, deployed and sustained at relatively low cost and with local resources, and 3) has a greater potential to improve patient care in developing than in developed countries. PMID:14728338

Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.

PubMed

Cartmill, Randi S; Walker, James M; Blosky, Mary Ann; Brown, Roger L; Djurkovic, Svetolik; Dunham, Deborah B; Gardill, Debra; Haupt, Marilyn T; Parry, Dean; Wetterneck, Tosha B; Wood, Kenneth E; Carayon, Pascale

2012-11-01

To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients. We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated. The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration. The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Estimates of thermochemical relaxation lengths behind normal shock waves relevant to manned lunar and Mars return missions, the aeroassist flight experiment, and Mars entry

NASA Technical Reports Server (NTRS)

Howe, John T.

1991-01-01

Thermochemical relaxation distances behind the strong normal shock waves associated with vehicles that enter the Earth atmosphere upon returning from a manned lunar or Mars mission are estimated. The relaxation distances for a Mars entry are estimated as well, in order to highlight the extent of the relaxation phenomena early in currently envisioned space exploration studies. The thermochemical relaxation length for the Aeroassist Flight Experiment is also considered. These estimates provide an indication as to whether finite relaxation needs to be considered in subsequent detailed analyses. For the Mars entry, relaxation phenomena that are fully coupled to the flow field equations are used. The relaxation-distance estimates can be scaled to flight conditions other than those discussed.

Connecting Advanced and Secondary Mathematics

ERIC Educational Resources Information Center

Murray, Eileen; Baldinger, Erin; Wasserman, Nicholas; Broderick, Shawn; White, Diana

2017-01-01

There is an ongoing debate among scholars in understanding what mathematical knowledge secondary teachers should have in order to provide effective instruction. We explore connections between advanced and secondary mathematics as an entry point into this debate. In many cases, advanced mathematics is considered relevant for secondary teachers…

Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.

PubMed

Kawamoto, Kensaku; Lobach, David F

2003-01-01

Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions.

Reducing duplicate testing: a comparison of two clinical decision support tools.

PubMed

Procop, Gary W; Keating, Catherine; Stagno, Paul; Kottke-Marchant, Kandice; Partin, Mary; Tuttle, Robert; Wyllie, Robert

2015-05-01

Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry. Copyright© by the American Society for Clinical Pathology.

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

Important nonurgent imaging findings: use of a hybrid digital and administrative support tool for facilitating clinician communication.

PubMed

Johnson, Evan; Sanger, Joseph; Rosenkrantz, Andrew B

2015-01-01

A departmental tool that provides a digital/administrative solution for communication of important imaging findings was evaluated. The tool allows the radiologist to click a button to mark an examination for ordering physician follow-up with subsequent fax and confirmation. The tool's log was reviewed. Of 466 entries; 99.4% were successfully faxed with phone confirmation. Most common reasons for usage were lung nodule/mass (29.2%) and osseous fracture (12.4%). Subsequent clinical action was documented in 41.0% of entries. Our data show the reliability of the tool in assisting the communication of findings, as well as providing documentation of notification, with minimal workflow disruption. Copyright © 2015 Elsevier Inc. All rights reserved.

78 FR 48752 - Self-Regulatory Organizations; NASDAQ OMX BX, Inc.; Notice of Filing of Proposed Rule Change to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... particular MPID has been made by calculating the ratio between (i) entered orders, weighted by the distance... in part. The fee has been imposed on MPIDs with an ``Order Entry Ratio'' of more than 100. The Order Entry Ratio is calculated, and the Excess Order Fee imposed, on a monthly basis. BX is now proposing to...

78 FR 76642 - Public Land Order No. 7822; Partial Revocation of Secretarial Order Dated May 2, 1919; Wyoming

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... closed to settlement, sale, location, or entry under the general land laws, including the United States mining laws, until the Bureau of Land Management completes a planning review. Order By virtue of the... withdrew lands from settlement, sale location, or entry under the general land laws, including the United...

Information Retrieval Performance of Probabilistically Generated, Problem-Specific Computerized Provider Order Entry Pick-Lists: A Pilot Study

PubMed Central

Rothschild, Adam S.; Lehmann, Harold P.

2005-01-01

Objective: The aim of this study was to preliminarily determine the feasibility of probabilistically generating problem-specific computerized provider order entry (CPOE) pick-lists from a database of explicitly linked orders and problems from actual clinical cases. Design: In a pilot retrospective validation, physicians reviewed internal medicine cases consisting of the admission history and physical examination and orders placed using CPOE during the first 24 hours after admission. They created coded problem lists and linked orders from individual cases to the problem for which they were most indicated. Problem-specific order pick-lists were generated by including a given order in a pick-list if the probability of linkage of order and problem (PLOP) equaled or exceeded a specified threshold. PLOP for a given linked order-problem pair was computed as its prevalence among the other cases in the experiment with the given problem. The orders that the reviewer linked to a given problem instance served as the reference standard to evaluate its system-generated pick-list. Measurements: Recall, precision, and length of the pick-lists. Results: Average recall reached a maximum of .67 with a precision of .17 and pick-list length of 31.22 at a PLOP threshold of 0. Average precision reached a maximum of .73 with a recall of .09 and pick-list length of .42 at a PLOP threshold of .9. Recall varied inversely with precision in classic information retrieval behavior. Conclusion: We preliminarily conclude that it is feasible to generate problem-specific CPOE pick-lists probabilistically from a database of explicitly linked orders and problems. Further research is necessary to determine the usefulness of this approach in real-world settings. PMID:15684134

Youth Solid Waste Educational Materials List, November 1991.

ERIC Educational Resources Information Center

Cornell Univ., Ithaca, NY. Cooperative Extension Service.

This guide provides a brief description and ordering information for approximately 300 educational materials for grades K-12 on the subject of solid waste. The materials cover a variety of environmental issues and actions related to solid waste management. Entries are divided into five sections including audiovisual programs, books, magazines,…

A system to improve medication safety in the setting of acute kidney injury: initial provider response.

PubMed

McCoy, Allison B; McCoy, Allison Beck; Peterson, Josh F; Gadd, Cynthia S; Gadd, Cindy; Danciu, Ioana; Waitman, Lemuel R

2008-11-06

Clinical decision support systems can decrease common errors related to inappropriate or excessive dosing for nephrotoxic or renally cleared drugs. We developed a comprehensive medication safety intervention with varying levels of workflow intrusiveness within computerized provider order entry to continuously monitor for and alert providers about early-onset acute kidney injury. Initial provider response to the interventions shows potential success in improving medication safety and suggests future enhancements to increase effectiveness.

SHEFEX - the vehicle and sub-systems for a hypersonic re-entry flight experiment

NASA Astrophysics Data System (ADS)

Turner, John; Hörschgen, Marcus; Turner, Peter; Ettl, Josef; Jung, Wolfgang; Stamminger, Andreas

2005-08-01

The purpose of the Sharp Edge Flight Experiment (SHEFEX) is to investigate the aerodynamic behaviour and thermal problems of an unconventional shape for re-entry vehicles, comprising multi-facetted surfaces with sharp edges. The main object of this experiment is the correlation of numerical analysis with real flight data in terms of the aerodynamic effects and structural concept for the thermal protection system (TPS). The Mobile Rocket Base of the German Aerospace Center (DLR) is responsible for the test flight of SHEFEX on a two stage unguided solid propellant sounding rocket which is required to provide a velocity of the order of March 7 for more than 30 seconds during atmospheric re-entry. This paper discusses the problems associated with the mission requirements and the solutions developed for the vehicle and sub-systems.

Entry Guidance for the Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

Lu, Ping

1999-01-01

The X-33 Advanced Technology Demonstrator is a half-scale prototype developed to test the key technologies needed for a full-scale single-stage reusable launch vehicle (RLV). The X-33 is a suborbital vehicle that will be launched vertically, and land horizontally. The goals of this research were to develop an alternate entry guidance scheme for the X-33 in parallel to the actual X-33 entry guidance algorithms, provide comparative and complementary study, and identify potential new ways to improve entry guidance performance. Toward these goals, the nominal entry trajectory is defined by a piecewise linear drag-acceleration-versus-energy profile, which is in turn obtained by the solution of a semi-analytical parameter optimization problem. The closed-loop guidance is accomplished by tracking the nominal drag profile with primarily bank-angle modulation on-board. The bank-angle is commanded by a single full-envelope nonlinear trajectory control law. Near the end of the entry flight, the guidance logic is switched to heading control in order to meet strict conditions at the terminal area energy management interface. Two methods, one on ground-track control and the other on heading control, were proposed and examined for this phase of entry guidance where lateral control is emphasized. Trajectory dispersion studies were performed to evaluate the effectiveness of the entry guidance algorithms against a number of uncertainties including those in propulsion system, atmospheric properties, winds, aerodynamics, and propellant loading. Finally, a new trajectory-regulation method is introduced at the end as a promising precision entry guidance method. The guidance principle is very different and preliminary application in X-33 entry guidance simulation showed high precision that is difficult to achieve by existing methods.

Communications Blackout Predictions for Atmospheric Entry of Mars Science Laboratory

NASA Technical Reports Server (NTRS)

Morabito, David D.; Edquist, Karl

2005-01-01

The Mars Science Laboratory (MSL) is expected to be a long-range, long-duration science laboratory rover on the Martian surface. MSL will provide a significant milestone that paves the way for future landed missions to Mars. NASA is studying options to launch MSL as early as 2009. MSL will be the first mission to demonstrate the new technology of 'smart landers', which include precision landing and hazard avoidance in order to -land at scientifically interesting sites that would otherwise be unreachable. There are three elements to the spacecraft; carrier (cruise stage), entry vehicle, and rover. The rover will have an X-band direct-to-Earth (DTE) link as well as a UHF proximity link. There is also a possibility of an X-band proximity link. Given the importance of collecting critical event telemetry data during atmospheric entry, it is important to understand the ability of a signal link to be maintained, especially during the period near peak convective heating. The received telemetry during entry (or played back later) will allow for the performance of the Entry-Descent-Landing technologies to be assessed. These technologies include guided entry for precision landing, hazard avoidance, a new sky-crane landing system and powered descent. MSL will undergo an entry profile that may result in a potential communications blackout caused by ionized plasma for short periods near peak heating. The vehicle will use UHF and possibly X-band during the entry phase. The purpose of this report is to quantify or bound the likelihood of any such blackout at UHF frequencies (401 MHz) and X-band frequencies (8.4 GHz). Two entry trajectory scenarios were evaluated: a stressful entry trajectory to quantify an upper-bound for any possible blackout period, and a nominal likely trajectory to quantify likelihood of blackout for such cases.

The Impact of Order Source Misattribution on Computerized Provider Order Entry (CPOE) Performance Metrics

PubMed Central

Gellert, George A.; Catzoela, Linda; Patel, Lajja; Bruner, Kylynn; Friedman, Felix; Ramirez, Ricardo; Saucedo, Lilliana; Webster, S. Luke; Gillean, John A.

2017-01-01

Background One strategy to foster adoption of computerized provider order entry (CPOE) by physicians is the monthly distribution of a list identifying the number and use rate percentage of orders entered electronically versus on paper by each physician in the facility. Physicians care about CPOE use rate reports because they support the patient safety and quality improvement objectives of CPOE implementation. Certain physician groups are also motivated because they participate in contracted financial and performance arrangements that include incentive payments or financial penalties for meeting (or failing to meet) a specified CPOE use rate target. Misattribution of order sources can hinder accurate measurement of individual physician CPOE use and can thereby undermine providers’ confidence in their reported performance, as well as their motivation to utilize CPOE. Misattribution of order sources also has significant patient safety, quality, and medicolegal implications. Objective This analysis sought to evaluate the magnitude and sources of misattribution among hospitalists with high CPOE use and, if misattribution was found, to formulate strategies to prevent and reduce its recurrence, thereby ensuring the integrity and credibility of individual and facility CPOE use rate reporting. Methods A detailed manual order source review and validation of all orders issued by one hospitalist group at a midsize community hospital was conducted for a one-month study period. Results We found that a small but not dismissible percentage of orders issued by hospitalists—up to 4.18 percent (95 percent confidence interval, 3.84–4.56 percent) per month—were attributed inaccurately. Sources of misattribution by department or function were as follows: nursing, 42 percent; pharmacy, 38 percent; laboratory, 15 percent; unit clerk, 3 percent; and radiology, 2 percent. Order management and protocol were the most common correct order sources that were incorrectly attributed. Conclusion Order source misattribution can negatively affect reported provider CPOE use rates and should be investigated if providers perceive discrepancies between reported rates and their actual performance. Preventive education and communication efforts across departments can help prevent and reduce misattribution. PMID:28566988

39 CFR 761.8 - Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Servicing book-entry Postal Service securities... POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.8 Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

39 CFR 761.8 - Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Servicing book-entry Postal Service securities... POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.8 Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

39 CFR 761.8 - Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Servicing book-entry Postal Service securities... POSTAL SERVICE POSTAL SERVICE DEBT OBLIGATIONS; DISBURSEMENT POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.8 Servicing book-entry Postal Service securities; payment of interest, payment at maturity or upon...

Vertical Spin Tunnel Testing and Stability Analysis of Multi-Mission Earth Entry Vehicles

NASA Technical Reports Server (NTRS)

Glaab, Louis J.; Morelli, Eugene A.; Fremaux, C. Michael; Bean, Jacob

2014-01-01

Multi-Mission Earth Entry Vehicles (MMEEVs) are blunt-body vehicles designed with the purpose of transporting payloads from space to the surface of the Earth. To achieve high reliability and minimum weight, MMEEVs avoid using limited-reliability systems, such as parachutes, retro-rockets, and reaction control systems and rely on the natural aerodynamic stability of the vehicle throughout the Entry, Descent, and Landing phases of flight. Testing in NASA Langley's 20-FT Vertical Spin Tunnel (20-FT VST), dynamically-scaled MMEEV models was conducted to improve subsonic aerodynamic models and validate stability criteria for this class of vehicle. This report documents the resulting data from VST testing for an array of 60-deg sphere-cone MMEEVs. Model configurations included were 1.2 meter, and 1.8 meter designs. The addition of a backshell extender, which provided a 150% increase in backshell diameter for the 1.2 meter design, provided a third test configuration. Center of Gravity limits were established for all MMEEV configurations. An application of System Identification (SID) techniques was performed to determine the aerodynamic coefficients in order to provide databases for subsequent 6-degree-of-freedom simulations.

Use of Order Sets in Inpatient Computerized Provider Order Entry Systems: A Comparative Analysis of Usage Patterns at Seven Sites

PubMed Central

Wright, Adam; Feblowitz, Joshua C.; Pang, Justine E.; Carpenter, James D.; Krall, Michael A.; Middleton, Blackford; Sittig, Dean F.

2012-01-01

Background Many computerized provider order entry (CPOE) systems include the ability to create electronic order sets: collections of clinically-related orders grouped by purpose. Order sets promise to make CPOE systems more efficient, improve care quality and increase adherence to evidence-based guidelines. However, the development and implementation of order sets can be expensive and time-consuming and limited literature exists about their utilization. Methods Based on analysis of order set usage logs from a diverse purposive sample of seven sites with commercially- and internally-developed inpatient CPOE systems, we developed an original order set classification system. Order sets were categorized across seven non-mutually exclusive axes: admission/discharge/transfer (ADT), perioperative, condition-specific, task-specific, service-specific, convenience, and personal. In addition, 731 unique subtypes were identified within five axes: four in ADT (S=4), three in perioperative, 144 in condition-specific, 513 in task-specific, and 67 in service-specific. Results Order sets (n=1,914) were used a total of 676,142 times at the participating sites during a one-year period. ADT and perioperative order sets accounted for 27.6% and 24.2% of usage respectively. Peripartum/labor, chest pain/Acute Coronary Syndrome/Myocardial Infarction and diabetes order sets accounted for 51.6% of condition-specific usage. Insulin, angiography/angioplasty and arthroplasty order sets accounted for 19.4% of task-specific usage. Emergency/trauma, Obstetrics/Gynecology/Labor Delivery and anesthesia accounted for 32.4% of service-specific usage. Overall, the top 20% of order sets accounted for 90.1% of all usage. Additional salient patterns are identified and described. Conclusion We observed recurrent patterns in order set usage across multiple sites as well as meaningful variations between sites. Vendors and institutional developers should identify high-value order set types through concrete data analysis in order to optimize the resources devoted to development and implementation. PMID:22819199

39 CFR 761.3 - Scope and effect of book-entry procedure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Scope and effect of book-entry procedure. 761.3... POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.3 Scope and effect of book-entry procedure. (a) A Reserve Bank as fiscal agent of the United States acting on behalf of the Postal Service may apply the book...

39 CFR 761.3 - Scope and effect of book-entry procedure.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Scope and effect of book-entry procedure. 761.3... POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.3 Scope and effect of book-entry procedure. (a) A Reserve Bank as fiscal agent of the United States acting on behalf of the Postal Service may apply the book...

39 CFR 761.3 - Scope and effect of book-entry procedure.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Scope and effect of book-entry procedure. 761.3... POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.3 Scope and effect of book-entry procedure. (a) A Reserve Bank as fiscal agent of the United States acting on behalf of the Postal Service may apply the book...

39 CFR 761.3 - Scope and effect of book-entry procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Scope and effect of book-entry procedure. 761.3... POSTAL MONEY ORDERS BOOK-ENTRY PROCEDURES § 761.3 Scope and effect of book-entry procedure. (a) A Reserve Bank as fiscal agent of the United States acting on behalf of the Postal Service may apply the book...

Radiology reporting: a closed-loop cycle from order entry to results communication.

PubMed

Weiss, David L; Kim, Woojin; Branstetter, Barton F; Prevedello, Luciano M

2014-12-01

With the increasing prevalence of PACS over the past decade, face-to-face image review among health care providers has become a rarity. This change has resulted in increasing dependence on fast and accurate communication in radiology. Turnaround time expectations are now conveyed in minutes rather than hours or even days. Ideal modern radiology communication is a closed-loop cycle with multiple interoperable applications contributing to the final product. The cycle starts with physician order entry, now often performed through the electronic medical record, with clinical decision support to ensure that the most effective imaging study is ordered. Radiology reports are now almost all in electronic format. The majority are produced using speech recognition systems. Optimization of this software use can alleviate some, if not all, of the inherent user inefficiencies in this type of reporting. Integrated third-party software applications that provide data mining capability are extremely helpful in both academic and clinical settings. The closed-loop ends with automated communication of imaging results. Software products for this purpose should facilitate use of levels of alert, automated escalation to providers, and recording of audit trails of reports received. The multiple components of reporting should be completely interoperable with each other, as well as with the PACS, the RIS, and the electronic medical record. This integration will maximize radiologist efficiency and minimize the possibility of communication error. Copyright © 2014. Published by Elsevier Inc.

Practical Nursing (HO 17.060500). Career Merit Achievement Plan (Career MAP).

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee. Center for Instructional Development and Services.

This Career Merit Achievement Plan (MAP) includes the performance and knowledge competencies required for entry-level employment as a licensed practical nurse. Business and industry representatives have recommended that students in this field master these competencies in order to become employable. An overview provides information on use of the…

78 FR 62694 - Hoi Y. Kam, M.D.; Decision and Order

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... authorizes him to dispense controlled substances as a practitioner, as well as the denial of any pending... for Medicaid services which he did not perform and ``created false entries in [his patient] charts to... for the Medicaid services,'' that ``[t]he Medicaid provider number is not mine,'' and that he ``did...

Data Input for Publishers. State-of-the-Art Report.

ERIC Educational Resources Information Center

Buckland, Lawrence F.

Intended to serve as a guide for selecting the most suitable automated method for preparing and sending papers for publication, this report briefly describes data entry and editing procedures available from one publisher (Inforonics) and provides an estimate of processing costs for each procedure. The procedures, arranged in order of increasing…

Veterinary Safety's Conflicts in the EAEU

ERIC Educational Resources Information Center

Kalymbek, Bakytzhan; Shulanbekova, Gulmira K.; Madiyarova, Ainur S.; Mirambaeva, Gulnaz Zh.

2016-01-01

This article is devoted to the problem of veterinary safety of the countries under the Eurasian Economic Union. Animal health's measures are provided in order to prevent the entry and spread of infectious animal diseases, including common to humans and animals, as well as goods not conforming to the common veterinary and sanitary requirements.…

Nutrition Education Development Project. ESEA Title IVC Project. Pamphlet File.

ERIC Educational Resources Information Center

Luzerne Intermediate Unit 18, Kingston, PA.

This compilation of pamphlets and other educational materials on current issues in nutrition provides elementary and secondary teachers with a list of free or inexpensive materials to help them implement nutrition education into the existing curriculum. This list, organized in alphabetical order by topic, contains 293 entries and each one includes…

Attitude determination with three-axis accelerometer for emergency atmospheric entry

NASA Technical Reports Server (NTRS)

Garcia-Llama, Eduardo (Inventor)

2012-01-01

Two algorithms are disclosed that, with the use of a 3-axis accelerometer, will be able to determine the angles of attack, sideslip and roll of a capsule-type spacecraft prior to entry (at very high altitudes, where the atmospheric density is still very low) and during entry. The invention relates to emergency situations in which no reliable attitude and attitude rate are available. Provided that the spacecraft would not attempt a guided entry without reliable attitude information, the objective of the entry system in such case would be to attempt a safe ballistic entry. A ballistic entry requires three controlled phases to be executed in sequence: First, cancel initial rates in case the spacecraft is tumbling; second, maneuver the capsule to a heat-shield-forward attitude, preferably to the trim attitude, to counteract the heat rate and heat load build up; and third, impart a ballistic bank or roll rate to null the average lift vector in order to prevent prolonged lift down situations. Being able to know the attitude, hence the attitude rate, will allow the control system (nominal or backup, automatic or manual) to cancel any initial angular rates. Also, since a heat-shield forward attitude and the trim attitude can be specified in terms of the angles of attack and sideslip, being able to determine the current attitude in terms of these angles will allow the control system to maneuver the vehicle to the desired attitude. Finally, being able to determine the roll angle will allow for the control of the roll ballistic rate during entry.

Mars2020 Entry, Descent, and Landing Instrumentation (MEDLI2): Science Objectives and Instrument Requirements

NASA Technical Reports Server (NTRS)

Bose, Deepak; White, Todd; Schoenenberger, Mark; Karlgaard, Chris; Wright, Henry

2015-01-01

NASAs exploration and technology roadmaps call for capability advancements in Mars entry, descent, and landing (EDL) systems to enable increased landed mass, a higher landing precision, and a wider planetary access. It is also recognized that these ambitious EDL performance goals must be met while maintaining a low mission risk in order to pave the way for future human missions. As NASA is engaged in developing new EDL systems and technologies via testing at Earth, instrumentation of existing Mars missions is providing valuable engineering data for performance improvement, risk reduction, and an improved definition of entry loads and environment. The most notable recent example is the Mars Entry, Descent and Landing Instrument (MEDLI) suite hosted by Mars Science Laboratory for its entry in Aug 2012. The MEDLI suite provided a comprehensive dataset for Mars entry aerodynamics, aerothermodynamics and thermal protection system (TPS) performance. MEDLI data has since been used for unprecedented reconstruction of aerodynamic drag, vehicle attitude, in-situ atmospheric density, aerothermal heating, and transition to turbulence, in-depth TPS performance and TPS ablation. [1,2] In addition to validating predictive models, MEDLI data has demonstrated extra margin available in the MSL forebody TPS, which can potentially be used to reduce vehicle parasitic mass. The presentation will introduce a follow-on MEDLI instrumentation suite (called MEDLI2) that is being developed for Mars-2020 mission. MEDLI2 has an enhanced scope that includes backshell instrumentation, a wider forebody coverage, and instruments that specifically target supersonic aerodynamics. Similar to MEDLI, MEDLI2 uses thermal plugs with embedded thermocouples and ports through the TPS to measure surface pressure. MEDLI2, however, also includes heat flux sensors in the backshell and a low range pressure transducer to measure afterbody pressure.

Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial.

PubMed

Terrell, Kevin M; Perkins, Anthony J; Hui, Siu L; Callahan, Christopher M; Dexter, Paul R; Miller, Douglas K

2010-12-01

Emergency physicians prescribe several discharge medications that require dosage adjustment for patients with renal disease. The hypothesis for this research was that decision support in a computerized physician order entry system would reduce the rate of excessive medication dosing for patients with renal impairment. This was a randomized, controlled trial in an academic emergency department (ED), in which computerized physician order entry was used to write all prescriptions for patients being discharged from the ED. The sample included 42 physicians who were randomized to the intervention (21 physicians) or control (21 physicians) group. The intervention was decision support that provided dosing recommendations for targeted medications for patients aged 18 years and older when the patient's estimated creatinine clearance level was below the threshold for dosage adjustment. The primary outcome was the proportion of targeted medications that were excessively dosed. For 2,783 (46%) of the 6,015 patient visits, the decision support had sufficient information to estimate the patient's creatinine clearance level. The average age of these patients was 46 years, 1,768 (64%) were women, and 1,523 (55%) were black. Decision support was provided 73 times to physicians in the intervention group, who excessively dosed 31 (43%) prescriptions. In comparison, control physicians excessively dosed a significantly larger proportion of medications: 34 of 46, 74% (effect size=31%; 95% confidence interval 14% to 49%; P=.001). Emergency physicians often prescribed excessive doses of medications that require dosage adjustment for renal impairment. Computerized physician order entry with decision support significantly reduced excessive dosing of targeted medications. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

[Health personnel assessment about medical order entry systems of pharmacologic treatments in hospitalized patients].

PubMed

Villamañán, E; Larrubia, Y; Ruano, M; Moro, M; Sierra, A; Pérez, E; Herrero, A; Álvarez-Sala, R

2013-01-01

to evaluate health personnel perceptions about medical order entry systems concerning the effect on workflow, medication errors risk and assessment of its potential advantages. A cross-section opinion interview was conducted in a tertiary care hospital. Questionnaire consisted of three sections: perception of its effect on workflow, influence on medication error risk and assessment of potential advantages. We also asked them to assess drawbacks and provide suggestions about this prescription system. 76 health professionals were interviewed (58 physicians, 9 pharmacists and 9 nurses). They were satisfied mainly due to decrease the workload (85.5%; IC 95%: 75.58-92.55). They thought that the main characteristics that contribute to reduce medication errors are clinical decision supports related to predefined aspects which the program provided by default. Among potential benefits of medical order entry systems, legibility and warnings triggered by the program (98.7%; IC 95%: 92.90-99.97 and 97,4%; IC 95%: 90.81-99.68 respectively) were the most valuable. High technology dependence, IT failures and lack of infrastructure and medication therapy discontinuities at times of transition between different hospitals' units were the main drawbacks considered. The most repeated suggestion was related to the improvement of links between other health informatics applications used in the hospital. health personnel were highly satisfied with the CPOE system, which is considered to be effective and safe. Technology dependence and IT failures were the main disadvantages reported. According to them, a greater coordination and unification of all software applications available in the hospital would be desirable. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

Computerized N-acetylcysteine physician order entry by template protocol for acetaminophen toxicity.

PubMed

Thompson, Trevonne M; Lu, Jenny J; Blackwood, Louisa; Leikin, Jerrold B

2011-01-01

Some medication dosing protocols are logistically complex for traditional physician ordering. The use of computerized physician order entry (CPOE) with templates, or order sets, may be useful to reduce medication administration errors. This study evaluated the rate of medication administration errors using CPOE order sets for N-acetylcysteine (NAC) use in treating acetaminophen poisoning. An 18-month retrospective review of computerized inpatient pharmacy records for NAC use was performed. All patients who received NAC for the treatment of acetaminophen poisoning were included. Each record was analyzed to determine the form of NAC given and whether an administration error occurred. In the 82 cases of acetaminophen poisoning in which NAC was given, no medication administration errors were identified. Oral NAC was given in 31 (38%) cases; intravenous NAC was given in 51 (62%) cases. In this retrospective analysis of N-acetylcysteine administration using computerized physician order entry and order sets, no medication administration errors occurred. CPOE is an effective tool in safely executing complicated protocols in an inpatient setting.

Computerized physician order entry from a chief information officer perspective.

PubMed

Cotter, Carole M

2004-12-01

Designing and implementing a computerized physician order entry system in the critical care units of a large urban hospital system is an enormous undertaking. With their significant potential to improve health care and significantly reduce errors, the time for computerized physician order entry or physician order management systems is past due. Careful integrated planning is the key to success, requiring multidisciplinary teams at all levels of clinical and administrative management to work together. Articulated from the viewpoint of the Chief Information Officer of Lifespan, a not-for-profit hospital system in Rhode Island, the vision and strategy preceding the information technology plan, understanding the system's current state, the gap analysis between current and future state, and finally, building and implementing the information technology plan are described.

A Real Time Interface Between a Computerized Physician Order Entry System and the Computerized ICU Medication Administration Record

PubMed Central

Chen, Jeannie; Shabot, M. Michael; LoBue, Mark

2003-01-01

Prior attempts to interface ICU Clinical Information Systems (CIS) to Pharmacy systems have been less than successful. The major problem is that in ICUs, medications frequently have to be administered and charted in the CIS Medication Administration Record (MAR) before pharmacists can enter them into the Pharmacy system. When the Pharmacy system belatedly sends medication orders to the CIS MAR, this may create duplicate entries for medications that ICU nurses have had to enter manually to chart doses actually given. The authors have implemented a real time interface between a Computerized Physician Order Entry (CPOE) system and a CIS operating in ten ICUs that solves this problem. The interface transfers new medication orders including order details and alerts directly to the CIS Medication Administration Record (MAR), where they are immediately available for nurse charting. PMID:14728315

Discrimination of bullet types using analysis of lead isotopes deposited in gunshot entry wounds.

PubMed

Wunnapuk, Klintean; Minami, Takeshi; Durongkadech, Piya; Tohno, Setsuko; Ruangyuttikarn, Werawan; Moriwake, Yumi; Vichairat, Karnda; Sribanditmongkol, Pongruk; Tohno, Yoshiyuki

2009-01-01

In order to discriminate bullet types used in firearms, of which the victims died, the authors investigated lead isotope ratios in gunshot entry wounds from nine lead (unjacketed) bullets, 15 semi-jacketed bullets, and 14 full-jacketed bullets by inductively coupled plasma-mass spectrometry. It was found that the lead isotope ratio of 207/206 in gunshot entry wounds was the highest with lead bullets, and it decreased in order from full-jacketed to semi-jacketed bullets. Lead isotope ratios of 208/206 or 208/207 to 207/206 at the gunshot entry wound were able to discriminate semi-jacketed bullets from lead and full-jacketed ones, but it was difficult to discriminate between lead and full-jacketed bullets. However, a combination of element and lead isotope ratio analyses in gunshot entry wounds enabled discrimination between lead, semi-jacketed, and full-jacketed bullets.

Atmospheric Entry Heating of Micrometeorites Revisited: Higher Temperatures and Potential Biases

NASA Technical Reports Server (NTRS)

Love, S.; Alexander, C. M. OD.

2001-01-01

The atmospheric entry heating model of Love and Brownlee appears to have overestimated evaporation rates by as much as two orders of magnitude. Here we revisit the issue of atmospheric entry heating, using a revised prescription for evaporation rates. Additional information is contained in the original extended abstract.

43 CFR 2521.5 - Annual proof.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.5 Annual proof. (a) Showing required. (1) In order to test the sincerity and good faith of claimants under the desert... a desert-land entry unless made on account of that particular entry, and expenditures once credited...

43 CFR 2521.5 - Annual proof.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.5 Annual proof. (a) Showing required. (1) In order to test the sincerity and good faith of claimants under the desert... a desert-land entry unless made on account of that particular entry, and expenditures once credited...

43 CFR 2521.5 - Annual proof.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.5 Annual proof. (a) Showing required. (1) In order to test the sincerity and good faith of claimants under the desert... a desert-land entry unless made on account of that particular entry, and expenditures once credited...

30 CFR 717.14 - Backfilling and grading of road cuts, mine entry area cuts, and other surface work areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... order to prevent water pollution and sustained combustion, and to minimize adverse effects on plant growth and land uses. Where necessary to protect against upward migration of salts, exposure by erosion, to provide an adequate depth for plant growth, or to otherwise meet local conditions, the regulatory...

30 CFR 717.14 - Backfilling and grading of road cuts, mine entry area cuts, and other surface work areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... order to prevent water pollution and sustained combustion, and to minimize adverse effects on plant growth and land uses. Where necessary to protect against upward migration of salts, exposure by erosion, to provide an adequate depth for plant growth, or to otherwise meet local conditions, the regulatory...

30 CFR 717.14 - Backfilling and grading of road cuts, mine entry area cuts, and other surface work areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... order to prevent water pollution and sustained combustion, and to minimize adverse effects on plant growth and land uses. Where necessary to protect against upward migration of salts, exposure by erosion, to provide an adequate depth for plant growth, or to otherwise meet local conditions, the regulatory...

Women and Work--New Options. A Guide to Nonprint Media.

ERIC Educational Resources Information Center

Artel, Linda; Wheat, Valerie

The purpose of this guide is to gather together in one volume information about nonprint media dealing with new career options for women. The 112 films, filmstrips, videotapes and cassettes, slides, photograph sets and games included in the guide are listed in alphabetical order by title. For each entry the following information is provided:…

12 CFR 4.39 - Notification of parties and procedures for sharing and using OCC records in litigation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CURRENCY, DEPARTMENT OF THE TREASURY ORGANIZATION AND FUNCTIONS, AVAILABILITY AND RELEASE OF INFORMATION... Information § 4.39 Notification of parties and procedures for sharing and using OCC records in litigation. (a... information obtained pursuant to this subpart, and, upon entry of a protective order, shall provide copies of...

78 FR 1317 - Introduction to the Unified Agenda of Federal Regulatory and Deregulatory Actions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-08

... (5 U.S.C. 602). Executive Order 12866 ``Regulatory Planning and Review,'' signed September 30, 1993... entry. To provide comment on or to obtain further information about this publication, contact: John C... significant economic impact on a substantial number of small entities (5 U.S.C. 602). Agencies meet that...

34 CFR 403.172 - What special considerations must the State board give in approving projects, services, and...

Code of Federal Regulations, 2011 CFR

2011-07-01

... years of age in order to assist their entry into, or advancement in, high-technology occupations or to... EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What Kinds of Activities Does the... or industry, to provide high quality training for skilled workers and technicians in high technology...

34 CFR 403.172 - What special considerations must the State board give in approving projects, services, and...

Code of Federal Regulations, 2014 CFR

2014-07-01

... years of age in order to assist their entry into, or advancement in, high-technology occupations or to... EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What Kinds of Activities Does the... or industry, to provide high quality training for skilled workers and technicians in high technology...

34 CFR 403.172 - What special considerations must the State board give in approving projects, services, and...

Code of Federal Regulations, 2012 CFR

2012-07-01

... years of age in order to assist their entry into, or advancement in, high-technology occupations or to... EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What Kinds of Activities Does the... or industry, to provide high quality training for skilled workers and technicians in high technology...

34 CFR 403.172 - What special considerations must the State board give in approving projects, services, and...

Code of Federal Regulations, 2013 CFR

2013-07-01

... years of age in order to assist their entry into, or advancement in, high-technology occupations or to... EDUCATION STATE VOCATIONAL AND APPLIED TECHNOLOGY EDUCATION PROGRAM What Kinds of Activities Does the... or industry, to provide high quality training for skilled workers and technicians in high technology...

New Zealand Journal of Educational Studies: Cumulative Index of Volumes 1-17, 1966-1982.

ERIC Educational Resources Information Center

Marland, E. J., Comp.

This cumulative index lists all articles and book reviews published in the "New Zealand Journal of Educational Studies" from 1966 to 1982. The index consists of three sections. In the main entry section, citations are grouped in numerical order beginning with the first article published. The author and institution index provides access…

75 FR 48387 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-10

... of the PULSe order entry workstation and to make a technical correction to the numbering of the text in the fees schedule. The PULSe workstation is a front-end order entry system designed for use with...\\ In conjunction with the launch of the PULSe workstation, the Exchange waived various fees. To...

75 FR 80101 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-21

... entry, cancellation of such orders and the calculation and publication of imbalances. In particular... a Mandatory MOC/LOC Imbalance Publication. The rule therefore suggests that members or member... all MOC/LOC orders that would join the same side of a published MOC/LOC imbalance and the entry of MOC...

19 CFR 145.12 - Entry of merchandise.

Code of Federal Regulations, 2011 CFR

2011-04-01

... formal entry, even though they reach Customs at the same time and are covered by a single order or contract in excess of $2,000, unless there was a splitting of shipments in order to avoid the payment of... Postal Service for delivery and collection of duty. If the addressee has arranged to pick up such a...

19 CFR 145.12 - Entry of merchandise.

Code of Federal Regulations, 2010 CFR

2010-04-01

... formal entry, even though they reach Customs at the same time and are covered by a single order or contract in excess of $2,000, unless there was a splitting of shipments in order to avoid the payment of... Postal Service for delivery and collection of duty. If the addressee has arranged to pick up such a...

19 CFR 148.77 - Entry of effects on termination of assignment to extended duty, or on evacuation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... unaccompanied personal and household effects by either a United States Dispatch Agent or a designated... entry if there is a valid reason evident from the owner's travel orders or information at hand why the... of Government employee) Travel orders and information on hand in this office show that the named...

76 FR 38293 - Risk Management Controls for Brokers or Dealers With Market Access

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... securities to give broker- dealers with market access additional time to develop, test, and implement the... that exceed appropriate pre-set credit or capital thresholds,\\5\\ or that appear to be erroneous.\\6\\ The... satisfied on a pre-order entry basis,\\7\\ prevent the entry of orders that the broker- dealers or customer is...

Woven Thermal Protection System Based Heat-shield for Extreme Entry Environments Technology (HEEET)

NASA Technical Reports Server (NTRS)

Ellerby, Donald; Venkatapathy, Ethiraj; Stackpoole, Margaret; Chinnapongse, Ronald; Munk, Michelle; Dillman, Robert; Feldman, Jay; Prabhu, Dinesh; Beerman, Adam

2013-01-01

NASA's future robotic missions utilizing an entry system into Venus and the outer planets, namely, Saturn, Uranus, Neptune, result in extremely high entry conditions that exceed the capabilities of state of the art low to mid density ablators such as PICA or Avcoat. Therefore mission planners typically assume the use of a fully dense carbon phenolic heat shield similar to what was flown on Pioneer Venus and Galileo. Carbon phenolic is a robust TPS material however its high density and relatively high thermal conductivity constrain mission planners to steep entries, with high heat fluxes and pressures and short entry durations, in order for CP to be feasible from a mass perspective. The high entry conditions pose challenges for certification in existing ground based test facilities and the longer-term sustainability of CP will continue to pose challenges. In 2012 the Game Changing Development Program (GCDP) in NASA's Space Technology Mission Directorate funded NASA ARC to investigate the feasibility of a Woven Thermal Protection System (WTPS) to meet the needs of NASA's most challenging entry missions. This project was highly successful demonstrating that a Woven TPS solution compares favorably to CP in performance in simulated reentry environments and provides the opportunity to manufacture graded materials that should result in overall reduced mass solutions and enable a much broader set of missions than does CP. Building off the success of the WTPS project GCDP has funded a follow on project to further mature and scale up the WTPS concept for insertion into future NASA robotic missions. The matured WTPS will address the CP concerns associated with ground based test limitations and sustainability. This presentation will briefly discuss results from the WTPS Project and the plans for WTPS maturation into a heat-shield for extreme entry environment.

Woven Thermal Protection System Based Heat-shield for Extreme Entry Environments Technology (HEEET)

NASA Technical Reports Server (NTRS)

Chinnapongse, Ronald; Ellerbe, Donald; Stackpoole, Maragaret; Venkatapathy, Ethiraj; Beerman, Adam; Feldman, Jay; Peterson Keith; Prabhu, Dinesh; Dillman, Robert; Munk, Michelle

2013-01-01

NASA's future robotic missions utilizing an entry system into Venus and the outer planets, namely, Saturn, Uranus, Neptune, result in extremely severe entry conditions that exceed the capabilities of state of the art low to mid density ablators such as PICA or Avcoat. Therefore mission planners typically assume the use of a fully dense carbon phenolic heat shield similar to what was flown on Pioneer Venus and Galileo. Carbon phenolic (CP) is a robust TPS material however its high density and relatively high thermal conductivity constrain mission planners to steep entries, with high heat fluxes and pressures and short entry durations, in order for CP to be feasible from a mass perspective. The high entry conditions pose challenges for certification in existing ground based test facilities and the longer-­-term sustainability of CP will continue to pose challenges. In 2012 the Game Changing Development Program (GCDP) in NASA's Space Technology Mission Directorate funded NASA ARC to investigate the feasibility of a Woven Thermal Protection System (WTPS) to meet the needs of NASA's most challenging entry missions. This project was highly successful demonstrating that a Woven TPS solution compares favorably to CP in performance in simulated reentry environments and provides the opportunity to manufacture graded materials that should result in overall reduced mass solutions and enable a much broader set of missions than does CP. Building off the success of the WTPS project GCDP has funded a follow on project to further mature and scale up the WTPS concept for insertion into future NASA robotic missions. The matured WTPS will address the CP concerns associated with ground based test limitations and sustainability. This presentation will briefly discuss results from the WTPS Project and the plans for WTPS maturation into a heat-­-shield for extreme entry environment.

Simulation and analysis of a proposed replacement for the McCook port of entry inspection station

DOT National Transportation Integrated Search

1999-04-01

This report describes a study of a proposed replacement for the McCook Port of Entry inspection station at the entry to South Dakota. In order to assess the potential for a low-speed weigh in motion (WIM) scale within the station to pre-screen trucks...

Comparison of alphabetical versus categorical display format for medication order entry in a simulated touch screen anesthesia information management system: an experiment in clinician-computer interaction in anesthesia.

PubMed

Marian, Anil A; Dexter, Franklin; Tucker, Peter; Todd, Michael M

2012-05-29

Anesthesia information management system (AIMS) records should be designed and configured to facilitate the accurate and prompt recording of multiple drugs administered coincidentally or in rapid succession. We proposed two touch-screen display formats for use with our department's new EPIC touch-screen AIMS. In one format, medication "buttons" were arranged in alphabetical order (i.e. A-C, D-H etc.). In the other, buttons were arranged in categories (Common, Fluids, Cardiovascular, Coagulation etc.). Both formats were modeled on an iPad screen to resemble the AIMS interface. Anesthesia residents, anesthesiologists, and Certified Registered Nurse Anesthetists (n = 60) were then asked to find and touch the correct buttons for a series of medications whose names were displayed to the side of the entry screen. The number of entries made within 2 minutes was recorded. This was done 3 times for each format, with the 1st format chosen randomly. Data were analyzed from the third trials with each format to minimize differences in learning. The categorical format had a mean of 5.6 more drugs entered using the categorical method in two minutes than the alphabetical format (95% confidence interval [CI] 4.5 to 6.8, P < 0.0001). The findings were the same regardless of the order of testing (i.e. alphabetical-categorical vs. categorical - alphabetical) and participants' years of clinical experience. Most anesthesia providers made no (0) errors for most trials (N = 96/120 trials, lower 95% limit 73%, P < 0.0001). There was no difference in error rates between the two formats (P = 0.53). The use of touch-screen user interfaces in healthcare is increasingly common. Arrangement of drugs names in a categorical display format in the medication order-entry touch screen of an AIMS can result in faster data entry compared to an alphabetical arrangement of drugs. Results of this quality improvement project were used in our department's design of our final intraoperative electronic anesthesia record. This testing approach using cognitive and usability engineering methods can be used to objectively design and evaluate many aspects of the clinician-computer interaction in electronic health records.

Comparison of alphabetical versus categorical display format for medication order entry in a simulated touch screen anesthesia information management system: an experiment in clinician-computer interaction in anesthesia

PubMed Central

2012-01-01

Background Anesthesia information management system (AIMS) records should be designed and configured to facilitate the accurate and prompt recording of multiple drugs administered coincidentally or in rapid succession. Methods We proposed two touch-screen display formats for use with our department’s new EPIC touch-screen AIMS. In one format, medication “buttons” were arranged in alphabetical order (i.e. A-C, D-H etc.). In the other, buttons were arranged in categories (Common, Fluids, Cardiovascular, Coagulation etc.). Both formats were modeled on an iPad screen to resemble the AIMS interface. Anesthesia residents, anesthesiologists, and Certified Registered Nurse Anesthetists (n = 60) were then asked to find and touch the correct buttons for a series of medications whose names were displayed to the side of the entry screen. The number of entries made within 2 minutes was recorded. This was done 3 times for each format, with the 1st format chosen randomly. Data were analyzed from the third trials with each format to minimize differences in learning. Results The categorical format had a mean of 5.6 more drugs entered using the categorical method in two minutes than the alphabetical format (95% confidence interval [CI] 4.5 to 6.8, P < 0.0001). The findings were the same regardless of the order of testing (i.e. alphabetical-categorical vs. categorical - alphabetical) and participants’ years of clinical experience. Most anesthesia providers made no (0) errors for most trials (N = 96/120 trials, lower 95% limit 73%, P < 0.0001). There was no difference in error rates between the two formats (P = 0.53). Conclusions The use of touch-screen user interfaces in healthcare is increasingly common. Arrangement of drugs names in a categorical display format in the medication order-entry touch screen of an AIMS can result in faster data entry compared to an alphabetical arrangement of drugs. Results of this quality improvement project were used in our department’s design of our final intraoperative electronic anesthesia record. This testing approach using cognitive and usability engineering methods can be used to objectively design and evaluate many aspects of the clinician-computer interaction in electronic health records. PMID:22643058

Venus In Situ Explorer Mission design using a mechanically deployed aerodynamic decelerator

NASA Astrophysics Data System (ADS)

Smith, B.; Venkatapathy, E.; Wercinski, P.; Yount, B.; Prabhu, D.; Gage, P.; Glaze, L.; Baker, C.

The Venus In Situ Explorer (VISE) Mission addresses the highest priority science questions within the Venus community outlined in the National Research Council's Decadal Survey. The heritage Venus atmospheric entry system architecture, a 45° sphere-cone rigid aeroshell with a carbon phenolic thermal protection system, may no longer be the preferred entry system architecture compared to other viable alternatives being explored at NASA. A mechanically-deployed aerodynamic decelerator, known as the Adaptive Deployable Entry and Placement Technology (ADEPT), is an entry system alternative that can provide key operational benefits and risk reduction compared to a rigid aeroshell. This paper describes a mission feasibility study performed with the objectives of identifying potential adverse interactions with other mission elements and establishing requirements on decelerator performance. Feasibility is assessed through a launch-to-landing mission design study where the Venus Intrepid Tessera Lander (VITaL), a VISE science payload designed to inform the Decadal Survey results, is repackaged from a rigid aeroshell into the ADEPT decelerator. It is shown that ADEPT reduces the deceleration load on VITaL by an order of magnitude relative to a rigid aeroshell. The more benign entry environment opens up the VISE mission design environment for increased science return, reduced risk, and reduced cost. The ADEPT-VITAL mission concept of operations is presented and details of the entry vehicle structures and mechanisms are given. Finally, entry aerothermal analysis is presented that defines the operational requirements for a revolutionary structural-TPS material employed by ADEPT: three-dimensionally woven carbon cloth. Ongoing work to mitigate key risks identified in this feasibility study is presented.

EntrySat: A 3U CubeStat to study the reentry atmospheric environment

NASA Astrophysics Data System (ADS)

Anthony, Sournac; Raphael, Garcia; David, Mimoun; Jeremie, Chaix

2016-04-01

ISAE France Entrysat has for main scientific objective the study of uncontrolled atmospheric re-entry. This project, is developed by ISAE in collaboration with ONERA and University of Toulouse, is funded by CNES, in the overall frame of the QB50 project. This nano-satellite is a 3U Cubesat measuring 34*10*10 cm3, similar to secondary debris produced during the break up of a spacecraft. EntrySat will collect the external and internal temperatures, pressure, heat flux, attitude variations and drag force of the satellite between ≈150 and 90 km before its destruction in the atmosphere, and transmit them during the re-entry using the IRIDIUM satellite network. The result will be compared with the computations of MUSIC/FAST, a new 6-degree of freedom code developed by ONERA to predict the trajectory of space debris. In order to fulfil the scientific objectives, the satellite will acquire 18 re-entry sensors signals, convert them and compress them, thanks to an electronic board developed by ISAE students in cooperation with EREMS. In order to transmit these data every second during the re-entry phase, the satellite will use an IRIDIUM connection. In order to keep a stable enough attitudes during this phase, a simple attitude orbit and control system using magnetotorquers and an inertial measurement unit (IMU) is developed at ISAE by students. A commercial GPS board is also integrated in the satellite into Entry Sat to determine its position and velocity which are necessary during the re-entry phase. This GPS will also be used to synchronize the on-board clock with the real-time UTC data. During the orbital phase (≈2 year) EntrySat measurements will be recorded transmitted through a more classical "UHF/VHF" connection. Preference for presentation: Poster Most suitable session: Author for correspondence: Dr Raphael F. Garcia ISAE 10, ave E. Belin, 31400 Toulouse, France Raphael.GARCIA@isae.fr +33 5 61 33 81 14

Physician Utilization of a Hospital Information System: A Computer Simulation Model

PubMed Central

Anderson, James G.; Jay, Stephen J.; Clevenger, Stephen J.; Kassing, David R.; Perry, Jane; Anderson, Marilyn M.

1988-01-01

The purpose of this research was to develop a computer simulation model that represents the process through which physicians enter orders into a hospital information system (HIS). Computer simulation experiments were performed to estimate the effects of two methods of order entry on outcome variables. The results of the computer simulation experiments were used to perform a cost-benefit analysis to compare the two different means of entering medical orders into the HIS. The results indicate that the use of personal order sets to enter orders into the HIS will result in a significant reduction in manpower, salaries and fringe benefits, and errors in order entry.

The Impact of an Electronic Expensive Test Notification.

PubMed

Riley, Jacquelyn D; Stanley, Glenn; Wyllie, Robert; Kottke-Marchant, Kandice; Procop, Gary W

2018-04-25

The impact of clinical decision support tools (CDSTs) that display test cost information has been variable. We retrospectively analyzed the 3-year impact of a passive CDST that notified providers when the test order cost was $1,000 or more. We determined the most common expensive tests ordered, the frequency with which providers abandoned the order after notification, and the costs saved through this intervention. The average monthly abandonment rate was 12.5% (2014), 12.9% (2015), and 14.3% (2016). The cost savings from tests not performed for this 3-year period was $696,007. Molecular hematopathology assays were the most frequently ordered tests, with variable abandonment rates. Although this CDST was passive (ie, could be overridden at the point of order entry) and was associated with a relatively low abandonment rate, it achieved a considerable cost savings each year since each abandoned test saved the institution $1,000 or more.

Mid-Term Assessment of English 10 Students: A Comparison of Methods of Entry into the Course.

ERIC Educational Resources Information Center

Isonio, Steven

In spring 1992, a mid-term assessment of English 10 students was conducted at Golden West College, in California, in order to compare four course placement methods. English 10, "Writing Essentials," is a nontransferrable course which focuses on paragraph writing and grammar review in order to prepare students for entry into English 100.…

20 CFR 655.665 - Notice to the Department of Homeland Security and the Employment and Training Administration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Training Administration. (a) The Administrator shall promptly notify the DHS and ETA of the entry of a... part, unless the Administrator notifies the DHS and ETA of the entry of a subsequent order lifting the... the cease and desist order, without having on file with ETA an attestation pursuant to § 655.520 of...

76 FR 55166 - Actions Taken Pursuant to Executive Order 13382 Related to the Islamic Republic of Iran Shipping...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... Order 13382 Related to the Islamic Republic of Iran Shipping Lines (IRISL) AGENCY: Office of Foreign... connection to the Islamic Republic of Iran Shipping Lines (IRISL) and is updating the entries on OFAC's list... as property of the Islamic Republic of Iran Shipping Lines (IRISL) and updated the entries on OFAC's...

19 CFR 351.213 - Administrative review of orders and suspension agreements under section 751(a)(1) of the Act.

Code of Federal Regulations, 2010 CFR

2010-04-01

... concludes that, during the period covered by the review, there were no entries, exports, or sales of the... administrative review under this section will cover, as appropriate, entries, exports, or sales during the period... 19 Customs Duties 3 2010-04-01 2010-04-01 false Administrative review of orders and suspension...

77 FR 69688 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-20

... Items I, II and III below, which Items have been prepared by the Exchange. The Commission is publishing... Management Gateway service (``RMG'') would not be charged for order/ quote entry ports if such ports are... for order/quote entry ports that connect to the Exchange via the DMM Gateway.\\7\\ \\5\\ The Exchange...

Roles of Engineering Correlations in Hypersonic Entry Boundary Layer Transition Prediction

NASA Technical Reports Server (NTRS)

Campbell, Charles H.; Anderson, Brian P.; King, Rudolph A.; Kegerise, Michael A.; Berry, Scott A.; Horvath, Thomas J.

2010-01-01

Efforts to design and operate hypersonic entry vehicles are constrained by many considerations that involve all aspects of an entry vehicle system. One of the more significant physical phenomenon that affect entry trajectory and thermal protection system design is the occurrence of boundary layer transition from a laminar to turbulent state. During the Space Shuttle Return To Flight activity following the loss of Columbia and her crew of seven, NASA's entry aerothermodynamics community implemented an engineering correlation based framework for the prediction of boundary layer transition on the Orbiter. The methodology for this implementation relies upon similar correlation techniques that have been is use for several decades. What makes the Orbiter boundary layer transition correlation implementation unique is that a statistically significant data set was acquired in multiple ground test facilities, flight data exists to assist in establishing a better correlation and the framework was founded upon state of the art chemical nonequilibrium Navier Stokes flow field simulations. Recent entry flight testing performed with the Orbiter Discovery now provides a means to validate this engineering correlation approach to higher confidence. These results only serve to reinforce the essential role that engineering correlations currently exercise in the design and operation of entry vehicles. The framework of information related to the Orbiter empirical boundary layer transition prediction capability will be utilized to establish a fresh perspective on this role, and to discuss the characteristics which are desirable in a next generation advancement. The details of the paper will review the experimental facilities and techniques that were utilized to perform the implementation of the Orbiter RTF BLT Vsn 2 prediction capability. Statistically significant results for multiple engineering correlations from a ground testing campaign will be reviewed in order to describe why only certain correlations were selected for complete implementation to support the Shuttle Program. Historical Orbiter flight data on early boundary layer transition due to protruding gap fillers will be described in relation to the selected empirical correlations. In addition, Orbiter entry flight testing results from the BLT Flight Experiment will be discussed in relation to these correlations. Applicability of such correlations to the entry design problem will be reviewed, and finally a perspective on the desirable characteristics for a next generation capability based on high fidelity physical models will be provided.

Computerized Physician Order Entry: Reluctance of Physician Adoption of Technology Linked to Improving Health Care

ERIC Educational Resources Information Center

Ulinski, Don

2013-01-01

Physicians are the influential force in the complex field of patient care delivery. Physicians determine when and where patient healthcare is delivered and affect 80% of the money spent on it. Computerized systems used in the delivery of healthcare information have become an integral part that physicians use to provide patient care. This study…

19 CFR 10.199 - Duty-free entry for certain beverages produced in Canada from Caribbean rum.

Code of Federal Regulations, 2010 CFR

2010-04-01

... sources (e.g., rum the growth, product or manufacture of a CBI beneficiary country or of the U.S. Virgin... produced in the territory of Canada from rum, provided that the rum: (1) Is the growth, product, or... order to claim the exemption, the importer must have the records described in paragraphs (d), (e), (f...

76 FR 11705 - Office of the Attorney General; Certification Process for State Capital Counsel Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-03

..., Office of Legal Counsel, Re: The Scope of the Attorney General's Authority in Certifying Whether a State... rule sets out the mechanics of the certification process for States seeking to opt in to chapter 154... mechanism must provide for the entry of an order by a court of record-- (1) Appointing one or more attorneys...

General Metal Trades. Book II. Units of Instruction. Teacher's Guide.

ERIC Educational Resources Information Center

Hohhertz, Durwin

This teacher's guide was developed to aid in presenting units on general metal trades to students in Texas. The units are intended to provide students with basic knowledge and skills for each area of instruction in the general metal trades, and with the basic entry-level skills they will need to have in order to enter industry as trained workers.…

20-Year Subject and Author Index, Volume 1, 1997-Volume 20, 1996; Subject and Author Index, Volume 21, 1997.

ERIC Educational Resources Information Center

Weiler, Robert M.; Pealer, Lisa N.

1997-01-01

This index provides readers interested in health behavior, health education, and health promotion ordered access to materials published in Health Values and the American Journal of Health Behavior, 1977-1997. The index includes 115 subject headings and 5 department headings, classifying 918 entries by 1,319 authors and coauthors. (SM)

Mechanical Testing of Carbon Based Woven Thermal Protection Materials

NASA Technical Reports Server (NTRS)

Pham, John; Agrawal, Parul; Arnold, James O.; Peterson, Keith; Venkatapathy, Ethiraj

2013-01-01

Three Dimensional Woven thermal protection system (TPS) materials are one of the enabling technologies for mechanically deployable hypersonic decelerator systems. These materials have been shown capable of serving a dual purpose as TPS and as structural load bearing members during entry and descent operations. In order to ensure successful structural performance, it is important to characterize the mechanical properties of these materials prior to and post exposure to entry-like heating conditions. This research focuses on the changes in load bearing capacity of woven TPS materials after being subjected to arcjet simulations of entry heating. Preliminary testing of arcjet tested materials [1] has shown a mechanical degradation. However, their residual strength is significantly more than the requirements for a mission to Venus [2]. A systematic investigation at the macro and microstructural scales is reported here to explore the potential causes of this degradation. The effects of heating on the sizing (an epoxy resin coating used to reduce friction and wear during fiber handling) are discussed as one of the possible causes for the decrease in mechanical properties. This investigation also provides valuable guidelines for margin policies for future mechanically deployable entry systems.

Quality Assessment of Process Measures in Antimicrobial Stewardship: Concordance of Valacyclovir Indication and Automatic Prospective Approval in Computerized Provider Order Entry

PubMed Central

Lee, Tiffany; McCoy, Christopher; Mahoney, Monica V

2017-01-01

Abstract Background The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) recommend computerized decision support at the time of prescribing as an antimicrobial stewardship (AST) tool. Providing antimicrobial indications during prescribing can optimize infection-specific therapy through appropriate antimicrobial selection, dosing, and frequency. The Leapfrog group identifies this as a quality measure for their report card system. At Beth Israel Deaconess Medical Center (BIDMC), indication-based dosing has been incorporated in the computerized provider order entry (CPOE) system since 2006. At BIDMC, valacyclovir is only approved for the treatment of varicella zoster (VZV) infection or prophylaxis of solid organ transplant (SOT) patients at low risk for cytomegalovirus. These indications bypass the need for AST approval. Accuracy validation of the selected indications has not been formally performed. Methods A retrospective chart review was performed in patients prescribed valacyclovir during an 8-month period in 2016. Electronic medical records, laboratory reports, and pharmacy records were reviewed to identify the suspected/confirmed infection. The primary outcome was the concordance rate of selected CPOE valacyclovir indication compared with suspected/confirmed infection at the time of ordering. The secondary outcome was the proportion of valacyclovir use per institutional protocol. Results Overall, 117 patients were included, with a median age of 57.9 years, 51 (43.6%) were male, and 4 (3.4%) were located in an intensive care unit. Fifty-nine orders (50.4%) selected VZV as the indication, followed by 21 orders (17.9%) for SOT prophylaxis. Of orders with any CPOE indication, only 59/101 (58.4%) were concordant with suspected/confirmed infection. Of the valacyclovir orders with a VZV indication, 37 (62.7%) were concordant. Of the orders with SOT prophylaxis indications, 5 (23.8%) were concordant. Furthermore, only 46 orders (39.3%) were per BIDMC-protocol. Conclusion Concordance of CPOE indication selection and suspected/confirmed infection for valacyclovir was low. Using CPOE to grant automatic prospective approval must be monitored and audited for accuracy if employed as an AST tool. Disclosures All authors: No reported disclosures.

76 FR 47148 - Application(s) for Duty-Free Entry of Scientific Instruments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... work in microbiology and pathology, to study biological materials in order to identify bacterial or viral pathogens with clinical significance in veterinary medicine. Justification for Duty-Free Entry: No...

Shuttle Entry Air Data System (SEADS) hardware development. Volume 1: Summary

NASA Technical Reports Server (NTRS)

While, D. M.

1983-01-01

Hardware development of the Shuttle Entry Data System (SEADS) is described. The system consists of an array of fourteen pressure ports, installed in an Orbiter nose cap, which, when coupled with existing fuselage mounted static pressure ports permits computation of entry flight parameters. Elements of the system that are described include the following: (1) penetration assemblies to place pressure port openings at the surface of the nose cap; (2) pressure tubes to transmit the surface pressure to transducers; (3) support posts or manifolds to provide support for, and reduce the length of, the individual pressure tubes; (4) insulation for the manifolds; and (5) a SEADS nose cap. Design, analyses, and tests to develop and certify design for flight are described. Specific tests include plasma arc exposure, radiant thermal, vibration, and structural. Volume one summarizes highlights of the program, particularly as they relate to the final design of SEADS. Volume two summarizes all of the Vought responsible activities in essentially a chronological order.

Shuttle Entry Air Data System (SEADS) hardware development. Volume 2: History

NASA Technical Reports Server (NTRS)

While, D. M.

1983-01-01

Hardware development of the Shuttle Entry Air Data System (SEADS) is described. The system consists of an array of fourteen pressure ports, installed in an Orbiter nose cap, which, when coupled with existing fuselage mounted static pressure ports permits computation of entry flight parameters. Elements of the system that are described include the following: (1) penetration assemblies to place pressure port openings at the surface of the nose cap; (2) pressure tubes to transmit the surface pressure to transducers; (3) support posts or manifolds to provide support for, and reduce the length of, the individual pressure tubes; (4) insulation for the manifolds; and (5) a SEADS nose cap. Design, analyses, and tests to develop and certify design for flight are described. Specific tests included plasma arc exposure, radiant thermal, vibration, and structural. Volume one summarizes highlights of the program, particularly as they relate to the final design of SEADS. Volume two summarizes all of the Vought responsible activities in essentially a chronological order.

Computerized provider order entry systems - Research imperatives and organizational challenges facing pathology services.

PubMed

Georgiou, Andrew; Westbrook, Johanna; Braithwaite, Jeffrey

2010-07-13

Information and communication technologies (ICT) are contributing to major changes taking place in pathology and within health services more generally. In this article, we draw on our research experience for over 7 years investigating the implementation and diffusion of computerized provider order entry (CPOE) systems to articulate some of the key informatics challenges confronting pathology laboratories. The implementation of these systems, with their improved information management and decision support structures, provides the potential for enhancing the role that pathology services play in patient care pathways. Beyond eliminating legibility problems, CPOE systems can also contribute to the efficiency and safety of healthcare, reducing the duplication of test orders and diminishing the risk of misidentification of patient samples and orders. However, despite the enthusiasm for CPOE systems, their diffusion across healthcare settings remains variable and is often beset by implementation problems. Information systems like CPOE may have the ability to integrate work, departments and organizations, but unfortunately, health professionals, departments and organizations do not always want to be integrated in ways that information systems allow. A persistent theme that emerges from the research evidence is that one size does not fit all, and system success or otherwise is reliant on the conditions and circumstances in which they are located. These conditions and circumstances are part of what is negotiated in the complex, messy and challenging area of ICT implementation. The solution is not likely to be simple and easy, but current evidence suggests that a combination of concerted efforts, better research designs, more sophisticated theories and hypotheses as well as more skilled, multidisciplinary research teams, tackling this area of study will bring substantial benefits, improving the effectiveness of pathology services, and, as a direct corollary, the quality of patient care.

Entry order as a consideration for innovation strategies.

PubMed

Cohen, Fredric J

2006-04-01

Prior studies have defined an effect of market entry order on commercial success that depends on attributes of the underlying technology, the rate of change in technology improvement, consumer expectations of these attributes and the degree of unmet demand. Analyses of pharmaceutical sales data suggest that the commercial success of drugs is subject to similar forces. These findings have important implications for innovation strategies.

Reducing Wrong Patient Selection Errors: Exploring the Design Space of User Interface Techniques

PubMed Central

Sopan, Awalin; Plaisant, Catherine; Powsner, Seth; Shneiderman, Ben

2014-01-01

Wrong patient selection errors are a major issue for patient safety; from ordering medication to performing surgery, the stakes are high. Widespread adoption of Electronic Health Record (EHR) and Computerized Provider Order Entry (CPOE) systems makes patient selection using a computer screen a frequent task for clinicians. Careful design of the user interface can help mitigate the problem by helping providers recall their patients’ identities, accurately select their names, and spot errors before orders are submitted. We propose a catalog of twenty seven distinct user interface techniques, organized according to a task analysis. An associated video demonstrates eighteen of those techniques. EHR designers who consider a wider range of human-computer interaction techniques could reduce selection errors, but verification of efficacy is still needed. PMID:25954415

Reducing wrong patient selection errors: exploring the design space of user interface techniques.

PubMed

Sopan, Awalin; Plaisant, Catherine; Powsner, Seth; Shneiderman, Ben

2014-01-01

Wrong patient selection errors are a major issue for patient safety; from ordering medication to performing surgery, the stakes are high. Widespread adoption of Electronic Health Record (EHR) and Computerized Provider Order Entry (CPOE) systems makes patient selection using a computer screen a frequent task for clinicians. Careful design of the user interface can help mitigate the problem by helping providers recall their patients' identities, accurately select their names, and spot errors before orders are submitted. We propose a catalog of twenty seven distinct user interface techniques, organized according to a task analysis. An associated video demonstrates eighteen of those techniques. EHR designers who consider a wider range of human-computer interaction techniques could reduce selection errors, but verification of efficacy is still needed.

76 FR 33809 - Amendment and Update to the Entry for an Individual Named in the Annex to Executive Order 13219...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... Specially Designated Nationals and Blocked Persons (``SDN List''). The individual's date of birth has been amended and two addresses and an alternate place of birth have been added to the SDN List entry. The... entry of this individual on the SDN List is effective May 26, 2011. FOR FURTHER INFORMATION CONTACT...

MAPS: The Organization of a Spatial Database System Using Imagery, Terrain, and Map Data

DTIC Science & Technology

1983-06-01

segments which share the same pixel position. Finally, in any largo system, a logical partitioning of the database must be performed in order to avoid...34theodore roosevelt memoria entry 0; entry 1: Virginia ’northwest Washington* 2 en 11" ies for "crossover" for ’theodore roosevelt memor i entry 0

Structured physician order entry for trauma CT: value in improving clinical information transfer and billing efficiency.

PubMed

Wortman, Jeremy R; Goud, Asha; Raja, Ali S; Marchello, Dana; Sodickson, Aaron

2014-12-01

The purpose of this study was to measure the effects of use of a structured physician order entry system for trauma CT on the communication of clinical information and on coding practices and reimbursement efficiency. This study was conducted between April 1, 2011, and January 14, 2013, at a level I trauma center with 59,000 annual emergency department visits. On March 29, 2012, a structured order entry system was implemented for head through pelvis trauma CT, so-called pan-scan CT. This study compared the following factors before and after implementation: communication of clinical signs and symptoms and mechanism of injury, primary International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) code category, success of reimbursement, and time required for successful reimbursement for the examination. Chi-square statistics were used to compare all categoric variables before and after the intervention, and the Wilcoxon rank sum test was used to compare billing cycle times. A total of 457 patients underwent pan-scan CT in 2734 distinct examinations. After the intervention, there was a 62% absolute increase in requisitions containing clinical signs or symptoms (from 0.4% to 63%, p<0.0001) and a 99% absolute increase in requisitions providing mechanism of injury (from 0.4% to 99%, p<0.0001). There was a 19% absolute increase in primary ICD-9-CM codes representing clinical signs or symptoms (from 2.9% to 21.8%, p<0.0001), and a 7% absolute increase in reimbursement success for examinations submitted to insurance carriers (from 83.0% to 89.7%, p<0.0001). For reimbursed studies, there was a 14.7-day reduction in mean billing cycle time (from 68.4 days to 53.7 days, p=0.008). Implementation of structured physician order entry for trauma CT was associated with significant improvement in the communication of clinical history to radiologists. The improvement was also associated with changes in coding practices, greater billing efficiency, and an increase in reimbursement success.

A Development of Automatic Audit System for Written Informed Consent using Machine Learning.

PubMed

Yamada, Hitomi; Takemura, Tadamasa; Asai, Takahiro; Okamoto, Kazuya; Kuroda, Tomohiro; Kuwata, Shigeki

2015-01-01

In Japan, most of all the university and advanced hospitals have implemented both electronic order entry systems and electronic charting. In addition, all medical records are subjected to inspector audit for quality assurance. The record of informed consent (IC) is very important as this provides evidence of consent from the patient or patient's family and health care provider. Therefore, we developed an automatic audit system for a hospital information system (HIS) that is able to evaluate IC automatically using machine learning.

Implementing computerized physician order entry: the importance of special people.

PubMed

Ash, Joan S; Stavri, P Zoë; Dykstra, Richard; Fournier, Lara

2003-03-01

To articulate important lessons learned during a study to identify success factors for implementing computerized physician order entry (CPOE) in inpatient and outpatient settings. Qualitative study by a multidisciplinary team using data from observation, focus groups, and both formal and informal interviews. Data were analyzed using a grounded approach to develop a taxonomy of patterns and themes from the transcripts and field notes. The theme we call Special People is explored here in detail. A taxonomy of types of Special People includes administrative leaders, clinical leaders (champions, opinion leaders, and curmudgeons), and bridgers or support staff who interface directly with users. The recognition and nurturing of Special People should be among the highest priorities of those implementing computerized physician order entry. Their education and training must be a goal of teaching programs in health administration and medical informatics.

Aerodynamic Interactions of Propulsive Deceleration and Reaction Control System Jets on Mars-Entry Aeroshells

NASA Astrophysics Data System (ADS)

Alkandry, Hicham

Future missions to Mars, including sample-return and human-exploration missions, may require alternative entry, descent, and landing technologies in order to perform pinpoint landing of heavy vehicles. Two such alternatives are propulsive deceleration (PD) and reaction control systems (RCS). PD can slow the vehicle during Mars atmospheric descent by directing thrusters into the incoming freestream. RCS can provide vehicle control and steering by inducing moments using thrusters on the hack of the entry capsule. The use of these PD and RCS jets, however, involves complex flow interactions that are still not well understood. The fluid interactions induced by PD and RCS jets for Mars-entry vehicles in hypersonic freestream conditions are investigated using computational fluid dynamics (CFD). The effects of central and peripheral PD configurations using both sonic and supersonic jets at various thrust conditions are examined in this dissertation. The RCS jet is directed either parallel or transverse to the freestream flow at different thrust conditions in order to examine the effects of the thruster orientation with respect to the center of gravity of the aeroshell. The physical accuracy of the computational method is also assessed by comparing the numerical results with available experimental data. The central PD configuration decreases the drag force acting on the entry capsule due to a shielding effect that prevents mass and momentum in the hypersonic freestream from reaching the aeroshell. The peripheral PD configuration also decreases the drag force by obstructing the flow around the aeroshell and creating low surface pressure regions downstream of the PD nozzles. The Mach number of the PD jets, however, does not have a significant effect on the induced fluid interactions. The reaction control system also alters the flowfield, surface, and aerodynamic properties of the aeroshell, while the jet orientation can have a significant effect on the control effectiveness of the RCS.

Vocational Training for Economic Development: A Report on Business/Industry Relationships with Kansas Community Colleges and Area Vocational-Technical Schools, 1990-91 Academic Year.

ERIC Educational Resources Information Center

Kansas State Board of Education, Topeka. Lifelong Learning Div.

In order to provide educational opportunities for entry into and advancement within the work force, Kansas' 19 public community colleges and 14 area vocational technical schools (AVTSs) have expanded their offerings to include customized training for businesses and industries within Kansas. Vocational training is also supported by the Kansas…

Impact of Training Method on the Behavior of Physicians towards the Use of Computerized Provider Order Entry Systems

ERIC Educational Resources Information Center

Martinez, Fernando

2012-01-01

The use of workflow or simulated training has been used in the training of medical students for several decades. As technology emerged, training using simulation has grown as an effective way of enhancing training outcomes and increasing the clinical effectiveness of medical students. As a result of a heightened focus on the integration of…

El Camino Hospital: using health information technology to promote patient safety.

PubMed

Bukunt, Susan; Hunter, Christine; Perkins, Sharon; Russell, Diana; Domanico, Lee

2005-10-01

El Camino Hospital is a leader in the use of health information technology to promote patient safety, including bar coding, computerized order entry, electronic medical records, and wireless communications. Each year, El Camino Hospital's board of directors sets performance expectations for the chief executive officer, which are tied to achievement of local, regional, and national safety and quality standards, including the six Institute of Medicine quality dimensions. He then determines a set of explicit quality goals and measurable actions, which serve as guidelines for the overall hospital. The goals and progress reports are widely shared with employees, medical staff, patients and families, and the public. For safety, for example, the medication error reduction team tracks and reviews medication error rates. The hospital has virtually eliminated transcription errors through its 100% use of computerized physician order entry. Clinical pathways and standard order sets have reduced practice variation, providing a safer environment. Many projects focused on timeliness, such as emergency department wait time, lab turnaround time, and pneumonia time to initial antibiotic. Results have been mixed, with projects most successful when a link was established with patient outcomes, such as in reducing time to percutaneous transluminal coronary angioplasty for patients with acute myocardial infarction.

77 FR 19642 - Low Enriched Uranium From France: Final Results of Antidumping Duty Changed Circumstances Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... in U.S. customs territory, and (ii) are re-exported within eighteen (18) months of entry of the LEU... amend the scope of the order and to extend the deadline for the re-exportation of this sole LEU entry... transporter(s) while in U.S. customs territory, and (ii) are re-exported within eighteen (18) months of entry...

The VA Computerized Patient Record — A First Look

PubMed Central

Anderson, Curtis L.; Meldrum, Kevin C.

1994-01-01

In support of its in-house DHCP Physician Order Entry/Results Reporting application, the VA is developing the first edition of a Computerized Patient Record. The system will feature a physician-oriented interface with real time, expert system-based order checking, a controlled vocabulary, a longitudinal repository of patient data, HL7 messaging support, a clinical reminder and warning system, and full integration with existing VA applications including lab, pharmacy, A/D/T, radiology, dietetics, surgery, vitals, allergy tracking, discharge summary, problem list, progress notes, consults, and online physician order entry. PMID:7949886

Apollo experience report: Mission planning for Apollo entry

NASA Technical Reports Server (NTRS)

Graves, C. A.; Harpold, J. C.

1972-01-01

The problems encountered and the experience gained in the entry mission plans, flight software, trajectory-monitoring procedures, and backup trajectory-control techniques of the Apollo Program should provide a foundation upon which future spacecraft programs can be developed. Descriptions of these entry activities are presented. Also, to provide additional background information needed for discussion of the Apollo entry experience, descriptions of the entry targeting for the Apollo 11 mission and the postflight analysis of the Apollo 10 mission are presented.

High-Value, Cost-Conscious Care: Iterative Systems-Based Interventions to Reduce Unnecessary Laboratory Testing.

PubMed

Sadowski, Brett W; Lane, Alison B; Wood, Shannon M; Robinson, Sara L; Kim, Chin Hee

2017-09-01

Inappropriate testing contributes to soaring healthcare costs within the United States, and teaching hospitals are vulnerable to providing care largely for academic development. Via its "Choosing Wisely" campaign, the American Board of Internal Medicine recommends avoiding repetitive testing for stable inpatients. We designed systems-based interventions to reduce laboratory orders for patients admitted to the wards at an academic facility. We identified the computer-based order entry system as an appropriate target for sustainable intervention. The admission order set had allowed multiple routine tests to be ordered repetitively each day. Our iterative study included interventions on the automated order set and cost displays at order entry. The primary outcome was number of routine tests controlled for inpatient days compared with the preceding year. Secondary outcomes included cost savings, delays in care, and adverse events. Data were collected over a 2-month period following interventions in sequential years and compared with the year prior. The first intervention led to 0.97 fewer laboratory tests per inpatient day (19.4%). The second intervention led to sustained reduction, although by less of a margin than order set modifications alone (15.3%). When extrapolating the results utilizing fees from the Centers for Medicare and Medicaid Services, there was a cost savings of $290,000 over 2 years. Qualitative survey data did not suggest an increase in care delays or near-miss events. This series of interventions targeting unnecessary testing demonstrated a sustained reduction in the number of routine tests ordered, without adverse effects on clinical care. Published by Elsevier Inc.

CPOE system design aspects and their qualitative effect on usability.

PubMed

Khajouei, Reza; Jaspers, Monique W M

2008-01-01

Although many studies have discussed the benefits of Computerized Provider Order Entry (CPOE) systems, their configuration can have a great impact on clinicians' adoption of these systems. Poorly designed CPOE systems can lead to usability problems, users' dissatisfaction and may disrupt normal flow of clinical activities. This paper reports on a literature review focused on the identification of CPOE medication systems' design aspects that impact CPOE systems' usability and create opportunities for medication errors. Our review is based on a systematic literature search in PubMed, EMBASE and Ovid MEDLINE for relevant publications from 1986-2006. We categorized the design aspects extracted from relevant publications into six different groups: 1) timing of alerts, 2) log in/out procedures, 3) pick lists and drop down menus, 4) clues and guidelines, 5) documentation and data entry options, and 6) screen display and layout. Our review shows that the manner in which a CPOE system is configured can have a high impact on ease of system use, task behavior of clinicians in ordering drugs, and medication errors. Characterization of consequences associated with certain CPOE design aspects provides insight into how CPOE system designs can be improved to enhance physicians' adoption of these systems and their success. Recommendations are provided to enable CPOE system designers to create CPOE systems that are not only more user friendly and efficient but safer.

Individualization through standardization: electronic orders for subcutaneous insulin in the hospital.

PubMed

Kennihan, Mary; Zohra, Tatheer; Devi, Radha; Srinivasan, Chitra; Diaz, Josefina; Howard, Bradley S; Braithwaite, Susan S

2012-01-01

The objective was to design electronic order sets that would promote safe, effective, and individualized order entry for subcutaneous insulin in the hospital, based on a review of best practices. Saint Francis Hospital in Evanston, Illinois, a community teaching hospital, was selected as the pilot site for 6 hospitals in the Health Care System to introduce an electronic medical record. Articles dealing with management of hospital hyperglycemia, medical order entry systems, and patient safety were reviewed selectively. In the published literature on institutional glycemic management programs and insulin order sets, features were identified that improve safety and effectiveness of subcutaneous insulin therapy. Subcutaneous electronic insulin order sets were created, designated in short: "patients eating", "patients not eating", and "patients receiving overnight enteral feedings." Together with an option for free text entry, menus of administration instructions were designed within each order set that were applicable to specific insulin orders and expressed in standardized language, such as "hold if tube feeds stop" or "do not withhold." Two design features are advocated for electronic order sets for subcutaneous insulin that will both standardize care and protect individualization. First, within the order sets, the glycemic management plan should be matched to the carbohydrate exposure of the patients, with juxtaposition of appropriate orders for both glucose monitoring and insulin. Second, in order to convey precautions of insulin use to pharmacy and nursing staff, the prescriber must be able to attach administration instructions to specific insulin orders.

Medicare payment reform and provider entry and exit in the post-acute care market.

PubMed

Huckfeldt, Peter J; Sood, Neeraj; Romley, John A; Malchiodi, Alessandro; Escarce, José J

2013-10-01

To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services files between 1992 and 2010. We linked these measures with demographic information from the Census and American Community Survey, information on Certificate of Need laws, and Medicare share of facilities in each market drawn from Cost Report data. Payment reforms reducing average and marginal payments reduced entries and increased exits from the market. Entry effects were larger and more persistent than exit effects. Entry and exit rates fluctuated more for home health agencies than skilled nursing facilities. Effects on number of providers were consistent with entry and exit effects. Payment reform affects market entry and exit, which in turn may affect market structure, access to care, quality and cost of care, and patient outcomes. Policy makers should consider potential impacts of payment reforms on post-acute care market structure when implementing these reforms. © Health Research and Educational Trust.

Medicare Payment Reform and Provider Entry and Exit in the Post-Acute Care Market

PubMed Central

Huckfeldt, Peter J; Sood, Neeraj; Romley, John A; Malchiodi, Alessandro; Escarce, José J

2013-01-01

Objective To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Data Sources Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. Study Design We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. Data Extraction Methods We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services files between 1992 and 2010. We linked these measures with demographic information from the Census and American Community Survey, information on Certificate of Need laws, and Medicare share of facilities in each market drawn from Cost Report data. Principal Findings Payment reforms reducing average and marginal payments reduced entries and increased exits from the market. Entry effects were larger and more persistent than exit effects. Entry and exit rates fluctuated more for home health agencies than skilled nursing facilities. Effects on number of providers were consistent with entry and exit effects. Conclusions Payment reform affects market entry and exit, which in turn may affect market structure, access to care, quality and cost of care, and patient outcomes. Policy makers should consider potential impacts of payment reforms on post-acute care market structure when implementing these reforms. PMID:23557215

Data Mining on Numeric Error in Computerized Physician Order Entry System Prescriptions.

PubMed

Wu, Xue; Wu, Changxu

2017-01-01

This study revealed the numeric error patterns related to dosage when doctors prescribed in computerized physician order entry system. Error categories showed that the '6','7', and '9' key produced a higher incidence of errors in Numpad typing, while the '2','3', and '0' key produced a higher incidence of errors in main keyboard digit line typing. Errors categorized as omission and substitution were higher in prevalence than transposition and intrusion.

The impact of computerized provider order entry systems on inpatient clinical workflow: a literature review.

PubMed

Niazkhani, Zahra; Pirnejad, Habibollah; Berg, Marc; Aarts, Jos

2009-01-01

Previous studies have shown the importance of workflow issues in the implementation of CPOE systems and patient safety practices. To understand the impact of CPOE on clinical workflow, we developed a conceptual framework and conducted a literature search for CPOE evaluations between 1990 and June 2007. Fifty-one publications were identified that disclosed mixed effects of CPOE systems. Among the frequently reported workflow advantages were the legible orders, remote accessibility of the systems, and the shorter order turnaround times. Among the frequently reported disadvantages were the time-consuming and problematic user-system interactions, and the enforcement of a predefined relationship between clinical tasks and between providers. Regarding the diversity of findings in the literature, we conclude that more multi-method research is needed to explore CPOE's multidimensional and collective impact on especially collaborative workflow.

Calibration of the NASA Glenn 8- by 6-Foot Supersonic Wind Tunnel (1996 and 1997 Tests)

NASA Technical Reports Server (NTRS)

Arrington, E. Allen

2012-01-01

There were several physical and operational changes made to the NASA Glenn Research Center 8- by 6-Foot Supersonic Wind Tunnel during the period of 1992 through 1996. Following each of these changes, a facility calibration was conducted to provide the required information to support the research test programs. Due to several factors (facility research test schedule, facility downtime and continued facility upgrades), a full test section calibration was not conducted until 1996. This calibration test incorporated all test section configurations and covered the existing operating range of the facility. However, near the end of that test entry, two of the vortex generators mounted on the compressor exit tailcone failed causing minor damage to the honeycomb flow straightener. The vortex generators were removed from the facility and calibration testing was terminated. A follow-up test entry was conducted in 1997 in order to fully calibrate the facility without the effects of the vortex generators and to provide a complete calibration of the newly expanded low speed operating range. During the 1997 tunnel entry, all planned test points required for a complete test section calibration were obtained. This data set included detailed in-plane and axial flow field distributions for use in quantifying the test section flow quality.

Evaluation of Mars Entry Reconstructured Trajectories Based on Hypothetical 'Quick-Look' Entry Navigation Data

NASA Technical Reports Server (NTRS)

Pastor, P. Rick; Bishop, Robert H.; Striepe, Scott A.

2000-01-01

A first order simulation analysis of the navigation accuracy expected from various Navigation Quick-Look data sets is performed. Here quick-look navigation data are observations obtained by hypothetical telemetried data transmitted on the fly during a Mars probe's atmospheric entry. In this simulation study, navigation data consists of 3-axis accelerometer sensor and attitude information data. Three entry vehicle guidance types are studied: I. a Maneuvering entry vehicle (as with Mars 01 guidance where angle of attack and bank angle are controlled); II. Zero angle-of-attack controlled entry vehicle (as with Mars 98); and III. Ballistic, or spin stabilized entry vehicle (as with Mars Pathfinder);. For each type, sensitivity to progressively under sampled navigation data and inclusion of sensor errors are characterized. Attempts to mitigate the reconstructed trajectory errors, including smoothing, interpolation and changing integrator characteristics are also studied.

Orion Entry Display Feeder and Interactions with the Entry Monitor System

NASA Technical Reports Server (NTRS)

Baird, Darren; Bernatovich, Mike; Gillespie, Ellen; Kadwa, Binaifer; Matthews, Dave; Penny, Wes; Zak, Tim; Grant, Mike; Bihari, Brian

2010-01-01

The Orion spacecraft is designed to return astronauts to a landing within 10 km of the intended landing target from low Earth orbit, lunar direct-entry, and lunar skip-entry trajectories. Al pile the landing is nominally controlled autonomously, the crew can fly precision entries manually in the event of an anomaly. The onboard entry displays will be used by the crew to monitor and manually fly the entry, descent, and landing, while the Entry Monitor System (EMS) will be used to monitor the health and status of the onboard guidance and the trajectory. The entry displays are driven by the entry display feeder, part of the Entry Monitor System (EMS). The entry re-targeting module, also part of the EMS, provides all the data required to generate the capability footprint of the vehicle at any point in the trajectory, which is shown on the Primary Flight Display (PFD). It also provides caution and warning data and recommends the safest possible re-designated landing site when the nominal landing site is no longer within the capability of the vehicle. The PFD and the EMS allow the crew to manually fly an entry trajectory profile from entry interface until parachute deploy having the flexibility to manually steer the vehicle to a selected landing site that best satisfies the priorities of the crew. The entry display feeder provides data from the ENIS and other components of the GNC flight software to the displays at the proper rate and in the proper units. It also performs calculations that are specific to the entry displays and which are not made in any other component of the flight software. In some instances, it performs calculations identical to those performed by the onboard primary guidance algorithm to protect against a guidance system failure. These functions and the interactions between the entry display feeder and the other components of the EMS are described.

Systems design study of the Pioneer Venus spacecraft. Appendices to volume 1, section 7 (part 2 of 3). [procedures for predicting aeroheating environment of Venus entry probes

NASA Technical Reports Server (NTRS)

1973-01-01

The procedures for predicting the aeroheating environment of Venus entry probes are outlined. After some consideration, a number of assumptions were adopted in order to make the prediction techniques tractable. Among these assumptions are thermochemical equilibrium, uncoupled radiative and convective processes, and uncoupled ablation products effects. The single strip method of integral relations, appropriately constrained, is shown to provide adequate inviscid results as a basis for heating calculations on blunt configurations. Techniques for prediction of the laminar, transitional, and turbulent convective environment are outlined and shown to agree with data. The prediction of radiative heating in C, N, and O gas mixtures is discussed and a practical scheme adopted. A comparison with LRC calculations is made.

Return on Investment Point of Service Computerized Provider Charge Entry

PubMed Central

Kiepek, Wendy; FitzHenry, Fern; Shultz, Edward K

2003-01-01

Provider charge entry systems offer many benefits to users and organizations. At Vanderbilt University Medical Center, a web-based provider charge entry system promises to deliver benefits in reducing days in accounts receivable, reducing labor required for claims and edit processing, and implementing business rules that deliver both strategic and financial benefits. PMID:14728396

Navigation Strategy for the Mars 2001 Lander Mission

NASA Technical Reports Server (NTRS)

Mase, Robert A.; Spencer, David A.; Smith, John C.; Braun, Robert D.

2000-01-01

The Mars Surveyor Program (MSP) is an ongoing series of missions designed to robotically study, map and search for signs of life on the planet Mars. The MSP 2001 project will advance the effort by sending an orbiter, a lander and a rover to the red planet in the 2001 opportunity. Each vehicle will carry a science payload that will Investigate the Martian environment on both a global and on a local scale. Although this mission will not directly search for signs of life, or cache samples to be returned to Earth, it will demonstrate certain enabling technologies that will be utilized by the future Mars Sample Return missions. One technology that is needed for the Sample Return mission is the capability to place a vehicle on the surface within several kilometers of the targeted landing site. The MSP'01 Lander will take the first major step towards this type of precision landing at Mars. Significant reduction of the landed footprint will be achieved through two technology advances. The first, and most dramatic, is hypersonic aeromaneuvering; the second is improved approach navigation. As a result, the guided entry will produce in a footprint that is only tens of kilometers, which is an order of magnitude improvement over the Pathfinder and Mars Polar Lander ballistic entries. This reduction will significantly enhance scientific return by enabling the potential selection of otherwise unreachable landing sites with unique geologic interest and public appeal. A landed footprint reduction from hundreds to tens of kilometers is also a milestone on the path towards human exploration of Mars, where the desire is to place multiple vehicles within several hundred meters of the planned landing site. Hypersonic aeromaneuvering is an extension of the atmospheric flight goals of the previous landed missions, Pathfinder and Mars Polar Lander (MPL), that utilizes aerodynamic lift and an autonomous guidance algorithm while in the upper atmosphere. The onboard guidance algorithm will control the direction of the lift vector, via bank angle modulation, to keep the vehicle on the desired trajectory. While numerous autonomous guidance algorithms have been developed for use during hypersonic flight at Earth, this will be the first flight of an autonomously directed lifting entry vehicle at Mars. However, without sufficient control and knowledge of the atmospheric entry conditions, the guidance algorithm will not perform effectively. The goal of the interplanetary navigation strategy is to deliver the spacecraft to the desired entry condition with sufficient accuracy and knowledge to enable satisfactory guidance algorithm performance. Specifically, the entry flight path angle must not exceed 0.27 deg. to a 3 sigma confidence level. Entry errors will contribute directly to the size of the landed footprint and the most significant component is entry flight path angle. The size of the entry corridor is limited on the shallow side by integrated heating constraints, and on the steep side by deceleration (g-load) and terminal descent propellant. In order to meet this tight constraint it is necessary to place a targeting maneuver seven hours prior to the time of entry. At this time the trajectory knowledge will be quite accurate, and the effects of maneuver execution errors will be small. The drawback is that entry accuracy is dependent on the success of this final late maneuver. Because propulsive maneuvers are critical events, it is desirable to minimize their occurrence and provide the flight team with as much response time as possible in the event of a spacecraft fault. A mission critical maneuver at Entry - 7 hours does not provide much fault tolerance, and it is desirable to provide a strategy that minimizes reliance on this maneuver. This paper will focus on the Improvements in interplanetary navigation that will decrease entry errors and will reduce the landed footprint, even in the absence of aeromaneuvering. The easiest to take advantage of are Improvements In the knowledge of the Mars ephemeris and gravity field due to the MGS and MSP'98 missions. Improvements In data collection and reduction techniques such as "precislon ranging' and near-simultaneous tracking will also be utilized. In addition to precise trajectory control, a robust strategy for communications and flight operations must also be demonstrated. The result Is a navigation and communications strategy on approach that utilizes optimal maneuver placement to take advantage of trajectory knowledge, minimizes risk for the flight operations team, is responsive to spacecraft hardware limitations, and achieves the entry corridor. The MSP2001 mission Is managed at JPL under the auspices of the Mars Exploration Directorate. The spacecraft flight elements are built and managed by Lockheed-Martin Astronautics in Denver, Colorado.

Interaction of Human Tumor Viruses with Host Cell Surface Receptors and Cell Entry

PubMed Central

Schäfer, Georgia; Blumenthal, Melissa J.; Katz, Arieh A.

2015-01-01

Currently, seven viruses, namely Epstein-Barr virus (EBV), Kaposi’s sarcoma-associated herpes virus (KSHV), high-risk human papillomaviruses (HPVs), Merkel cell polyomavirus (MCPyV), hepatitis B virus (HBV), hepatitis C virus (HCV) and human T cell lymphotropic virus type 1 (HTLV-1), have been described to be consistently associated with different types of human cancer. These oncogenic viruses belong to distinct viral families, display diverse cell tropism and cause different malignancies. A key to their pathogenicity is attachment to the host cell and entry in order to replicate and complete their life cycle. Interaction with the host cell during viral entry is characterized by a sequence of events, involving viral envelope and/or capsid molecules as well as cellular entry factors that are critical in target cell recognition, thereby determining cell tropism. Most oncogenic viruses initially attach to cell surface heparan sulfate proteoglycans, followed by conformational change and transfer of the viral particle to secondary high-affinity cell- and virus-specific receptors. This review summarizes the current knowledge of the host cell surface factors and molecular mechanisms underlying oncogenic virus binding and uptake by their cognate host cell(s) with the aim to provide a concise overview of potential target molecules for prevention and/or treatment of oncogenic virus infection. PMID:26008702

A cognitive task analysis of information management strategies in a computerized provider order entry environment.

PubMed

Weir, Charlene R; Nebeker, Jonathan J R; Hicken, Bret L; Campo, Rebecca; Drews, Frank; Lebar, Beth

2007-01-01

Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system.

Method and system for entering data within a flight plan entry field

NASA Technical Reports Server (NTRS)

Gibbs, Michael J. (Inventor); Van Omen, Debi (Inventor); Adams, Michael B. (Inventor); Chase, Karl L. (Inventor); Lewis, Daniel E. (Inventor); McCrobie, Daniel E. (Inventor)

2005-01-01

The present invention provides systems, apparatus and methods for entering data into a flight plan entry field which facilitates the display and editing of aircraft flight-plan data. In one embodiment, the present invention provides a method for entering multiple waypoint and procedure identifiers at once within a single a flight plan entry field. In another embodiment, the present invention provides for the partial entry of any waypoint or procedure identifiers, and thereafter relating the identifiers with an aircraft's flight management system to anticipate the complete text entry for display. In yet another embodiment, the present invention discloses a method to automatically provide the aircraft operator with selectable prioritized arrival and approach routing identifiers by a single manual selection. In another embodiment, the present invention is a method for providing the aircraft operator with selectable alternate patterns to a new runway.

A comprehensive inpatient discharge system.

PubMed Central

O'Connell, E. M.; Teich, J. M.; Pedraza, L. A.; Thomas, D.

1996-01-01

Our group has developed a computer system that supports all phases of the inpatient discharge process. The system fills in most of the physician's discharge order form and the nurse's discharge abstract, using information available from sign-out, order entry, scheduling, and other databases. It supplies information for referrals to outside institutions, and provides a variety of instruction materials for patients. Discharge forms can be completed in advance, so that the patient is not waiting for final paperwork. Physicians and nurses can work on their components independently, rather than in series. Response to the system has been very favorable. PMID:8947755

Patient and Sample Identification. Out of the Maze?

PubMed

Lippi, Giuseppe; Chiozza, Laura; Mattiuzzi, Camilla; Plebani, Mario

2017-04-01

Patient and sample misidentification may cause significant harm or discomfort to the patients, especially when incorrect data is used for performing specific healthcare activities. It is hence obvious that efficient and quality care can only start from accurate patient identification. There are many opportunities for misidentification in healthcare and laboratory medicine, including homonymy, incorrect patient registration, reliance on wrong patient data, mistakes in order entry, collection of biological specimens from wrong patients, inappropriate sample labeling and inaccurate entry or erroneous transmission of test results through the laboratory information system. Many ongoing efforts are made to prevent this important healthcare problem, entailing streamlined strategies for identifying patients throughout the healthcare industry by means of traditional and innovative identifiers, as well as using technologic tools that may enhance both the quality and efficiency of blood tubes labeling. The aim of this article is to provide an overview about the liability of identification errors in healthcare, thus providing a pragmatic approach for diverging the so-called patient identification crisis.

Optimizing the user interface of a data entry module for an electronic patient record for cardiac rehabilitation: A mixed method usability approach.

PubMed

van Engen-Verheul, Mariëtte M; Peute, Linda W P; de Keizer, Nicolette F; Peek, Niels; Jaspers, Monique W M

2016-03-01

Cumbersome electronic patient record (EPR) interfaces may complicate data-entry in clinical practice. Completeness of data entered in the EPR determines, among other things, the value of computerized clinical decision support (CCDS). Quantitative usability evaluations can provide insight into mismatches between the system design model of data entry and users' data entry behavior, but not into the underlying causes for these mismatches. Mixed method usability evaluation studies may provide these insights, and thus support generating redesign recommendations for improving an EPR system's data entry interface. To improve the usability of the data entry interface of an EPR system with CCDS in the field of cardiac rehabilitation (CR), and additionally, to assess the value of a mixed method usability approach in this context. Seven CR professionals performed a think-aloud usability evaluation both before (beta-version) and after the redesign of the system. Observed usability problems from both evaluations were analyzed and categorized using Zhang et al.'s heuristic principles of good interface design. We combined the think-aloud usability evaluation of the system's beta-version with the measurement of a new usability construct: users' deviations in action sequence from the system's predefined data entry order sequence. Recommendations for redesign were implemented. We assessed whether the redesign improved CR professionals' (1) task efficacy (with respect to the completeness of data they collected), and (2) task efficiency (with respect to the average number of mouse clicks they needed to complete data entry subtasks). With the system's beta version, 40% of health care professionals' navigation actions through the system deviated from the predefined next system action. The causes for these deviations as revealed by the think-aloud method mostly concerned mismatches between the system design model for data entry action sequences and users expectations of these action sequences, based on their paper-based daily routines. This caused non completion of data entry tasks (31% of main tasks completed), and more navigation actions than minimally required (146% of the minimum required). In the redesigned system the data entry navigational structure was organized in a flexible way around an overview screen to better mimic users' paper-based daily routines of collecting patient data. This redesign resulted in an increased number of completed main tasks (70%) and a decrease in navigation actions (133% of the minimum required). The think-aloud usability evaluation of the redesigned system showed that remaining problems concerned flexibility (e.g., lack of customization options) and consistency (mainly with layout and position of items on the screen). The mixed method usability evaluation was supportive in revealing the magnitude and causes of mismatches between the system design model of data-entry with users' data entry behavior. However, as both task efficacy and efficiency were still not optimal with the redesigned EPR, we advise to perform a cognitive analysis on end users' mental processes and behavior patterns in daily work processes specifically during the requirements analysis phase of development of interactive healthcare information systems. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Adventures in Parallel Processing: Entry, Descent and Landing Simulation for the Genesis and Stardust Missions

NASA Technical Reports Server (NTRS)

Lyons, Daniel T.; Desai, Prasun N.

2005-01-01

This paper will describe the Entry, Descent and Landing simulation tradeoffs and techniques that were used to provide the Monte Carlo data required to approve entry during a critical period just before entry of the Genesis Sample Return Capsule. The same techniques will be used again when Stardust returns on January 15, 2006. Only one hour was available for the simulation which propagated 2000 dispersed entry states to the ground. Creative simulation tradeoffs combined with parallel processing were needed to provide the landing footprint statistics that were an essential part of the Go/NoGo decision that authorized release of the Sample Return Capsule a few hours before entry.

Passive vs. Parachute System Architecture for Robotic Sample Return Vehicles

NASA Technical Reports Server (NTRS)

Maddock, Robert W.; Henning, Allen B.; Samareh, Jamshid A.

2016-01-01

The Multi-Mission Earth Entry Vehicle (MMEEV) is a flexible vehicle concept based on the Mars Sample Return (MSR) EEV design which can be used in the preliminary sample return mission study phase to parametrically investigate any trade space of interest to determine the best entry vehicle design approach for that particular mission concept. In addition to the trade space dimensions often considered (e.g. entry conditions, payload size and mass, vehicle size, etc.), the MMEEV trade space considers whether it might be more beneficial for the vehicle to utilize a parachute system during descent/landing or to be fully passive (i.e. not use a parachute). In order to evaluate this trade space dimension, a simplified parachute system model has been developed based on inputs such as vehicle size/mass, payload size/mass and landing requirements. This model works in conjunction with analytical approximations of a mission trade space dataset provided by the MMEEV System Analysis for Planetary EDL (M-SAPE) tool to help quantify the differences between an active (with parachute) and a passive (no parachute) vehicle concept.

Comparison of viscous-shock-layer solutions by time-asymptotic and steady-state methods. [flow distribution around a Jupiter entry probe

NASA Technical Reports Server (NTRS)

Gupta, R. N.; Moss, J. N.; Simmonds, A. L.

1982-01-01

Two flow-field codes employing the time- and space-marching numerical techniques were evaluated. Both methods were used to analyze the flow field around a massively blown Jupiter entry probe under perfect-gas conditions. In order to obtain a direct point-by-point comparison, the computations were made by using identical grids and turbulence models. For the same degree of accuracy, the space-marching scheme takes much less time as compared to the time-marching method and would appear to provide accurate results for the problems with nonequilibrium chemistry, free from the effect of local differences in time on the final solution which is inherent in time-marching methods. With the time-marching method, however, the solutions are obtainable for the realistic entry probe shapes with massive or uniform surface blowing rates; whereas, with the space-marching technique, it is difficult to obtain converged solutions for such flow conditions. The choice of the numerical method is, therefore, problem dependent. Both methods give equally good results for the cases where results are compared with experimental data.

Survey of the supporting research and technology for the thermal protection of the Galileo Probe

NASA Technical Reports Server (NTRS)

Howe, J. T.; Pitts, W. C.; Lundell, J. H.

1981-01-01

The Galileo Probe, which is scheduled to be launched in 1985 and to enter the hydrogen-helium atmosphere of Jupiter up to 1,475 days later, presents thermal protection problems that are far more difficult than those experienced in previous planetary entry missions. The high entry speed of the Probe will cause forebody heating rates orders of magnitude greater than those encountered in the Apollo and Pioneer Venus missions, severe afterbody heating from base-flow radiation, and thermochemical ablation rates for carbon phenolic that rival the free-stream mass flux. This paper presents a comprehensive survey of the experimental work and computational research that provide technological support for the Probe's heat-shield design effort. The survey includes atmospheric modeling; both approximate and first-principle computations of flow fields and heat-shield material response; base heating; turbulence modelling; new computational techniques; experimental heating and materials studies; code validation efforts; and a set of 'consensus' first-principle flow-field solutions through the entry maneuver, with predictions of the corresponding thermal protection requirements.

Genetic Algorithm-Based Optimization to Match Asteroid Energy Deposition Curves

NASA Technical Reports Server (NTRS)

Tarano, Ana; Mathias, Donovan; Wheeler, Lorien; Close, Sigrid

2018-01-01

An asteroid entering Earth's atmosphere deposits energy along its path due to thermal ablation and dissipative forces that can be measured by ground-based and spaceborne instruments. Inference of pre-entry asteroid properties and characterization of the atmospheric breakup is facilitated by using an analytic fragment-cloud model (FCM) in conjunction with a Genetic Algorithm (GA). This optimization technique is used to inversely solve for the asteroid's entry properties, such as diameter, density, strength, velocity, entry angle, and strength scaling, from simulations using FCM. The previous parameters' fitness evaluation involves minimizing error to ascertain the best match between the physics-based calculated energy deposition and the observed meteors. This steady-state GA provided sets of solutions agreeing with literature, such as the meteor from Chelyabinsk, Russia in 2013 and Tagish Lake, Canada in 2000, which were used as case studies in order to validate the optimization routine. The assisted exploration and exploitation of this multi-dimensional search space enables inference and uncertainty analysis that can inform studies of near-Earth asteroids and consequently improve risk assessment.

Optimizing radiologist e-prescribing of CT oral contrast agent using a protocoling portal.

PubMed

Wasser, Elliot J; Galante, Nicholas J; Andriole, Katherine P; Farkas, Cameron; Khorasani, Ramin

2013-12-01

The purpose of this study is to quantify the time expenditure associated with radiologist ordering of CT oral contrast media when using an integrated protocoling portal and to determine radiologists' perceptions of the ordering process. This prospective study was performed at a large academic tertiary care facility. Detailed timing information for CT inpatient oral contrast orders placed via the computerized physician order entry (CPOE) system was gathered over a 14-day period. Analyses evaluated the amount of physician time required for each component of the ordering process. Radiologists' perceptions of the ordering process were assessed by survey. Descriptive statistics and chi-square analysis were performed. A total of 96 oral contrast agent orders were placed by 13 radiologists during the study period. The average time necessary to create a protocol for each case was 40.4 seconds (average range by subject, 20.0-130.0 seconds; SD, 37.1 seconds), and the average total time to create and sign each contrast agent order was 27.2 seconds (range, 10.0-50.0 seconds; SD, 22.4 seconds). Overall, 52.5% (21/40) of survey respondents indicated that radiologist entry of oral contrast agent orders improved patient safety. A minority of respondents (15% [6/40]) indicated that contrast agent order entry was either very or extremely disruptive to workflow. Radiologist e-prescribing of CT oral contrast agents using CPOE can be embedded in a protocol workflow. Integration of health IT tools can help to optimize user acceptance and adoption.

An inventory of publications on electronic medical records revisited.

PubMed

Moorman, P W; Schuemie, M J; van der Lei, J

2009-01-01

In this short review we provide an update of our earlier inventories of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. We retrieved and analyzed all references to English articles published before January 1, 2008, and indexed in PubMed with the MeSH term 'Medical Records Systems, Computerized'. We retrieved a total of 11,924 publications, of which 3937 (33%) appeared in a journal with an impact factor. Since 2002 the number of yearly publications, and the number of journals in which those publications appeared, increased. A cluster analysis revealed three clusters: an organizational issues cluster, a technically oriented cluster and a cluster about order-entry and research. Although our previous inventory in 2003 suggested a constant yearly production of publications on electronic medical records since 1998, the current inventory shows another rise in production since 2002. In addition, many new journals and countries have shown interest during the last five years. In the last 15 years, interest in organizational issues remained fairly constant, order entry and research with systems gained attention, while interest in technical issues relatively decreased.

19 CFR 142.44 - Entry number range.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Entry number range. 142.44 Section 142.44 Customs... (CONTINUED) ENTRY PROCESS Line Release § 142.44 Entry number range. After an application for Line Release has received final approval, filers must provide the port director, in writing, with a range of entry numbers...

ATV reentry

NASA Image and Video Library

2012-10-03

ISS033-E-009232 (3 Oct. 2012) --- This still photo taken by the Expedition 33 crew members aboard the International Space Station shows evidence of the fiery plunge through Earth?s atmosphere and the destructive re-entry of the European Automated Transfer Vehicle-3 (ATV-3) spacecraft, also known as ?Edoardo Amaldi.? The end of the ATV took place over a remote swath of the Pacific Ocean where any surviving debris safely splashed down a short time later, at around 1:30 a.m. (GMT) on Oct. 3, thus concluding the highly successful ATV-3 mission. Aboard the craft during re-entry was the Re Entry Breakup Recorder (REBR), a spacecraft ?black box? designed to gather data on vehicle disintegration during re-entry in order to improve future spacecraft re-entry models.

Effect of closed-loop order processing on the time to initial antimicrobial therapy.

PubMed

Panosh, Nicole; Rew, Richardd; Sharpe, Michelle

2012-08-15

The results of a study comparing the average time to initiation of i.v. antimicrobial therapy with closed-versus open-loop order entry and processing are reported. A retrospective cohort study was performed to compare order-to-administration times for initial doses of i.v. antimicrobials before and after a closed-loop order-processing system including computerized prescriber order entry (CPOE) was implemented at a large medical center. A total of 741 i.v. antimicrobial administrations to adult patients during designated five-month preimplementation and postimplementation study periods were assessed. Drug-use reports generated by the pharmacy database were used to identify order-entry times, and medication administration records were reviewed to determine times of i.v. antimicrobial administration. The mean ± S.D. order-to-administration times before and after the implementation of the CPOE system and closed-loop order processing were 3.18 ± 2.60 and 2.00 ± 1.89 hours, respectively, a reduction of 1.18 hours (p < 0.0001). Closed-loop order processing was associated with significant reductions in the average time to initiation of i.v. therapy in all patient care areas evaluated (cardiology, general medicine, and oncology). The study results suggest that CPOE-based closed-loop order processing can play an important role in achieving compliance with current practice guidelines calling for increased efforts to ensure the prompt initiation of i.v. antimicrobials for severe infections (e.g., sepsis, meningitis). Implementation of a closed-loop order-processing system resulted in a significant decrease in order-to-administration times for i.v. antimicrobial therapy.

Aerodynamic Heating Computations for Projectiles. Volume 1. In-Depth Heat Conduction Modifications to the ABRES Shape Change Code (BRLASCC)

DTIC Science & Technology

1984-06-01

preceding the corresponding pressure group of the surface thermochemistry deck as described below. The temperature entries within each section must be... pressure group the transfer coefficient values will be ordered. Within each transfer coefficient section, ablation rate entries need not he ordered in any...may not exceed 5 (and may be only I); the number of transfer coefficient values in each pressure group may not exceed 5 but may be only 1. If no

Computerized Provider Order Entry Reduces Length of Stay in a Community Hospital

PubMed Central

Peters, K.; Shaha, S.H.

2014-01-01

Summary Objective Does computerized provider order entry (CPOE) improve clinical, cost, and efficiency outcomes as quantified in shortened hospital length of stay (LOS)? Most prior studies were done in university settings with home-grown electronic records, and are now 20 years old. This study asked whether CPOE exerts a downward force on LOS in the current era of HITECH incentives, using a vendor product in a community hospital. Methods The methodology retrospectively evaluated correlation between CPOE and LOS on a perpatient, per-visit basis over 22 consecutive quarters, organized by discipline. All orders from all areas were eligible, except verbals, and medication orders in the emergency department which were not available via CPOE. These results were compared with quarterly case mix indices organized by discipline. Correlational and regression analyses were cross-checked to ensure validity of R-square coefficients, and data were smoothed for ease of display. Standard models were used to calculate the inflection point. Results Gains in CPOE adoption occurred iteratively house-wide, and in each discipline. LOS decreased in a sigmoid shaped curve. The inflection point shows that once CPOE adoption approaches 60%, further lowering of LOS accelerates. Overall there was a 20.2% reduction in LOS correlated with adoption of CPOE. Case mix index increased during the study period showing that reductions in LOS occurred despite increased patient complexity and resource utilization. Conclusions There was a 20.2% reduction in LOS correlated with rising adoption of CPOE. CPOE contributes to improved clinical, cost, and efficiency outcomes as quantified in reduced LOS, over and above other processes introduced to lower LOS. CPOE enabled a reduction in LOS despite an increase in the case mix index during the time frame of this study. PMID:25298809

A comparative analysis of the dissemination of best practice measures for key populations.

PubMed

Lundy, Jennifer; Santangelo, Jennifer; Rogers, Patrick; Kuehn, Lynn; Christensen, Sharon; Bournique, Judy; Mekhjian, Hagop; Kamal, Jyoti

2008-11-06

In collaboration with the department of Quality and Operations Improvement, Clinical Applications and the Information Warehouse, we have leveraged available Information Warehouse data to build a Best Practice Compliance Measurement Dashboard. This tool combines information from our operating room charting system, our order entry system and coding information from the patient billing and management system to provide 'previous day', data on a patients current course of treatment.

8 CFR 1.1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... successive re-delegation, the terms mean, to the extent that authority has been delegated to such official... having changed. Such status terminates upon entry of a final administrative order of exclusion... come into the United States at a port-of-entry, or an alien seeking transit through the United States...

Aerocapture Inflatable Decelerator for Planetary Entry

NASA Technical Reports Server (NTRS)

Reza, Sajjad; Hund, Richard; Kustas, Frank; Willcockson, William; Songer, Jarvis; Brown, Glen

2007-01-01

Forward Attached Inflatable Decelerators, more commonly known as inflatable aeroshells, provide an effective, cost efficient means of decelerating spacecrafts by using atmospheric drag for aerocapture or planetary entry instead of conventional liquid propulsion deceleration systems. Entry into planetary atmospheres results in significant heating and aerodynamic pressures which stress aeroshell systems to their useful limits. Incorporation of lightweight inflatable decelerator surfaces with increased surface-area footprints provides the opportunity to reduce heat flux and induced temperatures, while increasing the payload mass fraction. Furthermore, inflatable aeroshell decelerators provide the needed deceleration at considerably higher altitudes and Mach numbers when compared with conventional rigid aeroshell entry systems. Inflatable aeroshells also provide for stowage in a compact space, with subsequent deployment of a large-area, lightweight heatshield to survive entry heating. Use of a deployable heatshield decelerator enables an increase in the spacecraft payload mass fraction and may eliminate the need for a spacecraft backshell.

The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis

PubMed Central

2014-01-01

Background The Health Information Technology for Economic and Clinical Health (HITECH) Act subsidizes implementation by hospitals of electronic health records with computerized provider order entry (CPOE), which may reduce patient injuries caused by medication errors (preventable adverse drug events, pADEs). Effects on pADEs have not been rigorously quantified, and effects on medication errors have been variable. The objectives of this analysis were to assess the effectiveness of CPOE at reducing pADEs in hospital-related settings, and examine reasons for heterogeneous effects on medication errors. Methods Articles were identified using MEDLINE, Cochrane Library, Econlit, web-based databases, and bibliographies of previous systematic reviews (September 2013). Eligible studies compared CPOE with paper-order entry in acute care hospitals, and examined diverse pADEs or medication errors. Studies on children or with limited event-detection methods were excluded. Two investigators extracted data on events and factors potentially associated with effectiveness. We used random effects models to pool data. Results Sixteen studies addressing medication errors met pooling criteria; six also addressed pADEs. Thirteen studies used pre-post designs. Compared with paper-order entry, CPOE was associated with half as many pADEs (pooled risk ratio (RR) = 0.47, 95% CI 0.31 to 0.71) and medication errors (RR = 0.46, 95% CI 0.35 to 0.60). Regarding reasons for heterogeneous effects on medication errors, five intervention factors and two contextual factors were sufficiently reported to support subgroup analyses or meta-regression. Differences between commercial versus homegrown systems, presence and sophistication of clinical decision support, hospital-wide versus limited implementation, and US versus non-US studies were not significant, nor was timing of publication. Higher baseline rates of medication errors predicted greater reductions (P < 0.001). Other context and implementation variables were seldom reported. Conclusions In hospital-related settings, implementing CPOE is associated with a greater than 50% decline in pADEs, although the studies used weak designs. Decreases in medication errors are similar and robust to variations in important aspects of intervention design and context. This suggests that CPOE implementation, as subsidized under the HITECH Act, may benefit public health. More detailed reporting of the context and process of implementation could shed light on factors associated with greater effectiveness. PMID:24894078

Spatial and temporal variation in evacuee risk perception throughout the evacuation and return-entry process.

PubMed

Siebeneck, Laura K; Cova, Thomas J

2012-09-01

Developing effective evacuation and return-entry plans requires understanding the spatial and temporal dimensions of risk perception experienced by evacuees throughout a disaster event. Using data gathered from the 2008 Cedar Rapids, Iowa Flood, this article explores how risk perception and location influence evacuee behavior during the evacuation and return-entry process. Three themes are discussed: (1) the spatial and temporal characteristics of risk perception throughout the evacuation and return-entry process, (2) the relationship between risk perception and household compliance with return-entry orders, and (3) the role social influences have on the timing of the return by households. The results indicate that geographic location and spatial variation of risk influenced household risk perception and compliance with return-entry plans. In addition, sociodemographic characteristics influenced the timing and characteristics of the return groups. The findings of this study advance knowledge of evacuee behavior throughout a disaster and can inform strategies used by emergency managers throughout the evacuation and return-entry process. © 2012 Society for Risk Analysis.

The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

PubMed Central

Miller, Randolph A.; Waitman, Lemuel R.; Chen, Sutin; Rosenbloom, S. Trent

2006-01-01

The authors describe a pragmatic approach to the introduction of clinical decision support at the point of care, based on a decade of experience in developing and evolving Vanderbilt’s inpatient “WizOrder” care provider order entry (CPOE) system. The inpatient care setting provides a unique opportunity to interject CPOE-based decision support features that restructure clinical workflows, deliver focused relevant educational materials, and influence how care is delivered to patients. From their empirical observations, the authors have developed a generic model for decision support within inpatient CPOE systems. They believe that the model’s utility extends beyond Vanderbilt, because it is based on characteristics of end-user workflows and on decision support considerations that are common to a variety of inpatient settings and CPOE systems. The specific approach to implementing a given clinical decision support feature within a CPOE system should involve evaluation along three axes: what type of intervention to create (for which the authors describe 4 general categories); when to introduce the intervention into the user’s workflow (for which the authors present 7 categories), and how disruptive, during use of the system, the intervention might be to end-users’ workflows (for which the authors describe 6 categories). Framing decision support in this manner may help both developers and clinical end-users plan future alterations to their systems when needs for new decision support features arise. PMID:16290243

New Unintended Adverse Consequences of Electronic Health Records

PubMed Central

Wright, A.; Ash, J.; Singh, H.

2016-01-01

Summary Although the health information technology industry has made considerable progress in the design, development, implementation, and use of electronic health records (EHRs), the lofty expectations of the early pioneers have not been met. In 2006, the Provider Order Entry Team at Oregon Health & Science University described a set of unintended adverse consequences (UACs), or unpredictable, emergent problems associated with computer-based provider order entry implementation, use, and maintenance. Many of these originally identified UACs have not been completely addressed or alleviated, some have evolved over time, and some new ones have emerged as EHRs became more widely available. The rapid increase in the adoption of EHRs, coupled with the changes in the types and attitudes of clinical users, has led to several new UACs, specifically: complete clinical information unavailable at the point of care; lack of innovations to improve system usability leading to frustrating user experiences; inadvertent disclosure of large amounts of patient-specific information; increased focus on computer-based quality measurement negatively affecting clinical workflows and patient-provider interactions; information overload from marginally useful computer-generated data; and a decline in the development and use of internally-developed EHRs. While each of these new UACs poses significant challenges to EHR developers and users alike, they also offer many opportunities. The challenge for clinical informatics researchers is to continue to refine our current systems while exploring new methods of overcoming these challenges and developing innovations to improve EHR interoperability, usability, security, functionality, clinical quality measurement, and information summarization and display. PMID:27830226

Ultrasound beam transmission using a discretely orthogonal Gaussian aperture basis

NASA Astrophysics Data System (ADS)

Roberts, R. A.

2018-04-01

Work is reported on development of a computational model for ultrasound beam transmission at an arbitrary geometry transmission interface for generally anisotropic materials. The work addresses problems encountered when the fundamental assumptions of ray theory do not hold, thereby introducing errors into ray-theory-based transmission models. Specifically, problems occur when the asymptotic integral analysis underlying ray theory encounters multiple stationary phase points in close proximity, due to focusing caused by concavity on either the entry surface or a material slowness surface. The approach presented here projects integrands over both the transducer aperture and the entry surface beam footprint onto a Gaussian-derived basis set, thereby distributing the integral over a summation of second-order phase integrals which are amenable to single stationary phase point analysis. Significantly, convergence is assured provided a sufficiently fine distribution of basis functions is used.

Motivationally Significant Stimuli Show Visual Prior Entry: Evidence for Attentional Capture

ERIC Educational Resources Information Center

West, Greg L.; Anderson, Adam A. K.; Pratt, Jay

2009-01-01

Previous studies that have found attentional capture effects for stimuli of motivational significance do not directly measure initial attentional deployment, leaving it unclear to what extent these items produce attentional capture. Visual prior entry, as measured by temporal order judgments (TOJs), rests on the premise that allocated attention…

75 FR 80870 - Self-Regulatory Organizations; Chicago Stock Exchange, Inc.; Notice of Filing and Order Granting...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... Proposed Rule Change To Eliminate the Validated Cross Trade Entry Functionality December 16, 2010. Pursuant... eliminate the Validated Cross Trade Entry Functionality for Exchange-registered Institutional Brokers. The... Brokers (``Institutional Brokers'') by eliminating the ability of an Institutional Broker to execute...

19 CFR 141.68 - Time of entry.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (pursuant to § 24.25 of this chapter) have been successfully received by CBP via the Automated Broker... from warehouse for consumption. The time of entry of merchandise withdrawn from warehouse for... the order of the warehouse proprietor) is when: (1) CBP Form 7501 is executed in proper form and filed...

19 CFR 141.68 - Time of entry.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (pursuant to § 24.25 of this chapter) have been successfully received by CBP via the Automated Broker... from warehouse for consumption. The time of entry of merchandise withdrawn from warehouse for... the order of the warehouse proprietor) is when: (1) CBP Form 7501 is executed in proper form and filed...

19 CFR 141.68 - Time of entry.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (pursuant to § 24.25 of this chapter) have been successfully received by CBP via the Automated Broker... from warehouse for consumption. The time of entry of merchandise withdrawn from warehouse for... the order of the warehouse proprietor) is when: (1) CBP Form 7501 is executed in proper form and filed...

19 CFR 141.68 - Time of entry.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (pursuant to § 24.25 of this chapter) have been successfully received by CBP via the Automated Broker... from warehouse for consumption. The time of entry of merchandise withdrawn from warehouse for... the order of the warehouse proprietor) is when: (1) CBP Form 7501 is executed in proper form and filed...

19 CFR 141.68 - Time of entry.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (pursuant to § 24.25 of this chapter) have been successfully received by CBP via the Automated Broker... from warehouse for consumption. The time of entry of merchandise withdrawn from warehouse for... the order of the warehouse proprietor) is when: (1) CBP Form 7501 is executed in proper form and filed...

9 CFR 93.105 - Inspection at the port of entry.

Code of Federal Regulations, 2011 CFR

2011-01-01

... port of entry by a veterinary inspector of APHIS and such birds shall be permitted entry only at the....101(c)(2) shall be subject to veterinary inspection at any of the ports of entry listed in § 93.102... be inspected at the Customs port of entry by a veterinary inspector of APHIS and, except as provided...

A Comparison of Two Skip Entry Guidance Algorithms

NASA Technical Reports Server (NTRS)

Rea, Jeremy R.; Putnam, Zachary R.

2007-01-01

The Orion capsule vehicle will have a Lift-to-Drag ratio (L/D) of 0.3-0.35. For an Apollo-like direct entry into the Earth's atmosphere from a lunar return trajectory, this L/D will give the vehicle a maximum range of about 2500 nm and a maximum crossrange of 216 nm. In order to y longer ranges, the vehicle lift must be used to loft the trajectory such that the aerodynamic forces are decreased. A Skip-Trajectory results if the vehicle leaves the sensible atmosphere and a second entry occurs downrange of the atmospheric exit point. The Orion capsule is required to have landing site access (either on land or in water) inside the Continental United States (CONUS) for lunar returns anytime during the lunar month. This requirement means the vehicle must be capable of flying ranges of at least 5500 nm. For the L/D of the vehicle, this is only possible with the use of a guided Skip-Trajectory. A skip entry guidance algorithm is necessary to achieve this requirement. Two skip entry guidance algorithms have been developed: the Numerical Skip Entry Guidance (NSEG) algorithm was developed at NASA/JSC and PredGuid was developed at Draper Laboratory. A comparison of these two algorithms will be presented in this paper. Each algorithm has been implemented in a high-fidelity, 6 degree-of-freedom simulation called the Advanced NASA Technology Architecture for Exploration Studies (ANTARES). NASA and Draper engineers have completed several monte carlo analyses in order to compare the performance of each algorithm in various stress states. Each algorithm has been tested for entry-to-target ranges to include direct entries and skip entries of varying length. Dispersions have been included on the initial entry interface state, vehicle mass properties, vehicle aerodynamics, atmosphere, and Reaction Control System (RCS). Performance criteria include miss distance to the target, RCS fuel usage, maximum g-loads and heat rates for the first and second entry, total heat load, and control system saturation. The comparison of the performance criteria has led to a down select and guidance merger that will take the best ideas from each algorithm to create one skip entry guidance algorithm for the Orion vehicle.

Legacy system integration using web technology

NASA Astrophysics Data System (ADS)

Kennedy, Richard L.; Seibert, James A.; Hughes, Chris J.

2000-05-01

As healthcare moves towards a completely digital, multimedia environment there is an opportunity to provide for cost- effective, highly distributed physician access to clinical information including radiology-based imaging. In order to address this opportunity a Universal Clinical Desktop (UCD) system was developed. A UCD provides a single point of entry into an integrated view of all types of clinical data available within a network of disparate healthcare information systems. In order to explore the application of a UCD in a hospital environment, a pilot study was established with the University of California Davis Medical Center using technology from Trilix Information Systems. Within this pilot environment the information systems integrated under the UCD include a radiology information system (RIS), a picture archive and communication system (PACS) and a laboratory information system (LIS).

Analysis of Low Appropriateness Score Exam Trends in Decision Support-based Radiology Order Entry System.

PubMed

Gupta, Supriya; Klein, Kandace; Singh, Anand H; Thrall, James H

2017-05-01

Awareness of imaging utilization increased after implementation of Radiology Order Entry with decision support systems (ROE-DS). Our hypothesis is few exams with low Clinical Appropriateness Score (CAS) on ROE-DS are performed. Clinical indications of exams with CAS less than 3 (9-point scale) were re-reviewed and reports analyzed. Structured Query Language-based query retrieved exams with CAS less than 3 in ROE-DS from January 2007 to December 2011. Reasons provided by physicians for ordering these exams and reports of exams performed were analyzed. For each indication, number of exams ordered and performed was calculated. Statistical significance was assessed using Student's t test and χ 2 analysis (P < .05). From 445,984 exams, 12,615 exams (2.8%) had CAS less than 3, and 7,956 exams (63%) were performed. Reasons for ordering of 12,615 low CAS exams were as follows: Requests by physician specialists without further explanation (4,516 = 35.8%), notation of special clinical circumstances (2,877 = 22.8%), requests by nonphysician staff without further explanation (1,383 = 10.9%), absence of suspected finding on previous modality (1,099 = 8.7%), patient preference (737 = 5.8%), and requests based on radiologists' recommendations (706 = 5.6%). Difference between male and female (male < female) preferences for low CAS exams was statistically significant (P < .01). Imaging outcome was highest for extremity MRI cases (66.7%; P < .01). Less than 3% of exams ordered had low CAS and about two-thirds of these were performed. Most common indication for ordering these exams was physician specialist request based on opinion of medical necessity without specification. Extremity MRI constituted the highest positive findings for low CAS exams performed. Published by Elsevier Inc.

Specification for Qualification and Certification for Entry Level Welders.

ERIC Educational Resources Information Center

American Welding Society, Miami, FL.

This document provides a standard that defines the requirements and program for the American Welding Society to certify entry-level welders. The certification of entry-level welders requires performance qualification and practical knowledge tests that require a minimum of reading, computation, and manual skills to complete. The Entry-Level Welder…

9 CFR 93.421 - Special provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... this chapter for entry into Canada: Provided, That all ruminants offered for re-entry upon examination... immediate export shall be inspected at the border port of entry and, when accompanied by an import permit obtained under § 93.404 of this part and all conditions therein are observed, shall be allowed entry into...

9 CFR 93.421 - Special provisions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... this chapter for entry into Canada: Provided, That all ruminants offered for re-entry upon examination... immediate export shall be inspected at the border port of entry and, when accompanied by an import permit obtained under § 93.404 of this part and all conditions therein are observed, shall be allowed entry into...

9 CFR 93.421 - Special provisions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... this chapter for entry into Canada: Provided, That all ruminants offered for re-entry upon examination... immediate export shall be inspected at the border port of entry and, when accompanied by an import permit obtained under § 93.404 of this part and all conditions therein are observed, shall be allowed entry into...

9 CFR 93.421 - Special provisions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... this chapter for entry into Canada: Provided, That all ruminants offered for re-entry upon examination... immediate export shall be inspected at the border port of entry and, when accompanied by an import permit obtained under § 93.404 of this part and all conditions therein are observed, shall be allowed entry into...

9 CFR 93.421 - Special provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... this chapter for entry into Canada: Provided, That all ruminants offered for re-entry upon examination... immediate export shall be inspected at the border port of entry and, when accompanied by an import permit obtained under § 93.404 of this part and all conditions therein are observed, shall be allowed entry into...

Re-refinement from deposited X-ray data can deliver improved models for most PDB entries.

PubMed

Joosten, Robbie P; Womack, Thomas; Vriend, Gert; Bricogne, Gérard

2009-02-01

The deposition of X-ray data along with the customary structural models defining PDB entries makes it possible to apply large-scale re-refinement protocols to these entries, thus giving users the benefit of improvements in X-ray methods that have occurred since the structure was deposited. Automated gradient refinement is an effective method to achieve this goal, but real-space intervention is most often required in order to adequately address problems detected by structure-validation software. In order to improve the existing protocol, automated re-refinement was combined with structure validation and difference-density peak analysis to produce a catalogue of problems in PDB entries that are amenable to automatic correction. It is shown that re-refinement can be effective in producing improvements, which are often associated with the systematic use of the TLS parameterization of B factors, even for relatively new and high-resolution PDB entries, while the accompanying manual or semi-manual map analysis and fitting steps show good prospects for eventual automation. It is proposed that the potential for simultaneous improvements in methods and in re-refinement results be further encouraged by broadening the scope of depositions to include refinement metadata and ultimately primary rather than reduced X-ray data.

A Cognitive Task Analysis of Information Management Strategies in a Computerized Provider Order Entry Environment

PubMed Central

Weir, Charlene R.; Nebeker, Jonathan J.R.; Hicken, Bret L.; Campo, Rebecca; Drews, Frank; LeBar, Beth

2007-01-01

Objective Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objective of this study is to explore the information management strategies that clinicians use in the process of adapting to a CPOE system using cognitive task analysis techniques. Design Observation and semi-structured interviews were conducted with 88 primary-care clinicians at 10 Veterans Administration Medical Centers. Measurements Interviews were taped, transcribed, and extensively analyzed to identify key information management goals, strategies, and tasks. Tasks were aggregated into groups, common components across tasks were clarified, and underlying goals and strategies identified. Results Nearly half of the identified tasks were not fully supported by the available technology. Six core components of tasks were identified. Four meta-cognitive information management goals emerged: 1) Relevance Screening; 2) Ensuring Accuracy; 3) Minimizing memory load; and 4) Negotiating Responsibility. Strategies used to support these goals are presented. Conclusion Users develop a wide array of information management strategies that allow them to successfully adapt to new technology. Supporting the ability of users to develop adaptive strategies to support meta-cognitive goals is a key component of a successful system. PMID:17068345

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

PubMed

Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

2017-05-01

To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

Journal of Human Services Abstracts. Volume 3, Number 3.

ERIC Educational Resources Information Center

Department of Health, Education, and Welfare, Washington, DC. Project Share.

This index, containing 450 abstracts on human services, is published quarterly to make available a broad range of documents to those responsible for the planning, management, and delivery of human services. The entries are arranged alphabetically by title and indexed by subject matter. Each entry includes the title, order number, source, price,…

31 CFR 357.20 - Securities account in Legacy Treasury Direct ®.

Code of Federal Regulations, 2011 CFR

2011-07-01

... number. (c) If a bill is transferred from one Legacy Treasury Direct account to another, the price shown...-ENTRY TREASURY BONDS, NOTES AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND... securities portfolio associated with an account master record. (c) Account master record. In order for a...

31 CFR 357.20 - Securities account in Legacy Treasury Direct ®.

Code of Federal Regulations, 2014 CFR

2014-07-01

... number. (c) If a bill is transferred from one Legacy Treasury Direct account to another, the price shown... BOOK-ENTRY TREASURY BONDS, NOTES AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES... the securities portfolio associated with an account master record. (c) Account master record. In order...

31 CFR 357.20 - Securities account in Legacy Treasury Direct ®.

Code of Federal Regulations, 2013 CFR

2013-07-01

... number. (c) If a bill is transferred from one Legacy Treasury Direct account to another, the price shown...-ENTRY TREASURY BONDS, NOTES AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND... securities portfolio associated with an account master record. (c) Account master record. In order for a...

31 CFR 357.20 - Securities account in Legacy Treasury Direct ®.

Code of Federal Regulations, 2012 CFR

2012-07-01

... number. (c) If a bill is transferred from one Legacy Treasury Direct account to another, the price shown...-ENTRY TREASURY BONDS, NOTES AND BILLS HELD IN TREASURY/RESERVE AUTOMATED DEBT ENTRY SYSTEM (TRADES) AND... securities portfolio associated with an account master record. (c) Account master record. In order for a...

9 CFR 93.424 - Import permits and applications for inspection of ruminants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the veterinary inspector at the port of entry an application, in writing, for inspection, so that the veterinary inspector and customs representatives may make mutually satisfactory arrangements for the orderly... as required in § 93.427(d) shall be presented to the veterinary inspector at the port of entry when...

9 CFR 93.424 - Import permits and applications for inspection of ruminants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the veterinary inspector at the port of entry an application, in writing, for inspection, so that the veterinary inspector and customs representatives may make mutually satisfactory arrangements for the orderly... as required in § 93.427(d) shall be presented to the veterinary inspector at the port of entry when...

A Study on Re-entry Predictions of Uncontrolled Space Objects for Space Situational Awareness

NASA Astrophysics Data System (ADS)

Choi, Eun-Jung; Cho, Sungki; Lee, Deok-Jin; Kim, Siwoo; Jo, Jung Hyun

2017-12-01

The key risk analysis technologies for the re-entry of space objects into Earth’s atmosphere are divided into four categories: cataloguing and databases of the re-entry of space objects, lifetime and re-entry trajectory predictions, break-up models after re-entry and multiple debris distribution predictions, and ground impact probability models. In this study, we focused on re- entry prediction, including orbital lifetime assessments, for space situational awareness systems. Re-entry predictions are very difficult and are affected by various sources of uncertainty. In particular, during uncontrolled re-entry, large spacecraft may break into several pieces of debris, and the surviving fragments can be a significant hazard for persons and properties on the ground. In recent years, specific methods and procedures have been developed to provide clear information for predicting and analyzing the re-entry of space objects and for ground-risk assessments. Representative tools include object reentry survival analysis tool (ORSAT) and debris assessment software (DAS) developed by National Aeronautics and Space Administration (NASA), spacecraft atmospheric re-entry and aerothermal break-up (SCARAB) and debris risk assessment and mitigation analysis (DRAMA) developed by European Space Agency (ESA), and semi-analytic tool for end of life analysis (STELA) developed by Centre National d’Etudes Spatiales (CNES). In this study, various surveys of existing re-entry space objects are reviewed, and an efficient re-entry prediction technique is suggested based on STELA, the life-cycle analysis tool for satellites, and DRAMA, a re-entry analysis tool. To verify the proposed method, the re-entry of the Tiangong-1 Space Lab, which is expected to re-enter Earth’s atmosphere shortly, was simulated. Eventually, these results will provide a basis for space situational awareness risk analyses of the re-entry of space objects.

Assessing the Usability of Six Data Entry Mobile Interfaces for Caregivers: A Randomized Trial.

PubMed

Ehrler, Frederic; Haller, Guy; Sarrey, Evelyne; Walesa, Magali; Wipfli, Rolf; Lovis, Christian

2015-12-15

There is an increased demand in hospitals for tools, such as dedicated mobile device apps, that enable the recording of clinical information in an electronic format at the patient's bedside. Although the human-machine interface design on mobile devices strongly influences the accuracy and effectiveness of data recording, there is still a lack of evidence as to which interface design offers the best guarantee for ease of use and quality of recording. Therefore, interfaces need to be assessed both for usability and reliability because recording errors can seriously impact the overall level of quality of the data and affect the care provided. In this randomized crossover trial, we formally compared 6 handheld device interfaces for both speed of data entry and accuracy of recorded information. Three types of numerical data commonly recorded at the patient's bedside were used to evaluate the interfaces. In total, 150 health care professionals from the University Hospitals of Geneva volunteered to record a series of randomly generated data on each of the 6 interfaces provided on a smartphone. The interfaces were presented in a randomized order as part of fully automated data entry scenarios. During the data entry process, accuracy and effectiveness were automatically recorded by the software. Various types of errors occurred, which ranged from 0.7% for the most reliable design to 18.5% for the least reliable one. The length of time needed for data recording ranged from 2.81 sec to 14.68 sec, depending on the interface. The numeric keyboard interface delivered the best performance for pulse data entry with a mean time of 3.08 sec (SD 0.06) and an accuracy of 99.3%. Our study highlights the critical impact the choice of an interface can have on the quality of recorded data. Selecting an interface should be driven less by the needs of specific end-user groups or the necessity to facilitate the developer's task (eg, by opting for default solutions provided by commercial platforms) than by the level of speed and accuracy an interface can provide for recording information. An important effort must be made to properly validate mobile device interfaces intended for use in the clinical setting. In this regard, our study identified the numeric keyboard, among the proposed designs, as the most accurate interface for entering specific numerical values. This is an important step toward providing clearer guidelines on which interface to choose for the appropriate use of handheld device interfaces in the health care setting.

Assessing the Usability of Six Data Entry Mobile Interfaces for Caregivers: A Randomized Trial

PubMed Central

Haller, Guy; Sarrey, Evelyne; Walesa, Magali; Wipfli, Rolf; Lovis, Christian

2015-01-01

Background There is an increased demand in hospitals for tools, such as dedicated mobile device apps, that enable the recording of clinical information in an electronic format at the patient’s bedside. Although the human-machine interface design on mobile devices strongly influences the accuracy and effectiveness of data recording, there is still a lack of evidence as to which interface design offers the best guarantee for ease of use and quality of recording. Therefore, interfaces need to be assessed both for usability and reliability because recording errors can seriously impact the overall level of quality of the data and affect the care provided. Objective In this randomized crossover trial, we formally compared 6 handheld device interfaces for both speed of data entry and accuracy of recorded information. Three types of numerical data commonly recorded at the patient’s bedside were used to evaluate the interfaces. Methods In total, 150 health care professionals from the University Hospitals of Geneva volunteered to record a series of randomly generated data on each of the 6 interfaces provided on a smartphone. The interfaces were presented in a randomized order as part of fully automated data entry scenarios. During the data entry process, accuracy and effectiveness were automatically recorded by the software. Results Various types of errors occurred, which ranged from 0.7% for the most reliable design to 18.5% for the least reliable one. The length of time needed for data recording ranged from 2.81 sec to 14.68 sec, depending on the interface. The numeric keyboard interface delivered the best performance for pulse data entry with a mean time of 3.08 sec (SD 0.06) and an accuracy of 99.3%. Conclusions Our study highlights the critical impact the choice of an interface can have on the quality of recorded data. Selecting an interface should be driven less by the needs of specific end-user groups or the necessity to facilitate the developer’s task (eg, by opting for default solutions provided by commercial platforms) than by the level of speed and accuracy an interface can provide for recording information. An important effort must be made to properly validate mobile device interfaces intended for use in the clinical setting. In this regard, our study identified the numeric keyboard, among the proposed designs, as the most accurate interface for entering specific numerical values. This is an important step toward providing clearer guidelines on which interface to choose for the appropriate use of handheld device interfaces in the health care setting. PMID:27025648

Nondestructive identification for red ink entries of seals by Raman and Fourier transform infrared spectrometry.

PubMed

Wang, Xiang-Feng; Yu, Jing; Zhang, Ai-Lan; Zhou, Dai-Wei; Xie, Meng-Xia

2012-11-01

Determination of the red ink entries of seals on documents can provide valuable evidences for solving related crimes, distinguishing the truth of artworks, and so establishment of nondestructive approaches would play a key role in forensic analysis and related aspects. Raman and FT-IR spectroscopy have been applied for analyzing 105 kinds of red ink entries on documents. The dye components of the ink entries were identified by FT-Raman and confocal Raman microspectroscopy, and then the ink entries were classified into four groups based on these dye components. The ink entries were further discriminated by their FT-IR spectra according to adsorption peaks of the main components, the relative intensities of the characteristic bands and the profiles of the spectra. The results showed that 70 ink entries out of 105 have been individually identified and the remaining 35 ink entries can be divided into 13 subclasses. Combination of Raman and FT-IR spectroscopic methods can provide a powerful nondestructive discriminating tool for identification of the red ink entries of seals on papers. These approaches would have potential application in archeology, art and forensic science. Copyright © 2012 Elsevier B.V. All rights reserved.

Improving geriatric prescribing in the ED: a qualitative study of facilitators and barriers to clinical decision support tool use.

PubMed

Vandenberg, Ann E; Vaughan, Camille P; Stevens, Melissa; Hastings, Susan N; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Echt, Katharina V

2017-02-01

Clinical decision support (CDS) may improve prescribing for older adults in the Emergency Department (ED) if adopted by providers. Existing prescribing order entry processes were mapped at an initial Veterans Administration Medical Center site, demonstrating cognitive burden, effort and safety concerns. Geriatric order sets incorporating 2012 Beers guidelines and including geriatric prescribing advice and prepopulated order options were developed. Geriatric order sets were implemented at two sites as part of the multicomponent 'Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department' quality improvement initiative. Facilitators and barriers to order sets use at the two sites were evaluated. Phone interviews were conducted with two provider groups (n = 20), those 'EQUiPPED' with the interventions (n = 10, 5 at each site) and Comparison providers who were only exposed to order sets through a clickable option on the ED order menu within the patient's medical record (n = 10, 5 at each site). All providers were asked about order set 'use' and 'usefulness'. Users (n = 11) were asked about 'usability'. Order set adopters described 'usefulness' in terms of 'safety' and 'efficiency', whereas order set consultants and order set non-users described 'usefulness' in terms of 'information' or 'training'. Provider 'autonomy', 'comfort' level with existing tools, and 'learning curve' were stated as barriers to use. Quantifying efficiency advantages and communicating safety benefit over preexisting practices and tools may improve adoption of CDS in ED and in other settings of care. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Ablation and Chemical Alteration of Cosmic Dust Particles during Entry into the Earth’s Atmosphere

NASA Astrophysics Data System (ADS)

Rudraswami, N. G.; Shyam Prasad, M.; Dey, S.; Plane, J. M. C.; Feng, W.; Carrillo-Sánchez, J. D.; Fernandes, D.

2016-12-01

Most dust-sized cosmic particles undergo ablation and chemical alteration during atmospheric entry, which alters their original properties. A comprehensive understanding of this process is essential in order to decipher their pre-entry characteristics. The purpose of the study is to illustrate the process of vaporization of different elements for various entry parameters. The numerical results for particles of various sizes and various zenith angles are treated in order to understand the changes in chemical composition that the particles undergo as they enter the atmosphere. Particles with large sizes (> few hundred μm) and high entry velocities (>16 km s‑1) experience less time at peak temperatures compared to those that have lower velocities. Model calculations suggest that particles can survive with an entry velocity of 11 km s‑1 and zenith angles (ZA) of 30°–90°, which accounts for ∼66% of the region where particles retain their identities. Our results suggest that the changes in chemical composition of MgO, SiO2, and FeO are not significant for an entry velocity of 11 km s‑1 and sizes <300 μm, but the changes in these compositions become significant beyond this size, where FeO is lost to a major extent. However, at 16 km s‑1 the changes in MgO, SiO2, and FeO are very intense, which is also reflected in Mg/Si, Fe/Si, Ca/Si, and Al/Si ratios, even for particles with a size of 100 μm. Beyond 400 μm particle sizes at 16 km s‑1, most of the major elements are vaporized, leaving the refractory elements, Al and Ca, suspended in the troposphere.

Computerised Order Entry Systems and Pathology Services - A Synthesis of the Evidence

PubMed Central

Georgiou, Andrew; Westbrook, Johanna I

2006-01-01

Computerised Physician Order Entry (CPOE) systems have been promoted in Australia and internationally for their potential to improve the quality of care. The existing research of the effect of CPOE on pathology laboratories has been variable, pointing to the potential to increase efficiency and effectiveness and contribute to enhancing the quality of patient care on the one hand, while leading to significant disruptions in work organisation with a negative impact on departmental relations on the other hand. In this paper we provide an overview of the research evidence about the impact of CPOE on four areas associated with pathology services; a) efficiency of the ordering process, e.g. test turnaround times, b) effectiveness as measured by test ordering volumes and test order appropriateness, c) quality of care, particularly its effects on patient care and d) work organisation patterns, which can be severely disrupted by CPOE. We discuss the possible ramifications of CPOE and offer three broad, but important recommendations for pathology laboratories, based on our own research experience investigating CPOE implementations over three years. Firstly, pathology laboratories need to be active participants in planning the implementation of CPOE. Secondly, the importance of building a firm organisational foundation for the introduction of the new system that includes openness and responsiveness to feedback. And thirdly, the implementation process needs to be underpinned by a strong commitment to a multi-method evaluation at every stage of the process to be able to measure the impact of the system on work practices and outcomes. PMID:17077878

Analytic Guidance for the First Entry in a Skip Atmospheric Entry

NASA Technical Reports Server (NTRS)

Garcia-Llama, Eduardo

2007-01-01

This paper presents an analytic method to generate a reference drag trajectory for the first entry portion of a skip atmospheric entry. The drag reference, expressed as a polynomial function of the velocity, will meet the conditions necessary to fit the requirements of the complete entry phase. The generic method proposed to generate the drag reference profile is further simplified by thinking of the drag and the velocity as density and cumulative distribution functions respectively. With this notion it will be shown that the reference drag profile can be obtained by solving a linear algebraic system of equations. The resulting drag profile is flown using the feedback linearization method of differential geometric control as guidance law with the error dynamics of a second order homogeneous equation in the form of a damped oscillator. This approach was first proposed as a revisited version of the Space Shuttle Orbiter entry guidance. However, this paper will show that it can be used to fly the first entry in a skip entry trajectory. In doing so, the gains in the error dynamics will be changed at a certain point along the trajectory to improve the tracking performance.

46 CFR Section 1 - What this order does.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false What this order does. Section 1 Section 1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY GENERAL AGENT'S RESPONSIBILITY IN CONNECTION WITH FOREIGN REPAIR CUSTOM'S ENTRIES Section 1 What this order does. This order...

46 CFR Section 1 - What this order does.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false What this order does. Section 1 Section 1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY GENERAL AGENT'S RESPONSIBILITY IN CONNECTION WITH FOREIGN REPAIR CUSTOM'S ENTRIES Section 1 What this order does. This order...

46 CFR Section 1 - What this order does.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false What this order does. Section 1 Section 1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION A-NATIONAL SHIPPING AUTHORITY GENERAL AGENT'S RESPONSIBILITY IN CONNECTION WITH FOREIGN REPAIR CUSTOM'S ENTRIES Section 1 What this order does. This order...

Development of a data entry auditing protocol and quality assurance for a tissue bank database.

PubMed

Khushi, Matloob; Carpenter, Jane E; Balleine, Rosemary L; Clarke, Christine L

2012-03-01

Human transcription error is an acknowledged risk when extracting information from paper records for entry into a database. For a tissue bank, it is critical that accurate data are provided to researchers with approved access to tissue bank material. The challenges of tissue bank data collection include manual extraction of data from complex medical reports that are accessed from a number of sources and that differ in style and layout. As a quality assurance measure, the Breast Cancer Tissue Bank (http:\\\\www.abctb.org.au) has implemented an auditing protocol and in order to efficiently execute the process, has developed an open source database plug-in tool (eAuditor) to assist in auditing of data held in our tissue bank database. Using eAuditor, we have identified that human entry errors range from 0.01% when entering donor's clinical follow-up details, to 0.53% when entering pathological details, highlighting the importance of an audit protocol tool such as eAuditor in a tissue bank database. eAuditor was developed and tested on the Caisis open source clinical-research database; however, it can be integrated in other databases where similar functionality is required.

Numerical Investigation of Rockfall Impacts on Muckpiles for Underground Portals

NASA Astrophysics Data System (ADS)

Effeindzourou, Anna; Giacomini, Anna; Thoeni, Klaus; Sloan, Scott W.

2017-06-01

Small-scale waste rock piles or muckpiles are commonly used as energy absorption barriers in various surface mining applications. This paper numerically investigates the impact behaviour of blocks on muckpiles used as cushion layer on top of underground portal entries. A three-dimensional discrete element model is implemented into the open-source framework YADE and validated using full-scale experimental data. The model allows estimating the energy absorption capacity of the muckpile and the impact forces acting on the portal structure. It also provides valuable information on the rebound characteristics which are useful for the definition of the potential safety areas in the vicinity of an underground entry. In order to show its capabilities, the model is applied to a large number of cases representing potential design conditions. The influence of block mass, impact velocity and absorbing cushion thickness on the forces at the base of the muckpile and the rebound trajectories after impact are investigated.

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

Deng,Y.; Liu, J.; Zheng, Q.

Entry of SARS coronavirus into its target cell requires large-scale structural transitions in the viral spike (S) glycoprotein in order to induce fusion of the virus and cell membranes. Here we describe the identification and crystal structures of four distinct a-helical domains derived from the highly conserved heptad-repeat (HR) regions of the S2 fusion subunit. The four domains are an antiparallel four-stranded coiled coil, a parallel trimeric coiled coil, a four-helix bundle, and a six-helix bundle that is likely the final fusogenic form of the protein. When considered together, the structural and thermodynamic features of the four domains suggest amore » possible mechanism whereby the HR regions, initially sequestered in the native S glycoprotein spike, are released and refold sequentially to promote membrane fusion. Our results provide a structural framework for understanding the control of membrane fusion and should guide efforts to intervene in the SARS coronavirus entry process.« less

Optimization of orbital assignment and specification of service areas in satellite communications

NASA Technical Reports Server (NTRS)

Wang, Cou-Way; Levis, Curt A.; Buyukdura, O. Merih

1987-01-01

The mathematical nature of the orbital and frequency assignment problem for communications satellites is explored, and it is shown that choosing the correct permutations of the orbit locations and frequency assignments is an important step in arriving at values which satisfy the signal-quality requirements. Two methods are proposed to achieve better spectrum/orbit utilization. The first, called the delta S concept, leads to orbital assignment solutions via either mixed-integer or restricted basis entry linear programming techniques; the method guarantees good single-entry carrier-to-interference ratio results. In the second, a basis for specifying service areas is proposed for the Fixed Satellite Service. It is suggested that service areas should be specified according to the communications-demand density in conjunction with the delta S concept in order to enable the system planner to specify more satellites and provide more communications supply.

Recommending a minimum English proficiency standard for entry-level nursing.

PubMed

O'Neill, Thomas R; Tannenbaum, Richard J; Tiffen, Jennifer

2005-01-01

When nurses who are educated internationally immigrate to the United States, they are expected to have English language proficiency in order to function as a competent nurse. The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures, the Simulated Minimally Competent Candidate (SMCC) procedure and the Examinee Paper Selection Method, were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220. Because the adoption of this standard rests entirely with the individual state, NCSBN has little more to do with implementing the standard, other than answering questions and providing documentation about the standard.

7 CFR 1216.60 - Reports.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE PEANUT PROMOTION, RESEARCH, AND INFORMATION ORDER Peanut Promotion, Research, and Information Order Reports, Books, and Records § 1216.60... following: (1) Number of pounds of peanuts produced or handled; (2) Price paid to producers (entry in value...

36 CFR 261.50 - Orders.

Code of Federal Regulations, 2010 CFR

2010-07-01

... in Areas Designated by Order § 261.50 Orders. (a) The Chief, each Regional Forester, each Experiment... issue orders which close or restrict the use of described areas within the area over which he has jurisdiction. An order may close an area to entry or may restrict the use of an area by applying any or all of...

Data entry errors and design for model-based tight glycemic control in critical care.

PubMed

Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

2012-01-01

Tight glycemic control (TGC) has shown benefits but has been difficult to achieve consistently. Model-based methods and computerized protocols offer the opportunity to improve TGC quality but require human data entry, particularly of blood glucose (BG) values, which can be significantly prone to error. This study presents the design and optimization of data entry methods to minimize error for a computerized and model-based TGC method prior to pilot clinical trials. To minimize data entry error, two tests were carried out to optimize a method with errors less than the 5%-plus reported in other studies. Four initial methods were tested on 40 subjects in random order, and the best two were tested more rigorously on 34 subjects. The tests measured entry speed and accuracy. Errors were reported as corrected and uncorrected errors, with the sum comprising a total error rate. The first set of tests used randomly selected values, while the second set used the same values for all subjects to allow comparisons across users and direct assessment of the magnitude of errors. These research tests were approved by the University of Canterbury Ethics Committee. The final data entry method tested reduced errors to less than 1-2%, a 60-80% reduction from reported values. The magnitude of errors was clinically significant and was typically by 10.0 mmol/liter or an order of magnitude but only for extreme values of BG < 2.0 mmol/liter or BG > 15.0-20.0 mmol/liter, both of which could be easily corrected with automated checking of extreme values for safety. The data entry method selected significantly reduced data entry errors in the limited design tests presented, and is in use on a clinical pilot TGC study. The overall approach and testing methods are easily performed and generalizable to other applications and protocols. © 2012 Diabetes Technology Society.

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

Weighted re-randomization tests for minimization with unbalanced allocation.

PubMed

Han, Baoguang; Yu, Menggang; McEntegart, Damian

2013-01-01

Re-randomization test has been considered as a robust alternative to the traditional population model-based methods for analyzing randomized clinical trials. This is especially so when the clinical trials are randomized according to minimization, which is a popular covariate-adaptive randomization method for ensuring balance among prognostic factors. Among various re-randomization tests, fixed-entry-order re-randomization is advocated as an effective strategy when a temporal trend is suspected. Yet when the minimization is applied to trials with unequal allocation, fixed-entry-order re-randomization test is biased and thus compromised in power. We find that the bias is due to non-uniform re-allocation probabilities incurred by the re-randomization in this case. We therefore propose a weighted fixed-entry-order re-randomization test to overcome the bias. The performance of the new test was investigated in simulation studies that mimic the settings of a real clinical trial. The weighted re-randomization test was found to work well in the scenarios investigated including the presence of a strong temporal trend. Copyright © 2013 John Wiley & Sons, Ltd.

19 CFR Appendix to 19 Cfr Part 0 - Treasury Department Order No. 100-16

Code of Federal Regulations, 2010 CFR

2010-04-01

... completion of entry or substance of entry summary including duty assessment and collection, classification... the Committee on Ways and Means and the Chairman and Ranking Member of the Committee on Finance every... Ranking Member of the Committee on Finance every six months. The Secretary of the Treasury shall list any...

78 FR 3913 - Public Land Order No. 7807: Withdrawal of Public Lands for the Camp Michael Monsoor Mountain...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-17

..., location, and entry under the general land laws, including the United States mining laws, for a period of... Training Facility. This withdrawal also transfers administrative jurisdiction of the lands to the... entry under the general land laws, including the United States mining laws, but not from leasing under...

A discussion of higher order software concepts as they apply to functional requirements and specifications. [space shuttles and guidance

NASA Technical Reports Server (NTRS)

Hamilton, M.

1973-01-01

The entry guidance software functional requirements (requirements design phase), its architectural requirements (specifications design phase), and the entry guidance software verified code are discussed. It was found that the proper integration of designs at both the requirements and specifications levels are of high priority consideration.

Chinese-English 2,000 Selected Chinese Common Sayings (Yale Romanization).

ERIC Educational Resources Information Center

Wu, C.K.; Wu, K.S.

Compiled here for the first time in Yale romanization are 2,000 common Chinese sayings, idioms, proverbs, and other figures of speech. The entries are arranged in two series: once in alphabetic order according to the Yale romanization and then again by the stroke-count of the Chinese characters. The romanized entries are accompanied by several…

76 FR 78886 - Certain Welded Carbon Steel Standard Pipe and Tube From Turkey: Intent To Rescind Countervailing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... Standard Pipe and Tube From Turkey: Intent To Rescind Countervailing Duty Administrative Review, in Part... certain welded carbon steel pipe and tube from Turkey. See Antidumping or Countervailing Duty Order... Certain Welded Carbon Steel Standard Pipe from Turkey,'' (October 27, 2011). A Type 3 entry is an entry of...

Develop and Implement an Integrated Enterprise Information System for a Computer-Integrated Apparel Enterprise (CIAE).

DTIC Science & Technology

1998-01-24

the Apparel Manufacturing Architecture (AMA), a generic architecture for an apparel enterprise. ARN-AIMS consists of three modules - Order Processing , Order...Tracking and Shipping & Invoicing. The Order Processing Module is designed to facilitate the entry of customer orders for stock and special

Publisher Source Directory: A List of Where to Buy or Rent Instructional Materials and Other Educational Aids, Devices, and Media Including More Than 1,600 Publishers and Producers in the U.S., Canada, and Europe. Revised Edition.

ERIC Educational Resources Information Center

National Center on Educational Media and Materials for the Handicapped, Columbus, OH.

Listed are more than 1,600 publishers, producers, and distributors of educational materials for use with the handicapped. Entries are presented in alphabetical order according to name. Beneath each source's name and address are code numbers which correspond to the type of materials each publisher's catalog lists. Provided is a list of the codes…

Low temperature simulation of subliming boundary layer flow in Jupiter atmosphere

NASA Technical Reports Server (NTRS)

Chen, C. J.

1976-01-01

A low-temperature approximate simulation for the sublimation of a graphite heat shield under Jovian entry conditions is studied. A set of algebraic equations is derived to approximate the governing equation and boundary conditions, based on order-of-magnitude analysis. Characteristic quantities such as the wall temperature and the subliming velocity are predicted. Similarity parameters that are needed to simulate the most dominant phenomena of the Jovian entry flow are also given. An approximate simulation of the sublimation of the graphite heat shield is performed with an air-dry-ice model. The simulation with the air-dry-ice model may be carried out experimentally at a lower temperature of 3000 to 6000 K instead of the entry temperature of 14,000 K. The rate of graphite sublimation predicted by the present algebraic approximation agrees to the order of magnitude with extrapolated data. The limitations of the simulation method and its utility are discussed.

The business case for patient safety.

PubMed

Hwang, Raymond W; Herndon, James H

2007-04-01

Recent trends have focused attention on improving patient safety in the United States healthcare system. Lapses in patient safety create undue, often preventable, morbidity. These include adverse drug events, adverse surgical events and nosocomial infections. From an organizational perspective, these events are both inefficient and expensive. Many safe practices and quality enhancing improvements, such as computer provider order entry, proper infection surveillance, telemedicine intensive care, and registered nurse staffing are in fact cost-effective. However, in order to fully achieve higher quality, better adverse event reporting and a culture of safety must first be developed. Increased provider recognition, models of success, public awareness and consumer demand are propelling improvements. As we will outline in this review of the current literature, the business case for patient safety is a compelling one, offering substantial economic incentives for achieving the necessary goal of improved patient outcomes.

Protecting Astronaut Health at First Entry into Vehicles Visiting the international Space Station: Insights from Whole-Module Offgas Testing

NASA Technical Reports Server (NTRS)

Meyers, Valerie

2014-01-01

NASA has accumulated considerable experience in offgas testing of whole modules prior to their docking with the International Space Station (ISS). Since 1998, the Space Toxicology Office has performed offgas testing of the Lab module, both MPLM modules, US Airlock, Node 1, Node 2, Node 3, ATV1, HTV1, and three commercial vehicles. The goal of these tests is twofold: first, to protect the crew from adverse health effects of accumulated volatile pollutants when they first enter the module on orbit, and secondly, to determine the additional pollutant load that the ISS air revitalization systems must handle. In order to predict the amount of accumulated pollutants, the module is sealed for at least 1/5th the worst-case time interval that could occur between the last clean air purge and final hatch closure on the ground and the crew's first entry on orbit. This time can range from a few days to a few months. Typically, triplicate samples are taken at pre-planned times throughout the test. Samples are then analyzed by gas chromatography and mass spectrometry, and the rate of accumulation of pollutants is then extrapolated over time. The analytical values are indexed against 7-day spacecraft maximum allowable concentrations (SMACs) to provide a prediction of the total toxicity value (T-value) at the time of first entry. This T-value and the toxicological effects of specific pollutants that contribute most to the overall toxicity are then used to guide first entry operations. Finally, results are compared to first entry samples collected on orbit to determine the predictive ability of the ground-based offgas test.

Changes, disruption and innovation: An investigation of the introduction of new health information technology in a microbiology laboratory.

PubMed

Toouli, George; Georgiou, Andrew; Westbrook, Johanna

2012-01-01

It is expected that health information technology (HIT) will deliver a safer, more efficient and effective health care system. The aim of this study was to undertake a qualitative and video-ethnographic examination of the impact of information technologies on work processes in the reception area of a Microbiology Department, to ascertain what changed, how it changed and the impact of the change. The setting for this study was the microbiology laboratory of a large tertiary hospital in Sydney. The study consisted of qualitative (interview and focus group) data and observation sessions for the period August 2005 to October 2006 along with video footage shot in three sessions covering the original system and the two stages of the Cerner implementation. Data analysis was assisted by NVivo software and process maps were produced from the video footage. There were two laboratory information systems observed in the video footage with computerized provider order entry introduced four months later. Process maps highlighted the large number of pre data entry steps with the original system whilst the newer system incorporated many of these steps in to the data entry stage. However, any time saved with the new system was offset by the requirement to complete some data entry of patient information not previously required. Other changes noted included the change of responsibilities for the reception staff and the physical changes required to accommodate the increased activity around the data entry area. Implementing a new HIT is always an exciting time for any environment but ensuring that the implementation goes smoothly and with minimal trouble requires the administrator and their team to plan well in advance for staff training, physical layout and possible staff resource reallocation.

Woven Thermal Protection System (WTPS) a Novel Approach to Meet Nasa's Most Demanding Reentry Missions

NASA Technical Reports Server (NTRS)

Stackpoole, Margaret M.; Ellerby, Donald T.; Gasch, Matt; Ventkatapathy, Ethiraj; Beerman, Adam; Boghozian, Tane; Gonzales, Gregory; Feldman, Jay; Peterson, Keith; Prabhu, Dinesh

2014-01-01

NASA's future robotic missions to Venus and other planets, namely, Saturn, Uranus, Neptune, result in extremely high entry conditions that exceed the capabilities of current mid density ablators (PICA or Avcoat). Therefore mission planners assume the use of a fully dense carbon phenolic heatshield similar to what was flown on Pioneer Venus and Galileo. Carbon phenolic is a robust TPS, however, its high density and thermal conductivity constrain mission planners to steep entries, high fluxes, pressures and short entry durations, in order for CP to be feasible from a mass perspective. The high entry conditions pose certification challenges in existing ground based test facilities. In 2012 the Game Changing Development Program in NASA's Space Technology Mission Directorate funded NASA ARC to investigate the feasibility of a Woven Thermal Protection System to meet the needs of NASA's most challenging entry missions. This presentation will summarize the maturation of the WTPS project.

Human Mars Lander Design for NASA's Evolvable Mars Campaign

NASA Technical Reports Server (NTRS)

Polsgrove, Tara; Chapman, Jack; Sutherlin, Steve; Taylor, Brian; Fabisinski, Leo; Collins, Tim; Cianciolo Dwyer, Alicia; Samareh, Jamshid; Robertson, Ed; Studak, Bill;

31 CFR 351.60 - How are book-entry Series EE savings bonds purchased and held?

Code of Federal Regulations, 2014 CFR

2014-07-01

...-entry Series EE savings bonds purchased and held? Book-entry bonds must be purchased and held online through your New Treasury Direct account. We provide instructions for opening an account online at . ...

31 CFR 351.60 - How are book-entry Series EE savings bonds purchased and held?

Code of Federal Regulations, 2012 CFR

2012-07-01

...-entry Series EE savings bonds purchased and held? Book-entry bonds must be purchased and held online through your New Treasury Direct account. We provide instructions for opening an account online at . ...

Impact Testing of the H1224A Shipping/Storage Container

DTIC Science & Technology

1994-05-01

may not provide significant ener- gy absorption for the re - entry vehicle midsection but can provide some confinement of potentially damaged...Horizontal Low-Velocity impact test LHV Longitudinal High-Velocity impact test HHV Horizontal High-Velocity impact test RV Re - entry Vehicle midsection mass...Also, integration of these pulses showed that only a much shorter dura- tion pulse was necessary to slow the re - entry vehicle midsection velocity

Secretary | Center for Cancer Research

Cancer.gov

The Basic Science Program (BSP) pursues independent, multidisciplinary research programs in basic or applied molecular biology, immunology, retrovirology, cancer biology, or human genetics. Research efforts and support are an integral part of the Center for Cancer Research (CCR) at the Frederick national Laboratory for Cancer Research (FNLCR). The BSP Office provides procurement and logistical assistance in support of the research activities of the Center for Cancer Research.KEY ROLES/RESPONSIBILITIES The Secretary III will: Provide heavy-volume procurement support to a large customer base of laboratory staff, both Leidos Biomed and CCR (gov’t), using blanket orders, purchase requisitions, credit card, and online warehouse system Data entry into appropriate financial system component (CostPoint, Cor360), status checks on orders, maintenance of orders log, reconciliation of credit card transactions, maintenance of electronic filing systems Providing logistical support for the facilitation of travel packages (both pre-travel and post travel) for Leidos Biomed employees, as well as the coordination of seminar speakers and subsequent reimbursements Composing and answering emails/correspondence Communicating with all levels of personnel, both verbally and in writing, to gather and clearly convey information

Re-refinement from deposited X-ray data can deliver improved models for most PDB entries

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

Joosten, Robbie P.; Womack, Thomas; Vriend, Gert, E-mail: vriend@cmbi.ru.nl

2009-02-01

An evaluation of validation and real-space intervention possibilities for improving existing automated (re-)refinement methods. The deposition of X-ray data along with the customary structural models defining PDB entries makes it possible to apply large-scale re-refinement protocols to these entries, thus giving users the benefit of improvements in X-ray methods that have occurred since the structure was deposited. Automated gradient refinement is an effective method to achieve this goal, but real-space intervention is most often required in order to adequately address problems detected by structure-validation software. In order to improve the existing protocol, automated re-refinement was combined with structure validation andmore » difference-density peak analysis to produce a catalogue of problems in PDB entries that are amenable to automatic correction. It is shown that re-refinement can be effective in producing improvements, which are often associated with the systematic use of the TLS parameterization of B factors, even for relatively new and high-resolution PDB entries, while the accompanying manual or semi-manual map analysis and fitting steps show good prospects for eventual automation. It is proposed that the potential for simultaneous improvements in methods and in re-refinement results be further encouraged by broadening the scope of depositions to include refinement metadata and ultimately primary rather than reduced X-ray data.« less

Correlations for Boundary-Layer Transition on Mars Science Laboratory Entry Vehicle Due to Heat-Shield Cavities

NASA Technical Reports Server (NTRS)

Hollis, Brian R.; Liechty, Derek S.

2008-01-01

The influence of cavities (for attachment bolts) on the heat-shield of the proposed Mars Science Laboratory entry vehicle has been investigated experimentally and computationally in order to develop a criterion for assessing whether the boundary layer becomes turbulent downstream of the cavity. Wind tunnel tests were conducted on the 70-deg sphere-cone vehicle geometry with various cavity sizes and locations in order to assess their influence on convective heating and boundary layer transition. Heat-transfer coefficients and boundary-layer states (laminar, transitional, or turbulent) were determined using global phosphor thermography.

Clinicians' views on displaying cost information to increase clinician cost-consciousness.

PubMed

Kruger, Jenna F; Chen, Alice Hm; Rybkin, Alex; Leeds, Kiren; Frosch, Dominick L; Goldman, Elizabeth

2014-01-01

To evaluate 1) clinician attitudes towards incorporating cost information into decision making when ordering imaging studies; and 2) clinician reactions to the display of Medicare reimbursement information for imaging studies at clinician electronic order entry. Focus group study with inductive thematic analysis. We conducted focus groups of primary care clinicians and subspecialty physicians (nephrology, pulmonary, and neurology) (N = 50) who deliver outpatient care in 12 hospital-based clinics and community health centers in an urban safety net health system. We analyzed focus group transcripts using an inductive framework to identify emergent themes and illustrative quotations. Clinicians believed that their knowledge of healthcare costs was low and wanted access to relevant cost information for reference. However, many clinicians believed it was inappropriate and unethical to consider costs in individual patient care decisions. Among clinicians' negative reactions toward displaying costs at order entry, 4 underlying themes emerged: 1) belief that ordering is already limited to clinically necessary tests; 2) importance of prioritizing responsibility to patients above that to the healthcare system; 3) concern about worsening healthcare disparities; and 4) perceived lack of accountability for healthcare costs in the system. Although clinicians want relevant cost information, many voiced concerns about displaying cost information at clinician order entry in safety net health systems. Alternative approaches to increasing cost-consciousness may be more acceptable to clinicians.

19 CFR 181.61 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... entry of commercial samples of negligible value as provided for in Article 306 of the NAFTA and for purposes of the re-entry of goods after repair or alteration in Canada or Mexico as provided for in Article...

19 CFR 181.61 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... entry of commercial samples of negligible value as provided for in Article 306 of the NAFTA and for purposes of the re-entry of goods after repair or alteration in Canada or Mexico as provided for in Article...

19 CFR 181.61 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... entry of commercial samples of negligible value as provided for in Article 306 of the NAFTA and for purposes of the re-entry of goods after repair or alteration in Canada or Mexico as provided for in Article...

19 CFR 181.61 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... entry of commercial samples of negligible value as provided for in Article 306 of the NAFTA and for purposes of the re-entry of goods after repair or alteration in Canada or Mexico as provided for in Article...

19 CFR 181.61 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... entry of commercial samples of negligible value as provided for in Article 306 of the NAFTA and for purposes of the re-entry of goods after repair or alteration in Canada or Mexico as provided for in Article...

Validating a multiple mini-interview question bank assessing entry-level reasoning skills in candidates for graduate-entry medicine and dentistry programmes.

PubMed

Roberts, Chris; Zoanetti, Nathan; Rothnie, Imogene

2009-04-01

The multiple mini-interview (MMI) was initially designed to test non-cognitive characteristics related to professionalism in entry-level students. However, it may be testing cognitive reasoning skills. Candidates to medical and dental schools come from diverse backgrounds and it is important for the validity and fairness of the MMI that these background factors do not impact on their scores. A suite of advanced psychometric techniques drawn from item response theory (IRT) was used to validate an MMI question bank in order to establish the conceptual equivalence of the questions. Bias against candidate subgroups of equal ability was investigated using differential item functioning (DIF) analysis. All 39 questions had a good fit to the IRT model. Of the 195 checklist items, none were found to have significant DIF after visual inspection of expected score curves, consideration of the number of applicants per category, and evaluation of the magnitude of the DIF parameter estimates. The question bank contains items that have been studied carefully in terms of model fit and DIF. Questions appear to measure a cognitive unidimensional construct, 'entry-level reasoning skills in professionalism', as suggested by goodness-of-fit statistics. The lack of items exhibiting DIF is encouraging in a contemporary high-stakes admission setting where candidates of diverse personal, cultural and academic backgrounds are assessed by common means. This IRT approach has potential to provide assessment designers with a quality control procedure that extends to the level of checklist items.

Entry characteristics and performance in a Masters module in Tropical Medicine: a 5-year analysis.

PubMed

Weigel, R; Robinson, D; Stewart, M; Assinder, S

2016-06-01

Postgraduate courses can contribute to better-qualified personnel in resource-limited settings. We aimed to identify how entry characteristics of applicants predict performance in order to provide support measures early. We describe demographic data and end-of-module examination marks of medical doctors who enrolled in a first semester module of two one-year MSc programmes between 2010 and 2014. We used t-tests and one-way anova to compare, and post hoc tests to locate differences of mean marks between categories of entry characteristics in univariate analysis. After exclusion of collinear variables, multiple regression examined the effect of several characteristics in multivariable analysis. Eighty-nine students (47% male) with a mean age of 32 (SD 6.4) years who received their medical degree in the UK (19%), other European (22%), African (35%) or other countries (24%) attended the 3-months module. Their mean mark was 69.1% (SD 10.9). Medical graduates from UK universities achieved significantly higher mean marks than graduates from other countries. Students' age was significantly negatively correlated with the module mark. In multiple linear regression, place of medical degree (β = -0.44, P < 0.001) and time since graduation (β = -0.28, P = 0.007) were strongest predictors of performance, explaining 32% of the variation of mean marks. Students' performance substantially differs based on their entry criteria in this 1st semester module. Non-UK graduates and mature students might benefit from early support. © 2016 John Wiley & Sons Ltd.

31 CFR 359.45 - How are book-entry Series I savings bonds purchased and held?

Code of Federal Regulations, 2010 CFR

2010-07-01

...-entry Series I savings bonds purchased and held? Book-entry bonds must be purchased and held online through your New Treasury Direct account. We provide instructions for opening an account online at http...

31 CFR 359.45 - How are book-entry Series I savings bonds purchased and held?

Code of Federal Regulations, 2014 CFR

2014-07-01

...-entry Series I savings bonds purchased and held? Book-entry bonds must be purchased and held online through your New Treasury Direct account. We provide instructions for opening an account online at http...

31 CFR 359.45 - How are book-entry Series I savings bonds purchased and held?

Code of Federal Regulations, 2012 CFR

2012-07-01

...-entry Series I savings bonds purchased and held? Book-entry bonds must be purchased and held online through your New Treasury Direct account. We provide instructions for opening an account online at http...

31 CFR 359.45 - How are book-entry Series I savings bonds purchased and held?

Code of Federal Regulations, 2013 CFR

2013-07-01

...-entry Series I savings bonds purchased and held? Book-entry bonds must be purchased and held online through your New Treasury Direct account. We provide instructions for opening an account online at http...

Parametric Thermal Soak Model for Earth Entry Vehicles

NASA Technical Reports Server (NTRS)

Agrawal, Parul; Samareh, Jamshid; Doan, Quy D.

2013-01-01

The analysis and design of an Earth Entry Vehicle (EEV) is multidisciplinary in nature, requiring the application many disciplines. An integrated tool called Multi Mission System Analysis for Planetary Entry Descent and Landing or M-SAPE is being developed as part of Entry Vehicle Technology project under In-Space Technology program. Integration of a multidisciplinary problem is a challenging task. Automation of the execution process and data transfer among disciplines can be accomplished to provide significant benefits. Thermal soak analysis and temperature predictions of various interior components of entry vehicle, including the impact foam and payload container are part of the solution that M-SAPE will offer to spacecraft designers. The present paper focuses on the thermal soak analysis of an entry vehicle design based on the Mars Sample Return entry vehicle geometry and discusses a technical approach to develop parametric models for thermal soak analysis that will be integrated into M-SAPE. One of the main objectives is to be able to identify the important parameters and to develop correlation coefficients so that, for a given trajectory, can estimate the peak payload temperature based on relevant trajectory parameters and vehicle geometry. The models are being developed for two primary thermal protection (TPS) materials: 1) carbon phenolic that was used for Galileo and Pioneer Venus probes and, 2) Phenolic Impregnated Carbon Ablator (PICA), TPS material for Mars Science Lab mission. Several representative trajectories were selected from a very large trade space to include in the thermal analysis in order to develop an effective parametric thermal soak model. The selected trajectories covered a wide range of heatload and heatflux combinations. Non-linear, fully transient, thermal finite element simulations were performed for the selected trajectories to generate the temperature histories at the interior of the vehicle. Figure 1 shows the finite element model that was used for the simulations. The results indicate that it takes several hours for the thermal energy to soak into the interior of the vehicle and achieve maximum payload temperatures. In addition, a strong correlation between the heatload and peak payload container temperature is observed that will help establishing the parametric thermal soak model.

Examination of changes in pathology tests ordered by Diagnosis-Related Group (DRGs) following CPOE introduction.

PubMed

Vecellio, Elia; Georgiou, Andrew; Toouli, George; Eigenstetter, Alex; Li, Ling; Wilson, Roger; Westbrook, Johanna I

2013-01-01

Electronic test ordering, via the Electronic Medical Record (EMR), which incorporates computerised provider order entry (CPOE), is widely considered as a useful tool to support appropriate pathology test ordering. Diagnosis-related groups (DRGs) are clinically meaningful categories that allow comparisons in pathology utilisation by patient groups by controlling for many potentially confounding variables. This study used DRG data linked to pathology test data to examine changes in rates of test ordering across four years coinciding with the introduction of an EMR in six hospitals in New South Wales, Australia. This method generated a list of high pathology utilisation DRGs. We investigated patients with a Chest pain DRG to examine whether tests rates changed for specific test groups by hospital emergency department (ED) pre- and post-EMR. There was little change in testing rates between EDs or between time periods pre- and post-EMR. This is a valuable method for monitoring the impact of EMR and clinical decision support on test order rates.

Orders on file but no labs drawn: investigation of machine and human errors caused by an interface idiosyncrasy.

PubMed

Schreiber, Richard; Sittig, Dean F; Ash, Joan; Wright, Adam

2017-09-01

In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion. Although testing had shown that the laboratory system would cancel duplicate laboratory orders, it was thought that duplicate alerting in the new order entry system would prevent such events. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Characterisation of re-entrant circuit (or rotational activity) in vitro using the HL1-6 myocyte cell line.

PubMed

Houston, Charles; Tzortzis, Konstantinos N; Roney, Caroline; Saglietto, Andrea; Pitcher, David S; Cantwell, Chris D; Chowdhury, Rasheda A; Ng, Fu Siong; Peters, Nicholas S; Dupont, Emmanuel

2018-06-01

Fibrillation is the most common arrhythmia observed in clinical practice. Understanding of the mechanisms underlying its initiation and maintenance remains incomplete. Functional re-entries are potential drivers of the arrhythmia. Two main concepts are still debated, the "leading circle" and the "spiral wave or rotor" theories. The homogeneous subclone of the HL1 atrial-derived cardiomyocyte cell line, HL1-6, spontaneously exhibits re-entry on a microscopic scale due to its slow conduction velocity and the presence of triggers, making it possible to examine re-entry at the cellular level. We therefore investigated the re-entry cores in cell monolayers through the use of fluorescence optical mapping at high spatiotemporal resolution in order to obtain insights into the mechanisms of re-entry. Re-entries in HL1-6 myocytes required at least two triggers and a minimum colony area to initiate (3.5 to 6.4 mm 2 ). After electrical activity was completely stopped and re-started by varying the extracellular K + concentration, re-entries never returned to the same location while 35% of triggers re-appeared at the same position. A conduction delay algorithm also allows visualisation of the core of the re-entries. This work has revealed that the core of re-entries is conduction blocks constituted by lines and/or groups of cells rather than the round area assumed by the other concepts of functional re-entry. This highlights the importance of experimentation at the microscopic level in the study of re-entry mechanisms. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Entry Abort Determination Using Non-Adaptive Neural Networks for Mars Precision Landers

NASA Technical Reports Server (NTRS)

Graybeal, Sarah R.; Kranzusch, Kara M.

2005-01-01

The 2009 Mars Science Laboratory (MSL) will attempt the first precision landing on Mars using a modified version of the Apollo Earth entry guidance program. The guidance routine, Entry Terminal Point Controller (ETPC), commands the deployment of a supersonic parachute after converging the range to the landing target. For very dispersed cases, ETPC may not converge the range to the target and safely command parachute deployment within Mach number and dynamic pressure constraints. A full-lift up abort can save 85% of these failed trajectories while abandoning the precision landing objective. Though current MSL requirements do not call for an abort capability, an autonomous abort capability may be desired, for this mission or future Mars precision landers, to make the vehicle more robust. The application of artificial neural networks (NNs) as an abort determination technique was evaluated by personnel at the National Aeronautics and Space Administration (NASA) Johnson Space Center (JSC). In order to implement an abort, a failed trajectory needs to be recognized in real time. Abort determination is dependent upon several trajectory parameters whose relationships to vehicle survival are not well understood, and yet the lander must be trained to recognize unsafe situations. Artificial neural networks (NNs) provide a way to model these parameters and can provide MSL with the artificial intelligence necessary to independently declare an abort. Using the 2009 Mars Science Laboratory (MSL) mission as a case study, a non-adaptive NN was designed, trained and tested using Monte Carlo simulations of MSL descent and incorporated into ETPC. Neural network theory, the development history of the MSL NN, and initial testing with severe dust storm entry trajectory cases are discussed in Reference 1 and will not be repeated here. That analysis demonstrated that NNs are capable of recognizing failed descent trajectories and can significantly increase the survivability of MSL for very dispersed cases. NN testing was then broadened to evaluate fully dispersed entry trajectories. The NN correctly classified 99.7% of descent trajectories as abort or nonabort and reduced the probability of an unsafe parachute deployment by 83%. This second, broader testing phase is discussed in this paper.

A study of renal function influence by integrating cloud-based manometers and physician order entry systems.

PubMed

Lin, Yuh-Feng; Sheng, Li-Huei; Wu, Mei-Yi; Zheng, Cai-Mei; Chang, Tian-Jong; Li, Yu-Chuan; Huang, Yu-Hui; Lu, Hsi-Peng

2014-12-01

No evidence exists from randomized trials to support using cloud-based manometers integrated with available physician order entry systems for tracking patient blood pressure (BP) to assist in the control of renal function deterioration. We investigated how integrating cloud-based manometers with physician order entry systems benefits our outpatient chronic kidney disease patients compared with typical BP tracking systems. We randomly assigned 36 chronic kidney disease patients to use cloud-based manometers integrated with physician order entry systems or typical BP recording sheets, and followed the patients for 6 months. The composite outcome was that the patients saw improvement both in BP and renal function. We compared the systolic and diastolic BP (SBP and DBP), and renal function of our patients at 0 months, 3 months, and 6 months after using the integrated manometers and typical BP monitoring sheets. Nighttime SBP and DBP were significantly lower in the study group compared with the control group. Serum creatinine level in the study group improved significantly compared with the control group after the end of Month 6 (2.83 ± 2.0 vs. 4.38 ± 3.0, p = 0.018). Proteinuria improved nonsignificantly in Month 6 in the study group compared with the control group (1.05 ± 0.9 vs. 1.90 ± 1.3, p = 0.09). Both SBP and DBP during the nighttime hours improved significantly in the study group compared with the baseline. In pre-end-stage renal disease patients, regularly monitoring BP by integrating cloud-based manometers appears to result in a significant decrease in creatinine and improvement in nighttime BP control. Estimated glomerular filtration rate and proteinuria were found to be improved nonsignificantly, and thus, larger population and longer follow-up studies may be needed.

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia

PubMed Central

El.Mahalli, Azza; El-Khafif, Sahar H.; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended. PMID:26903780

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

PubMed

El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

An Assessment of Health Care Information and Management Systems Society and Leapfrog Data on Computerized Provider Order Entry

PubMed Central

Diana, Mark L; Kazley, Abby Swanson; Menachemi, Nir

2011-01-01

Objective To assess the internal consistency and agreement between the Health Care Information and Management Systems Society (HIMSS) and the Leapfrog computerized provider order entry (CPOE) data. Data Sources Secondary hospital data collected by HIMSS Analytics, the Leapfrog Group, and the American Hospital Association from 2005 to 2007. Study Design Dichotomous measures of full CPOE status were created for the HIMSS and Leapfrog datasets in each year. We assessed internal consistency by calculating the percent of full adopters in a given year that report full CPOE status in subsequent years. We assessed the level of agreement between the two datasets by calculating the κ statistic and McNemar's test. We examined responsiveness by assessing the change in full CPOE status rates, over time, reported by HIMSS and Leapfrog data, respectively. Principal Findings Findings indicate minimal agreement between the two datasets regarding positive hospital CPOE status, but adequate agreement within a given dataset from year to year. Relative to each other, the HIMSS data tend to overestimate increases in full CPOE status over time, while the Leapfrog data may underestimate year over year increases in national CPOE status. Conclusions Both Leapfrog and HIMSS data have strengths and weaknesses. Those interested in studying outcomes associated with CPOE use or adoption should be aware of the strengths and limitations of the Leapfrog and HIMSS datasets. Future development of a standard definition of CPOE status in hospitals will allow for a more comprehensive validation of these data. PMID:21449956

Assessing the anticipated consequences of Computer-based Provider Order Entry at three community hospitals using an open-ended, semi-structured survey instrument.

PubMed

Sittig, Dean F; Ash, Joan S; Guappone, Ken P; Campbell, Emily M; Dykstra, Richard H

2008-07-01

To determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals. We created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to. Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE. The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur.

Rapid Nipah virus entry into the central nervous system of hamsters via the olfactory route

PubMed Central

Munster, Vincent J.; Prescott, Joseph B.; Bushmaker, Trenton; Long, Dan; Rosenke, Rebecca; Thomas, Tina; Scott, Dana; Fischer, Elizabeth R.; Feldmann, Heinz; de Wit, Emmie

2012-01-01

Encephalitis is a hallmark of Nipah virus (NiV) infection in humans. The exact route of entry of NiV into the central nervous system (CNS) is unknown. Here, we performed a spatio-temporal analysis of NiV entry into the CNS of hamsters. NiV initially predominantly targeted the olfactory epithelium in the nasal turbinates. From there, NiV infected neurons were visible extending through the cribriform plate into the olfactory bulb, providing direct evidence of rapid CNS entry. Subsequently, NiV disseminated to the olfactory tubercle and throughout the ventral cortex. Transmission electron microscopy on brain tissue showed extravasation of plasma cells, neuronal degeneration and nucleocapsid inclusions in affected tissue and axons, providing further evidence for axonal transport of NiV. NiV entry into the CNS coincided with the occurrence of respiratory disease, suggesting that the initial entry of NiV into the CNS occurs simultaneously with, rather than as a result of, systemic virus replication. PMID:23071900

Mechanization of Library Procedures in the Medium-sized Medical Library: IX. Holding Statements in PHILSOM: a Study of their Activity *

PubMed Central

Beckwith, Helen K.

1970-01-01

A study was made of the serial holding statements in PHILSOM over a six-month period, in order to determine the desirability of printing the complete serial holding statements monthly. Attention was given to the frequency of internal and update changes in both active and dead entries. The results indicate that while sufficient activity is observed in active serial entries to warrant their monthly updating, dead serial entries remain constant over this period. This indicates that a large group of PHILSOM entries can be easily identified and isolated, facilitating division and independent updating of the resultant lists. The desirability of such a division, however, must also take into consideration the user's ease in handling such a segmented listing. Images PMID:5439902

Generic aerocapture atmospheric entry study, volume 1

NASA Technical Reports Server (NTRS)

1980-01-01

An atmospheric entry study to fine a generic aerocapture vehicle capable of missions to Mars, Saturn, and Uranus is reported. A single external geometry was developed through atmospheric entry simulations. Aerocapture is a system design concept which uses an aerodynamically controlled atmospheric entry to provide the necessary velocity depletion to capture payloads into planetary orbit. Design concepts are presented which provide the control accuracy required while giving thermal protection for the mission payload. The system design concepts consist of the following elements: (1) an extendable biconic aerodynamic configuration with lift to drag ratio between 1.0 and 2.0; (2) roll control system concepts to control aerodynamic lift and disturbance torques; (3) aeroshell design concepts capable of meeting dynamic pressure loads during aerocapture; and (4) entry thermal protection system design concepts to meet thermodynamic loads during aerocapture.

Optimizing TLB entries for mixed page size storage in contiguous memory

DOEpatents

Chen, Dong; Gara, Alan; Giampapa, Mark E.; Heidelberger, Philip; Kriegel, Jon K.; Ohmacht, Martin; Steinmacher-Burow, Burkhard

2013-04-30

A system and method for accessing memory are provided. The system comprises a lookup buffer for storing one or more page table entries, wherein each of the one or more page table entries comprises at least a virtual page number and a physical page number; a logic circuit for receiving a virtual address from said processor, said logic circuit for matching the virtual address to the virtual page number in one of the page table entries to select the physical page number in the same page table entry, said page table entry having one or more bits set to exclude a memory range from a page.

Importance of the type of provider seen to begin health care for a new episode low back pain: associations with future utilization and costs.

PubMed

Fritz, Julie M; Kim, Jaewhan; Dorius, Josette

2016-04-01

Low back pain (LBP) care can involve many providers. The provider chosen for entry into care may predict future health care utilization and costs. The objective of this study was to explore associations between entry settings and future LBP-related utilization and costs. A retrospective review of claims data identified new entries into health care for LBP. We examined the year after entry to identify utilization outcomes (imaging, surgeon or emergency visits, injections, surgery) and total LBP-related costs. Multivariate models with inverse probability weighting on propensity scores were used to evaluate relationships between utilization and cost outcomes with entry setting. 747 patients were identified (mean age = 38.2 (± 10.7) years, 61.2% female). Entry setting was primary care (n = 409, 54.8%), chiropractic (n = 207, 27.7%), physiatry (n = 83, 11.1%) and physical therapy (n = 48, 6.4%). Relative to primary care, entry in physiatry increased risk for radiographs (OR = 3.46, P = 0.001), advanced imaging (OR = 3.38, P < 0.001), injections (OR = 4.91, P < 0.001), surgery (OR = 4.76, P = 0.012) and LBP-related costs (standardized Β = 0.67, P < 0.001). Entry in chiropractic was associated with decreased risk for advanced imaging (OR = 0.21, P = 0.001) or a surgeon visit (OR = 0.13, P = 0.005) and increased episode of care duration (standardized Β = 0.51, P < 0.001). Entry in physical therapy decreased risk of radiographs (OR = 0.39, P = 0.017) and no patient entering in physical therapy had surgery. Entry setting for LBP was associated with future health care utilization and costs. Consideration of where patients chose to enter care may be a strategy to improve outcomes and reduce costs. © 2015 John Wiley & Sons, Ltd.

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

Rudraswami, N. G.; Prasad, M. Shyam; Dey, S.

Most dust-sized cosmic particles undergo ablation and chemical alteration during atmospheric entry, which alters their original properties. A comprehensive understanding of this process is essential in order to decipher their pre-entry characteristics. The purpose of the study is to illustrate the process of vaporization of different elements for various entry parameters. The numerical results for particles of various sizes and various zenith angles are treated in order to understand the changes in chemical composition that the particles undergo as they enter the atmosphere. Particles with large sizes (> few hundred μ m) and high entry velocities (>16 km s{sup −1})more » experience less time at peak temperatures compared to those that have lower velocities. Model calculations suggest that particles can survive with an entry velocity of 11 km s{sup −1} and zenith angles (ZA) of 30°–90°, which accounts for ∼66% of the region where particles retain their identities. Our results suggest that the changes in chemical composition of MgO, SiO{sub 2}, and FeO are not significant for an entry velocity of 11 km s{sup −1} and sizes <300 μ m, but the changes in these compositions become significant beyond this size, where FeO is lost to a major extent. However, at 16 km s{sup −1} the changes in MgO, SiO{sub 2}, and FeO are very intense, which is also reflected in Mg/Si, Fe/Si, Ca/Si, and Al/Si ratios, even for particles with a size of 100 μ m. Beyond 400 μ m particle sizes at 16 km s{sup −1}, most of the major elements are vaporized, leaving the refractory elements, Al and Ca, suspended in the troposphere.« less

17 CFR 201.510 - Temporary cease-and-desist orders: Application process.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Temporary cease-and-desist orders: Application process. 201.510 Section 201.510 Commodity and Securities Exchanges SECURITIES AND... § 201.510 Temporary cease-and-desist orders: Application process. (a) Procedure. A request for entry of...

17 CFR 201.510 - Temporary cease-and-desist orders: Application process.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Temporary cease-and-desist orders: Application process. 201.510 Section 201.510 Commodity and Securities Exchanges SECURITIES AND... § 201.510 Temporary cease-and-desist orders: Application process. (a) Procedure. A request for entry of...

17 CFR 201.510 - Temporary cease-and-desist orders: Application process.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Temporary cease-and-desist orders: Application process. 201.510 Section 201.510 Commodity and Securities Exchanges SECURITIES AND... § 201.510 Temporary cease-and-desist orders: Application process. (a) Procedure. A request for entry of...

Early College Entrance in Australia

ERIC Educational Resources Information Center

Jung, Jae Yup; Young, Marie; Gross, Miraca U. M.

2015-01-01

Early college entry is an educational intervention that is being increasingly used in Australia. Following a review of the current Australian literature on early college entry, an overview is provided of the characteristics of, and the procedures associated with, one formal Australian early college entry program (the Early Admission for…

76 FR 33794 - Self-Regulatory Organizations; Chicago Stock Exchange, Incorporated; Notice of Filing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... types and indications that are eligible for entry to and accepted by the Matching System. The Exchange... Exchange with the ability to determine on an order type by order type basis which orders and indications... Rule 43.2 relating to the types of orders handled on the CBOE's Screen Based Trading System (``SBT...

76 FR 60566 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Order Approving Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

.... Description of the Proposal The purpose of the proposal is to amend two subsections of Exchange Rule 1080 to allow entry of day limit orders for the proprietary accounts of SQTs and RSQTs. Current Rule 1080 (Phlx....\\4\\ Rule 1080 states that it governs the orders, execution reports and administrative order messages...

A Cross-site Qualitative Study of Physician Order Entry

PubMed Central

Ash, Joan S.; Gorman, Paul N.; Lavelle, Mary; Payne, Thomas H.; Massaro, Thomas A.; Frantz, Gerri L.; Lyman, Jason A.

2003-01-01

Objective: To describe the perceptions of diverse professionals involved in computerized physician order entry (POE) at sites where POE has been successfully implemented and to identify differences between teaching and nonteaching hospitals. Design: A multidisciplinary team used observation, focus groups, and interviews with clinical, administrative, and information technology staff to gather data at three sites. Field notes and transcripts were coded using an inductive approach to identify patterns and themes in the data. Measurements: Patterns and themes concerning perceptions of POE were identified. Results: Four high-level themes were identified: (1) organizational issues such as collaboration, pride, culture, power, politics, and control; (2) clinical and professional issues involving adaptation to local practices, preferences, and policies; (3) technical/implementation issues, including usability, time, training and support; and (4) issues related to the organization of information and knowledge, such as system rigidity and integration. Relevant differences between teaching and nonteaching hospitals include extent of collaboration, staff longevity, and organizational missions. Conclusion: An organizational culture characterized by collaboration and trust and an ongoing process that includes active clinician engagement in adaptation of the technology were important elements in successful implementation of physician order entry at the institutions that we studied. PMID:12595408

Orion Flight Test-1 Thermal Protection System Instrumentation

NASA Technical Reports Server (NTRS)

Kowal, T. John

2011-01-01

The Orion Crew Exploration Vehicle (CEV) was originally under development to provide crew transport to the International Space Station after the retirement of the Space Shuttle, and to provide a means for the eventual return of astronauts to the Moon. With the current changes in the future direction of the United States human exploration programs, the focus of the Orion project has shifted to the project s first orbital flight test, designated Orion Flight Test 1 (OFT-1). The OFT-1 is currently planned for launch in July 2013 and will demonstrate the Orion vehicle s capability for performing missions in low Earth orbit (LEO), as well as extensibility beyond LEO for select, critical areas. Among the key flight test objectives are those related to validation of the re-entry aerodynamic and aerothermal environments, and the performance of the thermal protection system (TPS) when exposed to these environments. A specific flight test trajectory has been selected to provide a high energy entry beyond that which would be experienced during a typical low Earth orbit return, given the constraints imposed by the possible launch vehicles. This trajectory resulted from a trade study that considered the relative benefit of conflicting objectives from multiple subsystems, and sought to provide the maximum integrated benefit to the re-entry state-of-the-art. In particular, the trajectory was designed to provide: a significant, measureable radiative heat flux to the windward surface; data on boundary transition from laminar to turbulent flow; and data on catalytic heating overshoot on non-ablating TPS. In order to obtain the necessary flight test data during OFT-1, the vehicle will need to have an adequate quantity of instrumentation. A collection of instrumentation is being developed for integration in the OFT-1 TPS. In part, this instrumentation builds upon the work performed for the Mars Science Laboratory Entry, Descent and Landing Instrument (MEDLI) suite to instrument the OFT-1 ablative heat shield. The MEDLI integrated sensor plugs and pressure sensors will be adapted for compatibility with the Orion TPS design. The sensor plugs will provide in-depth temperature data to support aerothermal and TPS model correlation, and the pressure sensors will provide a flush air data system for validation of the entry and descent aerodynamic environments. In addition, a radiometer design will be matured to measure the radiative component of the reentry heating at two locations on the heat shield. For the back shell, surface thermocouple and pressure port designs will be developed and applied which build upon the heritage of the Space Shuttle Program for instrumentation of reusable surface insulation (RSI) tiles. The quantity and location of the sensors has been determined to balance the needs of the reentry disciplines with the demands of the hardware development, manufacturing and integration. Measurements which provided low relative value and presented significant engineering development effort were, unfortunately, eliminated. The final TPS instrumentation has been optimized to target priority test objectives. The data obtained will serve to provide a better understanding of reentry environments for the Orion capsule design, reduce margins, and potentially reduce TPS mass or provide TPS extensibility for alternative missions.

Mapping proteins to disease terminologies: from UniProt to MeSH

PubMed Central

Mottaz, Anaïs; Yip, Yum L; Ruch, Patrick; Veuthey, Anne-Lise

2008-01-01

Background Although the UniProt KnowledgeBase is not a medical-oriented database, it contains information on more than 2,000 human proteins involved in pathologies. However, these annotations are not standardized, which impairs the interoperability between biological and clinical resources. In order to make these data easily accessible to clinical researchers, we have developed a procedure to link diseases described in the UniProtKB/Swiss-Prot entries to the MeSH disease terminology. Results We mapped disease names extracted either from the UniProtKB/Swiss-Prot entry comment lines or from the corresponding OMIM entry to the MeSH. Different methods were assessed on a benchmark set of 200 disease names manually mapped to MeSH terms. The performance of the retained procedure in term of precision and recall was 86% and 64% respectively. Using the same procedure, more than 3,000 disease names in Swiss-Prot were mapped to MeSH with comparable efficiency. Conclusions This study is a first attempt to link proteins in UniProtKB to the medical resources. The indexing we provided will help clinicians and researchers navigate from diseases to genes and from genes to diseases in an efficient way. The mapping is available at: . PMID:18460185

Thermal Protection System Mass Estimating Relationships for Blunt-Body, Earth Entry Spacecraft

NASA Technical Reports Server (NTRS)

Sepka, Steven A.; Samareh, Jamshid A.

2015-01-01

System analysis and design of any entry system must balance the level fidelity for each discipline against the project timeline. One way to inject high fidelity analysis earlier in the design effort is to develop surrogate models for the high-fidelity disciplines. Surrogate models for the Thermal Protection System (TPS) are formulated as Mass Estimating Relationships (MERs). The TPS MERs are presented that predict the amount of TPS necessary for safe Earth entry for blunt-body spacecraft using simple correlations that closely match estimates from NASA's high-fidelity ablation modeling tool, the Fully Implicit Ablation and Thermal Analysis Program (FIAT). These MERs provide a first order estimate for rapid feasibility studies. There are 840 different trajectories considered in this study, and each TPS MER has a peak heating limit. MERs for the vehicle forebody include the ablators Phenolic Impregnated Carbon Ablator (PICA) and Carbon Phenolic atop Advanced Carbon-Carbon. For the aftbody, the materials are Silicone Impregnated Reusable Ceramic Ablator (SIRCA), Acusil II, SLA-561V, and LI-900. The MERs are accurate to within 14% (at one standard deviation) of FIAT prediction, and the most any MER under predicts FIAT TPS thickness is 18.7%. This work focuses on the development of these MERs, the resulting equations, model limitations, and model accuracy.

Virtual Reality Modelling Simulation of the Re-entry Motion of an Axialsymmetric Vehicle

NASA Astrophysics Data System (ADS)

Guidi, A.; Chu, Q.. P.; Mulder, J. A.

This work started during the stability analysis of the Delft Aerospace Re-entry Test demonstrator (DART) which is a small axisymmetric ballistic re-entry vehicle. The dynamic stability evaluation of an axisymmetric re-entry vehicle is especially concerned on the behaviour of its angle of attack during the flight through the atmosphere. The variation in the angle of attack is essential for prediction of the trajectory of the vehicle and for heating requirement of the structure of the vehicle. The concept of the total angle of attack and the windward meridian plane are introduced. The position of the centre of pressure can be a crucial point in the stability of the vehicle. Although the simpleness of an axisymmetric shape, the re-entry of such a vehicle is characterised by several complex phenomenologies that were analysed with the aid of the flight simulator and of a 3D virtual reality modeling simulator. Simulations were performed with a 25° AOA initial condition in order to simulate the response of the vehicle to a disturbance that may occur during the flight causing a variation in attitude from its Trim . Certain aspects of re-entry vehicle motion are conveniently described in the terms of Euler angles. Using the Eulerian angle it is possible to generate a tridimensional animation of the output of the Flight Simulator. This tridimensional analysis is of great importance in order to understand the mentioned complex motions. Furthermore with growing in computer power it is possible to generate online visualisation of the simulations. The output of the flight simulator was used in a software written in Virtual Reality Modelling Language (VRML). With VRML this software was possible the visualisation of the re-entry motion of the vehicle. With this option the animation can run on-line during the with the flight simulator and can be also easily published on the internet or send to other users in very small file size. (the VRLM simulation of the re-entry, can be seen at the official DART internet site: www.dart-project.com)

Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

PubMed

Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

2014-11-01

This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system. Copyright © 2014 Elsevier Ltd. All rights reserved.

Entry, Descent, and Landing technological barriers and crewed MARS vehicle performance analysis

NASA Astrophysics Data System (ADS)

Subrahmanyam, Prabhakar; Rasky, Daniel

2017-05-01

Mars has been explored historically only by robotic crafts, but a crewed mission encompasses several new engineering challenges - high ballistic coefficient entry, hypersonic decelerators, guided entry for reaching intended destinations within acceptable margins for error in the landing ellipse, and payload mass are all critical factors for evaluation. A comprehensive EDL parametric analysis has been conducted in support of a high mass landing architecture by evaluating three types of vehicles -70° Sphere Cone, Ellipsled and SpaceX hybrid architecture called Red Dragon as potential candidate options for crewed entry vehicles. Aerocapture at the Martian orbit of about 400 km and subsequent Entry-from-orbit scenarios were investigated at velocities of 6.75 km/s and 4 km/s respectively. A study on aerocapture corridor over a range of entry velocities (6-9 km/s) suggests that a hypersonic L/D of 0.3 is sufficient for a Martian aerocapture. Parametric studies conducted by varying aeroshell diameters from 10 m to 15 m for several entry masses up to 150 mt are summarized and results reveal that vehicles with entry masses in the range of about 40-80 mt are capable of delivering cargo with a mass on the order of 5-20 mt. For vehicles with an entry mass of 20 mt to 80 mt, probabilistic Monte Carlo analysis of 5000 cases for each vehicle were run to determine the final landing ellipse and to quantify the statistical uncertainties associated with the trajectory and attitude conditions during atmospheric entry. Strategies and current technological challenges for a human rated Entry, Descent, and Landing to the Martian surface are presented in this study.

Preparing International Students for the Re-Entry Transition.

ERIC Educational Resources Information Center

Arthur, Nancy

2003-01-01

Counselors play an integral role in assisting international students to manage cross-cultural transitions. Re-entry counseling can support international students to examine their transition experiences, provide education about re-entry, and help to develop anticipatory coping strategies. An example of a workshop is described as a method of…

Bibliography...Books for Children. 1983 Edition.

ERIC Educational Resources Information Center

Roedder, Kathleen R., Comp.; And Others

Intended for use by librarians, teachers, parents, and community workers as a guide to good children's literature, this annotated bibliography contains more than 1,000 entries. Each entry provides author and title, publisher, date of publication, price, International Standard Book Number (ISBN), and appropriate age levels. The entries are arranged…

Bibliography of Books for Children.

ERIC Educational Resources Information Center

Roedder, Kathleen R., Comp.; Sidorsky, Phyllis G., Comp.

Intended for use by librarians, teachers, parents, and community workers as a guide to good children's literature, this annotated bibliography contains more than 1,000 entries. Each entry provides author and title, publisher, date of publication, price, and International Standard Book Number (ISBN). Age level is also indicated. The entries are…

32 CFR 763.5 - Entry procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... GOVERNING PUBLIC ACCESS Entry Regulations for Kaho'olawe Island, Hawaii § 763.5 Entry procedures. (a) It is... Harbor, Hawaii 96860, at least 15 days prior to the access requested, providing therein confirmed access... proscribed by either Federal law or the State of Hawaii Penal Code, as incorporated under the Federal...

Guidelines for Preparing Psychological Specialists: An Entry-Level Course on Intellectual Assessment

ERIC Educational Resources Information Center

Oakland, Thomas; Wechsler, Solange Muglia

2016-01-01

This article provides guidelines for an entry-level course that prepares psychology students and practitioners to acquire entry-level skills, abilities, knowledge, and attitudes important to the individual assessment of intellectual abilities of children and youth. The article reviews prominent international, regional, and national policies,…

75 FR 52980 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

.../maintaining): $303,512. Description: The Safety Standards for Underground Coal Mine Ventilation Belt Entry rule provides safety requirements for the use of the conveyor belt entry as a ventilation intake to... Underground Coal Mine Ventilation--Belt Entry Used as an Intake Air Course to Ventilate Working Sections and...

Supersonic Testing of 0.8 m Disk Gap Band Parachutes in the Wake of a 70 Deg Sphere Cone Entry Vehicle

NASA Technical Reports Server (NTRS)

Sengupta, Anita; Wernet, Mark; Roeder, James; Kelsch, Richard; Witkowski, Al; Jones, Thomas

2009-01-01

Supersonic wind tunnel testing of Viking-type 0.8 m Disk-Gap-Band (DGB) parachutes was conducted in the NASA Glenn Research Center 10'x10' wind-tunnel. The tests were conducted in support of the Mars Science Laboratory Parachute Decelerator System development and qualification program. The aerodynamic coupling of the entry-vehicle wake to parachute flow-field is under investigation to determine the cause and functional dependence of a supersonic canopy breathing phenomenon referred to as area oscillations, characteristic of DGB's above Mach 1.5 operation. Four percent of full-scale parachutes (0.8 m) were constructed similar to the flight-article in material and construction techniques. The parachutes were attached to a 70-deg sphere-cone entry-vehicle to simulate the Mars flight configuration. The parachutes were tested in the wind-tunnel from Mach 2 to 2.5 in a Reynolds number range of 2x105 to 1x106, representative of a Mars deployment. Three different test configurations were investigated. In the first two configurations, the parachutes were constrained horizontally through the vent region to measure canopy breathing and wake interaction for fixed trim angles of 0 and 10 degrees from the free-stream. In the third configuration the parachute was unconstrained, permitted to trim and cone, similar to free-flight (but capsule motion is constrained), varying its alignment relative to the entry-vehicle wake. Non-intrusive test diagnostics were chosen to quantify parachute performance and provide insight into the flow field structure. An in-line loadcell provided measurement of unsteady and mean drag. Shadowgraph of the upstream parachute flow field was used to capture bow-shock motion and wake coupling. Particle image velocimetry provided first and second order flow field statistics over a planar region of the flow field, just upstream of the parachute. A photogrammetric technique was used to quantify fabric motion using multiple high speed video cameras to record the location in time and space of reflective targets placed on the canopy interior. The experimental findings including an updated drag model and the physical basis of the area oscillation phenomenon will be discussed.

Study of Aerothermodynamic Modeling Issues Relevant to High-Speed Sample Return Vehicles

NASA Technical Reports Server (NTRS)

Johnston, Christopher O.

2014-01-01

This paper examines the application of state-of-the-art coupled ablation and radiation simulations to highspeed sample return vehicles, such as those returning from Mars or an asteroid. A defining characteristic of these entries is that the surface recession rates and temperatures are driven by nonequilibrium convective and radiative heating through a boundary layer with significant surface blowing and ablation products. Measurements relevant to validating the simulation of these phenomena are reviewed and the Stardust entry is identified as providing the best relevant measurements. A coupled ablation and radiation flowfield analysis is presented that implements a finite-rate surface chemistry model. Comparisons between this finite-rate model and a equilibrium ablation model show that, while good agreement is seen for diffusion-limited oxidation cases, the finite-rate model predicts up to 50% lower char rates than the equilibrium model at sublimation conditions. Both the equilibrium and finite rate models predict significant negative mass flux at the surface due to sublimation of atomic carbon. A sensitivity analysis to flowfield and surface chemistry rates show that, for a sample return capsule at 10, 12, and 14 km/s, the sublimation rates for C and C3 provide the largest changes to the convective flux, radiative flux, and char rate. A parametric uncertainty analysis of the radiative heating due to radiation modeling parameters indicates uncertainties ranging from 27% at 10 km/s to 36% at 14 km/s. Applying the developed coupled analysis to the Stardust entry results in temperatures within 10% of those inferred from observations, and final recession values within 20% of measurements, which improves upon the 60% over-prediction at the stagnation point obtained through an uncoupled analysis. Emission from CN Violet is shown to be over-predicted by nearly and order-of-magnitude, which is consistent with the results of previous independent analyses. Finally, the coupled analysis is applied to a 14 km/s Earth entry representative of a Mars sample return. Although the radiative heating provides a larger fraction of the total heating, the influence of ablation and radiation on the flowfield are shown to be similar to Stardust.

Potent D-peptide inhibitors of HIV-1 entry

PubMed Central

Welch, Brett D.; VanDemark, Andrew P.; Heroux, Annie; Hill, Christopher P.; Kay, Michael S.

2007-01-01

During HIV-1 entry, the highly conserved gp41 N-trimer pocket region becomes transiently exposed and vulnerable to inhibition. Using mirror-image phage display and structure-assisted design, we have discovered protease-resistant D-amino acid peptides (D-peptides) that bind the N-trimer pocket with high affinity and potently inhibit viral entry. We also report high-resolution crystal structures of two of these D-peptides in complex with a pocket mimic that suggest sources of their high potency. A trimeric version of one of these peptides is the most potent pocket-specific entry inhibitor yet reported by three orders of magnitude (IC50 = 250 pM). These results are the first demonstration that D-peptides can form specific and high-affinity interactions with natural protein targets and strengthen their promise as therapeutic agents. The D-peptides described here address limitations associated with current L-peptide entry inhibitors and are promising leads for the prevention and treatment of HIV/AIDS. PMID:17942675

Does attention speed up processing? Decreases and increases of processing rates in visual prior entry.

PubMed

Tünnermann, Jan; Petersen, Anders; Scharlau, Ingrid

2015-03-02

Selective visual attention improves performance in many tasks. Among others, it leads to "prior entry"--earlier perception of an attended compared to an unattended stimulus. Whether this phenomenon is purely based on an increase of the processing rate of the attended stimulus or if a decrease in the processing rate of the unattended stimulus also contributes to the effect is, up to now, unanswered. Here we describe a novel approach to this question based on Bundesen's Theory of Visual Attention, which we use to overcome the limitations of earlier prior-entry assessment with temporal order judgments (TOJs) that only allow relative statements regarding the processing speed of attended and unattended stimuli. Prevalent models of prior entry in TOJs either indirectly predict a pure acceleration or cannot model the difference between acceleration and deceleration. In a paradigm that combines a letter-identification task with TOJs, we show that indeed acceleration of the attended and deceleration of the unattended stimuli conjointly cause prior entry. © 2015 ARVO.

Woven Thermal Protection System (WTPS) a Novel Approach to Meet NASA's Most Demanding Reentry Missions

NASA Technical Reports Server (NTRS)

Stackpoole, Mairead

2014-01-01

NASA's future robotic missions to Venus and outer planets, namely, Saturn, Uranus, Neptune, result in extremely high entry conditions that exceed the capabilities of current mid-density ablators (PICA or Avcoat). Therefore mission planners assume the use of a fully dense carbon phenolic heat shield similar to what was flown on Pioneer Venus and Galileo. Carbon phenolic (CP) is a robust Thermal Protection System (TPS) however its high density and thermal conductivity constrain mission planners to steep entries, high heat fluxes, pressures and short entry durations, in order for CP to be feasible from a mass perspective. The high entry conditions pose certification challenges in existing ground based test facilities. In 2012 the Game Changing Development Program in NASA's Space Technology Mission Directorate funded NASA ARC to investigate the feasibility of a Woven Thermal Protection System (WTPS) to meet the needs of NASA's most challenging entry missions. This presentation will summarize maturation of the WTPS project.

An Improved Cross-Layering Design for IPv6 Fast Handover with IEEE 802.16m Entry Before Break Handover

NASA Astrophysics Data System (ADS)

Kim, Ronny Yongho; Jung, Inuk; Kim, Young Yong

IEEE 802.16m is an advanced air interface standard which is under development for IMT-Advanced systems, known as 4G systems. IEEE 802.16m is designed to provide a high data rate and a Quality of Service (QoS) level in order to meet user service requirements, and is especially suitable for mobilized environments. There are several factors that have great impact on such requirements. As one of the major factors, we mainly focus on latency issues. In IEEE 802.16m, an enhanced layer 2 handover scheme, described as Entry Before Break (EBB) was proposed and adopted to reduce handover latency. EBB provides significant handover interruption time reduction with respect to the legacy IEEE 802.16 handover scheme. Fast handovers for mobile IPv6 (FMIPv6) was standardized by Internet Engineering Task Force (IETF) in order to provide reduced handover interruption time from IP layer perspective. Since FMIPv6 utilizes link layer triggers to reduce handover latency, it is very critical to jointly design FMIPv6 with its underlying link layer protocol. However, FMIPv6 based on new handover scheme, EBB has not been proposed. In this paper, we propose an improved cross-layering design for FMIPv6 based on the IEEE 802.16m EBB handover. In comparison with the conventional FMIPv6 based on the legacy IEEE 802.16 network, the overall handover interruption time can be significantly reduced by employing the proposed design. Benefits of this improvement on latency reduction for mobile user applications are thoroughly investigated with both numerical analysis and simulation on various IP applications.

Supporting Patient Care in the Emergency Department with a Computerized Whiteboard System

PubMed Central

Aronsky, Dominik; Jones, Ian; Lanaghan, Kevin; Slovis, Corey M.

2008-01-01

Efficient information management and communication within the emergency department (ED) is essential to providing timely and high-quality patient care. The ED whiteboard (census board) usually serves as an ED’s central access point for operational and patient-related information. This article describes the design, functionality, and experiences with a computerized ED whiteboard, which has the ability to display relevant operational and patient-related information in real time. Embedded functionality, additional whiteboard views, and the integration with ED and institutional information system components, such as the computerized patient record or the provider order entry system, provide rapid access to more detailed information. As an information center, the computerized whiteboard supports our ED environment not only for providing patient care, but also for operational, educational, and research activities. PMID:18096913

Analytic Development of a Reference Profile for the First Entry in a Skip Atmospheric Entry

NASA Technical Reports Server (NTRS)

Garcia-Llama, Eduardo

2010-01-01

This note shows that a feasible reference drag profile for the first entry portion of a skip entry can be generated as a polynomial expression of the velocity. The coefficients of that polynomial are found through the resolution of a system composed of m + 1 equations, where m is the degree of the drag polynomial. It has been shown that a minimum of five equations (m = 4) are required to establish the range and the initial and final conditions on velocity and flight path angle. It has been shown that at least one constraint on the trajectory can be imposed through the addition of one extra equation in the system, which must be accompanied by the increase in the degree of the drag polynomial. In order to simplify the resolution of the system of equations, the drag was considered as being a probability density function of the velocity, with the velocity as a distribution function of the drag. Combining this notion with the introduction of empirically derived constants, it has been shown that the system of equations required to generate the drag profile can be successfully reduced to a system of linear algebraic equations. For completeness, the resulting drag profiles have been flown using the feedback linearization method of differential geometric control as a guidance law with the error dynamics of a second order homogeneous equation in the form of a damped oscillator. Satisfactory results were achieved when the gains in the error dynamics were changed at a certain point along the trajectory that is dependent on the velocity and the curvature of the drag as a function of the velocity. Future work should study the capacity to update the drag profile in flight when dispersions are introduced. Also, future studies should attempt to link the first entry, as presented and controlled in this note, with a more standard control concept for the second entry, such as the Apollo entry guidance, to try to assess the overall skip entry performance. A guidance law that includes an integral feedback term, as is the case in the actual Space Shuttle entry guidance and as is proposed in Ref 29, could be tried in future studies to assess whether its use results in an improvement of the tracking performance, and to evaluate the design needs when determining the control gains.

The effect of the electronic medical record on nurses' work.

PubMed

Robles, Jane

2009-01-01

The electronic medical record (EMR) is a workplace reality for most nurses. Its advantages include a single consolidated record for each person; capacity for data interfaces and alerts; improved interdisciplinary communication; and evidence-based decision support. EMRs can add to work complexity, by forcing better documentation of previously unrecorded data and/or because of poor design. Well-designed and well-implemented computerized provider order entry (CPOE) systems can streamline nurses' work. Generational differences in acceptance of and facility with EMRs can be addressed through open, healthy communication.

Lessons learned from a pharmacy practice model change at an academic medical center.

PubMed

Knoer, Scott J; Pastor, John D; Phelps, Pamela K

2010-11-01

The development and implementation of a new pharmacy practice model at an academic medical center are described. Before the model change, decentralized pharmacists responsible for order entry and verification and clinical specialists were both present on the care units. Staff pharmacists were responsible for medication distribution and sterile product preparation. The decentralized pharmacists handling orders were not able to use their clinical training, the practice model was inefficient, and few clinical services were available during evenings and weekends. A task force representing all pharmacy department roles developed a process and guiding principles for the model change, collected data, and decided on a model. Teams consisting of decentralized pharmacists, decentralized pharmacy technicians, and team leaders now work together to meet patients' pharmacy needs and further departmental safety, quality, and cost-saving goals. Decentralized service hours have been expanded through operational efficiencies, including use of automation (e.g., computerized provider order entry, wireless computers on wheels used during rounds with physician teams). Nine clinical specialist positions were replaced by five team leader positions and four pharmacists functioning in decentralized roles. Additional staff pharmacist positions were shifted into decentralized roles, and the hospital was divided into areas served by teams including five to eight pharmacists. Technicians are directly responsible for medication distribution. No individual's job was eliminated. The new practice model allowed better alignment of staff with departmental goals, expanded pharmacy hours and services, more efficient medication distribution, improved employee engagement, and a staff succession plan.

Significance of independent radon entry rate and air exchange rate assessment for the purpose of radon mitigation effectiveness proper evaluation: case studies.

PubMed

Froňka, A; Jílek, K; Moučka, L; Brabec, M

2011-05-01

Two new single-family houses identified as insufficient with regard to existing radon barrier efficiency, have been selected for further examination. A complex set of radon diagnosis procedures has been applied in order to localise and quantify radon entry pathways into the indoor environment. Independent assessment of radon entry rate and air exchange rate has been carried out using the continuous indoor radon measurement and a specific tracer gas application. Simultaneous assessment of these key determining factors has turned out to be absolutely crucial in the context of major cause identification of elevated indoor radon concentration.

Entry, Descent and Landing Systems Analysis Study: Phase 1 Report

NASA Technical Reports Server (NTRS)

DwyerCianciolo, Alicia M.; Davis, Jody L.; Komar, David R.; Munk, Michelle M.; Samareh, Jamshid A.; Powell, Richard W.; Shidner, Jeremy D.; Stanley, Douglas O.; Wilhite, Alan W.; Kinney, David J.;

Reduction in chemotherapy order errors with computerized physician order entry.

PubMed

Meisenberg, Barry R; Wright, Robert R; Brady-Copertino, Catherine J

2014-01-01

To measure the number and type of errors associated with chemotherapy order composition associated with three sequential methods of ordering: handwritten orders, preprinted orders, and computerized physician order entry (CPOE) embedded in the electronic health record. From 2008 to 2012, a sample of completed chemotherapy orders were reviewed by a pharmacist for the number and type of errors as part of routine performance improvement monitoring. Error frequencies for each of the three distinct methods of composing chemotherapy orders were compared using statistical methods. The rate of problematic order sets-those requiring significant rework for clarification-was reduced from 30.6% with handwritten orders to 12.6% with preprinted orders (preprinted v handwritten, P < .001) to 2.2% with CPOE (preprinted v CPOE, P < .001). The incidence of errors capable of causing harm was reduced from 4.2% with handwritten orders to 1.5% with preprinted orders (preprinted v handwritten, P < .001) to 0.1% with CPOE (CPOE v preprinted, P < .001). The number of problem- and error-containing chemotherapy orders was reduced sequentially by preprinted order sets and then by CPOE. CPOE is associated with low error rates, but it did not eliminate all errors, and the technology can introduce novel types of errors not seen with traditional handwritten or preprinted orders. Vigilance even with CPOE is still required to avoid patient harm.

Foster care re-entry: Exploring the role of foster care characteristics, in-home child welfare services and cross-sector services.

PubMed

Lee, Sangmoo; Jonson-Reid, Melissa; Drake, Brett

2012-09-01

This study seeks to advance our understanding of how modifiable and non-modifiable factors may impact the likelihood of re-entry into foster care. Children who entered foster care for the first time following at least one report of maltreatment and were then reunified were followed from exit to re-entry, age 18 or the end of the study period using longitudinal administrative data. Risk of re-entry was explored according to a range of modifiable and non-modifiable case and service characteristics. Children removed from homes with parents who had multiple risk factors (e.g., no high school diploma, mental health diagnosis, criminal record, or teen parents) or were receiving AFDC prior to entry were more likely to re-enter. The receipt of in-home child welfare services during or after foster care was associated with reduced risk of re-entry. Having the longest placement with a relative was associated with decreased risk of re-entry. In conclusion, both modifiable and non-modifiable factors are associated with re-entry into foster care. Among modifiable factors, services appear to have a particularly strong relationship to re-entry. Our data also suggest that in-home child welfare services provided during and after foster care may be associated with improved long-term permanency after return home. Given the continued import of caregiver risk factors even among reunified families, services provided to support reunification should include attention to caregiver needs outside parenting.

Foster care re-entry: Exploring the role of foster care characteristics, in-home child welfare services and cross-sector services☆

PubMed Central

Lee, Sangmoo; Jonson-Reid, Melissa; Drake, Brett

2013-01-01

This study seeks to advance our understanding of how modifiable and non-modifiable factors may impact the likelihood of re-entry into foster care. Children who entered foster care for the first time following at least one report of maltreatment and were then reunified were followed from exit to re-entry, age 18 or the end of the study period using longitudinal administrative data. Risk of re-entry was explored according to a range of modifiable and non-modifiable case and service characteristics. Children removed from homes with parents who had multiple risk factors (e.g., no high school diploma, mental health diagnosis, criminal record, or teen parents) or were receiving AFDC prior to entry were more likely to re-enter. The receipt of in-home child welfare services during or after foster care was associated with reduced risk of re-entry. Having the longest placement with a relative was associated with decreased risk of re-entry. In conclusion, both modifiable and non-modifiable factors are associated with re-entry into foster care. Among modifiable factors, services appear to have a particularly strong relationship to re-entry. Our data also suggest that in-home child welfare services provided during and after foster care may be associated with improved long-term permanency after return home. Given the continued import of caregiver risk factors even among reunified families, services provided to support reunification should include attention to caregiver needs outside parenting. PMID:23729947

Aeronautical engineering, a special bibliography, September 1971 (supplement 10)

NASA Technical Reports Server (NTRS)

1971-01-01

This supplement to Aeronautical Engineering-A Special Bibliography (NASA SP-7037) lists 413 reports, journal articles, and other documents originally announced in September 1971 in Scientific and Technical Aerospace Reports (STAR) or in International Aerospace Abstracts (IAA). The coverage includes documents on the engineering and theoretical aspects of design, construction, evaluation, testing, operation, and performance of aircraft (including aircraft engines) and associated components, equipment, and systems. It also includes research and development in aerodynamics, aeronautics, and ground support equipment for aeronautical vehicles. Each entry in the bibliography consists of a standard bibliographic citation accompanied by an abstract. The listing of the entries is arranged in two major sections, IAA Entries and STAR Entries in that order. The citations and abstracts are reproduced exactly as they appeared originally in IAA or STAR, including the original accession numbers from the respective announcement journals.

Automated quantitative assessment of proteins' biological function in protein knowledge bases.

PubMed

Mayr, Gabriele; Lepperdinger, Günter; Lackner, Peter

2008-01-01

Primary protein sequence data are archived in databases together with information regarding corresponding biological functions. In this respect, UniProt/Swiss-Prot is currently the most comprehensive collection and it is routinely cross-examined when trying to unravel the biological role of hypothetical proteins. Bioscientists frequently extract single entries and further evaluate those on a subjective basis. In lieu of a standardized procedure for scoring the existing knowledge regarding individual proteins, we here report about a computer-assisted method, which we applied to score the present knowledge about any given Swiss-Prot entry. Applying this quantitative score allows the comparison of proteins with respect to their sequence yet highlights the comprehension of functional data. pfs analysis may be also applied for quality control of individual entries or for database management in order to rank entry listings.

Aerocapture Inflatable Decelerator (AID)

NASA Technical Reports Server (NTRS)

Reza, Sajjad

2007-01-01

Forward Attached Inflatable Decelerators, more commonly known as inflatable aeroshells, provide an effective, cost efficient means of decelerating spacecrafts by using atmospheric drag for aerocapture or planetary entry instead of conventional liquid propulsion deceleration systems. Entry into planetary atmospheres results in significant heating and aerodynamic pressures which stress aeroshell systems to their useful limits. Incorporation of lightweight inflatable decelerator surfaces with increased surface-area footprints provides the opportunity to reduce heat flux and induced temperatures, while increasing the payload mass fraction. Furthermore, inflatable aeroshell decelerators provide the needed deceleration at considerably higher altitudes and Mach numbers when compared with conventional rigid aeroshell entry systems. Inflatable aeroshells also provide for stowage in a compact space, with subsequent deployment of a large-area, lightweight heatshield to survive entry heating. Use of a deployable heatshield decelerator not only enables an increase in the spacecraft payload mass fraction and but may also eliminate the need for a spacecraft backshell and cruise stage. This document is the viewgraph slides for the paper's presentation.

Influenza Virus-Mediated Membrane Fusion: Determinants of Hemagglutinin Fusogenic Activity and Experimental Approaches for Assessing Virus Fusion

PubMed Central

Hamilton, Brian S.; Whittaker, Gary R.; Daniel, Susan

2012-01-01

Hemagglutinin (HA) is the viral protein that facilitates the entry of influenza viruses into host cells. This protein controls two critical aspects of entry: virus binding and membrane fusion. In order for HA to carry out these functions, it must first undergo a priming step, proteolytic cleavage, which renders it fusion competent. Membrane fusion commences from inside the endosome after a drop in lumenal pH and an ensuing conformational change in HA that leads to the hemifusion of the outer membrane leaflets of the virus and endosome, the formation of a stalk between them, followed by pore formation. Thus, the fusion machinery is an excellent target for antiviral compounds, especially those that target the conserved stem region of the protein. However, traditional ensemble fusion assays provide a somewhat limited ability to directly quantify fusion partly due to the inherent averaging of individual fusion events resulting from experimental constraints. Inspired by the gains achieved by single molecule experiments and analysis of stochastic events, recently-developed individual virion imaging techniques and analysis of single fusion events has provided critical information about individual virion behavior, discriminated intermediate fusion steps within a single virion, and allowed the study of the overall population dynamics without the loss of discrete, individual information. In this article, we first start by reviewing the determinants of HA fusogenic activity and the viral entry process, highlight some open questions, and then describe the experimental approaches for assaying fusion that will be useful in developing the most effective therapies in the future. PMID:22852045

Ink dating part II: Interpretation of results in a legal perspective.

PubMed

Koenig, Agnès; Weyermann, Céline

2018-01-01

The development of an ink dating method requires an important investment of resources in order to step from the monitoring of ink ageing on paper to the determination of the actual age of a questioned ink entry. This article aimed at developing and evaluating the potential of three interpretation models to date ink entries in a legal perspective: (1) the threshold model comparing analytical results to tabulated values in order to determine the maximal possible age of an ink entry, (2) the trend tests that focusing on the "ageing status" of an ink entry, and (3) the likelihood ratio calculation comparing the probabilities to observe the results under at least two alternative hypotheses. This is the first report showing ink dating interpretation results on a ballpoint be ink reference population. In the first part of this paper three ageing parameters were selected as promising from the population of 25 ink entries aged during 4 to 304days: the quantity of phenoxyethanol (PE), the difference between the PE quantities contained in a naturally aged sample and an artificially aged sample (R NORM ) and the solvent loss ratio (R%). In the current part, each model was tested using the three selected ageing parameters. Results showed that threshold definition remains a simple model easily applicable in practice, but that the risk of false positive cannot be completely avoided without reducing significantly the feasibility of the ink dating approaches. The trend tests from the literature showed unreliable results and an alternative had to be developed yielding encouraging results. The likelihood ratio calculation introduced a degree of certainty to the ink dating conclusion in comparison to the threshold approach. The proposed model remains quite simple to apply in practice, but should be further developed in order to yield reliable results in practice. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

Thermal Protection System Mass Estimating Relationships For Blunt-Body, Earth Entry Spacecraft

NASA Technical Reports Server (NTRS)

Sepka, Steven A.; Samareh, Jamshid A.

2015-01-01

Mass estimating relationships (MERs) are developed to predict the amount of thermal protection system (TPS) necessary for safe Earth entry for blunt-body spacecraft using simple correlations that are non-ITAR and closely match estimates from NASA's highfidelity ablation modeling tool, the Fully Implicit Ablation and Thermal Analysis Program (FIAT). These MERs provide a first order estimate for rapid feasibility studies. There are 840 different trajectories considered in this study, and each TPS MER has a peak heating limit. MERs for the vehicle forebody include the ablators Phenolic Impregnated Carbon Ablator (PICA) and Carbon Phenolic atop Advanced Carbon-Carbon. For the aftbody, the materials are Silicone Impregnated Reusable Ceramic Ablator (SIRCA), Acusil II, SLA- 561V, and LI-900. The MERs are accurate to within 14% (at one standard deviation) of FIAT prediction, and the most any MER can under predict FIAT TPS thickness is 18.7%. This work focuses on the development of these MERs, the resulting equations, model limitations, and model accuracy.

78 FR 3928 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Order Disapproving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-17

... system protocol, to the NASDAQ matching engine or to the NASDAQ router as needed to complete the... Order application to the order entry gateway of NASDAQ's matching engine, but the amount of time gained... proposal represents another example of the blurring borders between exchanges and broker-dealers, and...

78 FR 8617 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... order upon entry and in certain cases again re-prices and re-displays an order at a more aggressive... extent it achieves a more aggressive price. However, the Exchange proposes to re-rank an order at the same price as the displayed price (i.e., a less aggressive price) in the event such order's displayed...

77 FR 33234 - Public Land Order No. 7790; Withdrawal of Public Lands for the Parting of the Ways National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

...] Public Land Order No. 7790; Withdrawal of Public Lands for the Parting of the Ways National Historic Site; Wyoming AGENCY: Bureau of Land Management, Interior. ACTION: Public land order. SUMMARY: This order withdraws 40 acres of public land from settlement, sale, location, and entry under the general land laws...

Enveloping Aerodynamic Decelerator

NASA Technical Reports Server (NTRS)

Nock, Kerry T. (Inventor); Aaron, Kim M. (Inventor); McRonald, Angus D. (Inventor); Gates, Kristin L. (Inventor)

2018-01-01

An inflatable aerodynamic deceleration method and system is provided for use with an atmospheric entry payload. The inflatable aerodynamic decelerator includes an inflatable envelope and an inflatant, wherein the inflatant is configured to fill the inflatable envelope to an inflated state such that the inflatable envelope surrounds the atmospheric entry payload, causing aerodynamic forces to decelerate the atmospheric entry payload.

78 FR 16521 - Agency Information Collection Activities: Declaration for Free Entry of Unaccompanied Articles

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

... Activities: Declaration for Free Entry of Unaccompanied Articles AGENCY: U.S. Customs and Border Protection...: Declaration for Free Entry of Unaccompanied Articles (Form 3299). This is a proposed extension of an... Unaccompanied Articles. OMB Number: 1651-0014. Form Number: Form 3299. Abstract: 19 U.S.C. 1498 provides that...

8 CFR 1101.1 - Presumption of lawful admission.

Code of Federal Regulations, 2012 CFR

2012-01-01

... daughter entered the United States. (f) Citizens of the Philippine Islands—(1) Entry prior to May 1, 1934... the date of his entry a citizen of the Philippine Islands, provided that for the purpose of... residence unless he was a citizen of the Commonwealth of the Philippines on July 2, 1946. (2) Entry between...

8 CFR 1101.1 - Presumption of lawful admission.

Code of Federal Regulations, 2011 CFR

2011-01-01

... daughter entered the United States. (f) Citizens of the Philippine Islands—(1) Entry prior to May 1, 1934... the date of his entry a citizen of the Philippine Islands, provided that for the purpose of... residence unless he was a citizen of the Commonwealth of the Philippines on July 2, 1946. (2) Entry between...

8 CFR 1101.1 - Presumption of lawful admission.

Code of Federal Regulations, 2013 CFR

2013-01-01

... daughter entered the United States. (f) Citizens of the Philippine Islands—(1) Entry prior to May 1, 1934... the date of his entry a citizen of the Philippine Islands, provided that for the purpose of... residence unless he was a citizen of the Commonwealth of the Philippines on July 2, 1946. (2) Entry between...

8 CFR 1101.1 - Presumption of lawful admission.

Code of Federal Regulations, 2014 CFR

2014-01-01

... daughter entered the United States. (f) Citizens of the Philippine Islands—(1) Entry prior to May 1, 1934... the date of his entry a citizen of the Philippine Islands, provided that for the purpose of... residence unless he was a citizen of the Commonwealth of the Philippines on July 2, 1946. (2) Entry between...

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

Bose, Sayantan, E-mail: sayantan_bose@hms.harvard.edu; Jardetzky, Theodore S.; Lamb, Robert A., E-mail: ralamb@northwestern.edu

The Paramyxoviridae include some of the great and ubiquitous disease-causing viruses of humans and animals. In most paramyxoviruses, two viral membrane glycoproteins, fusion protein (F) and receptor binding protein (HN, H or G) mediate a concerted process of recognition of host cell surface molecules followed by fusion of viral and cellular membranes, resulting in viral nucleocapsid entry into the cytoplasm. The interactions between the F and HN, H or G viral glycoproteins and host molecules are critical in determining host range, virulence and spread of these viruses. Recently, atomic structures, together with biochemical and biophysical studies, have provided major insightsmore » into how these two viral glycoproteins successfully interact with host receptors on cellular membranes and initiate the membrane fusion process to gain entry into cells. These studies highlight the conserved core mechanisms of paramyxovirus entry that provide the fundamental basis for rational anti-viral drug design and vaccine development. - Highlights: • New structural and functional insights into paramyxovirus entry mechanisms. • Current data on paramyxovirus glycoproteins suggest a core conserved entry mechanism. • Diverse mechanisms preventing premature fusion activation exist in these viruses. • Precise spacio-temporal interplay between paramyxovirus glycoproteins initiate entry.« less

Overview of the MEDLI Project

NASA Technical Reports Server (NTRS)

Gazarik, Michael J.; Hwang, Helen; Little, Alan; Cheatwood, Neil; Wright, Michael; Herath, Jeff

2007-01-01

The Mars Science Laboratory Entry, Descent, and Landing Instrumentation (MEDLI) Project's objectives are to measure aerothermal environments, sub-surface heatshield material response, vehicle orientation, and atmospheric density for the atmospheric entry and descent phases of the Mars Science Laboratory (MSL) entry vehicle. The flight science objectives of MEDLI directly address the largest uncertainties in the ability to design and validate a robust Mars entry system, including aerothermal, aerodynamic and atmosphere models, and thermal protection system (TPS) design. The instrumentation suite will be installed in the heatshield of the MSL entry vehicle. The acquired data will support future Mars entry and aerocapture missions by providing measured atmospheric data to validate Mars atmosphere models and clarify the design margins for future Mars missions. MEDLI thermocouple and recession sensor data will significantly improve the understanding of aeroheating and TPS performance uncertainties for future missions. MEDLI pressure data will permit more accurate trajectory reconstruction, as well as separation of aerodynamic and atmospheric uncertainties in the hypersonic and supersonic regimes. This paper provides an overview of the project including the instrumentation design, system architecture, and expected measurement response.

Overview of the MEDLI Project

NASA Technical Reports Server (NTRS)

Gazarik, Michael J.; Little, Alan; Cheatwood, F. Neil; Wright, Michael J.; Herath, Jeff A.; Martinez, Edward R.; Munk, Michelle; Novak, Frank J.; Wright, Henry S.

2008-01-01

The Mars Science Laboratory Entry, Descent, and Landing Instrumentation (MEDLI) Project s objectives are to measure aerothermal environments, sub-surface heatshield material response, vehicle orientation, and atmospheric density for the atmospheric entry and descent phases of the Mars Science Laboratory (MSL) entry vehicle. The flight science objectives of MEDLI directly address the largest uncertainties in the ability to design and validate a robust Mars entry system, including aerothermal, aerodynamic and atmosphere models, and thermal protection system (TPS) design. The instrumentation suite will be installed in the heatshield of the MSL entry vehicle. The acquired data will support future Mars entry and aerocapture missions by providing measured atmospheric data to validate Mars atmosphere models and clarify the design margins for future Mars missions. MEDLI thermocouple and recession sensor data will significantly improve the understanding of aeroheating and TPS performance uncertainties for future missions. MEDLI pressure data will permit more accurate trajectory reconstruction, as well as separation of aerodynamic and atmospheric uncertainties in the hypersonic and supersonic regimes. This paper provides an overview of the project including the instrumentation design, system architecture, and expected measurement response.

Different Infectivity of HIV-1 Strains Is Linked to Number of Envelope Trimers Required for Entry

PubMed Central

Brandenberg, Oliver F.; Magnus, Carsten; Rusert, Peter; Regoes, Roland R.; Trkola, Alexandra

2015-01-01

HIV-1 enters target cells by virtue of envelope glycoprotein trimers that are incorporated at low density in the viral membrane. How many trimers are required to interact with target cell receptors to mediate virus entry, the HIV entry stoichiometry, still awaits clarification. Here, we provide estimates of the HIV entry stoichiometry utilizing a combined approach of experimental analyses and mathematical modeling. We demonstrate that divergent HIV strains differ in their stoichiometry of entry and require between 1 to 7 trimers, with most strains depending on 2 to 3 trimers to complete infection. Envelope modifications that perturb trimer structure lead to an increase in the entry stoichiometry, as did naturally occurring antibody or entry inhibitor escape mutations. Highlighting the physiological relevance of our findings, a high entry stoichiometry correlated with low virus infectivity and slow virus entry kinetics. The entry stoichiometry therefore directly influences HIV transmission, as trimer number requirements will dictate the infectivity of virus populations and efficacy of neutralizing antibodies. Thereby our results render consideration of stoichiometric concepts relevant for developing antibody-based vaccines and therapeutics against HIV. PMID:25569556

Computer-supported weight-based drug infusion concentrations in the neonatal intensive care unit.

PubMed

Giannone, Gay

2005-01-01

This article addresses the development of a computerized provider order entry (CPOE)-embedded solution for weight-based neonatal drug infusion developed during the transition from a legacy CPOE system to a customized application of a neonatal CPOE product during a hospital-wide information system transition. The importance of accurate fluid management in the neonate is reviewed. The process of tailoring the system that eventually resulted in the successful development of a computer application enabling weight-based medication infusion calculation for neonates within the CPOE information system is explored. In addition, the article provides guidelines on how to customize a vendor solution for hospitals with neonatal intensive care unit.

Orion Entry Performance-Based Center-of-Gravity Box

NASA Technical Reports Server (NTRS)

Rea, Jeremy R.

2010-01-01

The Orion capsule is designed both for Low Earth Orbit missions to the ISS and for missions to the moon. For ISS class missions, the capsule will use an Apollo-style direct entry. For lunar return missions, depending on the timing of the mission, the capsule could perform a direct entry or a skip entry of up to 4800 n.mi. in order to land in the coastal waters of California. The physics of atmospheric re-entry determine the capability of the Orion vehicle. For a given vehicle mass and shape, physics tells us that the driving parameters for an entry vehicle are the hypersonic lift-to-drag ratio (L/D) and the flight path angle at entry interface (gamma(sub EI)). The design of the Orion atmospheric re-entry must meet constraints during both nominal and dispersed flight conditions on landing accuracy, heating rate, total heat load, sensed acceleration, and proper disposal of the Service Module. These constraints define an entry corridor in the space of L/D-gamma(sub EI); if the vehicle falls within this corridor, then all constraints are met. The gamma(sub EI) dimension of the corridor can be further constrained by the gloads experienced during emergency entries. Thus, the entry performance for the Orion vehicle can be described completely by the L/D. Bounds on the hypersonic L/D necessary to achieve all the mission requirements can be defined for the given entry corridor. Landing accuracy performance drives the lower limit on L/D. In order to achieve the desired landing accuracy, a minimum L/D must be ensured. The design of the Thermal Protection System (TPS) drives the upper limit on L/D. A higher L/D can drive mass into the design of the TPS. Conversely, once the TPS is designed, the L/D must be ensured to stay below a certain limit in order for the TPS to stay within its design envelop. The L/D must stay within its upper and lower bounds during dispersed flight conditions. L/D is a function of both the aerodynamics and the center-of-gravity (CG) of the vehicle. The aerodynamics of the vehicle are determined by Computational Fluid Mechanics (CFD) and wind tunnel tests. However, the aerodynamics are not known precisely. Instead, an aerodynamic database has been developed where the aerodynamic coefficients are known to fall within a probabilistic band defined by upper and lower bounds. It is expected that the probabilistic band will shrink after the first missions are flown and real-world data is collected. Until that time, the Orion must be designed to the current aerodynamic database. Thus, for a given aerodynamic database with given uncertainties, the allowable range in L/D can be mapped to an allowable box for the CG location. The CG box is used to set requirements on the dispersions allowed for vehicle packaging and cargo storage. As the aerodynamic uncertainties decrease, the size of the CG box can increase. This paper discusses the technique used to map the minimum and maximum L/D bounds set by the entry performance requirements to the allowable dispersions in CG while accounting for aerodynamic uncertainties. The L/D is defined as the ratio of the lift force to the drag force. It is equivalent to the ratio of lift coefficient (C(sub L)) over drag coefficient (C(sub D)). C(sub L) and C(sub D) are functions of Mach number (M) and angle of attack (alpha). A Mach number of 25 is used as a measuring point of the hypersonic L/D. Variations in C(sub L), C(sub D) and alpha cause variations in L/D. Equation (1) shows the three contributions to the variation in L/D.

BOOK REVIEW: The Complete A-Z Physics Handbook, Second Edition

NASA Astrophysics Data System (ADS)

Breithaupt, Jim

2000-11-01

The first edition of this book was published in 1997 and reviewed in Physics Education in March 1988. This second edition is 13 pages longer and contains a significant number of new entries, mostly in particle physics and astrophysics, to match the latest AS/A-level specifications. Some entries on topics such as surface tension that were removed from previous AS/A-level syllabuses have now been deleted. The revised book thus provides an effective alphabetical guide to key terms used in the latest AS/A-level specifications as most AS/A-level core terms are included, apart from terms for some of the new topics such as image processing in the new IOP AS/A-level specification. The style of the second edition is the same as the first, each entry commencing with the key term in bold print followed by an explanation of the term, accompanied by the relevant equation and/or a simple diagram where appropriate. Cross-references are given in italics. For example, the entry under quarks (which is one of the new entries) lists the six quarks and their characteristic properties in bullet point format then follows up with the information about the quark composition of baryons and mesons, giving the composition of the proton, the neutron and the pions as examples. The change of quark composition due to beta decay is mentioned with a cross-reference to beta decay. Other cross-references link to entries on the proton, the neutron and the four fundamental interactions. Lengthy entries such as the photoelectric effect each cover several pages, thus providing opportunities for in-depth revision. Useful theme entries provided in the first edition have been retained and referred to in a new two-page appendix on preparing for synoptic questions. Some proofs are provided such as the proof of the kinetic theory equation. Some experiments are described, each under an appropriate entry. Technically, the entries are reasonably accurate and usually expressed in appropriate and familiar language. The book ends with the same appendices as in the first edition (units, formulae, physical constants, examiners' terms, a suggested revision list and notes on examination preparation) plus the two-page synoptic appendix. The second edition with its additional entries on particle physics and astrophysics should prove useful as a study guide to supplement a textbook or as a revision guide as AS or A2 examinations approach. In addition, the concise nature of many of the entries could be valuable in helping physics students sharpen their written communication skills, thereby securing marks which all too often they lose on account of inadequate answers to descriptive questions.

Analysis of Management Control Techniques for the Data Processing Department at the Navy Finance Center, Cleveland, Ohio.

DTIC Science & Technology

1983-03-01

Sysiem are: Order processinq coordinators Order processing management Credit and collections Accounts receivable Support management Admin ianagemenr...or sales secretary, then by order processing (OP). Phone-in orders go directly to OP. The infor- mation is next Transcribed onto an order entry... ORDER PROCESSING : The central systems validate The order items and codes t!, processing them against the customer file, the prodicT or PA? ts file, and

76 FR 13356 - Magnesium Metal From the People's Republic of China: Continuation of Antidumping Duty Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-11

... recycling magnesium-based scrap into magnesium metal. The magnesium covered by the order includes blends of... deposits at the rates in effect at the time of entry for all imports of subject merchandise. The effective...

Experience of a Medicaid nursing home entry cohort

PubMed Central

Ray, Wayne A.; Federspiel, Charles F.; Baugh, David K.; Dodds, Suzanne

1989-01-01

Long-term care cost-containment policies have focused on reducing the numbers of persons entering nursing homes. To provide insight and background for such efforts, the authors studied the experience of Medicaid nursing home entry cohorts in three individual States. They found substantial interstate variation in rates of nursing home entry and subsequent patterns of discharge, suggesting the operation of fundamentally different policies for provision of Medicaid nursing home services. Analysis of the cost effectiveness and quality of care implications of these policies may provide guidance for future cost-containment efforts. PMID:10313279

ESA Venus Entry Probe Study

NASA Technical Reports Server (NTRS)

vandenBerg, M. L.; Falkner, P.; Phipps, A.; Underwood, J. C.; Lingard, J. S.; Moorhouse, J.; Kraft, S.; Peacock, A.

2005-01-01

The Venus Entry Probe is one of ESA s Technology Reference Studies (TRS). The purpose of the Technology Reference Studies is to provide a focus for the development of strategically important technologies that are of likely relevance for future scientific missions. The aim of the Venus Entry Probe TRS is to study approaches for low cost in-situ exploration of Venus and other planetary bodies with a significant atmosphere. In this paper, the mission objectives and an outline of the mission concept of the Venus Entry Probe TRS are presented.

Public Risk Assessment of Off-Nominal Genesis Entries

NASA Technical Reports Server (NTRS)

Mendeck, Gavin F.; Kadwa, Binaifer

2006-01-01

Public risk estimations were among the preparations for the entry of the Genesis sample return capsule. Personnel at the Johnson Space Center were requested to provide estimates of the public risk of off-nominal entries. These scenarios dealt with an incomplete trajectory maneuver that would result in the capsule landing outside of the controlled Utah Test and Training Range. Using a conservative approach to the inputs and assumptions, such off-nominal entries were demonstrated to fall within the project risk limits.

Adjustable Bracket For Entry Of Welding Wire

NASA Technical Reports Server (NTRS)

Gilbert, Jeffrey L.; Gutow, David A.

1993-01-01

Wire-entry bracket on welding torch in robotic welding system provides for adjustment of angle of entry of welding wire over range of plus or minus 30 degrees from nominal entry angle. Wire positioned so it does not hide weld joint in view of through-the-torch computer-vision system part of robot-controlling and -monitoring system. Swiveling bracket also used on nonvision torch on which wire-feed-through tube interferes with workpiece. Angle simply changed to one giving sufficient clearance.

Efficacy of education followed by computerized provider order entry with clinician decision support to reduce red blood cell utilization.

PubMed

Zuckerberg, Gabriel S; Scott, Andrew V; Wasey, Jack O; Wick, Elizabeth C; Pawlik, Timothy M; Ness, Paul M; Patel, Nishant D; Resar, Linda M S; Frank, Steven M

2015-07-01

Two necessary components of a patient blood management program are education regarding evidence-based transfusion guidelines and computerized provider order entry (CPOE) with clinician decision support (CDS). This study examines changes in red blood cell (RBC) utilization associated with each of these two interventions. We reviewed 5 years of blood utilization data (2009-2013) for 70,118 surgical patients from 10 different specialty services at a tertiary care academic medical center. Three distinct periods were compared: 1) before blood management, 2) education alone, and 3) education plus CPOE. Changes in RBC unit utilization were assessed over the three periods stratified by surgical service. Cost savings were estimated based on RBC acquisition costs. For all surgical services combined, RBC utilization decreased by 16.4% with education alone (p = 0.001) and then changed very little (2.5% increase) after subsequent addition of CPOE (p = 0.64). When we compared the period of education plus CPOE to the pre-blood management period, the overall decrease was 14.3% (p = 0.008; 2102 fewer RBC units/year, or a cost avoidance of $462,440/year). Services with the highest massive transfusion rates (≥10 RBC units) exhibited the least reduction in RBC utilization. Adding CPOE with CDS after a successful education effort to promote evidence-based transfusion practice did not further reduce RBC utilization. These findings suggest that education is an important and effective component of a patient blood management program and that CPOE algorithms may serve to maintain compliance with evidence-based transfusion guidelines. © 2015 AABB.

Open Entry-Open Exit: A Flexible Approach for Providing Skill Training Needs at AVTS.

ERIC Educational Resources Information Center

Robinson, George A.

Kansas Balance-of-State, a CETA (Comprehensive Employment and Training Act) prime sponsor explored the possibilities of open entry-open exit in meeting the classroom training needs of clients in area vocational technical schools (AVTS). The change to open entry-open exit was found to involve consideration of flexibility and self-paced,…

An Entry Flight Controls Analysis for a Reusable Launch Vehicle

NASA Technical Reports Server (NTRS)

Calhoun, Philip

2000-01-01

The NASA Langley Research Center has been performing studies to address the feasibility of various single-stage to orbit concepts for use by NASA and the commercial launch industry to provide a lower cost access to space. Some work on the conceptual design of a typical lifting body concept vehicle, designated VentureStar(sup TM) has been conducted in cooperation with the Lockheed Martin Skunk Works. This paper will address the results of a preliminary flight controls assessment of this vehicle concept during the atmospheric entry phase of flight. The work includes control analysis from hypersonic flight at the atmospheric entry through supersonic speeds to final approach and landing at subsonic conditions. The requirements of the flight control effectors are determined over the full range of entry vehicle Mach number conditions. The analysis was performed for a typical maximum crossrange entry trajectory utilizing angle of attack to limit entry heating and providing for energy management, and bank angle to modulation of the lift vector to provide downrange and crossrange capability to fly the vehicle to a specified landing site. Sensitivity of the vehicle open and closed loop characteristics to CG location, control surface mixing strategy and wind gusts are included in the results. An alternative control surface mixing strategy utilizing a reverse aileron technique demonstrated a significant reduction in RCS torque and fuel required to perform bank maneuvers during entry. The results of the control analysis revealed challenges for an early vehicle configuration in the areas of hypersonic pitch trim and subsonic longitudinal controllability.

Characterization of soluble glycoprotein D-mediated herpes simplex virus type 1 infection

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

Tsvitov, Marianna; Frampton, Arthur R.; Shah, Waris A.

2007-04-10

Herpes simplex virus type 1 (HSV-1) entry into permissive cells involves attachment to cell-surface glycosaminoglycans (GAGs) and fusion of the virus envelope with the cell membrane triggered by the binding of glycoprotein D (gD) to cognate receptors. In this study, we characterized the observation that soluble forms of the gD ectodomain (sgD) can mediate entry of gD-deficient HSV-1. We examined the efficiency and receptor specificity of this activity and used sequential incubation protocols to determine the order and stability of the initial interactions required for entry. Surprisingly, virus binding to GAGs did not increase the efficiency of sgD-mediated entry andmore » gD-deficient virus was capable of attaching to GAG-deficient cells in the absence of sgD. These observations suggested a novel binding interaction that may play a role in normal HSV infection.« less

Command generator tracker based direct model reference adaptive tracking guidance for Mars atmospheric entry

NASA Astrophysics Data System (ADS)

Li, Shuang; Peng, Yuming

2012-01-01

In order to accurately deliver an entry vehicle through the Martian atmosphere to the prescribed parachute deployment point, active Mars entry guidance is essential. This paper addresses the issue of Mars atmospheric entry guidance using the command generator tracker (CGT) based direct model reference adaptive control to reduce the adverse effect of the bounded uncertainties on atmospheric density and aerodynamic coefficients. Firstly, the nominal drag acceleration profile meeting a variety of constraints is planned off-line in the longitudinal plane as the reference model to track. Then, the CGT based direct model reference adaptive controller and the feed-forward compensator are designed to robustly track the aforementioned reference drag acceleration profile and to effectively reduce the downrange error. Afterwards, the heading alignment logic is adopted in the lateral plane to reduce the crossrange error. Finally, the validity of the guidance algorithm proposed in this paper is confirmed by Monte Carlo simulation analysis.

Mars Sample Return Using Commercial Capabilities: Propulsive Entry, Descent, and Landing of a Capsule Form Vehicle

NASA Technical Reports Server (NTRS)

Gonzales, Andrew A.; Lemke, Lawrence G.; Huynh, Loc C.

2014-01-01

This paper describes a critical portion of the work that has been done at NASA, Ames Research Center regarding the use of the commercially developed Dragon capsule as a delivery vehicle for the elements of a high priority Mars Sample Return mission. The objective of the investigation was to determine entry and landed mass capabilities that cover anticipated mission conditions. The "Red Dragon", Mars configuration, uses supersonic retro-propulsion, with no required parachute system, to perform Entry, Descent, and Landing (EDL) maneuvers. The propulsive system proposed for use is the same system that will perform an abort, if necessary, for a human rated version of the Dragon capsule. Standard trajectory analysis tools are applied to publically available information about Dragon and other legacy capsule forms in order to perform the investigation. Trajectory simulation parameters include entry velocity, flight path angle, lift to drag Ratio (L/D), landing site elevation, atmosphere density, and total entry mass, in addition engineering assumptions for the performance of the propulsion system are stated. Mass estimates for major elements of the overall proposed architecture are coupled to this EDL analysis to close the overall architecture. Three synodic launch opportunities, beginning with the 2022 opportunity, define the arrival conditions. Results state the relations between the analysis parameters as well as sensitivities to those parameters. The EDL performance envelope includes landing altitudes between 0 and -4 km referenced to the Mars Orbiter Laser Altimeter datum as well as minimum and maximum atmosphere density. Total entry masses between 7 and 10 mt are considered with architecture closure occurring between 9.0 and 10 mt. Propellant mass fractions for each major phase of the EDL - Entry, Terminal Descent, and Hazard Avoidance - have been derived. An assessment of the effect of the entry conditions on the Thermal Protection System (TPS) currently in use for Dragon missions shows no significant stressors. A useful payload mass of 2.0 mt is provided and includes mass and grow allowance for a Mars Ascent Vehicle (MAV), Earth Return Vehicle (ERV), and mission unique equipment. The useful payload supports an architecture that receives a sample from another surface asset and sends it directly back to Earth for recovery in a high Earth orbit. The work shows that emerging commercial capabilities as well as previously studied EDL methodologies can be used to efficiently support an important planetary science objective. The work also has applications for human exploration missions that will also use propulsive EDL techniques

Ebola Virus and Severe Acute Respiratory Syndrome Coronavirus Display Late Cell Entry Kinetics: Evidence that Transport to NPC1+ Endolysosomes Is a Rate-Defining Step

PubMed Central

Mingo, Rebecca M.; Simmons, James A.; Shoemaker, Charles J.; Nelson, Elizabeth A.; Schornberg, Kathryn L.; D'Souza, Ryan S.; Casanova, James E.

2014-01-01

ABSTRACT Ebola virus (EBOV) causes hemorrhagic fevers with high mortality rates. During cellular entry, the virus is internalized by macropinocytosis and trafficked through endosomes until fusion between the viral and an endosomal membrane is triggered, releasing the RNA genome into the cytoplasm. We found that while macropinocytotic uptake of filamentous EBOV viruslike particles (VLPs) expressing the EBOV glycoprotein (GP) occurs relatively quickly, VLPs only begin to enter the cytoplasm after a 30-min lag, considerably later than particles bearing the influenza hemagglutinin or GP from lymphocytic choriomeningitis virus, which enter through late endosomes (LE). For EBOV, the long lag is not due to the large size or unusual shape of EBOV filaments, the need to prime EBOV GP to the 19-kDa receptor-binding species, or a need for unusually low endosomal pH. In contrast, since we observed that EBOV entry occurs upon arrival in Niemann-Pick C1 (NPC1)-positive endolysosomes (LE/Lys), we propose that trafficking to LE/Lys is a key rate-defining step. Additional experiments revealed, unexpectedly, that severe acute respiratory syndrome (SARS) S-mediated entry also begins only after a 30-min lag. Furthermore, although SARS does not require NPC1 for entry, SARS entry also begins after colocalization with NPC1. Since the only endosomal requirement for SARS entry is cathepsin L activity, we tested and provide evidence that NPC1+ LE/Lys have higher cathepsin L activity than LE, with no detectable activity in earlier endosomes. Our findings suggest that both EBOV and SARS traffic deep into the endocytic pathway for entry and that they do so to access higher cathepsin activity. IMPORTANCE Ebola virus is a hemorrhagic fever virus that causes high fatality rates when it spreads from zoonotic vectors into the human population. Infection by severe acute respiratory syndrome coronavirus (SARS-CoV) causes severe respiratory distress in infected patients. A devastating outbreak of EBOV occurred in West Africa in 2014, and there was a significant outbreak of SARS in 2003. No effective vaccine or treatment has yet been approved for either virus. We present evidence that both viruses traffic late into the endocytic pathway, to NPC1+ LE/Lys, in order to enter host cells, and that they do so to access high levels of cathepsin activity, which both viruses use in their fusion-triggering mechanisms. This unexpected similarity suggests an unexplored vulnerability, trafficking to NPC1+ LE/Lys, as a therapeutic target for SARS and EBOV. PMID:25552710

Effects of computerized prescriber order entry on pharmacy order-processing time.

PubMed

Wietholter, Jon; Sitterson, Susan; Allison, Steven

2009-08-01

The effect of computerized prescriber order entry (CPOE) on the efficiency of medication-order-processing time was evaluated. This study was conducted at a 761-bed, tertiary care hospital. A total of 2988 medication orders were collected and analyzed before (n = 1488) and after CPOE implementation (n = 1500). Data analyzed included the time the prescriber ordered the medication, the time the pharmacy received the order, and the time the order was completed by a pharmacist. The mean order-processing time before CPOE implementation was 115 minutes from prescriber composition to pharmacist verification. After CPOE implementation, the mean order-processing time was reduced to 3 minutes (p < 0.0001). The time that an order was received by the pharmacy to the time it was verified by a pharmacist was reduced from 31 minutes before CPOE implementation to 3 minutes after CPOE implementation (p < 0.0001). The implementation of CPOE reduced the order-processing time (from order composition to verification) by 97%. Additionally, pharmacy-specific order-processing time (from order receipt in the pharmacy to pharmacist verification) was reduced by 90%. This reduction in order-processing time improves patient care by shortening the interval between physician prescribing and medication availability and may allow pharmacists to explore opportunities for enhanced clinical activities that will further positively impact patient care. CPOE implementation reduced the mean pharmacy order-processing time from composition to verification by 97%. After CPOE implementation, a new medication order was verified as appropriate by a pharmacist in three minutes, on average.

Significant reduction in red blood cell transfusions in a general hospital after successful implementation of a restrictive transfusion policy supported by prospective computerized order auditing.

PubMed

Yerrabothala, Swaroopa; Desrosiers, Kevin P; Szczepiorkowski, Zbigniew M; Dunbar, Nancy M

2014-10-01

Our hospital transfusion policy was recently revised to recommend single-unit red blood cell transfusion (RBC TXN) for nonbleeding inpatients when the hemoglobin (Hb) level is not more than 7 g/dL. Our computerized provider order entry system was reconfigured to provide real-time decision support using prospective computerized order auditing based on the most recent Hb level and to remove the single-click ordering option for 2-unit RBC TXNs to enhance compliance. This study was undertaken to assess the impact of these changes on hospital transfusion practice. This study analyzed the total number of transfusion events, proportion of single and 2-unit transfusions and the Hb transfusion trigger in the preimplementation period (October 2011-March 2012) compared to the postimplementation period (October 2012-March 2013). In the postimplementation period the total number of RBC units transfused/1000 patient-days decreased from 60.8 to 44.2 (p < 0.0001). The proportion of 2-unit TXNs decreased from 47% to 15% (p < 0.0001). We also observed significant decreases in pretransfusion Hb triggers. Implementation of restrictive transfusion policy supported by prospective computerized order auditing has resulted in significantly decreased RBC utilization at our institution. © 2014 AABB.

Mapping PDB chains to UniProtKB entries.

PubMed

Martin, Andrew C R

2005-12-01

UniProtKB/SwissProt is the main resource for detailed annotations of protein sequences. This database provides a jumping-off point to many other resources through the links it provides. Among others, these include other primary databases, secondary databases, the Gene Ontology and OMIM. While a large number of links are provided to Protein Data Bank (PDB) files, obtaining a regularly updated mapping between UniProtKB entries and PDB entries at the chain or residue level is not straightforward. In particular, there is no regularly updated resource which allows a UniProtKB/SwissProt entry to be identified for a given residue of a PDB file. We have created a completely automatically maintained database which maps PDB residues to residues in UniProtKB/SwissProt and UniProtKB/trEMBL entries. The protocol uses links from PDB to UniProtKB, from UniProtKB to PDB and a brute-force sequence scan to resolve PDB chains for which no annotated link is available. Finally the sequences from PDB and UniProtKB are aligned to obtain a residue-level mapping. The resource may be queried interactively or downloaded from http://www.bioinf.org.uk/pdbsws/.

Rotary wing aircraft and technical publications of NASA, 1970 - 1982

NASA Technical Reports Server (NTRS)

Hiemstra, J. D. (Compiler)

1982-01-01

This bibliography cites 933 documents in the NASA RECON data base which pertain to rotary wing aircraft. The entries are arranged in descending order by publication data except for the NASA-supported documents which are arranged in descending order by accession date.

Pathological implications of cell cycle re-entry in Alzheimer disease.

PubMed

Bonda, David J; Lee, Hyun-pil; Kudo, Wataru; Zhu, Xiongwei; Smith, Mark A; Lee, Hyoung-gon

2010-06-29

The complex neurodegeneration underlying Alzheimer disease (AD), although incompletely understood, is characterised by an aberrant re-entry into the cell cycle in neurons. Pathological evidence, in the form of cell cycle markers and regulatory proteins, suggests that cell cycle re-entry is an early event in AD, which precedes the formation of amyloid-beta plaques and neurofibrillary tangles (NFTs). Although the exact mechanisms that induce and mediate these cell cycle events in AD are not clear, significant advances have been made in further understanding the pathological role of cell cycle re-entry in AD. Importantly, recent studies indicate that cell cycle re-entry is not a consequence, but rather a cause, of neurodegeneration, suggesting that targeting of cell cycle re-entry may provide an opportunity for therapeutic intervention. Moreover, multiple inducers of cell cycle re-entry and their interactions in AD have been proposed. Here, we review the most recent advances in understanding the pathological implications of cell cycle re-entry in AD.

Preventing re-entry to foster care.

PubMed

Carnochan, Sarah; Rizik-Baer, Daniel; Austin, Michael J

2013-01-01

Re-entry to foster care generally refers to circumstances in which children who have been discharged from foster care to be reunified with their family of origin, adopted, or provided kinship guardianship are returned to foster care. In the context of the federal performance measurement system, re-entry refers specifically to a return to foster care following an unsuccessful reunification. The federal Children and Family Services Review measures re-entry to foster care with a single indicator, called the permanency of reunification indicator, one of four indicators comprising the reunification composite measure. This review focuses on research related to the re-entry indicator, including the characteristics of children, caregivers and families, as well as case and child welfare services that are associated with a higher or lower risk of re-entry to foster care. Promising post-reunification services designed to prevent re-entry to foster care are described.

Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

PubMed

Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

2014-07-01

Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and useful ways. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry.

PubMed

Oliven, A; Zalman, D; Shilankov, Y; Yeshurun, D; Odeh, M

2002-01-01

Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.

Development Of A Combined Sensor System For Atmospheric Entry Missions

NASA Astrophysics Data System (ADS)

Preci, A.; Eswein, N.; Herdrich, G.; Fasoulas, S.; Roser, H.-P.; Auweter-Kurtz, M.

2011-05-01

The payload COMPARE is developed at the Institute of Space Systems for various entry scenarios. It was previously laid out for a Mars entry mission and afterwards redesigned for the German Aerospace Centre suborbital re-entry mission SHEFEX II, which had its successful roll-out in July 2010 and is due to be launched in September 2011. The sensor system aims to simultaneously measure the temperature of the thermal protection shield, the radiation from the plasma and the pressure. The most recent development of COMPARE is a combined sensor system for ablative thermal protection systems enabling a separation of the radiative heat flux from the total heat flux. Furthermore, it enables also the detection of specific species in the plasma by measuring the radiative heat flux at a defined wavelength range. In the frame of an ESA funded project a breadboard has been build and tested in a plasma wind tunnel in order to prove the feasibility of such a sensor system for upcoming entry missions. Results of these measurements are presented in this work.

A new approach for the solution of fuzzy games

NASA Astrophysics Data System (ADS)

Krishnaveni, G.; Ganesan, K.

2018-04-01

In this paper, a new approach is proposed to solve the games with imprecise entries in its payoff matrix. All these imprecise entries are assumed to be trapezoidal fuzzy numbers. Also the proposed approach provides fuzzy optimal solution of the fuzzy valued game without converting to classical version. A numerical example is provided.

Entry Level Skills for the Event Management Profession: Implications for Curriculum Development

ERIC Educational Resources Information Center

Fletcher, Donna; Dunn, Julie; Prince, Rosemary

2009-01-01

The rapid growth of the event industry has resulted in a world-wide demand for education and training programs in event management. While the professional associations in event management have provided providing quality training and credentialing for their members, the 140 colleges and universities preparing students for entry level positions in…

Power selective optical filter devices and optical systems using same

DOEpatents

Koplow, Jeffrey P

2014-10-07

In an embodiment, a power selective optical filter device includes an input polarizer for selectively transmitting an input signal. The device includes a wave-plate structure positioned to receive the input signal, which includes at least one substantially zero-order, zero-wave plate. The zero-order, zero-wave plate is configured to alter a polarization state of the input signal passing in a manner that depends on the power of the input signal. The zero-order, zero-wave plate includes an entry and exit wave plate each having a fast axis, with the fast axes oriented substantially perpendicular to each other. Each entry wave plate is oriented relative to a transmission axis of the input polarizer at a respective angle. An output polarizer is positioned to receive a signal output from the wave-plate structure and selectively transmits the signal based on the polarization state.

Multidimensional FEM-FCT schemes for arbitrary time stepping

NASA Astrophysics Data System (ADS)

Kuzmin, D.; Möller, M.; Turek, S.

2003-05-01

The flux-corrected-transport paradigm is generalized to finite-element schemes based on arbitrary time stepping. A conservative flux decomposition procedure is proposed for both convective and diffusive terms. Mathematical properties of positivity-preserving schemes are reviewed. A nonoscillatory low-order method is constructed by elimination of negative off-diagonal entries of the discrete transport operator. The linearization of source terms and extension to hyperbolic systems are discussed. Zalesak's multidimensional limiter is employed to switch between linear discretizations of high and low order. A rigorous proof of positivity is provided. The treatment of non-linearities and iterative solution of linear systems are addressed. The performance of the new algorithm is illustrated by numerical examples for the shock tube problem in one dimension and scalar transport equations in two dimensions.

NASA thesaurus. Volume 2: Access vocabulary

NASA Technical Reports Server (NTRS)

1985-01-01

The Access Vocabulary, which is essentially a permuted index, provides access to any word or number in authorized postable and nonpostable terms. Additional entries include postable and nonpostable terms, other word entries, and pseudo-multiword terms that are permutations of words that contain words within words. The Access Vocabulary contains 40,738 entries that give increased access to the hierarchies in Volume 1 - Hierarchical Listing.

NASA Thesaurus. Volume 2: Access vocabulary

NASA Technical Reports Server (NTRS)

1982-01-01

The Access Vocabulary, which is essentially a permuted index, provides access to any word or number in authorized postable and nonpostable terms. Additional entries include postable and nonpostable terms, other word entries, and pseudo-multiword terms that are permutations of words that contain words within words. The Access Vocabulary contains, 40,661 entries that give increased access to he hierarchies in Volume 1 - Hierarchical Listing.

Equilibrium radiative heating tables for Earth entry

NASA Astrophysics Data System (ADS)

Sutton, Kenneth; Hartung, Lin C.

1990-05-01

The recent resurgence of interest in blunt-body atmospheric entry for applications such as aeroassisted orbital transfer and planetary return has engendered a corresponding revival of interest in radiative heating. Radiative heating may be of importance in these blunt-body flows because of the highly energetic shock layer around the blunt nose. Sutton developed an inviscid, stagnation point, radiation coupled flow field code for investigating blunt-body atmospheric entry. The method has been compared with ground-based and flight data, and reasonable agreement has been found. To provide information for entry body studies in support of lunar and Mars return scenarios of interest in the 1970's, the code was exercised over a matrix of Earth entry conditions. Recently, this matrix was extended slightly to reflect entry vehicle designs of current interest. Complete results are presented.

Reconstruction of the Genesis Entry

NASA Technical Reports Server (NTRS)

Desai, Prasun N.; Qualls, Garry D.; Schoenenberger, Mark

2005-01-01

This paper provides an overview of the findings from a reconstruction analysis of the Genesis capsule entry. First, a comparison of the atmospheric properties (density and winds) encountered during the entry to the pre-entry profile is presented. The analysis that was performed on the video footage (obtained from the tracking stations at UTTR) during the descent is then described from which the Mach number at the onset of the capsule tumble was estimated following the failure of the drogue parachute deployment. Next, an assessment of the Genesis capsule aerodynamics that was extracted from the video footage is discussed, followed by a description of the capsule hypersonic attitude that must have occurred during the entry based on examination of the recovered capsule heatshield. Lastly, the entry trajectory reconstruction that was performed is presented.

The Role of Phlebovirus Glycoproteins in Viral Entry, Assembly and Release

PubMed Central

Spiegel, Martin; Plegge, Teresa; Pöhlmann, Stefan

2016-01-01

Bunyaviruses are enveloped viruses with a tripartite RNA genome that can pose a serious threat to animal and human health. Members of the Phlebovirus genus of the family Bunyaviridae are transmitted by mosquitos and ticks to humans and include highly pathogenic agents like Rift Valley fever virus (RVFV) and severe fever with thrombocytopenia syndrome virus (SFTSV) as well as viruses that do not cause disease in humans, like Uukuniemi virus (UUKV). Phleboviruses and other bunyaviruses use their envelope proteins, Gn and Gc, for entry into target cells and for assembly of progeny particles in infected cells. Thus, binding of Gn and Gc to cell surface factors promotes viral attachment and uptake into cells and exposure to endosomal low pH induces Gc-driven fusion of the viral and the vesicle membranes. Moreover, Gn and Gc facilitate virion incorporation of the viral genome via their intracellular domains and Gn and Gc interactions allow the formation of a highly ordered glycoprotein lattice on the virion surface. Studies conducted in the last decade provided important insights into the configuration of phlebovirus Gn and Gc proteins in the viral membrane, the cellular factors used by phleboviruses for entry and the mechanisms employed by phlebovirus Gc proteins for membrane fusion. Here, we will review our knowledge on the glycoprotein biogenesis and the role of Gn and Gc proteins in the phlebovirus replication cycle. PMID:27455305

Titan Atmospheric Entry Radiative Heating

NASA Technical Reports Server (NTRS)

Brandis, A. M; Cruden, B. A.

2017-01-01

Detailed spectrally and spatially resolved radiance has been measured in the Electric Arc Shock Tube for conditions relevant to Titan entry, varying atmospheric composition, free-stream density (equivalent to altitude) and shock velocity. Permutations in atmospheric composition include 1.1, 2, 5 and 8.6 CH4 by mole with a balance of N2 and 1.5 CH4 0.5 Ar 98 N2 by mole, which is consistent with the current understanding of Titan's atmosphere. The effect of gas impurities identified in previous shock tube studies were also examined by testing in pure N2 and deliberate addition of air to the CH4N2 mixtures. The test campaign measured radiation at velocities from 4.7 kms to 8 kms and free-stream pressures from 0.1 to 0.47 Torr. These conditions cover a range of potential trajectories for flight missions, including a direct ballistic trajectory, a fly by or an extremely high speed entry. Radiances measured in this work are substantially larger compared to that reported both in past EAST test campaigns and other shock tube facilities. Depending on the metric used for comparison, the discrepancy can be as high as an order of magnitude. Potential causes for the discrepancy, such as the effect of oxygen due to Air leakage, gas composition and purity are discussed. The present work provides a new benchmark set of data to replace those published in previous studies.

Variation in Formulary Management Practices Within the Department of Veterans Affairs Health Care System.

PubMed

Radomski, Thomas R; Good, Chester B; Thorpe, Carolyn T; Zhao, Xinhua; Marcum, Zachary A; Glassman, Peter A; Lowe, John; Mor, Maria K; Fine, Michael J; Gellad, Walid F

2016-02-01

All Department of Veterans Affairs Medical Centers (VAMCs) operate under a single national drug formulary, yet substantial variation in prescribing and spending exists across facilities. Local management of the national formulary may differ across VAMCs and may be one cause of this variation. To characterize variation in the management of nonformulary medication requests and pharmacy and therapeutics (P&T) committee member perceptions of the formulary environment at VAMCs nationwide. We performed an online survey of the chief of pharmacy and an additional staff pharmacist and physician on the P&T committee at all VAMCs. Respondents were asked questions regarding criteria for use for nonformulary medications, specific procedures for ordering nonformulary medications in general and specific lipid-lowering and diabetes agents, the appeals process, and the formulary environment at their VAMCs. We compared responses across facilities and between chiefs of pharmacy, pharmacists, and physicians. A total of 212 chief pharmacists (n = 80), staff pharmacists (n = 78), and physicians (n = 54) responded, for an overall response rate of 49%. In total, 107/143 (75%) different VAMCs were represented. The majority of VAMCs reported adhering to national criteria for use, with 38 (36%) being very adherent and 69 (65%) being mostly adherent. There was substantial variation between VAMCs regarding how nonformulary drugs were ordered, evaluated, and appealed. The nonformulary lipid-lowering drugs ezetimibe, rosuvastatin, and atorvastatin were viewable to providers in the order entry screen at 67 (63%), 67 (63%), and 64 (60%) VAMCs, respectively. The nonformulary diabetes medication pioglitazone was only viewable at 58 (55%) VAMCs. In the remaining VAMCs, providers could not order these nonformulary drugs through the normal order-entry process. For questions about the formulary environment, physician respondent perceptions differed from those of staff pharmacists and chief pharmacists. Compared with pharmacy chiefs and staff pharmacists, physicians were less likely to agree that providers at their VAMC prescribed too many nonformulary medications (47% and 44% vs. 12%, P < 0.001), more likely to agree that providers must jump through too many hoops to prescribe nonformulary medication (5% and 3% vs. 25%, P < 0.001), and more likely to agree that providers make an effort to convert new patients from nonformulary to formulary lipid-lowering (65% and 73% vs. 94%, P <0.02) and diabetic medications (49% and 50% vs. 88%, P < 0.001). Although the Department of Veterans Affairs (VA) operates under a single national formulary, we found significant differences among VAMCs regarding their management of nonformulary medication requests. We also found differences among formulary leaders regarding their perception of the environment in which their VAMC's formulary is managed. These findings have important implications not just for VA, but for any organization that develops, implements, and manages drug formularies across multiple facilities.

Clarification of CERCLA Entry Policy

EPA Pesticide Factsheets

This memorandum provides Regional Counsel with clarification on EPA’s Policy: “Entry and Continued Access Under CERCLA.” The Policy focuses on consensually gaining access for CERCLA activities at a particular location.

Capturing Accurate and Useful Information on Medication-Related Telenursing Triage Calls.

PubMed

Lake, R; Li, L; Baysari, M; Byrne, M; Robinson, M; Westbrook, J I

2016-01-01

Registered nurses providing telenursing triage and advice services record information on the medication related calls they handle. However the quality and consistency of these data were rarely examined. Our aim was to examine medication related calls made to the healthdirect advice service in November 2014, to assess their basic characteristics and how the data entry format influenced information collected and data consistency. Registered nurses selected the patient question type from a range of categories, and entered the medications involved in a free text field. Medication names were manually extracted from the free text fields. We also compared the selected patient question type with the free text description of the call, in order to gauge data consistency. Results showed that nurses provided patients with advice on medication-related queries in a timely matter (the median call duration of 9 minutes). From 1835 calls, we were able to identify and classify 2156 medications into 384 generic names. However, in 204 cases (11.2% of calls) no medication name was entered. A further 308 (15.0%) of the medication names entered were not identifiable. When we compared the selected patient question with the free text description of calls, we found that these were consistent in 63.27% of cases. Telenursing and triage advice services provide a valuable resource to the public with quick and easily accessible advice. To support nurses provide quality services and record accurate information about the queries, appropriate data entry format and design would be beneficial.

Comparable Stocks, Boundedly Rational Stock Markets and IPO Entry Rates

PubMed Central

Chok, Jay; Qian, Jifeng

2013-01-01

In this study, we examine how initial public offerings (IPO) entry rates are affected when stock markets are boundedly rational and IPO firms infer information from their counterparts in the market. We hypothesize a curvilinear relationship between the number of comparable stocks and initial public offerings (IPO) entry rates into the NASDAQ Stock Exchange. Furthermore, we argue that trading volume and changes in stock returns partially mediates the relationship between the number of comparable stocks and IPO entry rates. The statistical evidence provides strong support for the hypotheses. PMID:23690924

Comparable stocks, boundedly rational stock markets and IPO entry rates.

PubMed

Chok, Jay; Qian, Jifeng

2013-01-01

In this study, we examine how initial public offerings (IPO) entry rates are affected when stock markets are boundedly rational and IPO firms infer information from their counterparts in the market. We hypothesize a curvilinear relationship between the number of comparable stocks and initial public offerings (IPO) entry rates into the NASDAQ Stock Exchange. Furthermore, we argue that trading volume and changes in stock returns partially mediates the relationship between the number of comparable stocks and IPO entry rates. The statistical evidence provides strong support for the hypotheses.

INTERIOR VIEW, EASTWEST CORRIDOR SEEN THROUGH EAST SIDE ENTRY (NOTE ...

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

INTERIOR VIEW, EAST-WEST CORRIDOR SEEN THROUGH EAST SIDE ENTRY (NOTE GLASS BLOCK TRANSOM PROVIDING LIGHT INTO CORRIDOR) - Greenbelt Community Building, 15 Crescent Road, Greenbelt, Prince George's County, MD

Electron-Impact Excitation Cross Sections for Modeling Non-Equilibrium Gas

NASA Technical Reports Server (NTRS)

Huo, Winifred M.; Liu, Yen; Panesi, Marco; Munafo, Alessandro; Wray, Alan; Carbon, Duane F.

2015-01-01

In order to provide a database for modeling hypersonic entry in a partially ionized gas under non-equilibrium, the electron-impact excitation cross sections of atoms have been calculated using perturbation theory. The energy levels covered in the calculation are retrieved from the level list in the HyperRad code. The downstream flow-field is determined by solving a set of continuity equations for each component. The individual structure of each energy level is included. These equations are then complemented by the Euler system of equations. Finally, the radiation field is modeled by solving the radiative transfer equation.

Later-borns Don't Give Up: The Temporary Effects of Birth Order on European Earnings.

PubMed

Bertoni, Marco; Brunello, Giorgio

2016-04-01

The existing empirical evidence on the effects of birth order on wages does not distinguish between temporary and permanent effects. Using data from 11 European countries for males born between 1935 and 1956, we show that firstborns enjoy on average a 13.7% premium in their entry wage compared with later-borns. This advantage, however, is short-lived and disappears 10 years after labor market entry. Although firstborns start with a better job, partially because of their higher education, later-borns quickly catch up by switching earlier and more frequently to better-paying jobs. We argue that a key factor driving our findings is that later-borns have lower risk aversion than firstborns.

75 FR 57061 - Public Land Order No. 7749; Extension of Public Land Order Nos. 6801 and 6812; Arizona

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... National Forest System lands from location or entry under the United States mining laws (30 U.S.C. chapter... Service Coronado National Forest Office, Federal Building, 300 West Congress Street, Tucson, Arizona 85701.... Public Land Order No. 6801 (55 FR 38550, (1990)) that withdrew 61.356 acres of National Forest System...

Market Ordering as a Device for Market-Making: The Case of the Emerging Students' Recruitment Industry

ERIC Educational Resources Information Center

Komljenovic, Janja

2017-01-01

This paper focuses on market-making in the higher education sector and particularly on the role of the market ordering processes. The entry point to examine relations between market ordering and market-making is a private company called ICEF GmbH from Germany. ICEF is engaged in selling particular kinds of education services, delivered by…

On-Board Entry Trajectory Planning Expanded to Sub-orbital Flight

NASA Technical Reports Server (NTRS)

Lu, Ping; Shen, Zuojun

2003-01-01

A methodology for on-board planning of sub-orbital entry trajectories is developed. The algorithm is able to generate in a time frame consistent with on-board environment a three-degree-of-freedom (3DOF) feasible entry trajectory, given the boundary conditions and vehicle modeling. This trajectory is then tracked by feedback guidance laws which issue guidance commands. The current trajectory planning algorithm complements the recently developed method for on-board 3DOF entry trajectory generation for orbital missions, and provides full-envelope autonomous adaptive entry guidance capability. The algorithm is validated and verified by extensive high fidelity simulations using a sub-orbital reusable launch vehicle model and difficult mission scenarios including failures and aborts.

Evaluation and Certification of Computerized Provider Order Entry Systems

PubMed Central

Classen, David C.; Avery, Anthony J.; Bates, David W.

2007-01-01

Computerized physician order entry (CPOE) is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. It is used in about 15% of U.S. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care. Most of these studies have been undertaken at CPOE exemplar sites with homegrown clinical information systems. With the increasing implementation of commercial CPOE systems in various settings of care has come evidence that some implementation approaches may not achieve previously published results or may actually cause new errors or even harm. This has lead to new initiatives to evaluate CPOE systems, which have been undertaken by both vendors and other groups who evaluate vendors, focused on CPOE vendor capabilities and effective approaches to implementation that can achieve benefits seen in published studies. In addition, an electronic health record (EHR) vendor certification process is ongoing under the province of the Certification Commission for Health Information Technology (CCHIT) (which includes CPOE) that will affect the purchase and use of these applications by hospitals and clinics and their participation in public and private health insurance programs. Large employers have also joined this focus by developing flight simulation tools to evaluate the capabilities of these CPOE systems once implemented, potentially linking the results of such programs to reimbursement through pay for performance programs. The increasing role of CPOE systems in health care has invited much more scrutiny about the effectiveness of these systems in actual practice which has the potential to improve their ultimate performance. PMID:17077453

Evaluation and certification of computerized provider order entry systems.

PubMed

Classen, David C; Avery, Anthony J; Bates, David W

2007-01-01

Computerized physician order entry (CPOE) is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. It is used in about 15% of U.S. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care. Most of these studies have been undertaken at CPOE exemplar sites with homegrown clinical information systems. With the increasing implementation of commercial CPOE systems in various settings of care has come evidence that some implementation approaches may not achieve previously published results or may actually cause new errors or even harm. This has lead to new initiatives to evaluate CPOE systems, which have been undertaken by both vendors and other groups who evaluate vendors, focused on CPOE vendor capabilities and effective approaches to implementation that can achieve benefits seen in published studies. In addition, an electronic health record (EHR) vendor certification process is ongoing under the province of the Certification Commission for Health Information Technology (CCHIT) (which includes CPOE) that will affect the purchase and use of these applications by hospitals and clinics and their participation in public and private health insurance programs. Large employers have also joined this focus by developing flight simulation tools to evaluate the capabilities of these CPOE systems once implemented, potentially linking the results of such programs to reimbursement through pay for performance programs. The increasing role of CPOE systems in health care has invited much more scrutiny about the effectiveness of these systems in actual practice which has the potential to improve their ultimate performance.

50 CFR 660.322 - Sablefish allocations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... are provided in § 660.385(a). (b) Between the limited entry and open access sectors. Sablefish is allocated between the limited entry and open access fisheries according to the procedure described in § 660...

Developing an Interactive Data Visualization Tool to Assess the Impact of Decision Support on Clinical Operations.

PubMed

Huber, Timothy C; Krishnaraj, Arun; Monaghan, Dayna; Gaskin, Cree M

2018-05-18

Due to mandates from recent legislation, clinical decision support (CDS) software is being adopted by radiology practices across the country. This software provides imaging study decision support for referring providers at the point of order entry. CDS systems produce a large volume of data, providing opportunities for research and quality improvement. In order to better visualize and analyze trends in this data, an interactive data visualization dashboard was created using a commercially available data visualization platform. Following the integration of a commercially available clinical decision support product into the electronic health record, a dashboard was created using a commercially available data visualization platform (Tableau, Seattle, WA). Data generated by the CDS were exported from the data warehouse, where they were stored, into the platform. This allowed for real-time visualization of the data generated by the decision support software. The creation of the dashboard allowed the output from the CDS platform to be more easily analyzed and facilitated hypothesis generation. Integrating data visualization tools into clinical decision support tools allows for easier data analysis and can streamline research and quality improvement efforts.

Transition, Retraining, and Change for Entry. Final Report from July 1, 1983 - August 31, 1984.

ERIC Educational Resources Information Center

VanderLugt, Marilyn J.

Goals of the "Transition, Retraining, and Change for Entry" project were to provide counseling and/or group support for single heads of households or persons entering nontraditional employment and to provide placement services for the target group. A third goal was to disseminate information about the value of and opportunities in…

Creation of a Book Order Management System Using a Microcomputer and a DBMS.

ERIC Educational Resources Information Center

Neill, Charlotte; And Others

1985-01-01

Describes management decisions and resultant technology-based system that allowed a medical library to meet increasing workloads without accompanying increases in resources available. Discussion covers system analysis; capabilities of book-order management system, "BOOKDIRT;" software and training; hardware; data files; data entry;…

78 FR 8220 - Actions Taken Pursuant to Executive Order 13382

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-05

... DEPARTMENT OF THE TREASURY Office of Foreign Assets Control Actions Taken Pursuant to Executive Order 13382 ACTION: Notice. SUMMARY: The Treasury Department's Office of Foreign Assets Control (``OFAC'') is announcing an update to the entry of an entity on OFAC's SDN List by adding an alias to the entity...

NASA thesaurus. Volume 2: Access vocabulary

NASA Technical Reports Server (NTRS)

1988-01-01

The access vocabulary, which is essentially a permuted index, provides access to any word or number in authorized postable and nonpostable terms. Additional entries include postable and nonpostable terms, other word entries and pseudo-multiword terms that are permutations of words that contain words within words. The access vocabulary contains almost 42,000 entries that give increased access to the hierarchies in Volume 1 - Hierarchical Listing.

Expert Seeker: A People-Finder Knowledge Management System

NASA Technical Reports Server (NTRS)

Becerra-Fernandez, Irma

2000-01-01

The first objective for this report was to perform a comprehensive research of industry models currently being used for similar purposes, in order to provide the Center with ideas of what is being done in area by private companies and government agencies. The second objective was to evaluate the use of taxonomies or ontologies to describe and catalog the areas of expertise at GSFC. The creation of a knowledge taxonomy is necessary for information extraction in order for The Expert Seeker to adequately search and find experts in a particular area of expertise. The requirements to develop a taxonomy are: provide minimal descriptive text; have the appropriate level of abstration; facilitate browsing; ease of use and speed of data entry are critical for success; customized to the organization and its culture; extent of knowledge areas; expandable, so new skills could be develop; could be complemented with free text fields to allow users the option to describe their knowledge in detail.

Viral Infection at High Magnification: 3D Electron Microscopy Methods to Analyze the Architecture of Infected Cells

PubMed Central

Romero-Brey, Inés; Bartenschlager, Ralf

2015-01-01

As obligate intracellular parasites, viruses need to hijack their cellular hosts and reprogram their machineries in order to replicate their genomes and produce new virions. For the direct visualization of the different steps of a viral life cycle (attachment, entry, replication, assembly and egress) electron microscopy (EM) methods are extremely helpful. While conventional EM has given important information about virus-host cell interactions, the development of three-dimensional EM (3D-EM) approaches provides unprecedented insights into how viruses remodel the intracellular architecture of the host cell. During the last years several 3D-EM methods have been developed. Here we will provide a description of the main approaches and examples of innovative applications. PMID:26633469

Viral Infection at High Magnification: 3D Electron Microscopy Methods to Analyze the Architecture of Infected Cells.

PubMed

Romero-Brey, Inés; Bartenschlager, Ralf

2015-12-03

As obligate intracellular parasites, viruses need to hijack their cellular hosts and reprogram their machineries in order to replicate their genomes and produce new virions. For the direct visualization of the different steps of a viral life cycle (attachment, entry, replication, assembly and egress) electron microscopy (EM) methods are extremely helpful. While conventional EM has given important information about virus-host cell interactions, the development of three-dimensional EM (3D-EM) approaches provides unprecedented insights into how viruses remodel the intracellular architecture of the host cell. During the last years several 3D-EM methods have been developed. Here we will provide a description of the main approaches and examples of innovative applications.

Departure Energies, Trip Times and Entry Speeds for Human Mars Missions

NASA Technical Reports Server (NTRS)

Munk, Michelle M.

1999-01-01

The study examines how the mission design variables departure energy, entry speed, and trip time vary for round-trip conjunction-class Mars missions. These three parameters must be balanced in order to produce a mission that is acceptable in terms of mass, cost, and risk. For the analysis, a simple, massless- planet trajectory program was employed. The premise of this work is that if the trans-Mars and trans-Earth injection stages are designed for the most stringent opportunity in the energy cycle, then there is extra energy capability in the "easier" opportunities which can be used to decrease the planetary entry speed, or shorten the trip time. Both of these effects are desirable for a human exploration program.

Departure Energies, Trip Times and Entry Speeds for Human Mars Missions

NASA Technical Reports Server (NTRS)

Munk, Michelle M.

1999-01-01

The study examines how the mission design variables departure energy, entry speed, and trip time vary for round-trip conjunction-class Mars missions. These three parameters must be balanced in order to produce a mission that is acceptable in terms of mass, cost, and risk. For the analysis, a simple, massless-planet trajectory program was employed. The premise of this work is that if the trans-Mars and trans-Earth injection stages are designed for the most stringent opportunity in the energy cycle, then there is extra energy capability in the "easier" opportunities which can be used to decrease the planetary entry speed, or shorten the trip time. Both of these effects are desirable for a human exploration program.

Micromechanical Characterization and Testing of Carbon Based Woven Thermal Protection Materials

NASA Technical Reports Server (NTRS)

Agrawal, Parul; Pham, John T.; Arnold, James O.; Peterson, Keith; Venkatapathy, Ethiraj

2013-01-01

Woven thermal protection system (TPS) materials are one of the enabling technologies for mechanically deployable hypersonic decelerator systems. These materials can be simultaneously used for thermal protection and as structural load bearing members during the entry, descent and landing operations. In order to ensure successful thermal and structural performance during the atmospheric entry, it is important to characterize the properties of these materials, once they have been subjected to entry like conditions. The present paper focuses on mechanical characteristics of pre-and post arc-jet tested woven TPS samples at different scales. It also presents the observations from scanning electron microscope and computed tomography images, and explains the changes in microstructure after being subjected to combined thermal-mechanical loading environments.

Predicting Intentional Communication in Preverbal Preschoolers with Autism Spectrum Disorder.

PubMed

Sandbank, Micheal; Woynaroski, Tiffany; Watson, Linda R; Gardner, Elizabeth; Keçeli Kaysili, Bahar; Yoder, Paul

2017-06-01

Intentional communication has previously been identified as a value-added predictor of expressive language in preverbal preschoolers with autism spectrum disorder. In the present study, we sought to identify value-added predictors of intentional communication. Of five theoretically-motivated putative predictors of intentional communication measured early in the study (at study entry and 4 months after), three had significant zero-order correlations with later intentional communication (12 months after study entry) and were thus added to a linear model that predicted later intentional communication scores controlling for initial intentional communication scores at study entry. After controlling for initial intentional communication, early motor imitation was the only predictor that accounted for a significant amount of variance in children's later intentional communication.

Mission Sizing and Trade Studies for Low Ballistic Coefficient Entry Systems to Venus

NASA Technical Reports Server (NTRS)

Dutta, Soumyo; Smith, Brandon; Prabhu, Dinesh; Venkatapathy, Ethiraj

2012-01-01

The U.S and the U.S.S.R. have sent seventeen successful atmospheric entry missions to Venus. Past missions to Venus have utilized rigid aeroshell systems for entry. This rigid aeroshell paradigm sets performance limitations since the size of the entry vehicle is constrained by the fairing diameter of the launch vehicle. This has limited ballistic coefficients (beta) to well above 100 kg/m2 for the entry vehicles. In order to maximize the science payload and minimize the Thermal Protection System (TPS) mass, these missions have entered at very steep entry flight path angles (gamma). Due to Venus thick atmosphere and the steep-gamma, high- conditions, these entry vehicles have been exposed to very high heat flux, very high pressures and extreme decelerations (upwards of 100 g's). Deployable aeroshells avoid the launch vehicle fairing diameter constraint by expanding to a larger diameter after the launch. Due to the potentially larger wetted area, deployable aeroshells achieve lower ballistic coefficients (well below 100 kg/m2), and if they are flown at shallower flight path angles, the entry vehicle can access trajectories with far lower decelerations (50-60 g's), peak heat fluxes (400 W/cm2) and peak pressures. The structural and TPS mass of the shallow-gamma, low-beta deployables are lower than their steep-gamma, high-beta rigid aeroshell counterparts at larger diameters, contributing to lower areal densities and potentially higher payload mass fractions. For example, at large diameters, deployables may attain aeroshell areal densities of 10 kg/m2 as opposed to 50 kg/m2 for rigid aeroshells. However, the low-beta, shallow-gamma paradigm also raises issues, such as the possibility of skip-out during entry. The shallow-gamma could also increase the landing footprint of the vehicle. Furthermore, the deployable entry systems may be flexible, so there could be fluid-structure interaction, especially in the high altitude, low-density regimes. The need for precision in guidance, navigation and control during entry also has to be better understood. This paper investigates some of the challenges facing the design of a shallow-gamma, low-beta entry system.

Evaluating the environmental hazard of industrial chemicals from data collected during the REACH registration process.

PubMed

Gustavsson, Mikael B; Hellohf, Andreas; Backhaus, Thomas

2017-05-15

Registration dossiers for 11,678 industrial chemicals were retrieved from the database of the European Chemicals Agency, of which 3566 provided a numerical entry for the corresponding predicted no effect concentration for the freshwater environment (PNEC). A distribution-based examination of 2244 of these entries reveals that the average PNEC of an industrial chemical in Europe is 238nmol/L, covering a span of 9 orders of magnitude. A comparison with biocides, pesticides, pharmaceuticals and WFD-priority pollutants reveals that, in average, industrial chemicals are least hazardous (hazard ranking: industrial chemicals≪pharmaceuticals

What systems participants know about access and service entry and why managers should listen.

PubMed

Duncombe, Rohena

2017-08-01

Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners? Participatory design can inform policy makers and service providers. Entry systems could acknowledge the potential vulnerability or disadvantage of people approaching the service.

Validation of High Speed Earth Atmospheric Entry Radiative Heating from 9.5 to 15.5 km/s

NASA Technical Reports Server (NTRS)

Brandis, A. M.; Johnston, C. O.; Cruden, B. A.; Prabhu, D. K.

2016-01-01

This paper presents an overview of the analysis and measurements of equilibrium radiation obtained in the NASA Ames Research Center's Electric Arc Shock Tube (EAST) facility as a part of recent testing aimed at reaching shock velocities up to 15.5 km/s. The goal of these experiments was to measure the level of radiation encountered during high speed Earth entry conditions, such as would be relevant for an asteroid, inter-planetary or lunar return mission. These experiments provide the first spectrally and spatially resolved data for high speed Earth entry and cover conditions ranging from 9.5 to 15.5 km/s at 13.3 and 26.6 Pa (0.1 and 0.2 Torr). The present analysis endeavors to provide a validation of shock tube radiation measurements and simulations at high speed conditions. A comprehensive comparison between the spectrally resolved absolute equilibrium radiance measured in EAST and the predictive tools, NEQAIR and HARA, is presented. In order to provide a more accurate representation of the agreement between the experimental and simulation results, the integrated value of radiance has been compared across four spectral regions (VUV, UV/Vis, Vis/NIR and IR) as a function of velocity. Results have generally shown excellent agreement between the two codes and EAST data for the Vis through IR spectral regions, however, discrepancies have been identified in the VUV and parts of the UV spectral regions. As a result of the analysis presented in this paper, an updated parametric uncertainty for high speed radiation in air has been evaluated to be [9.0%, -6.3%]. Furthermore, due to the nature of the radiating environment at these high shock speeds, initial calculations aimed at modeling phenomena that become more significant with increasing shock speed have been performed. These phenomena include analyzing the radiating species emitting ahead of the shock and the increased significance of radiative cooling mechanisms.

Arctic Messages: Arctic Research in the Vocabulary of Poets and Artists

NASA Astrophysics Data System (ADS)

Samsel, F.

2017-12-01

Arctic Messages is a series of prints created by a multidisciplinary team designed to build understanding and encourage dialogue about the changing Arctic ecosystems and the impacts on global weather patterns. Our team comprised of Arctic researchers, a poet, a visual artist, photographers and visualization experts set out to blend the vocabularies of our disciplines in order to provide entry into the content for diverse audiences. Arctic Messages is one facet of our broader efforts experimenting with mediums of communication able to provide entry to those of us outside scientific of fields. We believe that the scientific understanding of change presented through the languages art will speak to our humanity as well as our intellect. The prints combine poetry, painting, visualization, and photographs, drawn from the Arctic field studies of the Next Generation Ecosystem Experiments research team at Los Alamos National Laboratory. The artistic team interviewed the scientists, read their papers and poured over their field blogs. The content and concepts are designed to portray the wonder of nature, the complexity of the science and the dedication of the researchers. Smith brings to life the intertwined connection between the research efforts, the ecosystems and the scientist's experience. Breathtaking photography of the research site is accompanied by Samsel's drawings and paintings of the ecosystem relationships and geological formations. Together they provide entry to the variety and wonder of life on the Arctic tundra and that resting quietly in the permafrost below. Our team has experimented with many means of presentation from complex interactive systems to quiet individual works. Here we are presenting a series of prints, each one based on a single thread of the research or the scientist's experience but containing intertwined relationships similar to the ecosystems they represent. Earlier interactive systems, while engaging, were not tuned to those seeking quieter contemplation. The long linear work spreads across the wall enable viewers to explore the content of interest at the pace and through the vocabulary that speaks to them.

Experimental energy resolution of a paracentric hemispherical deflector analyzer for different entry positions and bias

NASA Astrophysics Data System (ADS)

Dogan, M.; Ulu, M.; Gennarakis, G. G.; Zouros, T. J. M.

2013-04-01

A specially designed hemispherical deflector analyzer (HDA) with 5-element input lens having a movable entry position R0 suitable for electron energy analysis in atomic collisions was constructed and tested. The energy resolution of the HDA was experimentally determined for three different entry positions R0 = 84, 100, 112 mm as a function of the nominal entry potential V(R0) under pre-retardation conditions. The resolution for the (conventional) entry at the mean radius R0 = 100 mm was found to be a factor of 1.6-2 times worse than the resolution for the two (paracentric) positions R0 = 84 and 112 mm at particular values of V(R0). These results provide the first experimental verification and a proof of principle of the utility of such a paracentric HDA, while demonstrating its advantages over the conventional HDA: greater dispersion with reduced angular aberrations resulting in better energy resolution without the use of any additional fringing field correction electrodes. Supporting simulations of the entire lens plus HDA spectrometer are also provided and mostly found to be within 20%-30% of experimental values. The paracentric HDA is expected to provide a lower cost and/or more compact alternative to the conventional HDA particularly useful in modern applications utilizing a position sensitive detector.

Experimental energy resolution of a paracentric hemispherical deflector analyzer for different entry positions and bias.

PubMed

Dogan, M; Ulu, M; Gennarakis, G G; Zouros, T J M

2013-04-01

A specially designed hemispherical deflector analyzer (HDA) with 5-element input lens having a movable entry position R0 suitable for electron energy analysis in atomic collisions was constructed and tested. The energy resolution of the HDA was experimentally determined for three different entry positions R0 = 84, 100, 112 mm as a function of the nominal entry potential V(R0) under pre-retardation conditions. The resolution for the (conventional) entry at the mean radius R0 = 100 mm was found to be a factor of 1.6-2 times worse than the resolution for the two (paracentric) positions R0 = 84 and 112 mm at particular values of V(R0). These results provide the first experimental verification and a proof of principle of the utility of such a paracentric HDA, while demonstrating its advantages over the conventional HDA: greater dispersion with reduced angular aberrations resulting in better energy resolution without the use of any additional fringing field correction electrodes. Supporting simulations of the entire lens plus HDA spectrometer are also provided and mostly found to be within 20%-30% of experimental values. The paracentric HDA is expected to provide a lower cost and∕or more compact alternative to the conventional HDA particularly useful in modern applications utilizing a position sensitive detector.

Modelling vocabulary development among multilingual children prior to and following the transition to school entry.

PubMed

MacLeod, Andrea A N; Castellanos-Ryan, Natalie; Parent, Sophie; Jacques, Sophie; Séguin, Jean R

2018-01-01

Differences between monolingual and multilingual vocabulary development have been observed but few studies provide a longitudinal perspective on vocabulary development before and following school entry. This study compares vocabulary growth profiles of 106 multilingual children to 211 monolingual peers before and after school entry to examine whether: (1) school entry coincides with different rates of vocabulary growth compared to prior to school entry, (2) compared to monolingual peers, multilingual children show different vocabulary sizes or rates of vocabulary growth, (3) the age of onset of second-language acquisition for multilingual children is associated with vocabulary size or rate of vocabulary growth, and (4) the sociolinguistic context of the languages spoken by multilingual children is associated with vocabulary size or rate of vocabulary growth. Results showed increases in vocabulary size across time for all children, with a steeper increase prior to school entry. A significant difference between monolingual and multilingual children who speak a minority language was observed with regards to vocabulary size at school entry and vocabulary growth prior to school entry, but growth rate differences were no longer present following school entry. Taken together, results suggest that which languages children speak may matter more than being multilingual per se.

47 CFR 73.1820 - Station log.

Code of Federal Regulations, 2010 CFR

2010-10-01

... part. (iii) An entry of each test and activation of the Emergency Alert System (EAS) pursuant to the... functions may be utilized to record entries in the station log Provided: (1) The recording devices do not...

43 CFR 2520.0-3 - Authority.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries: General... March 3, 1891 (26 Stat. 1096; 43 U.S.C. 231, 323, 325, 327-329), provides for the making of desert-land...

43 CFR 2520.0-3 - Authority.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries: General... March 3, 1891 (26 Stat. 1096; 43 U.S.C. 231, 323, 325, 327-329), provides for the making of desert-land...

43 CFR 2520.0-3 - Authority.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries: General... March 3, 1891 (26 Stat. 1096; 43 U.S.C. 231, 323, 325, 327-329), provides for the making of desert-land...

43 CFR 2520.0-3 - Authority.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Desert-Land Entries: General... March 3, 1891 (26 Stat. 1096; 43 U.S.C. 231, 323, 325, 327-329), provides for the making of desert-land...

Development of Thermal Protection Materials for Future Mars Entry, Descent and Landing Systems

NASA Technical Reports Server (NTRS)

Cassell, Alan M.; Beck, Robin A. S.; Arnold, James O.; Hwang, Helen; Wright, Michael J.; Szalai, Christine E.; Blosser, Max; Poteet, Carl C.

2010-01-01

Entry Systems will play a crucial role as NASA develops the technologies required for Human Mars Exploration. The Exploration Technology Development Program Office established the Entry, Descent and Landing (EDL) Technology Development Project to develop Thermal Protection System (TPS) materials for insertion into future Mars Entry Systems. An assessment of current entry system technologies identified significant opportunity to improve the current state of the art in thermal protection materials in order to enable landing of heavy mass (40 mT) payloads. To accomplish this goal, the EDL Project has outlined a framework to define, develop and model the thermal protection system material concepts required to allow for the human exploration of Mars via aerocapture followed by entry. Two primary classes of ablative materials are being developed: rigid and flexible. The rigid ablatives will be applied to the acreage of a 10x30 m rigid mid L/D Aeroshell to endure the dual pulse heating (peak approx.500 W/sq cm). Likewise, flexible ablative materials are being developed for 20-30 m diameter deployable aerodynamic decelerator entry systems that could endure dual pulse heating (peak aprrox.120 W/sq cm). A technology Roadmap is presented that will be used for facilitating the maturation of both the rigid and flexible ablative materials through application of decision metrics (requirements, key performance parameters, TRL definitions, and evaluation criteria) used to assess and advance the various candidate TPS material technologies.

Cross-cultural re-entry for missionaries: a new application for the Dual Process Model.

PubMed

Selby, Susan; Clark, Sheila; Braunack-Mayer, Annette; Jones, Alison; Moulding, Nicole; Beilby, Justin

Nearly half a million foreign aid workers currently work worldwide, including over 140,000 missionaries. During re-entry these workers may experience significant psychological distress. This article positions previous research about psychological distress during re-entry, emphasizing loss and grief. At present there is no identifiable theoretical framework to provide a basis for assessment, management, and prevention of re-entry distress in the clinical setting. The development of theoretical concepts and frameworks surrounding loss and grief including the Dual Process Model (DPM) are discussed. All the parameters of the DPM have been shown to be appropriate for the proposed re-entry model, the Dual Process Model applied to Re-entry (DPMR). It is proposed that the DPMR is an appropriate framework to address the processes and strategies of managing re-entry loss and grief. Possible future clinical applications and limitations of the proposed model are discussed. The DPMR is offered for further validation and use in clinical practice.

PCMdb: Pancreatic Cancer Methylation Database

NASA Astrophysics Data System (ADS)

Nagpal, Gandharva; Sharma, Minakshi; Kumar, Shailesh; Chaudhary, Kumardeep; Gupta, Sudheer; Gautam, Ankur; Raghava, Gajendra P. S.

2014-02-01

Pancreatic cancer is the fifth most aggressive malignancy and urgently requires new biomarkers to facilitate early detection. For providing impetus to the biomarker discovery, we have developed Pancreatic Cancer Methylation Database (PCMDB, http://crdd.osdd.net/raghava/pcmdb/), a comprehensive resource dedicated to methylation of genes in pancreatic cancer. Data was collected and compiled manually from published literature. PCMdb has 65907 entries for methylation status of 4342 unique genes. In PCMdb, data was compiled for both cancer cell lines (53565 entries for 88 cell lines) and cancer tissues (12342 entries for 3078 tissue samples). Among these entries, 47.22% entries reported a high level of methylation for the corresponding genes while 10.87% entries reported low level of methylation. PCMdb covers five major subtypes of pancreatic cancer; however, most of the entries were compiled for adenocarcinomas (88.38%) and mucinous neoplasms (5.76%). A user-friendly interface has been developed for data browsing, searching and analysis. We anticipate that PCMdb will be helpful for pancreatic cancer biomarker discovery.

Parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccines

PubMed Central

Vercruysse, Jessica; Chigurupati, Nagasudha L.; Fung, Leslie; Apte, Gauri; Pierre-Joseph, Natalie; Perkins, Rebecca B.

2016-01-01

ABSTRACT Objective: To determine parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccination. Methods: Parents/guardians of 11–17 y old girls and pediatric healthcare providers at one inner-city public clinic and three private practices completed semi-structured interviews in 2012-2013. Participants were asked open-ended questions regarding their attitudes toward school-located provision and school-entry requirements for HPV vaccination. Parents' answers were analyzed with relationship to whether their daughters had not initiated, initiated but not completed, or completed the HPV vaccine series. Qualitative analysis was used to identify themes related to shared views. Results: 129 parents/guardians and 34 providers participated. 61% of parents supported providing HPV vaccinations in schools, citing reasons of convenience, improved access, and positive peer pressure. Those who opposed school-located provision raised concerns related to privacy and the capacity of school nurses to manage vaccine-related reactions. Parents whose daughters had not completed the series were more likely to intend to vaccinate their daughters in schools (70%) and support requirements (64%) than parents who had not initiated vaccination (42% would vaccinate at school, 46% support requirements) or completed the series (42% would vaccinate at school, 32% support requirements; p < 0 .05 for all comparisons). 81% of providers supported offering vaccination in schools, wanting to take advantage of the captive audience, improve vaccine completion rates, and decrease the administrative burden on medical office staff, but were concerned about adequate information transfer between schools and medical offices. Only 32% of providers supported school-entry requirements, largely because they felt that a requirement might provoke a public backlash that could further hinder vaccination efforts. Conclusions: School-located provision of HPV vaccination was widely accepted by healthcare providers and parents whose children have not completed the series, indicating that this venue might be a valuable addition to improve completion rates. Support for school-entry requirements was limited among both parents and healthcare providers. PMID:26934421

Parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccines.

PubMed

Vercruysse, Jessica; Chigurupati, Nagasudha L; Fung, Leslie; Apte, Gauri; Pierre-Joseph, Natalie; Perkins, Rebecca B

2016-06-02

To determine parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccination. Parents/guardians of 11-17 y old girls and pediatric healthcare providers at one inner-city public clinic and three private practices completed semi-structured interviews in 2012-2013. Participants were asked open-ended questions regarding their attitudes toward school-located provision and school-entry requirements for HPV vaccination. Parents' answers were analyzed with relationship to whether their daughters had not initiated, initiated but not completed, or completed the HPV vaccine series. Qualitative analysis was used to identify themes related to shared views. 129 parents/guardians and 34 providers participated. 61% of parents supported providing HPV vaccinations in schools, citing reasons of convenience, improved access, and positive peer pressure. Those who opposed school-located provision raised concerns related to privacy and the capacity of school nurses to manage vaccine-related reactions. Parents whose daughters had not completed the series were more likely to intend to vaccinate their daughters in schools (70%) and support requirements (64%) than parents who had not initiated vaccination (42% would vaccinate at school, 46% support requirements) or completed the series (42% would vaccinate at school, 32% support requirements; p < 0 .05 for all comparisons). 81% of providers supported offering vaccination in schools, wanting to take advantage of the captive audience, improve vaccine completion rates, and decrease the administrative burden on medical office staff, but were concerned about adequate information transfer between schools and medical offices. Only 32% of providers supported school-entry requirements, largely because they felt that a requirement might provoke a public backlash that could further hinder vaccination efforts. School-located provision of HPV vaccination was widely accepted by healthcare providers and parents whose children have not completed the series, indicating that this venue might be a valuable addition to improve completion rates. Support for school-entry requirements was limited among both parents and healthcare providers.

28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 5 U.S.C. 557, to review any final order of an Administrative Law Judge in accordance with the... request for administrative review within ten (10) days of the date of entry of the Administrative Law... Administrative Hearing Officer may review an Administrative Law Judge's final order on his or her own initiative...

Study of Enlistment Test Scores and Other Attrition Factors from the Navy’s Delayed Entry Program

DTIC Science & Technology

2009-03-01

fiscal years 1999 through 2008 and were provided by the Defense Manpower Data Center (DMDC). Men and women were analyzed separately because of...years 1999 through 2008 and were provided by the Defense Manpower Data Center (DMDC). Men and women were analyzed separately because of historic...ANALYSIS OF DELAYED ENTRY PROGRAM ATTRITION BY WOMEN

Discovery of natural mouse serum derived HIV-1 entry inhibitor(s).

PubMed

Wei, M; Chen, Y; Xi, J; Ru, S; Ji, M; Zhang, D; Fang, Q; Tang, B

Among rationally designed human immunodeficiency virus 1 (HIV-1) inhibitors, diverse natural factors have showed as potent anti-HIV activity in human blood. We have discovered that the boiled supernatant of healthy mouse serum could suppress HIV-1 entry, and exhibited reduced inhibitory activity after trypsin digestion. Further analysis demonstrated that only the fraction containing 10-25 K proteins could inhibit HIV-1 mediated cell-cell fusion. These results suggest that the 10-25 K protein(s) is novel natural HIV-1 entry inhibitor(s). Our findings provide important information about novel natural HIV entry inhibitors in mouse serum.

Qualitative analysis of vendor discussions on the procurement of Computerised Physician Order Entry and Clinical Decision Support systems in hospitals

PubMed Central

Cresswell, Kathrin M; Lee, Lisa; Slee, Ann; Coleman, Jamie; Bates, David W; Sheikh, Aziz

2015-01-01

Objectives We studied vendor perspectives about potentially transferable lessons for implementing organisations and national strategies surrounding the procurement of Computerised Physician Order Entry (CPOE)/Clinical Decision Support (CDS) systems in English hospitals. Setting Data were collected from digitally audio-recorded discussions from a series of CPOE/CDS vendor round-table discussions held in September 2014 in the UK. Participants Nine participants, representing 6 key vendors operating in the UK, attended. The discussions were transcribed verbatim and thematically analysed. Results Vendors reported a range of challenges surrounding the procurement and contracting processes of CPOE/CDS systems, including hospitals’ inability to adequately assess their own needs and then select a suitable product, rushed procurement and implementation processes that resulted in difficulties in meaningfully engaging with vendors, as well as challenges relating to contracting leading to ambiguities in implementation roles. Consequently, relationships between system vendors and hospitals were often strained, the vendors attributing this to a lack of hospital management's appreciation of the complexities associated with implementation efforts. Future anticipated challenges included issues surrounding the standardisation of data to enable their aggregation across systems for effective secondary uses, and implementation of data exchange with providers outside the hospital. Conclusions Our results indicate that there are significant issues surrounding capacity to procure and optimise CPOE/CDS systems among UK hospitals. There is an urgent need to encourage more synergistic and collaborative working between providers and vendors and for a more centralised support for National Health Service hospitals, which draws on a wider body of experience, including a formalised procurement framework with value-based product specifications. PMID:26503385

Magnetic-Field-Tunable Superconducting Rectifier

NASA Technical Reports Server (NTRS)

Sadleir, John E.

2009-01-01

Superconducting electronic components have been developed that provide current rectification that is tunable by design and with an externally applied magnetic field to the circuit component. The superconducting material used in the device is relatively free of pinning sites with its critical current determined by a geometric energy barrier to vortex entry. The ability of the vortices to move freely inside the device means this innovation does not suffer from magnetic hysteresis effects changing the state of the superconductor. The invention requires a superconductor geometry with opposite edges along the direction of current flow. In order for the critical current asymmetry effect to occur, the device must have different vortex nucleation conditions at opposite edges. Alternative embodiments producing the necessary conditions include edges being held at different temperatures, at different local magnetic fields, with different current-injection geometries, and structural differences between opposite edges causing changes in the size of the geometric energy barrier. An edge fabricated with indentations of the order of the coherence length will significantly lower the geometric energy barrier to vortex entry, meaning vortex passage across the device at lower currents causing resistive dissipation. The existing prototype is a two-terminal device consisting of a thin-film su - perconducting strip operating at a temperature below its superconducting transition temperature (Tc). Opposite ends of the strip are connected to electrical leads made of a higher Tc superconductor. The thin-film lithographic process provides an easy means to alter edge-structures, current-injection geo - metries, and magnetic-field conditions at the edges. The edge-field conditions can be altered by using local field(s) generated from dedicated higher Tc leads or even using the device s own higher Tc superconducting leads.

Post-Flight Analysis of the Guidance, Navigation, and Control Performance During Orion Exploration Flight Test 1

NASA Technical Reports Server (NTRS)

Barth, Andrew; Mamich, Harvey; Hoelscher, Brian

2015-01-01

The first test flight of the Orion Multi-Purpose Crew Vehicle presented additional challenges for guidance, navigation and control as compared to a typical re-entry from the International Space Station or other Low Earth Orbit. An elevated re-entry velocity and steeper flight path angle were chosen to achieve aero-thermal flight test objectives. New IMU's, a GPS receiver, and baro altimeters were flight qualified to provide the redundant navigation needed for human space flight. The guidance and control systems must manage the vehicle lift vector in order to deliver the vehicle to a precision, coastal, water landing, while operating within aerodynamic load, reaction control system, and propellant constraints. Extensive pre-flight six degree-of-freedom analysis was performed that showed mission success for the nominal mission as well as in the presence of sensor and effector failures. Post-flight reconstruction analysis of the test flight is presented in this paper to show whether that all performance metrics were met and establish how well the pre-flight analysis predicted the in-flight performance.

Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry

PubMed Central

Gurav, Abhijit Ningappa; Shete, Abhijeet Rajendra; Naiktari, Ritam

2015-01-01

Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect. PMID:26941526

Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry.

PubMed

Gurav, Abhijit Ningappa; Shete, Abhijeet Rajendra; Naiktari, Ritam

2015-01-01

Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect.

Review: Modelling chemical kinetics and convective heating in giant planet entries

NASA Astrophysics Data System (ADS)

Reynier, Philippe; D'Ammando, Giuliano; Bruno, Domenico

2018-01-01

A review of the existing chemical kinetics models for H2 / He mixtures and related transport and thermodynamic properties is presented as a pre-requisite towards the development of innovative models based on the state-to-state approach. A survey of the available results obtained during the mission preparation and post-flight analyses of the Galileo mission has been undertaken and a computational matrix has been derived. Different chemical kinetics schemes for hydrogen/helium mixtures have been applied to numerical simulations of the selected points along the entry trajectory. First, a reacting scheme, based on literature data, has been set up for computing the flow-field around the probe at high altitude and comparisons with existing numerical predictions are performed. Then, a macroscopic model derived from a state-to-state model has been constructed and incorporated into a CFD code. Comparisons with existing numerical results from the literature have been performed as well as cross-check comparisons between the predictions provided by the different models in order to evaluate the potential of innovative chemical kinetics models based on the state-to-state approach.

Mars Phoenix Entry, Descent, and Landing Simulation Design and Modelling Analysis

NASA Technical Reports Server (NTRS)

Prince, Jill L.; Desai, Prasun N.; Queen, Eric M.; Grover, Myron R.

2008-01-01

The 2007 Mars Phoenix Lander was launched in August of 2007 on a ten month cruise to reach the northern plains of Mars in May 2008. Its mission continues NASA s pursuit to find evidence of water on Mars. Phoenix carries upon it a slew of science instruments to study soil and ice samples from the northern region of the planet, an area previously undiscovered by robotic landers. In order for these science instruments to be useful, it was necessary for Phoenix to perform a safe entry, descent, and landing (EDL) onto the surface of Mars. The EDL design was defined through simulation and analysis of the various phases of the descent. An overview of the simulation and various models developed to characterize the EDL performance is provided. Monte Carlo statistical analysis was performed to assess the performance and robustness of the Phoenix EDL system and are presented in this paper. Using these simulation and modelling tools throughout the design and into the operations phase, the Mars Phoenix EDL was a success on May 25, 2008.

Development of a Newcastle disease virus vector expressing a foreign gene through an internal ribosomal entry site provides direct proof for a sequential transcription mechanism.

PubMed

Zhang, Zhenyu; Zhao, Wei; Li, Deshan; Yang, Jinlong; Zsak, Laszlo; Yu, Qingzhong

2015-08-01

In the present study, we developed a novel approach for foreign gene expression by Newcastle disease virus (NDV) from a second ORF through an internal ribosomal entry site (IRES). Six NDV LaSota strain-based recombinant viruses vectoring the IRES and a red fluorescence protein (RFP) gene behind the nucleocapsid (NP), phosphoprotein (P), matrix (M), fusion (F), haemagglutinin-neuraminidase (HN) or large polymerase (L) gene ORF were generated using reverse genetics technology. The insertion of the second ORF slightly attenuated virus pathogenicity, but did not affect ability of the virus to grow. Quantitative measurements of RFP expression in virus-infected DF-1 cells revealed that the abundance of viral mRNAs and red fluorescence intensity were positively correlated with the gene order of NDV, 3'-NP-P-M-F-HN-L-5', proving the sequential transcription mechanism for NDV. The results herein suggest that the level of foreign gene expression could be regulated by selecting the second ORF insertion site to maximize the efficacy of vaccine and gene therapy.

Multi-Mission System Analysis for Planetary Entry (M-SAPE) Version 1

NASA Technical Reports Server (NTRS)

Samareh, Jamshid; Glaab, Louis; Winski, Richard G.; Maddock, Robert W.; Emmett, Anjie L.; Munk, Michelle M.; Agrawal, Parul; Sepka, Steve; Aliaga, Jose; Zarchi, Kerry;

Timing is everything: Fine-tuned molecular machines orchestrate paramyxovirus entry

PubMed Central

Bose, Sayantan; Jardetzky, Theodore S.; Lamb, Robert A.

2015-01-01

The Paramyxoviridae include some of the great and ubiquitous disease-causing viruses of humans and animals. In most paramyxoviruses, two viral membrane glycoproteins, fusion protein (F) and receptor binding protein (HN, H or G) mediate a concerted process of recognition of host cell surface molecules followed by fusion of viral and cellular membranes, resulting in viral nucleocapsid entry into the cytoplasm. The interactions between the F and HN, H or G viral glycoproteins and host molecules are critical in determining host range, virulence and spread of these viruses. Recently, atomic structures, together with biochemical and biophysical studies, have provided major insights into how these two viral glycoproteins successfully interact with host receptors on cellular membranes and initiate the membrane fusion process to gain entry into cells. These studies highlight the conserved core mechanisms of paramyxovirus entry that provide the fundamental basis for rational anti-viral drug design and vaccine development. PMID:25771804

Mission and Navigation Design for the 2009 Mars Science Laboratory Mission

NASA Technical Reports Server (NTRS)

D'Amario, Louis A.

2008-01-01

NASA s Mars Science Laboratory mission will launch the next mobile science laboratory to Mars in the fall of 2009 with arrival at Mars occurring in the summer of 2010. A heat shield, parachute, and rocket-powered descent stage, including a sky crane, will be used to land the rover safely on the surface of Mars. The direction of the atmospheric entry vehicle lift vector will be controlled by a hypersonic entry guidance algorithm to compensate for entry trajectory errors and counteract atmospheric and aerodynamic dispersions. The key challenges for mission design are (1) develop a launch/arrival strategy that provides communications coverage during the Entry, Descent, and Landing phase either from an X-band direct-to-Earth link or from a Ultra High Frequency link to the Mars Reconnaissance Orbiter for landing latitudes between 30 deg North and 30 deg South, while satisfying mission constraints on Earth departure energy and Mars atmospheric entry speed, and (2) generate Earth-departure targets for the Atlas V-541 launch vehicle for the specified launch/arrival strategy. The launch/arrival strategy employs a 30-day baseline launch period and a 27-day extended launch period with varying arrival dates at Mars. The key challenges for navigation design are (1) deliver the spacecraft to the atmospheric entry interface point (Mars radius of 3522.2 km) with an inertial entry flight path angle error of +/- 0.20 deg (3 sigma), (2) provide knowledge of the entry state vector accurate to +/- 2.8 km (3 sigma) in position and +/- 2.0 m/s (3 sigma) in velocity for initializing the entry guidance algorithm, and (3) ensure a 99% probability of successful delivery at Mars with respect to available cruise stage propellant. Orbit determination is accomplished via ground processing of multiple complimentary radiometric data types: Doppler, range, and Delta-Differential One-way Ranging (a Very Long Baseline Interferometry measurement). The navigation strategy makes use of up to five interplanetary trajectory correction maneuvers to achieve entry targeting requirements. The requirements for cruise propellant usage and atmospheric entry targeting and knowledge are met with ample margins.

POLLUX: a program for simulated cloning, mutagenesis and database searching of DNA constructs.

PubMed

Dayringer, H E; Sammons, S A

1991-04-01

Computer support for research in biotechnology has developed rapidly and has provided several tools to aid the researcher. This report describes the capabilities of new computer software developed in this laboratory to aid in the documentation and planning of experiments in molecular biology. The program, POLLUX, provides a graphical medium for the entry, edit and manipulation of DNA constructs and a textual format for display and edit of construct descriptive data. Program operation and procedures are designed to mimic the actual laboratory experiments with respect to capability and the order in which they are performed. Flexible control over the content of the computer-generated displays and program facilities is provided by a mouse-driven menu interface. Programmed facilities for mutagenesis, simulated cloning and searching of the database from networked workstations are described.

Neural Network Assisted Inverse Dynamic Guidance for Terminally Constrained Entry Flight

PubMed Central

Chen, Wanchun

2014-01-01

This paper presents a neural network assisted entry guidance law that is designed by applying Bézier approximation. It is shown that a fully constrained approximation of a reference trajectory can be made by using the Bézier curve. Applying this approximation, an inverse dynamic system for an entry flight is solved to generate guidance command. The guidance solution thus gotten ensures terminal constraints for position, flight path, and azimuth angle. In order to ensure terminal velocity constraint, a prediction of the terminal velocity is required, based on which, the approximated Bézier curve is adjusted. An artificial neural network is used for this prediction of the terminal velocity. The method enables faster implementation in achieving fully constrained entry flight. Results from simulations indicate improved performance of the neural network assisted method. The scheme is expected to have prospect for further research on automated onboard control of terminal velocity for both reentry and terminal guidance laws. PMID:24723821

Mars Science Laboratory (MSL) Entry, Descent, and Landing Instrumentation (MEDLI): Complete Flight Data Set

NASA Technical Reports Server (NTRS)

Cheatwood, F. McNeil; Bose, Deepak; Karlgaard, Christopher D.; Kuhl, Christopher A.; Santos, Jose A.; Wright, Michael J.

2014-01-01

The Mars Science Laboratory (MSL) entry vehicle (EV) successfully entered the Mars atmosphere and landed the Curiosity rover safely on the surface of the planet in Gale crater on August 6, 2012. MSL carried the MSL Entry, Descent, and Landing (EDL) Instrumentation (MEDLI). MEDLI delivered the first in-depth understanding of the Mars entry environments and the response of the entry vehicle to those environments. MEDLI was comprised of three major subsystems: the Mars Entry Atmospheric Data System (MEADS), the MEDLI Integrated Sensor Plugs (MISP), and the Sensor Support Electronics (SSE). Ultimately, the entire MEDLI sensor suite consisting of both MEADS and MISP provided measurements that were used for trajectory reconstruction and engineering validation of aerodynamic, atmospheric, and thermal protection system (TPS) models in addition to Earth-based systems testing procedures. This report contains in-depth hardware descriptions, performance evaluation, and data information of the three MEDLI subsystems.

Human Mars Entry, Descent and Landing Architectures Study Overview

NASA Technical Reports Server (NTRS)

Polsgrove, Tara T.; Dwyer Cianciolo, Alicia

2016-01-01

Landing humans on Mars will require entry, descent and landing (EDL) capability beyond the current state of the art. Nearly twenty times more delivered payload and an order of magnitude improvement in precision landing capability will be necessary. Several EDL technologies capable of meeting the human class payload delivery requirements are being considered. The EDL technologies considered include low lift-to-drag vehicles like Hypersonic Inflatable Aerodynamic Decelerators (HIAD), Adaptable Deployable Entry and Placement Technology (ADEPT), and mid range lift-to-drag vehicles like rigid aeroshell configurations. To better assess EDL technology options and sensitivities to future human mission design variations, a series of design studies has been conducted. The design studies incorporate EDL technologies with conceptual payload arrangements defined by the Evolvable Mars Campaign to evaluate the integrated system with higher fidelity than have been performed to date. This paper describes the results of the design studies for a lander design using the HIAD, ADEPT and rigid shell entry technologies and includes system and subsystem design details including mass and power estimates. This paper will review the point design for three entry configurations capable of delivering a 20 t human class payload to the surface of Mars.

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

PubMed

Chan, Julie; Shojania, Kaveh G; Easty, Anthony C; Etchells, Edward E

2011-05-01

Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems. We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper). 27 staff physicians, residents and medical students. Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada. Methods Participants completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centred Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only. Completion time (efficiency), requests for assistance (usability), and errors in the submitted orders (safety). 27 study participants completed 108 order sets. Mean task times were: User Centred Design format 273 s, Paper format 293 s (p=0.73 compared to UCD format), and CPOE Test format 637 s (p<0.0001 compared to UCD format). Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats (p<0.01). There were no significant differences in number of errors between formats. The User Centred Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. We conclude that application of user-centred design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation.

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

PubMed Central

Chan, Julie; Shojania, Kaveh G; Easty, Anthony C

2011-01-01

Background Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems. Objective We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper). Participants 27staff physicians, residents and medical students. Setting Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada. Methods Participants completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centred Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only. Main Measures Completion time (efficiency), requests for assistance (usability), and errors in the submitted orders (safety). Results 27 study participants completed 108 order sets. Mean task times were: User Centred Design format 273 s, Paper format 293 s (p=0.73 compared to UCD format), and CPOE Test format 637 s (p<0.0001 compared to UCD format). Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats (p<0.01). There were no significant differences in number of errors between formats. Conclusions The User Centred Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. We conclude that application of user-centred design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation. PMID:21486886

NASA Video Catalog. Supplement 15

NASA Technical Reports Server (NTRS)

2005-01-01

This issue of the NASA Video Catalog cites video productions listed in the NASA STI Database. The videos listed have been developed by the NASA centers, covering Shuttle mission press conferences; fly-bys of planets; aircraft design, testing and performance; environmental pollution; lunar and planetary exploration; and many other categories related to manned and unmanned space exploration. Each entry in the publication consists of a standard bibliographic citation accompanied by an abstract. The Table of Contents shows how the entries are arranged by divisions and categories according to the NASA Scope and Coverage Category Guide. For users with specific information, a Title Index is available. A Subject Term Index, based on the NASA Thesaurus, is also included. Guidelines for usage of NASA audio/visual material, ordering information, and order forms are also available.

NASA Video Catalog. Supplement 13

NASA Technical Reports Server (NTRS)

2003-01-01

This issue of the NASA Video Catalog cites video productions listed in the NASA STI Database. The videos listed have been developed by the NASA centers, covering Shuttle mission press conferences; fly-bys of planets; aircraft design, testing and performance; environmental pollution; lunar and planetary exploration; and many other categories related to manned and unmanned space exploration. Each entry in the publication consists of a standard bibliographic citation accompanied by an abstract. The Table of Contents shows how the entries are arranged by divisions and categories according to the NASA Scope and Coverage Category Guide. For users with specific information, a Title Index is available. A Subject Term Index, based on the NASA Thesaurus, is also included. Guidelines for usage of NASA audio/visual material, ordering information, and order forms are also available.

NASA Video Catalog. Supplement 14

NASA Technical Reports Server (NTRS)

2004-01-01

This issue of the NASA Video Catalog cites video productions listed in the NASA STI Database. The videos listed have been developed by the NASA centers, covering Shuttle mission press conferences; fly-bys of planets; aircraft design, testing and performance; environmental pollution; lunar and planetary exploration; and many other categories related to manned and unmanned space exploration. Each entry in the publication consists of a standard bibliographic citation accompanied by an abstract. The Table of Contents shows how the entries are arranged by divisions and categories according to the NASA Scope and Coverage Category Guide. For users with specific information, a Title Index is available. A Subject Term Index, based on the NASA Thesaurus, is also included. Guidelines for usage of NASA audio/visual material, ordering information, and order forms are also available.

NASA Video Catalog

NASA Technical Reports Server (NTRS)

2006-01-01

This issue of the NASA Video Catalog cites video productions listed in the NASA STI database. The videos listed have been developed by the NASA centers, covering Shuttle mission press conferences; fly-bys of planets; aircraft design, testing and performance; environmental pollution; lunar and planetary exploration; and many other categories related to manned and unmanned space exploration. Each entry in the publication consists of a standard bibliographic citation accompanied by an abstract. The Table of Contents shows how the entries are arranged by divisions and categories according to the NASA Scope and Subject Category Guide. For users with specific information, a Title Index is available. A Subject Term Index, based on the NASA Thesaurus, is also included. Guidelines for usage of NASA audio/visual material, ordering information, and order forms are also available.

77 FR 38006 - Approval and Promulgation of Implementation Plans; State of Iowa: Regional Haze

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-26

... Class I Areas'' contained one numerical error. Iowa's 2002 contribution to Voyagers should read 2.16... environmental effects, using practicable and legally permissible methods, under Executive Order 12898 (59 FR... a new entry (39) in numerical order to read as follows: Sec. 52.820 Identification of plan...

75 FR 43590 - Self-Regulatory Organizations; Notice of Filing and Immediate Effectiveness of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... PHLX, Inc. Relating to Order Re-Entry July 20, 2010. Pursuant to section 19(b)(1) of the Securities... a system enhancement that automatically re-enters unexecuted contracts when, after trading at the..., upon the written instruction of the member that initially submitted the order, re-submit unexecuted...

40 CFR 52.1190 - Original Identification of plan section.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Plan for the General Motors Corporation Buick Motor Division in the form of an Alteration of... is in the form of a Stipulation for Entry of Consent Order and Final Order (No. 23-1984). The Consent... suspended particulates (TSP). The revision, in the form of Air Pollution Control Act (APCA) No. 65, revises...

40 CFR 52.1190 - Original Identification of plan section.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Plan for the General Motors Corporation Buick Motor Division in the form of an Alteration of... is in the form of a Stipulation for Entry of Consent Order and Final Order (No. 23-1984). The Consent... suspended particulates (TSP). The revision, in the form of Air Pollution Control Act (APCA) No. 65, revises...

40 CFR 52.1190 - Original Identification of plan section.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Plan for the General Motors Corporation Buick Motor Division in the form of an Alteration of... is in the form of a Stipulation for Entry of Consent Order and Final Order (No. 23-1984). The Consent... suspended particulates (TSP). The revision, in the form of Air Pollution Control Act (APCA) No. 65, revises...

40 CFR 52.1190 - Original Identification of plan section.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Plan for the General Motors Corporation Buick Motor Division in the form of an Alteration of... is in the form of a Stipulation for Entry of Consent Order and Final Order (No. 23-1984). The Consent... suspended particulates (TSP). The revision, in the form of Air Pollution Control Act (APCA) No. 65, revises...

40 CFR 52.1190 - Original Identification of plan section.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Plan for the General Motors Corporation Buick Motor Division in the form of an Alteration of... is in the form of a Stipulation for Entry of Consent Order and Final Order (No. 23-1984). The Consent... suspended particulates (TSP). The revision, in the form of Air Pollution Control Act (APCA) No. 65, revises...

17 CFR Appendix A to Part 37 - Guidance on Compliance With Registration Criteria

Code of Federal Regulations, 2011 CFR

2011-04-01

... facility should include the system's trade-matching algorithm and order entry procedures. A submission involving a trade-matching algorithm that is based on order priority factors other than on a best price/earliest time basis should include a brief explanation of the alternative algorithm. (b) A board of trade's...

17 CFR Appendix A to Part 37 - Guidance on Compliance With Registration Criteria

Code of Federal Regulations, 2012 CFR

2012-04-01

... facility should include the system's trade-matching algorithm and order entry procedures. A submission involving a trade-matching algorithm that is based on order priority factors other than on a best price/earliest time basis should include a brief explanation of the alternative algorithm. (b) A board of trade's...

76 FR 49816 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... Quote Traders and Remote Streaming Quote Traders Entering Certain Option Day Limit Orders August 5, 2011... allow entry of day limit orders for the proprietary accounts of Streaming Quote Traders and Remote... proprietary accounts of Streaming Quote Traders (SQTs'') and Remote Streaming Quote Traders (``RSQTs''). The...

The Approximation of Two-Mode Proximity Matrices by Sums of Order-Constrained Matrices.

ERIC Educational Resources Information Center

Hubert, Lawrence; Arabie, Phipps

1995-01-01

A least-squares strategy is proposed for representing a two-mode proximity matrix as an approximate sum of a small number of matrices that satisfy certain simple order constraints on their entries. The primary class of constraints considered defines Q-forms for particular conditions in a two-mode matrix. (SLD)

77 FR 33256 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

...-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate Effectiveness of... is hereby given that on May 22, 2012, The NASDAQ Stock Market LLC (``NASDAQ'' or ``Exchange'') filed... Order Fee,\\3\\ aimed at reducing inefficient order entry practices of certain market participants that...

19 CFR 141.111 - Carrier's release order.

Code of Federal Regulations, 2013 CFR

2013-04-01

... given to release the articles covered by this certified duplicate bill of lading or air waybill to: (c) Blanket release order. Merchandise may be released to the person named in the bill of lading or air...)(4); or (4) If a certified duplicate bill of lading or air waybill is used for entry purposes in...

19 CFR 141.111 - Carrier's release order.

Code of Federal Regulations, 2014 CFR

2014-04-01

... given to release the articles covered by this certified duplicate bill of lading or air waybill to: (c) Blanket release order. Merchandise may be released to the person named in the bill of lading or air...)(4); or (4) If a certified duplicate bill of lading or air waybill is used for entry purposes in...

19 CFR 141.111 - Carrier's release order.

Code of Federal Regulations, 2010 CFR

2010-04-01

... given to release the articles covered by this certified duplicate bill of lading or air waybill to: (c) Blanket release order. Merchandise may be released to the person named in the bill of lading or air...)(4); or (4) If a certified duplicate bill of lading or air waybill is used for entry purposes in...

19 CFR 141.111 - Carrier's release order.

Code of Federal Regulations, 2012 CFR

2012-04-01

... given to release the articles covered by this certified duplicate bill of lading or air waybill to: (c) Blanket release order. Merchandise may be released to the person named in the bill of lading or air...)(4); or (4) If a certified duplicate bill of lading or air waybill is used for entry purposes in...

19 CFR 141.111 - Carrier's release order.

Code of Federal Regulations, 2011 CFR

2011-04-01

... given to release the articles covered by this certified duplicate bill of lading or air waybill to: (c) Blanket release order. Merchandise may be released to the person named in the bill of lading or air...)(4); or (4) If a certified duplicate bill of lading or air waybill is used for entry purposes in...

RxTerms - a drug interface terminology derived from RxNorm.

PubMed

Fung, Kin Wah; McDonald, Clement; Bray, Bruce E

2008-11-06

A good interface terminology is an essential component of any Computerized Provider Order Entry system. RxTerms is a drug interface terminology derived from RxNorm. By reorganizing the drug information into two dimensions as prescribers do when writing prescriptions and by eliminating drug names that are less likely to be needed in a prescribing environment, RxTerms helps the user to efficiently enter complete prescription orders. Preliminary evaluation of RxTerms using a list of most commonly prescribed drugs showed that its coverage was very good (99% for both generic and branded drug names). There was significant efficiency gain compared to using the unprocessed RxNorm names. RxTerms fills the gap for a free, up-to-date drug interface terminology that is linked to RxNorm, the U.S. designated standard for clinical drugs.

Ebola virus and severe acute respiratory syndrome coronavirus display late cell entry kinetics: evidence that transport to NPC1+ endolysosomes is a rate-defining step.

PubMed

Mingo, Rebecca M; Simmons, James A; Shoemaker, Charles J; Nelson, Elizabeth A; Schornberg, Kathryn L; D'Souza, Ryan S; Casanova, James E; White, Judith M

2015-03-01

Ebola virus (EBOV) causes hemorrhagic fevers with high mortality rates. During cellular entry, the virus is internalized by macropinocytosis and trafficked through endosomes until fusion between the viral and an endosomal membrane is triggered, releasing the RNA genome into the cytoplasm. We found that while macropinocytotic uptake of filamentous EBOV viruslike particles (VLPs) expressing the EBOV glycoprotein (GP) occurs relatively quickly, VLPs only begin to enter the cytoplasm after a 30-min lag, considerably later than particles bearing the influenza hemagglutinin or GP from lymphocytic choriomeningitis virus, which enter through late endosomes (LE). For EBOV, the long lag is not due to the large size or unusual shape of EBOV filaments, the need to prime EBOV GP to the 19-kDa receptor-binding species, or a need for unusually low endosomal pH. In contrast, since we observed that EBOV entry occurs upon arrival in Niemann-Pick C1 (NPC1)-positive endolysosomes (LE/Lys), we propose that trafficking to LE/Lys is a key rate-defining step. Additional experiments revealed, unexpectedly, that severe acute respiratory syndrome (SARS) S-mediated entry also begins only after a 30-min lag. Furthermore, although SARS does not require NPC1 for entry, SARS entry also begins after colocalization with NPC1. Since the only endosomal requirement for SARS entry is cathepsin L activity, we tested and provide evidence that NPC1(+) LE/Lys have higher cathepsin L activity than LE, with no detectable activity in earlier endosomes. Our findings suggest that both EBOV and SARS traffic deep into the endocytic pathway for entry and that they do so to access higher cathepsin activity. Ebola virus is a hemorrhagic fever virus that causes high fatality rates when it spreads from zoonotic vectors into the human population. Infection by severe acute respiratory syndrome coronavirus (SARS-CoV) causes severe respiratory distress in infected patients. A devastating outbreak of EBOV occurred in West Africa in 2014, and there was a significant outbreak of SARS in 2003. No effective vaccine or treatment has yet been approved for either virus. We present evidence that both viruses traffic late into the endocytic pathway, to NPC1(+) LE/Lys, in order to enter host cells, and that they do so to access high levels of cathepsin activity, which both viruses use in their fusion-triggering mechanisms. This unexpected similarity suggests an unexplored vulnerability, trafficking to NPC1(+) LE/Lys, as a therapeutic target for SARS and EBOV. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Factors affecting the entry of for-profit providers into a price regulated market for formal long-term care services: a case study from Japan.

PubMed

Tokunaga, Mutsumi; Hashimoto, Hideki

2013-01-01

While the distinct behaviors of for-profit and non-profit providers in the healthcare market have been compared in the economic literature, their choices regarding market entry and exit have only recently been debated. Since 2000, when public Long-Term Care Insurance was introduced in Japan, for-profit providers have been able to provide formal long-term homecare services. The aim of this study is to determine which factors have affected market entry of for-profit providers under price regulation and in competition with existing non-profit providers. We used nation-wide panel data from 2002 to 2010, aggregated at the level of local public insurers (n = 1557), a basic area unit of service provision. The number of for-profit providers per elderly population in the area unit was regressed against factors related to local demand and service costs using first-difference linear regression, a fixed effects model, and Tobit regression for robustness checking. Results showed that demand (the number of eligible care recipients) and cost factors (population density and minimum wage) significantly influenced for-profit providers' choice of market entry. These findings indicate that for-profit providers will strategically choose a local market for maximizing profit. We believe that price regulation should be redesigned to incorporate quality of care and market conditions, regardless of the profit status of the providers, to ensure equal access to efficient delivery of long-term care across all regions. Copyright © 2012 Elsevier Ltd. All rights reserved.

Obtaining orthotropic elasticity tensor using entries zeroing method.

NASA Astrophysics Data System (ADS)

Gierlach, Bartosz; Danek, Tomasz

2017-04-01

A generally anisotropic elasticity tensor obtained from measurements can be represented by a tensor belonging to one of eight material symmetry classes. Knowledge of symmetry class and orientation is helpful for describing physical properties of a medium. For each non-trivial symmetry class except isotropic this problem is nonlinear. A common method of obtaining effective tensor is a choosing its non-trivial symmetry class and minimizing Frobenius norm between measured and effective tensor in the same coordinate system. Global optimization algorithm has to be used to determine the best rotation of a tensor. In this contribution, we propose a new approach to obtain optimal tensor, with the assumption that it is orthotropic (or at least has a similar shape to the orthotropic one). In orthotropic form tensor 24 out of 36 entries are zeros. The idea is to minimize the sum of squared entries which are supposed to be equal to zero through rotation calculated with optimization algorithm - in this case Particle Swarm Optimization (PSO) algorithm. Quaternions were used to parametrize rotations in 3D space to improve computational efficiency. In order to avoid a choice of local minima we apply PSO several times and only if we obtain similar results for the third time we consider it as a correct value and finish computations. To analyze obtained results Monte-Carlo method was used. After thousands of single runs of PSO optimization, we obtained values of quaternion parts and plot them. Points concentrate in several points of the graph following the regular pattern. It suggests the existence of more complex symmetry in the analyzed tensor. Then thousands of realizations of generally anisotropic tensor were generated - each tensor entry was replaced with a random value drawn from normal distribution having a mean equal to measured tensor entry and standard deviation of the measurement. Each of these tensors was subject of PSO based optimization delivering quaternion for optimal rotation. Computations were parallelized with OpenMP to decrease computational time what enables different tensors to be processed by different threads. As a result the distributions of rotated tensor entries values were obtained. For the entries which were to be zeroed we can observe almost normal distributions having mean equal to zero or sum of two normal distributions having inverse means. Non-zero entries represent different distributions with two or three maxima. Analysis of obtained results shows that described method produces consistent values of quaternions used to rotate tensors. Despite of less complex target function in a process of optimization in comparison to common approach, entries zeroing method provides results which can be applied to obtain an orthotropic tensor with good reliability. Modification of the method can produce also a tool for obtaining effective tensors belonging to another symmetry classes. This research was supported by the Polish National Science Center under contract No. DEC-2013/11/B/ST10/0472.

19 CFR 149.5 - Eligibility to file an Importer Security Filing, authorized agents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... data interchange system. If the Importer Security Filing and entry or entry summary are provided via a... must retain powers of attorney in English until revoked. Revoked powers of attorney and letters of...

34 CFR 668.4 - Payment period.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the State; or (iii) Ten percent of the clock hours in the payment period. (f) Re-entry within 180 days... provisions of § 668.22. (g) Re-entry after 180 days or transfer. (1) Except as provided in paragraph (g)(3...

34 CFR 668.4 - Payment period.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the State; or (iii) Ten percent of the clock hours in the payment period. (f) Re-entry within 180 days... provisions of § 668.22. (g) Re-entry after 180 days or transfer. (1) Except as provided in paragraph (g)(3...

34 CFR 668.4 - Payment period.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the State; or (iii) Ten percent of the clock hours in the payment period. (f) Re-entry within 180 days... provisions of § 668.22. (g) Re-entry after 180 days or transfer. (1) Except as provided in paragraph (g)(3...

34 CFR 668.4 - Payment period.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the State; or (iii) Ten percent of the clock hours in the payment period. (f) Re-entry within 180 days... provisions of § 668.22. (g) Re-entry after 180 days or transfer. (1) Except as provided in paragraph (g)(3...

34 CFR 668.4 - Payment period.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the State; or (iii) Ten percent of the clock hours in the payment period. (f) Re-entry within 180 days... provisions of § 668.22. (g) Re-entry after 180 days or transfer. (1) Except as provided in paragraph (g)(3...