Sample records for qi maturity tool

  1. Qi Xu | NREL

    Science.gov Websites

    Qi Xu Qi Xu Researcher IV-Molecular Biology Qi.Xu@nrel.gov | 303-384-7789 Research Interests Qi Xu joined the National Renewable Energy Laboratory in 2004 as a Research Associate in the Chemical Sciences team. His research focuses on nanobiotechnology. His main research interest is array quantum dots (QDs

  2. Interprofessional QI Training Enhances Competency and QI Productivity Among Graduates: Findings From Nationwide Children's Hospital.

    PubMed

    Bartman, Thomas; Heiser, Karen; Bethune, Andrew; Crandall, Wallace; McClead, Richard; Davis, J Terrance; Brilli, Richard J

    2018-02-01

    Significant resources are expended on quality improvement (QI) training courses. The authors sought to determine whether education provided in QI course training improves self-assessed QI content competence and QI-related productivity among course graduates. "Quality Improvement Essentials" is a four-month didactic and experiential course designed to prepare multidisciplinary professionals to participate in and lead QI efforts at Nationwide Children's Hospital (NCH). This study used a milestone-based self-assessment survey of graduates from 2012 to 2014 to gauge change in participants' self-assessed QI competency after course completion. Four competency domains were evaluated: QI knowledge; testing and implementing change using teams; data management and analysis; and spreading and sustaining science. Metrics for assessing individual QI productivity were presentation or publication of QI work outside NCH; local, regional, or national QI teaching; serving on a local, regional, or national QI committee; appointment as a QI leader; involvement in an internal or external QI collaborative; and leading a maintenance of certification Part IV project approved by NCH. Course participation more than doubled participants' self-assessed QI competence across all four domains. Gains continued after the course, increasing with time rather than degrading. Self-assessed competency increase was significantly associated with increased QI productivity. Self-assessed QI competence dramatically improved after participation in an educational course and continued to increase over time. Increased self-assessed QI competency correlated with increased individual QI productivity. Further studies are necessary to fully evaluate "return on investment" for this type of course.

  3. Thermography applied acupuncture and qi-gong

    NASA Astrophysics Data System (ADS)

    Qin, Yuwen; Ji, Hong-Wei; Chen, Jin-Long; Li, Hong-Qi

    1997-04-01

    Thermographic technique can be used to measure temperature distribution of body surface in real-time, non-contact and full-field, which has been successfully used in medical diagnosis, remote sensing, and NDT, etc. The authors have developed a thermographic experiment that can be applied to inspect the effect of action of acupuncture and qi-gong (a system of deep breathing exercises) by measuring the temperature of hand and arm. The observation is performed respectively by thermography for the dynamic changes of temperature of the arm and hand after acupuncture therapy and qi-gong therapy. Thermographic results show that the temperature on the collateral channels increases markedly. In the meantime, it can be seen that the above therapies of Chinese medicine can stimulate the channel collateral system. This also contributes a new basis to the effect of action of the therapies of Chinese medicine. The work shows that thermographic technique is a powerful tool for research in Chinese medicine. In this paper, some thermal images are obtained from the persons treated with acupuncture and qi- gong.

  4. System Maturity and Architecture Assessment Methods, Processes, and Tools

    DTIC Science & Technology

    2012-03-02

    Deshmukh , and M. Sarfaraz. Development of Systems Engineering Maturity Models and Management Tools. Systems Engineering Research Center Final Technical...Ramirez- Marquez, D. Nowicki, A. Deshmukh , and M. Sarfaraz. Development of Systems Engineering Maturity Models and Management Tools. Systems Engineering

  5. Measurements of VOC fluxes by Eddy-covariance with a PTR-Qi-TOF-MS over a mature wheat crop near Paris: Evaluation of data quality and uncertainties.

    NASA Astrophysics Data System (ADS)

    Buysse, Pauline; Loubet, Benjamin; Ciuraru, Raluca; Lafouge, Florence; Zurfluh, Olivier; Gonzaga-Gomez, Lais; Fanucci, Olivier; Gueudet, Jean-Christophe; Decuq, Céline; Gros, Valérie; Sarda, Roland; Zannoni, Nora

    2017-04-01

    The quantification of volatile organic compounds (VOC) fluxes exchanged by terrestrial ecosystems is of large interest because of their influence on the chemistry and composition of the atmosphere including aerosols and oxidants. Latest developments in the techniques for detecting, identifying and measuring VOC fluxes have considerably improved the abilities to get reliable estimates. Among these, the eddy-covariance (EC) methodology constitutes the most direct approach, and relies on both well-established principles (Aubinet et al. 2000) and a sound continuously worldwide improving experience. The combination of the EC methodology with the latest proton-transfer-reaction mass spectrometer (PTR-MS) device, the PTR-Qi-TOF-MS, which allows the identification and quantification of more than 500 VOC at high frequency, now provides a very powerful and precise tool for an accurate quantification of VOC fluxes on various types of terrestrial ecosystems. The complexity of the whole methodology however demands that several data quality requirements are fulfilled. VOC fluxes were measured by EC with a PTR-Qi-TOF-MS (national instrument within the ANAEE-France framework) for one month and a half over a mature wheat crop near Paris (FR-GRI ICOS site). Most important emissions (by descending order) were observed from detected compounds with mass-over-charge (m/z) ratios of 33.033 (methanol), 45.033 (acetaldehyde), 93.033 (not identified yet), 59.049 (acetone), and 63.026 (dimethyl sulfide or DMS). Emissions from higher-mass compounds, which might be due to pesticide applications at the beginning of our observation period, were also detected. Some compounds were also seen to deposit (e.g. m/z 47.013, 71.085, 75.044, 83.05) while others exhibited bidirectional fluxes (e.g. m/z 57.07, 69.07). Before analyzing VOC flux responses to meteorological and crop development drivers, a data quality check was performed which included (i) uncertainty analysis of mass and concentration

  6. [Clinical examples of professor LI Zhi-dao's "tonifying three qi" acupuncture method].

    PubMed

    Li, Rui-Chao; Li, Yan; Fu, Yuan-Xin; Zhao, Xiang-Fei; Sun, Jing; Li, Lan-Yuan

    2014-08-01

    Professor LI Zhi-dao, according to acupoint selection of syndrome differentiation in TCM basic theory, concluded a new therapy, namely "tonifying three qi" that is mainly based on three acupoints in the Conception Vessel. This method is consisted of Danzhong (CV 17), Zhongwan (CV 12) and Qihai (CV 6) in the Conception Vessel, which could successively nourish clear qi, stomach qi and original qi. In clinic, according to the severity of symptoms of three qi, the acupoints are selected flexibly, which could respectively treat deficiency of heart-lung qi, deficiency of stomach-spleen qi and deficiency of original qi. Some examples are also given in the article.

  7. [Comparative analysis on the biological basis of blood stasis syndrome induced by qi-stagnation and qi-deficiency in patients with unstable angina pectoris].

    PubMed

    Ren, Jian-xun; Liu, Jian-xun; Lin, Cheng-ren

    2010-04-01

    To comparatively analyse the objective characteristics of different syndrome types of qi-disturbance-induced blood stasis syndrome (QDBS) in the pathogenetic evolution of unstable angina coronary heart disease (UA-CHD). Seventy-eight patients with UA-CHD of QDBS were differentiated into 2 groups: 55 in the qi-deficiency-induced blood-stasis syndrome group (A) and 23 in the qi-stagnation-induced blood-stasis syndrome group (B). The comparative analysis on them was carried out through comparing their blood pressure, glucose and lipid metabolisms, coagulation function, thyroid function and inflammation reaction changes, etc. In the pathogenetic process of qi-disturbance induced blood stasis, the initiating age, levels of HbA1c, TSH, PT and APTT between the two groups were significantly different (P < 0.05). Levels of TNF-alpha and LN were higher and levels of sIgA lower in patients than those in healthy subjects (P < 0.05). Inflammation immune reaction may play an important role in the pathogenetic process of blood-stasis syndrome, and the functional disturbance of hypothalamus, pituitary and endocrinal secretion induced by emotional stress is possibly the essence of qi-stagnation induced blood stasis syndrome.

  8. Development of a Multi-Domain Assessment Tool for Quality Improvement Projects.

    PubMed

    Rosenbluth, Glenn; Burman, Natalie J; Ranji, Sumant R; Boscardin, Christy K

    2017-08-01

    Improving the quality of health care and education has become a mandate at all levels within the medical profession. While several published quality improvement (QI) assessment tools exist, all have limitations in addressing the range of QI projects undertaken by learners in undergraduate medical education, graduate medical education, and continuing medical education. We developed and validated a tool to assess QI projects with learner engagement across the educational continuum. After reviewing existing tools, we interviewed local faculty who taught QI to understand how learners were engaged and what these faculty wanted in an ideal assessment tool. We then developed a list of competencies associated with QI, established items linked to these competencies, revised the items using an iterative process, and collected validity evidence for the tool. The resulting Multi-Domain Assessment of Quality Improvement Projects (MAQIP) rating tool contains 9 items, with criteria that may be completely fulfilled, partially fulfilled, or not fulfilled. Interrater reliability was 0.77. Untrained local faculty were able to use the tool with minimal guidance. The MAQIP is a 9-item, user-friendly tool that can be used to assess QI projects at various stages and to provide formative and summative feedback to learners at all levels.

  9. A critical courier role of volatile oils from Dalbergia odorifera for cardiac protection in vivo by QiShenYiQi.

    PubMed

    Yu, Jiahui; Zhang, Wen; Zhang, Yiqian; Wang, Yadong; Zhang, Boli; Fan, Guanwei; Zhu, Yan

    2017-08-04

    Component-based Chinese medicine (CCM) is derived from traditional Chinese medicine but produced with modern pharmaceutical standard and clearer clinical indications. However, it still faces challenges of defining individual component contribution in the complex formula. Using QiShenYiQi (QSYQ) as a model CCM, we investigated the role of Dalbergia odorifera (DO), an herbal component, in preventing myocardial damage. We showed that in vitro, QSYQ exerted considerable protective activities on cardiomyocytes from H 2 O 2 -induced mitochondrial dysfunction with or without DO. However, in isolated rat hearts, myocardial protection by QSYQ was significantly weakened without DO. In everted gut sac model, DO significantly enhanced absorption of the major QSYQ ingredients in different regions of rat intestine. Finally, in in vivo mouse model of doxorubicin (DOX)-induced myocardial damage, only QSYQ, but not QiShenYiQi without DO (QSYQ-DO), exerted a full protection. Taken together, our results showed that instead of directly contributing to the myocardial protection, Dalbergia odorifera facilitates the major active ingredients absorption and increases their efficacy, eventually enhancing the in vivo potency of QSYQ. These findings may shed new lights on our understanding of the prescription compatibility theory, as well as the impacts of "courier herbs" in component-based Chinese medicine.

  10. Technology for the production of Zero Q.I pitch from coal tar

    NASA Astrophysics Data System (ADS)

    Karthik, K.; Kumar, K. Rajesh; Rao, C. V. Nageswara; Kumar, B. Vinod; Murty, J. V. S.

    2013-06-01

    Zero Quinoline Insolubles (Q.I) pitch is a special type of pitch obtained from pre-treatment of coal tar, which is converted into pitch. This is used for impregnation of electrodes for improving the strength, electrical properties and also used as a pre-cursor for Mesophase pitch for producing Mesophase pitch based carbon fibers, carbon foam, and Meso carbon micro beads. This paper discusses the technology of Q.I separation from Coal Tar by using decantation of Coal Tar mixed with Heavy Creosote Oil (HC Oil) at different temperatures. By this method we were able to produce the Zero Q.I pitch with a Q.I value of 0.1%.

  11. [Qi as a materialist concept on the level of medical philosophy].

    PubMed

    Su, Zhan-Qing

    2005-03-01

    This paper has made a distinction between the materialist concept of qi on the medical philosophical level and its substantial existence, and illustrated the materiality and multiplicity of qi. Materiality refers to the objective reality, a summation of various things or phenomena related to human beings; while multiplicity refers to diversity of specific substances, each holding its individual essence. Based on two essential conceptions "xiang" and "xiangji", and combining the theories of traditional Chinese medicine and Western medicine, this paper has also made a preliminary study on the substantial existence of qi at macro- and micro-levels, and on physiological (normal) and pathological (abnormal) aspects. It is the author's argument that studies of the substantial existence of qi from different aspects, micro-dimension in particular, will push the syndrome differentiation of traditional Chinese medicine to a more subtle sphere.

  12. [Professor GAO Yuchun's experience on "sequential acupuncture leads to smooth movement of qi"].

    PubMed

    Wang, Yanjun; Xing, Xiao; Cui, Linhua

    2016-01-01

    Professor GAO Yuchun is considered as the key successor of GAO's academic school of acupuncture and moxibustion in Yanzhao region. Professor GAO's clinical experience of, "sequential acupuncture" is introduced in details in this article. In Professor GAO's opinions, appropriate acupuncture sequence is the key to satisfactory clinical effects during treatment. Based on different acupoints, sequential acupuncture can achieve the aim of qi following needles and needles leading qi; based on different symptoms, sequential acupuncture can regulate qi movement; based on different body positions, sequential acupuncture can harmonize qi-blood and reinforcing deficiency and reducing excess. In all, according to the differences of disease condition and constitution, based on the accurate acupoint selection and appropriate manipulation, it is essential to capture the nature of diseases and make the order of acupuncture, which can achieve the aim of regulating qi movement and reinforcing deficiency and reducing excess.

  13. [Study on qi deficiency syndrome distribution and quality of life in patients with advanced non-small cell lung cancer].

    PubMed

    Yuan, Lin; Zhang, Pei-tong; Yang, Zong-yan

    2011-07-01

    To study the qi deficiency syndrome distribution and quality of life (QOL) of patients with advanced non-small cell lung cancer (NSCLC). A questionnaire survey was conducted in 120 patients with advanced NSCLC using the QOL scale "Functional Assessment of Cancer Therapy" (FACT-L) (Version 4.0). Meanwhile, syndrome typing was performed. On the basis of results of syndrome typing, patients of different syndrome types were grouped and compared, thus studying the distribution of advanced NSCLC patients of qi deficiency syndrome and qi deficiency syndrome correlated QOL features. Qi deficiency, blood stasis, yin deficiency, phlegm and dampness dominated in syndrome types of the 120 patients with advanced NSCLC. Of syndrome types accounting for larger ratios in 112 patients, pure qi deficiency syndrome accounted for 30.36% (34 cases), qi deficiency and blood stasis syndrome for 18. 75% (21 cases), both qi and yin deficiency syndrome for 10. 71% (12 cases). There was no correlation between the appearance of qi deficiency syndrome and patients' age, sex, pathological typing (adenocarcinoma/squamous carcinoma), or the disease duration. NSCLC patients in phase IV were mostly complicated with qi deficiency syndrome (P<0.05). Scores of physical states, emotional states, functional states, and total scores in the FACT-L scale were lower in those complicated with qi deficiency syndrome (89 cases) than in those without complicated qi deficiency syndrome (31 cases), showing statistical difference (P<0.01, P<0.05). The scores of the lung cancer specific module (additional concerns) in the FACT-L scale showed statistical difference, sequenced as qi deficiency and blood stasis syndrome > pure qi deficiency syndrome > both qi and yin deficiency syndrome (P<0.05). Qi deficiency syndrome is the main syndrome of advanced NSCLC. The QOL of advanced NSCLC patients complicated with qi deficiency syndrome was poorer than those without complicated qi deficiency syndrome. Besides, along with

  14. Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

    PubMed

    Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

    2017-07-01

    This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

  15. The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical

    PubMed Central

    2012-01-01

    Background Accidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI) activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting. Methods This observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1) the fall risk assessment tool, 2) an intervention protocol to prevent in-patient falls, 3) specific environmental safety interventions, 4) staff education, and 5) multidisciplinary healthcare staff compliance monitoring and feedback mechanisms. Results The overall fall rate was 2.13 falls per 1000 patient days (350/164331) in 2004 versus 1.53 falls per 1000 patient days (263/172325) in 2010, representing a significant decrease (p = 0.039). In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368), increasing to 97.6% in 2010 (10564/10828). The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010. Conclusion In our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective. PMID:22788785

  16. Weaker cognitive control abilities of Pi (Spleen) qi-deficient individuals supported Chinese medicine diagnosis.

    PubMed

    Lin, Hui-Yan; Zhao, Yan-Ping; Xu, Gui-Ping; Li, Yun-Si; Xie, Wei-Yun; Bai, Li-Hua; Jin, Hua

    2017-07-28

    To investigate whether Pi (Spleen) qi-deficiency affected psychological and neural responses in relevance to cognitive control. Pi qi-deficient and balanced participants were asked to perform the Stroop task, a classical cognitive control paradigm. In this paradigm, participants had to judge the color of the prompted word. The word's meaning indicated the color (the consistent condition) or not (the inconsistent condition), or were unrelated to the color (the neutral condition). Electroencephalograph (EEG) was recorded during the task. Event-related potential (ERP) results showed that Pi qi-deficient individuals failed to exhibit a normal Stroop effect as Balanced individuals did, such as the accuracy differences between the consistent and the inconsistent conditions as well as the N450 effect (P>0.05). Meanwhile, Pi qi-deficient individuals displayed larger P2 and P3 amplitudes than balanced individuals did during performing the cognitive control task (P<0.05). Pi qi-deficiency had psychological and neural basis at least in cognitive control aspect.

  17. Traditional Chinese medicine formula Bi-Qi capsule alleviates rheumatoid arthritis-induced inflammation, synovial hyperplasia, and cartilage destruction in rats.

    PubMed

    Wang, Kai; Zhang, Dongmei; Liu, Yan; Wang, Xuan; Zhao, Jiantong; Sun, Tingting; Jin, Tingting; Li, Baoli; Pathak, Janak L

    2018-03-14

    Traditional Chinese medicine (TCM) formula Bi-Qi capsule (Bi-Qi) is a commonly prescribed drug to treat rheumatoid arthritis (RA). However, the mechanism of Bi-Qi-mediated amelioration of RA pathogenesis is still a mystery. Collagen induced arthritis (CIA) in rats is an established model that shares many similarities with RA in humans. In this study we investigated the effect of Bi-Qi on the pathogenesis of CIA in rats. CIA was developed in Sprague-Dawley (S.D) rats (n = 60, female) and used as a model resembling RA in humans. Rats were treated with a high or moderate dose of Bi-Qi, or methotrexate (MTX). Effects of the treatment on local joint and systemic inflammation, synovial hyperplasia, cartilage destruction, and other main features in the pathogenesis of CIA were analyzed. Inflamed and swollen ankles and joints were observed in arthritic rats, while Bi-Qi or MTX treatment alleviated these symptoms. Only the Bi-Qi moderate dose decreased RA-induced serum levels of tumor necrosis factor-alpha (TNF-α). Both Bi-Qi and MTX reduced the interleukin (IL)-18 serum level. Protein levels of cartilage oligomeric matrix protein and osteopontin in serum, synovium, and cartilage were elevated in arthritic rats, while Bi-Qi alleviated these effects. Synovial hyperplasia, inflammatory cell infiltration in synovium and a high degree of cartilage degradation was observed in RA, and Bi-Qi or MTX alleviated this effect. Bi-Qi at the moderate dose was the most effective in mitigating CIA-related clinical complications. Our findings showed that Bi-Qi alleviates CIA-induced inflammation, synovial hyperplasia, cartilage destruction, and the other main features in the pathogenesis of CIA. This provides fundamental evidence for the anti-arthritic properties of Bi-Qi and corroborates the use of Bi-Qi TCM formula for the treatment of RA.

  18. Dan-Qi prescription ameliorates insulin resistance through overall corrective regulation of glucose and fat metabolism.

    PubMed

    Xie, Zhishen; Loi Truong, Thanh; Zhang, Pei; Xu, Fengguo; Xu, Xiaojun; Li, Ping

    2015-08-22

    Danshen and Sanqi Prescription (Dan-Qi) is commonly used to treat cardiovascular diseases (CVD) in China. Since Danshen and Sanqi are reported to ameliorate lipid metabolism disorders at treatment of cardiovascular diseases. Meanwhile, it is reported that co-administration of Danshen and Sanqi exhibited significant pharmacokinetic herb-herb interactions. We reasoned that Danshen and Sanqi combination could be potentially function synergistically in treating diet induced insulin resistance. Using high calori food induced Drosophila and mice models, we assessed Danshen and Sanqi treatment for their anti-diabetic effects. The combination of Danshen and Sanqi (Dan-Qi) effectively improved fat and glucose metabolism of the high-sugar and high-fat diet fed fruit flies. More importantly, Dan-Qi significantly ameliorated hyperlipidemia and hyperglycemia phenotype caused in high-fat diet induced obesity (DIO) mouse model. The Dan-Qi treated DIO mice showed lower fasting insulin, triglycerides, total and low-density lipoprotein cholesterol (LDL-C) levels in plasma, much better than Danshen or Sanqi treated alone. It was shown that Dan-Qi prescription reduced fat accumulation in the liver with Sanqi playing the major role. Interestingly, it was not Danshen or Sanqi alone, but the combination markedly increased glycogen deposition in mice liver. Quantitative RT-PCR showed Dan-Qi increased liver glycogen synthesis gene like Glut-1, GK, and Glut-4, reduced fat and cholesterol anabolism genes such as SREBP-1c, ACC, ATP-CL, ACS. Meanwhilpose tissues and muscle tissues, the glucose and fat metabolism genes are changed accordingly to pro-catabolism status. Notably, endogenous plasma metabolites of Dan-Qi treated mice displayed much better overral rectifying effects than the Danshen or Sanqi alone. Our data demonstrated that Danshen and Sanqi combination exerted significant anti-diabetic efficacy, and Dan-Qi prescription could be potentially considered as a therapeutic application in

  19. Tooth mineralization stages as a diagnostic tool for assessment of skeletal maturity.

    PubMed

    Surendran, Sharmila; Thomas, Eapen

    2014-01-01

    The objective of this study was to determine whether dental calcification can be used as a first-level diagnostic tool for assessment of skeletal maturity. A total of 150 healthy subjects (79 boys, 71 girls; mean age, 12.19 ± 2.03 years; range, 8-16 years) were enrolled in the study. Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine, the first and second premolars, and the second molar. Determination of skeletal maturity was according to the modified middle phalanx of third finger (MP3) stages method on digital radiographs. Diagnostic ability was evaluated according to the dental maturation stages for each tooth for identification of the MP3 stages and the growth phases (prepubertal, pubertal, postpubertal) using positive likelihood ratios. Dental maturation stage E of the first premolars and the combination of canine stage F, first premolar stage E, second premolar stage E, and second molar stage D (FEED) gave the highest values for identification of the prepubertal growth phase, and stage H of the second molar had the highest value for identification of the postpubertal growth phase. Dental maturation assessment is only useful for diagnosis of the prepubertal and postpubertal growth phases. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  20. QI2S - Quick Image Interpretation System

    NASA Astrophysics Data System (ADS)

    Naghmouchi, Jamin; Aviely, Peleg; Ginosar, Ran; Ober, Giovanna; Bischoff, Ole; Nadler, Ron; Guiser, David; Citroen, Meira; Freddi, Riccardo; Berekovic, Mladen

    2015-09-01

    The evolution of the Earth Observation mission will be driven by many factors, and the deveploment of new processing paradigms to facilitate data downlink, handling and storage will be a key factor. Next generation EO satellites will generate a great amount of data at a very high data rate, both radar and optical. Real-time onboard processing can be the solution to reduce data downlink and management on ground. Radiometric, geometric, and atmospheric corrections of EO data as well as material/object detection in addition to the well-known needs for image compression and signal processing can be performed directly on board and the aim of QI2S project is to demonstrate this. QI2S, a concept prototype system for novel onboard image processing and image interpretation which has been designed, developed and validated in the framework of an EU FP7 project, targets these needs and makes a significant step towards exceeding current roadmaps of leading space agencies for future payload processors. The QI2S system features multiple chip components of the RC64, a novel rad-hard 64-core signal processing chip, which targets DSP performance of 75 GMACs (16bit), 150 GOPS and 38 single precision GFLOPS while dissipating less than 10 Watts. It integrates advanced DSP cores with a multibank shared memory and a hardware scheduler, also supporting DDR2/3 memory and twelve 3.125 Gbps full duplex high-speed serial links using SpaceFibre and other protocols. The processor is being developed within the European FP7 Framework Program and will be qualified to the highest space standards.

  1. Impact of Qi-invigorating traditional Chinese medicines on intestinal flora: A basis for rational choice of prebiotics.

    PubMed

    Wang, Xiao-Meng; Li, Xiao-Bo; Peng, Ying

    2017-04-01

    According to the theory of traditional Chinese medicine (TCM), Qi (vital energy) is regarded as a driving force of biological activities in human body, including both nutrient substances and organ functions. Qi-invigorating TCMs are widely used to treat various symptoms and disorders, such as fatigue, obesity, immunosuppression, intestinal flora imbalance, and gastrointestinal diseases, in which Qi is considered to be reduced or depleted. Interestingly, abundant clinical evidences suggest that these disorders are associated with the alternation of intestinal flora, which directly affects disease status. Herein we review the interaction between gut microbiota and Qi-invigorating TCMs under healthy and disease conditions and discuss the mechanisms of action and applications of Qi-invigorating TCMs in enhancing health status through microbial alternation. A better understanding of the role of Qi-invigorating TCMs in modulating microbial composition and the association between intestinal microbiota and diseases would help reveal the clinical consequences of microbiota alteration and explore opportunities to harness this symbiotic relationship to improve public health. Copyright © 2017 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

  2. Qi-Dan Fang ameliorates adriamycin-induced nephrotic syndrome rat model by enhancing renal function and inhibiting podocyte injury.

    PubMed

    Wu, Jun-Biao; Ye, Shu-Fang; Liang, Chun-Ling; Li, Yu-Cui; Yu, Ying-Jia; Lai, Jie-Mei; Lin, Hui; Zheng, Jie; Zhou, Jiu-Yao

    2014-02-12

    Nephrotic syndrome (NS) is a clinical syndrome with a variety of causes, mainly characterized by heavy proteinuria. Podocyte injury plays a key role in proteinuria, one of the principal means for the control of NS is to prevent podocyte injury. Qi-Dan Fang consists of two of the most extensively applied herbal remedies among Traditional Chinese Medicine (TCM) (Radix Astragali Mongolici and Radix Salviae Miltiorrhizae, with a weight ratio of 5:1) which are specifically used for the treatment of various kidney diseases. In previous studies, we found that Qi-Dan Fang provides improvement to patients with adriamycin-induced nephrotic syndrome by alleviating proteinuria and serum lipid. The aim of this study is to study the efficiency of Qi-Dan Fang on NS model rat with renal dysfunction and podocyte injury, something which has not been carried out yet. The rats were divided into Normal, Model, Jin Gui Shen Qi Pill (4.12 g/kg), Qi-Dan Fang (3.09, 6.17 and 12.34 g/kg/d) groups, they were each given a single tail intravenous injection of Adriamycin (6.0 mg/kg) except for the Normal group and were orally administered dosages of Qi-Dian Fang and Jin Gui Shen Qi pills once daily for 7 weeks. Following the treatment, the content of cystation C (CysC), blood urea nitrogen (BUN), serum creatinine (Scr) were measured with an autobiochemical analyser. The pathomorphological changes to the glomeruli, the mRNA expressions of nephrin, podocin, CD2AP genes and p53, bax, bcl-2 proteins expressions were also carried out to probe the effects of Qi-Dan Fang. (1) Qi-Dan Fang treatment raised the level of CysC in blood serum while lowering the content of BUN and Scr in the adriamycin-induced nephrotic syndrome rat model; (2) Long-term administration of Qi-Dan Fang was able to ameliorate pathomorphological change of glomeruli and repair the organization structure of Glomerulus; (3) Qi-Dan Fang could increase the mRNA expression of nephrin, podocin and CD2AP genes, down-regulate the

  3. [Guiding-qi acupuncture for dry eye syndrome].

    PubMed

    Xie, Wenzhang; Zeng, Liang; Tao, Ying; Zhou, Yingfan; Zhao, Ran; Huang, Xinyun; Hou, Wenguang; Zhang, Ren; Zong, Lei

    2018-02-12

    To observe the clinical efficacy differences between different needling methods for dry eye syndrome. Sixty patients of dry eye syndrome were randomly divided into an observation group and a control group, 30 cases (60 eyes) in each group. Shangjingming (Extra), Xiajingming (Extra), Tongziliao (GB 1), Cuanzhu (BL 2), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) were selected in the two groups. The control group was treated with conventional acupuncture, while the observation group was treated with guiding- qi acupuncture. Electroacupuncture (EA) was used at bilateral Tongziliao (GB1) and Cuanzhu (BL 2), 30 min per treatment. The treatment was given three times per week. Totally 1-month treatment (12 treatments) was given. The eye symptom score, breakup time of tear film (BUT), Schirmer Ⅰ test (SⅠT) and visual analogue scale (VAS) score were compared before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared before treatment, the eye symptom score, BUT, SⅠT and VAS score were improved after treatment in the two groups (all P <0.001); the improvements of eye symptom score and SⅠT in the observation group were superior to those in the control group (both P <0.05). The differences of BUT and VSA score between the two groups were not significant (both P >0.05). The total effective rate was 86.7% (52/60) in the observation group, which was superior to 73.3% (44/60) in the control group ( P <0.05). . The conventional EA and guiding- qi acupuncture combined with EA are both effective for dry eye syndrome, and the efficacy of guiding- qi acupuncture combined with EA is superior to that of conventional EA.

  4. Effect and Mechanism of QiShenYiQi Pill on Experimental Autoimmune Myocarditis Rats.

    PubMed

    Lv, Shichao; Wu, Meifang; Li, Meng; Wang, Qiang; Xu, Ling; Wang, Xiaojing; Zhang, Junping

    2016-03-06

    To observe the effect of QiShenYiQi pill (QSYQ) on experimental autoimmune myocarditis rats, and to explore its mechanism of action. Lewis rats underwent the injection of myocardial myosin mixed with Freund's complete adjuvant were randomized into 3 groups: model, valsartan, and QSYQ groups. Rats injected with phosphate-buffered saline (PBS) mixed with Freund's complete adjuvant were used as the control group. Rats were euthanized at 4 and 8 weeks, and we weighed rat body mass, heart mass, and left ventricular mass. Myocardium sections were stained with hematoxylin and eosin (H&E) and Masson trichrome. Myocardial TGF-β1 and CTGF protein expression was detected by immunohistochemistry, and myocardial TGF-β1 and CTGF mRNA expression was detected by real-time qPCR. QSYQ reduced HMI and LVMI, as well as the histological score of hearts and CVF, which further decreased over time, and its effect was significantly greater than that of valsartan at 4 and 8 weeks. After 4 weeks, QSYQ inhibited the protein and mRNA expression of TGF-β1 and CTGF, and its effect on lowering CTGF was significantly greater than that of valsartan. In addition, after 8 weeks, QSYQ also inhibited the protein and mRNA expression of CTGF, whereas there was no significant difference in the expression of myocardial TGF-β1. This study provides evidence that QSYQ can improve cardiac remodeling of experimental autoimmune myocarditis rats. It also effectively improved the degree of myocardial fibrosis, which is related to the mechanism of regulation of TGF-β1 CTGF.

  5. Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

    PubMed

    John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

    2014-04-01

    Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

  6. The Chinese Herb Yi-Qi-Huo-Xue Protects Cardiomyocyte Function in Diabetic Cardiomyopathy.

    PubMed

    Wang, Xiangsheng; Huang, Jing; Wang, Shengyi; Ni, Qing

    2018-01-01

    Aims. To study the effect of the Chinese herb Yi-qi-huo-xue on cardiomyopathy in diabetic rats. Methods . Rats were fed a high fat and high glucose diet and injected with 50 ml/kg streptozotocin (STZ) to induce diabetic cardiomyopathy (DCM), followed by treatment with Yi-qi-huo-xue for 4 weeks. We measured the rats' heart weight index, observed the myocardial morphology using hematoxylin eosin (HE) staining, and determined the content of collagen types I and III in the myocardium using enzyme-linked immunosorbent assay (ELISA). We determined Bcl-2, Bax, and P53 protein expression by Western blot analysis and the cardiomyocyte apoptosis rate via a flow cytometry assay. Results. Compared with the rats in the control group, the diabetic rats gained weight and had increased blood sugar levels, an enhanced heart weight index, and increased myocardial pathophysiological damage. There was a decrease in their Bcl-2 expression, and their Bax and P53 expression increased. The Bcl-2/Bax ratio was enhanced, and there was an increase in the content of collagen types I and III in the myocardium. After treatment with Yi-qi-huo-xue, all levels listed above returned to normal. Conclusion. The Chinese herb Yi-qi-huo-xue degraded the myocardial interstitial collagen types I and III to protect the myocardium of the diabetic rats, thus delaying the role of myocardial fibrosis. Yi-qi-huo-xue could play an important role in protecting the myocardium of DCM rats by enhancing the expression of the Bcl-2 protein, inhibiting the expression of the Bax and P53 proteins, increasing the ratio of Bcl-2/Bax, and inhibiting the apoptosis of cardiomyocytes.

  7. Some properties of the Catalan-Qi function related to the Catalan numbers.

    PubMed

    Qi, Feng; Mahmoud, Mansour; Shi, Xiao-Ting; Liu, Fang-Fang

    2016-01-01

    In the paper, the authors find some properties of the Catalan numbers, the Catalan function, and the Catalan-Qi function which is a generalization of the Catalan numbers. Concretely speaking, the authors present a new expression, asymptotic expansions, integral representations, logarithmic convexity, complete monotonicity, minimality, logarithmically complete monotonicity, a generating function, and inequalities of the Catalan numbers, the Catalan function, and the Catalan-Qi function. As by-products, an exponential expansion and a double inequality for the ratio of two gamma functions are derived.

  8. Effect and Mechanism of QiShenYiQi Pill on Experimental Autoimmune Myocarditis Rats

    PubMed Central

    Lv, Shichao; Wu, Meifang; Li, Meng; Wang, Qiang; Xu, Ling; Wang, Xiaojing; Zhang, Junping

    2016-01-01

    Background To observe the effect of QiShenYiQi pill (QSYQ) on experimental autoimmune myocarditis rats, and to explore its mechanism of action. Material/methods Lewis rats underwent the injection of myocardial myosin mixed with Freund’s complete adjuvant were randomized into 3 groups: model, valsartan, and QSYQ groups. Rats injected with phosphate-buffered saline (PBS) mixed with Freund’s complete adjuvant were used as the control group. Rats were euthanized at 4 and 8 weeks, and we weighed rat body mass, heart mass, and left ventricular mass. Myocardium sections were stained with hematoxylin and eosin (H&E) and Masson trichrome. Myocardial TGF-β1 and CTGF protein expression was detected by immunohistochemistry, and myocardial TGF-β1 and CTGF mRNA expression was detected by real-time qPCR. Results QSYQ reduced HMI and LVMI, as well as the histological score of hearts and CVF, which further decreased over time, and its effect was significantly greater than that of valsartan at 4 and 8 weeks. After 4 weeks, QSYQ inhibited the protein and mRNA expression of TGF-β1 and CTGF, and its effect on lowering CTGF was significantly greater than that of valsartan. In addition, after 8 weeks, QSYQ also inhibited the protein and mRNA expression of CTGF, whereas there was no significant difference in the expression of myocardial TGF-β1. Conclusions This study provides evidence that QSYQ can improve cardiac remodeling of experimental autoimmune myocarditis rats. It also effectively improved the degree of myocardial fibrosis, which is related to the mechanism of regulation of TGF-β1 CTGF. PMID:26946470

  9. Evaluation of medical students using the "qi, blood, and fluid" system of Kampo medicine.

    PubMed

    Arai, Makoto; Arai, Katsuhiko; Hioki, Chizuko; Takashi, Masanori; Matsumoto, Kaori; Honda, Masamitsu; Izumi, Shun-ichiro

    2013-04-20

    Although "qi, blood, and fluid" (QBF) is the most important concept for patients in Kampo medicine, there are few studies about the conditions of the QBF system among healthy populations. We used QBF pattern scores to determine whether or not medical students, presumed to be healthy, had any potentially pathological conditions. Six consecutive fourth-year classes totaling 652 medical students evaluated their own QBF conditions using Terasawa's QBF pattern scores. The six conditions: "qi deficiency" (QD), "qi stagnation" (QS), "qi counterflow" (QC), "blood deficiency" (BD), "blood stasis" (BS), and "fluid disturbance" (FD), were categorized according to Terasawa's criteria. The Mann-Whitney U test was used to compare the score differences between the genders, Chi-square test was used to examine gender differences in the QBF diagnoses, and the Spearman's rank-order correlation coefficient analysis was used to analyze the correlation between each category of QBF. In all, 44.6% of the students met at least one diagnostic criterion in the QBF system. QC, BD, BS, and FD were established more in females, and QD and QS were established without gender differences. Most students who were presumed to be healthy were revealed to have some potentially pathological conditions using the QBF system.

  10. The Role of Rumination and Stressful Life Events in the Relationship between the Qi Stagnation Constitution and Depression in Women: A Moderated Mediation Model.

    PubMed

    Liu, Mingfan; Jiang, Ying; Wang, Xiumei; Liu, Qiaosheng; Wu, Hou

    2017-01-01

    The qi stagnation constitution is associated with depression in traditional Chinese medicine. It is unclear how rumination and stressful life events affect the relationship between the qi stagnation constitution and depression. The Qi Stagnation Constitution Scale, Ruminative Response Scale, Center for Epidemiologic Studies Depression Scale, and Adolescent Self-Rating Life Events Checklist were used to assess this association in 1200 female college students. The results revealed that the qi stagnation constitution was positively associated with depression. Furthermore, rumination was a partial mediator of the relationship between the qi stagnation constitution and depression. In addition, stressful life events moderated the direct effect and mediating effect of the qi stagnation constitution on depression. These findings indicate that rumination and stressful life events may affect the relationship between the qi stagnation constitution and depression in women.

  11. The Role of Rumination and Stressful Life Events in the Relationship between the Qi Stagnation Constitution and Depression in Women: A Moderated Mediation Model

    PubMed Central

    Liu, Qiaosheng

    2017-01-01

    The qi stagnation constitution is associated with depression in traditional Chinese medicine. It is unclear how rumination and stressful life events affect the relationship between the qi stagnation constitution and depression. The Qi Stagnation Constitution Scale, Ruminative Response Scale, Center for Epidemiologic Studies Depression Scale, and Adolescent Self-Rating Life Events Checklist were used to assess this association in 1200 female college students. The results revealed that the qi stagnation constitution was positively associated with depression. Furthermore, rumination was a partial mediator of the relationship between the qi stagnation constitution and depression. In addition, stressful life events moderated the direct effect and mediating effect of the qi stagnation constitution on depression. These findings indicate that rumination and stressful life events may affect the relationship between the qi stagnation constitution and depression in women. PMID:28757889

  12. Longitudinal Evaluation of Quality Improvement and Public Health Accreditation Readiness in Nebraska Local Health Departments, 2011-2016.

    PubMed

    Chen, Li-Wu; Gregg, Abbey; Palm, David

    Public health accreditation is intended to improve the performance of public health departments, and quality improvement (QI) is an important component of the Public Health Accreditation Board process. The objective of this study was to evaluate the QI maturity and accreditation readiness of local health departments (LHDs) in Nebraska during a 6-year period that included several statewide initiatives to progress readiness, including funding and technical assistance. We used a mixed-methods approach that consisted of both online surveys and key informant interviews to assess QI maturity and accreditation readiness. Nineteen of Nebraska's 21 LHDs completed the survey in 2011 and 2013, 20 of 20 LHDs completed the survey in 2015, and 19 of 20 LHDs completed the survey in 2016. We facilitated a large group discussion with staff members from 16 LHDs in 2011, and we conducted key informant interviews with staff members from 4 LHDs in 2015. Both QI maturity and accreditation readiness improved from 2011 to 2016. In 2011, of 19 LHDs, only 6 LHD directors agreed that their LHD had a culture that focused on QI, but this number increased every year up to 12 in 2016. The number of LHDs that had a high capacity to engage in QI efforts improved from 3 in 2011 to 8 in 2016. The number of LHDs with a QI plan increased from 3 in 2011 to 10 in 2016. The number of LHDs that were confident in their ability to obtain Public Health Accreditation Board accreditation improved from 6 in 2011 to 13 in 2016. Although their QI maturity generally increased over time, LHDs interviewed in 2015 still faced challenges adopting a formal QI system. External financial and technical support helped LHDs build their QI maturity and accreditation readiness. Funding and technical assistance can improve LHDs' QI maturity and accreditation readiness. Improvement takes time and sustained efforts by LHDs, and support from external partners (eg, state health departments) helps build LHDs' QI maturity and

  13. The effects of Qi exercise on maternal/fetal interaction and maternal well-being during pregnancy.

    PubMed

    Ji, Eun Sun; Han, Hae-Ra

    2010-01-01

    To investigate the effects of Qi exercise on maternal outcomes during pregnancy. A prospective, two-group, quasi-experimental, pretest/post test design was used. A convenience sample was recruited from one women's wellness center and one women's health clinic in Seoul, Korea. Participants were healthy pregnant women at more than 18 weeks gestation. A total of 70 women were included in the final analysis. Qi exercise was carried out for 90 minutes, twice a week for 12 weeks. Study outcomes were measured by the Intrapersonal Communication Questionnaire (Talking to Your Baby), Zung's Self-rating Depression Scale (ZSDS), the State Trait Anxiety Inventory (STAI), and the Pregnancy Mild Discomfort Index. Analysis of covariance was used to compare outcomes between groups, after adjusting for baseline scores. The Qi exercise group had higher post test maternal/fetal interaction and lower maternal depressive symptoms and physical discomfort scores than the control group. There was no difference in anxiety. The findings suggest that the holistic approach of Qi exercise may positively influence maternal/fetal interaction and mother's health. Whether these beneficial effects can be sustained throughout pregnancy requites additional research.

  14. Requirement of histidine 217 for ubiquinone reductase activity (Qi site) in the cytochrome bc1 complex.

    PubMed

    Gray, K A; Dutton, P L; Daldal, F

    1994-01-25

    Folding models suggest that the highly conserved histidine 217 of the cytochrome b subunit from the cytochrome bc1 complex is close to the quinone reductase (Qi) site. This histidine (bH217) in the cytochrome b polypeptide of the photosynthetic bacterium Rhodobacter capsulatus has been replaced with three other residues, aspartate (D), arginine (R), and leucine (L). bH217D and bH217R are able to grow photoheterotrophically and contain active cytochrome bc1 complexes (60% of wild-type activity), whereas the bH217L mutant is photosynthetically incompetent and contains a cytochrome bc1 complex that has only 10% of the wild-type activity. Single-turnover flash-activated electron transfer experiments show that cytochrome bH is reduced via the Qo site with near native rates in the mutant strains but that electron transfer between cytochrome bH and quinone bound at the Qi site is greatly slowed. These results are consistent with redox midpoint potential (Em) measurements of the cytochrome b subunit hemes and the Qi site quinone. The Em values of cyt bL and bH are approximately the same in the mutants and wild type, although the mutant strains have a larger relative concentration of what may be the high-potential form of cytochrome bH, called cytochrome b150. However, the redox properties of the semiquinone at the Qi site are altered significantly. The Qi site semiquinone stability constant of bH217R is 10 times higher than in the wild type, while in the other two strains (bH217D and bH217L) the stability constant is much lower than in the wild type. Thus H217 appears to have major effects on the redox properties of the quinone bound at the Qi site. These data are incorporated into a suggestion that H217 forms part of the binding pocket of the Qi site in a manner reminiscent of the interaction between quinone bound at the Qb site and H190 of the L subunit of the bacterial photosynthetic reaction center.

  15. External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

    PubMed

    Lee, Myeong Soo; Woo, Won-Hong; Lim, Hyun-Ja; Hong, Sung-Soo; Kim, Hye-Jung; Moon, Sun-Rock

    2004-01-01

    We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

  16. Education in Quality Improvement for Pediatric Practice: an online program to teach clinicians QI.

    PubMed

    Bundy, David G; Morawski, Lori F; Lazorick, Suzanne; Bradbury, Scott; Kamachi, Karen; Suresh, Gautham K

    2014-01-01

    Education in Quality Improvement for Pediatric Practice (EQIPP) is an online program designed to improve evidence-based care delivery by teaching front-line clinicians quality improvement (QI) skills. Our objective was to evaluate EQIPP data to characterize 1) participant enrollment, use patterns, and demographics; 2) changes in performance in clinical QI measures from baseline to follow-up measurement; and 3) participant experience. We conducted an observational study of EQIPP participants utilizing 1 of 3 modules (asthma, immunizations, gastroesophageal reflux disease) from 2009 to 2013. Enrollment and use, demographic, and quality measure data were extracted directly from the EQIPP system; participant experience was assessed via an optional online survey. Study participants (n = 3501) were diverse in their gender, age, and race; most were board certified. Significant quality gaps were observed across many of the quality measures at baseline; sizable improvements were observed across most quality measures at follow-up. Participants were generally satisfied with their experience. The most influential module elements were collecting and analyzing data, creating and implementing aim statements and improvement plans, and completing "QI Basics." Online educational programs, such as EQIPP, hold promise for front-line clinicians to learn QI. The sustainability of the observed improvements in care processes and their linkage to improvements in health outcomes are unknown and are an essential topic for future study. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Quality improvement in neonatal digital radiography: implementing the basic quality improvement tools.

    PubMed

    Eslamy, Hedieh K; Newman, Beverley; Weinberger, Ed

    2014-12-01

    A quality improvement (QI) program may be implemented using the plan-do-study-act cycle (as a model for making improvements) and the basic QI tools (used to visually display and analyze variation in data). Managing radiation dose has come to the forefront as a safety goal for radiology departments. This is especially true in the pediatric population, which is more radiosensitive than the adult population. In this article, we use neonatal digital radiography to discuss developing a QI program with the principle goals of decreasing the radiation dose, decreasing variation in radiation dose, and optimizing image quality. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery.

    PubMed

    Wei, A C; Devitt, K S; Wiebe, M; Bathe, O F; McLeod, R S; Urbach, D R

    2014-04-01

    Surgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits. The present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes. The expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures. Surgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery.

  19. 78 FR 43857 - Order Relating to Yaming Nina Qi Hanson

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... the procedures that apply to this matter. \\2\\ 50 U.S.C. app. 2401-2420 (2000). Since August 21, 2001... provided her with $75,000 to purchase the autopilots from the Canadian seller. Qi Hanson knew at the time... XiangYu Aviation Technical Group of Xian, China, had given her money to finance the entire purchase. In...

  20. [Analysis in pulmonary ventilatory function from 100 patients with ano-rectal diseases caused by deficiency of qi].

    PubMed

    Wang, W

    1999-03-01

    To explore the pathogenesis of ano-rectal diseases caused by deficiency of Qi, which is correlated with obstruction of pulmonary ventilation. The pulmonary ventilatory function was measured in 100 patients with the internal piles, the interno-external hemorrhoid and prolapse of rectum, the prolapse of anus was the principal symptom of them. Data from the 100 patients showed that 67% of them were diagnosed with the obstruction of pulmonary ventilation, the ratio was far less in the health control group. FEV 1.0 (mean +/- s) (2011.65 +/- 875) ml, MMF (1.84 +/- 1.24) L/s and PEF (2.34 +/- 1.51) L/s in male patients, (1551.54 +/- 514) ml, (1.57 +/- 0.62) L/s and (1.85 +/- 0.92) L/s in female patients, but those values were higher in the control than in the patients. The statistical analysis was performed and the difference was significant between patients and the control group (P < 0.01). The patients with ano-rectal diseases caused by deficiency of Qi accompanied with obstruction of pulmonary ventilation in different degree and varied sorts, it confirmed that the pathogenesis of ano-rectal diseases caused by deficiency of Qi is related with "sinking of pectoral Qi".

  1. How do hospital boards govern for quality improvement? A mixed methods study of 15 organisations in England

    PubMed Central

    Pomeroy, Linda; Burnett, Susan; Anderson, Janet E; Fulop, Naomi J

    2017-01-01

    Background Health systems worldwide are increasingly holding boards of healthcare organisations accountable for the quality of care that they provide. Previous empirical research has found associations between certain board practices and higher quality patient care; however, little is known about how boards govern for quality improvement (QI). Methods We conducted fieldwork over a 30-month period in 15 healthcare provider organisations in England as part of a wider evaluation of a board-level organisational development intervention. Our data comprised board member interviews (n=65), board meeting observations (60 hours) and documents (30 sets of board meeting papers, 15 board minutes and 15 Quality Accounts). We analysed the data using a framework developed from existing evidence of links between board practices and quality of care. We mapped the variation in how boards enacted governance of QI and constructed a measure of QI governance maturity. We then compared organisations to identify the characteristics of those with mature QI governance. Results We found that boards with higher levels of maturity in relation to governing for QI had the following characteristics: explicitly prioritising QI; balancing short-term (external) priorities with long-term (internal) investment in QI; using data for QI, not just quality assurance; engaging staff and patients in QI; and encouraging a culture of continuous improvement. These characteristics appeared to be particularly enabled and facilitated by board-level clinical leaders. Conclusions This study contributes to a deeper understanding of how boards govern for QI. The identified characteristics of organisations with mature QI governance seemed to be enabled by active clinical leadership. Future research should explore the biographies, identities and work practices of board-level clinical leaders and their role in organisation-wide QI. PMID:28689191

  2. Influence of de qi on the immediate analgesic effect of SP6 acupuncture in patients with primary dysmenorrhoea and cold and dampness stagnation: a multicentre randomised controlled trial.

    PubMed

    Zhao, Min-Yi; Zhang, Peng; Li, Jing; Wang, Lin-Peng; Zhou, Wei; Wang, Yan-Xia; She, Yan-Fen; Ma, Liang-Xiao; Wang, Pei; Hu, Ni-Juan; Lin, Chi; Hu, Shang-Qin; Wu, Gui-Wen; Wang, Ya-Feng; Sun, Jun-Jun; Jiang, Si-Zhu; Zhu, Jiang

    2017-10-01

    The aim of this multicentre randomised controlled trial was to investigate the contribution of de qi to the immediate analgesic effect of acupuncture in patients with primary dysmenorrhoea and the specific traditional Chinese medicine diagnosis cold and dampness stagnation . Eighty-eight patients with primary dysmenorrhoea and cold and dampness stagnation were randomly assigned to de qi (n=43) or no de qi (n=45) groups and underwent 30 min of SP6 acupuncture. The de qi group received deep needling at SP6 with manipulation using thick needles; the no de qi group received shallow needling with no manipulation using thin needles. In both groups the pain scores and actual de qi sensation were evaluated using a visual analogue scale for pain (VAS-P) and the acupuncture de qi clinical assessment scale (ADCAS), respectively. Both groups showed reductions in VAS-P, with no signficant differences between groups. ADCAS scores showed 43/43 and 25/45 patients in de qi and no de qi groups, respectively, actually experienced de qi sensation. Independent of original group allocation, VAS-P reductions associated with actual de qi (n=68) were greater than those without (28.4±18.19 mm vs 14.6±12.28 mm, p=0.008). This study showed no significant difference in VAS-P scores in patients with primary dysmenorrhoea and cold and dampness stagnation immediately after SP6 acupuncture designed to induce or avoid de qi sensation. Both treatments significantly reduced VAS-P relative to baseline. Irrespective of group allocation, patients experiencing actual de qi sensation demonstrated larger reductions in pain score relative to those without, suggesting greater analgesic effects. Chinese Clinical Trial Registry (ChiCTR-TRC-13003086); Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Surgical process improvement tools: defining quality gaps and priority areas in gastrointestinal cancer surgery

    PubMed Central

    Wei, A.C.; Devitt, K.S.; Wiebe, M.; Bathe, O.F.; McLeod, R.S.; Urbach, D.R.

    2014-01-01

    Background Surgery is a cornerstone of cancer treatment, but significant differences in the quality of surgery have been reported. Surgical process improvement tools (spits) modify the processes of care as a means to quality improvement (qi). We were interested in developing spits in the area of gastrointestinal (gi) cancer surgery. We report the recommendations of an expert panel held to define quality gaps and establish priority areas that would benefit from spits. Methods The present study used the knowledge-to-action cycle was as a framework. Canadian experts in qi and in gi cancer surgery were assembled in a nominal group workshop. Participants evaluated the merits of spits, described gaps in current knowledge, and identified and ranked processes of care that would benefit from qi. A qualitative analysis of the workshop deliberations using modified grounded theory methods identified major themes. Results The expert panel consisted of 22 participants. Experts confirmed that spits were an important strategy for qi. The top-rated spits included clinical pathways, electronic information technology, and patient safety tools. The preferred settings for use of spits included preoperative and intraoperative settings and multidisciplinary contexts. Outcomes of interest were cancer-related outcomes, process, and the technical quality of surgery measures. Conclusions Surgical process improvement tools were confirmed as an important strategy. Expert panel recommendations will be used to guide future research efforts for spits in gi cancer surgery. PMID:24764704

  4. [Professor Shi Qi's experience of applying herbal paste for treating chronic musculoskeletal conditions].

    PubMed

    Li, Xiao-feng; Wang, Yong-jun; Ye, Xiu-lan; Zhou, Chong-jian

    2012-06-01

    Professor Shi Qi is a famous traditional Chinese medicine doctor specializing in orthopaedics and traumatology, who has formatted a set of systematic protocols for the diagnosis and treatment of chronic musculoskeletal conditions. When it is time for using tonics in winter, he advocates applying herbal paste for treating chronic musculoskeletal diseases. This paper introduces Professor Shi Qi's commonly used prescription for treating chronic musculoskeletal conditions and puts forward demands and understandings in concocting herbal paste, experience in herbal paste for treating chronic musculoskeletal diseases such as cervical spondylosis, lumbar disc herniation, lumbar spinal stenosis, lumbar muscle strain, ankylosing spondylitis, osteoporosis, knee osteoarthritis and avascular necrosis of femoral head, and the advantages of herbal paste for treating chronic musculoskeletal conditions as opposed to alternative treatments.

  5. NorthStar, a support tool for the design and evaluation of quality improvement interventions in healthcare.

    PubMed

    Akl, Elie A; Treweek, Shaun; Foy, Robbie; Francis, Jill; Oxman, Andrew D

    2007-06-26

    The Research-Based Education and Quality Improvement (ReBEQI) European partnership aims to establish a framework and provide practical tools for the selection, implementation, and evaluation of quality improvement (QI) interventions. We describe the development and preliminary evaluation of the software tool NorthStar, a major product of the ReBEQI project. We focused the content of NorthStar on the design and evaluation of QI interventions. A lead individual from the ReBEQI group drafted each section, and at least two other group members reviewed it. The content is based on published literature, as well as material developed by the ReBEQI group. We developed the software in both a Microsoft Windows HTML help system version and a web-based version. In a preliminary evaluation, we surveyed 33 potential users about the acceptability and perceived utility of NorthStar. NorthStar consists of 18 sections covering the design and evaluation of QI interventions. The major focus of the intervention design sections is on how to identify determinants of practice (factors affecting practice patterns), while the major focus of the intervention evaluation sections is on how to design a cluster randomised trial. The two versions of the software can be transferred by email or CD, and are available for download from the internet. The software offers easy navigation and various functions to access the content. Potential users (55% response rate) reported above-moderate levels of confidence in carrying out QI research related tasks if using NorthStar, particularly when developing a protocol for a cluster randomised trial NorthStar is an integrated, accessible, practical, and acceptable tool to assist developers and evaluators of QI interventions.

  6. Craniometric examination of Longxian and Qi Li Cun archaeological sites to assess population continuity in ancient northern China.

    PubMed

    Gibbon, Victoria E; Porter, Tarun A; Wu, Xiujie; Liu, Wu

    2016-10-01

    In this paper, population continuity and discontinuity in northern China are explored using craniometric analyses from two archaeological sites, Longxian (Warring States) and Qi Li Cun (Han Dynasty). Neither population has been previously studied. Artefactual evidence shows the individuals from Qi Li Cun were Xianbei, descendants from Mongolia. Longxian is from further south in the central plains at an earlier time, thus, we expect to observe variability between these groups. In total, 24 cranial measurements were obtained on 66 crania from these sites. Howells's cranial measurements on Anyang (42 crania) and Hainan (83 crania) Chinese samples were included for comparative purposes. Less variability is expected between Longxian and Howells's Chinese data due to geographic and temporal similarity. With closer geographic and temporal affinity with Anyang, the expectation is for Longxian and Anyang to be similar. Few statistical differences exist between Longxian and Qi Li Cun; this was supported by the similarity found through principal components analysis (PCA). Regardless of sex, canonical discriminant analysis shows clustering of Longxian and Qi Li Cun separate from those of Anyang and Hainan. Their similarity indicates the people from Longxian and Qi Li Cun likely share Mongolian ancestry. Our results, supported by other studies, suggest that despite temporal differences, Mongolians living in China during the Warring States and Han dynasty retained their cultural and genetic Mongolian identity. These data add valuable bioarchaeological information regarding the peopling of northern China during a crucial period of cultural and political change in the Early Bronze Age and Iron Age. Copyright © 2016 Elsevier GmbH. All rights reserved.

  7. Effectiveness of De Qi during acupuncture for the treatment of tinnitus: study protocol for a randomized controlled trial.

    PubMed

    Xie, Hui; Li, Xinrong; Lai, Jiaqin; Zhou, Yanan; Wang, Caiying; Liang, Jiao

    2014-10-15

    Acupuncture has been used in China to treat tinnitus for a long time. There is debate as to whether or not De Qi is a key factor in achieving the efficacy of acupuncture. However, there is no sufficient evidence obtained from randomized controlled trials to confirm the role of De Qi in the treatment of acupuncture for tinnitus. This study aims to identify the effect of De Qi for patients who receive acupuncture to alleviate tinnitus by a prospective, double-blind, randomized, sham-controlled trial. This study compares two acupuncture groups (with or without manipulation) in 292 patients with a history of subjective tinnitus. The trial will be conducted in the Teaching Hospital of Chengdu University of Traditional Chinese Medicine. In the study, the patients will be randomly assigned into two groups according to a computer-generated randomization list and assessed prior to treatment. Then, they will receive 5 daily sessions of 30 minutes each time for 4 consecutive weeks and undergo a 12-week follow-up phase. The administration of acupuncture follows the guidelines for clinical research on acupuncture (WHO Regional Publication, Western Pacific Series Number 15, 1995), and is performed double-blind by physicians well-trained in acupuncture. The measures of outcome include the subjective symptoms scores and quantitative sensations of De Qi evaluated by Visual Analog Scales (VAS) and the Chinese version of the 'modified' Massachusetts General Hospital Acupuncture Sensation Scale (C-MMASS). Furthermore, adverse events are recorded and analyzed. If any subjects are withdrawn from the trial, intention-to-treat analysis (ITT) and per-protocol (PP) analysis will be performed. The key features of this trial include the randomization procedures, large sample and the standardized protocol to evaluate De Qi qualitatively and quantitatively in the treatment of acupuncture for tinnitus. The trial will be the first study with a high evidence level in China to assess the efficacy

  8. [Post-stroke constipation treated with acupuncture therapy of regulating qi circulation of fu-organ].

    PubMed

    Ren, Zhen; Wu, Qing-Ming; Li, Dan-Dan; Liu, Wei-Ai; Li, Xiang-Rong; Lin, Xu-Ming

    2013-10-01

    To compare the difference in the efficacy on post-stroke constipation between acupuncture therapy of regulating qi circulation of fe-organ and Shengxue Tongbian Capsules. Seventy-five patients of post-stroke constipation were randomized into an acupuncture group (39 cases) and a Chinese medicine group (36 cases). The unit mode comprehensive therapy of stroke was adopted as basic treatment in the two groups. In the acupuncture group, acupuncture therapy of regulating qi circulation of fu-organ was added at Tianshu (ST 25), Zhigou (TE 6), Qihai (CV 6) and Zusanli (ST 36), once every day. In the Chinese medicine group, Shengrue Tongbian Capsules were supplemented for oral administration, once every day, 10 g each time. The clinical symptom score of constipation was observed before treatment, after 1 and 2 weeks treatment in the two groups, respectively. The efficacy in 1 week and 2 weeks of treatment and the adverse reaction were observed. In 1 and 2 weeks of treatment, the clinical symptom score of constipation was reduced significantly as compared with that before treatment in the two groups (all P < 0.05). The improvements in the acupuncture group were significant than those in the Chinese medicine group in 2 weeks of treatment (8.03 +/- 2.38 vs 9.20 +/- 2.45, P < 0.05). Concerning to the occurrence of adverse reaction, there was 1 case of local bruises in needling local site in the acupuncture group; and there were 1 case of abdominal pain, 3 cases of diarrhea and 2 cases of nausea and vomiting in the Chinese medicine group. Both the acupuncture therapy of regulating qi circulation of fu-organ and Shengxue Tongbian Capsules achieve the significant efficacy on post-stroke constipation. The efficacy of the acupuncture therapy of regulating qi circulation of fe-organ is better and the adverse reaction is less after long-term persistent treatment.

  9. Fire-Heat and Qi Deficiency Syndromes as Predictors of Short-term Prognosis of Acute Ischemic Stroke

    PubMed Central

    Cheng, Shu-Chen; Lin, Chien-Hsiung; Chang, Yeu-Jhy; Lee, Tsong-Hai; Ryu, Shan-Jin; Chen, Chun-Hsien; Chang, Her-Kun; Chang, Chee-Jen

    2013-01-01

    Abstract Objectives To explore the relationships between traditional Chinese medicine (TCM) syndromes and disease severity and prognoses after ischemic stroke, such as neurologic deficits and decline in activities of daily living (ADLs). Methods The study included 211 patients who met the inclusion criteria of acute ischemic stroke based on clinical manifestations, computed tomography or magnetic resonance imaging findings, and onset of ischemic stroke within 72 hours with clear consciousness. To assess neurologic function and ADLs in patients with different TCM syndromes, the TCM Syndrome Differentiation Diagnostic Criteria for Apoplexy scale (containing assessments of wind, phlegm, blood stasis, fire-heat, qi deficiency, and yin deficiency with yang hyperactivity syndromes) was used within 72 hours of stroke onset, and Western medicine–based National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) assessments were performed at both admission and discharge. Results The most frequent TCM syndromes associated with acute ischemic stroke were wind syndrome, phlegm syndrome, and blood stasis syndrome. Improvement according to the BI at discharge and days of admission were significantly different between patients with and those without fire-heat syndrome. Patients with qi deficiency syndrome had longer hospital stays and worse NIHSS and BI assessments at discharge than patients without qi deficiency syndrome. All the reported differences reached statistical significance. Conclusions These results provide evidence that fire-heat syndrome and qi deficiency syndrome are essential elements that can predict short-term prognosis of acute ischemic stroke. PMID:23600945

  10. Serum metabolomics strategy for understanding pharmacological effects of ShenQi pill acting on kidney yang deficiency syndrome.

    PubMed

    Nan, Yang; Zhou, Xiaohang; Liu, Qi; Zhang, Aihua; Guan, Yu; Lin, Shanhua; Kong, Ling; Han, Ying; Wang, Xijun

    2016-07-15

    Kidney yang deficiency syndrome, a diagnostic pattern in Chinese medicine, is similar with clinical features of the glucocorticoid withdrawal syndrome. The aim of this present study was to explore low molecular mass differentiating metabolites between control group and model group of kidney yang deficiency rats induced with corticosterone as well as the therapeutic effect of Shen Qi Pill, a classic traditional Chinese medicine formula for treating Kidney yang deficiency syndrome in China. This study utilized ultra-performance liquid chromatography coupled with electrospray ionization synapt quadrupole time-of-flight high definition mass spectrometry (UPLC/ESI-SYNAPT-QTOF-HDMS) to identify the underlying biomarkers for clarifying mechanism of Shen Qi Pill in treating Kidney yang deficiency syndrome based on metabolite profiling of the serum samples and in conjunction with multivariate and pathway analysis. Meanwhile, blood biochemistry assay and histopathology were examined to identify specific changes in the model group rats. Distinct changes in the pattern of metabolites were observed by UPLC-HDMS. The changes in metabolic profiling were restored to their baseline values after treatment with Shen Qi Pill according to the combined with a principal component analysis (PCA) score plots. Altogether, the current metabolomics approach based on UPLC-HDMS and orthogonal projection to latent structures discriminate analysis (OPLS-DA) demonstrated 27 ions (18 in the negative mode, 9 in the positive mode, 17 ions restored by Shen Qi Pill). These results indicated that effectiveness of Shen Qi Pill in Kidney yang deficiency syndrome rats induced a substantial change in the metabolic profiles by regulating the biomarkers and adjusting the metabolic disorder. It suggested that the metabolomics approach was a powerful approach for elucidation of pathologic changes of Chinese medicine syndrome and action mechanisms of traditional Chinese medicine. Copyright © 2015 Elsevier B

  11. A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

    PubMed

    Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

    2016-06-01

    Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

  12. A Disorder of Qi: Breathing Exercise as a Cure for Neurasthenia in Japan, 1900–1945

    PubMed Central

    Wu, Yu-Chuan

    2016-01-01

    Neurasthenia became a common disease and caused widespread concern in Japan at the turn of the twentieth century, whereas only a couple of decades earlier the term “nerve” had been unfamiliar, if not unknown, to many Japanese. By exploring the theories and practices of breathing exercise—one of the most popular treatments for neurasthenia at the time—this paper attempts to understand how people who practiced breathing exercises for their nervous ills perceived, conceived, and accordingly cared for their nerves. It argues that they understood “nerve” based on their existing conceptions of qi. Neurasthenia was for them a disorder of qi, although the qi had assumed modern appearances as blood and nervous current. The paper hopes to contribute to the understanding of how the concept of nerves has been accepted and assimilated in East Asia. It also points out the need to understand the varied cultures of nerves not only at the level of concept and metaphor, but also at the level of perception and experience. PMID:26363046

  13. [Efficacy of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation].

    PubMed

    Li, Jian-xin; Lu, Qing-ge

    2015-05-01

    To observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE). A total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients. The IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P < 0.01), even longer in group C than in A and B (P < 0.01). The PEDT scores of the three groups were 5.1 ± 1.8, 4.9 ± 1.7, and 3.8 ± 1.2 after treatment and 8.2 ± 2.4, 8.1 ± 2.4, and 6.5 ± 2.1 at 1 month after drug withdrawal, significantly improved in comparison with 13.2 ± 3.2, 12.8 ± 3.1, and 13.1 ± 3.4 before treatment (P < 0.01), even more significantly in group C than in A and B (P < 0.01). Qilin Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

  14. Participants' evaluation of a group-based organisational assessment tool in Danish general practice: the Maturity Matrix.

    PubMed

    Buch, Martin Sandberg; Edwards, Adrian; Eriksson, Tina

    2009-01-01

    The Maturity Matrix is a group-based formative self-evaluation tool aimed at assessing the degree of organisational development in general practice and providing a starting point for local quality improvement. Earlier studies of the Maturity Matrix have shown that participants find the method a useful way of assessing their practice's organisational development. However, little is known about participants' views on the resulting efforts to implement intended changes. To explore users' perspectives on the Maturity Matrix method, the facilitation process, and drivers and barriers for implementation of intended changes. Observation of two facilitated practice meetings, 17 semi-structured interviews with participating general practitioners (GPs) or their staff, and mapping of reasons for continuing or quitting the project. General practices in Denmark Main outcomes: Successful change was associated with: a clearly identified anchor person within the practice, a shared and regular meeting structure, and an external facilitator who provides support and counselling during the implementation process. Failure to implement change was associated with: a high patient-related workload, staff or GP turnover (that seemed to affect small practices more), no clearly identified anchor person or anchor persons who did not do anything, no continuous support from an external facilitator, and no formal commitment to working with agreed changes. Future attempts to improve the impact of the Maturity Matrix, and similar tools for quality improvement, could include: (a) attention to matters of variation caused by practice size, (b) systematic counselling on barriers to implementation and support to structure the change processes, (c) a commitment from participants that goes beyond participation in two-yearly assessments, and (d) an anchor person for each identified goal who takes on the responsibility for improvement in practice.

  15. NorthStar, a support tool for the design and evaluation of quality improvement interventions in healthcare

    PubMed Central

    Akl, Elie A; Treweek, Shaun; Foy, Robbie; Francis, Jill; Oxman, Andrew D

    2007-01-01

    Background The Research-Based Education and Quality Improvement (ReBEQI) European partnership aims to establish a framework and provide practical tools for the selection, implementation, and evaluation of quality improvement (QI) interventions. We describe the development and preliminary evaluation of the software tool NorthStar, a major product of the ReBEQI project. Methods We focused the content of NorthStar on the design and evaluation of QI interventions. A lead individual from the ReBEQI group drafted each section, and at least two other group members reviewed it. The content is based on published literature, as well as material developed by the ReBEQI group. We developed the software in both a Microsoft Windows HTML help system version and a web-based version. In a preliminary evaluation, we surveyed 33 potential users about the acceptability and perceived utility of NorthStar. Results NorthStar consists of 18 sections covering the design and evaluation of QI interventions. The major focus of the intervention design sections is on how to identify determinants of practice (factors affecting practice patterns), while the major focus of the intervention evaluation sections is on how to design a cluster randomised trial. The two versions of the software can be transferred by email or CD, and are available for download from the internet. The software offers easy navigation and various functions to access the content. Potential users (55% response rate) reported above-moderate levels of confidence in carrying out QI research related tasks if using NorthStar, particularly when developing a protocol for a cluster randomised trial Conclusion NorthStar is an integrated, accessible, practical, and acceptable tool to assist developers and evaluators of QI interventions. PMID:17594495

  16. Predictive Capability Maturity Model (PCMM).

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

    Swiler, Laura Painton; Knupp, Patrick Michael; Urbina, Angel

    2010-10-01

    Predictive Capability Maturity Model (PCMM) is a communication tool that must include a dicussion of the supporting evidence. PCMM is a tool for managing risk in the use of modeling and simulation. PCMM is in the service of organizing evidence to help tell the modeling and simulation (M&S) story. PCMM table describes what activities within each element are undertaken at each of the levels of maturity. Target levels of maturity can be established based on the intended application. The assessment is to inform what level has been achieved compared to the desired level, to help prioritize the VU activities &more » to allocate resources.« less

  17. Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability-An Emerging Framework.

    PubMed

    Holve, Erin

    2013-01-01

    Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four "pillars" of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two "foundational considerations," adaptive capacity and policy levers, are also discussed.

  18. Assessment of Electromagnetic Interference with Active Cardiovascular Implantable Electronic Devices (CIEDs) Caused by the Qi A13 Design Wireless Charging Board

    PubMed Central

    Seckler, Tobias; Jagielski, Kai; Stunder, Dominik

    2015-01-01

    Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in CIEDs by Qi A13 design magnetic fields were measured and compared with the performance limits set by ISO 14117. In order to carry this out a measuring circuit was developed which can be connected with unipolar or bipolar pacemaker leads. The measuring system was positioned at the four most common implantation sites in a torso phantom filled with physiological saline solution. The phantom was exposed by using Helmholtz coils from 5 µT to 27 µT with 111 kHz sine-bursts or by using a Qi A13 design wireless charging board (Qi-A13-Board) in two operating modes “power transfer” and “pinging”. With the Helmholtz coils the lowest magnetic flux density at which the performance limit was exceeded is 11 µT. With the Qi-A13-Board in power transfer mode 10.8% and in pinging mode 45.7% (2.2% at 10 cm distance) of the performance limit were reached at maximum. In neither of the scrutinized cases, did the voltage induced by the Qi-A13-Board exceed the performance limits. PMID:26024360

  19. Effect of QiShenYiQi pill on myocardial collagen metabolism in experimental autoimmune myocarditis rats.

    PubMed

    Lv, Shi-Chao; Wu, Meifang; Li, Meng; Wang, Qiang; Wang, Xiao-Jing; Zhang, Ao; Xu, Ling; Zhang, Jun-Ping

    2017-04-01

    To observe the effect of QiShenYiQi pill (QSYQ) on myocardial collagen metabolism in experimental autoimmune myocarditis rats, and to explore its mechanism of action. Lewis rats underwent the injection of myocardial myosin mixed with freund's complete adjuvant were randomized into three groups: model, valsartan and QSYQ groups. And we treated rats which were injected phosphate buffered saline (PBS) mixed with freund's complete adjuvant as control group. Rats were intervened and euthanized at 4 and 8 weeks. We use alkaline hydrolysis to detect the content of myocardial hydroxyproline (HYP), and ELISA to detect the level of serum procollagen type I carboxyterminal peptide (PICP), procollagen type III amino-terminal peptide (PIIINP), and collagen C telopeptide type I (CTX-I). Myocardial MMP-1 and TIMP-1 protein expression was detected by immunohistochemistry, and myocardial MMP-1 and TIMP-1 mRNA expression was detected by real-time qPCR. QSYQ reduced the content of myocardial HYP, and this reduction was greater over time. QSYQ also reduced the serum concentration of PICP, PIIINP, CTX-I and the PICP/PIIINP ratio, which further reduced over time, whereas its effect on lowering PICP was significantly greater than that of valsartan at 4 and 8 weeks, and lowering CTX-I was significantly greater than that of valsartan at 8 weeks. In addition, after 4 weeks, QSYQ enhanced the protein and mRNA expression of MMP-1 and TIMP-1, and its effect on highering TIMP-1 was significantly greater than that of valsartan, whereas there was no significant difference in the expression of myocardial MMP-1 or TIMP-1 at 8 weeks. QSYQ reduced the ratio of MMP-1/TIMP-1, which further reduced over time, and the effect of QYSQ was significantly greater than that of valsartan after 4 weeks. This study provides evidence that QSYQ can reduce the rate of myocardial collagen synthesis and degradation. It also effectively improved the degree of myocardial fibrosis in experimental autoimmune myocarditis

  20. Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice

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

    Leong, Cheng Nang; Shakespeare, Thomas Philip; North Coast Cancer Institute, Coffs Harbour

    2006-12-01

    Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scoresmore » were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.« less

  1. VizieR Online Data Catalog: Follow-up of probable young star ASASSN-15qi (Herczeg+, 2016)

    NASA Astrophysics Data System (ADS)

    Herczeg, G. J.; Dong, S.; Shappee, B. J.; Chen, P.; Hillenbrand, L. A.; Jose, J.; Kochanek, C. S.; Prieto, J. L.; Stanek, K. Z.; Kaplan, K.; Holoien, T.-S.; Mairs, S.; Johnstone, D.; Gully-Santiago, M.; Zhu, Z.; Smith, M. C.; Bersier, D.; Mulders, G. D.; Filippenko, A. V.; Ayani, K.; Brimacombe, J.; Brown, J. S.; Connelley, M.; Harmanen, J.; Itoh, R.; Kawabata, K. S.; Maehara, H.; Takata, K.; Yuk, H.; Zheng, W.

    2017-02-01

    The outburst of ASASSN-15qi (2MASS J22560882+5831040) occurred on JD2457298 (2015 October 2; UTC dates are used herein). The All-Sky Automated Survey for Supernovae (ASAS-SN) is an all-sky V-band transient survey with a limiting magnitude of ~17. ASAS-SN photometry of ASASSN-15qi was obtained from two different telescopes on Haleakala, Hawaii with intervals of one to three days. ASAS-SN photometry is listed in Table 2. Archival photometry, ground-based optical photometry with Las Cumbres Observatory Global Telescope Network (LCOGT) 1m telescope at McDonald Observatory between 2015 October 23 and December 23 and at the Liverpool Telescope on 2016 April 26 and June 11, Swift/UVOT photometry on 2015 October 12 (ID 00034098001) and 2015 December 27 (ID 00034098002), NIR photometry with the NOTCam camera at the Nordic Optical Telescope (NOT) on 2015 December 22 and Spitzer/IRAC MIR photometry on 2006 December 29 (Program ID 30734, PI Donald Figer) and James Clerk Maxwell Telescope (JCMT) SCUBA2 submillimeter observations of ASASSN-15qi on 2015 November 5 and optical and NIR spectroscopy observations are also described in section 2. (1 data file).

  2. Ensuring Support for Research and Quality Improvement (QI) Networks: Four Pillars of Sustainability—An Emerging Framework

    PubMed Central

    Holve, Erin

    2013-01-01

    Multi-institutional research and quality improvement (QI) projects using electronic clinical data (ECD) hold great promise for improving quality of care and patient outcomes but typically require significant infrastructure investments both to initiate and maintain the project over its duration. Consequently, it is important for these projects to think holistically about sustainability to ensure their long-term success. Four “pillars” of sustainability are discussed based on the experiences of EDM Forum grantees and other research and QI networks. These include trust and value, governance, management, and financial and administrative support. Two “foundational considerations,” adaptive capacity and policy levers, are also discussed. PMID:25848557

  3. Cardioprotective Effects of QiShenYiQi Dripping Pills on Transverse Aortic Constriction-Induced Heart Failure in Mice.

    PubMed

    Ruan, Guoran; Ren, Haojin; Zhang, Chi; Zhu, Xiaogang; Xu, Chao; Wang, Liyue

    2018-01-01

    QiShenYiQi dripping pills (QSYQ), a traditional Chinese medicine, are commonly used to treat coronary heart disease, and QSYQ was recently approved as a complementary treatment for ischemic heart failure in China. However, only few studies reported on whether QSYQ exerts a protective effect on heart failure induced by pressure overload. In this study, we explored the role of QSYQ in a mouse model of heart failure induced by transverse aortic constriction (TAC). Twenty-eight C57BL/6J mice were divided into four groups: Sham + NS group, Sham + QSYQ group, TAC + NS group, and TAC + QSYQ group. QSYQ dissolved in normal saline (NS) was administered intragastrically (3.5 mg/100 g/day) in the Sham + QSYQ and TAC + QSYQ groups. In the Sham + NS and TAC + NS groups, NS was provided every day intragastrically. Eight weeks after TAC, echocardiography, and cardiac catheterization were performed to evaluate the cardiac function, and immunofluorescent staining with anti-actinin2 antibody was performed to determine the structure of the myocardial fibers. Moreover, TUNEL staining and Masson trichrome staining were employed to assess the effects of QSYQ on cardiac apoptosis and cardiac fibrosis. Western blots and real-time polymerase chain reaction (PCR) were used to measure the expression levels of vascular endothelial growth factor (VEGF) in the heart, and immunohistochemical staining with anti-CD31 antibody was performed to explore the role of QSYQ in cardiac angiogenesis. Results showed that TAC-induced cardiac dysfunction and disrupted structure of myocardial fibers significantly improved after QSYQ treatment. Moreover, QSYQ treatment also significantly improved cardiac apoptosis and cardiac fibrosis in TAC-induced heart failure, which was accompanied by an increase in VEGF expression levels and maintenance of microvessel density in the heart. In conclusion, QSYQ exerts a protective effect on TAC-induced heart failure, which could be attributed to enhanced cardiac angiogenesis

  4. BVRI photometry of ASASSN-15qi using the Tautenburg Schmidt telescope

    NASA Astrophysics Data System (ADS)

    Stecklum, Bringfried; Eisloeffel, Jochen; Scholz, Alexander

    2015-10-01

    We report on photometric observations of the optical transient ASASSN-15qi performed at the Th & uuml;ringer Landessternwarte Tautenburg. The brightening of this source was discovered by the All-Sky Automated Survey for Supernovae (ASAS-SN, Shappee et al. 2014, ApJ, 788, 48). The object is located west of the HII region SH2-148 and a likely member of the star forming region.

  5. Developing a tool for assessing competency in root cause analysis.

    PubMed

    Gupta, Priyanka; Varkey, Prathibha

    2009-01-01

    Root cause analysis (RCA) is a tool for identifying the key cause(s) contributing to a sentinel event or near miss. Although training in RCA is gaining popularity in medical education, there is no published literature on valid or reliable methods for assessing competency in the same. A tool for assessing competency in RCA was pilot tested as part of an eight-station Objective Structured Clinical Examination that was conducted at the completion of a three-week quality improvement (QI) curriculum for the Mayo Clinic Preventive Medicine and Endocrinology fellowship programs. As part of the curriculum, fellows completed a QI project to enhance physician communication of the diagnosis and treatment plan at the end of a patient visit. They had a didactic session on RCA, followed by process mapping of the information flow at the project clinic, after which fellows conducted an actual RCA using the Ishikawa fishbone diagram. For the RCA competency assessment, fellows performed an RCA regarding a scenario describing an adverse medication event and provided possible solutions to prevent such errors in the future. All faculty strongly agreed or agreed that they were able to accurately assess competency in RCA using the tool. Interrater reliability for the global competency rating and checklist scoring were 0.96 and 0.85, respectively. Internal consistency (Cronbach's alpha) was 0.76. Six of eight of the fellows found the difficulty level of the test to be optimal. Assessment methods must accompany education programs to ensure that graduates are competent in QI methodologies and are able to apply them effectively in the workplace. The RCA assessment tool was found to be a valid, reliable, feasible, and acceptable method for assessing competency in RCA. Further research is needed to examine its predictive validity and generalizability.

  6. MatureP: prediction of secreted proteins with exclusive information from their mature regions.

    PubMed

    Orfanoudaki, Georgia; Markaki, Maria; Chatzi, Katerina; Tsamardinos, Ioannis; Economou, Anastassios

    2017-06-12

    More than a third of the cellular proteome is non-cytoplasmic. Most secretory proteins use the Sec system for export and are targeted to membranes using signal peptides and mature domains. To specifically analyze bacterial mature domain features, we developed MatureP, a classifier that predicts secretory sequences through features exclusively computed from their mature domains. MatureP was trained using Just Add Data Bio, an automated machine learning tool. Mature domains are predicted efficiently with ~92% success, as measured by the Area Under the Receiver Operating Characteristic Curve (AUC). Predictions were validated using experimental datasets of mutated secretory proteins. The features selected by MatureP reveal prominent differences in amino acid content between secreted and cytoplasmic proteins. Amino-terminal mature domain sequences have enhanced disorder, more hydroxyl and polar residues and less hydrophobics. Cytoplasmic proteins have prominent amino-terminal hydrophobic stretches and charged regions downstream. Presumably, secretory mature domains comprise a distinct protein class. They balance properties that promote the necessary flexibility required for the maintenance of non-folded states during targeting and secretion with the ability of post-secretion folding. These findings provide novel insight in protein trafficking, sorting and folding mechanisms and may benefit protein secretion biotechnology.

  7. Atomistic determinants of co-enzyme Q reduction at the Qi-site of the cytochrome bc1 complex

    NASA Astrophysics Data System (ADS)

    Postila, Pekka A.; Kaszuba, Karol; Kuleta, Patryk; Vattulainen, Ilpo; Sarewicz, Marcin; Osyczka, Artur; Róg, Tomasz

    2016-09-01

    The cytochrome (cyt) bc1 complex is an integral component of the respiratory electron transfer chain sustaining the energy needs of organisms ranging from humans to bacteria. Due to its ubiquitous role in the energy metabolism, both the oxidation and reduction of the enzyme’s substrate co-enzyme Q has been studied vigorously. Here, this vast amount of data is reassessed after probing the substrate reduction steps at the Qi-site of the cyt bc1 complex of Rhodobacter capsulatus using atomistic molecular dynamics simulations. The simulations suggest that the Lys251 side chain could rotate into the Qi-site to facilitate binding of half-protonated semiquinone - a reaction intermediate that is potentially formed during substrate reduction. At this bent pose, the Lys251 forms a salt bridge with the Asp252, thus making direct proton transfer possible. In the neutral state, the lysine side chain stays close to the conserved binding location of cardiolipin (CL). This back-and-forth motion between the CL and Asp252 indicates that Lys251 functions as a proton shuttle controlled by pH-dependent negative feedback. The CL/K/D switching, which represents a refinement to the previously described CL/K pathway, fine-tunes the proton transfer process. Lastly, the simulation data was used to formulate a mechanism for reducing the substrate at the Qi-site.

  8. Association between hospital size and quality improvement for pharmaceutical services.

    PubMed

    Nau, David P; Garber, Mathew C; Lipowski, Earlene E; Stevenson, James G

    2004-01-15

    The relationship between hospital size and quality improvement (QI) for pharmaceutical services was studied. A questionnaire on QI was sent to hospital pharmacy directors in Michigan and Florida in 2002. The questionnaire included items on QI lead-team composition, QI tools, QI training, and QI culture. Usable responses were received from 162 (57%) of 282 pharmacy directors. Pharmacy QI lead teams were present in 57% of institutions, with larger teams in large hospitals (> or = 300 patients). Only two QI tools were used by a majority of hospitals: root-cause analysis (62%) and flow charts (66%). Small hospitals (< 50 patients) were less likely than medium-sized hospitals (50-299 patients) and large hospitals to use several QI tools, including control charts, cause-and-effect diagrams, root-cause analysis, flow charts, and histograms. Large hospitals were more likely than small and medium-sized hospitals to use root-cause analysis and control charts. There was no relationship between hospital size and the frequency with which physician or patient satisfaction with pharmaceutical services was measured. There were no differences in QI training or QI culture across hospital size categories. A survey suggested that a majority of hospital pharmacies in Michigan and Florida have begun to adopt QI techniques but that most are not using rigorous QI tools. Pharmacies in large hospitals had more QI lead-team members and were more likely to use certain QI tools, but there was no relationship between hospital size and satisfaction measurements, QI training, or QI culture.

  9. [Correlation between spirit-qi acupuncture and lifting-thrusting twirling method for spirit in Huangdi Neijing].

    PubMed

    Wang, Feng; Qin, Yuge; Qin, Yuheng; Li, Li; Li, Mei

    2016-03-01

    By analyzing the articles in Huangdi Neijing (Inner Canon of Yellow Emperor), combined with the verification of consciousness in vitro in clinic and modern science, it is found Huangdi Neijing has made special requirements of treating spirit for physicians using spirit-qi acupuncture. The physicians consciously use different methods to motivate the spirit of physician and patients, especially patients, to transform it to the physiological effect of patients, which could minimize the psychological factors that make negative influence on treatment; also the psychotherapy is considered as the most important principle of treating spirit. The reinforcing and reducing methods in later generations, mainly lifting-thrusting twirling method, unintentionally lead patients into a basic or strong status of treating spirit or keeping spirit during the process of achieving stimulation and needle sensation. To partially perform the special role of treating spirit for physicians in Huangdi Neijing on patients could cause the chages including patient-based using spirit to move qi. It not only inspires the body's natural resistance to disease and self-healing, but also motivates the self-protection mechanism of keeping spirit.

  10. Correlation between cervical vertebral and dental maturity in Iranian subjects.

    PubMed

    Heravi, Farzin; Imanimoghaddam, Mahrokh; Rahimi, Hoda

    2011-12-01

    Determination of the skeletal maturation is extremely important in clinical orthodontics. Cervical vertebral maturation is an effective diagnostic tool for determining the adolescent growth spurt. The aim of this study was to investigate the correlation between the stages of calcification of teeth and the cervical vertebral maturity stages.

  11. [Analysis on content of serum monoamine neurotransmitters in macaques with anger-in-induced premenstrual syndrome and liver-qi depression syndrome].

    PubMed

    Wei, Sheng; Hou, Jin-Liang; Chao, Yu-Bin; Du, Xi-Yang; Zong, Shao-Bo

    2012-08-01

    To observe the changes in content of monoamine neurotransmitters in the serum of rhesus macaques, and explore the role of serum monoamine neurotransmitters in premenstrual syndrome (PMS) and liver-qi depression induced by anger-in emotion. Social level pressure was applied on 24 female macaques to induce the angry emotional reaction, and then nine of the low-status macaques with anger-in emotional reaction were screened out and were divided into anger-in emotion group, PMS and liver-qi depression group (model group) and Jingqianshu Granule group. Macaques in the last two groups were suffered extruding in a pack cage for inducing PMS liver-qi depression. After 5 d of extruding, experimental animals were evaluated according to the emotional evaluation scale, meanwhile, macaque serum of follicular phase and middle-late luteal phase was collected to analyze the content of serum norepinephrine, dopamine, and 5-hydroxytryptamine. Compared with the normal control group, the scores of depression of the model group and the anger-in emotion group evaluated with emotional evaluation scale were significantly increased (P<0.01, P<0.05); while the score of the model group was significantly higher than that of the anger-in emotion group (P<0.05), and it returned to normal after Jingqianshu Granule treatment. As compared to the normal control group, serum monoamine neurotransmitter levels of the model group and the anger-in emotion group were increased (P<0.05, P<0.01), and the serum monoamine neurotransmitter levels of the model group were significantly higher than those of the anger-in emotion group (P<0.05), while there was no significant difference when compared with the normal control group after the treatment. Anger-in emotion can induce liver-qi depression syndrome which is related to the changes in monoamine neurotransmitters.

  12. Roles of the µ-opioid receptor and its related signaling pathways in the pathogenesis of premenstrual syndrome liver-qi stagnation

    PubMed Central

    Song, Chunhong; Xue, Ling

    2017-01-01

    The present study aimed to investigate the roles of the µ-opioid receptor (MOR) and its related signaling pathways in the pathogenesis of premenstrual syndrome (PMS) liver-qi stagnation, along with the therapeutic effects of the Shu-Yu capsule in treating the condition. A PMS liver-qi stagnation rat model was established using a chronic restraint stress method. The protein expression level of MOR within rat hippocampal tissue was detected via western blot analysis and cyclic adenosine monophosphate (cAMP) levels within the supernatant of a rat hippocampal cell culture were determined by ELISA. The western blot analysis indicated that the hippocampal expression level of MOR was significantly elevated in the PMS liver-qi stagnation model group. However, subsequent treatment with a Shu-Yu capsule was found to significantly decrease the level of MOR expression. In addition, in vitro experiments were performed, whereby primary hippocampal neurons were treated with model rat serum. It was observed that the level of MOR expression was significantly elevated, while brain-derived neurotrophic factor (BDNF) and cAMP levels in the culture supernatant were significantly decreased. These effects were reversed by treatment with serum from the Shu-Yu capsule-treated rats. Furthermore, when treated with the MOR activator DAMGO, the following were significantly decreased in the primary neurons: Phosphorylation levels of cAMP response element binding protein and extracellular signal-regulated protein kinases (ERK); BDNF expression; and cAMP content in the culture supernatant. These effects were reversed in primary neurons treated with DAMGO and Shu-Yu-containing rat serum. Collectively, the data suggest that increased MOR expression and activation of the cAMP/ERK signaling pathway in the hippocampus may be involved in the pathogenesis of PMS liver-qi stagnation. Furthermore, the efficacy of the Shu-Yu capsule in treating the condition may be via its regulation of MOR receptor

  13. Development and validation of the Eating Maturity Questionnaire: Preliminary findings.

    PubMed

    Potocka, Adrianna; Najder, Anna

    2016-10-01

    This article describes the development of the Eating Maturity Questionnaire, a self-reported measurement of eating maturity that initiates and gives direction to human eating behaviors. The Eating Maturity Questionnaire was designed to study individuals' biological and psychosocial motives for eating. The Eating Maturity Questionnaire is a 21-item tool with satisfactory psychometric values (Cronbach's α coefficients between 0.83 and 0.88) consisting of two subscales: Rational Eating and Psychosocial Maturity Eating Maturity Questionnaire results may be used to design programs that target eating behaviors and body mass modification. © The Author(s) 2015.

  14. Maturity method demonstration : final report.

    DOT National Transportation Integrated Search

    2003-07-01

    The concrete maturity method is a quality control/quality assurance tool that can be used to assist contractors and transportation officials in producing cost-efficient, durable concrete structures. This report documents the findings of an investigat...

  15. The Effects of Yin, Yang and Qi in the Skin on Pain.

    PubMed

    Adams, James David

    2016-01-29

    The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang) and antagonists (yin) that help the body control pain. Acupuncture works through modulation of these receptor activities (qi) in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients.

  16. The Effects of Yin, Yang and Qi in the Skin on Pain

    PubMed Central

    Adams, James David

    2016-01-01

    The most effective and safe treatment site for pain is in the skin. This chapter discusses the reasons to treat pain in the skin. Pain is sensed in the skin through transient receptor potential cation channels and other receptors. These receptors have endogenous agonists (yang) and antagonists (yin) that help the body control pain. Acupuncture works through modulation of these receptor activities (qi) in the skin; as do moxibustion and liniments. The treatment of pain in the skin has the potential to save many lives and improve pain therapy in most patients. PMID:28930115

  17. Ergonomic sustainability based on the ergonomic maturity level measurement.

    PubMed

    Vidal, Mario Cesar; Guizze, Carmen Lucia Campos; Bonfatti, Renato José; Silva e Santos, Marcello

    2012-01-01

    This paper aims at the application of an ergonomic maturity model (EMM), in order to assess the ergonomic sustainability outreach of ergonomic actions. This proposition was motivated by the widespread sensation that the development of the discipline, its educational devices and related practices depends on the attitude of ergonomics practitioners rather than environmental macroergonomic conditions. Maturity modeling in this paper is undertaken as a tool for ergonomic practitioners. Thus, its foundations were uprooted from diverse fields: Clinic Psychology, Quality Management and Project Management. The paper brings about a detailled explanation of this ergonomic maturity tool. The empirical part is fulfilled by the examination - using the EMM - of four emblematic cases excerpted from our research lab ergonomic portfolio.

  18. An intermediate luminosity optical transient (ILOTs) model for the young stellar object ASASSN-15qi

    NASA Astrophysics Data System (ADS)

    Kashi, Amit; Soker, Noam

    2017-07-01

    We construct a scenario where the outburst of the young stellar object ASASSN-15qi is an intermediate luminosity optical transient (ILOT). In this scenario, a sub-Jupiter young planet was tidally destructed on to a young main-sequence (MS) star. The system is young, and therefore the radius of the planet is larger than its final value; consequently, its density is smaller. The lower density allows the tidal destruction of the young Saturn-like planet on to the MS star of mass ≈2.4 M⊙, resulting in the formation of a disc and a gravitationally powered ILOT. Unlike the case of the more energetic ILOT V838 Mon, the mass of the destructed planet is too low to inflate a giant envelope, and hence the merger remnant remains hot. If our suggested model holds, this ILOT possesses two interesting properties: (I) its luminosity and total energy are below those of novae; (II) it is not as red as other ILOTs. The unusual outburst of ASASSN-15qi - if indeed is an ILOT - further increases the diversity of the already heterogeneous group of ILOTs. We mark the region on the energy-time diagram occupied by such young ILOTs.

  19. Clinical Utility of Quantitative Imaging

    PubMed Central

    Rosenkrantz, Andrew B; Mendiratta-Lala, Mishal; Bartholmai, Brian J.; Ganeshan, Dhakshinamoorthy; Abramson, Richard G.; Burton, Kirsteen R.; Yu, John-Paul J.; Scalzetti, Ernest M.; Yankeelov, Thomas E.; Subramaniam, Rathan M.; Lenchik, Leon

    2014-01-01

    Quantitative imaging (QI) is increasingly applied in modern radiology practice, assisting in the clinical assessment of many patients and providing a source of biomarkers for a spectrum of diseases. QI is commonly used to inform patient diagnosis or prognosis, determine the choice of therapy, or monitor therapy response. Because most radiologists will likely implement some QI tools to meet the patient care needs of their referring clinicians, it is important for all radiologists to become familiar with the strengths and limitations of QI. The Association of University Radiologists Radiology Research Alliance Quantitative Imaging Task Force has explored the clinical application of QI and summarizes its work in this review. We provide an overview of the clinical use of QI by discussing QI tools that are currently employed in clinical practice, clinical applications of these tools, approaches to reporting of QI, and challenges to implementing QI. It is hoped that these insights will help radiologists recognize the tangible benefits of QI to their patients, their referring clinicians, and their own radiology practice. PMID:25442800

  20. Distinguishing ovarian maturity of farmed white sturgeon (Acipenser transmontanus) by Fourier transform infrared spectroscopy: a potential tool for caviar production management.

    PubMed

    Lu, Xiaonan; Webb, Molly; Talbott, Mariah; Van Eenennaam, Joel; Palumbo, Amanda; Linares-Casenave, Javier; Doroshov, Serge; Struffenegger, Peter; Rasco, Barbara

    2010-04-14

    Fourier transform infrared spectroscopy (FT-IR, 4000-400 cm(-1)) was applied to blood plasma of farmed white sturgeon (N = 40) to differentiate and predict the stages of ovarian maturity. Spectral features of sex steroids (approximately 3000 cm(-1)) and vitellogenin (approximately 1080 cm(-1)) were identified. Clear segregation of maturity stages (previtellogenesis, vitellogenesis, postvitellogenesis, and follicular atresia) was achieved using principal component analysis (PCA). Progression of oocyte development in the late phase of vitellogenesis was also monitored using PCA based on changes in plasma concentrations of sex steroid and lipid content. The observed oocyte polarization index (PI, a measure of nuclear migration) was correlated with changes in plasma sex steroid levels revealed by FT-IR PCA results. A partial least squares (PLS) model predicted PI values within the range 0.12-0.40 (R = 0.95, SEP = 2.18%) from differences in spectral features. These results suggest that FT-IR may be a good tool for assessing ovarian maturity in farmed sturgeon and will reduce the need for the invasive ovarian biopsy required for PI determination.

  1. Geospatial Information System Capability Maturity Models

    DOT National Transportation Integrated Search

    2017-06-01

    To explore how State departments of transportation (DOTs) evaluate geospatial tool applications and services within their own agencies, particularly their experiences using capability maturity models (CMMs) such as the Urban and Regional Information ...

  2. Perception of Therapeutic Qi, a Nonmechanical, Nonpsychological Factor in Acupuncture That Originates from the Therapist.

    PubMed

    Hochstrasser, Raphael J; Endler, P Christian; Klein, Sabine D

    2015-08-01

    So far, most research attempts to explain the mechanism of the action of acupuncture have focused mostly on mechanically-triggered active factors and have produced inconclusive findings. In this study, we investigate whether acupuncture might also involve nonmechanical, nonpsychological active factors originating in the therapist. In 30 individuals, an acupuncture needle was inserted in the acupoint PC6 using a special device without touching the needle. A second device was used to fix the needle rigidly in place, excluding any mechanical transmission of movement from the handle to the needle's tip. Each participant was exposed in random order to a control and a stimulation phase. During the stimulation phase, the free needle's end was held by the therapist to allow the transmission of Qi; during the control phase, it was left untouched. Participants' subjective sensations during the stimulation phase and the control phase were recorded using a questionnaire. Twenty-two of 28 (79%; p = 0.003) test participants believed that they had received stimulation when it had actually been performed, and 26 (93%; p < 0.001) sensed differences between the two experimental phases. Thus, participants were able to sense the transmission of therapeutic Qi in the absence of mechanical or psychological factors. Copyright © 2015. Published by Elsevier B.V.

  3. Maturity of hospital information systems: Most important influencing factors.

    PubMed

    Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

    2017-07-01

    Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

  4. 78 FR 56264 - Big Bear Mining Corp., Four Rivers BioEnergy, Inc., Mainland Resources, Inc., QI Systems Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Big Bear Mining Corp., Four Rivers BioEnergy, Inc., Mainland Resources, Inc., QI Systems Inc., South Texas Oil Co., and Synova Healthcare Group, Inc... concerning the securities of Four Rivers BioEnergy, Inc. because it has not filed any periodic reports since...

  5. Using Quality Improvement Tools to Reduce Chronic Lung Disease.

    PubMed

    Picarillo, Alan Peter; Carlo, Waldemar

    2017-09-01

    Rates of chronic lung disease (CLD) in very low birthweight infants have not decreased at the same pace as other neonatal morbidities over the past 20 years. Multifactorial causes of CLD make this common morbidity difficult to reduce, although there have been several successful quality improvement (QI) projects in individual neonatal intensive care units. QI projects have become a mainstay of neonatal care over the past decade, with an increasing number of publications devoted to this topic. A specific QI project for CLD must be based on best available evidence in the medical literature, expert recommendations, or based on work by previous QI initiatives. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. PREFACE: International Conference on Quantum Optics and Quantum Information (icQoQi) 2013

    NASA Astrophysics Data System (ADS)

    2014-11-01

    Quantum Information can be understood as being naturally derived from a new understanding of information theory when quantum systems become information carriers and quantum effects become non negligible. Experiments and the realization of various interesting phenomena in quantum information within the established field of quantum optics have been reported, which has provided a very convenient framework for the former. Together, quantum optics and quantum information are among the most exciting areas of interdisciplinary research in modern day science which cover a broad spectrum of topics, from the foundations of quantum mechanics and quantum information science to the introduction of new types of quantum technologies and metrology. The International Conference on Quantum Optics and Quantum Information (icQoQi) 2013 was organized by the Faculty of Science, International Islamic University Malaysia with the objective of bringing together leading academic scientists, researchers and scholars in the domain of interest from around the world to share their experiences and research results about all aspects of quantum optics and quantum information. While the event was organized on a somewhat modest scale, it was in fact a rather fruitful meeting for established researchers and students as well, especially for the local scene where the field is relatively new. We would therefore, like to thank the organizing committee, our advisors and all parties for having made this event successful and last but not least would extend our sincerest gratitude to IOP for publishing these selected papers from icQoQi2013 in Journal of Physics: Conference Series.

  7. Development and preliminary evaluation of a practice-based learning and improvement tool for assessing resident competence and guiding curriculum development.

    PubMed

    Lawrence, Renée H; Tomolo, Anne M

    2011-03-01

    Although practice-based learning and improvement (PBLI) is now recognized as a fundamental and necessary skill set, we are still in need of tools that yield specific information about gaps in knowledge and application to help nurture the development of quality improvement (QI) skills in physicians in a proficient and proactive manner. We developed a questionnaire and coding system as an assessment tool to evaluate and provide feedback regarding PBLI self-efficacy, knowledge, and application skills for residency programs and related professional requirements. Five nationally recognized QI experts/leaders reviewed and completed our questionnaire. Through an iterative process, a coding system based on identifying key variables needed for ideal responses was developed to score project proposals. The coding system comprised 14 variables related to the QI projects, and an additional 30 variables related to the core knowledge concepts related to PBLI. A total of 86 residents completed the questionnaire, and 2 raters coded their open-ended responses. Interrater reliability was assessed by percentage agreement and Cohen κ for individual variables and Lin concordance correlation for total scores for knowledge and application. Discriminative validity (t test to compare known groups) and coefficient of reproducibility as an indicator of construct validity (item difficulty hierarchy) were also assessed. Interrater reliability estimates were good (percentage of agreements, above 90%; κ, above 0.4 for most variables; concordances for total scores were R  =  .88 for knowledge and R  =  .98 for application). Despite the residents' limited range of experiences in the group with prior PBLI exposure, our tool met our goal of differentiating between the 2 groups in our preliminary analyses. Correcting for chance agreement identified some variables that are potentially problematic. Although additional evaluation is needed, our tool may prove helpful and provide

  8. Development and Preliminary Evaluation of a Practice-Based Learning and Improvement Tool for Assessing Resident Competence and Guiding Curriculum Development

    PubMed Central

    Lawrence, Renée H; Tomolo, Anne M

    2011-01-01

    Background Although practice-based learning and improvement (PBLI) is now recognized as a fundamental and necessary skill set, we are still in need of tools that yield specific information about gaps in knowledge and application to help nurture the development of quality improvement (QI) skills in physicians in a proficient and proactive manner. We developed a questionnaire and coding system as an assessment tool to evaluate and provide feedback regarding PBLI self-efficacy, knowledge, and application skills for residency programs and related professional requirements. Methods Five nationally recognized QI experts/leaders reviewed and completed our questionnaire. Through an iterative process, a coding system based on identifying key variables needed for ideal responses was developed to score project proposals. The coding system comprised 14 variables related to the QI projects, and an additional 30 variables related to the core knowledge concepts related to PBLI. A total of 86 residents completed the questionnaire, and 2 raters coded their open-ended responses. Interrater reliability was assessed by percentage agreement and Cohen κ for individual variables and Lin concordance correlation for total scores for knowledge and application. Discriminative validity (t test to compare known groups) and coefficient of reproducibility as an indicator of construct validity (item difficulty hierarchy) were also assessed. Results Interrater reliability estimates were good (percentage of agreements, above 90%; κ, above 0.4 for most variables; concordances for total scores were R  =  .88 for knowledge and R  =  .98 for application). Conclusion Despite the residents' limited range of experiences in the group with prior PBLI exposure, our tool met our goal of differentiating between the 2 groups in our preliminary analyses. Correcting for chance agreement identified some variables that are potentially problematic. Although additional evaluation is needed, our tool

  9. How we used a patient visit tracker tool to advance experiential learning in systems-based practice and quality improvement in a medical student clinic.

    PubMed

    Chen, Chen Amy; Park, Ryan J; Hegde, John V; Jun, Tomi; Christman, Mitalee P; Yoo, Sun M; Yamasaki, Alisa; Berhanu, Aaron; Vohra-Khullar, Pamela; Remus, Kristin; Schwartzstein, Richard M; Weinstein, Amy R

    2016-01-01

    Poorly designed healthcare systems increase costs and preventable medical errors. To address these issues, systems-based practice (SBP) education provides future physicians with the tools to identify systemic errors and implement quality improvement (QI) initiatives to enhance the delivery of cost-effective, safe and multi-disciplinary care. Although SBP education is being implemented in residency programs and is mandated by the Accreditation Council for Graduate Medical Education (ACGME) as one of its core competencies, it has largely not been integrated into undergraduate medical education. We propose that Medical Student-Faculty Collaborative Clinics (MSFCCs) may be the ideal environment in which to train medical students in SBPs and QI initiatives, as they allow students to play pivotal roles in project development, administration, and management. Here we describe a process of experiential learning that was developed within a newly established MSFCC, which challenged students to identify inefficiencies, implement interventions, and track the results. After identifying bottlenecks in clinic operations, our students designed a patient visit tracker tool to monitor clinic flow and implemented solutions to decrease patient visit times. Our model allowed students to drive their own active learning in a practical clinical setting, providing early and unique training in crucial QI skills.

  10. CFD - Mature Technology?

    NASA Technical Reports Server (NTRS)

    Kwak, Dochan

    2005-01-01

    Over the past 30 years, numerical methods and simulation tools for fluid dynamic problems have advanced as a new discipline, namely, computational fluid dynamics (CFD). Although a wide spectrum of flow regimes are encountered in many areas of science and engineering, simulation of compressible flow has been the major driver for developing computational algorithms and tools. This is probably due to a large demand for predicting the aerodynamic performance characteristics of flight vehicles, such as commercial, military, and space vehicles. As flow analysis is required to be more accurate and computationally efficient for both commercial and mission-oriented applications (such as those encountered in meteorology, aerospace vehicle development, general fluid engineering and biofluid analysis) CFD tools for engineering become increasingly important for predicting safety, performance and cost. This paper presents the author's perspective on the maturity of CFD, especially from an aerospace engineering point of view.

  11. 2011 John M. Eisenberg Patient Safety and Quality Awards. Mentored implementation: building leaders and achieving results through a collaborative improvement model. Innovation in patient safety and quality at the national level.

    PubMed

    Maynard, Gregory A; Budnitz, Tina L; Nickel, Wendy K; Greenwald, Jeffrey L; Kerr, Kathleen M; Miller, Joseph A; Resnic, JoAnne N; Rogers, Kendall M; Schnipper, Jeffrey L; Stein, Jason M; Whitcomb, Winthrop F; Williams, Mark V

    2012-07-01

    The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource Rooms," as well as the mentor's own experience, provided best-practice definitions, practical implementation tips, measurement strategies, and other tools. E-mail interactions and mentoring were augmented by regularly scheduled teleconferences; group webinars; and, in some instances, a site visit. Performance was tracked in a centralized data tracking center. Preliminary data on all three MI programs show significant improvement in patient outcomes, as well as enhancements of communication and leadership skills of the hospitalists and their QI teams. Although objective data on outcomes and process measures for the MI program's efficacy remain preliminary at this time, the maturing data tracking system, multiple awards, and early results indicate that the MI programs are successful in providing QI training and accelerating improvement efforts.

  12. A comparison of skeletal maturation in patients with tooth agenesis and unaffected controls assessed by the cervical vertebral maturation (CVM) index.

    PubMed

    Casey, Christine; Gill, Daljit S; Jones, Steven P

    2013-12-01

    The aims of this study were to (1) investigate if there is a difference in skeletal maturation between tooth agenesis and control patients and (2) whether skeletal maturation is affected by the severity of tooth agenesis. The cervical vertebral maturation (CVM) index can be used to assess skeletal maturation. A retrospective cross-sectional study. Eastman Dental Hospital, London, UK. A total of 360 cephalograms of patients aged 9-17 years (164 males and 196 females) allocated to four subgroups (mild, moderate and severe tooth agenesis patients, and controls) were assessed retrospectively. There were 90 patients in each of the four subgroups. The skeletal maturation of each subject was assessed both quantitatively and qualitatively using the CVM index. All patients in the study were either currently receiving treatment or had been discharged from the hospital. There was no statistically significant relationship between skeletal maturation and the presence of tooth agenesis. Furthermore, there was no statistically significant relationship between the skeletal maturity of patients and different severities of tooth agenesis. The data obtained from this group of patients and using this measurement tool alone does not supply sufficient reason to reject the null hypothesis. However, it suggests that it is possible that no difference exists between the groups.

  13. Skeletal maturation evaluation using mandibular second molar calcification stages.

    PubMed

    Kumar, Sushil; Singla, Anu; Sharma, Rekha; Virdi, Mandeep S; Anupam, Anant; Mittal, Bindia

    2012-05-01

    To investigate (1) the relationships between the stages of mandibular second molar calcification and skeletal maturity; and (2) whether second molar calcification stages can be used as a reliable diagnostic tool to determine skeletal maturity. Samples were derived from panoramic radiographs and lateral cephalograms of 300 subjects (137 males and 163 females) with ages ranging from 9 to 18 years, and estimates of dental maturity (Demirjian Index [DI]) and skeletal maturity (cervical vertebrae maturation indicators [CVMI]) were made. A highly significant association (C*  =  0.854 for males and 0.866 for females) was found between DI and CVMI. DI stage E corresponded to stage 2 of CVMI (pre-peak of pubertal growth spurt) and DI stages F and G corresponded to stages 3 and 4 of CVMI (peak of pubertal growth spurt). DI stage H was associated with stages 5 and 6 of CVMI (end of pubertal growth spurt). A highly significant association exists between DI and CVMI. Mandibular second molar DI stages are reliable indicators of skeletal maturity.

  14. Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department.

    PubMed

    Chartier, Lucas B; Cheng, Amy H Y; Stang, Antonia S; Vaillancourt, Samuel

    2018-01-01

    Emergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses-Ishikawa diagrams, Pareto charts and process mapping-and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

  15. Space Mission Concept Development Using Concept Maturity Levels

    NASA Technical Reports Server (NTRS)

    Wessen, Randii R.; Borden, Chester; Ziemer, John; Kwok, Johnny

    2013-01-01

    Over the past five years, pre-project formulation experts at the Jet Propulsion Laboratory (JPL) has developed and implemented a method for measuring and communicating the maturity of space mission concepts. Mission concept development teams use this method, and associated tools, prior to concepts entering their Formulation Phases (Phase A/B). The organizing structure is Concept Maturity Level (CML), which is a classification system for characterizing the various levels of a concept's maturity. The key strength of CMLs is the ability to evolve mission concepts guided by an incremental set of assessment needs. The CML definitions have been expanded into a matrix form to identify the breadth and depth of analysis needed for a concept to reach a specific level of maturity. This matrix enables improved assessment and communication by addressing the fundamental dimensions (e.g., science objectives, mission design, technical risk, project organization, cost, export compliance, etc.) associated with mission concept evolution. JPL's collaborative engineering, dedicated concept development, and proposal teams all use these and other CML-appropriate design tools to advance their mission concept designs. This paper focuses on mission concept's early Pre-Phase A represented by CMLs 1- 4. The scope was limited due to the fact that CMLs 5 and 6 are already well defined based on the requirements documented in specific Announcement of Opportunities (AO) and Concept Study Report (CSR) guidelines, respectively, for competitive missions; and by NASA's Procedural Requirements NPR 7120.5E document for Projects in their Formulation Phase.

  16. Computer-Aided Analysis of Patents for Product Technology Maturity Forecasting

    NASA Astrophysics Data System (ADS)

    Liang, Yanhong; Gan, Dequan; Guo, Yingchun; Zhang, Peng

    Product technology maturity foresting is vital for any enterprises to hold the chance for innovation and keep competitive for a long term. The Theory of Invention Problem Solving (TRIZ) is acknowledged both as a systematic methodology for innovation and a powerful tool for technology forecasting. Based on TRIZ, the state -of-the-art on the technology maturity of product and the limits of application are discussed. With the application of text mining and patent analysis technologies, this paper proposes a computer-aided approach for product technology maturity forecasting. It can overcome the shortcomings of the current methods.

  17. An exploratory analysis of the model for understanding success in quality.

    PubMed

    Kaplan, Heather C; Froehle, Craig M; Cassedy, Amy; Provost, Lloyd P; Margolis, Peter A

    2013-01-01

    Experience suggests that differences in context produce variability in the effectiveness of quality improvement (QI) interventions. However, little is known about which contextual factors affect success or how they exert influence. Using the Model for Understanding Success in Quality (MUSIQ), we perform exploratory quantitative tests of the role of context in QI success. We used a cross-sectional design to survey individuals participating in QI projects in three settings: a pediatric hospital, hospitals affiliated with a state QI collaborative, and organizations sponsoring participants in an improvement advisor training program. Individuals participating in QI projects completed a questionnaire assessing contextual factors included in MUSIQ and measures of perceived success. Path analysis was used to test the direct, indirect, and total effects of context variables on QI success as hypothesized in MUSIQ. In the 74 projects studied, most contextual factors in MUSIQ were found to be significantly related to at least one QI project performance outcome. Contextual factors exhibiting significant effects on two measures of perceived QI success included resource availability, QI team leadership, team QI skills, microsystem motivation, microsystem QI culture, and microsystem QI capability. There was weaker evidence for effects of senior leader project sponsors, organizational QI culture, QI team decision-making, and microsystem QI leadership. These initial tests add to the validity of MUSIQ as a tool for identifying which contextual factors affect improvement success and understanding how they exert influence. Using MUSIQ, managers and QI practitioners can begin to identify aspects of context that must be addressed before or during the execution of QI projects and plan strategies to modify context for increased success. Additional work by QI researchers to improve the theory, refine measurement approaches, and validate MUSIQ as a predictive tool in a wider range of QI

  18. A Maturity Model: Does It Provide a Path for Online Course Design?

    ERIC Educational Resources Information Center

    Neuhauser, Charlotte

    2004-01-01

    Maturity models are successfully used by organizations attempting to improve their processes, products, and delivery. As more faculty include online course design and teaching, a maturity model of online course design may serve as a tool in planning and assessing their courses for improvement based on best practices. This article presents such a…

  19. Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement.

    PubMed

    Ovretveit, John; Mittman, Brian; Rubenstein, Lisa; Ganz, David A

    2017-10-09

    Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.

  20. [Analysis of on medication rules for Qi-deficiency and blood-stasis syndrome of chronic heart failure based on data mining technology].

    PubMed

    Wang, Qian; Yao, Geng-Zhen; Pan, Guang-Ming; Huang, Jing-Yi; An, Yi-Pei; Zou, Xu

    2017-01-01

    To analyze the medication features and the regularity of prescriptions of traditional Chinese medicine in treating patients with Qi-deficiency and blood-stasis syndrome of chronic heart failure based on modern literature. In this article, CNKI Chinese academic journal database, Wanfang Chinese academic journal database and VIP Chinese periodical database were all searched from January 2000 to December 2015 for the relevant literature on traditional Chinese medicine treatment for Qi-deficiency and blood-stasis syndrome of chronic heart failure. Then a normalized database was established for further data mining and analysis. Subsequently, the medication features and the regularity of prescriptions were mined by using traditional Chinese medicine inheritance support system(V2.5), association rules, improved mutual information algorithm, complex system entropy clustering and other mining methods. Finally, a total of 171 articles were included, involving 171 prescriptions, 140 kinds of herbs, with a total frequency of 1 772 for the herbs. As a result, 19 core prescriptions and 7 new prescriptions were mined. The most frequently used herbs included Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma), Fuling(Poria), Renshen(Ginseng Radix et Rhizoma), Tinglizi(Semen Lepidii), Baizhu(Atractylodis Macrocephalae Rhizoma), and Guizhi(Cinnamomum Ramulus). The core prescriptions were composed of Huangqi(Astragali Radix), Danshen(Salviae Miltiorrhizae Radix et Rhizoma) and Fuling(Poria), etc. The high frequent herbs and core prescriptions not only highlight the medication features of Qi-invigorating and blood-circulating therapy, but also reflect the regularity of prescriptions of blood-circulating, Yang-warming, and urination-promoting therapy based on syndrome differentiation. Moreover, the mining of the new prescriptions provide new reference and inspiration for clinical treatment of various accompanying symptoms of chronic heart failure. In conclusion

  1. Efficacy of modified LiuJunZi decoction on functional dyspepsia of spleen-deficiency and qi-stagnation syndrome: a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Chinese herbal medicine (CHM) has been used in China and some other countries for the treatment of patients with functional dyspepsia (FD). However, controlled studies supporting the efficacy of such treatments in patients with FD are lacking. In this trial, we aimed to assess the efficacy and safety of modified LiuJunZi decoction in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods We performed a randomized, double-blind, placebo-controlled trial with patients from five centers. Patients with FD of spleen-deficiency and qi-stagnation syndrome (n = 160) were randomly assigned to groups given CHM modified LiuJunZi decoction or placebo in a 2:1 ratio. Herbal or placebo granules were dissolved in 300 ml of boiled water cooled to 70°C. Patients in both groups were administered 150 ml (50°C) twice daily. The trial included a 4-week treatment period and a 4-week follow-up period. The primary outcomes were dyspepsia symptom scores, measured by the total dyspepsia symptom scale and the single dyspepsia symptom scale at weeks 0, 1, 2, 3, 4 and 8. The secondary outcome was the change of radiopaque barium markers emptied from the stomach between week 0 and week 4 of treatment. Results Compared with patients in the placebo group, patients in the CHM group showed significant improvements according to the scores of total dyspepsia symptoms and single dyspepsia symptoms obtained from patients (P < 0.01) and investigators (P < 0.01). They also showed an improvement in the number of radiopaque barium markers emptied from the stomach (P < 0.05). Conclusions CHM modified LiuJunZi decoction appears to offer symptomatic improvement in patients with FD of spleen-deficiency and qi-stagnation syndrome. Trial registration Chinese Clinical Trial Registry (ChiCTR): http://ChiCTR-TRC-10001074 PMID:23453018

  2. Skeletal maturity assessment using mandibular canine calcification stages.

    PubMed

    Džemidžić, Vildana; Tiro, Alisa; Zukanović, Amila; Redžić, Ismeta; Nakaš, Enita

    2016-11-01

    The aims of this study were: to investigate the relationship between mandibular canine calcification stages and skeletal maturity; and to evaluate whether the mandibular canine calcification stages may be used as a reliable diagnostic tool for skeletal maturity assessment. This study included 151 subjects: 81 females and 70 males, with ages ranging from 9 to 16 years (mean age: 12.29±1.86 years). The inclusion criteria for subjects were as follows: age between 9 and 16 years; good general health without any hormonal, nutritional, growth or dental development problems. Subjects who were undergoing or had previously received orthodontic treatment were not included in this study. The calcification stages of the left permanent mandibular canine were assessed according to the method of Demirjian, on panoramic radiographs. Assessment of skeletal maturity was carried out using the cervical vertebral maturation index (CVMI), as proposed by the Hassel-Farman method, on lateral cephalograms. The correlation between the calcification stages of mandibular canine and skeletal maturity was estimated separately for male and female subjects. Correlation coefficients between calcification stages of mandibular canine and skeletal maturity were 0.895 for male and 0.701 for female subjects. A significant correlation was found between the calcification stages of the mandibular canine and skeletal maturity. The calcification stages of the mandibular canine show a satisfactory diagnostic performance only for assessment of pre-pubertal growth phase. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

  3. Can social media be used as a hospital quality improvement tool?

    PubMed

    Lagu, Tara; Goff, Sarah L; Craft, Ben; Calcasola, Stephanie; Benjamin, Evan M; Priya, Aruna; Lindenauer, Peter K

    2016-01-01

    Many hospitals wish to improve their patients' experience of care. To learn whether social media could be used as a tool to engage patients and to identify opportunities for hospital quality improvement (QI), we solicited patients' narrative feedback on the Baystate Medical Center Facebook page during a 3-week period in 2014. Two investigators used directed qualitative content analysis to code comments and descriptive statistics to assess the frequency of selected codes and themes. We identified common themes, including: (1) comments about staff (17/37 respondents, 45.9%); (2) comments about specific departments (22/37, 59.5%); (3) comments on technical aspects of care, including perceived errors and inattention to pain control (9/37, 24.3%); and (4) comments describing the hospital physical plant, parking, and amenities (9/37, 24.3%). A small number (n = 3) of patients repeatedly responded, accounting for 30% (45/148) of narratives. Although patient feedback on social media could help to drive hospital QI efforts, any potential benefits must be weighed against the reputational risks, the lack of representativeness among respondents, and the volume of responses needed to identify areas of improvement. © 2015 Society of Hospital Medicine.

  4. [Thunder-fire Moxibustion for Qi Deficiency-induced Fatigue in Breast Cancer Patients Under-going Chemotherapy].

    PubMed

    Lu, Lu; Li, Wei-Han; Guo, Xiao-Chuan; Fu, Wen-Bin

    2018-02-25

    To observe the clinical effect of thunder-fire moxibustion in the treatment of qi deficiency-induced fatigue in breast cancer patients undergoing chemotherapy. Sixty breast cancer patients undergoing chemotherapy were randomly divided into thunder-fire moxibustion (Moxi) and conventional nursing (nursing) groups ( n =30 in each group). Patients in the Moxi group were treated with thunder-fire moxibustion applied to the back part of body from Pishu (BL 20) to Qihaishu (BL 24) on the bilateral sides and to the abdominal part from Zhongwan (CV 12) to Guanyuan (CV 4) for 30 min, once a day for 14 days. Patients in the nursing group were treated with health education and conventional nursing care. The simple fatigue scale, traditional Chinese medicine (TCM) syndrome score, clinical curative effect were observed before and after the treatment, and white blood cell (WBC) count was observed 5 days ofter chemotherapy and after the treatment respectively. After the treatment, the simple fatigue scales and TCM syndrome scores were significantly decreased and WBC counts were significantly increased in both groups relevant to their individual pre-treatment ( P <0.01). The therapeutic effect of the Moxi group was appa-rently superior to that of the nursing group in lowering the simple fatigue scale and TCM syndrome score and in up-regulating WBC count ( P <0.01, P <0.05). The total effective rate of the Moxi group was significantly higher than that of the nursing group (83.3%[25/30]vs 36.7% [11/30], P <0.01). Thunder-fire moxibustion can effectively relieve the degree of fatigue and the symptoms of qi deficiency in breast cancer patients undergoing chemotherapy.

  5. Correlation between dental maturity and cervical vertebral maturity.

    PubMed

    Chen, Jianwei; Hu, Haikun; Guo, Jing; Liu, Zeping; Liu, Renkai; Li, Fan; Zou, Shujuan

    2010-12-01

    The aim of this study was to investigate the association between dental and skeletal maturity. Digital panoramic radiographs and lateral skull cephalograms of 302 patients (134 boys and 168 girls, ranging from 8 to 16 years of age) were examined. Dental maturity was assessed by calcification stages of the mandibular canines, first and second premolars, and second molars, whereas skeletal maturity was estimated by the cervical vertebral maturation (CVM) stages. The Spearman rank-order correlation coefficient was used to measure the association between CVM stage and dental calcification stage of individual teeth. The mean chronologic age of girls was significantly lower than that of boys in each CVM stage. The Spearman rank-order correlation coefficients between dental maturity and cervical vertebral maturity ranged from 0.391 to 0.582 for girls and from 0.464 to 0.496 for boys (P < 0.05). In girls, the mandibular second molar had the highest and the canine the lowest correlation. In boys, the canine had the highest and the first premolar the lowest correlation. Tooth calcification stage was significantly correlated with cervical vertebral maturation stage. The development of the mandibular second molar in females and that of the mandibular canine in males had the strongest correlations with cervical vertebral maturity. Therefore, it is practical to consider the relationship between dental and skeletal maturity when planning orthodontic treatment. Copyright © 2010 Mosby, Inc. All rights reserved.

  6. [Metabonomic phenotype of "formula corresponding to pattern types" based on "qi and yin deficiency pattern" of myocardial ischemia rat model].

    PubMed

    Yan, Bei; A, Ji-Ye; Hao, Hai-Ping; Wang, Guang-Ji; Liu, Lin-Sheng; Zha, Wei-Bin; Zhang, Ying; Gu, Sheng-Hua

    2011-08-01

    In order to explore the scientific connotation of "Fangzhengduiying (formula corresponding to pattern types)", "Qiyinliangxuzheng (Qi and Yin deficiency pattern)" of myocardial ischemia rat model and GC-TOF/MS based metabonomic method were used for comparing the effects of Sheng-mai injection, Salvia injection and propranolol in the present study. After data processing and pattern recognition, Sheng-mai injection showed better efficacy than the other two drugs in accordance with not only visual observation from PLS-DA scores plots but also the number of abnormal endogenous compounds restored to the normal level. Further studies showed that Sheng-mai injection could normalize the level of plasma endothelin-1, the index related to cardiovascular diseases and sleep disorders, which verified the results of metabonomics. Finally, the regulated metabolites and related metabolic pathways were analyzed, and it was supposed that the effects of Sheng-mai injection involved in the alternation of energy metabolism, lipid metabolism, amino acids metabolism, and so on. These findings provided scientific evidence to Shengmai "Fang" used for "Qi and Yin deficiency pattern" correspondingly, indicating that metabonomics has great potential in traditional Chinese medical research, which provides a novel approach and way to modernization of traditional Chinese medicine.

  7. Climbing the ladder: capability maturity model integration level 3

    NASA Astrophysics Data System (ADS)

    Day, Bryce; Lutteroth, Christof

    2011-02-01

    This article details the attempt to form a complete workflow model for an information and communication technologies (ICT) company in order to achieve a capability maturity model integration (CMMI) maturity rating of 3. During this project, business processes across the company's core and auxiliary sectors were documented and extended using modern enterprise modelling tools and a The Open Group Architectural Framework (TOGAF) methodology. Different challenges were encountered with regard to process customisation and tool support for enterprise modelling. In particular, there were problems with the reuse of process models, the integration of different project management methodologies and the integration of the Rational Unified Process development process framework that had to be solved. We report on these challenges and the perceived effects of the project on the company. Finally, we point out research directions that could help to improve the situation in the future.

  8. Evaluating the Maturity of Cybersecurity Programs for Building Control Systems

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

    Glantz, Clifford S.; Somasundaram, Sriram; Mylrea, Michael E.

    The cyber-physical security threat to buildings is complex, non-linear, and rapidly evolving as operational and information technologies converge and connect buildings to cyberspace. Cyberattacks on buildings can exploit smart building controls and breach corporate networks, causing financial and reputational damage. This may result in the loss of sensitive building information or the disruption of, or damage to, the systems necessary for the safe and efficient operation of buildings. For the buildings and facility infrastructure, there is a need for a robust national cybersecurity strategy for buildings, guidance on the selection and implementation of appropriate cybersecurity controls for buildings, an approachmore » to evaluate the maturity and adequacy of the cybersecurity programs. To provide an approach for evaluating the maturity of the cybersecurity programs for building control systems, the US Department of Energy’s widely used Cybersecurity Capability and Maturity Model (C2M2) has been adapted into a building control systems version. The revised model, the Buildings-C2M2 (B-C2M2) provides maturity level indicators for cybersecurity programmatic domains. A “B-C2M2 Lite” version allows facility managers and building control system engineers, or information technology personnel to perform rapid self-assessments of their cybersecurity program. Both tools have been pilot tested on several facilities. This paper outlines the concept of a maturity model, describes the B-C2M2 tools, presents results and observations from the pilot assessments, and lays out plans for future work.« less

  9. The changes in quality ingredients of Qi chrysanthemum flowers treated with elevated UV-B radiation at different growth stages.

    PubMed

    Yao, Xiaoqin; Chu, Jianzhou; He, Xueli; Ma, Chunhui; Han, Chao; Shen, Haiyu

    2015-05-01

    The paper mainly reported the changes in quality ingredients of Qi chrysanthemum flowers treated with elevated UV-B radiation at different growth stages. The experiment included two levels of UV-B radiation (ambient UV-B, a 10% increase in ambient UV-B). Elevated UV-B radiation was carried out for 10-days during seedling, vigorous growth, bud and flower stages of Qi chrysanthemum, respectively. Elevated UV-B treatments applied during four development stages did not significantly affect flower yield, the rate of superoxide radical production and malondialdehyde concentration in flowers, while increased free amino acid concentration. The amino acid concentration induced by elevated UV-B radiation applied during bud stage was higher than that during the other stages. Elevated UV-B radiation applied during vigorous growth (except for flavone), bud and flower stages of chrysanthemum significantly increased hydrogen peroxide concentration, phenylalanine ammonia lyase enzyme activity, vitamin C, chlorogenic acid and flavone concentrations in flowers. These results suggested that active and nutritional ingredients in flowers of chrysanthemum could be increased by elevated UV-B radiation applied during the later growth stages of chrysanthemum. The paper supplied a simple and environmental-friendly method to improve quality of medicinal plants. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Use of Standardized Assessment Tools to Improve the Effectiveness of Palliative Care Rounds: A Quality Improvement Initiative.

    PubMed

    Spaner, Donna; Caraiscos, Valerie B; Muystra, Christina; Furman, Margaret Lynn; Zaltz-Dubin, Jodi; Wharton, Marilyn; Whitehead, Katherine

    Optimal care for patients in the palliative care setting requires effective clinical teamwork. Communication may be challenging for health-care workers from different disciplines. Daily rounds are one way for clinical teams to share information and develop care plans for patients. The objective of this initiative was to improve the structure and process of daily palliative care rounds by incorporating the use of standardized tools and improved documentation into the meeting. We chose a quality improvement (QI) approach to address this initiative. Our aims were to increase the use of assessment tools when discussing patient care in rounds and to improve the documentation and accessibility of important information in the health record, including goals of care. This QI initiative used a preintervention and postintervention comparison of the outcome measures of interest. The initiative was tested in a palliative care unit (PCU) over a 22-month period from April 2014 to January 2016. Participants were clinical staff in the PCU. Data collected after the completion of several plan-do-study-act cycles showed increased use and incorporation of the Edmonton Symptom Assessment System and Palliative Performance Scale into patient care discussions as well as improvement in inclusion of goals of care into the patient plan of care. Our findings demonstrate that the effectiveness of daily palliative care rounds can be improved by incorporating the use of standard assessment tools and changes into the meeting structure to better focus and direct patient care discussions.

  11. Prospects and Problems of Transferring Quality-Improvement Methods from Health Care to Social Services: Two Case Studies

    PubMed Central

    Neubeck, Truls; Elg, Mattias; Schneider, Thomas; Andersson-Gäre, Boel

    2014-01-01

    Introduction: This study examines the use of quality-improvement (QI) methods in social services. Particularly the key aspects—generalizable knowledge, interprofessional teamwork, and measurements—are studied in projects from the QI program Forum for Values in Sweden. Methods: This is a mixed-method case study. Two projects using standard QI methods and tools as used in health care were chosen as critical cases to highlight some problems and prospects with the use of QI in social services. The cases were analyzed through documented results and qualitative interviews with participants one year after the QI projects ended. Results: The social service QI projects led to measurable improvements when they used standard methods and tools for QI in health care. One year after the projects, the improvements were either not continuously measured or not reported in any infrastructure for measurements. The study reveals that social services differ from health care regarding the availability and use of evidence, the role of professional expertise, and infrastructure for measurements. Conclusions: We argue that QI methods as used in health care are applicable in social services and can lead to measurable improvements. The study gives valuable insights for QI, not only in social services but also in health care, on how to assess and sustain improvements when infrastructures for measurements are lacking. In addition, when one forms QI teams, the focus should be on functions instead of professions, and QI methods can be used to support implementation of evidence-based practice. PMID:24867549

  12. Quality Improvement Strategies in Accountable Care Organization Hospitals.

    PubMed

    Mora, Arthur M; Walker, Daniel

    2016-01-01

    Accountable Care Organizations (ACOs) are hoped to lower costs and improve health care quality. However, hospitals remain unsure how to bring about the quality improvement (QI) required to increase financial viability. This success may hinge on the use of sophisticated measurement tracking and the use of multiple QI tools. This study aims to assess the current approaches that ACO hospitals are using to improve quality and to compare their strategies with non-ACO hospitals. The 2013 American Hospital Association's Annual Survey and the Survey of Care Systems and Payment data were merged to identify ACO and non-ACO hospitals. ACO and non-ACO hospital rates of reported use of multiple QI tools and the ability to detect and track readmissions across organizational boundaries were compared. ACO hospitals were significantly less likely to use only 1 QI tool (43.5% vs 65.2%; P < .001) and more likely to use 2 (36.4% vs 28.1%; P < .05), 3 (12.1% vs 6.5%; P < .001), or 4 (8.0% vs 0.2%; P < .001) QI tools. ACO hospitals were significantly more likely to have the capability to detect readmissions (34.1% vs 22.8%; P < .001) and track readmissions (90.5% vs 85.7%; P < .05). Results suggest that ACO hospitals are incorporating more sophisticated measurements and combinations of QI tools than non-ACO hospitals. It remains to be seen whether this leads to accelerated changes across the quality domains in ACO hospitals.

  13. Teaching Quality Improvement in Graduate Medical Education: An Experiential and Team-Based Approach to the Acquisition of Quality Improvement Competencies.

    PubMed

    Hall Barber, Karen; Schultz, Karen; Scott, Abigail; Pollock, Emily; Kotecha, Jyoti; Martin, Danyal

    2015-10-01

    An emerging priority in medical education is the need to facilitate learners' acquisition of quality improvement (QI) competencies. Accreditation bodies in both Canada and the United States have included QI and patient safety in their core competencies. In 2010, the Department of Family Medicine at Queen's University designed a graduate medical education curriculum to engage residents in a clinical QI program that would meet accreditation requirements. Monthly didactic sessions were combined with an experiential, team-based QI project that aligned with existing clinic priorities. The curriculum spans the first year of residency and is divided into three stages: (1) Engaging, (2) Understanding, and (3) Improving and translating. In Stage 1, teams of residents select a clinical QI topic, engage stakeholders, and collect baseline data related to their topic. In Stage 2, they focus on understanding their problem, interpreting their results, and applying QI tools. In Stage 3, they develop change ideas, translate their knowledge, and prepare to hand over their project. This QI curriculum aided residents in effectively acquiring QI competencies and allowed them to experience real-world challenges, such as securing project buy-in, negotiating with peers, and developing solutions to problems. Unlike in many QI programs, residents learned how to improve quality rather than about QI; thus, they formed the necessary foundation to carry out QI work in the future. The curriculum will be evaluated using a knowledge assessment and satisfaction tool and postproject resident interviews. Facilitators will focus more on improving faculty develop ment in QI.

  14. The DEDUCE Guided Query Tool: Providing Simplified Access to Clinical Data for Research and Quality Improvement

    PubMed Central

    Horvath, Monica M.; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

    2011-01-01

    In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction—the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a guided query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. PMID:21130181

  15. The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

    PubMed

    Horvath, Monica M; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

    2011-04-01

    In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a Guided Query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

    PubMed

    Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

    2015-08-01

    To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct

  17. Validation of a method for assessing resident physicians' quality improvement proposals.

    PubMed

    Leenstra, James L; Beckman, Thomas J; Reed, Darcy A; Mundell, William C; Thomas, Kris G; Krajicek, Bryan J; Cha, Stephen S; Kolars, Joseph C; McDonald, Furman S

    2007-09-01

    Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking. We developed an instrument for assessing resident QI proposals--the Quality Improvement Proposal Assessment Tool (QIPAT-7)-and determined its validity and reliability. QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised. Seven raters used the instrument to assess 45 resident QI proposals. Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach's alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively. QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach's alpha = 0.87) were high. This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.

  18. Maturity Group Classification and Maturity Locus Genotyping of Early-Maturing Soybean Varieties from High-Latitude Cold Regions

    PubMed Central

    Lu, Wencheng; Hou, Wensheng; Sun, Shi; Yan, Hongrui; Han, Tianfu

    2014-01-01

    Background With the migration of human beings, advances of agricultural sciences, evolution of planting patterns and global warming, soybeans have expanded to both tropical and high-latitude cold regions (HCRs). Unlike other regions, HCRs have much more significant and diverse photoperiods and temperature conditions over seasons or across latitudes, and HCR soybeans released there show rich diversity in maturity traits. However, HCR soybeans have not been as well classified into maturity groups (MGs) as other places. Therefore, it is necessary to identify MGs in HCRs and to genotype the maturity loci. Methods Local varieties were collected from the northern part of Northeast China and the far-eastern region of Russia. Maturity group reference (MGR) soybeans of MGs MG000, MG00, and MG0 were used as references during field experiments. Both local varieties and MGR soybeans were planted for two years (2010-2011) in Heihe (N 50°15′, E 127°27′, H 168.5 m), China. The days to VE (emergence), R1 (beginning bloom) and R7 (beginning maturity) were recorded and statistically analyzed. Furthermore, some varieties were further genotyped at four molecularly-identified maturity loci E1, E2, E3 and E4. Results The HCR varieties were classified into MG0 or even more early-maturing. In Heihe, some varieties matured much earlier than MG000, which is the most early-maturing known MG, and clustered into a separate group. We designated the group as MG0000, following the convention of MGs. HCR soybeans had relatively stable days to beginning bloom from emergence. The HCR varieties diversified into genotypes of E1, E2, E3 and E4. These loci had different effects on maturity. Conclusion HCRs diversify early-maturing MGs of soybean. MG0000, a new MG that matures much earlier than known MGs, was developed. HCR soybean breeding should focus more on shortening post-flowering reproductive growth. E1, E2, E3, and E4 function differentially. PMID:24740097

  19. Maturity group classification and maturity locus genotyping of early-maturing soybean varieties from high-latitude cold regions.

    PubMed

    Jia, Hongchang; Jiang, Bingjun; Wu, Cunxiang; Lu, Wencheng; Hou, Wensheng; Sun, Shi; Yan, Hongrui; Han, Tianfu

    2014-01-01

    With the migration of human beings, advances of agricultural sciences, evolution of planting patterns and global warming, soybeans have expanded to both tropical and high-latitude cold regions (HCRs). Unlike other regions, HCRs have much more significant and diverse photoperiods and temperature conditions over seasons or across latitudes, and HCR soybeans released there show rich diversity in maturity traits. However, HCR soybeans have not been as well classified into maturity groups (MGs) as other places. Therefore, it is necessary to identify MGs in HCRs and to genotype the maturity loci. Local varieties were collected from the northern part of Northeast China and the far-eastern region of Russia. Maturity group reference (MGR) soybeans of MGs MG000, MG00, and MG0 were used as references during field experiments. Both local varieties and MGR soybeans were planted for two years (2010-2011) in Heihe (N 50°15', E 127°27', H 168.5 m), China. The days to VE (emergence), R1 (beginning bloom) and R7 (beginning maturity) were recorded and statistically analyzed. Furthermore, some varieties were further genotyped at four molecularly-identified maturity loci E1, E2, E3 and E4. The HCR varieties were classified into MG0 or even more early-maturing. In Heihe, some varieties matured much earlier than MG000, which is the most early-maturing known MG, and clustered into a separate group. We designated the group as MG0000, following the convention of MGs. HCR soybeans had relatively stable days to beginning bloom from emergence. The HCR varieties diversified into genotypes of E1, E2, E3 and E4. These loci had different effects on maturity. HCRs diversify early-maturing MGs of soybean. MG0000, a new MG that matures much earlier than known MGs, was developed. HCR soybean breeding should focus more on shortening post-flowering reproductive growth. E1, E2, E3, and E4 function differentially.

  20. Water relations in culture media influence maturation of avocado somatic embryos.

    PubMed

    Márquez-Martín, Belén; Sesmero, Rafael; Quesada, Miguel A; Pliego-Alfaro, Fernando; Sánchez-Romero, Carolina

    2011-11-15

    Application of transformation and other biotechnological tools in avocado (Persea americana Mill.) is hampered by difficulties in obtaining mature somatic embryos capable of germination at an acceptable rate. In this work, we evaluated the effect of different compounds affecting medium water relations on maturation of avocado somatic embryos. Culture media were characterized with respect to gel strength, water potential and osmotic potential. Improved production of mature somatic embryos was achieved with gelling agent concentrations higher than those considered standard. The osmotic agents such as sorbitol and PEG did not have positive effects on embryo maturation. The number of w-o mature somatic embryos per culture was positively correlated with medium gel strength. Gel strength was significantly affected by gelling agent type as well as by gelling agent and PEG concentration. Medium water potential was influenced by sorbitol concentration; incorporation of PEG to a culture medium did not affect medium water potential. The highest maturation results were achieved on a medium gelled with 10 gl(-1) agar. Moreover, these somatic embryos had improved germination rates. These results corroborate the role of water restriction as a key factor controlling maturation of somatic embryos. Copyright © 2011 Elsevier GmbH. All rights reserved.

  1. [Maturity Levels of Quality and Risk Management at the University Hospital Schleswig-Holstein].

    PubMed

    Jussli-Melchers, Jill; Hilbert, Carsten; Jahnke, Iris; Wehkamp, Kai; Rogge, Annette; Freitag-Wolf, Sandra; Kahla-Witzsch, Heike A; Scholz, Jens; Petzina, Rainer

    2018-05-16

    Quality and risk management in hospitals are not only required by law but also for an optimal patient-centered and process-optimized patient care. To evaluate the maturity levels of quality and risk management at the University Hospital Schleswig-Holstein (UKSH), a structured analytical tool was developed for easy and efficient application. Four criteria concerning quality management - quality assurance (QS), critical incident reporting system (CIRS), complaint management (BM) and process management (PM) - were evaluated with a structured questionnaire. Self-assessment and external assessment were performed to classify the maturity levels at the UKSH (location Kiel and Lübeck). Every quality item was graded into four categories from "A" (fully implemented) to "D" (not implemented at all). First of all, an external assessment was initiated by the head of the department of quality and risk management. Thereafter, a self-assessment was performed by 46 clinical units of the UKSH. Discrepancies were resolved in a collegial dialogue. Based on these data, overall maturity levels were obtained for every clinical unit. The overall maturity level "A" was reached by three out of 46 (6.5%) clinical units. No unit was graded with maturity level "D". 50% out of all units reached level "B" and 43.5% level "C". The distribution of the four different quality criteria revealed a good implementation of complaint management (maturity levels "A" and "B" in 78.3%), whereas the levels for CIRS were "C" and "D" in 73.9%. Quality assurance and process management showed quite similar distributions for the levels of maturity "B" and "C" (87% QS; 91% PM). The structured analytical tool revealed maturity levels of 46 clinical units of the UKSH and defined the maturity levels of four relevant quality criteria (QS, CIRS, BM, PM). As a consequence, extensive procedures were implemented to raise the standard of quality and risk management. In future, maturity levels will be reevaluated every two

  2. Using Lean Quality Improvement Tools to Increase Delivery of Evidence-Based Tobacco Use Treatment in Hospitalized Neurosurgical Patients.

    PubMed

    Sisler, Laurel; Omofoye, Oluwaseun; Paci, Karina; Hadar, Eldad; Goldstein, Adam O; Ripley-Moffitt, Carol

    2017-12-01

    Health care providers routinely undertreat tobacco dependence, indicating a need for innovative ways to increase delivery of evidence-based care. Lean, a set of quality improvement (QI) tools used increasingly in health care, can help streamline processes, create buy-in for use of evidence-based practices, and lead to the identification of solutions on the basis of a problem's root causes. To date, no published research has examined the use of Lean tools in tobacco dependence. A 12-month QI project using Lean tools was conducted to increase delivery of evidence-based tobacco use treatment (TUT) to hospitalized neurosurgical patients. The study team developed a nicotine replacement therapy (NRT) and counseling protocol for neurosurgery inpatients who indicated current tobacco use and used Lean tools to increase protocol adherence. Rates of NRT prescription, referrals to counseling, and follow-up phone calls were compared pre- and postintervention. Secondary measures included patient satisfaction with intervention, quit rates, and reduction rates at 4 weeks postdischarge. Referrals to counseling doubled from 31.7% at baseline to 62.0% after implementation of the intervention, and rates of nicotine replacement therapy (NRT) prescriptions during hospitalization and at discharge increased from 15.3% to 28.5% and 9.0% to 19.3%, respectively. Follow-up phone call rates also dramatically increased. The majority of satisfaction survey respondents indicated that counseling had a positive or neutral impact on stress level and overall satisfaction. Lean tools can dramatically increase use of evidence-based TUT in hospitalized patients. This project is easily replicable by professionals seeking to improve delivery of tobacco treatment. These findings may be particularly helpful to inpatient surgical departments that have traditionally been reticent to prescribe NRT. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  3. Early Experiences After Adopting a Quality Improvement Portfolio Into the Academic Advancement Process.

    PubMed

    Sehgal, Niraj L; Neeman, Naama; King, Talmadge E

    2017-01-01

    Academic medical centers (AMCs) and their academic departments are increasingly assuming leadership in the education, science, and implementation of quality improvement (QI) and patient safety efforts. Fostering, recognizing, and promoting faculty leading these efforts is challenging using traditional academic metrics for advancement. The authors adapted a nationally developed QI portfolio, adopted it into their own department's advancement process in 2012, and tracked its utilization and impact over the first two years of implementation. Sixty-seven QI portfolios were submitted with 100% of faculty receiving their requested academic advancement. Women represented 60% of the submitted portfolios, while the Divisions of General Internal Medicine and Hospital Medicine accounted for 60% of the submissions. The remaining 40% were from faculty in 10 different specialty divisions. Faculty attitudes about the QI portfolio were overwhelmingly positive, with 83% agreeing that it "was an effective tool for helping to better recognize faculty contributions in QI work" and 85% agreeing that it "was an effective tool for elevating the importance of QI work in our department." The QI portfolio was one part of a broader effort to create opportunities to recognize and support faculty involved in improvement work. Further adapting the tool to ensure that it complements-rather than duplicates-other elements of the advancement process is critical for continued utilization by faculty. This will also drive desired dissemination to other departments locally and other AMCs nationally who are similarly committed to cultivating faculty career paths in systems improvement.

  4. A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module.

    PubMed

    Boggan, Joel C; Cheely, George; Shah, Bimal R; Heffelfinger, Randy; Springall, Deanna; Thomas, Samantha M; Zaas, Aimee; Bae, Jonathan

    2014-09-01

    Systematically engaging residents in large programs in quality improvement (QI) is challenging. To coordinate a shared QI project in a large residency program using an online tool. A web-based QI tool guided residents through a 2-phase evaluation of performance of foot examinations in patients with diabetes. In phase 1, residents completed reviews of health records with online data entry. Residents were then presented with personal performance data relative to peers and were prompted to develop improvement plans. In phase 2, residents again reviewed personal performance. Rates of performance were compared at the program and clinic levels for each phase, with data presented for residents. Acceptability was measured by the number of residents completing each phase. Feasibility was measured by estimated faculty, programmer, and administrator time and costs. Seventy-nine of 86 eligible residents (92%) completed improvement plans and reviewed 1471 patients in phase 1, whereas 68 residents (79%) reviewed 1054 patient charts in phase 2. Rates of performance of examination increased significantly between phases (from 52% to 73% for complete examination, P < .001). Development of the tool required 130 hours of programmer time. Project analysis and management required 6 hours of administrator and faculty time monthly. An online tool developed and implemented for program-wide QI initiatives successfully engaged residents to participate in QI activities. Residents using this tool demonstrated improvement in a selected quality target. This tool could be adapted by other graduate medical education programs or for faculty development.

  5. Managing expectations when publishing tools and methods for computational proteomics.

    PubMed

    Martens, Lennart; Kohlbacher, Oliver; Weintraub, Susan T

    2015-05-01

    Computational tools are pivotal in proteomics because they are crucial for identification, quantification, and statistical assessment of data. The gateway to finding the best choice of a tool or approach for a particular problem is frequently journal articles, yet there is often an overwhelming variety of options that makes it hard to decide on the best solution. This is particularly difficult for nonexperts in bioinformatics. The maturity, reliability, and performance of tools can vary widely because publications may appear at different stages of development. A novel idea might merit early publication despite only offering proof-of-principle, while it may take years before a tool can be considered mature, and by that time it might be difficult for a new publication to be accepted because of a perceived lack of novelty. After discussions with members of the computational mass spectrometry community, we describe here proposed recommendations for organization of informatics manuscripts as a way to set the expectations of readers (and reviewers) through three different manuscript types that are based on existing journal designations. Brief Communications are short reports describing novel computational approaches where the implementation is not necessarily production-ready. Research Articles present both a novel idea and mature implementation that has been suitably benchmarked. Application Notes focus on a mature and tested tool or concept and need not be novel but should offer advancement from improved quality, ease of use, and/or implementation. Organizing computational proteomics contributions into these three manuscript types will facilitate the review process and will also enable readers to identify the maturity and applicability of the tool for their own workflows.

  6. Trauma quality improvement in low and middle income countries of the Asia-Pacific region: a mixed methods study.

    PubMed

    Stelfox, Henry Thomas; Joshipura, Manjul; Chadbunchachai, Witaya; Ellawala, Ranjith N; O'Reilly, Gerard; Nguyen, Thai Son; Gruen, Russell L

    2012-08-01

    Quality Improvement (QI) programs have been shown to be a valuable tool to strengthen care of severely injured patients, but little is known about them in low and middle income countries (LMIC). We sought to explore opportunities to improve trauma QI activities in LMIC, focusing on the Asia-Pacific region. We performed a mixed methods research study using both inductive thematic analysis of a meeting convened at the Royal Australasian College of Surgeons, Melbourne, Australia, November 21-22, 2010 and a pre-meeting survey to explore experiences with trauma QI activities in LMIC. Purposive sampling was employed to invite participants with demonstrated leadership in trauma care to provide diverse representation of organizations and countries within Asia-Pacific. A total of 22 experts participated in the meeting and reported that trauma QI activities varied between countries and organizations: morbidity and mortality conferences (56 %), monitoring complications (31 %), preventable death studies (25 %), audit filters (19 %), and statistical methods for analyzing morbidity and mortality (6 %). Participants identified QI gaps to include paucity of reliable/valid injury data, lack of integrated trauma QI activities, absence of standards of care, lack of training in QI methods, and varying cultures of quality and safety. The group highlighted barriers to QI: limited engagement of leaders, organizational diversity, limited resources, heavy clinical workload, and medico-legal concerns. Participants proposed establishing the Asia-Pacific Trauma Quality Improvement Network (APTQIN) as a tool to facilitate training and dissemination of QI methods, injury data management, development of pilot QI projects, and advocacy for quality trauma care. Our study provides the first description of trauma QI practices, gaps in existing practices, and barriers to QI in LMIC of the Asia-Pacific region. In this study we identified opportunities for addressing these challenges, and that work

  7. [Experimental study on the treatment of serious soft tissue injuries with strengthening the spleen and replenishing qi].

    PubMed

    Chen, Xun-wen; Zhu, Yong-zhan; Chen, Zhi-wei; Wu, Zheng-jie; He, Li-lei

    2008-09-01

    To study the effects of Chinese drugs based on strengthening the spleen and replenishing qi treatment rule on neoformative capillaries and fibroblast during the soft tissue repair after serious trauma in rats, so as to explore the biological basis of the TCM theory "the spleen dominate extremities and muscles" applied to the treatment of soft tissue injuries. The model rats were established by bleeding from femoral artery and lancing method, and the rats were randomly divided into the control group, strengthening the spleen group and activating blood and resolving stasis group. The samples were got from the tissue of the wounded area at the 5th, 10th and 15th days after oral administration of the traditional Chinese medicine. After fixation and section, the tissues were stained by CD31 and PCNA staining. The amount of the capillaries and fibroblasts in the tissue of the wounded area were observed through multi-purpose microscope (ZEISS Axioskop2). Quantitative analysis was carried out on Image-ProPlus image analyzer. The amount of the capillaries and fibroblasts in the wounded tissue in the strengthening the spleen group were larger than that in the control group at the 5th, 10th and 15th day. And the proliferation speed of capillaries and fibroblasts was faster than those in the control group or the activating blood and resolving stasis group. The Chinese drugs according to strengthening the spleen and replenishing qi treatment rule were effective to promote growth of the granulation tissue and facilitate healing of the wounded area. And it has better effect than the treatment of promoting blood circulation and removing stasis.

  8. Utilizing Quality Improvement Methods to Improve Patient Care Outcomes in a Pediatric Residency Program

    PubMed Central

    Akins, Ralitsa B.; Handal, Gilbert A.

    2009-01-01

    Objective Although there is an expectation for outcomes-oriented training in residency programs, the reality is that few guidelines and examples exist as to how to provide this type of education and training. We aimed to improve patient care outcomes in our pediatric residency program by using quality improvement (QI) methods, tools, and approaches. Methods A series of QI projects were implemented over a 3-year period in a pediatric residency program to improve patient care outcomes and teach the residents how to use QI methods, tools, and approaches. Residents experienced practice-based learning and systems-based assessment through group projects and review of their own patient outcomes. Resident QI experiences were reviewed quarterly by the program director and were a mandatory part of resident training portfolios. Results Using QI methodology, we were able to improve management of children with obesity, to achieve high compliance with the national patient safety goals, improve the pediatric hotline service, and implement better patient flow in resident continuity clinic. Conclusion Based on our experiences, we conclude that to successfully implement QI projects in residency programs, QI techniques must be formally taught, the opportunities for resident participation must be multiple and diverse, and QI outcomes should be incorporated in resident training and assessment so that they experience the benefits of the QI intervention. The lessons learned from our experiences, as well as the projects we describe, can be easily deployed and implemented in other residency programs. PMID:21975995

  9. On the qi deficiency in traditional Chinese medicine.

    PubMed

    Chiang, Hui-Chu; Chang, Hen-Hong; Huang, Po-Yu; Hsu, Mutsu

    2014-09-01

    Qi deficiency (QD), one of the most common disorders in Traditional Chinese medicine (TCM), is relevant to many disorders in obstetrics and gynecology. This study aimed to identify the common processes and criteria for diagnosing QD among contemporary proficient TCM practitioners. Steps of decision tree analysis and modified Delphi method were merged together into four-round postal questionnaires to collect qualitative and quantitative data. Open-ended questions and content analysis were used to explore the proficient TCM practitioners' cognitive activities used for diagnosis. The statements obtained from the qualitative responses were used to develop the items for subsequent questionnaires. Based on the TCM practitioners' responses, the diagnostic processes and criteria for making diagnosis were generated. Twenty-eight out of the 30 participants completed all four questionnaires from June 2007 to January 2010. The 11 diagnostic procedures identified in the returned first round of questionnaires were used as the alternatives to select and rank for all the steps to diagnose QD. After three more rounds of postal surveys, an algorithm with a five-stage diagnostic process as well as sets of decision criteria were identified. Although the priorities of procedures and descriptions of reasoning were varied, the content revealed the major themes in the model. The criteria to differentiate signs and symptoms (S/S) included five principles for correlating S/S with QD, and 17 S/S should be differentiated carefully. The results demonstrate that the TCM practitioners precisely diagnosed QD using a number of specific procedures and criteria that could be used as a reference to understand women complaining of S/S that could be similar to QD. Copyright © 2014. Published by Elsevier B.V.

  10. Mature Luffa Leaves (Luffa cylindrica L.) as a Tool for Gene Expression Analysis by Agroinfiltration

    PubMed Central

    Błażejewska, Kamila; Kapusta, Małgorzata; Zielińska, Elżbieta; Tukaj, Zbigniew; Chincinska, Izabela A.

    2017-01-01

    We exploited the potential of cucurbits for ectopic gene expression. Agroinfiltration is a simple and commonly used method to obtain transient expression of foreign genes in plants. In contrast to in vitro transformation techniques, agroinfiltration can be used for genetic modification of mature plant tissues. Although the cucurbits are commonly used as model plants for molecular biology and biotechnology studies, to date there are no literature sources on the possibility of transient gene expression in mature cucurbit tissues. Our research has shown that mature leaves of Luffa cylindrica L. (luffa), in contrast to other cucurbit species, can be successfully transiently transformed with Agrobacterium tumefaciens. We efficiently transformed luffa leaves with a reporter gene encoding β-glucuronidase (GUS). The GUS activity in transiently transformed leaf tissues was detected within 24 h after the infiltration with bacteria. Additionally, we have shown that the activity of a transiently expressed the GUS gene can be monitored directly in the EDTA-exudates collected from the cut petioles of the agroinfiltrated leaves. The results suggest that luffa leaves can be useful as a plant expression system for studies of physiological and biochemical processes in cucurbits. PMID:28270826

  11. Pediatrics Residents' Confidence and Performance Following a Longitudinal Quality Improvement Curriculum.

    PubMed

    Courtlandt, Cheryl; Noonan, Laura; Koricke, Maureen Walsh; Zeskind, Philip Sanford; Mabus, Sarah; Feld, Leonard

    2016-02-01

    Quality improvement (QI) training is an integral part of residents' education. Understanding the educational value of a QI curriculum facilitates understanding of its impact. The purpose of this study was to evaluate the effects of a longitudinal QI curriculum on pediatrics residents' confidence and competence in the acquisition and application of QI knowledge and skills. Three successive cohorts of pediatrics residents (N = 36) participated in a longitudinal curriculum designed to increase resident confidence in QI knowledge and skills. Key components were a succession of progressive experiential projects, QI coaching, and resident team membership culminating in leadership of the project. Residents completed precurricular and postcurricular surveys and demonstrated QI competence by performance on the pediatric QI assessment scenario. Residents participating in the Center for Advancing Pediatric Excellence QI curriculum showed significant increases in pre-post measures of confidence in QI knowledge and skills. Coaching and team leadership were ranked by resident participants as having the most educational value among curriculum components. A pediatric QI assessment scenario, which correlated with resident-perceived confidence in acquisition of QI skills but not QI knowledge, is a tool available to test pediatrics residents' QI knowledge. A 3-year longitudinal, multimodal, experiential QI curriculum increased pediatrics residents' confidence in QI knowledge and skills, was feasible with faculty support, and was well-accepted by residents.

  12. Thermal maturity map of the lower part of the Upper Cretaceous Mesaverde Group, Uintah Basin, Utah

    USGS Publications Warehouse

    Nuccio, Vito F.; Johnson, Ronald C.

    1986-01-01

    The ability of rock to generate oil and gas is directly related to the type and quantity of kerogen and to its thermal maturity; therefore, thermal maturity is a commonly used tool for oil and gas exploration.  The purpose of this study ws to provide a thermal-maturity map for the lower part of the Upper Cretaceous Mesaverde Group in the eastern part of the Uinta Basin.  Prior to this study, thermal-maturity data were not available for the Uinta Basin.  This study uses coal rank to show the thermal maturity of the associated rocks.  The map was prepared in cooperation with the U.S. Department of Energy under its western gas sands project.

  13. [Health assessment of Qi'ao Island mangrove wetland ecosystem in Pearl River Estuary].

    PubMed

    Wang, Shu-Gong; Zheng, Yao-Hui; Peng, Yi-Sheng; Chen, Gui-Zhu

    2010-02-01

    Based on the theories of wetland ecosystem health and by using "Pressure-State-Response" model, a health assessment indicator system for Qi' ao Island mangrove wetland ecosystem in Pearl River Estuary was built, and the assessment indices, assessment criteria, indices weighted values, assessment grades, and assessment methods were established to assess the health state of this ecosystem. In 2008, the overall health index of this ecosystem was 0.6580, health level was of grade II (healthy), and the pressure, state, and response indices were 0.3469, 0.8718, and 0.7754, respectively, suggesting that this ecosystem was good in state and response, but still had definite pressure. As a provincial nature reserve, this ecosystem was to be further improved in its health level. However, the research on the health assessment of mangrove wetland ecosystem was still young. Further studies should be made on the selection of assessment indices, long-term oriented monitoring of these indices, and quantification of the relations between ecosystem health level and ecosystem services.

  14. Recovery of Red Fluorescent Protein Chromophore Maturation Deficiency through Rational Design

    PubMed Central

    Moore, Matthew M.; Oteng-Pabi, Samuel K.; Pandelieva, Antonia T.; Mayo, Stephen L.; Chica, Roberto A.

    2012-01-01

    Red fluorescent proteins (RFPs) derived from organisms in the class Anthozoa have found widespread application as imaging tools in biological research. For most imaging experiments, RFPs that mature quickly to the red chromophore and produce little or no green chromophore are most useful. In this study, we used rational design to convert a yellow fluorescent mPlum mutant to a red-emitting RFP without reverting any of the mutations causing the maturation deficiency and without altering the red chromophore’s covalent structure. We also created an optimized mPlum mutant (mPlum-E16P) that matures almost exclusively to the red chromophore. Analysis of the structure/function relationships in these proteins revealed two structural characteristics that are important for efficient red chromophore maturation in DsRed-derived RFPs. The first is the presence of a lysine residue at position 70 that is able to interact directly with the chromophore. The second is an absence of non-bonding interactions limiting the conformational flexibility at the peptide backbone that is oxidized during red chromophore formation. Satisfying or improving these structural features in other maturation-deficient RFPs may result in RFPs with faster and more complete maturation to the red chromophore. PMID:23285050

  15. Tailored tools to improve pharmacotherapy in infants.

    PubMed

    Allegaert, Karel

    2014-08-01

    Extensive within-population variability is the essence of neonatal pharmacology. Despite this, infants remain one of the last therapeutic orphans. Together with additional legal initiatives, tailoring of already available tools (modeling, covariates, pharmacovigilance) may significantly improve pharmacotherapy in infants. Modeling approaches that hold the promise to improve pharmacotherapy in infants are between-compound extrapolation for compounds that undergo the same route of elimination and integration of time-varying physiology to adapt for the fast maturational changes. Besides these maturational covariates (size, age), newly emerging covariates relate to novel treatment modalities (extracorporeal circulation, hypothermia), environmental issues (microbiome, critical illness) or pharmacogenetics. All these covariates interact with the maturational variation. Finally, pharmacovigilance also needs to be tailored to the characteristics of this population. This relates to preventive strategies, signal detection and assessment of causality. Knowledge on pharmacotherapy in infants is lagging. Tailoring available tools to the specific characteristics (maturation) and clinical needs (newly emerging covariates) of infants is feasible but needs creativity and a multidisciplinary collaboration between modelers, academia, clinical researchers and, obviously, the public, including parents.

  16. Continuity, Change and Mature Musical Identity Construction: Using "Rivers of Musical Experience" to Trace the Musical Lives of Six Mature-Age Keyboard Players

    ERIC Educational Resources Information Center

    Taylor, Angela

    2011-01-01

    "Rivers of Musical Experience" were used as a research tool to explore the wide range of musical experiences and concomitant identity construction that six amateur keyboard players over the age of 55 brought to their learning as mature adults. It appears that significant changes in their lives acted as triggers for them to engage in musical…

  17. A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module

    PubMed Central

    Boggan, Joel C.; Cheely, George; Shah, Bimal R.; Heffelfinger, Randy; Springall, Deanna; Thomas, Samantha M.; Zaas, Aimee; Bae, Jonathan

    2014-01-01

    Background Systematically engaging residents in large programs in quality improvement (QI) is challenging. Objective To coordinate a shared QI project in a large residency program using an online tool. Methods A web-based QI tool guided residents through a 2-phase evaluation of performance of foot examinations in patients with diabetes. In phase 1, residents completed reviews of health records with online data entry. Residents were then presented with personal performance data relative to peers and were prompted to develop improvement plans. In phase 2, residents again reviewed personal performance. Rates of performance were compared at the program and clinic levels for each phase, with data presented for residents. Acceptability was measured by the number of residents completing each phase. Feasibility was measured by estimated faculty, programmer, and administrator time and costs. Results Seventy-nine of 86 eligible residents (92%) completed improvement plans and reviewed 1471 patients in phase 1, whereas 68 residents (79%) reviewed 1054 patient charts in phase 2. Rates of performance of examination increased significantly between phases (from 52% to 73% for complete examination, P < .001). Development of the tool required 130 hours of programmer time. Project analysis and management required 6 hours of administrator and faculty time monthly. Conclusions An online tool developed and implemented for program-wide QI initiatives successfully engaged residents to participate in QI activities. Residents using this tool demonstrated improvement in a selected quality target. This tool could be adapted by other graduate medical education programs or for faculty development. PMID:26279782

  18. The effects of UV-B radiation intensity on biochemical parameters and active ingredients in flowers of Qi chrysanthemum and Huai chrysanthemum.

    PubMed

    Yao, Xiao-Qin; Chu, Jian-Zhou; He, Xue-Li; Si, Chao

    2014-01-01

    The article studied UV-B effects on biochemical parameters and active ingredients in flowers of Qi chrysanthemum and Huai chrysanthemum during the bud stage. The experiment included four UV-B radiation levels (CK, ambient UV-B; T1, T2 and T3 indicated a 5%, 10% and 15% increase in ambient UV-BBE, respectively) to determine the optimal UV-B radiation intensity in regulating active ingredients level in flowers of two chrysanthemum varieties. Flower dry weight of two cultivars was not affected by UV-B radiation under experimental conditions reported here. UV-B treatments significantly increased the rate of superoxide radical production, hydrogen peroxide (H2O2) (except for T1) and malondialdehyde concentration in flowers of Huai chrysanthemum and H2O2 concentration in flowers of Qi chrysanthemum. T2 and T3 treatments induced a significant increase in phenylalanine ammonia lyase enzyme (PAL) activity, anthocyanins, proline, ascorbic acid, chlorogenic acid and flavone content in flowers of two chrysanthemum varieties, and there were no significant differences in PAL activity, ascorbic acid, flavone and chlorogenic acid content between the two treatments. These results indicated that appropriate UV-B radiation intensity did not result in the decrease in flower yield, and could regulate PAL activity and increase active ingredients content in flowers of two chrysanthemum varieties. © 2014 The American Society of Photobiology.

  19. Assessment of Electromagnetic Interference with Active Cardiovascular Implantable Electronic Devices (CIEDs) Caused by the Qi A13 Design Wireless Charging Board.

    PubMed

    Seckler, Tobias; Jagielski, Kai; Stunder, Dominik

    2015-05-27

    Electromagnetic interference is a concern for people wearing cardiovascular implantable electronic devices (CIEDs). The aim of this study was to assess the electromagnetic compatibility between CIEDs and the magnetic field of a common wireless charging technology. To do so the voltage induced in CIEDs by Qi A13 design magnetic fields were measured and compared with the performance limits set by ISO 14117. In order to carry this out a measuring circuit was developed which can be connected with unipolar or bipolar pacemaker leads. The measuring system was positioned at the four most common implantation sites in a torso phantom filled with physiological saline solution. The phantom was exposed by using Helmholtz coils from 5 µT to 27 µT with 111 kHz sine‑bursts or by using a Qi A13 design wireless charging board (Qi‑A13‑Board) in two operating modes "power transfer" and "pinging". With the Helmholtz coils the lowest magnetic flux density at which the performance limit was exceeded is 11 µT. With the Qi‑A13‑Board in power transfer mode 10.8% and in pinging mode 45.7% (2.2% at 10 cm distance) of the performance limit were reached at maximum. In neither of the scrutinized cases, did the voltage induced by the Qi‑A13‑Board exceed the performance limits.

  20. Evaluation of skeletal maturation using mandibular third molar development in Indian adolescents.

    PubMed

    Mehta, Nishit; Patel, Dolly; Mehta, Falguni; Gupta, Bhaskar; Zaveri, Grishma; Shah, Unnati

    2016-01-01

    This study was done with the following objectives: to estimate dental maturity using the Demirjian Index (DI) for the mandibular third molar; to investigate the relationship between dental maturity and skeletal maturity among growing patients; to evaluate the use of the mandibular third molar as an adjunctive tool for adolescent growth assessment in combination with the cervical vertebrae; to evaluate the clinical value of the third molar as a growth evaluation index. Samples were derived from panoramic radiographs and lateral cephalograms of 615 subjects (300 males and 315 females) of ages ranging 9-18 years, and estimates of dental maturity (DI) and skeletal maturity [cervical vertebrae maturation indicators (CVMI)] were made. A highly significant association (r = 0.81 for males and r = 0.72 for females) was found between DI and CVMI. DI Stage B corresponded to Stage 2 of CVMI (prepeak of pubertal growth spurt) in both sexes. In males, DI stages C and D represent the peak of the pubertal growth spurt. In females, stages B and C show that the peak of the pubertal growth spurt has not been passed. DI stage E in females and DI Stage F in males correlate that the peak of the pubertal growth spurt has been passed. A highly significant association exists between DI and CVMI. Mandibular third molar DI stages are reliable adjunctive indicators of skeletal maturity.

  1. Smart Grid Interoperability Maturity Model

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

    Widergren, Steven E.; Levinson, Alex; Mater, J.

    2010-04-28

    The integration of automation associated with electricity resources (including transmission and distribution automation and demand-side resources operated by end-users) is key to supporting greater efficiencies and incorporating variable renewable resources and electric vehicles into the power system. The integration problems faced by this community are analogous to those faced in the health industry, emergency services, and other complex communities with many stakeholders. To highlight this issue and encourage communication and the development of a smart grid interoperability community, the GridWise Architecture Council (GWAC) created an Interoperability Context-Setting Framework. This "conceptual model" has been helpful to explain the importance of organizationalmore » alignment in addition to technical and informational interface specifications for "smart grid" devices and systems. As a next step to building a community sensitive to interoperability, the GWAC is investigating an interoperability maturity model (IMM) based on work done by others to address similar circumstances. The objective is to create a tool or set of tools that encourages a culture of interoperability in this emerging community. The tools would measure status and progress, analyze gaps, and prioritize efforts to improve the situation.« less

  2. Redefining "Mature Writing."

    ERIC Educational Resources Information Center

    Odell, Lee

    Although certain features have been identified as most indicative of "syntactic maturity," these only partially answer the question, "What is mature writing?" Mature thought on the part of the author is reflected in writing in the following ways: recognizing that the audience is different from himself or herself; providing an appropriate context…

  3. Lipidomics study of plasma phospholipid metabolism in early type 2 diabetes rats with ancient prescription Huang-Qi-San intervention by UPLC/Q-TOF-MS and correlation coefficient.

    PubMed

    Wu, Xia; Zhu, Jian-Cheng; Zhang, Yu; Li, Wei-Min; Rong, Xiang-Lu; Feng, Yi-Fan

    2016-08-25

    Potential impact of lipid research has been increasingly realized both in disease treatment and prevention. An effective metabolomics approach based on ultra-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF-MS) along with multivariate statistic analysis has been applied for investigating the dynamic change of plasma phospholipids compositions in early type 2 diabetic rats after the treatment of an ancient prescription of Chinese Medicine Huang-Qi-San. The exported UPLC/Q-TOF-MS data of plasma samples were subjected to SIMCA-P and processed by bioMark, mixOmics, Rcomdr packages with R software. A clear score plots of plasma sample groups, including normal control group (NC), model group (MC), positive medicine control group (Flu) and Huang-Qi-San group (HQS), were achieved by principal-components analysis (PCA), partial least-squares discriminant analysis (PLS-DA) and orthogonal partial least-squares discriminant analysis (OPLS-DA). Biomarkers were screened out using student T test, principal component regression (PCR), partial least-squares regression (PLS) and important variable method (variable influence on projection, VIP). Structures of metabolites were identified and metabolic pathways were deduced by correlation coefficient. The relationship between compounds was explained by the correlation coefficient diagram, and the metabolic differences between similar compounds were illustrated. Based on KEGG database, the biological significances of identified biomarkers were described. The correlation coefficient was firstly applied to identify the structure and deduce the metabolic pathways of phospholipids metabolites, and the study provided a new methodological cue for further understanding the molecular mechanisms of metabolites in the process of regulating Huang-Qi-San for treating early type 2 diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Mature Teachers Matter

    ERIC Educational Resources Information Center

    Berl, Patricia Scallan

    2005-01-01

    In this article, the author discusses the consequences of losing mature teachers due to voluntary separation or retirement and the mindset of a mature teacher that is different from younger teachers in a number of ways. Mature teachers are colleagues over 45 years of age possessing significant experience in the field. Future trends in teacher…

  5. Survival of mature mouse olfactory sensory neurons labeled genetically perinatally.

    PubMed

    Holl, Anna-Maria

    2018-04-01

    The main olfactory epithelium (MOE) of an adult mouse harbors a few million mature olfactory sensory neurons (OSNs), which are traditionally defined as mature by their expression of the olfactory marker protein (OMP). Mature OSNs differentiate in situ from stem cells at the base of the MOE. The consensus view is that mature OSNs have a defined lifespan and then undergo programmed cell death, and that the adult MOE maintains homeostasis by generating new mature OSNs from stem cells. But there is also evidence for mature OSNs that are long-lived. Thus far modern genetic tools have not been applied to quantify survival of a population of OSNs that are mature at a given point in time. Here, a genetic strategy was developed to label irreversibly OMP-expressing OSNs in mice. A gene-targeted OMP-CreERT2 strain was generated in which mature OSNs express an enzymatically inactive version of the Cre recombinase. The fusion protein CreERT2 becomes transiently active when exposed to tamoxifen, and in the presence of a Cre reporter in the genome such as tdRFP, CreERT2-expressing cells become irreversibly labeled. A cohort of mice was generated with the same day of birth by in vitro fertilization and embryo transfer, and injected tamoxifen in their mothers at E18.5 of gestation. I counted RFP immunoreactive cells in the MOE and vomeronasal organ of 36 tamoxifen-exposed OMP-CreERT2 × tdRFP mice from 7 age groups: postnatal day (PD)1.5, PD3.5, PD6.5, 3 weeks, 9 weeks, 6 months, and 12 months. Approximately 7.8% of perinatally labeled cells remain at 12 months, confirming that some mature OSNs are indeed long-lived. The survival curve of the population of perinatally labeled MOE cells can be modeled with a mean half-life of 26 days for the population as a whole, excluding the long-lived cells. Copyright © 2018 The Author. Published by Elsevier Inc. All rights reserved.

  6. Protease-Mediated Maturation of HIV: Inhibitors of Protease and the Maturation Process.

    PubMed

    Adamson, Catherine S

    2012-01-01

    Protease-mediated maturation of HIV-1 virus particles is essential for virus infectivity. Maturation occurs concomitant with immature virus particle release and is mediated by the viral protease (PR), which sequentially cleaves the Gag and Gag-Pol polyproteins into mature protein domains. Maturation triggers a second assembly event that generates a condensed conical capsid core. The capsid core organizes the viral RNA genome and viral proteins to facilitate viral replication in the next round of infection. The fundamental role of proteolytic maturation in the generation of mature infectious particles has made it an attractive target for therapeutic intervention. Development of small molecules that target the PR active site has been highly successful and nine protease inhibitors (PIs) have been approved for clinical use. This paper provides an overview of their development and clinical use together with a discussion of problems associated with drug resistance. The second-half of the paper discusses a novel class of antiretroviral drug termed maturation inhibitors, which target cleavage sites in Gag not PR itself. The paper focuses on bevirimat (BVM) the first-in-class maturation inhibitor: its mechanism of action and the implications of naturally occurring polymorphisms that confer reduced susceptibility to BVM in phase II clinical trials.

  7. Diagnostic performance of dental maturity for identification of skeletal maturation phase.

    PubMed

    Perinetti, G; Contardo, L; Gabrieli, P; Baccetti, T; Di Lenarda, R

    2012-08-01

    The objective of this study is to analyse the diagnostic performance of the circumpubertal dental maturation phases for the identification of individual-specific skeletal maturation phases. A total of 354 healthy subjects, 208 females and 146 males (mean age, 11.1 ± 2.4 years; range, 6.8-17.1 years), were enrolled in the study. Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine, the first and second premolars, and the second molar. Determination of skeletal maturity was according to the cervical vertebra maturation (CVM) method on lateral cephalograms. Diagnostic performances were evaluated according to the dental maturation stages for each tooth for the identification of the CVM stages and growth phases (as pre-pubertal, pubertal, and post-pubertal) using positive likelihood ratios (LHRs). A positive LHR threshold of 10 or more was considered for satisfactory reliability of any dental maturation stage for the identification of any of the CVM stages or growth phases. The positive LHRs were generally less than 2.0, with a few exceptions. These four teeth showed positive LHRs greater than 10 only for the identification of the pre-pubertal growth phase, with values from 10.8 for the second molar (stage E) to 39.3 for the first premolar (stage E). Dental maturation assessment is only useful for diagnosis of the pre-pubertal growth phase, and thus, precise information in relation to the timing of the onset of the growth spurt is not provided by these indices.

  8. Advancing Quality Improvement in Public Health Departments Through a Statewide Training Program.

    PubMed

    Davis, Mary V; Cornett, Amanda; Mahanna, Elizabeth; See, Claire; Randolph, Greg

    2016-01-01

    To examine the effectiveness of an ongoing statewide public health quality improvement training program (PH QI 101) among 4 cohorts of training participants. We conducted a mixed-method evaluation of the PH QI 101 training program that included measures of participants' satisfaction, learning, behavior change, and participants' translation and spread to their organizations what was learned. Data analysis included descriptive quantitative statistics and qualitative reviews. The Mann-Whitney U test was used to examine changes in participants' confidence to conduct a QI project from pre- to posttraining and 6 months posttraining. Two hundred two staff members from 37 North Carolina local health departments. An 8-month experiential learning process in which participants learn to use QI methods by applying them to a specific project. More than 90% of participants reported satisfaction with the program. Median scores on perceived self-confidence to conduct a QI project significantly increased for all training waves. At least 85% of participants reported spreading QI tools to coworkers posttraining. Two-thirds of participants in 3 waves reported that the QI project conducted during the training was at the sustaining results stage. Most participants in 3 of the training waves reported initiating new QI projects at their health department following training. Facilitators to implementation included interest and support from managers and leaders. Lack of interest and competing priorities among other staff were key barriers to implementation. This program successfully trained 4 waves of public health professionals in QI tools and methods. Leader training and involvement was a key addition to the adapted model. This statewide approach may serve as a model to other states as they seek to achieve national accreditation standards.

  9. Cannabinoids induce incomplete maturation of cultured human leukemia cells

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

    Murison, G.; Chubb, C.B.H.; Maeda, S.

    Monocyte maturation markers were induced in cultured human myeloblastic ML-2 leukemia cells after treatment for 1-6 days with 0.03-30 ..mu..M ..delta../sup 9/-tetrahydrocannabinol (THC), the major psychoactive component of marijuana. After a 2-day or longer treatment, 2- to 5-fold increases were found in the percentages of cells exhibiting reactivity with either the murine OKM1 monoclonal antibody of the Leu-M5 monoclonal antibody, staining positively for nonspecific esterase activity, and displaying a promonocyte morphology. The increases in these differentiation markers after treatment with 0.03-1 ..mu..M THC were dose dependent. At this dose range, THC did not cause an inhibition of cell growth. Themore » THC-induced cell maturation was also characterized by specific changes in the patterns of newly synthesized proteins. The THC-induced differentiation did not, however, result in cells with a highly developed mature monocyte phenotype. However, treatment of these incompletely matured cells with either phorbol 12-myristate 13-acetate of 1..cap alpha..,25-dihydroxycholecalciferol, which are inducers of differentiation in myeloid leukemia cells (including ML-2 cells), produced cells with a mature monocyte morphology. The ML-2 cell system described here may be a useful tool for deciphering critical biochemical events that lead to the cannabinoid-induced incomplete cell differentiation of ML-2 cells and other related cell types. Findings obtained from this system may have important implications for studies of cannabinoid effects on normal human bone-marrow progenitor cells.« less

  10. 7 CFR 51.1313 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1313 Section 51.1313 Agriculture... Standards for Winter Pears 1 Definitions § 51.1313 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper completion of the ripening process. (b) Before a mature...

  11. 7 CFR 51.1313 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1313 Section 51.1313 Agriculture... Standards for Winter Pears 1 Definitions § 51.1313 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper completion of the ripening process. (b) Before a mature...

  12. 7 CFR 51.1313 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1313 Section 51.1313 Agriculture... Standards for Winter Pears 1 Definitions § 51.1313 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper completion of the ripening process. (b) Before a mature...

  13. Probabilistic maturation reaction norms assessed from mark–recaptures of wild fish in their natural habitat

    PubMed Central

    Olsen, Esben M; Serbezov, Dimitar; Vøllestad, Leif A

    2014-01-01

    Reaction norms are a valuable tool in evolutionary biology. Lately, the probabilistic maturation reaction norm approach, describing probabilities of maturing at combinations of age and body size, has been much applied for testing whether phenotypic changes in exploited populations of fish are mainly plastic or involving an evolutionary component. However, due to typical field data limitations, with imperfect knowledge about individual life histories, this demographic method still needs to be assessed. Using 13 years of direct mark–recapture observations on individual growth and maturation in an intensively sampled population of brown trout (Salmo trutta), we show that the probabilistic maturation reaction norm approach may perform well even if the assumption of equal survival of juvenile and maturing fish does not hold. Earlier studies have pointed out that growth effects may confound the interpretation of shifts in maturation reaction norms, because this method in its basic form deals with body size rather than growth. In our case, however, we found that juvenile body size, rather than annual growth, was more strongly associated with maturation. Viewed against earlier studies, our results also underscore the challenges of generalizing life-history patterns among species and populations. PMID:24967078

  14. T2N as a new tool for robust electrophysiological modeling demonstrated for mature and adult-born dentate granule cells

    PubMed Central

    Mongiat, Lucas Alberto; Schwarzacher, Stephan Wolfgang

    2017-01-01

    Compartmental models are the theoretical tool of choice for understanding single neuron computations. However, many models are incomplete, built ad hoc and require tuning for each novel condition rendering them of limited usability. Here, we present T2N, a powerful interface to control NEURON with Matlab and TREES toolbox, which supports generating models stable over a broad range of reconstructed and synthetic morphologies. We illustrate this for a novel, highly detailed active model of dentate granule cells (GCs) replicating a wide palette of experiments from various labs. By implementing known differences in ion channel composition and morphology, our model reproduces data from mouse or rat, mature or adult-born GCs as well as pharmacological interventions and epileptic conditions. This work sets a new benchmark for detailed compartmental modeling. T2N is suitable for creating robust models useful for large-scale networks that could lead to novel predictions. We discuss possible T2N application in degeneracy studies. PMID:29165247

  15. Do Secular Trends in Skeletal Maturity Occur Equally in Both Sexes?

    PubMed

    Duren, Dana L; Nahhas, Ramzi W; Sherwood, Richard J

    2015-08-01

    months), for girls only; and (4) later maturation of indicators of long bone shape (3 months) for boys only. A secular trend has occurred in the tempo of maturation of individual components of the pediatric skeleton, and it has occurred in a sex-specific manner. The mosaic nature of this trend, with both earlier and later maturation of individual components of the skeletal age phenotype, calls for greater attention to specific aspects of maturation in addition to the overall skeletal age estimate. The Fels method is currently the most robust method for capturing these components, and future work by our group will deliver an updated, user-friendly version of the Fels assessment tool. Appreciation of sex-specific secular changes in maturation is important for clinical management, including treatment timing, of orthopaedic patients, because children today exhibit a different pattern of maturation than children on whom original maturity assessments were based (including Fels and Greulich-Pyle).

  16. Studies on the psychosomatic functioning of ill-health according to eastern and Western medicine. 2. Anxiety-affinitive constitution associated with qi, blood, and body fluid--diagnostic and therapeutic methods.

    PubMed

    Takeichi, M; Sato, T; Takefu, M

    1999-01-01

    The objective of this investigation was to identify characteristics of psychosomatic function in medical students (N = 62, mean age, 23.3, SD, 1.7 years) whose ill-health was related to unbalanced qi, blood, and body fluid, and to develop a diagnosis and treatment method for these conditions. Our study revealed complicated characteristics. At the psychological level, these characteristics are stress-related emotional disturbances, including anxiety, insomnia and anergy, and the lowering of social function. At the physiological level, these characteristics are associated with high complexity of fractal dimension of eye (horizontal) and respiratory (thoracic) movements correlated to STA1-trait anxiety. Thus, the three psychosomatic characteristics related to unbalanced qi, blood, and body fluid suggest the concept of an anxiety-affinitive constitution, also described as the equivalent of ill-health. This indicates that diagnosis and treatment of this type of constitution has the potential to be useful for both the prevention of stress-related and life-style disease, and the treatment of current disease.

  17. Proteomic analysis of mature and immature ejaculated spermatozoa from fertile men

    PubMed Central

    Cui, Zhihong; Sharma, Rakesh; Agarwal, Ashok

    2016-01-01

    Dysfunctional spermatozoa maturation is the main reason for the decrease in sperm motility and morphology in infertile men. Ejaculated spermatozoa from healthy fertile men were separated into four fractions using three-layer density gradient. Proteins were extracted and bands were digested on a LTQ-Orbitrap Elite hybrid mass spectrometer system. Functional annotations of proteins were obtained using bioinformatics tools and pathway databases. Western blotting was performed to verify the expression levels of the proteins of interest. 1469 proteins were identified in four fractions of spermatozoa. The number of detected proteins decreased according to the maturation level of spermatozoa. During spermatozoa maturation, proteins involved in gamete generation, cell motility, energy metabolism and oxidative phosphorylation processes showed increasing expression levels and those involved in protein biosynthesis, protein transport, protein ubiquitination, and response to oxidative stress processes showed decreasing expression levels. We validated four proteins (HSP 70 1A, clusterin, tektin 2 and tektin 3) by Western blotting. The study shows protein markers that may provide insight into the ejaculated spermatozoa proteins in different stages of sperm maturation that may be altered or modified in infertile men. PMID:26510506

  18. Evaluating the implementation of confusion assessment method-intensive care unit using a quality improvement approach.

    PubMed

    Stewart, C; Bench, S

    2018-05-15

    Quality improvement (QI) is a way through which health care delivery can be made safer and more effective. Various models of quality improvement methods exist in health care today. These models can help guide and manage the process of introducing changes into clinical practice. The aim of this project was to implement the use of a delirium assessment tool into three adult critical care units within the same hospital using a QI approach. The objective was to improve the identification and management of delirium. Using the Model for Improvement framework, a multidisciplinary working group was established. A delirium assessment tool was introduced via a series of educational initiatives. New local guidelines regarding the use of delirium assessment and management for the multidisciplinary team were also produced. Audit data were collected at 6 weeks and 5 months post-implementation to evaluate compliance with the use of the tool across three critical care units within a single hospital in London. At 6 weeks, in 134 assessment points out of a possible 202, the tool was deemed to be used appropriately, meaning that 60% of patients received timely assessment; 18% of patients were identified as delirious in audit one. Five months later, only 95 assessment points out of a possible 199 were being appropriately assessed (47%); however, a greater number (32%) were identified as delirious. This project emphasizes the complexity of changing practice in a large busy critical care centre. Despite an initial increase in delirium assessment, this was not sustained over time. The use of a QI model highlights the continuous process of embedding changes into clinical practice and the need to use a QI method that can address the challenging nature of modern health care. QI models guide changes in practice. Consideration should be given to the type of QI model used. © 2018 British Association of Critical Care Nurses.

  19. Maturational and Non-Maturational Factors in Heritage Language Acquisition

    ERIC Educational Resources Information Center

    Moon, Ji Hye

    2012-01-01

    This dissertation aims to understand the maturational and non-maturational aspects of early bilingualism and language attrition in heritage speakers who have acquired their L1 incompletely in childhood. The study highlights the influential role of age and input dynamics in early L1 development, where the timing of reduction in L1 input and the…

  20. A comparison of skeletal maturity assessed by radiological and ultrasonic methods.

    PubMed

    Utczas, Katinka; Muzsnai, Agota; Cameron, Noel; Zsakai, Annamaria; Bodzsar, Eva B

    2017-07-08

    The estimation of skeletal maturity is a useful tool in pediatric practice to determine the degree of delay or advancement in growth disorders and the effectiveness of treatment in conditions that influence linear growth. Skeletal maturity of children is commonly assessed using either Greulich-Pyle (GP) or Tanner-Whitehouse methods (TW2 and TW3). However, a less invasive ultrasonic method, that does not use ionizing radiation, has been suggested for use in epidemiological studies of skeletal maturity. The main purpose of the present study was to determine the accuracy of an ultrasonic method based on the GP maturity indicators compared to the standard GP radiographic method. Skeletal maturity of 1502 healthy children, aged from 6 to 18 years, was estimated by quantitative ultrasound and compared to GP bone ages estimated from left hand and wrist radiographs of a subsample of 47 randomly selected participants. The ultrasonic bone age estimation demonstrated very strong correlations with all the radiological age estimations. The correlation coefficients ranged between 0.895 and 0.958, and the strongest correlation of ultrasonic skeletal maturity estimation was found with the Tanner-Whitehouse RUS method. The ultrasonic bone age estimation is suggested for use between the chronological ages of 8.5-16.0 years in boys and 7.5-15.0 years in girls. The ultrasonic bone age estimation is suggested for use in epidemiological surveys since the sensitivity for screening for not normal bone development is appropriate, at least within the 8-15 years age interval. © 2017 Wiley Periodicals, Inc.

  1. To compare the efficacy of two kinds of Zhizhu pills in the treatment of functional dyspepsia of spleen-deficiency and qi-stagnation syndrome:a randomized group sequential comparative trial

    PubMed Central

    2011-01-01

    Background In Traditional Chinese Medicine (TCM) theory, functional dyspepsia (FD) can be divided into different syndromes according to different clinical symptoms and signs, and the most common one is spleen-deficiency and qi-stagnation syndrome that can be treated by Chinese traditional patent medicine ---- two kinds of Zhizhu pills, between which the primary difference in ingredients is that one contains immature orange fruit of Citrus aurantium L.(IFCA) and the other contains that of Citrus sinensis Osbeck (IFCS). The trial's objective was to compare the efficacy of two kinds of Zhizhu pills on symptom changes in patients with FD of spleen-deficiency and qi-stagnation syndrome. Methods A randomized, group sequential, double-blinded, multicenter trial was conducted in patients with FD of spleen-deficiency and qi-stagnation syndrome at 3 hospitals in Beijing between June 2003 and May 2005. Participants were randomly allocated into two groups (IFCA group and IFCS group) in a 1:1 ratio, and respectively took one of the two kinds of Zhizhu pills orally, 6 g each time, 3 times a day, for 4 weeks. Statistical analysis was performed with use of a group sequential method, the triangular test (TT). Results A total of 163 patients were randomized, and 3 patients were excluded from analysis because of early dropouts, leaving 160 patients (IFCA group: n = 82; IFCS group: n = 78) for statistical analysis. Three interim analyses were done after 62, 116, and 160 patients had completed their 4-week treatment, respectively. At the third interim analysis, the sample path crossed the upper boundary and the trial was stopped, the cure-markedly effective rates were 45% for IFCS group and 67% for IFCA group, respectively, the one-sided p-value was 0.0036, the median unbiased estimate of the odds ratio (OR) for the benefit of IFCA relative to IFCS was 2.91 with 95%CI: 1.40 to 6.06. No adverse events were observed in the two groups. Conclusions Zhizhu pills containing IFCA was superior

  2. THE ERUPTION OF THE CANDIDATE YOUNG STAR ASASSN-15QI

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

    Herczeg, Gregory J.; Dong, Subo; Chen, Ping

    Outbursts on young stars are usually interpreted as accretion bursts caused by instabilities in the disk or the star–disk connection. However, some protostellar outbursts may not fit into this framework. In this paper, we analyze optical and near-infrared spectra and photometry to characterize the 2015 outburst of the probable young star ASASSN-15qi. The ∼3.5 mag brightening in the V band was sudden, with an unresolved rise time of less than one day. The outburst decayed exponentially by 1 mag for 6 days and then gradually back to the pre-outburst level after 200 days. The outburst is dominated by emission frommore » ∼10,000 K gas. An explosive release of energy accelerated matter from the star in all directions, seen in a spectacular cool, spherical wind with a maximum velocity of 1000 km s{sup −1}. The wind and hot gas both disappeared as the outburst faded and the source returned to its quiescent F-star spectrum. Nebulosity near the star brightened with a delay of 10–20 days. Fluorescent excitation of H{sub 2} is detected in emission from vibrational levels as high as v = 11, also with a possible time delay in flux increase. The mid-infrared spectral energy distribution does not indicate the presence of warm dust emission, though the optical photospheric absorption and CO overtone emission could be related to a gaseous disk. Archival photometry reveals a prior outburst in 1976. Although we speculate about possible causes for this outburst, none of the explanations are compelling.« less

  3. 7 CFR 51.2841 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.2841 Section 51.2841 Agriculture... Creole Types) Definitions § 51.2841 Mature. Mature means well cured. Midseason onions which are not customarily held in storage shall be considered mature when harvested in accordance with good commercial...

  4. 7 CFR 51.2841 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.2841 Section 51.2841 Agriculture... Creole Types) Definitions § 51.2841 Mature. Mature means well cured. Midseason onions which are not customarily held in storage shall be considered mature when harvested in accordance with good commercial...

  5. 7 CFR 51.3746 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.3746 Section 51.3746 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Definitions § 51.3746 Mature. Mature means that the melon has reached the stage of maturity which will insure...

  6. 7 CFR 51.3746 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.3746 Section 51.3746 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Definitions § 51.3746 Mature. Mature means that the melon has reached the stage of maturity which will insure...

  7. A Patient-Centered Framework for Evaluating Digital Maturity of Health Services: A Systematic Review

    PubMed Central

    Callahan, Ryan; Darzi, Ara; Mayer, Erik

    2016-01-01

    Background Digital maturity is the extent to which digital technologies are used as enablers to deliver a high-quality health service. Extensive literature exists about how to assess the components of digital maturity, but it has not been used to design a comprehensive framework for evaluation. Consequently, the measurement systems that do exist are limited to evaluating digital programs within one service or care setting, meaning that digital maturity evaluation is not accounting for the needs of patients across their care pathways. Objective The objective of our study was to identify the best methods and metrics for evaluating digital maturity and to create a novel, evidence-based tool for evaluating digital maturity across patient care pathways. Methods We systematically reviewed the literature to find the best methods and metrics for evaluating digital maturity. We searched the PubMed database for all papers relevant to digital maturity evaluation. Papers were selected if they provided insight into how to appraise digital systems within the health service and if they indicated the factors that constitute or facilitate digital maturity. Papers were analyzed to identify methodology for evaluating digital maturity and indicators of digitally mature systems. We then used the resulting information about methodology to design an evaluation framework. Following that, the indicators of digital maturity were extracted and grouped into increasing levels of maturity and operationalized as metrics within the evaluation framework. Results We identified 28 papers as relevant to evaluating digital maturity, from which we derived 5 themes. The first theme concerned general evaluation methodology for constructing the framework (7 papers). The following 4 themes were the increasing levels of digital maturity: resources and ability (6 papers), usage (7 papers), interoperability (3 papers), and impact (5 papers). The framework includes metrics for each of these levels at each

  8. 7 CFR 51.1313 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1313 Section 51.1313 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Winter Pears 1 Definitions § 51.1313 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper completion of...

  9. 7 CFR 51.2841 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.2841 Section 51.2841 Agriculture... Mature. Mature means well cured. Midseason onions which are not customarily held in storage shall be considered mature when harvested in accordance with good commercial practice at a stage which will not result...

  10. 7 CFR 51.484 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.484 Section 51.484 Agriculture Regulations..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Cantaloups 1 Definitions § 51.484 Mature. Mature means that the cantaloup has reached the stage of maturity which will insure the proper completion...

  11. 7 CFR 51.1313 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1313 Section 51.1313 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Winter Pears 1 Definitions § 51.1313 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper completion of...

  12. 7 CFR 51.484 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.484 Section 51.484 Agriculture Regulations..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Cantaloups 1 Definitions § 51.484 Mature. Mature means that the cantaloup has reached the stage of maturity which will insure the proper completion...

  13. 7 CFR 51.1272 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1272 Section 51.1272 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Summer and Fall Pears 1 Definitions § 51.1272 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper...

  14. 7 CFR 51.2841 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.2841 Section 51.2841 Agriculture... Mature. Mature means well cured. Midseason onions which are not customarily held in storage shall be considered mature when harvested in accordance with good commercial practice at a stage which will not result...

  15. 7 CFR 51.1272 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1272 Section 51.1272 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Summer and Fall Pears 1 Definitions § 51.1272 Mature. (a) Mature means that the pear has reached the stage of maturity which will insure the proper...

  16. 7 CFR 51.1272 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1272 Section 51.1272 Agriculture... Standards for Summer and Fall Pears 1 Definitions § 51.1272 Mature. (a) Mature means that the pear has... a mature pear becomes overripe it will show varying degrees of firmness, depending upon the stage of...

  17. 7 CFR 51.1272 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1272 Section 51.1272 Agriculture... Standards for Summer and Fall Pears 1 Definitions § 51.1272 Mature. (a) Mature means that the pear has... a mature pear becomes overripe it will show varying degrees of firmness, depending upon the stage of...

  18. 7 CFR 51.1272 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1272 Section 51.1272 Agriculture... Standards for Summer and Fall Pears 1 Definitions § 51.1272 Mature. (a) Mature means that the pear has... a mature pear becomes overripe it will show varying degrees of firmness, depending upon the stage of...

  19. Hospital readiness for health information exchange: development of metrics associated with successful collaboration for quality improvement.

    PubMed

    Korst, Lisa M; Aydin, Carolyn E; Signer, Jordana M K; Fink, Arlene

    2011-08-01

    The development of readiness metrics for organizational participation in health information exchange is critical for monitoring progress toward, and achievement of, successful inter-organizational collaboration. In preparation for the development of a tool to measure readiness for data-sharing, we tested whether organizational capacities known to be related to readiness were associated with successful participation in an American data-sharing collaborative for quality improvement. Cross-sectional design, using an on-line survey of hospitals in a large, mature data-sharing collaborative organized for benchmarking and improvement in nursing care quality. Factor analysis was used to identify salient constructs, and identified factors were analyzed with respect to "successful" participation. "Success" was defined as the incorporation of comparative performance data into the hospital dashboard. The most important factor in predicting success included survey items measuring the strength of organizational leadership in fostering a culture of quality improvement (QI Leadership): (1) presence of a supportive hospital executive; (2) the extent to which a hospital values data; (3) the presence of leaders' vision for how the collaborative advances the hospital's strategic goals; (4) hospital use of the collaborative data to track quality outcomes; and (5) staff recognition of a strong mandate for collaborative participation (α=0.84, correlation with Success 0.68 [P<0.0001]). The data emphasize the importance of hospital QI Leadership in collaboratives that aim to share data for QI or safety purposes. Such metrics should prove useful in the planning and development of this complex form of inter-organizational collaboration. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Hospital readiness for health information exchange: development of metrics associated with successful collaboration for quality improvement

    PubMed Central

    Korst, Lisa M.; Aydin, Carolyn E.; Signer, Jordana M. K.; Fink, Arlene

    2011-01-01

    Objective The development of readiness metrics for organizational participation in health information exchange is critical for monitoring progress toward, and achievement of, successful inter-organizational collaboration. In preparation for the development of a tool to measure readiness for data-sharing, we tested whether organizational capacities known to be related to readiness were associated with successful participation in an American data-sharing collaborative for quality improvement. Design Cross-sectional design, using an on-line survey of hospitals in a large, mature data-sharing collaborative organized for benchmarking and improvement in nursing care quality. Measurements Factor analysis was used to identify salient constructs, and identified factors were analyzed with respect to “successful” participation. “Success” was defined as the incorporation of comparative performance data into the hospital dashboard. Results The most important factor in predicting success included survey items measuring the strength of organizational leadership in fostering a culture of quality improvement (QI Leadership): 1) presence of a supportive hospital executive; 2) the extent to which a hospital values data; 3) the presence of leaders’ vision for how the collaborative advances the hospital’s strategic goals; 4) hospital use of the collaborative data to track quality outcomes; and 5) staff recognition of a strong mandate for collaborative participation (α = 0.84, correlation with Success 0.68 [P < 0.0001]). Conclusion The data emphasize the importance of hospital QI Leadership in collaboratives that aim to share data for QI or safety purposes. Such metrics should prove useful in the planning and development of this complex form of inter-organizational collaboration. PMID:21330191

  1. Methodological and ethical aspects of the sexual maturation assessment in adolescents

    PubMed Central

    de Faria, Eliane Rodrigues; Franceschini, Sylvia do Carmo C.; Peluzio, Maria do Carmo G.; Sant'Ana, Luciana Ferreira da R.; Priore, Silvia Eloiza

    2013-01-01

    OBJECTIVE To analyze methodological and ethical aspects in the sexual maturation assessment of adolescents. DATA SOURCES Books and theses, articles and legislations on the Medline, SciELO, Science Direct databases, besides institutional documents of the World Health Organization and the Pediatric Societies of Brazil and São Paulo, considering the period from 1962 to 2012. The following keywords were used in Portuguese and English: "sexual maturation", "self-assessment", "ethics", "OBJECTIVE assessment of sexual maturation", "puberty", "adolescent", and "adolescentdevelopment". DATA SYNTHESIS The sexual maturation assessment is used in populatinal studies and in clinical daily care. The direct evaluation is performed by a specialized physician, whereas the self-assessment is carried out by the adolescent. This evaluation should be carefully performed in the appropriate place, taking into account the ethical aspects. The patient should not be constrained and the physician must respect the privacy and the confidentiality. Before this evaluation and independently of the used method, the adolescent should receive information and explanation about the procedure and the tools that will be applied. Furthermore, the patient has the right to want or not an adult close to him. CONCLUSIONS Validation studies showed that self-assessment is inferior to clinical assessment and should, therefore, be performed only when the direct examination by physicians is not possible. PMID:24142325

  2. Development of Systems Engineering Maturity Models and Management Tools

    DTIC Science & Technology

    2011-01-21

    Ph.D., Senior Personnel, Stevens Institute of Technology Abhi Deshmukh, Ph.D., Senior Personnel, Texas A&M University Matin Sarfaraz, Research ...WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Stevens Institute of Technology,Systems Engineering Research Center (SERC),1...tools (MPT) for effectively and efficiently addressing these challenges are likewise being challenged. The goal of this research was to develop a

  3. Validation of endoscopy for determination of maturity in small salmonids and sex of mature individuals

    Treesearch

    Erica A. Swenson; Amanda E. Rosenberger; Philip J. Howell

    2007-01-01

    Fish maturity status, sex ratio, and age and size at first maturity are important parameters in population assessments and life history studies. In most empirical studies of these variables, fish are sacrificed and dissected to obtain data. However, maturity status and the sex of mature individuals can be determined by inserting an endoscope through a small incision in...

  4. Sexual maturation in kokanee Oncorhynchus nerka

    USGS Publications Warehouse

    Patterson, S.D.; Scarnecchia, D.L.; Congleton, J.L.

    2008-01-01

    We used observational and experimental approaches to obtain information on factors affecting the timing of maturation of kokanee Oncorhynchus nerka, a semelparous, landlocked salmon. Gonadal staging criteria were developed and applied to three kokanee populations in Idaho lakes and reservoirs. Testes were classified into three stages: immature (stage one, S1), maturing (S2), and mature (S3). Ovaries were classified into eight stages: immature (S1-S3), transitional (stage S4), maturing (S5-S7), and mature (S8). Males entered the maturing stage (S2) in February through April of the spawning year. Females entered maturing stage (S5) as early as July of the year before the spawning year, and as late as March of the spawning year. Three hatchery experiments demonstrated that attainment of a larger body size 10 to 16 months before spawning increased the likelihood of initiation of maturation in both sexes. No gonads in a state of regression were observed. A gonadosomatic index above 0.1 by early July was a good indicator of a maturing male, and a gonadosomatic index above 1.0 by early July was a good indicator of a maturing female. Instantaneous growth rates were not good predictors of maturation, but attaining a size threshold of 18 to 19 cm in the fall was a good predictor of maturation the following year. This improved knowledge of kokanee maturation will permit more effectively management of the species for age, growth and size at maturity as well as for contributions to fisheries. ?? 2008 by the Northwest Scientific Association. All rights reserved.

  5. Use of a structured template to facilitate practice-based learning and improvement projects.

    PubMed

    McClain, Elizabeth K; Babbott, Stewart F; Tsue, Terance T; Girod, Douglas A; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

    2012-06-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008-2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level.

  6. Use of a Structured Template to Facilitate Practice-Based Learning and Improvement Projects

    PubMed Central

    McClain, Elizabeth K.; Babbott, Stewart F.; Tsue, Terance T.; Girod, Douglas A.; Clements, Debora; Gilmer, Lisa; Persons, Diane; Unruh, Greg

    2012-01-01

    Background The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to meet and demonstrate outcomes across 6 competencies. Measuring residents' competency in practice-based learning and improvement (PBLI) is particularly challenging. Purpose We developed an educational tool to meet ACGME requirements for PBLI. The PBLI template helped programs document quality improvement (QI) projects and supported increased scholarly activity surrounding PBLI learning. Methods We reviewed program requirements for 43 residency and fellowship programs and identified specific PBLI requirements for QI activities. We also examined ACGME Program Information Form responses on PBLI core competency questions surrounding QI projects for program sites visited in 2008–2009. Data were integrated by a multidisciplinary committee to develop a peer-protected PBLI template guiding programs through process, documentation, and evaluation of QI projects. All steps were reviewed and approved through our GME Committee structure. Results An electronic template, companion checklist, and evaluation form were developed using identified project characteristics to guide programs through the PBLI process and facilitate documentation and evaluation of the process. During a 24 month period, 27 programs have completed PBLI projects, and 15 have reviewed the template with their education committees, but have not initiated projects using the template. Discussion The development of the tool generated program leaders' support because the tool enhanced the ability to meet program-specific objectives. The peer-protected status of this document for confidentiality and from discovery has been beneficial for program usage. The document aggregates data on PBLI and QI initiatives, offers opportunities to increase scholarship in QI, and meets the ACGME goal of linking measures to outcomes important to meeting accreditation requirements at the program and institutional level. PMID

  7. Mechanisms of lipase maturation

    PubMed Central

    Péterfy, Miklós

    2010-01-01

    Lipases are acyl hydrolases that represent a diverse group of enzymes present in organisms ranging from prokaryotes to humans. This article focuses on an evolutionarily related family of extracellular lipases that include lipoprotein lipase, hepatic lipase and endothelial lipase. As newly synthesized proteins, these lipases undergo a series of co- and post-translational maturation steps occurring in the endoplasmic reticulum, including glycosylation and glycan processing, and protein folding and subunit assembly. This article identifies and discusses mechanisms that direct early and late events in lipase folding and assembly. Lipase maturation employs the two general chaperone systems operating in the endoplasmic reticulum, as well as a recently identified lipase-specific chaperone termed lipase maturation factor 1. We propose that the two general chaperone systems act in a coordinated manner early in lipase maturation in order to help create partially folded monomers; lipase maturation factor 1 then facilitates final monomer folding and subunit assembly into fully functional homodimers. Once maturation is complete, the lipases exit the endoplasmic reticulum and are secreted to extracellular sites, where they carry out a number of functions related to lipoprotein and lipid metabolism. PMID:20543905

  8. Chlorogenic acid supplementation during in vitro maturation improves maturation, fertilization and developmental competence of porcine oocytes.

    PubMed

    Nguyen, T-V; Tanihara, F; Do, Ltk; Sato, Y; Taniguchi, M; Takagi, M; Van Nguyen, T; Otoi, T

    2017-12-01

    Chlorogenic acid (CGA) is a quinic acid conjugate of caffeic acid, and a phytochemical found in many fruits and beverages that acts as an antioxidant. The present study investigated the effects of CGA supplementation during in vitro maturation (IVM), on in vitro development of porcine oocytes, to improve the porcine in vitro production (IVP) system. Oocytes were matured either without (control) or with CGA (10, 50, 100 and 200 μM). Subsequently, the matured oocytes were fertilized and cultured in vitro for 7 day. The rates of maturation, fertilization and blastocyst formation of oocytes matured with 50 μM CGA were significantly (p < .05) higher than those of the control oocytes. Hydrogen peroxide (H 2 O 2 ) is one of the reactive oxygen species and induces DNA damage in porcine oocytes. When oocytes were matured with 1 mM H 2 O 2 to assess the protective effect of CGA, 50 μM CGA supplementation improved the maturation rate and the proportion of DNA-fragmented nuclei in oocytes compared with control oocytes matured without CGA. Moreover, when oocytes were matured with either 50 μM CGA (control) or caffeic acid (10, 50 and 100 μM), the rates of maturation, fertilization and the blastocyst formation of oocytes matured with 50 μM CGA were similar to those of oocytes matured with 10 and 50 μM caffeic acid. Our results suggest that CGA has comparable effects to caffeic acid, and IVM with 50 μM CGA is particularly beneficial to IVP of porcine embryos and protects oocytes from DNA damage induced by oxidative stress. Supplementation of CGA to the maturation medium has a potential to improve porcine IVP system. © 2017 Blackwell Verlag GmbH.

  9. 7 CFR 51.3746 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Standards for Grades of Honey Dew and Honey Ball Type Melons Definitions § 51.3746 Mature. Mature means that the melon has reached the stage of maturity which will insure the proper completion of the normal...

  10. 7 CFR 51.3746 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Standards for Grades of Honey Dew and Honey Ball Type Melons Definitions § 51.3746 Mature. Mature means that the melon has reached the stage of maturity which will insure the proper completion of the normal...

  11. Maturation inhibitors: a new therapeutic class targets the virus structure.

    PubMed

    Salzwedel, Karl; Martin, David E; Sakalian, Michael

    2007-01-01

    The current standard of care for HIV/AIDS in the developed world is HAART therapy, usually a combination of two reverse transcriptase inhibitors and a protease inhibitor. Despite the success of this regimen, there is a continuing need for new drug options to overcome problems with tolerability and the emergence of viral resistance. In this review we discuss the discovery of a potential new class of antiretroviral therapeutics, known as maturation inhibitors, and the development of the first-in-class compound, bevirimat. Bevirimat is distinguished from the currently available antiretrovirals by its unique target and mode of action. While the specific interactions responsible for activity have yet to be fully characterized, it is clear that the target for bevirimat is the Gag polyprotein precursor, the main structural protein responsible for assembly and budding of virion particles. As basic research continues on the precise mechanism of action of bevirimat, clinical development is progressing, with demonstration of both safety and efficacy in early-stage trials. These encouraging results, coupled with the discovery and development of future generations of maturation inhibitors, suggest that maturation inhibitors may be added to the growing set of tools available to control HIV/AIDS.

  12. Translation of an Action Learning Collaborative Model Into a Community-Based Intervention to Promote Physical Activity and Healthy Eating.

    PubMed

    Schifferdecker, Karen E; Adachi-Mejia, Anna M; Butcher, Rebecca L; O'Connor, Sharon; Li, Zhigang; Bazos, Dorothy A

    2016-01-01

    Action Learning Collaboratives (ALCs), whereby teams apply quality improvement (QI) tools and methods, have successfully improved patient care delivery and outcomes. We adapted and tested the ALC model as a community-based obesity prevention intervention focused on physical activity and healthy eating. The intervention used QI tools (e.g., progress monitoring) and team-based activities and was implemented in three communities through nine monthly meetings. To assess process and outcomes, we used a longitudinal repeated-measures and mixed-methods triangulation approach with a quasi-experimental design including objective measures at three time points. Most of the 97 participants were female (85.4%), White (93.8%), and non-Hispanic/Latino (95.9%). Average age was 52 years; 28.0% had annual household income of $20,000 or less; and mean body mass index was 35. Through mixed-effects models, we found some physical activity outcomes improved. Other outcomes did not significantly change. Although participants favorably viewed the QI tools, components of the QI process such as sharing goals and data on progress in teams and during meetings were limited. Participants' requests for more education or activities around physical activity and healthy eating, rather than progress monitoring and data sharing required for QI activities, challenged ALC model implementation. An ALC model for community-based obesity prevention may be more effective when applied to preexisting teams in community-based organizations. © 2015 Society for Public Health Education.

  13. 7 CFR 51.1238 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1238 Section 51.1238 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.1238 Mature. Mature means that the shells are firm and well developed. ...

  14. 7 CFR 51.1238 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1238 Section 51.1238 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.1238 Mature. Mature means that the shells are firm and well developed. ...

  15. Cryopreservation of somatic embryogenic cultures of Pinus pinaster: effects on regrowth and embryo maturation.

    PubMed

    Álvarez, José M; Cortizo, Millán; Ordás, Ricardo J

    2012-01-01

    Pinus pinaster is one of the most economically important conifers in the world. Somatic embryogenesis is a powerful tool in breeding programmes because it allows the generation of a great number of different clonal lines from seeds of superior genotypes. Unfortunately, embryogenic competence decreases with the age of cultures. Therefore, it is necessary to have a cryopreservation protocol that ensures a continuous supply of juvenile mass while allowing good maturation and conversion rates into vigorously growing plants. In this work we studied the influence of several cryopreservation parameters, such as cryoprotectant solution and pre-cooling temperature, on embryogenic culture regrowth and embryo maturation. Recovery of rewarmed samples after cryopreservation in a -150 degree C freezer depended on the cooling temperature reached prior to plunging the tubes into liquid nitrogen. As a result, we present an optimised cryopreservation protocol that ensures high recovery and embryo maturation rates. The protocol presented is a simple and fast alternative and enabled successful cryopreservation and recovery of 100 percent of the lines tested. Cryopreserved lines presented the same maturation rates as non-cryopreserved controls.

  16. Diagnostic performance of skeletal maturity for the assessment of midpalatal suture maturation.

    PubMed

    Angelieri, Fernanda; Franchi, Lorenzo; Cevidanes, Lucia H S; McNamara, James A

    2015-12-01

    The aim of this study was to analyze the diagnostic performance of the cervical vertebral maturation (CVM) method in estimating accurately the stages of maturation of the midpalatal suture. Cone-beam computed tomography (CBCT) images from 142 subjects (84 female, 58 male; mean age, 14.8 ± 9.7 years) were analyzed by 2 calibrated examiners to define, by visual analysis, the maturational stages of the cervical vertebrae and the midpalatal suture. These CBCT images were required by orthodontists and surgeons for diagnosis and treatment purposes. Positive likelihood ratios (LHRs) were calculated to evaluate the diagnostic performance of the CVM stages in identifying the maturational stages of the midpalatal suture. Positive LHRs greater than 10 were found for several cervical vertebral stages (CSs), including CS1 and CS2 for the identification of midpalatal suture stages A and B, CS3 for the diagnosis of midpalatal suture stage C, and CS5 for the assessment of midpalatal suture stages D and E. These positive LHRs indicated large and often conclusive increases in the likelihood that the CVM stages were associated with specific stages of midpalatal suture maturation. At CS4, there were a moderate positive LHR for stage C and low positive LHRs for stages D and E. Most CVM stages can be used for the diagnosis of the stages of maturation of the midpalatal suture, so that CBCT imaging may not be necessary in these patients. In the postpubertal period, however, an assessment of the midpalatal suture maturation using CBCT images may be indicated in deciding between conventional rapid maxillary expansion and surgically assisted rapid maxillary expansion. On the other hand, if the CVM stage cannot be assessed, chronologic age may be a viable alternative to predict some midpalatal suture stages (particularly the early stages). Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  17. Academic Achievement of High School Students in Relation to Their Anxiety, Emotional Maturity and Social Maturity

    ERIC Educational Resources Information Center

    Puar, Surjit Singh

    2013-01-01

    The present study has been designed to investigate the non-cognitive variables like anxiety, emotional maturity and social maturity and their relationship with academic achievement and also to see the locale-wise differences on the basis of their anxiety, emotional maturity and social maturity. The study was conducted over a sample of 400 (200…

  18. Malignant tumors associated with ovarian mature teratoma: A single institution experience.

    PubMed

    Trabzonlu, Levent; Durmaz, Guray; Vural, Cigdem; Muezzinoglu, Bahar; Corakci, Aydin

    2017-05-01

    The aims of this study are to present demographical features of cases diagnosed with malignant tumor associated with ovarian mature teratoma and to analyze histopathological features and clinical follow up of these tumors. Single-institution retrospective charts were reviewed to identify all cases of ovarian mature teratoma diagnosed from 1998 to 2015. Clinicopathological parameters that were analyzed include age, tumor size, tumor stage, histological type, laterality, IOC diagnosis and whether or not patient has received adjuvant chemotherapy. A total of 218 ovarian mature teratoma cases were identified during the study period. Of the 218 ovarian mature teratoma specimens, eight (3.7%) exhibited malignant tumors. The average age for cases of malignancy associated with ovarian mature teratoma was 44.6 years. The average size of tumors was 10.36cm. On final pathology, histological types of tumors were as follows: two cases each of squamous cell carcinoma and papillary thyroid carcinoma; one case each of mucinous adenocarcinoma, metastatic adenocarcinoma, sebaceous carcinoma and oligodendroglioma. Only one patient with Stage IIB tumor died of disease. One patient was alive with metastatic disease two months after initial diagnosis. Mean and median follow-up times were 64.1 and 49 months, respectively. An ovarian mass that has characteristics of a teratoma in a postmenopausal patient should alert for malignancy -regardless of tumor size. IOC is a valuable tool for the detection of malignancy and should be requested to determine the modality of surgical approach. Copyright © 2017 Elsevier GmbH. All rights reserved.

  19. Leveraging People-Related Maturity Issues for Achieving Higher Maturity and Capability Levels

    NASA Astrophysics Data System (ADS)

    Buglione, Luigi

    During the past 20 years Maturity Models (MM) become a buzzword in the ICT world. Since the initial Crosby's idea in 1979, plenty of models have been created in the Software & Systems Engineering domains, addressing various perspectives. By analyzing the content of the Process Reference Models (PRM) in many of them, it can be noticed that people-related issues have little weight in the appraisals of the capabilities of organizations while in practice they are considered as significant contributors in traditional process and organizational performance appraisals, as stressed instead in well-known Performance Management models such as MBQA, EFQM and BSC. This paper proposes some ways for leveraging people-related maturity issues merging HR practices from several types of maturity models into the organizational Business Process Model (BPM) in order to achieve higher organizational maturity and capability levels.

  20. A Blueprint for Early Care and Education Quality Improvement Initiatives. Publication #2015-07

    ERIC Educational Resources Information Center

    Tout, Kathryn; Epstein, Dale; Soli, Meg; Lowe, Claire

    2015-01-01

    As Quality Rating and Improvement Systems (QRIS) continue to launch and mature across states, questions emerge from stakeholders about how to design and implement effective quality improvement (QI) initiatives that accompany a QRIS. Funders, policymakers, and program developers with limited resources are looking to invest in activities that will…

  1. Neural networks predict tomato maturity stage

    NASA Astrophysics Data System (ADS)

    Hahn, Federico

    1999-03-01

    Almost 40% of the total horticultural produce exported from Mexico the USA is tomato, and quality is fundamental for maintaining the market. Many fruits packed at the green-mature stage do not mature towards a red color as they were harvested before achieving its physiological maturity. Tomato gassed for advancing maturation does not respond on those fruits, and repacking is necessary at terminal markets, causing losses to the producer. Tomato spectral signatures are different on each maturity stage and tomato size was poorly correlated against peak wavelengths. A back-propagation neural network was used to predict tomato maturity using reflectance ratios as inputs. Higher success rates were achieved on tomato maturity stage recognition with neural networks than with discriminant analysis.

  2. 7 CFR 51.693 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.693 Section 51.693 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., California, and Arizona) Definitions § 51.693 Mature. Mature shall have the same meaning currently assigned...

  3. 7 CFR 51.1585 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1585 Section 51.1585 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Consumer Standards for Potatoes Definitions § 51.1585 Mature. Mature means that the outer skin (epidermis...

  4. 7 CFR 51.631 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.631 Section 51.631 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Florida, California, and Arizona) Definitions § 51.631 Mature. Mature shall have the same meaning...

  5. 7 CFR 51.3058 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.3058 Section 51.3058 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., CERTIFICATION, AND STANDARDS) United States Standards for Florida Avocados Definitions § 51.3058 Mature. Mature...

  6. 7 CFR 51.1585 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1585 Section 51.1585 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Consumer Standards for Potatoes Definitions § 51.1585 Mature. Mature means that the outer skin (epidermis...

  7. 7 CFR 51.631 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.631 Section 51.631 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Florida, California, and Arizona) Definitions § 51.631 Mature. Mature shall have the same meaning...

  8. 7 CFR 51.1585 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1585 Section 51.1585 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Consumer Standards for Potatoes Definitions § 51.1585 Mature. Mature means that the outer skin (epidermis...

  9. 7 CFR 51.1351 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1351 Section 51.1351 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., CERTIFICATION, AND STANDARDS) United States Standards for Pears for Canning Definitions § 51.1351 Mature. Mature...

  10. 7 CFR 51.1907 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1907 Section 51.1907 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Consumer Standards for Fresh Tomatoes Definitions § 51.1907 Mature. Mature means that the tomato has...

  11. 7 CFR 51.1907 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1907 Section 51.1907 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Consumer Standards for Fresh Tomatoes Definitions § 51.1907 Mature. Mature means that the tomato has...

  12. 7 CFR 51.1585 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1585 Section 51.1585 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., CERTIFICATION, AND STANDARDS) United States Consumer Standards for Potatoes Definitions § 51.1585 Mature. Mature...

  13. 7 CFR 51.1907 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1907 Section 51.1907 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Consumer Standards for Fresh Tomatoes Definitions § 51.1907 Mature. Mature means that the tomato has...

  14. 7 CFR 51.693 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.693 Section 51.693 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., California, and Arizona) Definitions § 51.693 Mature. Mature shall have the same meaning currently assigned...

  15. 7 CFR 51.1585 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1585 Section 51.1585 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., CERTIFICATION, AND STANDARDS) United States Consumer Standards for Potatoes Definitions § 51.1585 Mature. Mature...

  16. 7 CFR 51.3058 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.3058 Section 51.3058 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., CERTIFICATION, AND STANDARDS) United States Standards for Florida Avocados Definitions § 51.3058 Mature. Mature...

  17. 7 CFR 51.1351 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1351 Section 51.1351 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing..., CERTIFICATION, AND STANDARDS) United States Standards for Pears for Canning Definitions § 51.1351 Mature. Mature...

  18. Impact of a competency based curriculum on quality improvement among internal medicine residents.

    PubMed

    Fok, Mark C; Wong, Roger Y

    2014-11-28

    Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency

  19. Vocational Maturity and Self Concepts.

    ERIC Educational Resources Information Center

    Helbing, Hans

    The relationship between separate dimensions of vocational maturity and different self-concept and identity variables were examined. Subjects were Dutch students, age 14-18 years. The vocational maturity dimensions were measured by Dutch adaptations of American vocational maturity scales. Instruments for self-concept and identity measurement were…

  20. 7 CFR 51.2930 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.2930 Section 51.2930 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Apricots Definitions § 51.2930 Mature. Mature means having reached the stage of...

  1. 7 CFR 51.1238 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1238 Section 51.1238 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Cleaned Virginia Type Peanuts in the Shell Definitions § 51.1238 Mature. Mature means that the...

  2. 7 CFR 51.3058 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.3058 Section 51.3058 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Florida Avocados Definitions § 51.3058 Mature. Mature means that the avocado has reached a...

  3. 7 CFR 51.1823 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1823 Section 51.1823 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. Mature shall have the same meaning assigned the term in the Florida Citrus Code, Chapter 601...

  4. 7 CFR 51.767 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.767 Section 51.767 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. Mature shall have the same meaning assigned the term in the Florida Citrus Code, Chapter 601...

  5. 7 CFR 51.1238 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1238 Section 51.1238 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Cleaned Virginia Type Peanuts in the Shell Definitions § 51.1238 Mature. Mature means that the...

  6. 7 CFR 51.2930 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.2930 Section 51.2930 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Apricots Definitions § 51.2930 Mature. Mature means having reached the stage of...

  7. 7 CFR 51.2930 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.2930 Section 51.2930 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Apricots Definitions § 51.2930 Mature. Mature means having reached the stage of...

  8. 7 CFR 51.1530 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1530 Section 51.1530 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. “Mature” means that the fruit has reached the stage of maturity which will insure a proper...

  9. 7 CFR 51.1823 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1823 Section 51.1823 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Florida Tangerines Definitions § 51.1823 Mature. Mature shall have the same meaning...

  10. 7 CFR 51.1158 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1158 Section 51.1158 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.1158 Mature. Mature shall have the same meaning assigned the term in the Florida Citrus Code...

  11. 7 CFR 51.1158 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1158 Section 51.1158 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.1158 Mature. Mature shall have the same meaning assigned the term in the Florida Citrus Code...

  12. 7 CFR 51.693 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.693 Section 51.693 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.693 Mature. Mature shall have the same meaning currently assigned that term in the laws and...

  13. 7 CFR 51.1158 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1158 Section 51.1158 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Florida Oranges and Tangelos Definitions § 51.1158 Mature. Mature shall have the...

  14. 7 CFR 51.484 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.484 Section 51.484 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Cantaloups 1 Definitions § 51.484 Mature. Mature means that the cantaloup has...

  15. 7 CFR 51.3058 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.3058 Section 51.3058 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Florida Avocados Definitions § 51.3058 Mature. Mature means that the avocado has reached a...

  16. 7 CFR 51.693 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.693 Section 51.693 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.693 Mature. Mature shall have the same meaning currently assigned that term in the laws and...

  17. 7 CFR 51.484 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.484 Section 51.484 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Cantaloups 1 Definitions § 51.484 Mature. Mature means that the cantaloup has...

  18. 7 CFR 51.767 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.767 Section 51.767 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Florida Grapefruit Definitions § 51.767 Mature. Mature shall have the same meaning...

  19. 7 CFR 51.3203 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.3203 Section 51.3203 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Bermuda-Granex-Grano Type Onions Definitions § 51.3203 Mature. Mature means that the...

  20. 7 CFR 51.1823 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1823 Section 51.1823 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Florida Tangerines Definitions § 51.1823 Mature. Mature shall have the same meaning...

  1. 7 CFR 51.3203 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.3203 Section 51.3203 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.3203 Mature. Mature means that the onion is fairly well cured, and at least fairly firm. ...

  2. 7 CFR 51.1238 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1238 Section 51.1238 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Cleaned Virginia Type Peanuts in the Shell Definitions § 51.1238 Mature. Mature means that the...

  3. 7 CFR 51.3203 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.3203 Section 51.3203 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Bermuda-Granex-Grano Type Onions Definitions § 51.3203 Mature. Mature means that the...

  4. 7 CFR 51.1351 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1351 Section 51.1351 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Pears for Canning Definitions § 51.1351 Mature. Mature means that the pear has reached the...

  5. 7 CFR 51.1351 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1351 Section 51.1351 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Pears for Canning Definitions § 51.1351 Mature. Mature means that the pear has reached the...

  6. 7 CFR 51.767 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.767 Section 51.767 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Florida Grapefruit Definitions § 51.767 Mature. Mature shall have the same meaning...

  7. 7 CFR 51.3203 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.3203 Section 51.3203 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.3203 Mature. Mature means that the onion is fairly well cured, and at least fairly firm. ...

  8. 7 CFR 51.484 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.484 Section 51.484 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Cantaloups 1 Definitions § 51.484 Mature. Mature means that the cantaloup has...

  9. 7 CFR 51.3058 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.3058 Section 51.3058 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Florida Avocados Definitions § 51.3058 Mature. Mature means that the avocado has reached a...

  10. 7 CFR 51.1158 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1158 Section 51.1158 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Florida Oranges and Tangelos Definitions § 51.1158 Mature. Mature shall have the...

  11. 7 CFR 51.2651 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.2651 Section 51.2651 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades for Sweet Cherries 1 Definitions § 51.2651 Mature. Mature means that the cherries have...

  12. 7 CFR 51.2651 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.2651 Section 51.2651 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. Mature means that the cherries have reached the stage of growth which will insure the proper...

  13. 7 CFR 51.3203 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.3203 Section 51.3203 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Bermuda-Granex-Grano Type Onions Definitions § 51.3203 Mature. Mature means that the...

  14. 7 CFR 51.1823 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1823 Section 51.1823 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. Mature shall have the same meaning assigned the term in the Florida Citrus Code, Chapter 601...

  15. 7 CFR 51.2651 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.2651 Section 51.2651 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades for Sweet Cherries 1 Definitions § 51.2651 Mature. Mature means that the cherries have...

  16. 7 CFR 51.693 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.693 Section 51.693 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... § 51.693 Mature. Mature shall have the same meaning currently assigned that term in the laws and...

  17. 7 CFR 51.1351 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1351 Section 51.1351 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Pears for Canning Definitions § 51.1351 Mature. Mature means that the pear has reached the...

  18. 7 CFR 51.2651 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.2651 Section 51.2651 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. Mature means that the cherries have reached the stage of growth which will insure the proper...

  19. 7 CFR 51.2651 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.2651 Section 51.2651 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades for Sweet Cherries 1 Definitions § 51.2651 Mature. Mature means that the cherries have...

  20. 7 CFR 51.1530 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1530 Section 51.1530 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. “Mature” means that the fruit has reached the stage of maturity which will insure a proper...

  1. 7 CFR 51.767 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.767 Section 51.767 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Mature. Mature shall have the same meaning assigned the term in the Florida Citrus Code, Chapter 601...

  2. 7 CFR 51.1554 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1554 Section 51.1554 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Potatoes 1 Definitions § 51.1554 Mature. Mature means that the skins of the potatoes...

  3. 7 CFR 51.631 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.631 Section 51.631 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing...) Definitions § 51.631 Mature. Mature shall have the same meaning currently assigned that term in the laws and...

  4. 7 CFR 51.1907 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1907 Section 51.1907 Agriculture..., CERTIFICATION, AND STANDARDS) United States Consumer Standards for Fresh Tomatoes Definitions § 51.1907 Mature. Mature means that the tomato has reached the stage of development which will insure a proper completion...

  5. 7 CFR 51.1907 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1907 Section 51.1907 Agriculture..., CERTIFICATION, AND STANDARDS) United States Consumer Standards for Fresh Tomatoes Definitions § 51.1907 Mature. Mature means that the tomato has reached the stage of development which will insure a proper completion...

  6. 7 CFR 51.3746 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.3746 Section 51.3746 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Honey Dew and Honey Ball Type Melons Definitions § 51.3746 Mature. Mature means that...

  7. 7 CFR 51.1554 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1554 Section 51.1554 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Potatoes 1 Definitions § 51.1554 Mature. Mature means that the skins of the potatoes...

  8. 7 CFR 51.631 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.631 Section 51.631 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing...) Definitions § 51.631 Mature. Mature shall have the same meaning currently assigned that term in the laws and...

  9. 7 CFR 51.631 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.631 Section 51.631 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing...) Definitions § 51.631 Mature. Mature shall have the same meaning currently assigned that term in the laws and...

  10. 7 CFR 51.2930 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.2930 Section 51.2930 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apricots Definitions § 51.2930 Mature. Mature means having reached the stage of development which will insure a proper completion of the...

  11. 7 CFR 51.2930 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.2930 Section 51.2930 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apricots Definitions § 51.2930 Mature. Mature means having reached the stage of development which will insure a proper completion of the...

  12. 7 CFR 51.1554 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1554 Section 51.1554 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Potatoes 1 Definitions § 51.1554 Mature. Mature means that the skins of the potatoes...

  13. Transportation Energy Futures Series. Projected Biomass Utilization for Fuels and Power in a Mature Market

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

    Ruth, M.; Mai, T.; Newes, E.

    2013-03-01

    The viability of biomass as transportation fuel depends upon the allocation of limited resources for fuel, power, and products. By focusing on mature markets, this report identifies how biomass is projected to be most economically used in the long term and the implications for greenhouse gas (GHG) emissions and petroleum use. In order to better understand competition for biomass between these markets and the potential for biofuel as a market-scale alternative to petroleum-based fuels, this report presents results of a micro-economic analysis conducted using the Biomass Allocation and Supply Equilibrium (BASE) modeling tool. The findings indicate that biofuels can outcompetemore » biopower for feedstocks in mature markets if research and development targets are met. The BASE tool was developed for this project to analyze the impact of multiple biomass demand areas on mature energy markets. The model includes domestic supply curves for lignocellulosic biomass resources, corn for ethanol and butanol production, soybeans for biodiesel, and algae for diesel. This is one of a series of reports produced as a result of the Transportation Energy Futures (TEF) project, a Department of Energy-sponsored multi-agency project initiated to pinpoint underexplored strategies for abating GHGs and reducing petroleum dependence related to transportation.« less

  14. Transportation Energy Futures Series: Projected Biomass Utilization for Fuels and Power in a Mature Market

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

    Ruth, M.; Mai, T.; Newes, E.

    2013-03-01

    The viability of biomass as transportation fuel depends upon the allocation of limited resources for fuel, power, and products. By focusing on mature markets, this report identifies how biomass is projected to be most economically used in the long term and the implications for greenhouse gas (GHG) emissions and petroleum use. In order to better understand competition for biomass between these markets and the potential for biofuel as a market-scale alternative to petroleum-based fuels, this report presents results of a micro-economic analysis conducted using the Biomass Allocation and Supply Equilibrium (BASE) modeling tool. The findings indicate that biofuels can outcompetemore » biopower for feedstocks in mature markets if research and development targets are met. The BASE tool was developed for this project to analyze the impact of multiple biomass demand areas on mature energy markets. The model includes domestic supply curves for lignocellulosic biomass resources, corn for ethanol and butanol production, soybeans for biodiesel, and algae for diesel. This is one of a series of reports produced as a result of the Transportation Energy Futures (TEF) project, a Department of Energy-sponsored multi-agency project initiated to pinpoint underexplored strategies for abating GHGs and reducing petroleum dependence related to transportation.« less

  15. Slab replacement maturity guidelines.

    DOT National Transportation Integrated Search

    2014-04-01

    This study investigated the use of maturity method to determine early age strength of concrete in slab : replacement application. Specific objectives were (1) to evaluate effects of various factors on the compressive : maturity-strength relationship ...

  16. The Ontario Psychosocial Oncology Framework: a quality improvement tool.

    PubMed

    Li, Madeline; Green, Esther

    2013-05-01

    To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

  17. 7 CFR 51.1554 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1554 Section 51.1554 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Potatoes 1 Definitions § 51.1554 Mature. Mature means that the skins of the potatoes are generally firmly set and not more than 5 percent of the...

  18. 7 CFR 51.1554 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1554 Section 51.1554 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Potatoes 1 Definitions § 51.1554 Mature. Mature means that the skins of the potatoes are generally firmly set and not more than 5 percent of the...

  19. The developmental dynamics of gait maturation with a focus on spatiotemporal measures.

    PubMed

    Kraan, C M; Tan, A H J; Cornish, K M

    2017-01-01

    Gait analysis is recognised as a powerful clinical tool for studying relationships between motor control and brain function. By drawing on the literature investigating gait in individuals with neurological disorders, this review provides insight into the neural processes that contribute to and regulate specific spatiotemporal sub-components of gait and how they may mature across early to late childhood. This review also discusses the roles of changing anthropomorphic characteristics, and maturing sensory and higher-order cognitive processes in differentiating the developmental trajectories of the sub-components of gait. Importantly, although studies have shown that cognitive-gait interference is larger in children compared to adults, the contributing neurocognitive mechanisms may vary across age groups who have different types of attentional or cognitive vulnerabilities. These findings have implications for current models of gait maturation by highlighting the need for a dynamic model that focuses on the integration of various factors that contribute to gait though experience and practice. This is essential to elucidating why gait and other motor deficits are often contiguous with cognitive neurodevelopmental disorders. Copyright © 2016. Published by Elsevier B.V.

  20. Effect of sericin supplementation during in vitro maturation on the maturation, fertilization and development of porcine oocytes.

    PubMed

    Do, L T K; Namula, Z; Luu, V V; Sato, Y; Taniguchi, M; Isobe, T; Kikuchi, K; Otoi, T

    2014-04-01

    This study aimed to examine the effects of sericin supplementation during in vitro oocyte maturation on the nuclear maturation, fertilization and development of porcine oocytes. Cumulus-oocyte complexes (COCs) were cultured in maturation medium supplemented with 0 (control), 0.1, 0.5, 1.0, 2.5 or 5.0% sericin and were then subjected to in vitro fertilization and embryo culture. More COCs matured with 1.0% sericin underwent germinal vesicle breakdown and reached metaphase II compared with the control COCs matured without sericin (p < 0.01). The proportions of oocytes with DNA-fragmented nuclei did not differ between the groups, regardless of the sericin level. The total fertilization rate of oocytes matured with 1.0% sericin was higher (p < 0.05) than that of oocytes matured with 0.1%, 2.5% and 5.0% sericin. Supplementation with more than 1.0% sericin decreased the DNA fragmentation index of the blastocysts compared with the control group (p < 0.05). However, the supplementation of the maturation medium with sericin had no beneficial effects on the cleavage, development to the blastocyst stage and the total cell number of the embryos. Our findings indicate that supplementation with 1.0% sericin during maturation culture may improve the nuclear maturation and the quality of the embryos but does not affect blastocyst formation. © 2014 Blackwell Verlag GmbH.

  1. Xenopus laevis oocyte maturation is affected by metal chlorides.

    PubMed

    Marin, Matthieu; Slaby, Sylvain; Marchand, Guillaume; Demuynck, Sylvain; Friscourt, Noémie; Gelaude, Armance; Lemière, Sébastien; Bodart, Jean-François

    2015-08-01

    Few studies have been conducted using Xenopus laevis germ cells as oocytes, though these cells offer many advantages allowing both electrophysiological studies and morphological examination. Our aim was to investigate the effects of metal (cadmium, lead, cobalt and zinc) exposures using cell biology approaches. First, cell survival was evaluated with both phenotypical and electrophysiological approaches. Secondly, the effect of metals on oocyte maturation was assessed with morphological observations and electrophysiological recordings. From survival experiments, our results showed that metal chlorides did not affect cell morphology but strongly depolarized X. laevis oocyte resting potential. In addition, cadmium chloride was able to inhibit progesterone-induced oocyte maturation. By contrast, zinc, but also to a lesser extent cadmium, cobalt and lead, were able to enhance spontaneous oocyte maturation in the absence of progesterone stimulation. Finally, electrophysiological recordings revealed that some metal chlorides (lead, cadmium) exposures could disturb calcium signaling in X. laevis oocyte by modifying calcium-activated chloride currents. Our results demonstrated the high sensitivity of X. laevis oocytes toward exogenous metals such as lead and cadmium. In addition, the cellular events recorded might have a predictive value of effects occurring later on the ability of oocytes to be fertilized. Together, these results suggest a potential use of this cellular lab model as a tool for ecotoxicological assessment of contaminated fresh waters. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. A Socioanalytic Model of Maturity

    ERIC Educational Resources Information Center

    Hogan, Robert; Roberts, Brent W.

    2004-01-01

    K0 describes a point of view on maturity that departs from earlier treatments in two ways. First, it rejects the popular assumption from humanistic psychology that maturity is a function of self-actualization and stipulates that maturity is related to certain performance capacities--namely, the ability to form lasting relationships and to achieve…

  3. Serum and urine insulin-like growth factor-1 as biochemical growth maturity indicators.

    PubMed

    Sinha, Mohita; Tripathi, Tulika; Rai, Priyank; Gupta, Santosh Kumar

    2016-12-01

    Biochemical markers are agents directly involved in bone growth and remodeling and can be quantitatively evaluated from various biologic fluids. The aim of this study was to assess the changes in the levels of insulin-like growth factor-1 (IGF-1) in serum and urine as a growth maturity indicator and to compare them with the cervical vertebral maturation radiographic stages. The study was conducted with 72 female subjects aged 8 to 20 years. Cervical vertebral maturation stages, and serum and urine IGF-1 levels were recorded for all subjects, and the subjects were equally divided into the 6 cervical vertebral maturation groups. Median values of IGF-1 for each stage of cervical vertebral maturation were calculated and statistically compared with those of the other stages. The levels of serum and urine IGF-1 at stage 4 of cervical vertebral maturation were significantly higher than those from the other stages (P <0.01). Stage 4 corresponded to a mean age of 13.67 years. A significant correlation was observed between serum and urine IGF-1 (P <0.001). Urine IGF-1 follows the growth curve similar to serum IGF-1. Thus, urine IGF-1 may be regarded as a promising noninvasive tool for growth assessment. Further research is necessary to validate these results in a different population and with a larger sample. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  4. MS-QI: A Modulation Spectrum-Based ECG Quality Index for Telehealth Applications.

    PubMed

    Tobon V, Diana P; Falk, Tiago H; Maier, Martin

    2016-08-01

    As telehealth applications emerge, the need for accurate and reliable biosignal quality indices has increased. One typical modality used in remote patient monitoring is the electrocardiogram (ECG), which is inherently susceptible to several different noise sources, including environmental (e.g., powerline interference), experimental (e.g., movement artifacts), and physiological (e.g., muscle and breathing artifacts). Accurate measurement of ECG quality can allow for automated decision support systems to make intelligent decisions about patient conditions. This is particularly true for in-home monitoring applications, where the patient is mobile and the ECG signal can be severely corrupted by movement artifacts. In this paper, we propose an innovative ECG quality index based on the so-called modulation spectral signal representation. The representation quantifies the rate of change of ECG spectral components, which are shown to be different from the rate of change of typical ECG noise sources. The proposed modulation spectral-based quality index, MS-QI, was tested on 1) synthetic ECG signals corrupted by varying levels of noise, 2) single-lead recorded data using the Hexoskin garment during three activity levels (sitting, walking, running), 3) 12-lead recorded data using conventional ECG machines (Computing in Cardiology 2011 dataset), and 4) two-lead ambulatory ECG recorded from arrhythmia patients (MIT-BIH Arrhythmia Database). Experimental results showed the proposed index outperforming two conventional benchmark quality measures, particularly in the scenarios involving recorded data in real-world environments.

  5. Intimal Hyperplasia, Stenosis, and Arteriovenous Fistula Maturation Failure in the Hemodialysis Fistula Maturation Study.

    PubMed

    Cheung, Alfred K; Imrey, Peter B; Alpers, Charles E; Robbin, Michelle L; Radeva, Milena; Larive, Brett; Shiu, Yan-Ting; Allon, Michael; Dember, Laura M; Greene, Tom; Himmelfarb, Jonathan; Roy-Chaudhury, Prabir; Terry, Christi M; Vazquez, Miguel A; Kusek, John W; Feldman, Harold I

    2017-10-01

    Intimal hyperplasia and stenosis are often cited as causes of arteriovenous fistula maturation failure, but definitive evidence is lacking. We examined the associations among preexisting venous intimal hyperplasia, fistula venous stenosis after creation, and clinical maturation failure. The Hemodialysis Fistula Maturation Study prospectively observed 602 men and women through arteriovenous fistula creation surgery and their postoperative course. A segment of the vein used to create the fistula was collected intraoperatively for histomorphometric examination. On ultrasounds performed 1 day and 2 and 6 weeks after fistula creation, we assessed fistula venous stenosis using pre-specified criteria on the basis of ratios of luminal diameters and peak blood flow velocities at certain locations along the vessel. We determined fistula clinical maturation using criteria for usability during dialysis. Preexisting venous intimal hyperplasia, expressed per 10% increase in a hyperplasia index (range of 0%-100%), modestly associated with lower fistula blood flow rate (relative change, -2.5%; 95% confidence interval [95% CI], -4.6% to -0.4%; P =0.02) at 6 weeks but did not significantly associate with stenosis (odds ratio [OR], 1.07; 95% CI, 1.00 to 1.16; P =0.07) at 6 weeks or failure to mature clinically without procedural assistance (OR, 1.07; 95% CI, 0.99 to 1.15; P =0.07). Fistula venous stenosis at 6 weeks associated with maturation failure (OR, 1.98; 95% CI, 1.25 to 3.12; P =0.004) after controlling for case mix factors, dialysis status, and fistula location. These findings suggest that postoperative fistula venous stenosis associates with fistula maturation failure. Preoperative venous hyperplasia may associate with maturation failure but if so, only modestly. Copyright © 2017 by the American Society of Nephrology.

  6. Comparison of dental maturity in children of different ethnic origins: international maturity curves for clinicians.

    PubMed

    Chaillet, Nils; Nyström, Marjatta; Demirjian, Arto

    2005-09-01

    Dental maturity was studied with 9577 dental panoramic tomograms of healthy subjects from 8 countries, aged between 2 and 25 years of age. Demirjian's method based on 7 teeth was used for determining dental maturity scores, establishing gender-specific tables of maturity scores and development graphs. The aim of this study was to give dental maturity standards when the ethnic origin is unknown and to compare the efficiency and applicability of this method to forensic sciences and dental clinicians. The second aim was to compare the dental maturity of these different populations. We noted an high efficiency for International Demirjian's method at 99% CI (0.85% of misclassified and a mean accuracy between 2 to 18 years +/- 2.15 years), which makes it useful for forensic purposes. Nevertheless, this international method is less accurate than Demirjian's method developed for a specific country, because of the inter-ethnic variability obtained by the addition of 8 countries in the dental database. There are inter-ethnic differences classified in three major groups. Australians have the fastest dental maturation and Koreans have the slowest.

  7. Impact of Contextual Factors on Interventions to Reduce Acute Care Transfers II Implementation and Hospital Readmission Rates.

    PubMed

    Rask, Kimberly J; Hodge, Jennifer; Kluge, Linda

    2017-11-01

    Identify contextual and implementation factors impacting the effectiveness of an organizational-level intervention to reduce preventable hospital readmissions from affiliated skilled nursing facilities (SNFs). Observational study of the implementation of Interventions to Reduce Acute Care Transfers tools in 3 different cohorts. SNFs. SNFs belonging to 1 of 2 corporate entities and a group of independent SNFs that volunteered to participate in a Quality Improvement Organization (QIO) training program. Two groups of SNFs received INTERACT II training and technical assistance from corporate staff, and 1 group of SNFs received training from QIO staff. Thirty-day acute care hospital readmissions from Medicare fee-for-service claims, contextual factors using the Model for Understanding Success in Quality framework. All 3 cohorts were able to deliver the INTERACT training program to their constituent facilities through regional events as well as onsite technical assistance, but the impact on readmission rates varied. Facilities supported by the QIO and corporation A were able to achieve statistically significant reductions in 30-day readmission rates. A review of contextual factors found that although all cohorts were challenged by staff turnover and workload, corporation B facilities struggled with a less mature quality improvement (QI) culture and infrastructure. Both corporations demonstrated a strong corporate commitment to implementing INTERACT II, but differences in training strategies, QI culture, capacity, and competing pressures may have impacted the effectiveness of the training. Proactively addressing these factors may help long-term care organizations interested in reducing acute care readmission rates increase the likelihood of QI success. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

  8. Comparisons among tools, surface orientation, and pencil grasp for children 23 months of age.

    PubMed

    Yakimishyn, Janet E; Magill-Evans, Joyce

    2002-01-01

    The purpose of this study was to determine whether writing tool type and angle of writing surface affect grasp. Fifty-one children 23 to 24 months of age who were typically developing drew with a primary marker, colored pencil, and small piece of crayon on a table and an easel. The marker and pencil were presented pointing left, right, and toward the child. The order of writing tool presentation was counterbalanced. Grasps were scored with a 5-point rating system and analyzed with dependent t tests. Children used a more mature grasp when drawing with a piece of crayon than with a pencil. No difference in grasp maturity was found when using a pencil compared with a marker. A more mature grasp when drawing on the easel compared with the table was used with the crayon but not with the marker or pencil. Results imply that a short writing tool combined with a vertical surface can influence the grasp of young children.

  9. People Capability Maturity Model. SM.

    DTIC Science & Technology

    1995-09-01

    People Capability Maturity Model SM .^^^^_ -——’ Bill Curtis William E. ] Sally Mille] Hefley r Accesion For t NTIS DTIC...People CMM The P-CMM adapts the architecture and the maturity framework underlying the CMM for use with people-related improvement issues. The CMM...focuses on helping organizations improve their software development processes. By adapting the maturity framework and the CMM architecture

  10. Chromophore maturation and fluorescence fluctuation spectroscopy of fluorescent proteins in a cell-free expression system

    PubMed Central

    Macdonald, Patrick J.; Chen, Yan; Mueller, Joachim D.

    2012-01-01

    Cell-free synthesis, a method for the rapid expression of proteins, is increasingly used to study interactions of complex biological systems. GFP and its variants have become indispensable for fluorescence studies in live cells and are equally attractive as reporters for cell-free systems. This work investigates the use of fluorescence fluctuation spectroscopy (FFS) as a tool for quantitative analysis of protein interactions in cell-free expression systems. We also explore chromophore maturation of fluorescent proteins, which is of crucial importance for fluorescence studies. A droplet sample protocol was developed that ensured sufficient oxygenation for chromophore maturation and ease of manipulation for titration studies. The kinetics of chromophore maturation of EGFP, EYFP, and mCherry were analyzed as a function of temperature. A strong increase in the rate from room temperature to 37 °C was observed. We further demonstrate that all EGFP proteins fully mature in the cell-free solution and that brightness is a robust parameter specifying stoichiometry. Finally, FFS is applied to study the stoichiometry of the nuclear transport factor 2 in a cell-free system over a broad concentration range. We conclude that combining cell-free expression and FFS provides a powerful technique for quick, quantitative study of chromophore maturation and protein-protein interaction. PMID:22093611

  11. The reliability of Fishman method of skeletal maturation for age estimation in children of South Indian population

    PubMed Central

    Mohammed, Rezwana Begum; Kalyan, V. Siva; Tircouveluri, Saritha; Vegesna, Goutham Chakravarthy; Chirla, Anil; Varma, D. Maruthi

    2014-01-01

    Introduction: Determining the age of a person in the absence of documentary evidence of birth is essential for legal and medico-legal purpose. Fishman method of skeletal maturation is widely used for this purpose; however, the reliability of this method for people with all geographic locations is not well-established. Aims and Objectives: In this study, we assessed various stages of carpal and metacarpal bone maturation and tested the reliability of Fishman method of skeletal maturation to estimate the age in South Indian population. We also evaluated the correlation between the chronological age (CA) and predicted age based on the Fishman method of skeletal maturation. Materials and Methods: Digital right hand-wrist radiographs of 330 individuals aged 9-20 years were obtained and the skeletal maturity stage for each subject was determined using Fishman method. The skeletal maturation indicator scores were obtained and analyzed with reference to CA and sex. Data was analyzed using the SPSS software package (version 12, SPSS Inc., Chicago, IL, USA). Results: The study subjects had a tendency toward late maturation with the mean skeletal age (SA) estimated being significantly lowers (P < 0.05) than the mean CA at various skeletal maturity stages. Nevertheless, significant correlation was observed in this study between SA and CA for males (r = 0.82) and females (r = 0.85). Interestingly, female subjects were observed to be advanced in SA compared with males. Conclusion: Fishman method of skeletal maturation can be used as an alternative tool for the assessment of mean age of an individual of unknown CA in South Indian children. PMID:25097402

  12. The reliability of Fishman method of skeletal maturation for age estimation in children of South Indian population.

    PubMed

    Mohammed, Rezwana Begum; Kalyan, V Siva; Tircouveluri, Saritha; Vegesna, Goutham Chakravarthy; Chirla, Anil; Varma, D Maruthi

    2014-07-01

    Determining the age of a person in the absence of documentary evidence of birth is essential for legal and medico-legal purpose. Fishman method of skeletal maturation is widely used for this purpose; however, the reliability of this method for people with all geographic locations is not well-established. In this study, we assessed various stages of carpal and metacarpal bone maturation and tested the reliability of Fishman method of skeletal maturation to estimate the age in South Indian population. We also evaluated the correlation between the chronological age (CA) and predicted age based on the Fishman method of skeletal maturation. Digital right hand-wrist radiographs of 330 individuals aged 9-20 years were obtained and the skeletal maturity stage for each subject was determined using Fishman method. The skeletal maturation indicator scores were obtained and analyzed with reference to CA and sex. Data was analyzed using the SPSS software package (version 12, SPSS Inc., Chicago, IL, USA). The study subjects had a tendency toward late maturation with the mean skeletal age (SA) estimated being significantly lowers (P < 0.05) than the mean CA at various skeletal maturity stages. Nevertheless, significant correlation was observed in this study between SA and CA for males (r = 0.82) and females (r = 0.85). Interestingly, female subjects were observed to be advanced in SA compared with males. Fishman method of skeletal maturation can be used as an alternative tool for the assessment of mean age of an individual of unknown CA in South Indian children.

  13. Development of a fourth generation predictive capability maturity model.

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

    Hills, Richard Guy; Witkowski, Walter R.; Urbina, Angel

    2013-09-01

    The Predictive Capability Maturity Model (PCMM) is an expert elicitation tool designed to characterize and communicate completeness of the approaches used for computational model definition, verification, validation, and uncertainty quantification associated for an intended application. The primary application of this tool at Sandia National Laboratories (SNL) has been for physics-based computational simulations in support of nuclear weapons applications. The two main goals of a PCMM evaluation are 1) the communication of computational simulation capability, accurately and transparently, and 2) the development of input for effective planning. As a result of the increasing importance of computational simulation to SNLs mission, themore » PCMM has evolved through multiple generations with the goal to provide more clarity, rigor, and completeness in its application. This report describes the approach used to develop the fourth generation of the PCMM.« less

  14. The maturity index as a tool to facilitate the interpretation of changes in vitellogenin production and sex ratio in the Fish Sexual Development Test.

    PubMed

    Baumann, Lisa; Holbech, Henrik; Keiter, Susanne; Kinnberg, Karin Lund; Knörr, Susanne; Nagel, Tina; Braunbeck, Thomas

    2013-03-15

    In July 2011, the Fish Sexual Development Test (FSDT) has officially been adopted as OECD test guideline 234 for the detection of endocrine disrupting chemicals (EDCs). Sex ratio and vitellogenin (VTG) induction are the mandatory endocrine endpoints within this test, whereas gonad staging is only included as an option. In the present study, five FSDTs with zebrafish (Danio rerio) were conducted with EDCs with different modes of action (17α-ethinylestradiol, dihydrotestosterone, 17β-trenbolone, prochloraz and 4-tert-pentylphenol). Results document that not only sex ratio and VTG production of the exposed fish were massively affected, but also gonad maturation. As a novel approach for the quantification of gonad maturation in zebrafish, the maturity index was developed to allow not only an improved assessment of dose-dependent EDC-related effects on gonad maturation, but also statistical analysis of histological data. VTG induction and maturity index showed an excellent correlation for all five EDCs tested. Most importantly, the maturity index often helped to find appropriate interpretations for results that seemed contradictory at first sight. Results show that histological analyses and their predictive power for population fitness are currently underestimated and should become a standard component in the evaluation of potential EDCs. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Applying the High Reliability Health Care Maturity Model to Assess Hospital Performance: A VA Case Study.

    PubMed

    Sullivan, Jennifer L; Rivard, Peter E; Shin, Marlena H; Rosen, Amy K

    2016-09-01

    The lack of a tool for categorizing and differentiating hospitals according to their high reliability organization (HRO)-related characteristics has hindered progress toward implementing and sustaining evidence-based HRO practices. Hospitals would benefit both from an understanding of the organizational characteristics that support HRO practices and from knowledge about the steps necessary to achieve HRO status to reduce the risk of harm and improve outcomes. The High Reliability Health Care Maturity (HRHCM) model, a model for health care organizations' achievement of high reliability with zero patient harm, incorporates three major domains critical for promoting HROs-Leadership, Safety Culture, and Robust Process Improvement ®. A study was conducted to examine the content validity of the HRHCM model and evaluate whether it can differentiate hospitals' maturity levels for each of the model's components. Staff perceptions of patient safety at six US Department of Veterans Affairs (VA) hospitals were examined to determine whether all 14 HRHCM components were present and to characterize each hospital's level of organizational maturity. Twelve of the 14 components from the HRHCM model were detected; two additional characteristics emerged that are present in the HRO literature but not represented in the model-teamwork culture and system-focused tools for learning and improvement. Each hospital's level of organizational maturity could be characterized for 9 of the 14 components. The findings suggest the HRHCM model has good content validity and that there is differentiation between hospitals on model components. Additional research is needed to understand how these components can be used to build the infrastructure necessary for reaching high reliability.

  16. Geometric morphometric evaluation of cervical vertebrae shape and its relationship to skeletal maturation.

    PubMed

    Chatzigianni, Athina; Halazonetis, Demetrios J

    2009-10-01

    Cervical vertebrae shape has been proposed as a diagnostic factor for assessing skeletal maturation in orthodontic patients. However, evaluation of vertebral shape is mainly based on qualitative criteria. Comprehensive quantitative measurements of shape and assessments of its predictive power have not been reported. Our aims were to measure vertebral shape by using the tools of geometric morphometrics and to evaluate the correlation and predictive power of vertebral shape on skeletal maturation. Pretreatment lateral cephalograms and corresponding hand-wrist radiographs of 98 patients (40 boys, 58 girls; ages, 8.1-17.7 years) were used. Skeletal age was estimated from the hand-wrist radiographs. The first 4 vertebrae were traced, and 187 landmarks (34 fixed and 153 sliding semilandmarks) were used. Sliding semilandmarks were adjusted to minimize bending energy against the average of the sample. Principal components analysis in shape and form spaces was used for evaluating shape patterns. Shape measures, alone and combined with centroid size and age, were assessed as predictors of skeletal maturation. Shape alone could not predict skeletal maturation better than chronologic age. The best prediction was achieved with the combination of form space principal components and age, giving 90% prediction intervals of approximately 200 maturation units in the girls and 300 units in the boys. Similar predictive power could be obtained by using centroid size and age. Vertebrae C2, C3, and C4 gave similar results when examined individually or combined. C1 showed lower correlations, signifying lower integration with hand-wrist maturation. Vertebral shape is strongly correlated to skeletal age but does not offer better predictive value than chronologic age.

  17. Developing a caries risk registry to support caries risk assessment and management for children: A quality improvement initiative.

    PubMed

    Ruff, Jesley C; Herndon, Jill Boylston; Horton, Roger A; Lynch, Julie; Mathwig, Dawn C; Leonard, Audra; Aravamudhan, Krishna

    2017-10-27

    Health registries are commonly used in medicine to support public health activities and are increasingly used in quality improvement (QI) initiatives. Illustrations of dental registries and their QI applications are lacking. Within dentistry, caries risk assessment implementation and documentation are vital to optimal patient care. The purpose of this article is to describe the processes used to develop a caries risk assessment registry as a QI initiative to support clinical caries risk assessment, caries prevention, and disease management for children. Developmental steps reflected Agency for Healthcare Research and Quality recommendations for planning QI registries and included engaging "champions," defining the project, identifying registry features, defining performance dashboard indicators, and pilot testing with participant feedback. We followed Standards for Quality Improvement Reporting Excellence guidelines. Registry eligibility is patients aged 0-17 years. QI tools include prompts to register eligible patients; decision support tools grounded in evidence-based guidelines; and performance dashboard reports delivered at the provider and aggregated levels at regular intervals. The registry was successfully piloted in two practices with documented caries risk assessment increasing from 57 percent to 92 percent and positive feedback regarding the potential to improve dental practice patient centeredness, patient engagement and education, and quality of care. The caries risk assessment registry demonstrates how dental registries may be used in QI efforts to promote joint patient and provider engagement, foster shared decision making, and systematically collect patient information to generate timely and actionable data to improve care quality and patient outcomes at the individual and population levels. © 2017 American Association of Public Health Dentistry.

  18. Using a State Birth Registry as a Quality Improvement Tool.

    PubMed

    Lannon, Carole; Kaplan, Heather C; Friar, Kelly; Fuller, Sandra; Ford, Susan; White, Beth; Besl, John; Paulson, John; Marcotte, Michael; Krew, Michael; Bailit, Jennifer; Iams, Jay

    2017-08-01

    Background  Birth registry data are universally collected, generating large administrative datasets. However, these data are typically not used for quality improvement (QI) initiatives in perinatal medicine because the quality and timeliness of the information is uncertain. Objective  We sought to identify and address causes of inaccuracy in recording birth registry information so that birth registry data could support statewide obstetrical quality initiatives in Ohio. Study Design  The Ohio Perinatal Quality Collaborative and the Ohio Department of Health Vital Statistics used QI techniques in 15 medium-sized maternity hospitals to identify and remove systemic sources of inaccuracy in birth registry data. The primary outcome was the rate of scheduled deliveries without medical indication between 37 0/7 and 38 6/7 weeks at participating hospitals from birth registry data. Results  Inaccurate birth registry data most commonly resulted from limited communication between clinical and medical record staff. The rate of scheduled births between 37 0/7 and 38 6/7 weeks' gestation without a documented medical indication as recorded in the birth registry declined by 35%. Conclusion  A QI initiative aimed at increasing the accuracy of birth registry information demonstrated the utility of these data for surveillance of perinatal outcomes and has led to ongoing efforts to support birth registrars in submitting accurate data. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Effect of Thermal Maturation on n-alkanes and Kerogen in Preserved Organic Matter: Implications for Paleoenvironment Biomarkers

    NASA Astrophysics Data System (ADS)

    Craven, O. D.; Longbottom, T. L.; Hockaday, W. C.; Blackaby, E.

    2017-12-01

    between the matured type I and II organic matter indicate that organic matter type affects when n-alkane measurements change due to maturity. Additionally, the kerogen carbonyl functional group (FaC) decreases greatly from immature to low maturities, leveling off between 300 °C and 325 °C, allowing FaC to be a tool for determining low maturities.

  20. Naturally Engineered Maturation of Cardiomyocytes

    PubMed Central

    Scuderi, Gaetano J.; Butcher, Jonathan

    2017-01-01

    Ischemic heart disease remains one of the most prominent causes of mortalities worldwide with heart transplantation being the gold-standard treatment option. However, due to the major limitations associated with heart transplants, such as an inadequate supply and heart rejection, there remains a significant clinical need for a viable cardiac regenerative therapy to restore native myocardial function. Over the course of the previous several decades, researchers have made prominent advances in the field of cardiac regeneration with the creation of in vitro human pluripotent stem cell-derived cardiomyocyte tissue engineered constructs. However, these engineered constructs exhibit a functionally immature, disorganized, fetal-like phenotype that is not equivalent physiologically to native adult cardiac tissue. Due to this major limitation, many recent studies have investigated approaches to improve pluripotent stem cell-derived cardiomyocyte maturation to close this large functionality gap between engineered and native cardiac tissue. This review integrates the natural developmental mechanisms of cardiomyocyte structural and functional maturation. The variety of ways researchers have attempted to improve cardiomyocyte maturation in vitro by mimicking natural development, known as natural engineering, is readily discussed. The main focus of this review involves the synergistic role of electrical and mechanical stimulation, extracellular matrix interactions, and non-cardiomyocyte interactions in facilitating cardiomyocyte maturation. Overall, even with these current natural engineering approaches, pluripotent stem cell-derived cardiomyocytes within three-dimensional engineered heart tissue still remain mostly within the early to late fetal stages of cardiomyocyte maturity. Therefore, although the end goal is to achieve adult phenotypic maturity, more emphasis must be placed on elucidating how the in vivo fetal microenvironment drives cardiomyocyte maturation. This

  1. 7 CFR 51.1904 - Maturity classification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Maturity classification. 51.1904 Section 51.1904 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Maturity Classification § 51.1904 Maturity classification. Tomatoes which are characteristically red when...

  2. 7 CFR 51.1904 - Maturity classification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Maturity classification. 51.1904 Section 51.1904 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards... Maturity Classification § 51.1904 Maturity classification. Tomatoes which are characteristically red when...

  3. [metabonomics research on coronary heart disease patients of phlegm turbidity syndrome and qi deficiency syndrome].

    PubMed

    Cheng, Peng; Chen, Ze-qi; Wang, Dong-sheng

    2015-02-01

    To study the correlation between Chinese medical types of coronary heart disease (CHD) [i.e., phlegm turbidity syndrome (PTS) and qi deficiency syndrome (QDS)] and their metabolites. Recruited were 65 CHD patients including 37 cases of PTS and 28 cases of QDS. Serum endogenous metabolites in the two syndrome types were determined by gas chromatograph-mass spectrometer-computer (GC/MS), and their differences between their metabolic profiles analyzed. More than 100 chromatographic peaks were totally scanned. Chromatograms obtained was matched with mass spectrum bank, and finally we got the category contribution value of 46 kinds of substances. Results of MCTree analysis showed patients of PTS and patients of QDS could be effectively distinguished. Compounds contributing to identify the two syndromes were sequenced as serine, valine, 2 hydroxy propionic acid. Comparison of metabolites showed contents of serine and 2 hydroxy propionic acid were higher in patients of PTS than in patients of QDS (P<0.05). The differences in the metabonomics of CHD TCM syndrome types could provide material bases for TCM syndrome differentiation of CHD, indicating that metabonomics technologies might become a new research method for TCM syndrome typing.

  4. A novel approach to leveraging electronic health record data to enhance pediatric surgical quality improvement bundle process compliance.

    PubMed

    Fisher, Jason C; Godfried, David H; Lighter-Fisher, Jennifer; Pratko, Joseph; Sheldon, Mary Ellen; Diago, Thelma; Kuenzler, Keith A; Tomita, Sandra S; Ginsburg, Howard B

    2016-06-01

    Quality improvement (QI) bundles have been widely adopted to reduce surgical site infections (SSI). Improvement science suggests when organizations achieve high-reliability to QI processes, outcomes dramatically improve. However, measuring QI process compliance is poorly supported by electronic health record (EHR) systems. We developed a custom EHR tool to facilitate capture of process data for SSI prevention with the aim of increasing bundle compliance and reducing adverse events. Ten SSI prevention bundle processes were linked to EHR data elements that were then aggregated into a snapshot display superimposed on weekly case-log reports. The data aggregation and user interface facilitated efficient review of all SSI bundle elements, providing an exact bundle compliance rate without random sampling or chart review. Nine months after implementation of our custom EHR tool, we observed centerline shifts in median SSI bundle compliance (46% to 72%). Additionally, as predicted by high reliability principles, we began to see a trend toward improvement in SSI rates (1.68 to 0.87 per 100 operations), but a discrete centerline shift was not detected. Simple informatics solutions can facilitate extraction of QI process data from the EHR without relying on adjunctive systems. Analyses of these data may drive reductions in adverse events. Pediatric surgical departments should consider leveraging the EHR to enhance bundle compliance as they implement QI strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Innovative model of delivering quality improvement education for trainees--a pilot project.

    PubMed

    Ramar, Kannan; Hale, Curt W; Dankbar, Eugene C

    2015-01-01

    After incorporating quality improvement (QI) education as a required curriculum for our trainees in 2010, a need arose to readdress our didactic sessions as they were too long, difficult to schedule, and resulting in a drop in attendance. A 'flipped classroom' (FC) model to deliver QI education was touted to be an effective delivery method as it allows the trainees to view didactic materials on videos, on their own time, and uses the classroom to clarify concepts and employ learned tools on case-based scenarios including workshops. The Mayo Quality Academy prepared 29 videos that incorporated the previously delivered 17 weekly didactic sessions, for a total duration of 135 min. The half-day session clarified questions related to the videos, followed by case examples and a hands-on workshop on how to perform and utilize a few commonly used QI tools and methods. Seven trainees participated. There was a significant improvement in knowledge as measured by pre- and post-FC model test results [improvement by 40.34% (SD 16.34), p<0.001]. The survey results were overall positive about the FC model with all trainees strongly agreeing that we should continue with this model to deliver QI education. The pilot project of using the FC model to deliver QI education was successful in a small sample of trainees.

  6. Promoting antenatal steroid use for fetal maturation: results from the California Perinatal Quality Care Collaborative.

    PubMed

    Wirtschafter, David D; Danielsen, Beate H; Main, Elliott K; Korst, Lisa M; Gregory, Kimberly D; Wertz, Andrew; Stevenson, David K; Gould, Jeffrey B

    2006-05-01

    The California Perinatal Quality Care Collaborative (CPQCC) was formed to seek perinatal care improvements by creating a confidential multi-institutional database to identify topics for quality improvement (QI). We aimed to evaluate this approach by assessing antenatal steroid administration before preterm (24 to 33 weeks of gestation) delivery. We hypothesized that mean performance would improve and the number of centers performing below the lowest quartile of the baseline year would decrease. In 1998, a statewide QI cycle targeting antenatal steroid use was announced, calling for the evaluation of the 1998 baseline data, dissemination of recommended interventions using member-developed educational materials, and presentations to California neonatologists in 1999-2000. Postintervention data were assessed for the year 2001 and publicly released in 2003. A total of 25 centers voluntarily participated in the intervention. Antenatal steroid administration rate increased from 76% of 1524 infants in 1998 to 86% of 1475 infants in 2001 (P < .001). In 2001, 23 of 25 hospitals exceeded the 1998 lower-quartile cutoff point of 69.3%. Regional collaborations represent an effective strategy for improving the quality of perinatal care.

  7. Education Practices and Maturation

    ERIC Educational Resources Information Center

    Froumin, I. D.

    2018-01-01

    The article briefly discusses the question of how we should establish special educational practices that could help students mature. In identifying such practices, the author looks to a number of empirical studies that allow us to understand what significance the concept of "maturation" has for children and teenagers. In conclusion, the…

  8. Debt-maturity structures should match risk preferences.

    PubMed

    Gapenski, L C

    1999-12-01

    Key to any debt-maturity matching strategy is financing assets with the appropriate debt structure. Financial managers need to establish an optimal capital structure and then choose the best maturity-matching structure for their debt. Two maturity-matching strategies that are available to healthcare financial managers are the accounting approach and the finance approach. The accounting approach, which defines asset maturities as current or fixed, is a riskier financing strategy than the finance approach, which defines asset maturities as permanent or temporary. The added risk occurs because of the accounting approach's heavy reliance on short-term debt. The accounting approach offers the potential for lower costs at the expense of higher risk. Healthcare financial managers who believe the financing function should support the organization's operations without adding undue risk should use the finance approach to maturity matching. Asset maturities in those organizations then should be considered permanent or temporary rather than current or fixed, and the debt-maturity structure should reflect this.

  9. 7 CFR 51.1904 - Maturity classification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Maturity classification. 51.1904 Section 51.1904... STANDARDS) United States Consumer Standards for Fresh Tomatoes Size and Maturity Classification § 51.1904 Maturity classification. Tomatoes which are characteristically red when ripe, but are not overripe or soft...

  10. 7 CFR 51.1904 - Maturity classification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Maturity classification. 51.1904 Section 51.1904... STANDARDS) United States Consumer Standards for Fresh Tomatoes Size and Maturity Classification § 51.1904 Maturity classification. Tomatoes which are characteristically red when ripe, but are not overripe or soft...

  11. 7 CFR 51.1904 - Maturity classification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Maturity classification. 51.1904 Section 51.1904... STANDARDS) United States Consumer Standards for Fresh Tomatoes Size and Maturity Classification § 51.1904 Maturity classification. Tomatoes which are characteristically red when ripe, but are not overripe or soft...

  12. Retrovirus maturation-an extraordinary structural transformation.

    PubMed

    Mattei, Simone; Schur, Florian Km; Briggs, John Ag

    2016-06-01

    Retroviruses such as HIV-1 assemble and bud from infected cells in an immature, non-infectious form. Subsequently, a series of proteolytic cleavages catalysed by the viral protease leads to a spectacular structural rearrangement of the viral particle into a mature form that is competent to fuse with and infect a new cell. Maturation involves changes in the structures of protein domains, in the interactions between protein domains, and in the architecture of the viral components that are assembled by the proteins. Tight control of proteolytic cleavages at different sites is required for successful maturation, and the process is a major target of antiretroviral drugs. Here we will describe what is known about the structures of immature and mature retrovirus particles, and about the maturation process by which one transitions into the other. Despite a wealth of available data, fundamental questions about retroviral maturation remain unanswered. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  13. The RY/Sph element mediates transcriptional repression of maturation genes from late maturation to early seedling growth.

    PubMed

    Guerriero, Gea; Martin, Nathalie; Golovko, Anna; Sundström, Jens F; Rask, Lars; Ezcurra, Ines

    2009-11-01

    In orthodox seeds, the transcriptional activator ABI3 regulates two major stages in embryo maturation: a mid-maturation (MAT) stage leading to accumulation of storage compounds, and a late maturation (LEA) stage leading to quiescence and desiccation tolerance. Our aim was to elucidate mechanisms for transcriptional shutdown of MAT genes during late maturation, to better understand phase transition between MAT and LEA stages. Using transgenic and transient approaches in Nicotiana, we examined activities of two ABI3-dependent reporter genes driven by multimeric RY and abscisic acid response elements (ABREs) from a Brassica napus napin gene, termed RY and ABRE, where the RY reporter requires ABI3 DNA binding. Expression of RY peaks during mid-maturation and drops during late maturation, mimicking the MAT gene program, and in Arabidopsis thaliana RY elements are over-represented in MAT, but not in LEA, genes. The ABI3 transactivation of RY is inhibited by staurosporine, by a PP2C phosphatase, and by a repressor of maturation genes, VAL1/HSI2. The RY element mediates repression of MAT genes, and we propose that transcriptional shutdown of the MAT program during late maturation involves inhibition of ABI3 DNA binding by dephosphorylation. Later, during seedling growth, VAL1/HSI2 family repressors silence MAT genes by binding RY elements.

  14. Cervical vertebral maturation as a biologic indicator of skeletal maturity.

    PubMed

    Santiago, Rodrigo César; de Miranda Costa, Luiz Felipe; Vitral, Robert Willer Farinazzo; Fraga, Marcelo Reis; Bolognese, Ana Maria; Maia, Lucianne Cople

    2012-11-01

    To identify and review the literature regarding the reliability of cervical vertebrae maturation (CVM) staging to predict the pubertal spurt. The selection criteria included cross-sectional and longitudinal descriptive studies in humans that evaluated qualitatively or quantitatively the accuracy and reproducibility of the CVM method on lateral cephalometric radiographs, as well as the correlation with a standard method established by hand-wrist radiographs. The searches retrieved 343 unique citations. Twenty-three studies met the inclusion criteria. Six articles had moderate to high scores, while 17 of 23 had low scores. Analysis also showed a moderate to high statistically significant correlation between CVM and hand-wrist maturation methods. There was a moderate to high reproducibility of the CVM method, and only one specific study investigated the accuracy of the CVM index in detecting peak pubertal growth. This systematic review has shown that the studies on CVM method for radiographic assessment of skeletal maturation stages suffer from serious methodological failures. Better-designed studies with adequate accuracy, reproducibility, and correlation analysis, including studies with appropriate sensitivity-specificity analysis, should be performed.

  15. Correlation between chronological age, cervical vertebral maturation and Fishman's skeletal maturity indicators in southern Chinese.

    PubMed

    Alkhal, Hessa Abdulla; Wong, Ricky W K; Rabie, A Bakr M

    2008-07-01

    To investigate the correlation between chronological age, cervical vertebral maturation (CVM), and Fishman's hand-wrist skeletal maturity indicators in southern Chinese. Four hundred contemporary hand-wrist and lateral cephalometric radiographs of southern Chinese subjects were randomly selected and analyzed. The female subjects were between 10 and 15 years of age, and the male subjects were between 12 and 17 years of age; all subjects were within the circumpubertal period. The CVM was assessed using the method developed by Baccetti and coworkers, but the hand-wrist maturation was assessed using the method developed by Fishman. These two methods and the chronological age were correlated using the Spearman rank correlation analysis. The CVM was significantly correlated with the hand-wrist skeletal age (Spearman r male = 0.9206, female = 0.9363). All patients in the cervical maturation stage (CS3) of CVM were discovered to be in the skeletal maturational indicator (SMI2 or SMI3) stages of hand-wrist maturation (HWM), which was around the peak of the growth spurt. Low correlations were found between the CVM and chronological age (male r = 0.7577; female r = 0.7877) and between the HWM and chronological age (male r = 0.7492; female r = 0.7758). CVM is a valid indicator of skeletal growth during the circumpubertal and has a high correlation with the HWM for the southern Chinese population. However, the low correlations found between the chronological age and both CVM and HWM showed that the chronological age was not suitable to measure skeletal maturity.

  16. Development and Validation of an UPLC-MS/MS Method for Pharmacokinetic Comparison of Five Alkaloids from JinQi Jiangtang Tablets and Its Monarch Drug Coptidis Rhizoma

    PubMed Central

    Sun, Lili; Ding, Feifei; You, Guangjiao; Liu, Han; Wang, Meng; Ren, Xiaoliang; Deng, Yanru

    2017-01-01

    JinQi Jiangtang (JQJT) tablets, a Chinese patent medicine approved by the State Food and Drug Administration, are composed of Coptidis Rhizoma, Astragali Radix, and Lonicerae Japonicae Flos, and have a significant effect on diabetes. Coptidis Rhizoma is monarch drug in the prescription. The aim of the present study was to investigate and compare the pharmacokinetics of multiple ingredients from JQJT tablets and Coptidis Rhizoma extract (CRE) following oral administration in rats. Five alkaloids: coptisine chloride, epiberberine chloride, berberine chloride, jatrorrhizine chloride, and palmatine chloride, were simultaneously determined in rat plasma using established and validated ultra-high performance liquid chromatography mass spectrometry (UPLC-MS/MS). Significant pharmacokinetic differences were observed for the five alkaloids after a single administration of CRE and JQJT tablets. Compared with CRE, the Cmax values of palmatine chloride and jatrorrhizine chloride were decreased significantly, the AUC0–t values of four alkaloids (all except jatrorrhizine chloride) were notably decreased, and the mean residence times of all five alkaloids were significantly decreased after administration of JQJT tablets. The results indicated that the absorption characteristics of the five alkaloids from Coptidis Rhizoma would be influenced by the compatibility of Astragali Radix or Lonicerae Japonicae Flos from JQJT tablets, such that absorption was inhibited and elimination was accelerated. In conclusion, the developed strategy was suitable for the comparison of five alkaloids from JinQi Jiangtang tablets and its monarch drug, which could be valuable for compatibility studies of traditional Chinese medicines. PMID:29286316

  17. Precursor processing for plant peptide hormone maturation by subtilisin-like serine proteinases.

    PubMed

    Schardon, Katharina; Hohl, Mathias; Graff, Lucile; Pfannstiel, Jens; Schulze, Waltraud; Stintzi, Annick; Schaller, Andreas

    2016-12-23

    Peptide hormones that regulate plant growth and development are derived from larger precursor proteins by proteolytic processing. Our study addressed the role of subtilisin-like proteinases (SBTs) in this process. Using tissue-specific expression of proteinase inhibitors as a tool to overcome functional redundancy, we found that SBT activity was required for the maturation of IDA (INFLORESCENCE DEFICIENT IN ABSCISSION), a peptide signal for the abscission of floral organs in Arabidopsis We identified three SBTs that process the IDA precursor in vitro, and this processing was shown to be required for the formation of mIDA (the mature and bioactive form of IDA) as the endogenous signaling peptide in vivo. Hence, SBTs act as prohormone convertases in plants, and several functionally redundant SBTs contribute to signal biogenesis. Copyright © 2016, American Association for the Advancement of Science.

  18. Toward a Concept of Psychosocial Maturity.

    ERIC Educational Resources Information Center

    Greenberger, Ellen; Sorensen, Aage B.

    The first in a series of related reports (see TM 000 775), this paper attempts to define a concept of psychosocial maturity which would be appropriate as a comprehensive educational goal. Biological, sociological, psychological and temporal formulations of maturity are discussed and compared. Am interdisciplinary model of maturity is evolved which…

  19. Towards a theory of PACS deployment: an integrative PACS maturity framework.

    PubMed

    van de Wetering, Rogier; Batenburg, Ronald

    2014-06-01

    Owing to large financial investments that go along with the picture archiving and communication system (PACS) deployments and inconsistent PACS performance evaluations, there is a pressing need for a better understanding of the implications of PACS deployment in hospitals. We claim that there is a gap in the research field, both theoretically and empirically, to explain the success of the PACS deployment and maturity in hospitals. Theoretical principles are relevant to the PACS performance; maturity and alignment are reviewed from a system and complexity perspective. A conceptual model to explain the PACS performance and a set of testable hypotheses are then developed. Then, structural equation modeling (SEM), i.e. causal modeling, is applied to validate the model and hypotheses based on a research sample of 64 hospitals that use PACS, i.e. 70 % of all hospitals in the Netherlands. Outcomes of the SEM analyses substantiate that the measurements of all constructs are reliable and valid. The PACS alignment-modeled as a higher-order construct of five complementary organizational dimensions and maturity levels-has a significant positive impact on the PACS performance. This result is robust and stable for various sub-samples and segments. This paper presents a conceptual model that explains how alignment in deploying PACS in hospitals is positively related to the perceived performance of PACS. The conceptual model is extended with tools as checklists to systematically identify the improvement areas for hospitals in the PACS domain. The holistic approach towards PACS alignment and maturity provides a framework for clinical practice.

  20. A Quality Improvement Activity to Promote Interprofessional Collaboration Among Health Professions Students

    PubMed Central

    Stevenson, Katherine; Busch, Angela; Scott, Darlene J.; Henry, Carol; Wall, Patricia A.

    2009-01-01

    Objectives To develop and evaluate a classroom-based curriculum designed to promote interprofessional competencies by having undergraduate students from various health professions work together on system-based problems using quality improvement (QI) methods and tools to improve patient-centered care. Design Students from 4 health care programs (nursing, nutrition, pharmacy, and physical therapy) participated in an interprofessional QI activity. In groups of 6 or 7, students completed pre-intervention and post-intervention reflection tools on attitudes relating to interprofessio nal teams, and a tool designed to evaluate group process. Assessment One hundred thirty-four students (76.6%) completed both self-reflection instruments, and 132 (74.2%) completed the post-course group evaluation instrument. Although already high prior to the activity, students' mean post-intervention reflection scores increased for 12 of 16 items. Post-intervention group evaluation scores reflected a high level of satisfaction with the experience. Conclusion Use of a quality-based case study and QI methodology were an effective approach to enhancing interprofessional experiences among students. PMID:19657497

  1. Selection of Aptamers for Mature White Adipocytes by Cell SELEX Using Flow Cytometry

    PubMed Central

    Kim, Eun Young; Kim, Ji Won; Kim, Won Kon; Han, Baek Soo; Park, Sung Goo; Chung, Bong Hyun; Lee, Sang Chul; Bae, Kwang-Hee

    2014-01-01

    Background Adipose tissue, mainly composed of adipocytes, plays an important role in metabolism by regulating energy homeostasis. Obesity is primarily caused by an abundance of adipose tissue. Therefore, specific targeting of adipose tissue is critical during the treatment of obesity, and plays a major role in overcoming it. However, the knowledge of cell-surface markers specific to adipocytes is limited. Methods and Results We applied the CELL SELEX (Systematic Evolution of Ligands by EXponential enrichment) method using flow cytometry to isolate molecular probes for specific recognition of adipocytes. The aptamer library, a mixture of FITC-tagged single-stranded random DNAs, is used as a source for acquiring molecular probes. With the increasing number of selection cycles, there was a steady increase in the fluorescence intensity toward mature adipocytes. Through 12 rounds of SELEX, enriched aptamers showing specific recognition toward mature 3T3-L1 adipocyte cells were isolated. Among these, two aptamers (MA-33 and 91) were able to selectively bind to mature adipocytes with an equilibrium dissociation constant (Kd) in the nanomolar range. These aptamers did not bind to preadipocytes or other cell lines (such as HeLa, HEK-293, or C2C12 cells). Additionally, it was confirmed that MA-33 and 91 can distinguish between mature primary white and primary brown adipocytes. Conclusions These selected aptamers have the potential to be applied as markers for detecting mature white adipocytes and monitoring adipogenesis, and could emerge as an important tool in the treatment of obesity. PMID:24844710

  2. Generation of mature T cells from human hematopoietic stem/progenitor cells in artificial thymic organoids

    PubMed Central

    Seet, Christopher S.; He, Chongbin; Bethune, Michael T.; Li, Suwen; Chick, Brent; Gschweng, Eric H.; Zhu, Yuhua; Kim, Kenneth; Kohn, Donald B.; Baltimore, David; Crooks, Gay M.; Montel-Hagen, Amélie

    2017-01-01

    Studies of human T cell development require robust model systems that recapitulate the full span of thymopoiesis, from hematopoietic stem and progenitor cells (HSPCs) through to mature T cells. Existing in vitro models induce T cell commitment from human HSPCs; however, differentiation into mature CD3+TCRab+ single positive (SP) CD8+ or CD4+ cells is limited. We describe here a serum-free, artificial thymic organoid (ATO) system that supports highly efficient and reproducible in vitro differentiation and positive selection of conventional human T cells from all sources of HSPCs. ATO-derived T cells exhibited mature naïve phenotypes, a diverse TCR repertoire, and TCR-dependent function. ATOs initiated with TCR-engineered HSPCs produced T cells with antigen specific cytotoxicity and near complete lack of endogenous TCR Vβ expression, consistent with allelic exclusion of Vβ loci. ATOs provide a robust tool for studying human T cell development and stem cell based approaches to engineered T cell therapies. PMID:28369043

  3. Determining skeletal maturation using insulin-like growth factor I (IGF-I) test.

    PubMed

    Gupta, Shreya; Jain, Sandhya; Gupta, Puneet; Deoskar, Anuradha

    2012-11-01

    To investigate the validity of Insulin like Growth Factor -1(IGF-1) as a skeletal maturity indicator by comparing serum IGF-1 levels with the stages in cervical vertebral maturation (CVM) and in the middle phalanx of the third finger (MP3). The study population was selected by using simple random sampling technique and consisted of 30 female subjects in the age range of 8-23 years who had blood sample, cephalometric and MP3 radiographs taken on the same day. Serum IGF-I estimation was carried out on the blood samples using chemiluminescence immunoassay (CLIA) method. CVM was evaluated using method by Baccetti et al and MP3 staging was done using Rajagopal & Kansal method. Mean IGF-1 level between the stages was compared by Kruskal-Wallis and Mann Whitney test. Serum IGF-1 levels in females correlate well with skeletal maturity determined by CVM and MP3 stages and increase sharply during early pubertal stages followed by a decrease in late puberty. In addition we hypothesis that serum IGF-1 testing can be undertaken as a preliminary screening test in patients in whom the orthodontist predicts the possibility of using myofunctional appliance but in whom the chronologic age is not suggestive for a growth modification therapy. The finding of the study highlights the fact that the serum IGF-1 estimation can be a valuable tool in assessing skeletal maturation. Copyright © 2012 Società Italiana di Ortodonzia SIDO. Published by Elsevier Srl. All rights reserved.

  4. Towards a unified analysis of brain maturation and aging across the entire lifespan: A MRI analysis.

    PubMed

    Coupé, Pierrick; Catheline, Gwenaelle; Lanuza, Enrique; Manjón, José Vicente

    2017-11-01

    There is no consensus in literature about lifespan brain maturation and senescence, mainly because previous lifespan studies have been performed on restricted age periods and/or with a limited number of scans, making results instable and their comparison very difficult. Moreover, the use of nonharmonized tools and different volumetric measurements lead to a great discrepancy in reported results. Thanks to the new paradigm of BigData sharing in neuroimaging and the last advances in image processing enabling to process baby as well as elderly scans with the same tool, new insights on brain maturation and aging can be obtained. This study presents brain volume trajectory over the entire lifespan using the largest age range to date (from few months of life to elderly) and one of the largest number of subjects (N = 2,944). First, we found that white matter trajectory based on absolute and normalized volumes follows an inverted U-shape with a maturation peak around middle life. Second, we found that from 1 to 8-10 y there is an absolute gray matter (GM) increase related to body growth followed by a GM decrease. However, when normalized volumes were considered, GM continuously decreases all along the life. Finally, we found that this observation holds for almost all the considered subcortical structures except for amygdala which is rather stable and hippocampus which exhibits an inverted U-shape with a longer maturation period. By revealing the entire brain trajectory picture, a consensus can be drawn since most of the previously discussed discrepancies can be explained. Hum Brain Mapp 38:5501-5518, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  5. The modified Yi qi decoction protects cardiac ischemia-reperfusion induced injury in rats.

    PubMed

    Yu, Xiao; Zhao, Xiao-Dong; Bao, Rong-Qi; Yu, Jia-Yu; Zhang, Guo-Xing; Chen, Jing-Wei

    2017-06-21

    To investigate the effects and involved mechanisms of the modified Yi Qi decoction (MYQ) in cardiac ischemia-reperfusion (IR) induced injury. Male Sprague-Dawley rats were subjected to a 30-min coronary arterial occlusion followed by reperfusion, low or high dose decoction of MYQ was administrated orally for 1 week or 1 month. Both in 1 week and 1 month IR rat groups, cardiac function indexes were significantly impaired compared with sham group rats, accompanied with higher ratio of infarct size to risk size, decreased expressions of sodium calcium exchanger (NCX1) and sarcoplasmic reticulum Ca 2+ -ATPase (Serca2a), and different expressions of autophagic proteins, Beclin-1 and LC3. Treatment with MYQ (low or high dose) for 1 week showed no marked beneficial effects on cardiac function and cardiac injury (ratio of infarct size to risk size), although expressions of anti-apoptotic protein, Bcl-2, NCX1 and Serca2a were increased. Treatment with MYQ (low or high dose) for 1 month showed significantly improved effects on cardiac function and cardiac injury (ratio of infarct size to risk size), accompanied with increase of Bcl-2, NCX1 and Serca2a expressions, and decrease of Bax (a pro-apoptotic protein) and Beclin-1 expressions. The results show that MYQ have potential therapeutic effects on IR-induced cardiac injury, which may be through regulation of apoptotic proteins, cytosolic Ca 2+ handling proteins and autophagic proteins signal pathways.

  6. In vitro fertilization of in vitro-matured equine oocytes: effect of maturation medium, duration of maturation, and sperm calcium ionophore treatment, and comparison with rates of fertilization in vivo after oviductal transfer.

    PubMed

    Hinrichs, K; Love, C C; Brinsko, S P; Choi, Y H; Varner, D D

    2002-07-01

    Three experiments were conducted to evaluate the effect of oocyte and sperm treatments on rates of in vitro fertilization (IVF) in the horse and to determine the capacity of in vitro-matured horse oocytes to be fertilized in vivo. There was no effect of duration of oocyte maturation (24 vs. 42 h) or calcium ionophore concentration during sperm capacitation (3 microM vs. 7.14 microM) on in vitro fertilization rates. Oocytes matured in 100% follicular fluid had significantly higher fertilization (13% to 24%) than did oocytes matured in maturation medium or in 20% follicular fluid (0% to 12%; P < 0.05). There was no significant difference in fertilization rate among 3 sperm treatments utilizing 7.14 microM calcium ionophore (12% to 21%). Of in vitro-matured oocytes recovered 40-44 h after transfer to the oviducts of inseminated mares, 77% showed normal fertilization (2 pronuclei to normal cleavage). Cleavage to 2 or more cells was seen in 22% of oocytes matured in follicular fluid and 63% of oocytes matured in maturation medium; this difference was significant (P < 0.05). We conclude that in vitro-matured horse oocytes are capable of being fertilized at high rates in the appropriate environment and that in vitro maturation of oocytes in follicular fluid increases fertilization rate in vitro but reduces embryo development after fertilization in vivo. Further work is needed to determine the optimum environment for sperm capacitation and IVF in the horse.

  7. Use of homologous and heterologous gene expression profiling tools to characterize transcription dynamics during apple fruit maturation and ripening.

    PubMed

    Costa, Fabrizio; Alba, Rob; Schouten, Henk; Soglio, Valeria; Gianfranceschi, Luca; Serra, Sara; Musacchi, Stefano; Sansavini, Silviero; Costa, Guglielmo; Fei, Zhangjun; Giovannoni, James

    2010-10-25

    Fruit development, maturation and ripening consists of a complex series of biochemical and physiological changes that in climacteric fruits, including apple and tomato, are coordinated by the gaseous hormone ethylene. These changes lead to final fruit quality and understanding of the functional machinery underlying these processes is of both biological and practical importance. To date many reports have been made on the analysis of gene expression in apple. In this study we focused our investigation on the role of ethylene during apple maturation, specifically comparing transcriptomics of normal ripening with changes resulting from application of the hormone receptor competitor 1-methylcyclopropene. To gain insight into the molecular process regulating ripening in apple, and to compare to tomato (model species for ripening studies), we utilized both homologous and heterologous (tomato) microarray to profile transcriptome dynamics of genes involved in fruit development and ripening, emphasizing those which are ethylene regulated.The use of both types of microarrays facilitated transcriptome comparison between apple and tomato (for the later using data previously published and available at the TED: tomato expression database) and highlighted genes conserved during ripening of both species, which in turn represent a foundation for further comparative genomic studies. The cross-species analysis had the secondary aim of examining the efficiency of heterologous (specifically tomato) microarray hybridization for candidate gene identification as related to the ripening process. The resulting transcriptomics data revealed coordinated gene expression during fruit ripening of a subset of ripening-related and ethylene responsive genes, further facilitating the analysis of ethylene response during fruit maturation and ripening. Our combined strategy based on microarray hybridization enabled transcriptome characterization during normal climacteric apple ripening, as well as

  8. Use of homologous and heterologous gene expression profiling tools to characterize transcription dynamics during apple fruit maturation and ripening

    PubMed Central

    2010-01-01

    Background Fruit development, maturation and ripening consists of a complex series of biochemical and physiological changes that in climacteric fruits, including apple and tomato, are coordinated by the gaseous hormone ethylene. These changes lead to final fruit quality and understanding of the functional machinery underlying these processes is of both biological and practical importance. To date many reports have been made on the analysis of gene expression in apple. In this study we focused our investigation on the role of ethylene during apple maturation, specifically comparing transcriptomics of normal ripening with changes resulting from application of the hormone receptor competitor 1-Methylcyclopropene. Results To gain insight into the molecular process regulating ripening in apple, and to compare to tomato (model species for ripening studies), we utilized both homologous and heterologous (tomato) microarray to profile transcriptome dynamics of genes involved in fruit development and ripening, emphasizing those which are ethylene regulated. The use of both types of microarrays facilitated transcriptome comparison between apple and tomato (for the later using data previously published and available at the TED: tomato expression database) and highlighted genes conserved during ripening of both species, which in turn represent a foundation for further comparative genomic studies. The cross-species analysis had the secondary aim of examining the efficiency of heterologous (specifically tomato) microarray hybridization for candidate gene identification as related to the ripening process. The resulting transcriptomics data revealed coordinated gene expression during fruit ripening of a subset of ripening-related and ethylene responsive genes, further facilitating the analysis of ethylene response during fruit maturation and ripening. Conclusion Our combined strategy based on microarray hybridization enabled transcriptome characterization during normal climacteric

  9. Bicarbonate Transport During Enamel Maturation.

    PubMed

    Yin, Kaifeng; Paine, Michael L

    2017-11-01

    Amelogenesis (tooth enamel formation) is a biomineralization process consisting primarily of two stages (secretory stage and maturation stage) with unique features. During the secretory stage, the inner epithelium of the enamel organ (i.e., the ameloblast cells) synthesizes and secretes enamel matrix proteins (EMPs) into the enamel space. The protein-rich enamel matrix forms a highly organized architecture in a pH-neutral microenvironment. As amelogenesis transitions to maturation stage, EMPs are degraded and internalized by ameloblasts through endosomal-lysosomal pathways. Enamel crystallite formation is initiated early in the secretory stage, however, during maturation stage the more rapid deposition of calcium and phosphate into the enamel space results in a rapid expansion of crystallite length and mineral volume. During maturation-stage amelogenesis, the pH value of enamel varies considerably from slightly above neutral to acidic. Extracellular acid-base balance during enamel maturation is tightly controlled by ameloblast-mediated regulatory networks, which include significant synthesis and movement of bicarbonate ions from both the enamel papillary layer cells and ameloblasts. In this review we summarize the carbonic anhydrases and the carbonate transporters/exchangers involved in pH regulation in maturation-stage amelogenesis. Proteins that have been shown to be instrumental in this process include CA2, CA6, CFTR, AE2, NBCe1, SLC26A1/SAT1, SLC26A3/DRA, SLC26A4/PDS, SLC26A6/PAT1, and SLC26A7/SUT2. In addition, we discuss the association of miRNA regulation with bicarbonate transport in tooth enamel formation.

  10. Maturation of high-density lipoproteins

    PubMed Central

    Shih, Amy Y.; Sligar, Stephen G.; Schulten, Klaus

    2009-01-01

    Human high-density lipoproteins (HDLs) are involved in the transport of cholesterol. The mechanism by which HDL assembles and functions is not well understood owing to a lack of structural information on circulating spherical HDL. Here, we report a series of molecular dynamics simulations that describe the maturation of discoidal HDL into spherical HDL upon incorporation of cholesterol ester as well as the resulting atomic level structure of a mature circulating spherical HDL particle. Sixty cholesterol ester molecules were added in a stepwise fashion to a discoidal HDL particle containing two apolipoproteins wrapped around a 160 dipalmitoylphosphatidylcholine lipid bilayer. The resulting matured particle, captured in a coarse-grained description, was then described in a consistent all-atom representation and analysed in chemical detail. The simulations show that maturation results from the formation of a highly dynamic hydrophobic core comprised of cholesterol ester surrounded by phospholipid and protein; the two apolipoprotein strands remain in a belt-like conformation as seen in the discoidal HDL particle, but with flexible N- and C-terminal helices and a central region stabilized by salt bridges. In the otherwise flexible lipoproteins, a less mobile central region provides an ideal location to bind lecithin cholesterol acyltransferase, the key enzyme that converts cholesterol to cholesterol ester during HDL maturation. PMID:19570799

  11. Growth indicators in orthodontic patients. Part 1: comparison of cervical vertebral maturation and hand-wrist skeletal maturation.

    PubMed

    Litsas, G; Ari-Demirkaya, A

    2010-12-01

    The purpose of this study was to predict the skeletal maturation status based on the assessment of cervical vertebrae from lateral cephalometric radiographs and to compare these findings with the skeletal maturity of the same individuals judged from the hand-wrist radiographs. Lateral cephalometric and left hand-wrist radiographs of 393 Caucasian children from 8 to 18 years old were evaluated. On the hand-wrist radiographs the classification of Bjork [1972] and Grave and Brown [1976] was used to assess skeletal maturity (HWSS). Cervical vertebral maturation was also evaluated on lateral cephalometric radiographs using the improved CVMS method described by Baccetti, Franchi, and McNamara [2002]. These methods were correlated using the chi-square test. The chi-square test showed that skeletal maturational values obtained by the CVMS method were significantly correlated with the skeletal values obtained from the hand-wrist analysis for both genders (p<0.05). However, gender differentiation exists in CVMS method regarding the peak of growth spurt. The results of this study show that the CVMS method was compatible with a commonly used hand-wrist analysis method. The lateral cephalometric radiograph belonging to the standard set of records would be sufficient to evaluate skeletal maturity.

  12. Genome-wide association mapping of flowering time and maturity dates in early mature soybean germplasm

    USDA-ARS?s Scientific Manuscript database

    Soybean (Glycine max L. Merr.) is a photoperiod-sensitive and short-day major crop grown worldwide. Days to flowering (DTF) and maturity (DTM) are two traits affecting soybean adaptability and yield. Some genes conditioning soybean flowering and maturity have been recently characterized. However, ...

  13. Using quality improvement to promote breast-feeding in a local health department.

    PubMed

    Wright, Sarah S; Lea, C Suzanne; Holloman, Roxanne; Cornett, Amanda; Harrison, Lisa Macon; Randolph, Greg D

    2012-01-01

    In 2008, breast-feeding initiation and continuation rates in Beaufort County, North Carolina, were lower than statewide rates. A quality improvement (QI) project was initiated to increase breast-feeding rates by enhancing the overall environment that supports breast-feeding at the Beaufort County Health Department. This case study describes one of the first QI initiatives implemented through the North Carolina Center for Public Health Quality QI training program, conducted in 2009. The aim of this project was to improve the health and wellness of mothers and infants in Beaufort County by promoting breast-feeding among Beaufort County Health Department Women, Infants and Children (WIC) clients. Using QI tools, 4 new approaches to breast-feeding promotion were tested and implemented: creating a nurturing location to breast-feed while at the health department, actively telephoning new mothers to provide breast-feeding support, incentivizing adoption of educational messages by providing a breast-feeding tote bag, and promoting new WIC food packages. These enhancements involved staff in QI planning and implementation and correlated with improved breast-feeding initiation for WIC clients during the year following project completion.

  14. Developing Quality Improvement capacity and capability across the Children in Fife partnership.

    PubMed

    Morris, Craig; Alexander, Ingrid

    2016-01-01

    A Project Manager from the Fife Early Years Collaborative facilitated a large-scale Quality Improvement (herein QI) project to build organisational capacity and capability across the Children in Fife partnership through three separate, eight month training cohorts. This 18 month QI project enabled 32 practitioners to increase their skills, knowledge, and experiences in a variety of QI tools including the Model for Improvement which then supported the delivery of high quality improvement projects and improved outcomes for children and families. Essentially growing the confidence and capability of practitioners to deliver sustainable QI. 27 respective improvement projects were delivered, some leading to service redesign, reduced waiting times, increased uptake of health entitlements, and improved accessibility to front-line health services. 13 improvement projects spread or scaled beyond the initial site and informal QI mentoring took place with peers in respective agencies. Multiple PDSA cycles were conducted testing the most efficient and effective support mechanisms during and post training, maintaining regular contact, and utilising social media to share progress and achievements.

  15. Generation of mature T cells from human hematopoietic stem and progenitor cells in artificial thymic organoids.

    PubMed

    Seet, Christopher S; He, Chongbin; Bethune, Michael T; Li, Suwen; Chick, Brent; Gschweng, Eric H; Zhu, Yuhua; Kim, Kenneth; Kohn, Donald B; Baltimore, David; Crooks, Gay M; Montel-Hagen, Amélie

    2017-05-01

    Studies of human T cell development require robust model systems that recapitulate the full span of thymopoiesis, from hematopoietic stem and progenitor cells (HSPCs) through to mature T cells. Existing in vitro models induce T cell commitment from human HSPCs; however, differentiation into mature CD3 + TCR-αβ + single-positive CD8 + or CD4 + cells is limited. We describe here a serum-free, artificial thymic organoid (ATO) system that supports efficient and reproducible in vitro differentiation and positive selection of conventional human T cells from all sources of HSPCs. ATO-derived T cells exhibited mature naive phenotypes, a diverse T cell receptor (TCR) repertoire and TCR-dependent function. ATOs initiated with TCR-engineered HSPCs produced T cells with antigen-specific cytotoxicity and near-complete lack of endogenous TCR Vβ expression, consistent with allelic exclusion of Vβ-encoding loci. ATOs provide a robust tool for studying human T cell differentiation and for the future development of stem-cell-based engineered T cell therapies.

  16. 7 CFR 51.3153 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.3153 Section 51.3153 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Nectarines Definitions § 51.3153 Mature. “Mature” means that the nectarine has...

  17. 7 CFR 51.3153 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.3153 Section 51.3153 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Nectarines Definitions § 51.3153 Mature. “Mature” means that the nectarine has...

  18. 7 CFR 51.3153 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.3153 Section 51.3153 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Nectarines Definitions § 51.3153 Mature. “Mature” means that the nectarine has...

  19. Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment.

    PubMed

    Hegde, Deepa Y; Baliga, Sudhindra; Yeluri, Ramakrishna; Munshi, A K

    2012-01-01

    To evaluate the reliability of the digital radiograph of the middle phalanx of the third finger (MP3) in skeletal maturity assessment. Fifty children (24 girls and 26 boys) belonging to the circumpubertal age-group were selected for the study. Two radiographs - lateral cephalogram and digital radiograph of the MP3 region - were taken in each child. Age assessment was based on the changes in shape of the cervical vertebrae and the epiphysis of the middle phalanx of the third finger of the left hand. The radiographs were assessed by three examiners. The inter- and intraexaminer variability were determined by the Wilcoxon rank sign test and the Kruskal-Wallis test and were found to be nonsignificant. Examiner 3 showed the best intraexaminer agreement and was selected to evaluate the radiographs for the entire study. The correlation determined between the MP3 stages and cervical vertebrae maturity index (CVMI) stages, the peak-wise distribution of the MP3 stages, and the correlation between the MP3 stages and the chronological age were found to be highly significant. Digital radiograph of the MP3 region is definitely a simple, reliable, cost-effective, and time-saving technique for the assessment of skeletal maturity.

  20. Maturation capacity, morphology and morphometric assessment of human immature oocytes after vitrification and in-vitro maturation

    PubMed Central

    Nazari, Saeedeh; Khalili, Mohammad Ali; Esmaielzadeh, Forouzan; Mohsenzadeh, Mehdi

    2011-01-01

    Background: In general, 15% of oocytes collected in ART cycles are immature. These oocytes may be cryopreserved further for use in in-vitro maturation (IVM) program. Objective: The aim of this study was to determine maturation capacity, morphometric parameters and morphology of human immature oocytes in both fresh IVM (fIVM) and vitrified-IVM (vIVM) oocytes. Materials and Methods: 93 women who underwent controlled ovarian stimulation for ART were included. The immature oocytes (n=203) were divided into two groups: the first group (n=101) directly matured in vitro; and the second group (n=102) first vitrified, then matured in vitro. All oocytes underwent IVM in Ham’s F10 supplemented with LH+FSH and human follicular fluid. After 48h of incubation, the oocyte maturation rates, as well as morphometric and morphologic characteristics were assessed using cornus imaging and were compared. Results: Oocyte maturation rates were reduced in vIVM, (40.4%), in comparison with fIVM (59.4%, p<0.001). Following morphometric assessment, there was no difference in the mean oocyte diameters (µm) between fIVM and vIVM, 156.3±6.8 and 154.07±9.9, respectively. Other parameters of perimeters, egg areas, as well as oocyte and ooplasm volumes were similar in two groups. In addition, more morphologic abnormalities, such as, vacuole, and dark oocyte were observed in vIVM oocytes. Conclusion: fIVM was more successful than vIVM groups. No statistical differences were noticed in morphometry assessment in two groups. This suggests that morphometric parameters can not be applied as prognosis factor in oocyte maturation outcome in IVM program. PMID:26396566

  1. Optimizing IV and V for Mature Organizations

    NASA Technical Reports Server (NTRS)

    Fuhman, Christopher

    2003-01-01

    NASA is intending for its future software development agencies to have at least a Level 3 rating in the Carnegie Mellon University Capability Maturity Model (CMM). The CMM has built-in Verification and Validation (V&V) processes that support higher software quality. Independent Verification and Validation (IV&V) of software developed by mature agencies can be therefore more effective than for software developed by less mature organizations. How is Independent V&V different with respect to the maturity of an organization? Knowing a priori the maturity of an organization's processes, how can IV&V planners better identify areas of need choose IV&V activities, etc? The objective of this research is to provide a complementary set of guidelines and criteria to assist the planning of IV&V activities on a project using a priori knowledge of the measurable levels of maturity of the organization developing the software.

  2. Maturation of the human fetal startle response: evidence for sex-specific maturation of the human fetus.

    PubMed

    Buss, Claudia; Davis, Elysia Poggi; Class, Quetzal A; Gierczak, Matt; Pattillo, Carol; Glynn, Laura M; Sandman, Curt A

    2009-10-01

    Despite the evidence for early fetal experience exerting programming influences on later neurological development and health risk, very few prospective studies of human fetal behavior have been reported. In a prospective longitudinal study, fetal nervous system maturation was serially assessed by monitoring fetal heart rate (FHR) responses to vibroacoustic stimulation (VAS) in 191 maternal/fetal dyads. Responses were not detected at 26 weeks gestational age (GA). Sex-specific, age-characteristic changes in the FHR response to VAS were observed by 31 weeks' GA. Males showed larger responses and continued to exhibit maturational changes until 37 weeks' GA, females however, presented with a mature FHR startle response by 31 weeks' GA. The results indicate that there are different rates of maturation in the male and female fetuses that may have implications for sex-specific programming influences.

  3. Cellular maturity and apoptosis in human sperm: creatine kinase, caspase-3 and Bcl-XL levels in mature and diminished maturity sperm.

    PubMed

    Cayli, Sevil; Sakkas, Denny; Vigue, Lynne; Demir, Ramazan; Huszar, Gabor

    2004-05-01

    The relationship between human sperm maturity and apoptosis is of interest because of the persistence of immature sperm in ejaculates in spite of various apoptotic processes during spermatogenesis. We assessed sperm maturity by HspA2 chaperone levels, and plasma membrane maturity by sperm binding to immobilized hyaluronic acid (HA). We also utilized objective morphometry. Sperm were stained with three antibody combinations: active caspase-3/creatine kinase (CK, a marker of cytoplasmic retention), caspase-3/the antiapoptotic Bcl-(XL), and CK/Bcl-(XL). In semen, 13% of sperm stained with CK, caspase-3 or Bcl-(XL), and 28% had stained with two markers. In the mature HA-bound sperm fraction, <4% were single- or double-stained. Regarding sperm regions, CK staining, whether alone or as double staining, occurred in the head and midpiece (15-20%), whereas caspase-3 and Bcl-(XL) were primarily (>80% of sperm) in the midpiece. Morphometrical attributes of clear, single- and double-stained sperm, in line with their more pronounced maturation arrest, showed an incremental increase in head size (due to cytoplasmic retention) and shorter tail length. We hypothesize that during faulty sperm development, three alternatives may occur: (i) elimination of aberrant germ cells by apoptosis; (ii) in surviving immature cells, caspase-3 is activated, and in response the antiapoptotic Bcl-(XL), and perhaps HspA2, provide protection; (iii) in a third type of immature sperm, in addition to the CK, caspase-3 and Bcl-(XL) expression, there are related manifestations of increased head size and shorter tail length. Thus, immature sperm may vary in the type of developmental arrest and in protection mechanisms for apoptosis. These variations are likely to explain the persistence of immature sperm in the ejaculate.

  4. Assessment of skeletal maturation using mandibular second molar maturation stages.

    PubMed

    Goyal, S; Goyal, S; Gugnani, N

    2014-01-01

    To investigate the relationship between cervical vertebrae maturation and mandibular second molar calcification stages. The study was designed as a retrospective, descriptive and crosssectional research project. Pre-treatment lateral cephalograms and panoramic radiographs of 99 males and 110 females in the age range of 7 to 18 years 7 months were evaluated with Demirjian Index (DI) and cervical vertebrae maturation indicators (CVMI) of Hassel and Farman. A null hypothesis was proposed that there is no relation between CVMI and DI. A highly significant association (Pearson's contingency coefficient 0.713 for males and 0.863 for females) was found between DI and CVMI. In males, the DI stage E corresponded to stage 2 of CVMI (pre-peak of pubertal growth spurt) and DI stages F and G corresponded to stages 3 and 4 of CVMI (peak of pubertal growth spurt). DI stage H was associated with stages 5 and 6 of CVMI (end of pubertal growth spurt). In females, the DI stages C, D corresponded to CVMI stages 1, 2; DI stages E, F with CVMI stages 3, 4; DI stages G, H with CVMI stages 5, 6. Mandibular second molar calcification stages can be used as indicators for assessment of skeletal maturity.

  5. 7 CFR 51.1530 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1530 Section 51.1530 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Fresh Plums and Prunes Definitions § 51.1530 Mature. “Mature” means that the fruit...

  6. 7 CFR 51.1218 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1218 Section 51.1218 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Peaches Definitions § 51.1218 Mature. “Mature” means that the peach has reached the...

  7. 7 CFR 51.1218 - Mature.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Mature. 51.1218 Section 51.1218 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Peaches Definitions § 51.1218 Mature. “Mature” means that the peach has reached the...

  8. 7 CFR 51.1530 - Mature.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Mature. 51.1530 Section 51.1530 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Fresh Plums and Prunes Definitions § 51.1530 Mature. “Mature” means that the fruit...

  9. 7 CFR 51.1530 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1530 Section 51.1530 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Fresh Plums and Prunes Definitions § 51.1530 Mature. “Mature” means that the fruit...

  10. 7 CFR 51.1218 - Mature.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Mature. 51.1218 Section 51.1218 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Peaches Definitions § 51.1218 Mature. “Mature” means that the peach has reached the...

  11. Technology Maturation in Preparation for the Cryogenic Propellant Storage and Transfer (CPST) Technology Demonstration Mission (TDM)

    NASA Technical Reports Server (NTRS)

    Meyer, Michael L.; Doherty, Michael P.; Moder, Jeffrey P.

    2014-01-01

    In support of its goal to find an innovative path for human space exploration, NASA embarked on the Cryogenic Propellant Storage and Transfer (CPST) Project, a Technology Demonstration Mission (TDM) to test and validate key cryogenic capabilities and technologies required for future exploration elements, opening up the architecture for large in-space cryogenic propulsion stages and propellant depots. Recognizing that key Cryogenic Fluid Management (CFM) technologies anticipated for on-orbit (flight) demonstration would benefit from additional maturation to a readiness level appropriate for infusion into the design of the flight demonstration, the NASA Headquarters Space Technology Mission Directorate (STMD) authorized funding for a one-year technology maturation phase of the CPST project. The strategy, proposed by the CPST Project Manager, focused on maturation through modeling, concept studies, and ground tests of the storage and fluid transfer of CFM technology sub-elements and components that were lower than a Technology Readiness Level (TRL) of 5. A technology maturation plan (TMP) was subsequently approved which described: the CFM technologies selected for maturation, the ground testing approach to be used, quantified success criteria of the technologies, hardware and data deliverables, and a deliverable to provide an assessment of the technology readiness after completion of the test, study or modeling activity. The specific technologies selected were grouped into five major categories: thick multilayer insulation, tank applied active thermal control, cryogenic fluid transfer, propellant gauging, and analytical tool development. Based on the success of the technology maturation efforts, the CPST project was approved to proceed to flight system development.

  12. Skeletal maturation in obese patients.

    PubMed

    Giuca, Maria Rita; Pasini, Marco; Tecco, Simona; Marchetti, Enrico; Giannotti, Laura; Marzo, Giuseppe

    2012-12-01

    The objective of this study was to compare skeletal maturation in obese patients and in subjects of normal weight to evaluate the best timing for orthopedic and orthodontic treatment. The null hypothesis was that obese and normal-weight patients show similar degrees of skeletal maturation. The sample for this retrospective study consisted of 50 white patients (28 boys, 22 girls) whose x-rays (hand-wrist and lateral cephalometric radiographs) were already available. The test group included 25 obese patients (11 girls, 14 boys; average age, 9.8 ± 2.11 years), and the control group included 25 subjects of normal weight (11 girls, 14 boys; average age, 9.9 ± 2.5 years). Skeletal maturation was determined by using the carpal analysis method and the cervical vertebral maturation method. According to the carpal analysis, there was a significant difference between skeletal and chronologic ages between the test group (11.8 ± 11.4 months) and the control group (-2.9 ± 3.1 months). Furthermore, the obese subjects exhibited a significantly higher mean cervical vertebral maturation score (2.8 ± 0.7) than did the control subjects (2 ± 0.6) (P <0.05). Compared with the normal-weight subjects, the obese subjects showed a higher mean discrepancy between skeletal and chronologic ages according to the carpal analysis and had a significantly higher cervical vertebral maturation score. Thus, to account for the growth in obese patients with skeletal discrepancies, it might be necessary to perform examinations and dentofacial and orthopedic treatments earlier than in normal-weight subjects. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  13. 7 CFR 51.1555 - Fairly well matured.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Fairly well matured. 51.1555 Section 51.1555 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards....1555 Fairly well matured. Fairly well matured means that the skins of the potatoes are generally fairly...

  14. 7 CFR 51.1555 - Fairly well matured.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Fairly well matured. 51.1555 Section 51.1555 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards....1555 Fairly well matured. Fairly well matured means that the skins of the potatoes are generally fairly...

  15. 7 CFR 51.312 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Definitions § 51.312 Mature. “Mature” means that the apples have reached the stage of development which will insure the proper completion of the ripening process. Before a mature apple becomes overripe it will show varying degrees of firmness...

  16. 7 CFR 51.312 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Apples Definitions § 51.312 Mature. “Mature” means that the apples have reached the stage of development which will insure the proper completion of the ripening process. Before a mature apple becomes overripe it will show varying degrees of firmness...

  17. 7 CFR 51.3153 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.3153 Section 51.3153 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Nectarines Definitions § 51.3153 Mature. “Mature” means that the nectarine has reached the stage of growth which will insure a proper completion of...

  18. 7 CFR 51.3153 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.3153 Section 51.3153 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Nectarines Definitions § 51.3153 Mature. “Mature” means that the nectarine has reached the stage of growth which will insure a proper completion of...

  19. The postcranial skeletal maturation of Australopithecus sediba.

    PubMed

    Cameron, Noel; Bogin, Barry; Bolter, Debra; Berger, Lee R

    2017-07-01

    In 2008, an immature hominin defined as the holotype of the new species Australopithecus sediba was discovered at the 1.9 million year old Malapa site in South Africa. The specimen (MH1) includes substantial post-cranial skeletal material, and provides a unique opportunity to assess its skeletal maturation. Skeletal maturity indicators observed on the proximal and distal humerus, proximal ulna, distal radius, third metacarpal, ilium and ischium, proximal femur and calcaneus were used to assess the maturity of each bone in comparison to references for modern humans and for wild chimpanzees (Pan troglodytes). In comparison to humans the skeletal maturational ages for Au. sediba correspond to between 12.0 years and 15.0 years with a mean (SD) age of 13.1 (1.1) years. In comparison to the maturational pattern of chimpanzees the Au. sediba indicators suggest a skeletal maturational age of 9-11 years. Based on either of these skeletal maturity estimates and the body length at death of MH1, an adult height of 150-156 cm is predicted. We conclude that the skeletal remains of MH1 are consistent with an ape-like pattern of maturity when dental age estimates are also taken into consideration. This maturity schedule in australopiths is consistent with ape-like estimates of age at death for the Nariokotome Homo erectus remains (KMN-WT 15000), which are of similar postcranial immaturity to MH1. The findings suggest that humans may have distinctive and delayed post-cranial schedules from australopiths and H. erectus, implicating a recent evolution of somatic and possibly life history strategies in human evolution. © 2017 Wiley Periodicals, Inc.

  20. 7 CFR 51.1218 - Mature.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 2 2013-01-01 2013-01-01 false Mature. 51.1218 Section 51.1218 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Peaches Definitions § 51.1218 Mature. “Mature” means that the peach has reached the stage of growth which will ensure a proper completion of the...

  1. 7 CFR 51.1218 - Mature.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 2 2014-01-01 2014-01-01 false Mature. 51.1218 Section 51.1218 Agriculture..., CERTIFICATION, AND STANDARDS) United States Standards for Grades of Peaches Definitions § 51.1218 Mature. “Mature” means that the peach has reached the stage of growth which will ensure a proper completion of the...

  2. Molecular differences between mature and immature dental pulp cells: Bioinformatics and preliminary results.

    PubMed

    Chen, Long; Jiang, Yifeng; Du, Zhen

    2018-04-01

    Although previous studies have demonstrated that dental pulp stem cells (DPSCs) from mature and immature teeth exhibit potential for multi-directional differentiation, the molecular and biological difference between the DPSCs from mature and immature permanent teeth has not been fully investigated. In the present study, 500 differentially expressed genes from dental pulp cells (DPCs) in mature and immature permanent teeth were obtained from the Gene Expression Omnibus online database. Based on bioinformatics analysis using the Database for Annotation, Visualization and Integrated Discovery, these genes were divided into a number of subgroups associated with immunity, inflammation and cell signaling. The results of the present study suggest that immune features, response to infection and cell signaling may be different in DPCs from mature and immature permanent teeth; furthermore, DPCs from immature permanent teeth may be more suitable for use in tissue engineering or stem cell therapy. The Online Mendelian Inheritance in Man database stated that Sonic Hedgehog (SHH), a differentially expressed gene in DPCs from mature and immature permanent teeth, serves a crucial role in the development of craniofacial tissues, including teeth, which further confirmed that SHH may cause DPCs from mature and immature permanent teeth to exhibit different biological characteristics. The Search Tool for the Retrieval of Interacting Genes/Proteins database revealed that SHH has functional protein associations with a number of other proteins, including Glioma-associated oncogene (GLI)1, GLI2, growth arrest-specific protein 1, bone morphogenetic protein (BMP)2 and BMP4, in mice and humans. It was also demonstrated that SHH may interact with other genes to regulate the biological characteristics of DPCs. The results of the present study may provide a useful reference basis for selecting suitable DPSCs and molecules for the treatment of these cells to optimize features for tissue

  3. Mycobacterium avium subspecies impair dendritic cell maturation.

    PubMed

    Basler, Tina; Brumshagen, Christina; Beineke, Andreas; Goethe, Ralph; Bäumer, Wolfgang

    2013-10-01

    Mycobacterium avium ssp. paratuberculosis (MAP) causes Johne's disease, a chronic, granulomatous enteritis of ruminants. Dendritic cells (DC) of the gut are ideally placed to combat invading mycobacteria; however, little is known about their interaction with MAP. Here, we investigated the interaction of MAP and the closely related M. avium ssp. avium (MAA) with murine DC and the effect of infected macrophages on DC maturation. The infection of DC with MAP or MAA induced DC maturation, which differed to that of LPS as maturation was accompanied by higher production of IL-10 and lower production of IL-12. Treatment of maturing DC with supernatants from mycobacteria-infected macrophages resulted in impaired DC maturation, leading to a semi-mature, tolerogenic DC phenotype expressing low levels of MHCII, CD86 and TNF-α after LPS stimulation. Though the cells were not completely differentiated they responded with an increased IL-10 and a decreased IL-12 production. Using recombinant cytokines we provide evidence that the semi-mature DC phenotype results from a combination of secreted cytokines and released antigenic mycobacterial components of the infected macrophage. Our results indicate that MAP and MAA are able to subvert DC function directly by infecting and indirectly via the milieu created by infected macrophages.

  4. 7 CFR 51.1555 - Fairly well matured.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 2 2011-01-01 2011-01-01 false Fairly well matured. 51.1555 Section 51.1555... STANDARDS) United States Standards for Grades of Potatoes 1 Definitions § 51.1555 Fairly well matured. Fairly well matured means that the skins of the potatoes are generally fairly firmly set and not more...

  5. 7 CFR 51.1555 - Fairly well matured.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 2 2012-01-01 2012-01-01 false Fairly well matured. 51.1555 Section 51.1555... STANDARDS) United States Standards for Grades of Potatoes 1 Definitions § 51.1555 Fairly well matured. Fairly well matured means that the skins of the potatoes are generally fairly firmly set and not more...

  6. Introducing quality improvement to pre-qualification nursing students: evaluation of an experiential programme.

    PubMed

    Kyrkjebø, J M; Hanssen, T A; Haugland, B Ø

    2001-12-01

    To evaluate a programme introducing quality improvement (QI) in nursing education. Betanien College of Nursing and clinical practices at hospitals in Bergen. 52 nursing students from a second year class working in 16 groups undertaking hospital based practical studies. Second year nursing students were assigned to follow a patient during a day's work and to record the processes of care from the patient's perspective. Data collected included waiting times, patient information, people in contact with the patient, investigations, and procedures performed. Students also identified aspects of practice that could be improved. They then attended a 2 day theoretical introductory course in QI and each group produced flow charts, cause/effect diagrams, and outlines of quality goals using structure, process, and results criteria to describe potential improvements. Each group produced a report of their findings. Main measures-A two-part questionnaire completed by the students before and after the intervention was used to assess the development of their understanding of QI. Evidence that students could apply a range of QI tools and techniques in the specific setting of a hospital ward was assessed from the final reports of their clinical attachments. The students had a significantly better knowledge of QI after the introductory course and group work than before it, and most students indicated that they considered the topic highly relevant for their later career. They reported that it was quite useful to observe one patient throughout one shift and, to some extent, they learned something new. Students found the introductory course and working in groups useful, and most thought the programme should be included in the curriculum for other nursing students. They considered it important for nurses in general to have knowledge about QI, indicating a high perceived relevance of the course. All 16 groups delivered reports of their group work which were approved by the tutors. Through

  7. Graphic representation of skeletal maturity determinations.

    PubMed

    Boechat, M Ines; Lee, David Choen

    2007-10-01

    Skeletal maturation determinations are usually reported as numeric data indicating accordance with chronologic age. However, significant changes in skeletal maturation can occur without falling outside two SDs. The purpose of our study was to design simple computer-generated sex-based charts to enhance the evaluation of skeletal maturation, especially when frequent assessments are made. The graphic representation of successive reports clearly depicts whether values retain their position in relation to the mean. In addition, the report includes computation of the exact SD score.

  8. The Maturely, Immature Orientale Impact Basin

    NASA Astrophysics Data System (ADS)

    Cahill, J. T.; Lawrence, D. J.; Stickle, A. M.; Delen, O.; Patterson, G.; Greenhagen, B. T.

    2015-12-01

    Lunar surface maturity is consistently examined using the NIR optical maturity parameter (OMAT) [1]. However, the NIR only provides a perspective of the upper microns of the lunar surface. Recent studies of Lunar Prospector (LP) and Lunar Reconnaissance Orbiter data sets are now demonstrating additional measures of maturity with sensitivities to greater depths (~2 m) in the regolith. These include thermal infrared, S-band radar, and epithermal neutron data sets [2-4]. Interestingly, each of these parameters is directly comparable to OMAT despite each measuring slightly different aspects of the regolith. This is demonstrated by Lawrence et al. [3] where LP-measured non-polar highlands epithermal neutrons trend well with albedo, OMAT, and the Christensen Feature (CF). Lawrence et al. [3] used these data to derive and map highlands hydrogen (H) which is dominantly a function of H-implantation. With this in mind, areas of enriched-H are mature, while areas of depleted H are immature. Surface roughness as measured by S-band radar [4], also provides a measure of maturity. In this case, the circular polarization ratio (CPR) is high when rough and immature, and low when smooth and mature. Knowing this, one can recognize areas in the non-polar lunar highlands that show contradictory measures of maturity. For example, while many lunar localities show consistently immature albedo, OMAT, CF, CPR, and H concentrations (e.g., Tycho), others do not. Orientale basin is the most prominent example, shown to have immature CPR, CF, and H concentrations despite a relatively mature albedo and OMAT values as well as an old age determination (~3.8 Ga). To better understand how the lunar regolith is weathering in the upper 1-2 m of regolith with time we examine the Orientale basin relative to other highlands regions. [1] Lucey et al. (2000) JGR, 105, 20377; [2] Lucey et al. (2013) LPSC, 44, 2890; [3] Lawrence et al. (2015) Icarus, j.icarus.2015.01.005; [4] Neish et al. (2013) JGR, 118

  9. The Concept of the Relationship between Information System Maturity and Industry Performance in Indonesia

    NASA Astrophysics Data System (ADS)

    Palilingan, V. R.; Mario, T. P.

    2018-01-01

    Industry in Indonesia continues to grow from year to year. Along with these developments, the use of information technology, which is the basis of information systems, should be considered as a handy tool to survive in the competition in the industry. Various previous studies have discussed much the use of information systems and their role at the strategic level. But more in-depth research is still needed to find out the extent to which the maturity of the use of information systems through its elements can affect the performance of companies in various sectors industries in Indonesia. It is hoped that this concept can be used as a subsequent research by distributing questionnaires based on the method of statements that have been defined by researchers. With this concepts, the next development will continue to measure the relationship information systems maturity in general with the organizations performance. The result of the concept proposed by the researcher is expected to be able to measure the maturity relationship of an information system with the connection with the consumer, demand/supply planning element, innovation, performance measurement, IT impact management and also internal process.

  10. Treating mature stands for wildlife

    Treesearch

    William H. Healy; Gary F. Houf

    1989-01-01

    Stands older than 60 years or that are medium to large sawtimber size generally provide good wildlife habitat. Mature trees usually produce abundant mast and provide den sites (see fig. 1 in Note 9.04 Treating Immature Stands). The undergrowth in these stands produces moderate amounts of browse and herbage. Mature stands also provide opportunities for management...

  11. Financial maturity of yellow birch

    Treesearch

    William B. Leak

    1969-01-01

    The methods used to compute financial maturity of yellow birch sawtimber are similar to those used for paper birch sawtimber, except for minor differences in detail. The procedure followed for yellow-birch veneer-log trees was also similar, except that local veneer grades and local veneer-log prices were used as the basis for the financial maturity computations.

  12. Young macaques (Macaca fascicularis) preferentially bias attention towards closer, older, and better tool users.

    PubMed

    Tan, Amanda W Y; Hemelrijk, Charlotte K; Malaivijitnond, Suchinda; Gumert, Michael D

    2018-05-12

    Examining how animals direct social learning during skill acquisition under natural conditions, generates data for examining hypotheses regarding how transmission biases influence cultural change in animal populations. We studied a population of macaques on Koram Island, Thailand, and examined model-based biases during interactions by unskilled individuals with tool-using group members. We first compared the prevalence of interactions (watching, obtaining food, object exploration) and proximity to tool users during interactions, in developing individuals (infants, juveniles) versus mature non-learners (adolescents, adults), to provide evidence that developing individuals are actively seeking information about tool use from social partners. All infants and juveniles, but only 49% of mature individuals carried out interacted with tool users. Macaques predominantly obtained food by scrounging or stealing, suggesting maximizing scrounging opportunities motivates interactions with tool users. However, while interactions by adults was limited to obtaining food, young macaques and particularly infants also watched tool users and explored objects, indicating additional interest in tool use itself. We then ran matrix correlations to identify interaction biases, and what attributes of tool users influenced these. Biases correlated with social affiliation, but macaques also preferentially targeted tool users that potentially increase scrounging and learning opportunities. Results suggest that social structure may constrain social learning, but the motivation to bias interactions towards tool users to maximize feeding opportunities may also socially modulate learning by facilitating close proximity to better tool users, and further interest in tool-use actions and materials, especially during development.

  13. Correlation among chronologic age, skeletal maturity, and dental age.

    PubMed

    Sukhia, Rashna H; Fida, Mubassar

    2010-01-01

    To determine the correlation among chronologic age, skeletal maturity, and dental age in reference to both sexes. In 380 subjects (147 males and 233 females) between 7 and 17 years of age, skeletal maturity was assessed using the cervical vertebral maturation stages described by Baccetti et al. Dental age was determined using the Demirjian method. The correlation between skeletal maturity and chronologic age on one side and between skeletal maturity and dental age on the other was assessed with Spearman rank correlation coefficients. Pearson correlation coefficients were used to assess the correlation between chronologic and dental age. For both sexes, significant correlations among chronologic age, skeletal maturity, and dental age were found. The mandibular first premolar had the highest correlation with skeletal maturation in both sexes. As skeletal maturity and dental age are significantly correlated, tooth development may be used to assess a patient's skeletal maturity at an early age. © 2011 BY QUINTESSENCE PUBLISHING CO, INC.

  14. Activation of maturation promoting factor in Bufo arenarum oocytes: injection of mature cytoplasm and germinal vesicle contents.

    PubMed

    Toranzo, G Sánchez; Bonilla, F; Zelarayán, L; Oterino, J; Bühler, M I

    2006-11-01

    Although progesterone is the established maturation inducer in amphibians, Bufo arenarum oocytes obtained during the reproductive period (spring-summer) resume meiosis with no need of an exogenous hormonal stimulus if deprived of their enveloping follicle cells, a phenomenon called spontaneous maturation. In this species it is possible to obtain oocytes competent and incompetent to undergo spontaneous maturation according to the seasonal period in which animals are captured. Reinitiation of meiosis is regulated by maturation promoting factor (MPF), a complex of the cyclin-dependent kinase p34cdc2 and cyclin B. Although the function and molecule of MPF are common among species, the formation and activation mechanisms of MPF differ according to species. This study was undertaken to evaluate the presence of pre-MPF in Bufo arenarum oocytes incompetent to mature spontaneously and the effect of the injection of mature cytoplasm or germinal vesicle contents on the resumption of meiosis. The results of our treatment of Bufo arenarum immature oocytes incompetent to mature spontaneously with sodium metavanadate (NaVO3) and dexamethasone (DEX) indicates that these oocytes have a pre-MPF, which activates and induces germinal vesicle breakdown (GVBD) by dephosphorylation on Thr-14/Tyr-15 by cdc25 phosphatase and without cyclin B synthesis. The injection of cytoplasm containing active MPF is sufficient to activate an amplification loop that requires the activation of cdc25 and protein kinase C, the decrease in cAMP levels, and is independent of protein synthesis. However, the injection of germinal vesicle content also induces GVBD in the immature receptor oocyte, a process dependent on protein synthesis but not on cdc25 phosphatase or PKC activity.

  15. Micropropagation of juvenile and mature american beech

    Treesearch

    Melanie J. Barker; Paula M. Pijut; Michael E. Ostry; David R. Houston

    1997-01-01

    The purpose of this study was to micropropagate juvenile and mature American beech (Fagus grandifolia Ehrh.) resistant to beech bark disease. Shoot tips (from juvenile seedlings and root sprouts of mature trees) and buds from branches of mature trees, were cultured and multiplied on aspen culture medium supplemented with 0.89 ?M 6-benzyladenine, 0.27 ?M a-...

  16. Effects of Crocin Supplementation during In Vitro Maturation of Mouse Oocytes on Glutathione Synthesis and Cytoplasmic Maturation

    PubMed Central

    Mokhber Maleki, Elham; Eimani, Hussein; Bigdeli, Mohammad Reza; Golkar Narenji, Afsane; Abedi, Reyhane

    2016-01-01

    Background Crocin is an active ingredient of saffron (Crocus sativus L.) and its antioxidant properties have been previously investigated. This carotenoid scavenges free radicals and stimulates glutathione (GSH) synthesis; consequently, it may protect cells against oxidative stress. The aim of this research is to protect oocytes from oxidative stress by the addition of a natural source antioxidant. Materials and Methods In the present in vitro experimental study, we collected cumulus oocyte complexes (COCs) from mouse ovaries of euthanized, 6-8 week-old female Naval Medical Research Institute (NMRI) mice. Oocytes were subjected to in vitro maturation (IVM) in the presence of either crocin (5 or 10 μg/ml), 5 mM buthionine-[S-R]- sulfoximine (BSO), or the combination of crocin plus BSO. Oocytes that matured in vitro in a medium without crocin or BSO supplements were considered as controls. Following 16-18 hours of IVM, matured oocytes (n=631) were fertilized by capacitated sperm from NMRI male mice, and cultured in vitro for up to 96 hours to assess preimplantation embryonic development. The levels of GSH in metaphase II (MII) oocytes after IVM (n=240) were also assessed by the 5, 5-dithio-bis (2-nitrobenzoic acid) (DTNB)-GSH reductase recycling assay. Results Supplementation of IVM media with 10 µg/ml crocin significantly (P<0.05) increased nuclear maturation, preimplantation development and GSH concentrations compared with the control group. Maturation of oocytes in IVM medium supplemented with BSO alone or the combination of 5 µg/ml crocin and BSO drastically decreased GSH concentrations and subsequently resulted in low rates of maturation, fertilization and blastocyst development. However, the combination of 10 µg/ml crocin with 5 mM BSO increased the level of nuclear maturation which was comparable to the control group. Conclusion Supplementation of IVM media with crocin can improve nuclear maturation rates and subsequent developmental potential of mouse

  17. Relation between clinical mature and immature lymphocyte cells in human peripheral blood and their spatial label free scattering patterns

    NASA Astrophysics Data System (ADS)

    Zhang, Lu; Zhao, Xin; Zhang, Zhenxi; Zhao, Hong; Chen, Wei; Yuan, Li

    2016-07-01

    A single living cell's light scattering pattern (LSP) in the horizontal plane, which has been denoted as the cell's "2D fingerprint," may provide a powerful label-free detection tool in clinical applications. We have recently studied the LSP in spatial scattering planes, denoted as the cell's "3D fingerprint," for mature and immature lymphocyte cells in human peripheral blood. The effects of membrane size, morphology, and the existence of the nucleus on the spatial LSP are discussed. In order to distinguish clinical label-free mature and immature lymphocytes, the special features of the spatial LSP are studied by statistical method in both the spatial and frequency domains. Spatial LSP provides rich information on the cell's morphology and contents, which can distinguish mature from immature lymphocyte cells and hence ultimately it may be a useful label-free technique for clinical leukemia diagnosis.

  18. Petrographic maturity parameters of a Devonian shale maturation series, Appalachian Basin, USA. ICCP Thermal Indices Working Group interlaboratory exercise

    USGS Publications Warehouse

    Araujo, Carla Viviane; Borrego, Angeles G.; Cardott, Brian; das Chagas, Renata Brenand A.; Flores, Deolinda; Goncalves, Paula; Hackley, Paul C.; Hower, James C.; Kern, Marcio Luciano; Kus, Jolanta; Mastalerz, Maria; Filho, João Graciano Mendonça; de Oliveira Mendonça, Joalice; Rego Menezes, Taissa; Newman, Jane; Suarez-Ruiz, Isabel; Sobrinho da Silva, Frederico; Viegas de Souza, Igor

    2014-01-01

    This paper presents results of an interlaboratory exercise on organic matter optical maturity parameters using a natural maturation series comprised by three Devonian shale samples (Huron Member, Ohio Shale) from the Appalachian Basin, USA. This work was conducted by the Thermal Indices Working Group of the International Committee for Coal and Organic Petrology (ICCP) Commission II (Geological Applications of Organic Petrology). This study aimed to compare: 1. maturation predicted by different types of petrographic parameters (vitrinite reflectance and spectral fluorescence of telalginite), 2. reproducibility of the results for these maturation parameters obtained by different laboratories, and 3. improvements in the spectral fluorescence measurement obtained using modern detection systems in comparison with the results from historical round robin exercises.Mean random vitrinite reflectance measurements presented the highest level of reproducibility (group standard deviation 0.05) for low maturity and reproducibility diminished with increasing maturation (group standard deviation 0.12).Corrected fluorescence spectra, provided by 14 participants, showed a fair to good correspondence. Standard deviation of the mean values for spectral parameters was lowest for the low maturity sample but was also fairly low for higher maturity samples.A significant improvement in the reproducibility of corrected spectral fluorescence curves was obtained in the current exercise compared to a previous investigation of Toarcian organic matter spectra in a maturation series from the Paris Basin. This improvement is demonstrated by lower values of standard deviation and is interpreted to reflect better performance of newer photo-optical measuring systems.Fluorescence parameters measured here are in good agreement with vitrinite reflectance values for the least mature shale but indicate higher maturity than shown by vitrinite reflectance for the two more mature shales. This red shift in

  19. Prediction of individual brain maturity using fMRI.

    PubMed

    Dosenbach, Nico U F; Nardos, Binyam; Cohen, Alexander L; Fair, Damien A; Power, Jonathan D; Church, Jessica A; Nelson, Steven M; Wig, Gagan S; Vogel, Alecia C; Lessov-Schlaggar, Christina N; Barnes, Kelly Anne; Dubis, Joseph W; Feczko, Eric; Coalson, Rebecca S; Pruett, John R; Barch, Deanna M; Petersen, Steven E; Schlaggar, Bradley L

    2010-09-10

    Group functional connectivity magnetic resonance imaging (fcMRI) studies have documented reliable changes in human functional brain maturity over development. Here we show that support vector machine-based multivariate pattern analysis extracts sufficient information from fcMRI data to make accurate predictions about individuals' brain maturity across development. The use of only 5 minutes of resting-state fcMRI data from 238 scans of typically developing volunteers (ages 7 to 30 years) allowed prediction of individual brain maturity as a functional connectivity maturation index. The resultant functional maturation curve accounted for 55% of the sample variance and followed a nonlinear asymptotic growth curve shape. The greatest relative contribution to predicting individual brain maturity was made by the weakening of short-range functional connections between the adult brain's major functional networks.

  20. Mandibular dimensional changes and skeletal maturity.

    PubMed

    Subramaniam, Priya; Naidu, Premila

    2010-10-01

    Growth and development of the human face provides a fascinating interplay of form and function. Among the various facial bones, the mandible plays a very important role during various growth-modification therapies. These treatment modalities will yield a better result in less time if properly correlated with skeletal maturity. It is very essential to know where the site of growth occurs and also the time when it occurs or ceases to occur. This study was conducted to assess the mandibular dimensions at various stages of skeletal maturation. The subjects included 6 to 18-year-old children who were grouped according to their middle phalanx of the third finger stages of skeletal maturity. Lateral cephalographs were taken and, from their cephalometric tracings, linear and angular measurements of the mandible were made. The values obtained were subjected to statistical analysis. Results showed that the mandibular height, length and symphysis thickness increased with skeletal maturity. An increase in angles SNB (Sella, Nasion, Supramentale) and L1-MP (Long axis lower incisors- Mandibular plane) and a decrease in the gonial angle and ANB (Subspinale, Nasion, Supramentale) angle were observed. The study showed a significant correlation between mandibular growth and skeletal maturity.

  1. Wild capuchin monkeys adjust stone tools according to changing nut properties.

    PubMed

    Luncz, Lydia V; Falótico, Tiago; Pascual-Garrido, Alejandra; Corat, Clara; Mosley, Hannah; Haslam, Michael

    2016-09-14

    Animals foraging in their natural environments need to be proficient at recognizing and responding to changes in food targets that affect accessibility or pose a risk. Wild bearded capuchin monkeys (Sapajus libidinosus) use stone tools to access a variety of nut species, including otherwise inaccessible foods. This study tests whether wild capuchins from Serra da Capivara National Park in Brazil adjust their tool selection when processing cashew (Anacardium spp.) nuts. During the ripening process of cashew nuts, the amount of caustic defensive substance in the nut mesocarp decreases. We conducted field experiments to test whether capuchins adapt their stone hammer selection to changing properties of the target nut, using stones of different weights and two maturation stages of cashew nuts. The results show that although fresh nuts are easier to crack, capuchin monkeys used larger stone tools to open them, which may help the monkeys avoid contact with the caustic hazard in fresh nuts. We demonstrate that capuchin monkeys are actively able to distinguish between the maturation stages within one nut species, and to adapt their foraging behaviour accordingly.

  2. Wild capuchin monkeys adjust stone tools according to changing nut properties

    PubMed Central

    Luncz, Lydia V.; Falótico, Tiago; Pascual-Garrido, Alejandra; Corat, Clara; Mosley, Hannah; Haslam, Michael

    2016-01-01

    Animals foraging in their natural environments need to be proficient at recognizing and responding to changes in food targets that affect accessibility or pose a risk. Wild bearded capuchin monkeys (Sapajus libidinosus) use stone tools to access a variety of nut species, including otherwise inaccessible foods. This study tests whether wild capuchins from Serra da Capivara National Park in Brazil adjust their tool selection when processing cashew (Anacardium spp.) nuts. During the ripening process of cashew nuts, the amount of caustic defensive substance in the nut mesocarp decreases. We conducted field experiments to test whether capuchins adapt their stone hammer selection to changing properties of the target nut, using stones of different weights and two maturation stages of cashew nuts. The results show that although fresh nuts are easier to crack, capuchin monkeys used larger stone tools to open them, which may help the monkeys avoid contact with the caustic hazard in fresh nuts. We demonstrate that capuchin monkeys are actively able to distinguish between the maturation stages within one nut species, and to adapt their foraging behaviour accordingly. PMID:27624672

  3. Immature, Semi-Mature, and Fully Mature Dendritic Cells: Toward a DC-Cancer Cells Interface That Augments Anticancer Immunity

    PubMed Central

    Dudek, Aleksandra M.; Martin, Shaun; Garg, Abhishek D.; Agostinis, Patrizia

    2013-01-01

    Dendritic cells (DCs) are the sentinel antigen-presenting cells of the immune system; such that their productive interface with the dying cancer cells is crucial for proper communication of the “non-self” status of cancer cells to the adaptive immune system. Efficiency and the ultimate success of such a communication hinges upon the maturation status of the DCs, attained following their interaction with cancer cells. Immature DCs facilitate tolerance toward cancer cells (observed for many apoptotic inducers) while fully mature DCs can strongly promote anticancer immunity if they secrete the correct combinations of cytokines [observed when DCs interact with cancer cells undergoing immunogenic cell death (ICD)]. However, an intermediate population of DC maturation, called semi-mature DCs exists, which can potentiate either tolerogenicity or pro-tumorigenic responses (as happens in the case of certain chemotherapeutics and agents exerting ambivalent immune reactions). Specific combinations of DC phenotypic markers, DC-derived cytokines/chemokines, dying cancer cell-derived danger signals, and other less characterized entities (e.g., exosomes) can define the nature and evolution of the DC maturation state. In the present review, we discuss these different maturation states of DCs, how they might be attained and which anticancer agents or cell death modalities (e.g., tolerogenic cell death vs. ICD) may regulate these states. PMID:24376443

  4. Transcriptional maturation of the mouse auditory forebrain.

    PubMed

    Hackett, Troy A; Guo, Yan; Clause, Amanda; Hackett, Nicholas J; Garbett, Krassimira; Zhang, Pan; Polley, Daniel B; Mirnics, Karoly

    2015-08-14

    The maturation of the brain involves the coordinated expression of thousands of genes, proteins and regulatory elements over time. In sensory pathways, gene expression profiles are modified by age and sensory experience in a manner that differs between brain regions and cell types. In the auditory system of altricial animals, neuronal activity increases markedly after the opening of the ear canals, initiating events that culminate in the maturation of auditory circuitry in the brain. This window provides a unique opportunity to study how gene expression patterns are modified by the onset of sensory experience through maturity. As a tool for capturing these features, next-generation sequencing of total RNA (RNAseq) has tremendous utility, because the entire transcriptome can be screened to index expression of any gene. To date, whole transcriptome profiles have not been generated for any central auditory structure in any species at any age. In the present study, RNAseq was used to profile two regions of the mouse auditory forebrain (A1, primary auditory cortex; MG, medial geniculate) at key stages of postnatal development (P7, P14, P21, adult) before and after the onset of hearing (~P12). Hierarchical clustering, differential expression, and functional geneset enrichment analyses (GSEA) were used to profile the expression patterns of all genes. Selected genesets related to neurotransmission, developmental plasticity, critical periods and brain structure were highlighted. An accessible repository of the entire dataset was also constructed that permits extraction and screening of all data from the global through single-gene levels. To our knowledge, this is the first whole transcriptome sequencing study of the forebrain of any mammalian sensory system. Although the data are most relevant for the auditory system, they are generally applicable to forebrain structures in the visual and somatosensory systems, as well. The main findings were: (1) Global gene expression

  5. Myogenic Maturation by Optical-Training in Cultured Skeletal Muscle Cells.

    PubMed

    Asano, Toshifumi; Ishizuka, Toru; Yawo, Hiromu

    2017-01-01

    Optogenetic techniques are powerful tools for manipulating biological processes in identified cells using light under high temporal and spatial resolutions. Here, we describe an optogenetic training strategy to promote morphological maturation and functional development of skeletal muscle cells in vitro. Optical stimulation with a rhythmical frequency facilitates specific structural alignment of sarcomeric proteins. Optical stimulation also depolarizes the membrane potential, and induces contractile responses in synchrony with the given pattern of light pulses. These results suggest that optogenetic techniques can be employed to manipulate activity-dependent processes during myogenic development and control contraction of photosensitive skeletal muscle cells with high temporal and special precision.

  6. Social Maturity and Executive Function Among Deaf Learners

    PubMed Central

    Marschark, Marc; Kronenberger, William G.; Rosica, Mark; Borgna, Georgianna; Convertino, Carol; Durkin, Andreana; Machmer, Elizabeth; Schmitz, Kathryn L.

    2017-01-01

    Two experiments examined relations among social maturity, executive function, language, and cochlear implant (CI) use among deaf high school and college students. Experiment 1 revealed no differences between deaf CI users, deaf nonusers, and hearing college students in measures of social maturity. However, deaf students (both CI users and nonusers) reported significantly greater executive function (EF) difficulties in several domains, and EF was related to social maturity. Experiment 2 found that deaf CI users and nonusers in high school did not differ from each other in social maturity or EF, but individuals who relied on sign language reported significantly more immature behaviors than deaf peers who used spoken language. EF difficulties again were associated with social maturity. The present results indicate that EF and social maturity are interrelated, but those relations vary in different deaf subpopulations. As with academic achievement, CI use appears to have little long-term impact on EF or social maturity. Results are discussed in terms of their convergence with findings related to incidental learning and functioning in several domains. PMID:27686092

  7. Predicting the Timing of Maturational Spurts in Skeletal Age

    PubMed Central

    Nahhas, Ramzi W.; Sherwood, Richard J.; Chumlea, Wm. Cameron; Towne, Bradford; Duren, Dana L.

    2014-01-01

    Measures of maturity provide windows into the timing and tempo of childhood growth and maturation. Delayed maturation in a single child, or systemically in a population, can result from either genetic or environmental factors. In terms of the skeleton, delayed maturation may result in short stature or indicate another underlying issue. Thus, prediction of the timing of a maturational spurt is often desirable in order to determine the likelihood that a child will catch up to their chronological age peers. Serial data from the Fels Longitudinal Study were used to predict future skeletal age conditional on current skeletal age and to predict the timing of maturational spurts. For children who were delayed relative to their chronological age peers, the like-lihood of catch-up maturation increased through the average age of onset of puberty and decreased prior to the average age of peak height velocity. For boys, the probability of an imminent maturational spurt was higher for those who were less mature. For girls aged 11 to 13 years, however, this probability was higher for those who were more mature, potentially indicating the presence of a skeletal maturation plateau between multiple spurts. The prediction model, available on the web, is most relevant to children of European ancestry living in the Midwestern US. Our model may also provide insight into the tempo of maturation for children in other populations, but must be applied with caution if those populations are known to have high burdens of environmental stressors not typical of the Midwestern US. Am J Phys Anthropol 150:68–75, 2013. PMID:23283666

  8. Customer-Provider Strategic Alignment: A Maturity Model

    NASA Astrophysics Data System (ADS)

    Luftman, Jerry; Brown, Carol V.; Balaji, S.

    This chapter presents a new model for assessing the maturity of a ­customer-provider relationship from a collaborative service delivery perspective: the Customer-Provider Strategic Alignment Maturity (CPSAM) Model. This model builds on recent research for effectively managing the customer-provider relationship in IT service outsourcing contexts and a validated model for assessing alignment across internal IT service units and their business customers within the same organization. After reviewing relevant literature by service science and information systems researchers, the six overarching components of the maturity model are presented: value measurements, governance, partnership, communications, human resources and skills, and scope and architecture. A key assumption of the model is that all of the components need be addressed to assess and improve customer-provider alignment. Examples of specific metrics for measuring the maturity level of each component over the five levels of maturity are also presented.

  9. A correlative study of dental age and skeletal maturation.

    PubMed

    Sachan, Kiran; Sharma, Vijay Prakash; Tandon, Pradeep

    2011-01-01

    Skeletal age had been assessed by comparison between maturation of hand-wrist with stages of cervical vertebrae or canine calcification stages in past and this had been closely related to craniofacial growth. The importance of pubertal growth spurt in various types of orthodontic therapies is already established. Hence, this study was aimed to evaluate the relationship of skeletal maturity by hand-wrist with cervical vertebral maturation indicators and canine calcification stages. The study consisted of randomly selected 90 children from Lucknow population with 45 males (age range 10-13 years) and 45 females (age range 9-12 years). Lateral Cephalogram, hand-wrist x-ray, and periapical x-rays of maxillary and mandibular right canines were taken. Mean, standard deviation was calculated of different groups. Correlation was made among cervical vertebral maturation, hand wrist maturation, and canine calcification stages at various age groups. There was strong correlation between skeletal maturation indicator and cervical vertebral maturation indicator for both male (0.849) and female (0.932), whereas correlation between skeletal maturation indicator and canine calcification was good for both male and female (0.635, 0.891). It was concluded that cervical vertebral maturation indicator and canine calcification stages can also be used for assessing skeletal maturity.

  10. Physician Perceptions of Performance Feedback in a Quality Improvement Activity.

    PubMed

    Eden, Aimee R; Hansen, Elizabeth; Hagen, Michael D; Peterson, Lars E

    Physician performance and peer comparison feedback can affect physician care quality and patient outcomes. This study aimed to understand family physician perspectives of the value of performance feedback in quality improvement (QI) activities. This study analyzed American Board of Family Medicine open-ended survey data collected between 2004 and 2014 from physicians who completed a QI module that provided pre- and post-QI project individual performance data and peer comparisons. Physicians made 3480 comments in response to a question about this performance feedback, which were generally positive in nature (86%). Main themes that emerged were importance of accurate feedback data, enhanced detail in the content of feedback, and ability to customize peer comparison groups to compare performance to peers with similar patient populations or practice characteristics. Meaningful and tailored performance feedback may be an important tool for physicians to improve their care quality and should be considered an integral part of QI project design.

  11. Maturity status of youth football players: a noninvasive estimate.

    PubMed

    Malina, Robert M; Cumming, Sean P; Morano, Peter J; Barron, Mary; Miller, Susan J

    2005-06-01

    To estimate the biological maturity status of youth football players 9-14 yr old using a noninvasive method and to compare the body size of players of contrasting status. Subjects were members of youth football teams in two central Michigan communities. Height and weight were measured on 653 boys 8.7-14.6 yr. Heights of biological parents of 582 boys were reported and subsequently adjusted for overestimation. Decimal age, height, and weight of the player and midparent height were used to predict mature (adult) height for the boy. Current height of each player was expressed as a percentage of his predicted mature height to provide an estimate of biological maturity status. Percentage of predicted mature height of each boy was expressed as a z-score to classify players into maturity groups. ANCOVA, controlling for age, was used to compare body size in contrasting maturity groups. Mean percentages of predicted mature height of the players matched those of longitudinal reference samples, but there was a trend for higher percentages among older players, suggesting advanced maturation. Overall, 405 boys were classified as on time/average in maturity status (69.6% [95%CI 65.7-73.3]), 154 were classified as early/advanced (25.5% [95%CI 23.0-30.3]), and only 23 were classified as late/delayed (3.9% [95%CI 2.6-6.0]). The gradient for height, weight, and BMI was as follows: early > on time > late, and differences were greater for weight and the BMI than for height. Percentage of predicted mature height attained at a given age appears to be a reasonable indicator of maturity status. The method needs to be validated with other more direct indicators (skeletal age, sexual maturation) and applied to other samples.

  12. Maturation of sugar maple seed

    Treesearch

    Clayton M., Jr. Carl; Albert G., Jr. Snow; Albert G. Snow

    1971-01-01

    The seeds of a sugar maple tree (Acer saccharum Marsh.) do not mature at the same time every year. And different trees mature their seeds at different times. So time of year is not a reliable measure of when seeds are ripe. Better criteria are needed. In recent studies we have found that moisture content and color are the best criteria for judging when sugar maple...

  13. A net-shaped multicellular formation facilitates the maturation of hPSC-derived cardiomyocytes through mechanical and electrophysiological stimuli

    PubMed Central

    Liu, Taoyan; Huang, Chengwu; Li, Hongxia; Wu, Fujian; Luo, Jianwen; Lu, Wenjing

    2018-01-01

    The use of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) is limited in drug discovery and cardiac disease mechanism studies due to cell immaturity. Although many approaches have been reported to improve the maturation of hiPSC-CMs, the elucidation of the process of maturation is crucial. We applied a small-molecule-based differentiation method to generate cardiomyocytes (CMs) with multiple aggregation forms. The motion analysis revealed significant physical differences in the differently shaped CMs, and the net-shaped CMs had larger motion amplitudes and faster velocities than the sheet-shaped CMs. The net-shaped CMs displayed accelerated maturation at the transcriptional level and were more similar to CMs with a prolonged culture time (30 days) than to sheet-d15. Ion channel genes and gap junction proteins were up-regulated in net-shaped CMs, indicating that robust contraction was coupled with enhanced ion channel and connexin expression. The net-shaped CMs also displayed improved myofibril ultrastructure under transmission electron microscopy. In conclusion, different multicellular hPSC-CM structures, such as the net-shaped pattern, are formed using the conditioned induction method, providing a useful tool to improve cardiac maturation. PMID:29661985

  14. Quantifying Semantic Linguistic Maturity in Children.

    PubMed

    Hansson, Kristina; Bååth, Rasmus; Löhndorf, Simone; Sahlén, Birgitta; Sikström, Sverker

    2016-10-01

    We propose a method to quantify semantic linguistic maturity (SELMA) based on a high dimensional semantic representation of words created from the co-occurrence of words in a large text corpus. The method was applied to oral narratives from 108 children aged 4;0-12;10. By comparing the SELMA measure with maturity ratings made by human raters we found that SELMA predicted the rating of semantic maturity made by human raters over and above the prediction made using a child's age and number of words produced. We conclude that the semantic content of narratives changes in a predictable pattern with children's age and argue that SELMA is a measure quantifying semantic linguistic maturity. The study opens up the possibility of using quantitative measures for studying the development of semantic representation in children's narratives, and emphasizes the importance of word co-occurrences for understanding the development of meaning.

  15. Nursing Home Administrator Quality Improvement Self-Efficacy Scale.

    PubMed

    Siegel, Elena O; Zisberg, Anna; Bakerjian, Debra; Zysberg, Leehu

    Nursing home (NH) quality improvement (QI) is challenging. The critical role of NH leaders in successful QI is well established; however, current options for assessing the QI capabilities of leaders such as the licensed NH administrator are limited. This article presents the development and preliminary validation of an instrument to measure NH administrator self-efficacy in QI. We used a mixed-methods cross-sectional design to develop and test the measure. For item generation, 39 NH leaders participated in qualitative interviews. Item reduction and content validity were established with a sample of eight subject matter experts. A random sample of 211 administrators from NHs with the lowest and highest Centers for Medicare and Medicaid Services Five-Star Quality ratings completed the measure. We conducted exploratory and confirmatory factor analyses and tested the measure for internal reliability and convergent, discriminant, and known group validity. The final measure included five subscales and 32 items. Confirmatory factor analysis reaffirmed the factorial structure with good fit indices. The new measure's subscales correlated with valid measures of self-efficacy and locus of control, supporting the measure's convergent and discriminant validity. Significant differences in most of the subscales were found between the objective (Centers for Medicare and Medicaid Services Five-Star Quality rating) and subjective (Self-Rated Facility QI Index) quality outcomes, supporting the measure's known group validity. The instrument has usefulness to both NH organizations and individual NH administrators as a diagnostic tool to identify administrators with higher/lower chances of successfully implementing QI. Organizations and individuals can use this diagnostic to identify the administrator's professional development needs for QI, in general, and specific to the instrument's five subscales, informing directions for in-house training, mentoring, and outside professional

  16. Creating a Quality Improvement Course for Undergraduate Medical Education: Practice What You Teach.

    PubMed

    Bradham, Tamala S; Sponsler, Kelly C; Watkins, Scott C; Ehrenfeld, Jesse M

    2018-05-02

    More than half of U.S. medical schools have implemented curricula addressing quality improvement (QI); however, the evidence on which pedagogical methods are most effective is limited. As of January 2015, students at Vanderbilt University School of Medicine are required to take a QI course consisting of three 1-month-long (4 hours per week) blocks during their third or fourth year, in which student-identified faculty sponsors are paired with highly trained QI professionals from Vanderbilt University Medical Center. The three blocks of the QI course include didactic instruction using Institute for Healthcare Improvement Open School modules, readings, weekly assignments, and experiential learning activities (i.e., students develop and implement a QI project with two Plan-Do-Study-Act cycles using a systematic approach that employs the principles of improvement science, which they present as a poster on the last day of the third block). From January 2015 to January 2017, 132 students completed all three blocks, resulting in 110 completed QI projects. On evaluations (distributed after each completed block), a majority of students rated the clinical relevance of the blocks highly (191/273, 70%), agreed the blocks contributed to their development as a physician (192/273, 70%), and reported the blocks motivated them to continue to learn more about QI (168/273, 62%). The authors have applied QI tools and methods to improve the QI course and will aim to measure and assess the sustainability of the course by tracking clinical outcomes related to the projects and students' ongoing involvement in QI after graduation.Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

  17. Assessing the Organizational Characteristics Influencing Quality Improvement Implementation in Saudi Hospitals.

    PubMed

    Shamsuddin Alaraki, Mohammad

    The health care system in Saudi Arabia has serious problems with quality and safety that can be reduced through systematic quality improvement (QI) activities. Despite the use of different QI models to improve health care in Saudi hospitals during the last 2 decades, consistent improvements have not yet been achieved and the results are still far below expectations. This may reflect a problem in introducing and implementing the QI models in the local contexts. The objective of this study is to assess the extent of QI implementation in Saudi hospitals and to identify the organizational characteristics that make Saudi hospitals particularly challenging for QI. Understanding these characteristics can inform efforts to improve them and may lead to more successful implementation. A mixed-methods approach was conducted using 2 data collection tools: questionnaires and interviews. The quantitative phase (questionnaires) aimed to uncover the current level of QI implementation in Saudi hospital as measured by 7 critical dimensions adapted from the literature. The qualitative phase (interviews) aimed to understand the organizational characteristics that impede or underpin QI in Saudi hospitals. The QI implementation was found to be significantly poor across the 7 dimensions with average score ranging between 22.80 ± 0.57 and 2.11 ± 0.69 on a 5-point Likert scale and with P value of less than .05. We also found that the current level of QI implementation helped Saudi hospitals neither to improve "customer satisfaction" nor to achieve measurable improvements in "quality results" scoring significantly low at 2.11 ± 0.69 with P value of .000 and 2.47 ± 0.57 with P value of .000, respectively. Our study confirms the presence of a multitude of organizational barriers that impede QI in Saudi hospitals. These are related to organizational culture, human resources management, processes and systems, and structure. These 4 were found to have the strongest impact on QI in Saudi

  18. The immunoglobulin family member dendrite arborization and synapse maturation 1 (Dasm1) controls excitatory synapse maturation

    PubMed Central

    Shi, Song-Hai; Cheng, Tong; Jan, Lily Yeh; Jan, Yuh-Nung

    2004-01-01

    In the developing mammalian brain, a large fraction of excitatory synapses initially contain only N-methyl-d-aspartate receptor and thus are “silent” at the resting membrane potential. As development progresses, synapses acquire α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPA-Rs). Although this maturation of excitatory synapses has been well characterized, the molecular basis for this developmental change is not known. Here, we report that dendrite arborization and synapse maturation 1 (Dasm1), an Ig superfamily member, controls excitatory synapse maturation. Dasm1 is localized at the excitatory synapses. Suppression of Dasm1 expression by using RNA interference or expression of dominant negative deletion mutants of Dasm1 in hippocampal neurons at late developmental stage specifically impairs AMPA-R-mediated, but not N-methyl-d-aspartate receptor-mediated, synaptic transmission. The ability of Dasm1 to regulate synaptic AMPA-Rs requires its intracellular C-terminal PDZ domain-binding motif, which interacts with two synaptic PDZ domain-containing proteins involved in spine/synapse maturation, Shank and S-SCAM. Moreover, expression of dominant negative deletion mutants of Dasm1 leads to more immature silent synapses. These results suggest that Dasm1, as a transmembrane molecule, likely provides a link to bridge extracellular signals and intracellular signaling complexes in controlling excitatory synapse maturation. PMID:15340156

  19. Game Maturity Model for Health Care.

    PubMed

    de Boer, Jan C; Adriani, Paul; van Houwelingen, Jan Willem; Geerts, A

    2016-04-01

    This article introduces the Game Maturity Model for the healthcare industry as an extension to the general Game Maturity Model and describes the usage by two case studies of applied health games. The Game Maturity Model for healthcare provides a practical and value-adding method to assess existing games and to determine strategic considerations for application of applied health games. Our forecast is that within 5 years the use and development of applied games will have a role in our daily lives and the way we organize health care that will be similar to the role social media has today.

  20. Nutrient signaling and developmental timing of maturation.

    PubMed

    Danielsen, E Thomas; Moeller, Morten E; Rewitz, Kim F

    2013-01-01

    In animals, developmental timing of sexual maturation is tightly linked to nutrition and growth. Maturation only occurs once the juvenile has acquired sufficient nutrients and completed enough growth to produce a reproductively mature adult with a genetically predefined body size. Animals therefore adjust the duration of juvenile development to the dietary conditions. When nutrients are scarce the juvenile growth phase is extended to compensate for slow growth. Conversely, development is accelerated in nutrient rich environments where animals rapidly reach their genetic target size. To achieve such flexibility, nutrient-dependent growth regulators must feed into the endocrine system that controls the timing of maturation. Work on the fruit fly Drosophila has revealed a central role of secreted signal molecules with similarity to the conserved insulin-like growth factors (IGFs) in the decision making process. These molecules are involved in checkpoints that allow the endocrine system to decide whether to release the steroid hormone, ecdysone, that triggers maturation or extent development, depending on nutrient levels and growth status. Importantly, different dietary components influence timing of maturation in Drosophila, with proteins having the greatest impact; fat and sugar play a minor role, at least within the limits of what can be considered a balanced diet. Remarkably, excess dietary sugar concentrations that mimic physiological conditions associated with diabetes, negatively affect growth and delays maturation. Altogether, this shows that the source of energy in the diet is important for timing and may provide a paradigm for understanding the emerging links between diet, obesity and diabetes, and the onset of puberty. Here, we provide an overview of the system underlying developmental timing of maturation in Drosophila and review recent success in understanding its coupling to nutrition and growth. © 2013 Elsevier Inc. All rights reserved.

  1. Pronuclear synchronization and nuclear morphology of mature and in vitro matured oocytes in the rat: an ultrastructural study.

    PubMed

    Cincik, M; Baykal, B; Zeteroglu, S; Onalan, G; Ceyhan, S T; Ergur, R

    2005-01-01

    The objective of this study was to evaluate synchronous and asynchronous pronucleus (PN) formation and the related patterns of juxtapositional nucleolus (n) formation in immature (prophase I [PI] and metaphase I [MI]) and mature (metaphase II [MII]) oocytes after fertilization, both ultrastructurally and at the level of light microscope. A single dose of 15 IU gonadotrophin was injected subcutaneously to twenty four 26-wk-old, female Wistar rats to induce ovulation. Human chorionic gonadotrophin (4 IU) was administered 40 h later, and after 4-6 h the ovaries were dissected, and the oocytes were aspirated. A total of 214 rat oocytes were classified according to a maturation index as follows: group I, 80 PI oocytes; group II, 50 MI oocytes; and group III, 84 MII oocytes. Immature oocytes were in vitro matured for 18-36 h. Spermatozoa were acquired by microepididymal sperm aspiration and processed using swim-up technique. Intracytoplasmic sperm injection was performed on mature oocytes after 2 h of incubation and on in vitro matured (IVM) oocytes 4 h after maturation. Pronuclear synchronization [both pronucleases (PNs) centrally located, equal sized, with equal numbers and sizes of juxtapositional nucleoli (Nn)] was observed in fertilized oocytes. Asynchronous PN formation (diversity between male and female PNs, related to dimensions, localization, and the number of Nn) in groups I, II, and III was found in 75, 86, and 47% of preembryos, respectively. There was a significant difference of synchronous pronuclear formation between mature and IVM oocytes (P < 0.05). In IVM oocytes, asynchronous PN formation is high, and juxtapositional pronucleolar patterns are observed to be low by transmission electron microscope (TEM).

  2. Vegetative propagation of mature and juvenile northern red oak

    Treesearch

    James J. Zaczek; K. C. Steiner; C. W., Jr. Heuser

    1993-01-01

    Rooting trials were established to evaluate rooting success of cuttings from mature and juvenile, grafted and ungrafted northern red oak (NRO). Buds from 4 mature NRO ortets and juvenile seedlings were grafted onto juvenile and mature rootstock. Cuttings were collected from the grafts and from juvenile and mature shoots developed in situ and...

  3. Decision-Making Style and Vocational Maturity.

    ERIC Educational Resources Information Center

    Phillips, Susan D.; Strohmer, Douglas C.

    1982-01-01

    Examined the relationship between decision-making style, scholastic achievement, and vocational maturity for college students (N=64). Results did not support the hypothesized relationship between rationality and attitudinal and cognitive maturity. Scholastic achievement and lack of dependent decision style were found to be moderately predictive of…

  4. Secular trends in the timing of skeletal maturation as assessed by the cervical vertebrae maturation method.

    PubMed

    Montasser, Mona A; Viana, Grace; Evans, Carla A

    2017-04-01

    To investigate the presence of secular trends in skeletal maturation of girls and boys as assessed by the use of cervical vertebrae bones. The study compared two main groups: the first included data collected from the Denver growth study (1930s to 1960s) and the second included data collected from recent pretreatment records (1980s to 2010s) of patients from the orthodontic clinic of a North American University. The records from the two groups were all for Caucasian subjects. The sample for each group included 78 lateral cephalographs for girls and the same number for boys. The age of the subjects ranged from 7 to 18 years. Cervical vertebrae maturation (CVM) stages were directly assessed from the radiographs according to the method described by Hassel and Farman in which six CVM stages were designated from cervical vertebrae 2, 3, and 4. The mean age of girls from the Denver growth study and girls from the university clinic in each of the six CVM stages was not different at P ≤0.05. However, the mean age of boys from the two groups was not different only in stage 3 (P = 0.139) and stage 4 (P = 0.211). The results showed no evidence to indicate a tendency for earlier skeletal maturation of girls or boys. Boys in the university group started their skeletal maturation later than boys in the Denver group and completed their maturation earlier. Gender was a significant factor affecting skeletal maturation stages in both Denver and university groups. © The Author 2016. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  5. Comparison of the efficacy and safety of femtosecond laser capsulotomy between mature and non-mature cataracts.

    PubMed

    Asena, Bilgehan Sezgin; Kaskaloglu, Mahmut

    2016-08-01

    This study aims to compare the efficacy and safety of femtosecond (FS) laser capsulotomy between mature and non-mature cataracts. Kaskaloglu Eye Hospital, single center study. Prospective, controlled, and masked cross-sectional disease. A total of 133 eyes of 97 patients were included in this study. The Lens Opacities Classification System III grading scale was used in order to classify cataracts into two groups: mature and non-mature. The LenSx laser system (Alcon Labs Inc, Fort Worth, TX) was used. Data were extracted from patient charts, which included cataract grading, capsulotomy problems (tag, incomplete capsulotomy, and anterior capsule tears). The mean age was 69.2 ± 10 years (64 males, 34 females). There were 50 eyes in Group I and 83 eyes in Group II. In 20 out of 133 eyes (15%) capsule tags occurred. Of these 20 eyes, 12 were in Group I, and 8 were in Group II. The number of tag occurrences was statistically higher in Group I when compared to Group II (P = 0.011). Incomplete capsulotomy was significantly higher in Group I when compared to Group II (P < 0.0001). Free capsulotomy was present in 36 out of 50 eyes (72%) in Group I and 75 out of 83 eyes (90%) in Group II (P = 0.03). The grade of cataract significantly increased the number of suboptimal capsulotomy outcomes in FS laser capsulotomy. In mature cataract cases, the surgeon should be aware of limitations of FS laser in order to prevent capsule-related complications. Further studies of the relationship between pulse energy, patient interface design, and capsule burst strength will help elucidate the optimum parameters for laser capsulotomy creation in mature cataracts. Lasers Surg. Med. 48:590-595, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Color back projection for fruit maturity evaluation

    NASA Astrophysics Data System (ADS)

    Zhang, Dong; Lee, Dah-Jye; Desai, Alok

    2013-12-01

    In general, fruits and vegetables such as tomatoes and dates are harvested before they fully ripen. After harvesting, they continue to ripen and their color changes. Color is a good indicator of fruit maturity. For example, tomatoes change color from dark green to light green and then pink, light red, and dark red. Assessing tomato maturity helps maximize its shelf life. Color is used to determine the length of time the tomatoes can be transported. Medjool dates change color from green to yellow, and the orange, light red and dark red. Assessing date maturity helps determine the length of drying process to help ripen the dates. Color evaluation is an important step in the processing and inventory control of fruits and vegetables that directly affects profitability. This paper presents an efficient color back projection and image processing technique that is designed specifically for real-time maturity evaluation of fruits. This color processing method requires very simple training procedure to obtain the frequencies of colors that appear in each maturity stage. This color statistics is used to back project colors to predefined color indexes. Fruit maturity is then evaluated by analyzing the reprojected color indexes. This method has been implemented and used for commercial production.

  7. Basic concepts of quantum interference and electron transport in single-molecule electronics.

    PubMed

    Lambert, C J

    2015-02-21

    This tutorial outlines the basic theoretical concepts and tools which underpin the fundamentals of phase-coherent electron transport through single molecules. The key quantity of interest is the transmission coefficient T(E), which yields the electrical conductance, current-voltage relations, the thermopower S and the thermoelectric figure of merit ZT of single-molecule devices. Since T(E) is strongly affected by quantum interference (QI), three manifestations of QI in single-molecules are discussed, namely Mach-Zehnder interferometry, Breit-Wigner resonances and Fano resonances. A simple MATLAB code is provided, which allows the novice reader to explore QI in multi-branched structures described by a tight-binding (Hückel) Hamiltonian. More generally, the strengths and limitations of materials-specific transport modelling based on density functional theory are discussed.

  8. Induction of human dendritic cell maturation using transfection with RNA encoding a dominant positive toll-like receptor 4.

    PubMed

    Cisco, Robin M; Abdel-Wahab, Zeinab; Dannull, Jens; Nair, Smita; Tyler, Douglas S; Gilboa, Eli; Vieweg, Johannes; Daaka, Yehia; Pruitt, Scott K

    2004-06-01

    Maturation of dendritic cells (DC) is critical for the induction of Ag-specific immunity. Ag-loaded DC matured with LPS, which mediates its effects by binding to Toll-like receptor 4 (TLR4), induce Ag-specific CTL in vitro and in vivo in animal models. However, clinical use of LPS is limited due to potential toxicity. Therefore, we sought to mimic the maturation-inducing effects of LPS on DC by stimulating TLR4-mediated signaling in the absence of exogenous LPS. We developed a constitutively active TLR4 (caTLR4) and demonstrated that transfection of human DC with RNA encoding caTLR4 led to IL-12 and TNF-alpha secretion. Transfection with caTLR4 RNA also induced a mature DC phenotype. Functionally, transfection of DC with caTLR4 RNA enhanced allostimulation of CD4(+) T cells. DC transfected with RNA encoding the MART (Melan-A/MART-1) melanoma Ag were then used to stimulate T cells in vitro. Cotransfection of these DC with caTLR4 RNA enhanced the generation of MART-specific CTL. This CTL activity was superior to that seen when DC maturation was induced using either LPS or a standard mixture of cytokines (TNF-alpha, IL-6, IL-1beta, and PGE(2)). We conclude that transfection of DC with RNA encoding a functional signaling protein, such as caTLR4, may provide a new tool for studying TLR signaling in DC and may be a promising approach for the induction of DC maturation for tumor immunotherapy.

  9. Relationship between cervical vertebral maturation and mandibular growth.

    PubMed

    Ball, Gina; Woodside, Donald; Tompson, Bryan; Hunter, W Stuart; Posluns, James

    2011-05-01

    The cervical vertebrae have been proposed as a method of determining biologic maturity. The purposes of this study were to establish a pattern of mandibular growth and to relate this pattern to the stages of cervical vertebral maturation. Cephalometric radiographs, taken annually from ages 9 to 18 years, were evaluated for 90 boys from the Burlington Growth Center, Toronto, Ontario, Canada. Mandibular lengths were measured from articulare to gnathion, and incremental growth was determined. Cervical vertebral maturation stages were assessed by using a 6-stage method. Advanced, average, and delayed maturation groups were established. The prepubertal mandibular growth minimum velocity occurred during cervical stages 1 through 4 (P = 0.7327). Peak mandibular growth velocity occurred most frequently during stage 4 in all 3 maturation groups, with a statistical difference in the average and delayed groups (P <0.0001) and the advanced group (P = 0.0143). The average number of years spent in stage 4 was 3.79 (P <0.0001). The average amount of mandibular growth occurring during stage 4 was 9.40 mm (P <0.0001). The average amount of growth in stages 5 and 6 combined was 7.09 mm. Progression from cervical stages 1 through 6 does not occur annually; time spent in each stage varies depending on the stage and the maturation group. Cervical vertebral maturation stages cannot accurately identify the mandibular prepubertal growth minimum and therefore cannot predict the onset of the peak in mandibular growth. The cervical vertebral maturation stages should be used with other methods of biologic maturity assessment when considering both dentofacial orthopedic treatment and orthognathic surgery. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  10. Ares Project Technology Assessment: Approach and Tools

    NASA Technical Reports Server (NTRS)

    Hueter, Uwe; Tyson, Richard

    2010-01-01

    Technology assessments provide a status of the development maturity of specific technologies. Along with benefit analysis, the risks the project assumes can be quantified. Normally due to budget constraints, the competing technologies are prioritized and decisions are made which ones to fund. A detailed technology development plan is produced for the selected technologies to provide a roadmap to reach the desired maturity by the project s critical design review. Technology assessments can be conducted for both technology only tasks or for product development programs. This paper is primarily biased toward the product development programs. The paper discusses the Ares Project s approach to technology assessment. System benefit analysis, risk assessment, technology prioritization, and technology readiness assessment are addressed. A description of the technology readiness level tool being used is provided.

  11. A paradigm shift toward systemwide quality improvement education: meeting the needs of a rapidly changing health care environment: meeting the needs of a rapidly changing health care environment.

    PubMed

    Brownlee, Katherine; Minnier, Tamra E; Martin, Susan Christie; Greenhouse, Pamela K

    2013-01-01

    Widespread changes in the health care landscape require a paradigm shift from an educational model where quality improvement (QI) expertise is centralized to a model where foundational and functional QI knowledge is widespread through all levels of a health care organization. To support a new educational structure prioritizing QI education as a stand-alone priority, a 6-month educational course was introduced for operational leaders (requiring completion of a real-life improvement project) and a second, introductory QI education set of 5 stand-alone classes was introduced for managers and frontline staff; the latter is provided at centralized sites, on-site, and via webinars. Additional QI courses have been introduced for board members. Sixty operational leaders attended the first 2 offerings of the 6-month course and completed 50 associated QI projects, as of July 2012; nearly 1500 participants have attended the "Just-in-Time" classes, representing 13 University of Pittsburgh Medical Center hospitals and affiliated facilities. Eighty-three percent of recent participants rated the 6-month course a 4 or 5 in terms of efficacy. Two-thirds of participants from both 6-month series reported that they continued to work on their project once the class was over. The number of course attendees and their feedback regarding efficacy of this educational approach, as well as the volume of associated completed projects, indicate success in providing greater numbers of staff at all levels of the organization with QI education and tools. This educational format shows promise for further refinement and replicability.

  12. Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents.

    PubMed

    Ogrinc, Greg; Cohen, Emily S; van Aalst, Robertus; Harwood, Beth; Ercolano, Ellyn; Baum, Karyn D; Pattison, Adam J; Jones, Anne C; Davies, Louise; West, Al

    2016-10-01

    Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. We sought to determine the clinical and educational impact of an integrated QI curriculum. This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0-27) increased from 13.3 at baseline to 15.3 at end point ( P  < .01), as did the self-efficacy composite score ( P  < .05). Satisfaction with the curriculum was rated highly by all participants. Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

  13. Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.

    PubMed

    Padula, William V; Makic, Mary Beth F; Mishra, Manish K; Campbell, Jonathan D; Nair, Kavita V; Wald, Heidi L; Valuck, Robert J

    2015-06-01

    Prevention of pressure ulcers, one of the hospital-acquired conditions (HACs) targeted by the 2008 nonpayment policy of the Centers for Medicare & Medicaid Services (CMS), is a critical issue. This study was conducted to determine the comparative effectiveness of quality improvement (QI) interventions associated with reduced hospital-acquired pressure ulcer (HAPU) rates. In an quasi-experimental design, interrupted time series analyses were conducted to determine the correlation between HAPU incidence rates and adoption of QI interventions. Among University HealthSystem Consortium hospitals, 55 academic medical centers were surveyed from September 2007 through February 2012 for adoption patterns of QI interventions for pressure ulcer prevention, and hospital-level data for 5,208 pressure ulcer cases were analyzed. Between- and within-hospital reduction significance was tested with t-tests post-CMS policy intervention. Fifty-three (96%) of the 55 hospitals used QI interventions for pressure ulcer prevention. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates by greater than 1 case per 1,000 patient discharges per quarter: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition. The greatest reductions in rates occurred earlier in the adoption process (p<.05). Five QI interventions had clinically meaningful associations with reduced stage III and IV HAPU incidence rates in 55 academic medical centers. These QI interventions can be used in support of an evidence-based prevention protocol for pressure ulcers. Hospitals can not only use these findings from this study as part of a QI bundle for preventing HAPUs.

  14. The cost-effectiveness analysis of JinQi Jiangtang tablets for the treatment on prediabetes: a randomized, double-blind, placebo-controlled, multicenter design.

    PubMed

    Sun, Xiao; Guo, Liping; Shang, Hongcai; Ren, Ming; Wang, Yue; Huo, Da; Lei, Xiang; Wang, Hui; Zhai, Jingbo

    2015-11-03

    reduced the incidence of diabetes mellitus and enhanced reversion rate. compared with the control group (p< 0.05); the scores of SF-36 of two groups had no significant difference P> 0.05); finally the compliance of participants between the two groups had no significant difference. The cost-effectiveness analysis outcomes:in the intervention period of 12 months,on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio;on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio; in the follow-up period of 24 months, on the aspect of reversion rate, the treatment group had better economic advantage by using cost-effectiveness ratio and the incremental cost-effectiveness ratio, on the aspect of the incidence of diabetes, the control group had better economic advantage by using cost-effectivenes ratio and the incremental cost-effectiveness ratio.At the same time, these outcomes remained the same by sensitivity analysis. Assuming that prices and resident incomes rose 5%, the sensitiveness analysis shows that the two group affected by the paremeters changed little. The importance and effectiveness of lifestyle education and JinQi Jiangtang tablets was proven. In both the intervention period and follow-up, JinQi Jiangtang tablets combined with lifestyle education had a greater cost advantage effect than the lifestyle education alone on the reversion rate; the lifestyle education had a greater cost advantage effect than the JinQi Jiangtang tablets combined with lifestyle education on the incidence of diabetes. Chinese Clinical Trials ChiCTR-TRC-09000401 ) , registered on 25 May 2009.

  15. Promotion of Myogenic Maturation by Timely Application of Electric Field Along the Topographical Alignment.

    PubMed

    Ko, Ung Hyun; Park, Sukhee; Bang, Hyunseung; Kim, Mina; Shin, Hyunjun; Shin, Jennifer H

    2018-05-01

    Engineered muscular substitutes can restore the impaired muscle functions when integrated properly into the host tissue. To generate functional muscles with sufficient contractility at the site of transplant, the in vitro construction of fully differentiated muscle fibers would be desired. Many previous reports have identified either topographical alignment or electrical stimulation as an effective tool to promote myogenic differentiation. However, optimization of spatial and temporal arrangement of these two physical cues for better differentiation and maturation of skeletal muscles has not been investigated. In this article, we introduce a novel cell culture system that allows simultaneous application of these two independent directional cues at both orthogonal and parallel arrangements. We then show that the parallel arrangement of the aligned topography and the electric field synergistically facilitates better differentiation and maturation of C2C12, generating myotubes with more fused nuclei. Addition of the electric stimulation at the late stage of myogenic differentiation is found to further improve cell fusion to form multinucleate myotubes through a phosphatidylinositol-3-OH-kinase-dependent pathway. As such, we successfully demonstrated that the combined stimulation of topographical and electrical cues could effectively enhance both myogenic differentiation and maturation in a temporal and orientation-dependent manner, providing the basis for therapeutic strategies for regenerative tissue engineering.

  16. Genotype x environmental interaction for mature size and rate of maturing for Angus, Brahman, and reciprocal-cross cows grazing bermudagrass or endophyte infected fescue.

    PubMed

    Sandelin, B A; Brown, A H; Brown, M A; Johnson, Z B; Kellogg, D W; Stelzleni, A M

    2002-12-01

    Mature weight and rate of maturing were estimated in 177 Angus, Brahman, and reciprocal-cross cows grazing bermudagrass or endophyte-infected tall fescue over a 4-yr period to evaluate genotype x environment interactions. Data were collected every 28 d until cows were approximately 18 mo of age and then at prebreeding, postcalving, and weaning of calf. All cows with weight data to at least 42 mo of age were included in the analysis. Mature weight and rate of maturing were estimated using the three-parameter growth curve model described by Brody (1945). Data were pooled over year and analyzed by the general linear model procedure of SAS. Included in the models for mature weight and rate of maturing were the independent variables of genotype, environment, and genotype x environment interaction. There was a genotype x environment interaction (P < 0.01) for mature body weight (BW) but not for rate of maturing. Angus cows grazing fescue pastures had greater (P < 0.01) mean mature BW than Angus x Brahman cows grazing bermudagrass (611 +/- 17 vs 546 +/- 16 kg). Angus x Brahman cows grazing bermudagrass had lower (P < 0.05) mean mature BW than Brahman x Angus cows grazing bermudagrass or endophyte-infected fescue and Brahman cows grazing bermudagrass (546 +/- 16 vs 624 +/- 19, 614 +/- 22 and 598 +/- 20 kg, respectively). Brahman cows grazing endophyte-infected fescue had smaller (P < 0.05) mean mature BW than all genotype x forage combinations except for Angus x Brahman cows grazing bermudagrass. Angus cows had a smaller (P < 0.05) mean rate of maturing than Angus x Brahman and Brahman x Angus cows (0.039 +/- 0.002 vs 0.054 +/- 0.002 and 0.049 +/- 0.002%/mo, respectively), respectively, and Angus x Brahman cows had a larger (P < 0.05) mean rate of maturing than Brahman x Angus and Brahman cows (0.054 +/- 0.002 vs 0.049 +/- 0.002 and 0.041 +/- 0.002 %/mo, respectively). There was a direct breed x forage interaction (P < 0.05) for mature BW. These data suggest that the

  17. 24 CFR 201.11 - Loan maturities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Loan maturities. 201.11 Section 201... DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES TITLE I PROPERTY IMPROVEMENT AND MANUFACTURED HOME LOANS Loan and Note Provisions § 201.11 Loan maturities. (a...

  18. On the occurrence of nuclei in mature sieve elements.

    PubMed

    Event, R F; Davis, J D; Tucker, C M; Alfieri, F J

    1970-12-01

    The secondary phloem of 3 species of the Taxodiaceae and 13 species of woody dicotyledons was examined for the occurrence of nuclei in mature sieve elements. Nuclei were found in all mature sieve cells of Metasequoia glyptostroboides, Sequoia sempervirens and Taxodium distichum, and in some mature sieve-tube members in 12 of the 13 species of woody dicotyledons. Except for nuclei of sieve cells undergoing cessation of function, the nuclei in mature sieve cells of M. glyptostroboides, S. sempervirens and T. distichum were normal in appearance. The occurrence and morphology of nuclei in mature sieve-tube members of the woody dicotyledons were quite variable. Only 3 species, Robinia pseudoacacia, Ulmus americana and Vitis riparia, contained some mature sieve elements with apparently normal nuclei.

  19. Structure, function and dynamics in adenovirus maturation

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

    Mangel, Walter F.; San Martín, Carmen

    2014-11-21

    Here we review the current knowledge on maturation of adenovirus, a non-enveloped icosahedral eukaryotic virus. The adenovirus dsDNA genome fills the capsid in complex with a large amount of histone-like viral proteins, forming the core. Maturation involves proteolytic cleavage of several capsid and core precursor proteins by the viral protease (AVP). AVP uses a peptide cleaved from one of its targets as a “molecular sled” to slide on the viral genome and reach its substrates, in a remarkable example of one-dimensional chemistry. Immature adenovirus containing the precursor proteins lacks infectivity because of its inability to uncoat. The immature core ismore » more compact and stable than the mature one, due to the condensing action of unprocessed core polypeptides; shell precursors underpin the vertex region and the connections between capsid and core. Maturation makes the virion metastable, priming it for stepwise uncoating by facilitating vertex release and loosening the condensed genome and its attachment to the icosahedral shell. The packaging scaffold protein L1 52/55k is also a substrate for AVP. Proteolytic processing of L1 52/55k disrupts its interactions with other virion components, providing a mechanism for its removal during maturation. In conclusion, possible roles for maturation of the terminal protein are discussed.« less

  20. A Developmental Model of Intercultural Maturity

    ERIC Educational Resources Information Center

    King, Patricia M.; Baxter Magolda, Marcia B.

    2005-01-01

    This article focuses on the development of intercultural maturity, which is frequently cited as a desired collegiate outcome. We position our work on intercultural maturity in the context of a holistic approach to human development using Kegan's (1994) model as a foundation and relating this outcome to other collegiate learning outcomes. We…

  1. Career Maturity and Familial Independence among College Freshmen.

    ERIC Educational Resources Information Center

    Thomason, Sharon L.; Winer, Jane L.

    1994-01-01

    Data from 115 college freshmen under age 20 show that career maturity is not significantly related to independence from parents. Intelligence was significantly and positively related to most career maturity and independence scales for women but not for men. Men were both less career mature and more independent from their mothers than women were.…

  2. Volatile organic compounds sources and sinks in a wheat canopy. Analysis based on combined eddy-covariance fluxes, in-canopy profiles and chamber measurements with a PTR-TOF-Qi-MS

    NASA Astrophysics Data System (ADS)

    Loubet, Benjamin; Gonzaga, Lais; Buysse, Pauline; Ciuraru, Raluca; Lafouge, Florence; Decuq, Céline; Zurfluh, Olivier; Fortineau, Alain; Fanucci, Olivier; Sarda-Esteve, Roland; Zannoni, Nora; Truong, Francois; Boissard, Christophe; Gros, Valérie

    2017-04-01

    Volatile organic compounds (VOC) are essential drivers of atmospheric chemistry. Many VOCs are emitted from and deposited to ecosystems. While forests and grasslands have already been substantially studied, exchanges of VOCs with crops are less known, although these ecosystems represent more than 50% of the surface in France. In this study, we analyze sources and sinks of VOCs in a wheat field (at the ICOS FR-GRI site near Paris) at anthesis based on measurements of fluxes, concentration profiles and branch chambers. The VOCs were measured using a PTR-TOF-Qi-MS (where Qi stands for Quad Ion guide). Air was successively sampled through lines located at different heights within and above the canopy, of which one was used for Eddy Covariance and located near a sonic anemometer. Additional measurements included the standard ICOS meteorological data as well as leaf area index profiles and photosynthesis curves at several heights in the canopy. We report fluxes and profiles for more than 500 VOCs. The deposition velocities of depositing compounds are compared to the maximum exchange velocity and the ozone deposition velocity. The sources and sinks location and magnitude are evaluated by inverse Lagrangian modelling assuming no reaction and simple reaction schemes in the canopy. The sources and sinks of VOC in the canopy are interpreted in terms crop phenology and the potential for reaction with ozone and NOx is evaluated. This study takes place in the ADEME CORTEA COV3ER French project (http://www6.inra.fr/cov3er).

  3. Delayed plumage maturation and delayed reproductive investment in birds.

    PubMed

    Hawkins, Gerard L; Hill, Geoffrey E; Mercadante, Austin

    2012-05-01

    Delayed plumage maturation is the delayed acquisition of a definitive colour and pattern of plumage until after the first potential breeding period in birds. Here we provide a comprehensive overview of the numerous studies of delayed plumage maturation and a revised theoretical framework for understanding the function of delayed plumage maturation in all birds. We first distinguish between hypotheses that delayed plumage maturation is attributable to a moult constraint with no adaptive function and hypotheses that propose that delayed plumage maturation is a component of an adaptive life-history strategy associated with delayed reproductive investment. We then recognize three potential benefits of delayed plumage maturation: crypsis, mimicry and status signaling. Evidence suggests that delayed plumage maturation is not a consequence of developmental constraints and instead represents a strategy to maximize reproductive success in circumstances where young adults cannot effectively compete with older adults for limited resources, particularly breeding opportunities. A multi-factorial explanation that takes into account lifespan and the degree of competition for limited breeding resources and that combines the benefits of an inconspicuous appearance with the benefits of honest signaling of reduced competitiveness provides a general explanation for the function of delayed plumage maturation in most bird species. Delayed plumage maturation should be viewed as a component of alternative reproductive strategies that can include delay in both plumage and sexual development. Such strategies are frequently facultative, with individuals breeding prior to the acquisition of definitive plumages when conditions are favourable. Presumably, the benefits of delayed plumage maturation ultimately enhance lifetime reproductive success, and studying delayed plumage maturation within the context of lifetime reproductive success should be a goal of future studies. © 2011 The Authors

  4. Treatment of Goiter with Traditional Chinese Medicine Regimen Xing Qi Hua Ying Tang: A Clinical Study on 72 Patients with Multinodular and Diffuse Goiter.

    PubMed

    Yang, Ming-Li; Lu, Bo

    2018-04-01

    The present work aimed to further explore the therapeutic potential of Xing Qi Hua Ying Tang (XQHYT) by conducting a systemic clinical study in patients with goiter. Seventy-two patients with either multinodular or diffuse goiter were enrolled and randomly assigned into treatment group receiving XQHYT (n = 36) and control group receiving Hai Zao Yu Hu Tang (n = 36). Traditional Chinese Medicine Hospital of Shanxi. Patients were diagnosed multinodular goiter or diffuse goiter resulting from Qi stagnation. All patients took the extract twice a day (100 mL each time) for two courses of treatment, of which a single course lasted for 3 months. Before the treatment was commenced and after the completion of the treatment, general body checks, thyroid function test, and goiter size examination were performed. Scoring of the clinical symptoms using Chinese medicine symptomatology was also done. The symptom score of the treatment group was significantly lower than that of the control group (treatment group, 8.26 ± 2.62; control group, 10.02 ± 2.62; p < 0.05). Substantial reduction in goiter size was seen in 82.3% of XQHYT-treated patients, whereas in the control group only 67.7% of patients exhibited constricted goiter. When assessed by both the Chinese medicine criteria and goiter size, the overall effective rate of the treatment group was 91.2%, whereas that of the control group was only 67.7%. The difference was statistically significant (p < 0.05). XQHYT did not affect the normal functions of liver, kidney, and heart. For both groups of patients, their levels of thyroid-stimulating hormone, free T4 and free T3 were normal before the treatment, and were not affected by the treatment. XQHYT was shown to be a promising therapeutic regimen for the treatment of goiter. The herbal regimen ameliorated clinical symptoms of patients that were accompanied with reduction in the size of goiter.

  5. Ovarian follicle maturation and ovulation: An integrated perspective

    USGS Publications Warehouse

    Patino, R.; Thomas, P.; Yoshizaki, G.

    2003-01-01

    Numerous studies with teleosts have addressed the regulation and mechanisms of oocyte maturation, but largely at the exclusion of ovulation. A smaller but still considerable number of studies have focused on ovulation, and ignored maturation. Consequently, little is known about the mechanistic linkages between these two events. New information is presented here indicating that luteinizing hormone regulates the acquisition not only of oocyte maturational competence, but also ovulatory competence. The thesis is presented that maturation and ovulation are closely integrated and overlapping events that are best viewed conceptually and experimentally as parts of a functional whole. ?? 2004 Kluwer Academic Publishers.

  6. Asteroid Redirect Crewed Mission Space Suit and EVA System Maturation

    NASA Technical Reports Server (NTRS)

    Bowie, Jonathan; Buffington, Jesse; Hood, Drew; Kelly, Cody; Naids, Adam; Watson, Richard

    2015-01-01

    The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment selected for both functions is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS) currently under development for Advanced Exploration Systems (AES). The proposed architecture meets the ARCM constraints, but much more work is required to determine the details of the suit upgrades, the integration with the PLSS, and the tools and equipment necessary to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations were completed in the Neutral Buoyancy Lab (NBL) and interfacing options were prototyped and analyzed with testing planned for late 2014. This paper discusses the work done over the last year on the MACES enhancements, the use of tools while using the suit, and the integration of the PLSS with the MACES.

  7. Canopy temperature and maturity in cotton

    USDA-ARS?s Scientific Manuscript database

    Heat units are a widely used indicator of maturity in cotton. It is generally assumed that it takes approximately 2200°F (1222°C) heat units for a cotton plant on the South High Plains of Texas to mature. This value is based on a typical planting date of May 15 with ample irrigation. As water for c...

  8. Quantifying Semantic Linguistic Maturity in Children

    ERIC Educational Resources Information Center

    Hansson, Kristina; Bååth, Rasmus; Löhndorf, Simone; Sahlén, Birgitta; Sikström, Sverker

    2016-01-01

    We propose a method to quantify "semantic linguistic maturity" (SELMA) based on a high dimensional semantic representation of words created from the co-occurrence of words in a large text corpus. The method was applied to oral narratives from 108 children aged 4;0-12;10. By comparing the SELMA measure with maturity ratings made by human…

  9. Maturation-Associated Destabilization of Hepatitis B Virus Nucleocapsid

    PubMed Central

    Cui, Xiuji; Ludgate, Laurie; Ning, Xiaojun

    2013-01-01

    The mature nucleocapsid (NC) of hepatitis B virus containing the relaxed circular (RC) DNA genome can be secreted extracellularly as virions after envelopment with the viral surface proteins or, alternatively, can be disassembled to release RC DNA (i.e., uncoating) into the host cell nucleus to form the covalently closed circular (CCC) DNA, which sustains viral replication and persistence. In contrast, immature NCs containing the viral single-stranded DNA or the pregenomic RNA are incompetent for either envelopment or uncoating. Little is currently known about how mature NCs, and not the immature ones, are specifically selected for these processes. Here, we have carried out a biochemical analysis of the different NC populations upon their separation through sucrose gradient centrifugation. We have found that the maturation of NCs is associated with their destabilization, manifested as increased protease and nuclease sensitivity, altered sedimentation during sucrose gradient centrifugation, and retarded mobility during native agarose gel electrophoresis. Also, three distinct populations of intracellular mature NCs could be differentiated based on these characteristics. Furthermore, mature NCs generated in vitro under cell-free conditions acquired similar properties. These results have thus revealed significant structural changes associated with NC maturation that likely play a role in the selective uncoating of the mature NC for CCC DNA formation and/or its preferential envelopment for virion secretion. PMID:23966388

  10. Autophagy proteins are not universally required for phagosome maturation.

    PubMed

    Cemma, Marija; Grinstein, Sergio; Brumell, John H

    2016-09-01

    Phagocytosis plays a central role in immunity and tissue homeostasis. After internalization of cargo into single-membrane phagosomes, these compartments undergo a maturation sequences that terminates in lysosome fusion and cargo degradation. Components of the autophagy pathway have recently been linked to phagosome maturation in a process called LC3-associated phagocytosis (LAP). In this process, autophagy machinery is thought to conjugate LC3 directly onto the phagosomal membrane to promote lysosome fusion. However, a recent study has suggested that ATG proteins may in fact impair phagosome maturation to promote antigen presentation. Here, we examined the impact of ATG proteins on phagosome maturation in murine cells using FCGR2A/FcγR-dependent phagocytosis as a model. We show that phagosome maturation is not affected in Atg5-deficient mouse embryonic fibroblasts, or in Atg5- or Atg7-deficient bone marrow-derived macrophages using standard assays of phagosome maturation. We propose that ATG proteins may be required for phagosome maturation under some conditions, but are not universally required for this process.

  11. The FORGE AHEAD clinical readiness consultation tool: a validated tool to assess clinical readiness for chronic disease care mobilization in Canada's First Nations.

    PubMed

    Hayward, Mariam Naqshbandi; Mequanint, Selam; Paquette-Warren, Jann; Bailie, Ross; Chirila, Alexandra; Dyck, Roland; Green, Michael; Hanley, Anthony; Tompkins, Jordan; Harris, Stewart

    2017-03-23

    Given the astounding rates of diabetes and related complications, and the barriers to providing care present in Indigenous communities in Canada, intervention strategies that take into account contextual factors such as readiness to mobilize are needed to maximize improvements and increase the likelihood of success and sustainment. As part of the national FORGE AHEAD Program, we sought to develop, test and validate a clinical readiness consultation tool aimed at assessing the readiness of clinical teams working on-reserve in First Nations communities to participate in quality improvement (QI) to enhance diabetes care in Canada. A literature review was conducted to identify existing readiness tools. The ABCD - SAT was adapted using a consensus approach that emphasized a community-based participatory approach and prioritized the knowledge and wisdom held by community members. The tool was piloted with a group of 16 people from 7 provinces and 11 partnering communities to assess language use, clarity, relevance, format, and ease of completion using examples. Internal reliability analysis and convergence validity were conducted with data from 53 clinical team members from 11 First Nations communities (3-5 per community) who have participated in the FORGE AHEAD program. The 27-page Clinical Readiness Consultation Tool (CRCT) consists of five main components, 21 sub-components, and 74 items that are aligned with the Expanded Chronic Care Model. Five-point Likert scale feedback from the pilot ranged from 3.25 to 4.5. Length of the tool was reported as a drawback but respondents noted that all the items were needed to provide a comprehensive picture of the healthcare system. Results for internal consistency showed that all sub-components except for two were within acceptable ranges (0.77-0.93). The Team Structure and Function sub-component scale had a moderately significant positive correlation with the validated Team Climate Inventory, r = 0.45, p < 0.05. The

  12. Induced maturation of human immunodeficiency virus.

    PubMed

    Mattei, Simone; Anders, Maria; Konvalinka, Jan; Kräusslich, Hans-Georg; Briggs, John A G; Müller, Barbara

    2014-12-01

    HIV-1 assembles at the plasma membrane of virus-producing cells as an immature, noninfectious particle. Processing of the Gag and Gag-Pol polyproteins by the viral protease (PR) activates the viral enzymes and results in dramatic structural rearrangements within the virion--termed maturation--that are a prerequisite for infectivity. Despite its fundamental importance for viral replication, little is currently known about the regulation of proteolysis and about the dynamics and structural intermediates of maturation. This is due mainly to the fact that HIV-1 release and maturation occur asynchronously both at the level of individual cells and at the level of particle release from a single cell. Here, we report a method to synchronize HIV-1 proteolysis in vitro based on protease inhibitor (PI) washout from purified immature virions, thereby temporally uncoupling virus assembly and maturation. Drug washout resulted in the induction of proteolysis with cleavage efficiencies correlating with the off-rate of the respective PR-PI complex. Proteolysis of Gag was nearly complete and yielded the correct products with an optimal half-life (t(1/2)) of ~5 h, but viral infectivity was not recovered. Failure to gain infectivity following PI washout may be explained by the observed formation of aberrant viral capsids and/or by pronounced defects in processing of the reverse transcriptase (RT) heterodimer associated with a lack of RT activity. Based on our results, we hypothesize that both the polyprotein processing dynamics and the tight temporal coupling of immature particle assembly and PR activation are essential for correct polyprotein processing and morphological maturation and thus for HIV-1 infectivity. Cleavage of the Gag and Gag-Pol HIV-1 polyproteins into their functional subunits by the viral protease activates the viral enzymes and causes major structural rearrangements essential for HIV-1 infectivity. This proteolytic maturation occurs concomitant with virus release

  13. Morphological records of oocyte maturation in the parthenogenetic tick Amblyomma rotundatum Koch, 1844 (Acari: Ixodidae).

    PubMed

    Sanches, Gustavo S; Araujo, Andrea M; Martins, Thiago F; Bechara, Gervásio H; Labruna, Marcelo B; Camargo-Mathias, Maria I

    2012-02-01

    Oocyte maturation in the thelytokous parthenogenetic tick Amblyomma rotundatum was examined for the first time using light and scanning electron microscopy. The panoistic ovary lacks nurse and follicular cells and is a single continuous tubular structure forming a lumen delimited by the ovarian wall. Oocytes of tick species are usually classified according to cytoplasm appearance, the presence of germinal vesicle, the presence of yolk granules, and the chorion. However, for this species, we also use oocyte size as an auxiliary tool since most oocytes were in stages I-III and were histologically very similar. Oocytes were classified into five development stages, and specific characteristics were observed: mature oocytes with thin chorion, pedicel cells arranged forming an epithelium with two or more oocytes attached by the same structure, and a large number of oocytes in the process of reabsorption. Copyright © 2011 Elsevier GmbH. All rights reserved.

  14. Hospital antibiotic management in Austria--results of the ABS maturity survey of the ABS International group.

    PubMed

    Burgmann, Heinz; Janata, Oskar; Allerberger, Franz; Frank, Annegret

    2008-01-01

    The ABS International group conducted a survey to estimate the prevalence and characteristics of country-specific hospital antibiotic management programs. This paper summarizes the results for Austria. The survey was conducted in April and May 2007. A questionnaire with various items related to hospital antibiotic management was sent to 160 Austrian hospitals. Of 160 questionnaires sent, 80 were returned and evaluable. The mean total score for all items and all hospitals was 3.29 (median: 3.42; range 1.35-4.74). The larger the hospital the higher were the reported scores concerning diagnostics, antibiotic-related organization and antibiotic-consumption control, but the lower the scores for antibiotic-related personnel development and antibiotic-related relationships to relevant environments. The maturity figure for large hospitals (>500 beds) was 3.57, for medium hospitals 3.34, and for small hospitals (<200 beds) 3.01. The self-reported results of our questionnaire-based survey clearly show that there is still need for improvement. In all five categories surveyed, Austrian hospitals scored their antibiotic maturity lower than the international averages. The establishment of an antibiotic officer enables the development of antibiotic stewardship tools such as antibiotic lists. Such tools can be seen as quality indicators.

  15. [Using UV-Vis Absorbance for Characterization of Maturity in Composting Process with Different Materials].

    PubMed

    Zhao, Yue; Wei, Yu-quan; Li, Yang; Xi, Bei-dou; Wei, Zi-min; Wang, Xing-lei; Zhao, Zhi-nan; Ding, Jei

    2015-04-01

    The present study was conducted to assess the degree of humification in DOM during composting using different raw materials, and their effect on maturity of compost based on UV-Vis spectra measurements and chemometrics method. The raw materials of composting studied included chicken manure, pig manure, kitchen waste, lawn waste, fruits and vegetables waste, straw waste, green waste, sludge, and municipal solid waste. During composting, the parameters of UV-Vis spectra of DOM, including SUVA254 , SUVA280 , E250/E365, E4/E6, E2/E4, E2/E6, E253/E203, E253/E220, A226-400, S275-295 and S350-400 were calculated, Statistical analysis indicated that all the parameter were significantly changed during composting. SUVA254 and SUVA280 of DOM were continuously increased, E250/E365 and E4/E6 were continuously decreased in DOM, while A226-400, S275-295 and S350-400 of DOM at the final stage were significantly different with those at other stages of composting. Correlation analysis indicated that the parameters were significantly correlated with each other except for E2/E4 and E235/E203. Furthermore, principal component analysis suggested that A226-400, SUVA254, S350-400, SUVA280 and S275~295 were reasonable parameters for assessing the compost maturity. To distinguish maturity degree among different composts, hierarchical cluster analysis, an integrated tool utilizing multiple UV-Vis parameters, was performed based on the data (A226-400, SUVA254, S350-400, SUVA280 and S275-295) of DOM derived from the final stage of composting. Composts from different sources were clustered into 2 groups. The first group included chicken manure, pig manure, lawn waste, fruits and vegetables waste, green waste, sludge, and municipal solid waste characterized by a lower maturity degree, and the second group contained straw waste and kitchen waste associated with a higher maturity degree. The above results suggest that a multi-index of UV-Vis spectra could accurately evaluate the compost maturity

  16. The characteristics and experiences of mature nursing students.

    PubMed

    Montgomery, Laura E A; Tansey, Etain A; Roe, Sean M

    To explore the characteristics of mature nursing students, including how they perceive themselves, and to identify the problems they experience, which may influence whether they continue with their course. A sample of 239 students completed an anonymous questionnaire at the end of their first year of study for a diploma in nursing science. A question concerning age was included to enable identification of mature students, of which there were 90. Mature students as a group were desirable students, tending to perform better academically than their younger counterparts and bringing a wealth of caring experience to the course. However, mature students experienced additional pressures, for example financial concerns. When considering the potential benefits of educating mature students, the government and universities should be encouraging their recruitment and retention. An increase in the bursary and free or heavily subsidised childcare would help to alleviate financial concerns.

  17. New definitions for cotton fiber maturity ratio

    USDA-ARS?s Scientific Manuscript database

    Cotton fiber maturity affects fiber physical, mechanical, and chemical properties, as well as the processability and qualities of yarn and fabrics. New definitions of cotton fiber maturity ratio are introduced. The influences of sampling, sample preparation, measurement method, and correlations am...

  18. Genetic transformation of mature citrus plants.

    PubMed

    Cervera, Magdalena; Juárez, José; Navarro, Luis; Peña, Leandro

    2005-01-01

    Most woody fruit species have long juvenile periods that drastically prolong the time required to analyze mature traits. Evaluation of characteristics related to fruits is a requisite to release any new variety into the market. Because of a decline in regenerative and transformation potential, genetic transformation procedures usually employ juvenile material as the source of plant tissue, therefore resulting in the production of juvenile plants. Direct transformation of mature material could ensure the production of adult transgenic plants, bypassing in this way the juvenile phase. Invigoration of the source adult material, establishment of adequate transformation and regeneration conditions, and acceleration of plant development through grafting allowed us to produce transgenic mature sweet orange trees flowering and bearing fruits in a short time period.

  19. Pressure garment design tool to monitor exerted pressures.

    PubMed

    Macintyre, Lisa; Ferguson, Rhona

    2013-09-01

    Pressure garments are used in the treatment of hypertrophic scarring following serious burns. The use of pressure garments is believed to hasten the maturation process, reduce pruritus associated with immature hypertrophic scars and prevent the formation of contractures over flexor joints. Pressure garments are normally made to measure for individual patients from elastic fabrics and are worn continuously for up to 2 years or until scar maturation. There are 2 methods of constructing pressure garments. The most common method, called the Reduction Factor method, involves reducing the patient's circumferential measurements by a certain percentage. The second method uses the Laplace Law to calculate the dimensions of pressure garments based on the circumferential measurements of the patient and the tension profile of the fabric. The Laplace Law method is complicated to utilise manually and no design tool is currently available to aid this process. This paper presents the development and suggested use of 2 new pressure garment design tools that will aid pressure garment design using the Reduction Factor and Laplace Law methods. Both tools calculate the pressure garment dimensions and the mean pressure that will be exerted around the body at each measurement point. Monitoring the pressures exerted by pressure garments and noting the clinical outcome would enable clinicians to build an understanding of the implications of particular pressures on scar outcome, maturation times and patient compliance rates. Once the optimum pressure for particular treatments is known, the Laplace Law method described in this paper can be used to deliver those average pressures to all patients. This paper also presents the results of a small scale audit of measurements taken for the fabrication of pressure garments in two UK hospitals. This audit highlights the wide range of pressures that are exerted using the Reduction Factor method and that manual pattern 'smoothing' can dramatically

  20. Determinants of relative skeletal maturity in South African children.

    PubMed

    Hawley, Nicola L; Rousham, Emily K; Johnson, William; Norris, Shane A; Pettifor, John M; Cameron, Noël

    2012-01-01

    The variation of skeletal maturity about chronological age is a sensitive indicator of population health. Age appropriate or advanced skeletal maturity is a reflection of adequate environmental and social conditions, whereas delayed maturation suggests inadequate conditions for optimal development. There remains a paucity of data, however, to indicate which specific biological and environmental factors are associated with advancement or delay in skeletal maturity. The present study utilises longitudinal data from the South African Birth to Twenty (Bt20) study to indentify predictors of relative skeletal maturity (RSM) in early adolescence. A total of 244 black South African children (n=131 male) were included in this analysis. Skeletal maturity at age 9/10 years was assessed using the Tanner and Whitehouse III RUS technique. Longitudinal data on growth, socio-economic position and pubertal development were entered into sex-specific multivariable general linear regression models with relative skeletal maturity (skeletal age-chronological age) as the outcome. At 9/10 years of age males showed an average of 0.66 years delay in skeletal maturation relative to chronological age. Females showed an average of 1.00 year delay relative to chronological age. In males, being taller at 2 years (p<0.01) and heavier at 2 years (p<0.01) predicted less delay in RSM at age 9/10 years, independent of current size and body composition. In females, both height at 2 years and conditional weight at 2 years predicted less delay in RSM at 9/10 years (p<0.05) but this effect was mediated by current body composition. Having greater lean mass at 9/10 years was associated with less delayed RSM in females (p<0.01) as was pubertal status at the time of skeletal maturity assessment (p<0.01). This study identifies several predictors of skeletal maturation at 9/10 years, indicating a role for early life exposures in determining the rate of skeletal maturation during childhood independently of

  1. The efficacy and safety of Jiedu Tongluo granules for treating post-stroke depression with qi deficiency and blood stasis syndrome: study protocol for a randomized controlled trial.

    PubMed

    Zhao, Ai-Mei; Qiu, Wen-Ran; Mao, Li-Jun; Ren, Jun-Guo; Xu, Li; Yao, Ming-Jiang; Bilinksi, Kellie; Chang, Dennis; Liu, Jian-Xun

    2018-05-10

    Post-stroke depression (PSD) is the most common psychiatric complication after a stroke. The most frequently used antidepressants are selective serotonin receptor inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), however, these exhibit a series of side effects. Traditional Chinese medicine has been used to treat PSD with few side effects. The aim of this study is to evaluate the efficacy and safety of Jiedu Tongluo granules for treating PSD with qi deficiency and blood stasis syndrome. The planned study is a double-blind, randomized, placebo-controlled pilot trial. Eighty participants will be randomly assigned to receive either treatment or placebo. The treatment group will receive Jiedu Tongluo granules (JDTLG) with conventional treatment, and the placebo group will receive placebo with conventional treatment for 8 weeks. The primary outcome is the effectiveness of JDTLG on depression after 8 weeks treatment, which is defined as a decrease of 50% or more in 17-item Hamilton Depression Scale (HAMD-17) score or clinical recovery (score < 7). Secondary outcomes are improvement in neurological function, degree of independence, activities of daily living, and TCM syndrome at each visit, which will be measured with National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI) and TCM scale, respectively. Interleukin (IL)-6, IL-8, and small-molecule metabolites will be monitored to explore the mechanism of action of JDTLG on PSD. Safety measures include vital signs, results of electrocardiography, laboratory index (full blood count, kidney and liver function tests) and adverse events. The purpose of this trial is to evaluate the therapeutic effects and safety of JDTLG in individuals with PSD with concomitant qi deficiency and blood stasis syndrome. If successful, the outcome of this trial will provide a viable treatment option for PSD patients. ClinicalTrials.gov ID: NCT03147053 . Registered on

  2. Post-thymic maturation: young T cells assert their individuality.

    PubMed

    Fink, Pamela J; Hendricks, Deborah W

    2011-07-22

    T cell maturation was once thought to occur entirely within the thymus. Now, evidence is mounting that the youngest peripheral T cells in both mice and humans comprise a distinct population from their more mature, yet still naive, counterparts. These cells, termed recent thymic emigrants (RTEs), undergo a process of post-thymic maturation that can be monitored at the levels of cell phenotype and immune function. Understanding this final maturation step in the process of generating useful and safe T cells is of clinical relevance, given that RTEs are over-represented in neonates and in adults recovering from lymphopenia. Post-thymic maturation may function to ensure T cell fitness and self tolerance.

  3. Asteroid Redirect Crewed Mission Space Suit and EVA System Maturation

    NASA Technical Reports Server (NTRS)

    Bowie, Jonathan T.; Kelly, Cody; Buffington, Jesse; Watson, Richard D.

    2015-01-01

    The Asteroid Redirect Crewed Mission (ARCM) requires a Launch/Entry/Abort (LEA) suit capability and short duration Extra Vehicular Activity (EVA) capability from the Orion spacecraft. For this mission, the pressure garment that was selected, for both functions, is the Modified Advanced Crew Escape Suit (MACES) with EVA enhancements and the life support option that was selected is the Exploration Portable Life Support System (PLSS). The proposed architecture was found to meet the mission constraints, but much more work is required to determine the details of the required suit upgrades, the integration with the PLSS, and the rest of the tools and equipment required to accomplish the mission. This work has continued over the last year to better define the operations and hardware maturation of these systems. EVA simulations have been completed in the NBL and interfacing options have been prototyped and analyzed with testing planned for late 2014. For NBL EVA simulations, in 2013, components were procured to allow in-house build up for four new suits with mobility enhancements built into the arms. Boots outfitted with clips that fit into foot restraints have also been added to the suit and analyzed for possible loads. Major suit objectives accomplished this year in testing include: evaluation of mobility enhancements, ingress/egress of foot restraint, use of foot restraint for worksite stability, ingress/egress of Orion hatch with PLSS mockup, and testing with two crew members in the water at one time to evaluate the crew's ability to help one another. Major tool objectives accomplished this year include using various other methods for worksite stability, testing new methods for asteroid geologic sampling and improving the fidelity of the mockups and crew equipment. These tests were completed on a medium fidelity capsule mockup, asteroid vehicle mockup, and asteroid mockups that were more accurate for an asteroid type EVA than previous tests. Another focus was the

  4. Near infrared spectrometers determine stage maturity in channel catfish

    USDA-ARS?s Scientific Manuscript database

    Maturation is not synchronized in channel catfish and hence, individual fish are frequently handled and manually stage for maturation based on a selective subjective method. Fully matured fish are more responsive to hormone-induced spawning, and often result in better egg quality, higher relative f...

  5. Mature neurons dynamically restrict apoptosis via redundant premitochondrial brakes.

    PubMed

    Annis, Ryan P; Swahari, Vijay; Nakamura, Ayumi; Xie, Alison X; Hammond, Scott M; Deshmukh, Mohanish

    2016-12-01

    Apoptotic cell death is critical for the early development of the nervous system, but once the nervous system is established, the apoptotic pathway becomes highly restricted in mature neurons. However, the mechanisms underlying this increased resistance to apoptosis in these mature neurons are not completely understood. We have previously found that members of the miR-29 family of microRNAs (miRNAs) are induced with neuronal maturation and that overexpression of miR-29 was sufficient to restrict apoptosis in neurons. To determine whether endogenous miR-29 alone was responsible for the inhibition of cytochrome c release in mature neurons, we examined the status of the apoptotic pathway in sympathetic neurons deficient for all three miR-29 family members. Unexpectedly, we found that the apoptotic pathway remained largely restricted in miR-29-deficient mature neurons. We therefore probed for additional mechanisms by which mature neurons resist apoptosis. We identify miR-24 as another miRNA that is upregulated in the maturing cerebellum and sympathetic neurons that can act redundantly with miR-29 by targeting a similar repertoire of prodeath BH3-only genes. Overall, our results reveal that mature neurons engage multiple redundant brakes to restrict the apoptotic pathway and ensure their long-term survival. © 2016 Federation of European Biochemical Societies.

  6. One size does not fit all: a qualitative content analysis of the importance of existing quality improvement capacity in the implementation of Releasing Time to Care: the Productive Ward™ in Saskatchewan, Canada.

    PubMed

    Hamilton, Jessica; Verrall, Tanya; Maben, Jill; Griffiths, Peter; Avis, Kyla; Baker, G Ross; Teare, Gary

    2014-12-19

    Releasing Time to Care: The Productive Ward™ (RTC) is a method for conducting continuous quality improvement (QI). The Saskatchewan Ministry of Health mandated its implementation in Saskatchewan, Canada between 2008 and 2012. Subsequently, a research team was developed to evaluate its impact on the nursing unit environment. We sought to explore the influence of the unit's existing QI capacity on their ability to engage with RTC as a program for continuous QI. We conducted interviews with staff from 8 nursing units and asked them to speak about their experience doing RTC. Using qualitative content analysis, and guided by the Organizing for Quality framework, we describe the existing QI capacity and impact of RTC on the unit environment. The results focus on 2 units chosen to highlight extreme variation in existing QI capacity. Unit B was characterized by a strong existing environment. RTC was implemented in an environment with a motivated manager and collaborative culture. Aided by the structural support provided by the organization, the QI capacity on this unit was strengthened through RTC. Staff recognized the potential of using the RTC processes to support QI work. Staff on unit E did not have the same experience with RTC. Like unit B, they had similar structural supports provided by their organization but they did not have the same existing cultural or political environment to facilitate the implementation of RTC. They did not have internal motivation and felt they were only doing RTC because they had to. Though they had some success with RTC activities, the staff did not have the same understanding of the methods that RTC could provide for continuous QI work. RTC has the potential to be a strong tool for engaging units to do QI. This occurs best when RTC is implemented in a supporting environment. One size does not fit all and administrative bodies must consider the unique context of each environment prior to implementing large-scale QI projects. Use of an

  7. Cervical vertebral and dental maturity in Turkish subjects.

    PubMed

    Başaran, Güvenç; Ozer, Törün; Hamamci, Nihal

    2007-04-01

    The aim of this study was to investigate the relationships between the stages of calcification of teeth and the cervical vertebral maturity stages in Turkish subjects. A retrospective cross-sectional study was designed. The final study population consisted of 590 Turkish subjects. Statistical analysis of the data was performed with computer software. Spearman rank order correlation coefficients were used to assess the relationship between cervical vertebral and dental maturation. For a better understanding of the relationship between cervical vertebral maturation indexes and dental age, percentage distributions of the studied teeth were also calculated. Strict correlations were found between dental and cervical vertebral maturation of Turkish subjects. For males, the sequence from lowest to the highest was third molar, central incisor, canine, first premolar, second premolar, first molar, and second molar. For females, the sequence from lowest to the highest was third molar, canine, second premolar, first premolar, central incisor, first molar, and second molar. Dental maturation stages can be used as a reliable indicator of facial growth.

  8. The assessment and interpretation of Demirjian, Goldstein and Tanner's dental maturity.

    PubMed

    Liversidge, Helen M

    2012-09-01

    A frequently reported advancement in dental maturity compared with the 50(th) percentile of Demirjian, Goldstein and Tanner (1973, Hum Biol 45:211-27) has been interpreted as a population difference. To review the assessment and interpretation of Demirjian et al.'s dental maturity. Dental maturity of boys from published reports was compared as maturity curves and difference to the 50(th) percentile in terms of chronological age and score. Dental maturity, as well as maturity of individual teeth, was compared in the fastest and slowest maturing groups of boys from the Chaillet database. Maturity curves from published reports by age category were broadly similar and differences occurred at the steepest part of the curve. These reduced when expressed as score rather than age. Many studies report a higher than expected score for chronological age and the database contained more than expected children with scores>97(th) percentile. Revised scores for chronological age from this database were calculated (4072 males, 3958 females, aged 2.1-17.9). Most published reports were similar to the database smoothed maturity curve. This method of dental maturity is designed to assess maturity for a single child and is unsuitable to compare groups.

  9. Applying a Data Stewardship Maturity Matrix to the NOAA Observing System Portfolio Integrated Assessment Process

    NASA Astrophysics Data System (ADS)

    Peng, G.; Austin, M.

    2017-12-01

    Identification and prioritization of targeted user community needs are not always considered until after data has been created and archived. Gaps in data curation and documentation in the data production and delivery phases limit data's broad utility specifically for decision makers. Expert understanding and knowledge of a particular dataset is often required as a part of the data and metadata curation process to establish the credibility of the data and support informed decision-making. To enhance curation practices, content from NOAA's Observing System Integrated Assessment (NOSIA) Value Tree, NOAA's Data Catalog/Digital Object Identifier (DOI) projects (collection-level metadata) have been integrated with Data/Stewardship Maturity Matrices (data and stewardship quality information) focused on assessment of user community needs. This results in user focused evidence based decision making tools created by NOAA's National Environmental Satellite, Data, and Information Service (NESDIS) through identification and assessment of data content gaps related to scientific knowledge and application to key areas of societal benefit. Through enabling user need feedback from the beginning of data creation through archive allows users to determine the quality and value of data that is fit for purpose. Data gap assessment and prioritization are presented in a user-friendly way using the data stewardship maturity matrices as measurement of data management quality. These decision maker tools encourages data producers and data providers/stewards to consider users' needs prior to data creation and dissemination resulting in user driven data requirements increasing return on investment. A use case focused on need for NOAA observations linked societal benefit will be used to demonstrate the value of these tools.

  10. Role of arachidonic acid cascade in Rhinella arenarum oocyte maturation.

    PubMed

    Ortiz, Maria Eugenia; Arias-Torres, Ana Josefina; Zelarayán, Liliana Isabel

    2015-08-01

    There are no studies that document the production of prostaglandins (PGs) or their role in Rhinella arenarum oocyte maturation. In this study, we analysed the effect of arachidonic acid (AA) and prostaglandins (PGs) on maturation, activation and pronuclear formation in R. arenarum oocytes. Our results demonstrated that AA was capable of inducing maturation in time-dependent and dose-dependent manner. Arachidonic acid-induced maturation was inhibited by indomethacin. PGs from AA hydrolysis, such as prostaglandin F2α (PGF2α) and, to a lesser extent, PGE2, induced meiosis resumption. Oocyte maturation in response to PGF2α was similar to that produced by progesterone (P4). Oocyte response to PGE1 was scarce. Rhinella arenarum oocyte PGF2α-induced maturation showed seasonal variation. From February to June, oocytes presented low sensitivity to PGF2α. In following periods, this response increased until a maximum was reached during October to January, a close temporal correlation with oocyte response to P4 being observed. The effect of PGF2α on maturation was verified by analysing the capacity of oocytes to activate and form pronuclei after being injected with homologous sperm. The cytological analysis of activated oocytes demonstrated the absence of cortical granules in oocytes, suggesting that PGF2α induces germinal vesicle breakdown (GVBD) and meiosis resumption up to metaphase II. In turn, oocytes matured by the action of PGF2α were able to form pronuclei after fertilization in a similar way to oocyte maturated by P4. In microinjection of mature cytoplasm experiments, the transformation of pre-maturation promoting factor (pre-MPF) to MPF was observed when oocytes were treated with PGF2α. In summary, our results illustrated the participation of the AA cascade and its metabolites in maturation, activation and pronuclei formation in R. arenarum.

  11. Career Maturity Aspects of the Kuder Occupational Interest Survey.

    ERIC Educational Resources Information Center

    Wigington, John H.

    1982-01-01

    Determined if selected scores from the Kuder Occupational Interest Survey (KOIS) could be indicative of client career maturity. The data for each subject included three scores from the KOIS and one measure of career maturity. Significant correlations were found between the KOIS scores and career maturity. (Author)

  12. Maturation of metabolic connectivity of the adolescent rat brain

    PubMed Central

    Choi, Hongyoon; Choi, Yoori; Kim, Kyu Wan; Kang, Hyejin; Hwang, Do Won; Kim, E Edmund; Chung, June-Key; Lee, Dong Soo

    2015-01-01

    Neuroimaging has been used to examine developmental changes of the brain. While PET studies revealed maturation-related changes, maturation of metabolic connectivity of the brain is not yet understood. Here, we show that rat brain metabolism is reconfigured to achieve long-distance connections with higher energy efficiency during maturation. Metabolism increased in anterior cerebrum and decreased in thalamus and cerebellum during maturation. When functional covariance patterns of PET images were examined, metabolic networks including default mode network (DMN) were extracted. Connectivity increased between the anterior and posterior parts of DMN and sensory-motor cortices during maturation. Energy efficiency, a ratio of connectivity strength to metabolism of a region, increased in medial prefrontal and retrosplenial cortices. Our data revealed that metabolic networks mature to increase metabolic connections and establish its efficiency between large-scale spatial components from childhood to early adulthood. Neurodevelopmental diseases might be understood by abnormal reconfiguration of metabolic connectivity and efficiency. DOI: http://dx.doi.org/10.7554/eLife.11571.001 PMID:26613413

  13. Maturity Model for Advancing Smart Grid Interoperability

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

    Knight, Mark; Widergren, Steven E.; Mater, J.

    2013-10-28

    Abstract—Interoperability is about the properties of devices and systems to connect and work properly. Advancing interoperability eases integration and maintenance of the resulting interconnection. This leads to faster integration, lower labor and component costs, predictability of projects and the resulting performance, and evolutionary paths for upgrade. When specifications are shared and standardized, competition and novel solutions can bring new value streams to the community of stakeholders involved. Advancing interoperability involves reaching agreement for how things join at their interfaces. The quality of the agreements and the alignment of parties involved in the agreement present challenges that are best met withmore » process improvement techniques. The GridWise® Architecture Council (GWAC) sponsored by the United States Department of Energy is supporting an effort to use concepts from capability maturity models used in the software industry to advance interoperability of smart grid technology. An interoperability maturity model has been drafted and experience is being gained through trials on various types of projects and community efforts. This paper describes the value and objectives of maturity models, the nature of the interoperability maturity model and how it compares with other maturity models, and experiences gained with its use.« less

  14. Calcium Signaling enhancement during oocyte maturation

    NASA Astrophysics Data System (ADS)

    Jung, Peter; Ullah, Ghanim; Machaca, Khaled

    2006-03-01

    A Ca2+ signal with a special spatial and temporal characteristic universally removes cell-cycle arrest after fertilization of a mature egg cell. The Ca2+ signal is characterized by a fast rise of intracellular Ca2+ and a slow decay on the time scale of minutes. We use computational modeling of Ca2+ release on the microscale (Ca2+ puffs) and cell-scale in conjunction with experimental knowledge of the changes in the Ca2+ signaling apparatus during oocyte maturation and changing signaling patterns to explore the relationship between organization and sensitivity of IP3 receptors and SERCA pumps and the resulting signaling patterns. We hypothesize that potentiation of the IP3 receptors during oocyte maturation is the main cause for the differentiation in the signaling patterns.

  15. Testing Crites' Model of Career Maturity: A Hierarchical Strategy.

    ERIC Educational Resources Information Center

    Wallbrown, Fred H.; And Others

    1986-01-01

    Investigated the construct validity of Crites' model of career maturity and the Career Maturity Inventory (CMI). Results from a nationwide sample of adolescents, using hierarchical factor analytic methodology, indicated confirmatory support for the multidimensionality of Crites' model of career maturity, and the construct validity of the CMI as a…

  16. Patterns of pulmonary maturation in normal and abnormal pregnancy.

    PubMed

    Goldkrand, J W; Slattery, D S

    1979-03-01

    Fetal pulmonary maturation may be a variable event depending on various feto-maternal environmental and biochemical influences. The patterns of maturation were studied in 211 amniotic fluid samples from 123 patients (normal 55; diabetes 23; Rh sensitization 19; preeclampsia 26). The phenomenon of globule formation from the amniotic fluid lipid extract and is relation to pulmonary maturity was utilized for this analysis. Validation of this technique is presented. A normal curve was constructed from 22 to 42 weeks; gestation and compared to the abnormal pregnancies. Patients with class A, B, and C diabetes and Rh-sensitized pregnancies had delayed pulmonary maturation. Patients with class D diabetes and preclampsia paralleled the normal course of maturation. A discussion of these results and their possible cause is presented.

  17. Involvement of GABAA receptor in Bufo arenarum oocyte maturation.

    PubMed

    Toranzo, G Sánchez; Zelarayán, L; Bonilla, F; Oterino, J; Bühler, M I

    2008-05-01

    Amphibian oocytes meiotic arrest is released under the stimulus of progesterone; this hormone interacts with the oocyte surface and starts a cascade of events leading to the activation of a cytoplasmic maturation promoting factor (MPF) that induces germinal vesicle breakdown (GVBD), chromosome condensation and extrusion of the first polar body. The aim of this work was to determine whether the activation of a GABAA receptor is able to induce GVBD in fully grown denuded oocytes of Bufo arenarum and to analyse its possible participation in progesterone-induced maturation. We also evaluated the role of purines and phospholipids in the maturation process induced by a GABAA receptor agonist such as muscimol. Our results indicated that the activation of the GABAA receptor by muscimol induces maturation in a dose- and time-dependent manner and that this activation is a genuine maturation that enables oocytes to form pronuclei. Assays with a receptor antagonist, picrotoxine, showed that the maturation induced by muscimol was inhibited. Treatment with picrotoxine, however, shows that the participation of GABAA receptor in progesterone-induced maturation is not significant. In addition, our results indicate that high intracellular levels of purines obtained by the use of db-AMPc and theophylline or the inhibition of the phosphatidylinositol 4,5-bisphosphate (PIP2 hydrolysis by neomycin and PIP2 turn over by LiCl, respectively, inhibited the maturation induced by muscimol. Treatment with H-7 indicated, however, that PKC activation is not necessary for GVBD induced by the GABAA receptor agonist. Results suggest that the transduction pathway used by the GABAA receptor to induce maturation is different from those used by progesterone.

  18. Rab10 Disruption Results in Delayed OPC Maturation.

    PubMed

    Zhang, Zhao-Huan; Zhao, Wei-Qian; Ma, Fan-Fei; Zhang, Hui; Xu, Xiao-Hui

    2017-10-01

    Oligodendrocyte precursor cell (OPC) maturation requires membrane addition for myelin sheath formation. Since the Rab system has been shown to contribute to membrane addition in other cell types, in this study, we explored the role of Rab in OPC maturation. SiRNA and shRNA techniques and conditional knockout mice provided in vitro and in vivo evidence that Rab10 is involved in OPC maturation and may affect myelination during OPC development.

  19. Maturation of Binocular, Monocular Grating Acuity and of the Visual Interocular Difference in the First 2 Years of Life.

    PubMed

    Costa, Marcelo Fernandes; de Cássia Rodrigues Matos França, Valtenice; Barboni, Mirella Teles Salgueiro; Ventura, Dora Fix

    2018-05-01

    The sweep visual evoked potential method (sVEP) is a powerful tool for measurement of visual acuity in infants. Despite the applicability and reliability of the technique in measuring visual functions the understanding of sVEP acuity maturation and how interocular difference of acuity develops in early infancy, as well as the availability of normality ranges, are rare in the literature. We measured binocular and monocular sVEPS acuities in 481 healthy infants aged from birth to 24 months without ophthalmological diseases. Binocular sVEP acuity was significantly higher than monocular visual acuities for almost all ages. Maturation of monocular sVEP acuity showed 2 longer critical periods while binocular acuity showed three maturation periods in the same age range. We found a systematic variation of the mean interocular acuity difference (IAD) range according to age from 1.45 cpd at birth to 0.31 cpd at 24 months. An additional contribution was the determination of sVEP acuity norms for the entire age range. We conclude that binocular and monocular sVEP acuities have distinct growth curves reflecting different maturation profiles for each function. Differences in IAD range shorten according to age and they should be considered in using the sVEP acuity measurements for clinical diagnosis as amblyopia.

  20. Reversal of hippocampal neuronal maturation by serotonergic antidepressants

    PubMed Central

    Kobayashi, Katsunori; Ikeda, Yumiko; Sakai, Atsushi; Yamasaki, Nobuyuki; Haneda, Eisuke; Miyakawa, Tsuyoshi; Suzuki, Hidenori

    2010-01-01

    Serotonergic antidepressant drugs have been commonly used to treat mood and anxiety disorders, and increasing evidence suggests potential use of these drugs beyond current antidepressant therapeutics. Facilitation of adult neurogenesis in the hippocampal dentate gyrus has been suggested to be a candidate mechanism of action of antidepressant drugs, but this mechanism may be only one of the broad effects of antidepressants. Here we show a distinct unique action of the serotonergic antidepressant fluoxetine in transforming the phenotype of mature dentate granule cells. Chronic treatments of adult mice with fluoxetine strongly reduced expression of the mature granule cell marker calbindin. The fluoxetine treatment induced active somatic membrane properties resembling immature granule cells and markedly reduced synaptic facilitation that characterizes the mature dentate-to-CA3 signal transmission. These changes cannot be explained simply by an increase in newly generated immature neurons, but best characterized as “dematuration” of mature granule cells. This granule cell dematuration developed along with increases in the efficacy of serotonin in 5-HT4 receptor-dependent neuromodulation and was attenuated in mice lacking the 5-HT4 receptor. Our results suggest that serotonergic antidepressants can reverse the established state of neuronal maturation in the adult hippocampus, and up-regulation of 5-HT4 receptor-mediated signaling may play a critical role in this distinct action of antidepressants. Such reversal of neuronal maturation could affect proper functioning of the mature hippocampal circuit, but may also cause some beneficial effects by reinstating neuronal functions that are lost during development. PMID:20404165

  1. Skeletal maturity assessment with the use of cone-beam computerized tomography.

    PubMed

    Joshi, Vajendra; Yamaguchi, Tetsutaro; Matsuda, Yukiko; Kaneko, Norikazu; Maki, Kotarou; Okano, Tomohiro

    2012-06-01

    The aim of the study was to compare cervical vertebrae maturity assessed with the use of cone-beam computerized tomography (CBCT) with the hand-wrist maturation method and cervical vertebrae maturation assessed with the use of lateral cephalography for the assessment of skeletal maturity. Assessment of skeletal maturation was done using skeletal maturity indicators (SMI) from hand-wrist radiography, cervical vertebrae maturity index (CVMI) from CBCT and lateral cephalography (cephalo-CVMI). The Spearman correlation coefficient was used for statistical analysis. We observed a significant relationship between CBCT-CVMI and cephalo-CVMI as well as between CBCT-CVMI and SMI stages. The Spearman correlation coefficient value between CBCT-CVMI and cephalo-CVMI was 0.975 (P < .0001) and between CBCT-CVMI and SMI was 0.961(P < .0001). Cervical vertebrae maturity assessment with CBCT provided a reliable assessment of pubertal growth spurt, and therefore CBCT can be used to assess skeletal maturity. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Chemical composition, at consuming ripeness level of tomatoes irradiated at mature green and greenish yellow stages of maturity

    NASA Astrophysics Data System (ADS)

    Al-Wandawi, H. K.; Abdul-Rahman, M. H.; Al-Shaickley, K. A.

    Tomatoes (Lycopersicon esculentum L.,var.Monte carlo) have been Y-irradiated (100-400Krad) and left to ripen to consuming ripeness. The results revealed that in fruits irradiated with 100,200 and 300 krad at mature-green, 48 hour after harvesting and at greenish yellow stages of maturity, 24 hours after harvesting, the levels of ascorbic acid were accounted to 62, 51, 27% and 84, 59, 34% of control samples respectively. In fruits irradiated with 200 krad at mature-green stage and 48 hours after harvesting and in fruits irradiated with 400 krad at greenish yellow stage and 48 hours after harvesting, the levels of lycopene were 279 and 246% of that of control samples; while the lowest levels of lycopene were in fruits irradiated with 400 krad and at mature-green and greenish yellow stages and 48 hours after harvesting where lycopene accounted to 11 and 24% respectively when compared to control samples . on the other hand, radiation had no significant effect on PH, titrable acidity and °Brix of tomatoes.

  3. Strawberry Maturity Neural Network Detectng System Based on Genetic Algorithm

    NASA Astrophysics Data System (ADS)

    Xu, Liming

    The quick and non-detective detection of agriculture product is one of the measures to increase the precision and productivity of harvesting and grading. Having analyzed H frequency of different maturities in different light intensities, the results show that H frequency for the same maturity has little influence in different light intensities; Under the same light intensity, three strawberry maturities are changing in order. After having confirmed the H frequency section to distinguish the different strawberry maturity, the triplelayer feed-forward neural network system to detect strawberry maturity was designed by using genetic algorithm. The test results show that the detecting precision ratio is 91.7%, it takes 160ms to distinguish one strawberry. Therefore, the online non-detective detecting the strawberry maturity could be realized.

  4. Insulin-like growth factor I: a biologic maturation indicator.

    PubMed

    Ishaq, Ramy Abdul Rahman; Soliman, Sanaa Abou Zeid; Foda, Manal Yehya; Fayed, Mona Mohamed Salah

    2012-11-01

    Determination of the maturation level and the subsequent evaluation of growth potential during preadolescence and adolescence are important for optimal orthodontic treatment planning and timing. This study was undertaken to evaluate the applicability of insulin-like growth factor I (IGF-I) blood level as a maturation indicator by correlating it to the cervical vertebral maturation index. The study was conducted with 120 subjects, equally divided into 60 males (ages, 10-18 years) and 60 females (ages, 8-16 years). A lateral cephalometric radiograph and a blood sample were taken from each subject. For each subject, cervical vertebral maturation and IGF-I serum level were assessed. Mean values of IGF-I in each stage of cervical vertebral maturation were calculated, and the means in each stage were statistically compared with those of the other stages. The IGF-I mean value at each cervical vertebral maturation stage was statistically different from the mean values at the other stages. The highest mean values were observed in stage 4, followed by stage 5 in males and stage 3 in females. IGF-I serum level is a reliable maturation indicator that could be applied in orthodontic diagnosis. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  5. Objectives and Design of the Hemodialysis Fistula Maturation Study

    PubMed Central

    Dember, Laura M.; Imrey, Peter B.; Beck, Gerald J.; Cheung, Alfred K.; Himmelfarb, Jonathan; Huber, Thomas S.; Kusek, John W.; Roy-Chaudhury, Prabir; Vazquez, Miguel A.; Alpers, Charles E.; Robbin, Michelle L.; Vita, Joseph A.; Greene, Tom; Gassman, Jennifer J.; Feldman, Harold I.

    2014-01-01

    Background A large proportion of newly created arteriovenous fistulas cannot be used for dialysis because they fail to mature adequately to support the hemodialysis blood circuit. The Hemodialysis Fistula Maturation (HFM) Study was designed to elucidate clinical and biological factors associated with fistula maturation outcomes. Study Design Multicenter prospective cohort study. Setting & Participants Approximately 600 patients undergoing creation of a new hemodialysis fistula will be enrolled at 7 centers in the United States and followed up for as long as 4 years. Predictors Clinical, anatomical, biological, and process-of-care attributes identified pre-operatively, intra-operatively, or post-operatively. Outcomes The primary outcome is unassisted clinical maturation defined as successful use of the fistula for dialysis for four weeks without any maturation-enhancing procedures. Secondary outcomes include assisted clinical maturation, ultrasound-based anatomical maturation, fistula procedures, fistula abandonment, and central venous catheter use. Measurements Pre-operative ultrasound arterial and venous mapping, flow-mediated and nitroglycerin-mediated brachial artery dilation, arterial pulse wave velocity, and venous distensibility; intra-operative vein tissue collection for histopathological and molecular analyses; post-operative ultrasounds at 1 day, 2 weeks, 6 weeks, and prior to fistula intervention and initial cannulation. Results Assuming complete data, no covariate adjustment, and unassisted clinical maturation of 50%, there will be 80% power to detect ORs of 1.83 and 1.61 for dichotomous predictor variables with exposure prevalences of 20% and 50%, respectively. Limitations Exclusion of two-stage transposition fistulas limits generalizability. The requirement for study visits may result in a cohort that is healthier than the overall population of patients undergoing fistula creation. Conclusions The HFM Study will be of sufficient size and scope to 1

  6. Skeletal maturity and body size of teenage Belgian track and field athletes.

    PubMed

    Malina, R M; Beunen, G; Wellens, R; Claessens, A

    1986-01-01

    Attained skeletal maturity (TW2 RUS method), skeletal maturity relative to chronological age, and body size of national-level Belgian track and field athletes 15 to 18 years of age were considered. Among the 47 male athletes, 29 (62%) were skeletally mature, while 15 (52%) of the 29 female athletes were skeletally mature. There appeared to be a predominance of skeletally mature individuals among male sprinters and jumpers, while a majority of female sprinters were not skeletally mature. Both skeletally mature and immature individuals were rather evenly represented in the other track and field categories, with the exception of female throwers, who were skeletally mature. Mean statures and weights of skeletally mature and immature 16-, 17-and 18-year-old male athletes did not differ significantly, though the skeletally mature tended to be heavier. In contrast, the skeletally mature female athletes, on the average, were taller and heavier than the skeletally immature, although the differences among the small groups were not statistically significant.

  7. Bone density assessment for evaluation of gender differences in cervical vertebral maturation: A computed tomography study.

    PubMed

    Usha, K; Baskaranarayanan, Balashanmugam; Nagarajan, D; Selvarani, R; Vijjaykanth, M

    2016-10-01

    The cervical vertebral maturation (CVM) method is a vital tool for assessing the biological maturation of the orthodontic patient to evaluate the amount of mandibular bone growth left. To assess and visualize the cervical vertebral morphology (bone density) of orthodontic patients of the age group 9,16,27 years. Twenty four subjects with age group of 9,16,27 who were randomly selected and subjected to 3d tomographic study to estimate the biological age of the orthodontic patients by analyzing c1 c2 and c3 vertebrae. The results showed that bone density of males is lesser than females in 9 and 16 years, whereas they have more bone density than females in 27 years. The study provides qualitative method of assessing the biological age of the patient by using images of cervical vertebrae by three dimensional approach. Hence it can be useful for orthodontic diagnosis and treatment plan.

  8. Ascription of Maturity to Human Figure Drawings by Preschool Children

    ERIC Educational Resources Information Center

    Nash, Harvey

    1973-01-01

    Although Ss generally distinguished more mature from less mature figures on the basis of body proportions, the proportions of immature individuals nonetheless tended to be assimilated to those of the mature individual. (Author)

  9. 7 CFR 1427.174 - Maturity of seed cotton loans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Maturity of seed cotton loans. 1427.174 Section 1427..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.174 Maturity of seed cotton loans. Seed cotton loans mature on demand by CCC but no later than May 31 following...

  10. 7 CFR 1427.174 - Maturity of seed cotton loans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Maturity of seed cotton loans. 1427.174 Section 1427..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.174 Maturity of seed cotton loans. Seed cotton loans mature on demand by CCC but no later than May 31 following...

  11. 7 CFR 1427.174 - Maturity of seed cotton loans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Maturity of seed cotton loans. 1427.174 Section 1427..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.174 Maturity of seed cotton loans. Seed cotton loans mature on demand by CCC but no later than May 31 following...

  12. 7 CFR 1427.174 - Maturity of seed cotton loans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Maturity of seed cotton loans. 1427.174 Section 1427..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.174 Maturity of seed cotton loans. Seed cotton loans mature on demand by CCC but no later than May 31 following...

  13. 7 CFR 1427.174 - Maturity of seed cotton loans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Maturity of seed cotton loans. 1427.174 Section 1427..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.174 Maturity of seed cotton loans. Seed cotton loans mature on demand by CCC but no later than May 31 following...

  14. Computational Tools and Facilities for the Next-Generation Analysis and Design Environment

    NASA Technical Reports Server (NTRS)

    Noor, Ahmed K. (Compiler); Malone, John B. (Compiler)

    1997-01-01

    This document contains presentations from the joint UVA/NASA Workshop on Computational Tools and Facilities for the Next-Generation Analysis and Design Environment held at the Virginia Consortium of Engineering and Science Universities in Hampton, Virginia on September 17-18, 1996. The presentations focused on the computational tools and facilities for analysis and design of engineering systems, including, real-time simulations, immersive systems, collaborative engineering environment, Web-based tools and interactive media for technical training. Workshop attendees represented NASA, commercial software developers, the aerospace industry, government labs, and academia. The workshop objectives were to assess the level of maturity of a number of computational tools and facilities and their potential for application to the next-generation integrated design environment.

  15. Biological maturation of youth athletes: assessment and implications.

    PubMed

    Malina, Robert M; Rogol, Alan D; Cumming, Sean P; Coelho e Silva, Manuel J; Figueiredo, Antonio J

    2015-07-01

    The search for talent is pervasive in youth sports. Selection/exclusion in many sports follows a maturity-related gradient largely during the interval of puberty and growth spurt. As such, there is emphasis on methods for assessing maturation. Commonly used methods for assessing status (skeletal age, secondary sex characteristics) and estimating timing (ages at peak height velocity (PHV) and menarche) in youth athletes and two relatively recent anthropometric (non-invasive) methods (status-percentage of predicted near adult height attained at observation, timing-predicted maturity offset/age at PHV) are described and evaluated. The latter methods need further validation with athletes. Currently available data on the maturity status and timing of youth athletes are subsequently summarised. Selection for sport and potential maturity-related correlates are then discussed in the context of talent development and associated models. Talent development from novice to elite is superimposed on a constantly changing base-the processes of physical growth, biological maturation and behavioural development, which occur simultaneously and interact with each other. The processes which are highly individualised also interact with the demands of a sport per se and with involved adults (coaches, trainers, administrators, parents/guardians). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Tomato seeds maturity detection system based on chlorophyll fluorescence

    NASA Astrophysics Data System (ADS)

    Li, Cuiling; Wang, Xiu; Meng, Zhijun

    2016-10-01

    Chlorophyll fluorescence intensity can be used as seed maturity and quality evaluation indicator. Chlorophyll fluorescence intensity of seed coats is tested to judge the level of chlorophyll content in seeds, and further to judge the maturity and quality of seeds. This research developed a detection system of tomato seeds maturity based on chlorophyll fluorescence spectrum technology, the system included an excitation light source unit, a fluorescent signal acquisition unit and a data processing unit. The excitation light source unit consisted of two high power LEDs, two radiators and two constant current power supplies, and it was designed to excite chlorophyll fluorescence of tomato seeds. The fluorescent signal acquisition unit was made up of a fluorescence spectrometer, an optical fiber, an optical fiber scaffolds and a narrowband filter. The data processing unit mainly included a computer. Tomato fruits of green ripe stage, discoloration stage, firm ripe stage and full ripe stage were harvested, and their seeds were collected directly. In this research, the developed tomato seeds maturity testing system was used to collect fluorescence spectrums of tomato seeds of different maturities. Principal component analysis (PCA) method was utilized to reduce the dimension of spectral data and extract principal components, and PCA was combined with linear discriminant analysis (LDA) to establish discriminant model of tomato seeds maturity, the discriminant accuracy was greater than 90%. Research results show that using chlorophyll fluorescence spectrum technology is feasible for seeds maturity detection, and the developed tomato seeds maturity testing system has high detection accuracy.

  17. Social induction of maturation and sex determination in a coral reef fish.

    PubMed Central

    Hobbs, Jean-Paul A.; Munday, Philip L.; Jones, Geoffrey P.

    2004-01-01

    Labile maturation and sex determination should be advantageous where the probability of finding a mating partner is unpredictable. Here we tested the hypothesis that the presence of a potential mating partner induces maturation and sex determination in a coral-dwelling fish, Gobiodon erythrospilus. In natural populations at Lizard Island (Great Barrier Reef), single individuals were less likely to be mature than paired individuals and they matured at a larger size, indicating plasticity in the timing of maturation. By manipulating group structure we demonstrated that both the timing of maturation and the sex of maturing individuals are socially controlled. Single juveniles did not mature, but maturation was rapidly induced by the presence of an adult partner. In addition, sex determination was found to be labile, with juveniles maturing into the opposite sex of the partner encountered. To our knowledge, this is the first experimental demonstration of social induction of maturation in conjunction with labile sex determination at maturation in vertebrates. This flexibility enables individuals to maximize their reproductive success in an environment where the timing of mate acquisition and the sex of their future partner are unpredictable. PMID:15475329

  18. Texture Descriptors Ensembles Enable Image-Based Classification of Maturation of Human Stem Cell-Derived Retinal Pigmented Epithelium

    PubMed Central

    Caetano dos Santos, Florentino Luciano; Skottman, Heli; Juuti-Uusitalo, Kati; Hyttinen, Jari

    2016-01-01

    Aims A fast, non-invasive and observer-independent method to analyze the homogeneity and maturity of human pluripotent stem cell (hPSC) derived retinal pigment epithelial (RPE) cells is warranted to assess the suitability of hPSC-RPE cells for implantation or in vitro use. The aim of this work was to develop and validate methods to create ensembles of state-of-the-art texture descriptors and to provide a robust classification tool to separate three different maturation stages of RPE cells by using phase contrast microscopy images. The same methods were also validated on a wide variety of biological image classification problems, such as histological or virus image classification. Methods For image classification we used different texture descriptors, descriptor ensembles and preprocessing techniques. Also, three new methods were tested. The first approach was an ensemble of preprocessing methods, to create an additional set of images. The second was the region-based approach, where saliency detection and wavelet decomposition divide each image in two different regions, from which features were extracted through different descriptors. The third method was an ensemble of Binarized Statistical Image Features, based on different sizes and thresholds. A Support Vector Machine (SVM) was trained for each descriptor histogram and the set of SVMs combined by sum rule. The accuracy of the computer vision tool was verified in classifying the hPSC-RPE cell maturation level. Dataset and Results The RPE dataset contains 1862 subwindows from 195 phase contrast images. The final descriptor ensemble outperformed the most recent stand-alone texture descriptors, obtaining, for the RPE dataset, an area under ROC curve (AUC) of 86.49% with the 10-fold cross validation and 91.98% with the leave-one-image-out protocol. The generality of the three proposed approaches was ascertained with 10 more biological image datasets, obtaining an average AUC greater than 97%. Conclusions Here we

  19. [MALIGNANT TUMORS IN OVARIAN MATURE CYSTIC TERATOMAS INTRAOPERATIVE DIAGNOSTIC BASIS].

    PubMed

    Khachatryan, A

    2016-11-01

    Extremely rare ovarian primary tumors formed in a mature cystic teratomaare described in the literature. This research work studies the frequency of malignant mature cystic teratoma, as well as their clinical and morphological features and necessity of intraoperative histological examination of all teratomas. Cases histories of 56 patients, suffering from ovarian mature cystic teratomahave been studied in MC Shengavit in the period of 2003 - 2015. Among them 4 patients with the somatic malignancies were identified. Morphological methods, which are considered to be "gold standard" of tumor investigation, were used in staining the slides with hematoxylin - eosin. According to the literature the secondary malignant transformation rarely occurs and is typical in postmenopausal women, with a frequency of 0.17-3%. According to the results of our study, malignant tumors in mature cystic teratomas were observed in 4 (7,14%) from the total number of mature cystic teratomas (n=56). There was not revealed a correlation between the duration of the complaints, age of the patients, sizes of ovarian mature teratoma and malignization degree. Thus, the greatest difficulties of clinical diagnosis of malignant tumors in the ovarian mature cystic teratomas were in the early stage of the disease, because of a variety of clinical manifestations, not pathognomonic for malignization. All mentioned symptoms may be observed in the patients with usual mature cystic teratomas. Тhis cases confirm the necessity to take tissue samples from the other ovary for intraoperative histopathological evaluation in each case of mature cystic teratomas. It is necessary to examine a large number of tumor sites, to prevent errors in the assessment of the maturity degree of teratoma.

  20. Improving Cardiac Surgical Site Infection Reporting and Prevention By Using Registry Data for Case Ascertainment.

    PubMed

    Nayar, Vaidehi; Kennedy, Andrea; Pappas, Janine; Atchley, Krista D; Field, Cynthia; Smathers, Sarah; Teszner, Eva E; Sammons, Julia S; Coffin, Susan E; Gerber, Jeffrey S; Spray, Thomas L; Steven, James M; Bell, Louis M; Forrer, Joan; Gonzalez, Fernando; Chi, Albert; Nieczpiel, William J; Martin, John N; Gaynor, J William

    2016-01-01

    The use of administrative data for surgical site infection (SSI) surveillance leads to inaccurate reporting of SSI rates [1]. A quality improvement (QI) initiative was conducted linking clinical registry and administrative databases to improve reporting and reduce the incidence of SSI [2]. At our institution, The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) and infection surveillance database (ISD) were linked to the enterprise data warehouse containing electronic health record (EHR) billing data. A data visualization tool was created to (1) use the STS-CHSD for case ascertainment, (2) resolve discrepancies between the databases, and (3) assess impact of QI initiatives, including wound alert reports, bedside reviews, prevention bundles, and billing coder education. Over the 24-month study period, 1,715 surgical cases were ascertained according to the STS-CHSD clinical criteria, with 23 SSIs identified through the STS-CHSD, 20 SSIs identified through the ISD, and 32 SSIs identified through the billing database. The rolling 12-month STS-CHSD SSI rate decreased from 2.73% (21 of 769 as of January 2013) to 1.11% (9 of 813 as of December 2014). Thirty reporting discrepancies were reviewed to ensure accuracy. Workflow changes facilitated communication and improved adjudication of suspected SSIs. Billing coder education increased coding accuracy and narrowed variation between the 3 SSI sources. The data visualization tool demonstrated temporal relationships between QI initiatives and SSI rate reductions. Linkage of registry and infection control surveillance data with the EHR improves SSI surveillance. The visualization tool and workflow changes facilitated communication, SSI adjudication, and assessment of the QI initiatives. Implementation of these initiatives was associated with decreased SSI rates. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Genomic profiling of bovine corpus luteum maturation

    PubMed Central

    Wigoda, Noa; Ben-Dor, Shifra; Orr, Irit; Meidan, Rina

    2018-01-01

    To unveil novel global changes associated with corpus luteum (CL) maturation, we analyzed transcriptome data for the bovine CL on days 4 and 11, representing the developing vs. mature gland. Our analyses revealed 681 differentially expressed genes (363 and 318 on day 4 and 11, respectively), with ≥2 fold change and FDR of <5%. Different gene ontology (GO) categories were represented prominently in transcriptome data at these stages (e.g. days 4: cell cycle, chromosome, DNA metabolic process and replication and on day 11: immune response; lipid metabolic process and complement activation). Based on bioinformatic analyses, select genes expression in day 4 and 11 CL was validated with quantitative real-time PCR. Cell specific expression was also determined in enriched luteal endothelial and steroidogenic cells. Genes related to the angiogenic process such as NOS3, which maintains dilated vessels and MMP9, matrix degrading enzyme, were higher on day 4. Importantly, our data suggests day 11 CL acquire mechanisms to prevent blood vessel sprouting and promote their maturation by expressing NOTCH4 and JAG1, greatly enriched in luteal endothelial cells. Another endothelial specific gene, CD300LG, was identified here in the CL for the first time. CD300LG is an adhesion molecule enabling lymphocyte migration, its higher levels at mid cycle are expected to support the transmigration of immune cells into the CL at this stage. Together with steroidogenic genes, most of the genes regulating de-novo cholesterol biosynthetic pathway (e.g HMGCS, HMGCR) and cholesterol uptake from plasma (LDLR, APOD and APOE) were upregulated in the mature CL. These findings provide new insight of the processes involved in CL maturation including blood vessel growth and stabilization, leucocyte transmigration as well as progesterone synthesis as the CL matures. PMID:29590145

  2. Cone and Seed Maturation of Southern Pines

    Treesearch

    James P. Barnett

    1976-01-01

    If slightly reduced yields and viability are acceptable, loblolly and slash cone collections can begin 2 to 3 weeks before maturity if the cones are stored before processing. Longleaf(P. palestris Mill.) pine cones should be collected only when mature, as storage decreased germination of seeds from immature cones. Biochemical analyses to determine reducing sugar...

  3. Dispositional coping, coping effectiveness, and cognitive social maturity among adolescent athletes.

    PubMed

    Nicholls, Adam R; Perry, John L; Jones, Leigh; Morley, Dave; Carson, Fraser

    2013-06-01

    It is accepted among scholars that coping changes as people mature during adolescence, but little is known about the relationship between maturity and coping. The purpose of this paper was to assess a model, which included dispositional coping, coping effectiveness, and cognitive social maturity. We predicted that cognitive social maturity would have a direct effect on coping effectiveness, and also an indirect impact via dispositional coping. Two hundred forty-five adolescent athletes completed measures of dispositional coping, coping effectiveness, and cognitive social maturity, which has three dimensions: conscientiousness, peer influence on behavior, and rule following. Using structural equation modeling, we found support for our model, suggesting that coping is related to cognitive social maturity. This information can be used to influence the content of coping interventions for adolescents of different maturational levels.

  4. Mature Oocyte Cryopreservation for Fertility Preservation.

    PubMed

    Liang, Tina; Motan, Tarek

    2016-01-01

    In recent decades, advances in cancer treatment have led to a dramatic improvement in long term survival. This has led to an increasing focus on quality of life after surviving cancer treatment, with fertility being an important aspect. Given the known reproductive risks of cancer therapies, there has been a growing interest in the field of fertility preservation (also referred to as oncofertility). Mature oocyte cryopreservation is no longer considered experimental and has become a realistic option for reproductive aged women prior to undergoing cancer treatment. Additionally, as cryopreservation techniques improve, mature oocyte cryopreservation is increasing being marketed to healthy women without cancer wishing to delay child bearing, also termed "social egg freezing". This chapter provides a review of the current technology, use, and outcomes of mature oocyte cryopreservation. It also outlines the ethical debate surrounding social egg freezing and directions for future research in female fertility preservation.

  5. Moral Judgment Maturity of Process and Reactive Schizophrenics.

    ERIC Educational Resources Information Center

    Herron, William G.; And Others

    1983-01-01

    Premorbid adjustment, paranoid symptomatology, and orientation were examined as major predictors of moral judgment maturity in 40 schizophrenics. Results suggest the importance of cognitive and social skills in the development of schizophrenics' moral judgment maturity. (Author/RH)

  6. Improving chronic care delivery and outcomes: the impact of the cystic fibrosis Care Center Network.

    PubMed

    Mogayzel, Peter J; Dunitz, Jordan; Marrow, Laura C; Hazle, Leslie A

    2014-04-01

    Cystic fibrosis (CF) is a multisystem, life-shortening genetic disease that requires complex care. To facilitate this expert, multidisciplinary care, the CF Foundation established a Care Center Network and accredited the first care centres in 1961. This model of care brings together physicians and specialists from other disciplines to provide care, facilitate basic and clinical research, and educate the next generation of providers. Although the Care Center Network has been invaluable in achieving substantial gains in survival and quality of life, additional opportunities for improvements in CF care exist. In 1999, analysis of data from the CF Foundation's Patient Registry detected variation in care practices and outcomes across centres, identifying opportunities for improvement. In 2002, the CF Foundation launched a comprehensive quality improvement (QI) initiative to enhance care by assembling national experts to develop a strategic plan to disseminate QI training and processes throughout the Care Center Network. The QI strategies included developing leadership (nationally and within each care centre), identifying best CF care practices, and incorporating people with CF and their families into improvement efforts. The goal was to improve the care for every person with CF in the USA. Multiple tactics were undertaken to implement the strategic plan and disseminate QI training and tools throughout the Care Center Network. In addition, strategies to foster collaboration between care centre staff and individuals with CF and their families became a cornerstone of QI efforts. Today it is clear that the application of QI principles within the CF Care Center Network has improved adherence to clinical guidelines and achievement of important health outcomes.

  7. Application of quality improvement analytic methodology in emergency medicine research: A comparative evaluation.

    PubMed

    Harries, Bruce; Filiatrault, Lyne; Abu-Laban, Riyad B

    2018-05-30

    Quality improvement (QI) analytic methodology is rarely encountered in the emergency medicine literature. We sought to comparatively apply QI design and analysis techniques to an existing data set, and discuss these techniques as an alternative to standard research methodology for evaluating a change in a process of care. We used data from a previously published randomized controlled trial on triage-nurse initiated radiography using the Ottawa ankle rules (OAR). QI analytic tools were applied to the data set from this study and evaluated comparatively against the original standard research methodology. The original study concluded that triage nurse-initiated radiographs led to a statistically significant decrease in mean emergency department length of stay. Using QI analytic methodology, we applied control charts and interpreted the results using established methods that preserved the time sequence of the data. This analysis found a compelling signal of a positive treatment effect that would have been identified after the enrolment of 58% of the original study sample, and in the 6th month of this 11-month study. Our comparative analysis demonstrates some of the potential benefits of QI analytic methodology. We found that had this approach been used in the original study, insights regarding the benefits of nurse-initiated radiography using the OAR would have been achieved earlier, and thus potentially at a lower cost. In situations where the overarching aim is to accelerate implementation of practice improvement to benefit future patients, we believe that increased consideration should be given to the use of QI analytic methodology.

  8. Maturation of Sweetgum and American Sycamore Seeds

    Treesearch

    F. T. Bonner

    1972-01-01

    Over three consecutive years in central Mississippi, sweetgum (Liquidambar styraciflua L.) and sycamore (Platanus occidentalis L.) fruits had nearly reached full-size by late June. Sweetgum seeds were physiologically mature by mid-August, but dry weight increased until late September. As sweetgum seeds matured, the crude fat level rose to 27 percent of seed dry weight...

  9. CLIPS/Ada: An Ada-based tool for building expert systems

    NASA Technical Reports Server (NTRS)

    White, W. A.

    1990-01-01

    Clips/Ada is a production system language and a development environment. It is functionally equivalent to the CLIPS tool. CLIPS/Ada was developed in order to provide a means of incorporating expert system technology into projects where the use of the Ada language had been mandated. A secondary purpose was to glean information about the Ada language and its compilers. Specifically, whether or not the language and compilers were mature enough to support AI applications. The CLIPS/Ada tool is coded entirely in Ada and is designed to be used by Ada systems that require expert reasoning.

  10. Fluid therapy in mature cattle.

    PubMed

    Roussel, Allen J

    2014-07-01

    Fluid therapy for mature cattle differs from that for calves because the common conditions that result in dehydration and the metabolic derangements that accompany these conditions are different. The veterinarian needs to know which problem exists, what to administer to correct the problem, in what quantity, by what route, and at what rate. Mature cattle more frequently suffer from alkalosis; therefore, acidifying solutions containing K(+) and Cl(-) in concentrations greater than that of plasma are frequently indicated. The rumen provides a large-capacity reservoir into which oral rehydration solutions may be administered, which can save time and money. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Identification of a New Isoindole-2-yl Scaffold as a Qo and Qi Dual Inhibitor of Cytochrome bc 1 Complex: Virtual Screening, Synthesis, and Biochemical Assay.

    PubMed

    Azizian, Homa; Bagherzadeh, Kowsar; Shahbazi, Sophia; Sharifi, Niusha; Amanlou, Massoud

    2017-09-18

    Respiratory chain ubiquinol-cytochrome (cyt) c oxidoreductase (cyt bc 1 or complex III) has been demonstrated as a promising target for numerous antibiotics and fungicide applications. In this study, a virtual screening of NCI diversity database was carried out in order to find novel Qo/Qi cyt bc 1 complex inhibitors. Structure-based virtual screening and molecular docking methodology were employed to further screen compounds with inhibition activity against cyt bc 1 complex after extensive reliability validation protocol with cross-docking method and identification of the best score functions. Subsequently, the application of rational filtering procedure over the target database resulted in the elucidation of a novel class of cyt bc 1 complex potent inhibitors with comparable binding energies and biological activities to those of the standard inhibitor, antimycin.

  12. The protein-protein interface evolution acts in a similar way to antibody affinity maturation.

    PubMed

    Li, Bohua; Zhao, Lei; Wang, Chong; Guo, Huaizu; Wu, Lan; Zhang, Xunming; Qian, Weizhu; Wang, Hao; Guo, Yajun

    2010-02-05

    Understanding the evolutionary mechanism that acts at the interfaces of protein-protein complexes is a fundamental issue with high interest for delineating the macromolecular complexes and networks responsible for regulation and complexity in biological systems. To investigate whether the evolution of protein-protein interface acts in a similar way as antibody affinity maturation, we incorporated evolutionary information derived from antibody affinity maturation with common simulation techniques to evaluate prediction success rates of the computational method in affinity improvement in four different systems: antibody-receptor, antibody-peptide, receptor-membrane ligand, and receptor-soluble ligand. It was interesting to find that the same evolutionary information could improve the prediction success rates in all the four protein-protein complexes with an exceptional high accuracy (>57%). One of the most striking findings in our present study is that not only in the antibody-combining site but in other protein-protein interfaces almost all of the affinity-enhancing mutations are located at the germline hotspot sequences (RGYW or WA), indicating that DNA hot spot mechanisms may be widely used in the evolution of protein-protein interfaces. Our data suggest that the evolution of distinct protein-protein interfaces may use the same basic strategy under selection pressure to maintain interactions. Additionally, our data indicate that classical simulation techniques incorporating the evolutionary information derived from in vivo antibody affinity maturation can be utilized as a powerful tool to improve the binding affinity of protein-protein complex with a high accuracy.

  13. Association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity.

    PubMed

    Mahmood, Hafiz Taha; Shaikh, Attiya; Fida, Mubassar

    2016-10-01

    Various methods have been proposed to evaluate a patient's developmental status. However, most of them lacked precision and failed to give a reliable estimate of skeletal maturity. The aims of this study were to evaluate the association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity and to determine its validity in assessing the different stages of the adolescent growth spurt. A cross-sectional study was performed on the pretreatment lateral cephalograms of 252 subjects aged 8 to 21 years. The sample was divided into 6 groups based on the cervical vertebral maturation stages. The frontal sinus index was calculated by dividing the frontal sinus height and width, and the cervical stages were evaluated on the same radiograph. The Kruskal-Wallis test was applied to compare frontal sinus index values at different cervical stages, and the post hoc Dunnett T3 test was applied to compare frontal sinus index values between adjacent cervical stages for each sex. The Kendall tau-b values were computed to assess the correlation between the cervical stages and the sinus index. A P value of ≤0.05 was considered statistically significant. The height and width of the frontal sinus were significantly larger in the male subjects than in the females. A significant association was found between the frontal sinus height and width and cervical stages (P ≤0.001) in both sexes. However, the changes in the frontal sinus index across the different cervical stages were found to be significant (P ≤0.001) in male subjects only. Similarly, a weak negative correlation was found between the sinus index and the cervical stages in male subjects (tau-b = -0.271; P <0.001), whereas no correlation was found in female subjects (tau-b = -0.006; P <0.928). However, the post hoc analysis showed that the values of the sinus index were comparable between any 2 adjacent cervical stages. The frontal sinus index cannot be used to

  14. Effects of Vitrification on Outcomes of In Vivo-Mature, In Vitro-Mature and Immature Human Oocytes.

    PubMed

    Song, Wen-Yan; Peng, Zhao-Feng; Chen, Xue-Mei; Jin, Hai-Xia; Yao, Gui-Dong; Shi, Sen-Lin; Yang, Hong-Yi; Zhang, Xiang-Yang; Sun, Ying-Pu

    2016-01-01

    To observe the effects of vitrification on spindle, zona pellucida, embryonic aneuploidy and DNA injury in in vivo-maruted, in vitro-mature and immature human oocytes. Between January 2009 and February 2015, 223 immature oocytes from 450 infertile patients, and 31 in vivo-mature oocytes from 3 infertile couples were collected. Of the 223 immature oocytes, 113 were used for in vitro culture before vitrification. Some oocytes were randomly divided into in vivo-mature group (group A, n = 15), in vitro-mature group (group B, n = 88) and immature group (group C, n = 85), and then the oocytes with spindle in these three groups after freezing-thawing were selected to use for Polscope imaging, embryonic aneuploidy screening and embryo development evaluation. Other oocytes were randomly divided into group A (n = 16), group B (n = 25) and group C (n = 25) for detecting DNA injury. After thawing, spindle occurrence rate, spindle Retardance value, and cleavage rate were significantly higher in groups A and B than in group C (all P < 0.05), but there were no statistical differences in fertility rate, high-quality embryo rate, blastulation rate and aneuploidy rate amongst the three groups (all P > 0.05). Zona pellucida density (ZPD) was significantly lower in group A than in groups B and C both before and after vitrification (all P < 0.05). ZPD was significantly higher after thawing than before vitrification (all P < 0.05), but zona pellucida thickness (ZPT) was not significantly changed in all the three groups (all P > 0.05). Rate of comet cells was significantly lower in group A than in groups B and C (all P < 0.01). Comet tail was significantly longer in group C than in groups B and A (all P < 0.05). In vivo- and in vitro-mature human oocytes are more suitable to vitrification than immature human oocytes. Spindle Retardance value has more predictive value for embryonic development potential than ZPD and ZPT. © 2016 The Author(s) Published by S. Karger AG, Basel.

  15. ASSOCIATION BETWEEN DENTAL AND SKELETAL MATURATION STAGES IN CROATIAN SUBJECTS.

    PubMed

    Srkoc, Tamara; Mestrović, Senka; Anić-Milosević, Sandra; Slaj, Mladen

    2015-12-01

    This study investigated the relationships between the stages of calcification of teeth and cervical vertebral maturation. The sample consisted of 295 subjects (129 male and 166 female), mean age 13.36 ± 2.65 (range 7-18) years. Dental age was evaluated from panoramic radiographs according to the method of Demirjian. Cervical vertebral maturation was determined on lateral cephalometric radiographs using cervical vertebrae maturation stages (CVS). For assessing the relationship between cervical vertebral and dental maturation, percentage distributions of the stages of calcification for each studied tooth were calculated. Only in the first CVS stage, boys and girls were of the same age. In all other stages (CVS 2-CVS 6) girls were by 0.98 (range 0.23-1.86) younger than boys. Gender differences in the mineralization pattern were also observed. It was found that dental maturation was finished earlier in female subjects. The highest correlation coefficient between dental and skeletal maturity was found for second premolars. Mineralization pattern of second premolars could be considered as a guideline for prediction of the pubertal growth spurt. Dental maturation stages might be clinically useful as a reliable indicator of facial growth.

  16. In vitro maturation of human oocytes for assisted reproduction.

    PubMed

    Jurema, Marcus W; Nogueira, Daniela

    2006-11-01

    To describe and evaluate the current practice of in vitro maturation of oocytes for assisted reproduction. Review of the available and relevant literature regarding in vitro maturation of oocytes. In vitro maturation of human oocytes retrieved from antral ovarian follicles is an emerging procedure quickly being incorporated into the realm of assisted reproductive technologies. This new technology has several potential advantages over traditional controlled ovarian hyperstimulation for IVF, such as reduction of costs by minimizing gonadotropin and GnRH analogue use, elimination of ovarian hyperstimulation syndrome, and simplicity of protocol. In vitro maturation of oocytes for assisted reproduction in human beings still is undergoing refinement but currently is providing efficacy and safety outcome comparable to that of traditional IVF in recent selected studies. Implementing in vitro maturation into an established IVF practice is feasible and requires only a few simple adjustments. Crucial to the advancement and optimization of the technology is a better understanding of how to maximize immature oocyte developmental competence and endometrial receptivity.

  17. Homeostatic Signals do not Drive Post-thymic T cell Maturation

    PubMed Central

    Houston, Evan G.; Boursalian, Tamar E.; Fink, Pamela J.

    2012-01-01

    Recent thymic emigrants, the youngest T cells in the lymphoid periphery, undergo a 3-week-long period of functional and phenotypic maturation before being incorporated into the pool of mature, naïve T cells. Previous studies indicate that this maturation requires T cell exit from the thymus and access to secondary lymphoid organs, but is MHC-independent. We now show that post-thymic T cell maturation is independent of homeostatic and costimulatory pathways, requiring neither signals delivered by IL-7 nor CD80/86. Furthermore, while CCR7/CCL19,21-regulated homing of recent thymic emigrants to the T cell zones within the secondary lymphoid organs is not required for post-thymic T cell maturation, an intact dendritic cell compartment modulates this process. It is thus clear that, unlike T cell development and homeostasis, post-thymic maturation is focused not on interrogating the T cell receptor or the cell’s responsiveness to homeostatic or costimulatory signals, but on some as yet unrecognized property. PMID:22398309

  18. Toward the Decision Tree for Inferring Requirements Maturation Types

    NASA Astrophysics Data System (ADS)

    Nakatani, Takako; Kondo, Narihito; Shirogane, Junko; Kaiya, Haruhiko; Hori, Shozo; Katamine, Keiichi

    Requirements are elicited step by step during the requirements engineering (RE) process. However, some types of requirements are elicited completely after the scheduled requirements elicitation process is finished. Such a situation is regarded as problematic situation. In our study, the difficulties of eliciting various kinds of requirements is observed by components. We refer to the components as observation targets (OTs) and introduce the word “Requirements maturation.” It means when and how requirements are elicited completely in the project. The requirements maturation is discussed on physical and logical OTs. OTs Viewed from a logical viewpoint are called logical OTs, e.g. quality requirements. The requirements of physical OTs, e.g., modules, components, subsystems, etc., includes functional and non-functional requirements. They are influenced by their requesters' environmental changes, as well as developers' technical changes. In order to infer the requirements maturation period of each OT, we need to know how much these factors influence the OTs' requirements maturation. According to the observation of actual past projects, we defined the PRINCE (Pre Requirements Intelligence Net Consideration and Evaluation) model. It aims to guide developers in their observation of the requirements maturation of OTs. We quantitatively analyzed the actual cases with their requirements elicitation process and extracted essential factors that influence the requirements maturation. The results of interviews of project managers are analyzed by WEKA, a data mining system, from which the decision tree was derived. This paper introduces the PRINCE model and the category of logical OTs to be observed. The decision tree that helps developers infer the maturation type of an OT is also described. We evaluate the tree through real projects and discuss its ability to infer the requirements maturation types.

  19. The maturation and germination of Phytophthora ramorum Chlamydospores

    Treesearch

    Aaron L. Smith; Everett M. Hansen

    2008-01-01

    Chlamydospores are a distinctive feature of Phytophthora ramorum. They are formed quickly in agar, and within colonized leaves. We followed their development and maturation in vitro and in vivo, and studied conditions affecting their germination. Cell walls of mature P. ramorum chlamydospores...

  20. [Impacts on chronic fatigue syndrome of qi deficiency syndrome and T cell subgroups in patients treated with acupuncture at selective time].

    PubMed

    Ling, Jia-Yan; Shen, Lin; Liu, Qing; Wang, Ling-Yun

    2013-12-01

    To verify the clinical efficacy on chronic fatigue syndrome of qi deficiency syndrome treated with acupuncture at selective time and explore the effect mechanism. Eighty patients were randomized into a selective-time-acupuncture group and an acupuncture group, 40 cases in each one. Qihai (CV 6), Guanyuan (CV 4), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6) and Zusanli (ST 36) were selected in the two groups. In the selective-time-acupuncture group, acupuncture was used at 9:00am to 11:00am. In the acupuncture group, acupuncture was used at any time except in the range from 9:00am to 11:00am. No any manipulation was applied after the arrival of needling sensation. The treatment was given once every day, 10 day treatment made one session and two sessions of treatment were required. The fatigue scale was adopted to evaluate the efficacy before and after treatment in the patients of the two groups. The ratios among CD3+, CD4+ and CD8+ T cells in the peripheral blood were detected before ad b a after treatment. In the acupuncture group, the total score of fatigue and the score of physical fatigue were reduced after treatment as compared with those before treatment (all P<0.05). In the selective-time -acupuncture group, the total score of fatigue, the s core of physical fatigue and the score of mental fatigue after treatment were reduced obviously as compared with those hefore treatment (all P<0. 01). The improvements in the scores of the selective-time-acupuncture group were superior to the acupuncture group (all P<0. 05). The ratio of CD3+ and CD8+ T cells was increased obviously after treatment in the two groups (all P<0. 05) and the ratio of CD4+ and CD8+ T cells was reduced obviously in the selective-time-acupuncture group (P<0. 05), which was better than that in the acupuncture group (all P<0.05). The total effective rate was 95.0% (38/40) in the selective-time-acupuncture group, which was better than 80.0% (32/40) in the acupuncture group (P<0.05). The