Sample records for quality high intensity
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Regional variations in health care intensity and physician perceptions of quality of care.
Sirovich, Brenda E; Gottlieb, Daniel J; Welch, H Gilbert; Fisher, Elliott S
2006-05-02
Research has documented dramatic differences in health care utilization and spending across U.S. regions with similar levels of patient illness. Although patient outcomes and quality of care have been found to be no better in regions of high health care intensity, it is unknown whether physicians in these regions feel more capable of providing good patient care than those in low-intensity regions. To determine whether physicians in high-intensity regions feel better able to care for patients than physicians in low-intensity regions. Physician telephone survey. 51 metropolitan and 9 nonmetropolitan areas of the United States and a supplemental national sample. 10,577 physicians who provided care to adults in 1998 or 1999 were surveyed for the Community Tracking Study (response rate, 61%). The End-of-Life Expenditure Index, a measure of spending that reflects differences in the overall quantity of medical services provided rather than differences in illness or price, was used to determine health care intensity in the physicians' community. Outcomes included physicians' perceived availability of clinical services, ability to provide high-quality care to patients, and career satisfaction. Although the highest-intensity regions have substantially more hospital beds and specialists per capita, physicians in these regions reported more difficulty obtaining needed services for their patients. The proportion of physicians who felt able to obtain elective hospital admissions ranged from 50% in high-intensity regions to 64% in the lowest-intensity region (P < 0.001 for the relationship between intensity and perceived ability to obtain hospital admissions); the proportion of physicians who felt able to obtain high-quality specialist referrals ranged from 64% in high-intensity regions to 79% in low-intensity regions (P < 0.001). Compared with low-intensity regions, fewer physicians in high-intensity regions felt able to maintain good ongoing patient relationships (range, 62% to 70%; P < 0.001) or able to provide high-quality care (range, 72% to 77%; P = 0.009). In most cases, differences persisted but were attenuated in magnitude after adjustment for physician attributes, practice characteristics, and local market factors (for example, managed care penetration); the difference in perceived ability to provide high-quality care was no longer statistically significant (P = 0.099). The cross-sectional design prevented demonstration of a causal relationship between intensity and physician perceptions of quality. Despite more resources, physicians in regions of high health care intensity did not report greater ease in obtaining needed services or greater ability to provide high-quality care.
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Teno, Joan M; Mor, Vincent; Ward, Nicholas; Roy, Jason; Clarridge, Brian; Wennberg, John E; Fisher, Elliott S
2005-11-01
To compare the quality of end-of-life care of persons dying in regions of differing practice intensity. Mortality follow-back survey. Geographic regions in the highest and lowest deciles of intensive care unit (ICU) use. Bereaved family member or other knowledgeable informants. Unmet needs, concerns, and rating of quality of end-of-life care in five domains (physical comfort and emotional support of the decedent, shared decision-making, treatment of the dying person with respect, providing information and emotional support to family members). Decedents in high- (n=365) and low-intensity (n=413) hospital service areas (HSAs) did not differ in age, sex, education, marital status, leading causes of death, or the degree to which death was expected, but those in the high-intensity ICU HSAs were more likely to be black and to live in nonrural areas. Respondents in high-intensity HSAs were more likely to report that care was of lower quality in each domain, and these differences were statistically significant in three of five domains. Respondents from high-intensity HSAs were more likely to report inadequate emotional support for the decedent (relative risk (RR)=1.2, 95% confidence interval (CI)=1.0-1.4), concerns with shared decision-making (RR=1.8, 95% CI=1.0-2.9), inadequate information about what to expect (RR=1.5, 95% CI=1.3-1.8), and failure to treat the decedent with respect (RR=1.4, 95% CI=1.0-1.9). Overall ratings of the quality of end-of-life care were also significantly lower in high-intensity HSAs. Dying in regions with a higher use of ICU care is not associated with improved perceptions of quality of end-of-life care.
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[Concept for a department of intensive care].
Nierhaus, A; de Heer, G; Kluge, S
2014-10-01
Demographic change and increasing complexity are among the reasons for high-tech critical care playing a major and increasing role in today's hospitals. At the same time, intensive care is one of the most cost-intensive departments in the hospital. To guarantee high-quality care, close cooperation of specialised intensive care staff with specialists of all other medical areas is essential. A network of the intensive care units within the hospital may lead to synergistic effects concerning quality of care, simultaneously optimizing the use of human and technical resources. Notwithstanding any organisational concepts, development and maintenance of the highest possible quality of care should be of overriding importance.
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Sun, Xiaofei; Shi, Lin; Luo, Yishan; Yang, Wei; Li, Hongpeng; Liang, Peipeng; Li, Kuncheng; Mok, Vincent C T; Chu, Winnie C W; Wang, Defeng
2015-07-28
Intensity normalization is an important preprocessing step in brain magnetic resonance image (MRI) analysis. During MR image acquisition, different scanners or parameters would be used for scanning different subjects or the same subject at a different time, which may result in large intensity variations. This intensity variation will greatly undermine the performance of subsequent MRI processing and population analysis, such as image registration, segmentation, and tissue volume measurement. In this work, we proposed a new histogram normalization method to reduce the intensity variation between MRIs obtained from different acquisitions. In our experiment, we scanned each subject twice on two different scanners using different imaging parameters. With noise estimation, the image with lower noise level was determined and treated as the high-quality reference image. Then the histogram of the low-quality image was normalized to the histogram of the high-quality image. The normalization algorithm includes two main steps: (1) intensity scaling (IS), where, for the high-quality reference image, the intensities of the image are first rescaled to a range between the low intensity region (LIR) value and the high intensity region (HIR) value; and (2) histogram normalization (HN),where the histogram of low-quality image as input image is stretched to match the histogram of the reference image, so that the intensity range in the normalized image will also lie between LIR and HIR. We performed three sets of experiments to evaluate the proposed method, i.e., image registration, segmentation, and tissue volume measurement, and compared this with the existing intensity normalization method. It is then possible to validate that our histogram normalization framework can achieve better results in all the experiments. It is also demonstrated that the brain template with normalization preprocessing is of higher quality than the template with no normalization processing. We have proposed a histogram-based MRI intensity normalization method. The method can normalize scans which were acquired on different MRI units. We have validated that the method can greatly improve the image analysis performance. Furthermore, it is demonstrated that with the help of our normalization method, we can create a higher quality Chinese brain template.
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[Quality assurance and quality management in intensive care].
Notz, K; Dubb, R; Kaltwasser, A; Hermes, C; Pfeffer, S
2015-11-01
Treatment success in hospitals, particularly in intensive care units, is directly tied to quality of structure, process, and outcomes. Technological and medical advancements lead to ever more complex treatment situations with highly specialized tasks in intensive care nursing. Quality criteria that can be used to describe and correctly measure those highly complex multiprofessional situations have only been recently developed and put into practice.In this article, it will be shown how quality in multiprofessional teams can be definded and assessed in daily clinical practice. Core aspects are the choice of a nursing theory, quality assurance measures, and quality management. One possible option of quality assurance is the use of standard operating procedures (SOPs). Quality can ultimately only be achieved if professional groups think beyond their boundaries, minimize errors, and establish and live out instructions and SOPs.
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Effects of interdisciplinary teamwork on patient-reported experience of cancer care.
Tremblay, Dominique; Roberge, Danièle; Touati, Nassera; Maunsell, Elizabeth; Berbiche, Djamal
2017-03-20
Interdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients' perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity. The study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West's seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables. Outpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89-8.41). High ITW intensity also positively affected patients' perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25-4.51), Person-centred response (OR = 2.11; CI = 1.05-4.24], and Continuity of care (OR = 2.18; CI = 1.07-4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68-2.52) or Quality of the care environment (OR = 0.66; CI = 0.31-1.39). This study provides empirical evidence, from the patient's perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences.
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Can, Fulva Kamit; Anil, Ayse Berna; Anil, Murat; Zengin, Neslihan; Bal, Alkan; Bicilioglu, Yuksel; Gokalp, Gamze; Durak, Fatih; Ince, Gulberat
2017-10-15
To analyze the change in quality indicators due to the use of high-flow nasal cannula therapy as a non-invasive ventilation method in children with respiratory distress/failure in a non-invasive ventilation device-free pediatric intensive care unit. Retrospective chart review of children with respiratory distress/failure admitted 1 year before (period before high-flow nasal cannula therapy) and 1 year after (period after high-flow nasal cannula therapy) the introduction of high-flow nasal cannula therapy. We compared quality indicators as rate of mechanical ventilation, total duration of mechanical ventilation, rate of re-intubation, pediatric intensive care unit length of stay, and mortality rate between these periods. Between November 2012 and November 2014, 272 patients: 141 before and 131 after high-flow nasal cannula therapy were reviewed (median age was 20.5 mo). Of the patients in the severe respiratory distress/failure subgroup, the rate of intubation was significantly lower in period after than in period before high-flow nasal cannula therapy group (58.1% vs. 76.1%; P <0.05). The median pediatric intensive care unit length of stay was significantly shorter in patients who did not require mechanical ventilation in the period after than in the period before high-flow nasal cannula therapy group (3d vs. 4d; P<0,05). Implementation of high-flow nasal cannula therapy in pediatric intensive care unit significantly improves the quality of therapy and its outcomes.
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Dhondt, André A
2010-01-01
1. In studies on the effect of competition in plant communities two terms are used to describe its effects: the absolute reduction in growth of an individual as a consequence of the presence of another one is called intensity, while the relative impact of competition on an individual as a proportion of the impact of the whole environment is called importance. One school of thought is that the role of competition remains constant across productivity gradients, while the other is that it decreases with increasing severity. J.B. Grace (1991. A clarification of the debate between grime and tilman. Functional Ecology, 5, 583-587.) suggested that the apparent contradiction might be solved if we acknowledge that the two schools are discussing different aspects of competition: the intensity of competition might remain constant while its importance declines with increasing severity. 2. There are no studies that compare intensity and importance of competition in bird populations between areas that differ in quality or productivity and hence it is not possible to make predictions how intensity or importance of competition would vary between them. 3. I compared variation in intensity and importance of competition of three demographic variables between five plots that differ strongly in quality for great Parus major L. and blue tit Cyanistes caeruleus (L.). 4. Both intensity and importance of competition are larger in great than in blue tit populations meaning that the effect of competition on demographic variables is stronger in great than in blue tits and that the contribution of competition to variation in these variables is relatively higher in great than in blue tits. 5. Intensity of competition is higher in low quality than in high quality plots for both species, a result not expected from studies in plant communities. 6. Importance of competition varies strongly between plots. It is larger in oak-dominated plots than in mixed deciduous plots. 7. In birds breeding density increases with habitat quality but is limited by territorial behaviour. As a result competition for food is reduced in high quality habitats resulting in a reduction of competition intensity in high quality sites in which birds breed at high densities. 8. It can be predicted that in studies of territorial species density dependent effects on reproduction are more likely to be detected in low quality sites explaining in part differences in results between studies.
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Nelson, Judith E.; Puntillo, Kathleen A.; Pronovost, Peter J.; Walker, Amy S.; McAdam, Jennifer L.; Ilaoa, Debra; Penrod, Joan
2011-01-01
Objective Although the majority of hospital deaths occur in the intensive care unit and virtually all critically ill patients and their families have palliative needs, we know little about how patients and families, the most important “stakeholders,” define high-quality intensive care unit palliative care. We conducted this study to obtain their views on important domains of this care. Design Qualitative study using focus groups facilitated by a single physician. Setting A 20-bed general intensive care unit in a 382-bed community hospital in Oklahoma; 24-bed medical–surgical intensive care unit in a 377-bed tertiary, university hospital in urban California; and eight-bed medical intensive care unit in a 311-bed Veterans’ Affairs hospital in a northeastern city. Patients Randomly-selected patients with intensive care unit length of stay ≥5 days in 2007 to 2008 who survived the intensive care unit, families of survivors, and families of patients who died in the intensive care unit. Interventions None. Measurements and Main Results Focus group facilitator used open-ended questions and scripted probes from a written guide. Three investigators independently coded meeting transcripts, achieving consensus on themes. From 48 subjects (15 patients, 33 family members) in nine focus groups across three sites, a shared definition of high-quality intensive care unit palliative care emerged: timely, clear, and compassionate communication by clinicians; clinical decision-making focused on patients’ preferences, goals, and values; patient care maintaining comfort, dignity, and personhood; and family care with open access and proximity to patients, interdisciplinary support in the intensive care unit, and bereavement care for families of patients who died. Participants also endorsed specific processes to operationalize the care they considered important. Conclusions Efforts to improve intensive care unit palliative care quality should focus on domains and processes that are most valued by critically ill patients and their families, among whom we found broad agreement in a diverse sample. Measures of quality and effective interventions exist to improve care in domains that are important to intensive care unit patients and families. PMID:20198726
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NASA Astrophysics Data System (ADS)
Murphy, Sheila F.; Writer, Jeffrey H.; Blaine McCleskey, R.; Martin, Deborah A.
2015-08-01
Storms following wildfires are known to impair drinking water supplies in the southwestern United States, yet our understanding of the role of precipitation in post-wildfire water quality is far from complete. We quantitatively assessed water-quality impacts of different hydrologic events in the Colorado Front Range and found that for a three-year period, substantial hydrologic and geochemical responses downstream of a burned area were primarily driven by convective storms with a 30 min rainfall intensity >10 mm h-1. These storms, which typically occur several times each year in July-September, are often small in area, short-lived, and highly variable in intensity and geographic distribution. Thus, a rain gage network with high temporal resolution and spatial density, together with high-resolution stream sampling, are required to adequately characterize post-wildfire responses. We measured total suspended sediment, dissolved organic carbon (DOC), nitrate, and manganese concentrations that were 10-156 times higher downstream of a burned area compared to upstream during relatively common (50% annual exceedance probability) rainstorms, and water quality was sufficiently impaired to pose water-treatment concerns. Short-term water-quality impairment was driven primarily by increased surface runoff during higher intensity convective storms that caused erosion in the burned area and transport of sediment and chemical constituents to streams. Annual sediment yields downstream of the burned area were controlled by storm events and subsequent remobilization, whereas DOC yields were closely linked to annual runoff and thus were more dependent on interannual variation in spring runoff. Nitrate yields were highest in the third year post-wildfire. Results from this study quantitatively demonstrate that water quality can be altered for several years after wildfire. Because the southwestern US is prone to wildfires and high-intensity rain storms, the role of storms in post-wildfire water-quality impacts must be considered when assessing water-quality vulnerability.
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Murphy, Sheila F.; Writer, Jeffrey H.; McCleskey, R. Blaine; Martin, Deborah A.
2015-01-01
Storms following wildfires are known to impair drinking water supplies in the southwestern United States, yet our understanding of the role of precipitation in post-wildfire water quality is far from complete. We quantitatively assessed water-quality impacts of different hydrologic events in the Colorado Front Range and found that for a three-year period, substantial hydrologic and geochemical responses downstream of a burned area were primarily driven by convective storms with a 30 min rainfall intensity >10 mm h−1. These storms, which typically occur several times each year in July–September, are often small in area, short-lived, and highly variable in intensity and geographic distribution. Thus, a rain gage network with high temporal resolution and spatial density, together with high-resolution stream sampling, are required to adequately characterize post-wildfire responses. We measured total suspended sediment, dissolved organic carbon (DOC), nitrate, and manganese concentrations that were 10–156 times higher downstream of a burned area compared to upstream during relatively common (50% annual exceedance probability) rainstorms, and water quality was sufficiently impaired to pose water-treatment concerns. Short-term water-quality impairment was driven primarily by increased surface runoff during higher intensity convective storms that caused erosion in the burned area and transport of sediment and chemical constituents to streams. Annual sediment yields downstream of the burned area were controlled by storm events and subsequent remobilization, whereas DOC yields were closely linked to annual runoff and thus were more dependent on interannual variation in spring runoff. Nitrate yields were highest in the third year post-wildfire. Results from this study quantitatively demonstrate that water quality can be altered for several years after wildfire. Because the southwestern US is prone to wildfires and high-intensity rain storms, the role of storms in post-wildfire water-quality impacts must be considered when assessing water-quality vulnerability.
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Impact of High-Intensity-NIV on the heart in stable COPD: a randomised cross-over pilot study.
Duiverman, Marieke Leontine; Maagh, Petra; Magnet, Friederike Sophie; Schmoor, Claudia; Arellano-Maric, Maria Paola; Meissner, Axel; Storre, Jan Hendrik; Wijkstra, Peter Jan; Windisch, Wolfram; Callegari, Jens
2017-05-02
Although high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients. In a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients. Furthermore, CO during NIV, gas exchange, lung function, and health-related quality of life were investigated. Three patients dropped out: two deteriorated on low-intensity non-invasive ventilation, and one presented with decompensated heart failure while on high-intensity non-invasive ventilation. Eleven patients were included in the analysis. In general, cardiac output and NTproBNP did not change, although individual effects were noticed, depending on the pressures applied and/or the co-existence of heart failure. High-intensity non-invasive ventilation tended to be more effective in improving gas exchange, but both modes improved lung function and the health-related quality of life. Long-term non-invasive ventilation with adequate pressure to improve gas exchange and health-related quality of life did not have an overall adverse effect on cardiac performance. Nevertheless, in patients with pre-existing heart failure, the application of very high inspiratory pressures might reduce cardiac output. The trial was registered in the Deutsches Register Klinischer Studien (DRKS-ID: DRKS00007977 ).
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Scotti, Dennis J; Harmon, Joel; Behson, Scott J
2009-01-01
This study assesses the importance of customer-contact intensity at the service encounter level as a determinant of service quality assessments. Using data from the U.S. Department of Veterans Affairs, it shows that performance-driven human resources practices play an important role as determinants of employee customer orientation and service capability in both high-contact (outpatient healthcare) and low-contact (benefits claim processing) human service contexts. However, there existed significant differences across service delivery settings in the salience of customer orientation and the congruence between employee and customer perceptions of service quality, depending on the intensity of customer contact. In both contexts, managerial attention to high-performance work systems and customer-orientation has the potential to favorably impact perceptions of service quality, amplify consumer satisfaction, and enhance operational efficiency.
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Sensory and rapid instrumental methods as a combined tool for quality control of cooked ham.
Barbieri, Sara; Soglia, Francesca; Palagano, Rosa; Tesini, Federica; Bendini, Alessandra; Petracci, Massimiliano; Cavani, Claudio; Gallina Toschi, Tullia
2016-11-01
In this preliminary investigation, different commercial categories of Italian cooked pork hams have been characterized using an integrated approach based on both sensory and fast instrumental measurements. For these purposes, Italian products belonging to different categories (cooked ham, "selected" cooked ham and "high quality" cooked ham) were evaluated by sensory descriptive analysis and by the application of rapid tools such as image analysis by an "electronic eye" and texture analyzer. The panel of trained assessors identified and evaluated 10 sensory descriptors able to define the quality of the products. Statistical analysis highlighted that sensory characteristics related to appearance and texture were the most significant in discriminating samples belonged to the highest (high quality cooked hams) and the lowest (cooked hams) quality of the product whereas the selected cooked hams, showed intermediate characteristics. In particular, high quality samples were characterized, above all, by the highest intensity of pink intensity, typical appearance and cohesiveness, and, at the same time, by the lowest intensity of juiciness; standard cooked ham samples showed the lowest intensity of all visual attributes and the highest value of juiciness, whereas the intermediate category (selected cooked ham) was not discriminated from the other. Also physical-rheological parameters measured by electronic eye and texture analyzer were effective in classifying samples. In particular, the PLS model built with data obtained from the electronic eye showed a satisfactory performance in terms of prediction of the pink intensity and presence of fat attributes evaluated during the sensory visual phase. This study can be considered a first application of this combined approach that could represent a suitable and fast method to verify if the meat product purchased by consumer match its description in terms of compliance with the claimed quality.
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Kierkegaard, Marie; Lundberg, Ingrid E; Olsson, Tomas; Johansson, Sverker; Ygberg, Sofia; Opava, Christina; Holmqvist, Lotta Widén; Piehl, Fredrik
2016-03-15
High-intensity resistance training is unexplored in people with multiple sclerosis. To evaluate effects of high-intensity resistance training on immune markers and on measures of mood, fatigue, health-related quality of life, muscle strength, walking and cognition. Further, to describe participants' opinion and perceived changes of the training. Twenty patients with relapsing-remitting multiple sclerosis performed high-intensity resistance training at an intensity of 80% of one-repetition maximum, twice a week for 12 weeks. Blood and optional cerebrospinal fluid samples, and data on secondary outcome measures were collected before and after intervention. A study-specific questionnaire was used for capturing participants' opinion. Seventeen participants completed the study. Plasma cytokine levels of tumor necrosis factor were significantly decreased post-intervention (p=0.001). Exploratory cytokine analyses in cerebrospinal fluid (n=8) did not reveal major changes. Significant and clinically important improvements were found in fatigue (p=0.001) and health-related quality of life (p=0.004). Measures of mood (p=0.002), muscle strength (p ≤ 0.001), walking speed (p=0.013) and cognition (p=0.04) were also improved. A majority of participants evaluated the training as very good and perceived changes to the better. High-intensity resistance training in persons with relapsing remitting multiple sclerosis with low disability had positive effects on peripheral pro-inflammatory cytokine levels, led to clinically relevant improvements in measures of fatigue and health-related quality of life, and was well tolerated. These results provide a basis for a larger randomized trial. Copyright © 2016 Elsevier B.V. All rights reserved.
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NASA Astrophysics Data System (ADS)
Molina-Cardín, Alberto; Campuzano, Saioa A.; Rivero, Mercedes; Osete, María Luisa; Gómez-Paccard, Miriam; Pérez-Fuentes, José Carlos; Pavón-Carrasco, F. Javier; Chauvin, Annick; Palencia-Ortas, Alicia
2017-04-01
In this work we present the first archaeomagnetic intensity database for the Iberian Peninsula covering the last 3 millennia. In addition to previously published archaeointensities (about 100 data), we present twenty new high-quality archaeointensities. The new data have been obtained following the Thellier and Thellier method including pTRM-checks and have been corrected for the effect of the anisotropy of thermoremanent magnetization upon archaeointensity estimates. Importantly, about 50% of the new data obtained correspond to the first millennium BC, a period for which there was not possible to develop an intensity palaeosecular variation curve before due to the lack of high-quality archaeointensity data. The different qualities of the data included in the Iberian dataset have been evaluated following different palaeomagnetic criteria, such as the number of specimens analysed, the laboratory protocol applied and the kind of material analysed. Finally, we present the first intensity palaeosecular variation curve for the Iberian Peninsula centred at Madrid for the last 3000 years. In order to obtain the most reliable secular variation curve, it has been generated using only selected high-quality data from the catalogue.
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[Impacts of Ochotona pallasi disturbance on alpine grassland community characteristics].
Zhao, Guo-qin; Li, Guang-yong; Ma, Wen-hu; Zhao, Dian-zhi; Li, Xiao-yan
2013-08-01
Plateau pika is the main fossorial mammal in the alpine grassland in Qinghai Lake Watershed of Northwest China. Based on the field investigation data from 18 alpine grassland quadrats in the Watershed, and by using redundancy analysis (RDA) and the surface fitting offered by 'R-Vegan' , the disturbance intensity of plateau pika (Ochotona pallasi) was classified as four levels. In order to explore the impacts of plateau pika disturbance on the alpine grassland ecosystem and its grazing quality, the community characteristics under different disturbance intensities by plateau pika were analyzed, and a conceptual model about the alpine grassland community succession was proposed. The results showed that with the increase of the disturbance intensity, the dominant species changed from Juncus roemerianus to Poa pratensis and Laux maritima. When the disturbance was small, the community had high quantitative values of coverage, aboveground biomass, biodiversity, and species richness, but the proportion of weeds was also high. When the disturbance was large, the quantitative values were the lowest, while the proportion of weeds was the highest. When the disturbance was moderate, the community had relatively high quantitative values, and the proportion of grasses and sedges was the highest. It was concluded that the community' s characteristic values under low plateau pika disturbance intensity were high but the grazing quality was low, while high disturbance intensity resulted in the grassland degradation. Therefore, the disturbance intensity in the threshold could maintain the stability of alpine grassland ecosystem and improve its grazing quality.
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Krieger, James W.; Takaro, Tim K.; Song, Lin; Weaver, Marcia
2005-01-01
Objectives. We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers. Methods. We conducted a randomized controlled trial with 1-year follow-up among 274 low-income households containing a child aged 4–12 years who had asthma. Community health workers provided in-home environmental assessments, education, support for behavior change, and resources. Participants were assigned to either a high-intensity group receiving 7 visits and a full set of resources or a low-intensity group receiving a single visit and limited resources. Results. The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P= .138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189–$721. Conclusions. Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention. PMID:15798126
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Effect of Power Ultrasound on Food Quality
NASA Astrophysics Data System (ADS)
Lee, Hyoungill; Feng, Hao
Recent food processing technology innovations have been centered around producing foods with fresh-like attributes through minimal processing or nonthermal processing technologies. Instead of using thermal energy to secure food safety that is often accompanied by quality degradation in processed foods, the newly developed processing modalities utilize other types of physical energy such as high pressure, pulsed electric field or magnetic field, ultraviolet light, or acoustic energy to process foods. An improvement in food quality by the new processing methods has been widely reported. In comparison with its low-energy (high-frequency) counterpart which finds applications in food quality inspection, the use of high-intensity ultrasound, also called power ultrasound, in food processing is a relatively new endeavor. To understand the effect of high-intensity ultrasound treatment on food quality, it is important to understand the interactions between acoustic energy and food ingredients, which is covered in Chapter 10. In this chapter, the focus will be on changes in overall food quality attributes that are caused by ultrasound, such as texture, color, flavor, and nutrients.
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Schulz, Sebastian Viktor Waldemar; Laszlo, Roman; Otto, Stephanie; Prokopchuk, Dmytro; Schumann, Uwe; Ebner, Florian; Huober, Jens; Steinacker, Jürgen Michael
2018-06-01
To evaluate feasibility of an exercise intervention consisting of high-intensity interval endurance and strength training in breast cancer patients. Twenty-six women with nonmetastatic breast cancer were consecutively assigned to the exercise intervention- (n= 15, mean age 51.9 ± 9.8 years) and the control group (n = 11, mean age 56.9 ± 7.0 years). Cardiopulmonary exercise testing that included lactate sampling, one-repetition maximum tests and a HADS-D questionnaire were used to monitor patients both before and after a supervised six weeks period of either combined high-intensity interval endurance and strength training (intervention group, twice a week) or leisure training (control group). Contrarily to the control group, endurance (mean change of VO 2 , peak 12.0 ± 13.0%) and strength performance (mean change of cumulative load 25.9 ± 11.2%) and quality of life increased in the intervention group. No training-related adverse events were observed. Our guided exercise intervention could be used effectively for initiation and improvement of performance capacity and quality of life in breast cancer patients in a relatively short time. This might be especially attractive during medical treatment. Long-term effects have to be evaluated in randomized controlled studies also with a longer follow-up. Implications for Rehabilitation High-intensity interval training allows improvement of aerobic capacity within a comparable short time. Standard leisure training in breast cancer patients is rather suitable for the maintenance of performance capacity and quality of life. Guided high-intensity interval training combined with strength training can be used effectively for the improvement of endurance and strength capacity and also quality of life. After exclusion of contraindications, guided adjuvant high-intensity interval training combined with strength training can be safely used in breast cancer patients.
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Vitale, Jacopo A; Bonato, Matteo; Galasso, Letizia; La Torre, Antonio; Merati, Giampiero; Montaruli, Angela; Roveda, Eliana; Carandente, Franca
2017-01-01
The influence of the chronotype on the sleep quality in male collegiate soccer players in response to acute high intensity interval training (HIIT) performed at two different times of day was evaluated. The sleep quality was poorer in the morning-type than in the evening-type players after the evening HIIT session, whereas no significant changes in the sleep quality of the two chronotypes after the morning HIIT session was observed. The results suggest that an athlete's chronotype should be taken into account when scheduling training sessions and to promote faster recovery processes.
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Toohey, Kellie; Pumpa, Kate L; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S; Semple, Stuart
2016-01-01
The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group ( n = 8) or the continuous low to moderate intensity training group ( n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05-0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43-4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.
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Pumpa, Kate L.; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S.; Semple, Stuart
2016-01-01
Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8) or the continuous low to moderate intensity training group (n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Results Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings. PMID:27781180
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HIAF: New opportunities for atomic physics with highly charged heavy ions
NASA Astrophysics Data System (ADS)
Ma, X.; Wen, W. Q.; Zhang, S. F.; Yu, D. Y.; Cheng, R.; Yang, J.; Huang, Z. K.; Wang, H. B.; Zhu, X. L.; Cai, X.; Zhao, Y. T.; Mao, L. J.; Yang, J. C.; Zhou, X. H.; Xu, H. S.; Yuan, Y. J.; Xia, J. W.; Zhao, H. W.; Xiao, G. Q.; Zhan, W. L.
2017-10-01
A new project, High Intensity heavy ion Accelerator Facility (HIAF), is currently being under design and construction in China. HIAF will provide beams of stable and unstable heavy ions with high energies, high intensities and high quality. An overview of new opportunities for atomic physics using highly charged ions and radioactive heavy ions at HIAF is given.
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A statistical model for forecasting hourly ozone levels during fire season
Haiganoush K. Preisler; Shiyuan (Sharon) Zhong; Annie Esperanza; Leland Tarnay; Julide Kahyaoglu-Koracin
2009-01-01
Concerns about smoke from large high-intensity and managed low intensity fires have been increasing during the past decade. Because smoke from large high-intensity fires are known to contain and generate secondary fine particles (PM2.5) and ozone precursors, the effect of fires on air quality in the southern Sierra Nevada is a serious management...
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Virginia R. Tolbert; Carl C. Trettin; Dale W. Johnson; John W. Parsons; Allan E. Houston; David A. Mays
2001-01-01
Ensuring sustainability of intensively managed woody crops requires determining soil and water quality effects using a combination of field data and modeling projections. Plot- and catchrnent-scale research, models, and meta-analyses are addressing nutrient availability, site quality, and measures to increase short-rotation woody crop (SRWC) productivity and site...
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Iida, Fumiko; Miyazaki, Yuki; Tsuyuki, Risako; Kato, Kenichi; Egusa, Ai; Ogoshi, Hiro; Nishimura, Toshihide
2016-02-01
Analysis of the quality of highly marbled beef during dry aging for 60days after slaughter showed that the changes in some qualities differed from those of conventional meat. The tenderness of these meats did not change during aging for 50days but then gradually increased until day 60. The juiciness of these meats, as determined by sensory evaluation, did not change during aging for 60days, except for a decrease on day 20. The umami intensity of these meats in the sensory evaluation and the value calculated by Glu and IMP quantification were highest on day 40. This high umami intensity was induced by the synergistic effect of umami compounds such as Glu and IMP. These results for tenderness, juiciness, umami intensity, and flavor intensity suggested that the best duration of dry aging for highly marbled beef was 40days. Copyright © 2015 Elsevier Ltd. All rights reserved.
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The effect of light intensity on image quality in endoscopic ear surgery.
McCallum, R; McColl, J; Iyer, A
2018-05-16
Endoscopic ear surgery is a rapidly developing field with many advantages. But endoscopes can reach temperatures of over 110°C at the tip, raising safety concerns. Reducing the intensity of the light source reduces temperatures produced. However, quality of images at lower light intensities has not yet been studied. We set out to study the effect of light intensity on image quality in EES. Prospective study of patients undergoing EES from April to October 2016. Consecutive images of the same operative field at 10%, 30%, 50% and 100% light intensities were taken. Eight international experts were asked to each evaluate 100 anonymised, randomised images. District General Hospital. Twenty patients. Images were evaluated on a 5-point Likert scale (1 = significantly worse than average; 5 = significantly better than average) for detail of anatomy; colour contrast; overall quality; and suitability for operating. Mean scores for photographs at 10%, 30%, 50% and 100% light intensity were 3.22 (SD 0.93), 3.15 (SD 0.84), 3.08 (SD 0.88) and 3.10 (SD 0.86), respectively. In ANOVA models for the scores on each of the scales (anatomy, colour contrast, overall quality and suitability for operating), the effects of rater and patient were highly significant (P < .0005) but light intensity was non-significant (P = .34, .32, .21, .15, respectively). Images taken during surgery by our endoscope and operative camera have no loss of quality when taken at lower light intensities. We recommend the surgeon considers use of lower light intensities in endoscopic ear surgery. © 2018 John Wiley & Sons Ltd.
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Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen
2015-01-01
The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks.
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Monostori, István; Heilmann, Márk; Kocsy, Gábor; Rakszegi, Marianna; Ahres, Mohamed; Altenbach, Susan B.; Szalai, Gabriella; Pál, Magda; Toldi, Dávid; Simon-Sarkadi, Livia; Harnos, Noémi; Galiba, Gábor; Darko, Éva
2018-01-01
The use of light-emitting diode (LED) technology for plant cultivation under controlled environmental conditions can result in significant reductions in energy consumption. However, there is still a lack of detailed information on the lighting conditions required for optimal growth of different plant species and the effects of light intensity and spectral composition on plant metabolism and nutritional quality. In the present study, wheat plants were grown under six regimens designed to compare the effects of LED and conventional fluorescent lights on growth and development, leaf photosynthesis, thiol and amino acid metabolism as well as grain yield and flour quality of wheat. Benefits of LED light sources over fluorescent lighting were manifested in both yield and quality of wheat. Elevated light intensities made possible with LEDs increased photosynthetic activity, the number of tillers, biomass and yield. At lower light intensities, blue, green and far-red light operated antagonistically during the stem elongation period. High photosynthetic activity was achieved when at least 50% of red light was applied during cultivation. A high proportion of blue light prolonged the juvenile phase, while the shortest flowering time was achieved when the blue to red ratio was around one. Blue and far-red light affected the glutathione- and proline-dependent redox environment in leaves. LEDs, especially in Blue, Pink and Red Low Light (RedLL) regimens improved flour quality by modifying starch and protein content, dough strength and extensibility as demonstrated by the ratios of high to low molecular weight glutenins, ratios of glutenins to gliadins and gluten spread values. These results clearly show that LEDs are efficient for experimental wheat cultivation, and make it possible to optimize the growth conditions and to manipulate metabolism, yield and quality through modification of light quality and quantity. PMID:29780400
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Monostori, István; Heilmann, Márk; Kocsy, Gábor; Rakszegi, Marianna; Ahres, Mohamed; Altenbach, Susan B; Szalai, Gabriella; Pál, Magda; Toldi, Dávid; Simon-Sarkadi, Livia; Harnos, Noémi; Galiba, Gábor; Darko, Éva
2018-01-01
The use of light-emitting diode (LED) technology for plant cultivation under controlled environmental conditions can result in significant reductions in energy consumption. However, there is still a lack of detailed information on the lighting conditions required for optimal growth of different plant species and the effects of light intensity and spectral composition on plant metabolism and nutritional quality. In the present study, wheat plants were grown under six regimens designed to compare the effects of LED and conventional fluorescent lights on growth and development, leaf photosynthesis, thiol and amino acid metabolism as well as grain yield and flour quality of wheat. Benefits of LED light sources over fluorescent lighting were manifested in both yield and quality of wheat. Elevated light intensities made possible with LEDs increased photosynthetic activity, the number of tillers, biomass and yield. At lower light intensities, blue, green and far-red light operated antagonistically during the stem elongation period. High photosynthetic activity was achieved when at least 50% of red light was applied during cultivation. A high proportion of blue light prolonged the juvenile phase, while the shortest flowering time was achieved when the blue to red ratio was around one. Blue and far-red light affected the glutathione- and proline-dependent redox environment in leaves. LEDs, especially in Blue, Pink and Red Low Light (RedLL) regimens improved flour quality by modifying starch and protein content, dough strength and extensibility as demonstrated by the ratios of high to low molecular weight glutenins, ratios of glutenins to gliadins and gluten spread values. These results clearly show that LEDs are efficient for experimental wheat cultivation, and make it possible to optimize the growth conditions and to manipulate metabolism, yield and quality through modification of light quality and quantity.
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Warlich, Benjamin; Fritz, Fleur; Osada, Nani; Bruland, Philipp; Stumpf, Astrid; Schneider, Gudrun; Dugas, Martin; Pfleiderer, Bettina; Ständer, Sonja
2015-01-01
It is unknown if health-related quality of life (HRQoL) differs between diseases associated with chronic pruritus (CP). To analyze HRQoL in relation to age, gender, skin lesions (primary vs. scratch-induced secondary) and itch intensity. Consecutive patients of our itch clinic were assessed with the Dermatology Life Quality Index (DLQI) and visual analogue scale (VAS). In 510 CP patients (282 females; median age, 61.4 years), DLQI scores and VAS values were highly correlated, irrespective of the type of skin lesion. Overall, women had a lower HRQoL compared to men (females: 10.7 ± 6.7, males: 8.9 ± 6.7), but female gender was only associated with worse quality of life in patients <65 years old. HRQoL impairment in CP is highly influenced by pruritus intensity but not to the visible skin lesion or underlying cause. With limitations to item bias, DLQI is a suitable instrument for estimating quality of life impairment by CP. © 2015 S. Karger AG, Basel.
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Improving the geomagnetic field modeling with a selection of high-quality archaeointensity data
NASA Astrophysics Data System (ADS)
Pavon-Carrasco, Francisco Javier; Gomez-Paccard, Miriam; Herve, Gwenael; Osete, Maria Luisa; Chauvin, Annick
2014-05-01
Geomagnetic field reconstructions for the last millennia are based on archeomagnetic data. However, the scatter of the archaeointensity data is very puzzling and clearly suggests that some of the intensity data might not be reliable. In this work we apply different selection criteria to the European and Western Asian archaeointensity data covering the last three millennia in order to investigate if the data selection affects geomagnetic field models results. Thanks to the recently developed archeomagnetic databases, new valuable information related to the methodology used to determine the archeointensity data is now available. We therefore used this information to rank the archaeointensity data in four quality categories depending on the methodology used during the laboratory treatment of the samples and on the number of specimens retained to calculate the mean intensities. Results show how the intensity geomagnetic field component given by the regional models hardly depends on the selected quality data used. When all the available data are used a different behavior of the geomagnetic field is observed in Western and Eastern Europe. However, when the regional model is obtained from a selection of high-quality intensity data the same features are observed at the European scale.
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Moise, Nathalie; Huang, Chen; Rodgers, Anthony; Kohli-Lynch, Ciaran N; Tzong, Keane Y; Coxson, Pamela G; Bibbins-Domingo, Kirsten; Goldman, Lee; Moran, Andrew E
2016-07-01
The population health effect and cost-effectiveness of implementing intensive blood pressure goals in high-cardiovascular disease (CVD) risk adults have not been described. Using the CVD Policy Model, CVD events, treatment costs, quality-adjusted life years, and drug and monitoring costs were simulated over 2016 to 2026 for hypertensive patients aged 35 to 74 years. We projected the effectiveness and costs of hypertension treatment according to the 2003 Joint National Committee (JNC)-7 or 2014 JNC8 guidelines, and then for adults aged ≥50 years, we assessed the cost-effectiveness of adding an intensive goal of systolic blood pressure <120 mm Hg for patients with CVD, chronic kidney disease, or 10-year CVD risk ≥15%. Incremental cost-effectiveness ratios <$50 000 per quality-adjusted life years gained were considered cost-effective. JNC7 strategies treat more patients and are more costly to implement compared with JNC8 strategies. Adding intensive systolic blood pressure goals for high-risk patients prevents an estimated 43 000 and 35 000 annual CVD events incremental to JNC8 and JNC7, respectively. Intensive strategies save costs in men and are cost-effective in women compared with JNC8 alone. At a willingness-to-pay threshold of $50 000 per quality-adjusted life years gained, JNC8+intensive had the highest probability of cost-effectiveness in women (82%) and JNC7+intensive the highest probability of cost-effectiveness in men (100%). Assuming higher drug and monitoring costs, adding intensive goals for high-risk patients remained consistently cost-effective in men, but not always in women. Among patients aged 35 to 74 years, adding intensive blood pressure goals for high-risk groups to current national hypertension treatment guidelines prevents additional CVD deaths while saving costs provided that medication costs are controlled. © 2016 American Heart Association, Inc.
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High-Quality Carbohydrates and Physical Performance
Kanter, Mitch
2018-01-01
While all experts agreed that protein needs for performance are likely greater than believed in past generations, particularly for strength training athletes, and that dietary fat could sustain an active person through lower-intensity training bouts, current research still points to carbohydrate as an indispensable energy source for high-intensity performance. PMID:29449746
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Puhan, M; Schunemann, H; Frey, M; Scharplatz, M; Bachmann, L
2005-01-01
Background: Physical exercise is an important component of respiratory rehabilitation because it reverses skeletal muscle dysfunction, a clinically important manifestation of COPD associated with reduced health-related quality of life (HRQL) and survival. However, there is controversy regarding the components of the optimal exercise protocol. A study was undertaken to systematically evaluate and summarise randomised controlled trials (RCTs) comparing different exercise protocols for COPD patients. Methods: Six electronic databases, congress proceedings and bibliographies of included studies were searched without imposing language restrictions. Two reviewers independently screened all records and extracted data on study samples, interventions and methodological characteristics of included studies. Results: The methodological quality of the 15 included RCTs was low to moderate. Strength exercise led to larger improvements of HRQL than endurance exercise (weighted mean difference for Chronic Respiratory Questionnaire 0.27, 95% CI 0.02 to 0.52). Interval exercise seems to be of similar effectiveness as continuous exercise, but there are few data on clinically relevant outcomes. One small RCT which included patients with mild COPD compared the effect of high and low intensity exercise (at 80% and 40% of the maximum exercise capacity, respectively) and found larger physiological training effects from high intensity exercise. Conclusions: Strength exercise should be routinely incorporated in respiratory rehabilitation. There is insufficient evidence to recommend high intensity exercise for COPD patients and investigators should conduct larger high quality trials to evaluate exercise intensities in patients with moderate to severe COPD. PMID:15860711
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To Change the Things I Can: Making Instruction More Intensive
ERIC Educational Resources Information Center
Stevenson, Nathan A.; Reed, Deborah K.
2017-01-01
When students do not respond adequately to core instruction, teachers must provide instruction and intervention that is more intensive and, therefore, more effective. However, for many educators, it is often unclear what it means to intensify instruction and how intensive instruction differs from high-quality core instruction. This article…
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Cancer and Exercise: Warburg Hypothesis, Tumour Metabolism and High-Intensity Anaerobic Exercise.
Hofmann, Peter
2018-01-31
There is ample evidence that regular moderate to vigorous aerobic physical activity is related to a reduced risk for various forms of cancer to suggest a causal relationship. Exercise is associated with positive changes in fitness, body composition, and physical functioning as well as in patient-reported outcomes such as fatigue, sleep quality, or health-related quality of life. Emerging evidence indicates that exercise may also be directly linked to the control of tumour biology through direct effects on tumour-intrinsic factors. Beside a multitude of effects of exercise on the human body, one underscored effect of exercise training is to target the specific metabolism of tumour cells, namely the Warburg-type highly glycolytic metabolism. Tumour metabolism as well as the tumour⁻host interaction may be selectively influenced by single bouts as well as regularly applied exercise, dependent on exercise intensity, duration, frequency and mode. High-intensity anaerobic exercise was shown to inhibit glycolysis and some studies in animals showed that effects on tumour growth might be stronger compared with moderate-intensity aerobic exercise. High-intensity exercise was shown to be safe in patients; however, it has to be applied carefully with an individualized prescription of exercise.
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Fluorescent and high intensity discharge lamp use in chambers and greenhouses
NASA Technical Reports Server (NTRS)
Langhans, Robert W.
1994-01-01
Fluorescent and High Intensity Discharge lamps have opened up great opportunities for researchers to study plant growth under controlled environment conditions and for commercial growers to increase plant production during low/light periods. Specific technical qualities of fluorescent and HID lamps have been critically reviewed. I will direct my remarks to fluorescent and high intensity discharge (HID) lamps in growth chambers, growth rooms, and greenhouses. I will discuss the advantages and disadvantages of using each lamp in growth chambers, growth rooms and greenhouses.
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[Quality assurance in intensive care: the situation in Switzerland].
Frutiger, A
1999-10-30
The movement for quality in medicine is starting to take on the dimensions of a crusade. Quite logically it has also reached the intensive care community. Due to their complex multidisciplinary functioning and because of the high costs involved, ICUs are model services reflecting the overall situation in our hospitals. The situation of Swiss intensive care is particularly interesting, because for over 25 years standards for design and staffing of Swiss ICUs have been in effect and were enforced via onsite visits by the Swiss Society of Intensive Care without government involvement. Swiss intensive care thus defined its structures long before the word "accreditation" had even been used in this context. While intensive care in Switzerland is practised in clearly defined, well equipped and adequately staffed units, much less is known about process quality and outcomes of these services. Statistics on admissions, length of stay and length of mechanical ventilation, as well as severity data based on a simple classification system, are collected nationwide and allow some limited insight into the overall process of care. Results of intensive care are not systematically assessed. In response to the constant threat of cost containment, Swiss ICUs should increasingly focus on process quality and results, while maintaining their existing good structures.
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NASA Astrophysics Data System (ADS)
Murphy, S. F.; Writer, J. H.; McCleskey, R. B.; Martin, D. A.
2014-12-01
Communities in the southwestern U.S. rely on forested watersheds to provide high-quality water, but these watersheds are prone to major disturbance by wildfire. The loss of vegetation and litter can decrease water storage and infiltration and decrease nutrient uptake, leading to enhanced surface runoff, erosion, and nutrient export compared to undisturbed watersheds. Post-wildfire impacts on water quality vary widely across geographic regions, and are largely driven by post-fire storm timing and intensity. In the southwestern U.S., the North American Monsoon can produce high-intensity rain from July through September. A better understanding of the post-fire water-quality response of watersheds to monsoonal storms in this region is therefore critical. The Fourmile Canyon Fire burned 2600 ha near Boulder, Colorado in September 2010, including 23% of the Fourmile Creek watershed. This watershed had been recovering from historical mining activity, and dispersed waste rock and mine tailings were only partially revegetated before the wildfire. We collected water quality, hydrological, and meteorological data with high temporal and spatial density upstream and downstream of the burned area for 4 years post-fire. For 9 months post-fire, the area received snow or low-intensity rain, and the difference in stream water chemistry between burned and unburned watersheds was minimal. However, in the summer of 2011, and in the following two summers, relatively common monsoonal storms caused dramatic, but short-lived, increases in discharge, sediment, nitrate, dissolved organic carbon, and metals downstream of the burned area. Such pulses can degrade aquatic ecosystems, impair water treatability, and decrease reservoir capacity. Climate change is projected to increase wildfire frequency and size and lead to an earlier and longer wildfire season. Simultaneously, storm frequency and intensity are predicted to increase, and the monsoon season may occur later in the year, potentially decreasing the average length of time between wildfire and subsequent high-intensity rain events. This suggests that substantial water-quality impacts may be more common in the future, resulting in a new paradigm for water treatment in the southwestern U.S.
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Sediment yield along an actively managed riparian buffer
Ferhat Kara; Edward F. Loewenstein; Latif Kalin
2012-01-01
High quality water is generally associated with forested watersheds. However, intensive forestry activities within these watersheds can negatively affect water quality. In order to mitigate negative effects of forestry operations on water quality, best management practices (BMPs) are recommended. In this study, effects of silvicultural treatments on water quality are...
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Effect of high-hydrostatic pressure and moderate-intensity pulsed electric field on plum.
García-Parra, J; González-Cebrino, F; Delgado-Adámez, J; Cava, R; Martín-Belloso, O; Élez-Martínez, P; Ramírez, R
2018-03-01
Moderate intensity pulse electric fields were applied in plum with the aim to increase bioactive compounds content of the fruit, while high-hydrostatic pressure was applied to preserve the purées. High-hydrostatic pressure treatment was compared with an equivalent thermal treatment. The addition of ascorbic acid during purée manufacture was also evaluated. The main objective of this study was to assess the effects on microorganisms, polyphenoloxidase, color and bioactive compounds of high-hydrostatic pressure, or thermal-processed plum purées made of moderate intensity pulse electric field-treated or no-moderate intensity pulse electric field-treated plums, after processing during storage. The application of moderate intensity pulse electric field to plums slightly increased the levels of anthocyanins and the antioxidant activity of purées. The application of Hydrostatic-high pressure (HHP) increased the levels of bioactive compounds in purées, while the thermal treatment preserved better the color during storage. The addition of ascorbic acid during the manufacture of plum purée was an important factor for the final quality of purées. The color and the bioactive compounds content were better preserved in purées with ascorbic acid. The no inactivation of polyphenoloxidase enzyme with treatments applied in this study affected the stability purées. Probably more intense treatments conditions (high-hydrostatic pressure and thermal treatment) would be necessary to reach better quality and shelf life during storage.
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NASA Astrophysics Data System (ADS)
Bitew, M. M.; Jackson, C. R.; Vache, K. B.; Griffiths, N.; Starr, G.; McDonnell, J.; Rau, B.; Younger, S. E.; Fouts, K.
2016-12-01
Intensively managed loblolly pine is a candidate species for biofuel feedstock production in the southeastern Coastal Plain of the United States. However, the water quantity and quality effects of high intensity, short-rotation silviculture are largely unknown. Here we evaluate the potential hydrologic and water quality impacts of biofuel-induced land use changes based on model scenarios developed using existing forest BMPs and industry wide experiences. We quantified the effect of bio-energy production scenarios on each of water the balance components by applying an integrated physically based distributed watershed modeling system, and multi-objective assessment functions that accurately describes the flow regimes, water quality, and isotopic observations from three experimental headwater watersheds of Fourmile Creek at Savannah River Site, SC. The model incorporates optimized travel times of groundwater flowpaths and flow control processes in the riparian region allowing water quality analysis of groundwater dominated watershed systems. We compared five different short rotation pine management scenarios ranging from 35 year (low intensity) to 10 year (high intensity) rotations and a mixture of forestry and agriculture/pasture production practices. Simulation results, based on long-term climate records, revealed that complete conversion to short-rotation woody crops would have a negligible effect on water budget components; <2% decrease in streamflow, <1.5% increase in actual evapotranspiration, an average 0.5 m fall in the groundwater table, and no change in subsurface flow due to biofuel production. Simulation results of mixed 50% agriculture and pasture and 50% short-rotation woody crops showed the largest deviation in water budget components compared to the reference condition. Analysis of extreme stream flows showed that the largest effect was observed in the low intensity mixed land use scenario. The smallest effect was in the low intensity biomass production scenario with a 0.5% increase in a 100 year return event.
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Intensivist physician staffing and the process of care in academic medical centres
Kahn, Jeremy M; Brake, Helga; Steinberg, Kenneth P
2007-01-01
Background Although intensivist physician staffing is associated with improved outcomes in critical care, little is known about the mechanism leading to this observation. Objective To determine the relationship between intensivist staffing and select process‐based quality indicators in the intensive care unit. Research design Retrospective cohort study in 29 academic hospitals participating in the University HealthSystem Consortium Mechanically Ventilated Patient Bundle Benchmarking Project. Patients 861 adult patients receiving prolonged mechanical ventilation in an intensive care unit. Results Patient‐level information on physician staffing and process‐of‐care quality indicators were collected on day 4 of mechanical ventilation. By day 4, 668 patients received care under a high intensity staffing model (primary intensivist care or mandatory consult) and 193 patients received care under a low intensity staffing model (optional consultation or no intensivist). Among eligible patients, those receiving care under a high intensity staffing model were more likely to receive prophylaxis for deep vein thrombosis (risk ratio 1.08, 95% CI 1.00 to 1.17), stress ulcer prophylaxis (risk ratio 1.10, 95% CI 1.03 to 1.18), a spontaneous breathing trial (risk ratio 1.37, 95% CI 0.97 to 1.94), interruption of sedation (risk ratio 1.64, 95% CI 1.13 to 2.38) and intensive insulin treatment (risk ratio 1.40, 95% CI 1.18 to 1.79) on day 4 of mechanical ventilation. Models accounting for clustering by hospital produced similar estimates of the staffing effect, except for prophylaxis against thrombosis and stress ulcers. Conclusions High intensity physician staffing is associated with increased use of evidence‐based quality indictors in patients receiving mechanical ventilation. PMID:17913772
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Uyà, Marc; Bulleri, Fabio; Gribben, Paul E
2018-04-01
Invasion success is regulated by multiple factors. While the roles of disturbance and propagule pressure in regulating the establishment of non-native species are widely acknowledged, that of propagule morphology (a proxy for quality) is poorly known. By means of a multi-factorial field experiment, we tested how the number (5 vs. 10) and quality (intact, without fronds or without rhizoids) of fragments of the clonal invasive seaweed, Caulerpa cylindracea, influenced its ability to establish in patches of the native seagrass, Posidonia oceanica, exposed to different intensities of disturbance (0, 50, or 100% reduction in canopy cover). We hypothesized that the ability of fragments to establish would be greater for intact fragments (high quality) and reduced more by frond removal (low quality) than rhizoid removal (intermediate quality). At low propagule pressure or quality, fragment establishment was predicted to increase with increasing disturbance, whereas, at high propagule pressure or quality, it was predicted to be high regardless of disturbance intensity. Disturbance intensity, fragment number and quality had independent effects on C. cylindracea establishment success. Disturbance always facilitated fragment establishment. However, fragments retaining fronds, either intact or deprived of rhizoids, had higher establishment success than fragments deprived of fronds. Increasing propagule number had weak effects on the cover of C. cylindracea. Our results demonstrate that propagule traits enabling the acquisition of resources made available by disturbance can be more important than propagule number in determining the establishment and spread of clonal non-native plants. More generally, our study suggests that propagule quality is a key, yet underexplored, determinant of invasion success. © 2018 by the Ecological Society of America.
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Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter
2014-01-01
Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245
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Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter
2014-01-01
Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs - representing over 300 patient beds - had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.
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[The German DRG system 2003-2010 from the perspective of intensive care medicine].
Franz, Dominik; Bunzemeier, Holger; Roeder, Norbert; Reinecke, Holger
2010-01-01
Intensive care medicine is extremely heterogeneous, expensive and can only be partially planned and controlled. A correct and fair representation of intensive care medicine in the G-DRG system is an essential requirement for the use as a pricing system. From the perspective of intensive care medicine, pertinent changes of the DRG structure and differentiation of relevant parameters have been established within the G-DRG systems 2003-2010. Analysis of relevant diagnoses, medical procedures, co-payment structures and G-DRGs in the versions 2003-2010 based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Since the first G-DRG system version 2003, numerous measures improved quality of case allocation of intensive care medicine. Highly relevant to the system version 2010 are duration of mechanical ventilation, the intensive care treatment complex and complicating constellations. The number of G-DRGs relevant to intensive medical care increased from n = 3 (2003) to n = 58 (2010). For standard cases, quality of case allocation and G-DRG reimbursement are adequate in 2010. The G-DRG system gained complexity again. High demands are made on correct and complete coding of complex cases. Nevertheless, further adjustments of the G-DRG system especially for cases with extremely high costs are necessary. Where the G-DRG system is unable to cover extremely high-cost cases, reimbursement solutions beyond the G-DRG structure should be taken into account.
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Baguley, Brenton J; Skinner, Tina L; Leveritt, Michael D; Wright, Olivia R L
2017-01-03
Cancer-related fatigue is one of the most prevalent, prolonged and distressing side effects of prostate cancer treatment with androgen deprivation therapy. Preliminary evidence suggests natural therapies such as nutrition therapy and structured exercise prescription can reduce symptoms of cancer-related fatigue. Men appear to change their habitual dietary patterns after prostate cancer diagnosis, yet prostate-specific dietary guidelines provide limited support for managing adverse side effects of treatment. The exercise literature has shown high intensity interval training can improve various aspects of health that are typically impaired with androgen deprivation therapy; however exercise at this intensity is yet to be conducted in men with prostate cancer. The purpose of this study is to examine the effects of nutrition therapy beyond the current healthy eating guidelines with high intensity interval training for managing cancer-related fatigue in men with prostate cancer treated with androgen deprivation therapy. This is a two-arm randomized control trial of 116 men with prostate cancer and survivors treated with androgen deprivation therapy. Participants will be randomized to either the intervention group i.e. nutrition therapy and high intensity interval training, or usual care. The intervention group will receive 20 weeks of individualized nutrition therapy from an Accredited Practising Dietitian, and high intensity interval training (from weeks 12-20 of the intervention) from an Accredited Exercise Physiologist. The usual care group will maintain their standard treatment regimen over the 20 weeks. Both groups will undertake primary and secondary outcome testing at baseline, week 8, 12, and 20; testing includes questionnaires of fatigue and quality of life, objective measures of body composition, muscular strength, cardiorespiratory fitness, biomarkers for disease progression, as well as dietary analysis. The primary outcomes for this trial are measures of fatigue and quality of life. This study is the first of its kind to determine the efficacy of nutrition therapy above the healthy eating guidelines and high intensity interval training for alleviating prostate-cancer related fatigue. If successful, nutrition therapy and high intensity interval training may be proposed as an effective therapy for managing cancer-related fatigue and improving quality of life in men during and after prostate cancer treatment. Australian New Zealand Clinical Trials Registry ACTRN12615000512527 . Trial registered on the 22/5/2015.
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van Mol, Margo; Ista, Erwin; van Dijk, Monique
2018-05-02
This study aimed to measure the effects of a newly developed follow-up programme on intensive care unit patient quality of care, as perceived by their relatives, and the appropriateness of the programme according to nurses. This before and after implementation study was conducted in a level III intensive care unit for adult patients and related follow-up wards and included 135 intensive care nurses and 105 general ward nurses. The implemented programme included a personalised poster, a revised discharge protocol and follow-up visits on the ward. Eligible relatives of patients who had remained in the intensive care for a minimum of 48 hours were included. Total quality of care and communication were assessed by relatives as high according to the Quality Monitor. Most intensive care nurses evaluated the usefulness of the discharge protocol as positive (71.8% partly/totally agreed) and in accordance with the patients' needs (82.1% partly/totally agreed). Communication and general support as perceived by patients' relatives improved; however, no influence on the total quality of care of the revised discharge protocol was shown. Nurses considered the programme as useful. The intervention might enable nurses to better respond to the instrumental and affective needs of patients and their relatives. Copyright © 2018 Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Stecher, Brian M.; Garet, Michael S.; Hamilton, Laura S.; Steiner, Elizabeth D.; Robyn, Abby; Poirier, Jeffrey; Holtzman, Deborah; Fulbeck, Eleanor S.; Chambers, Jay; de los Reyes, Iliana Brodziak
2016-01-01
To improve the U.S. education system through more-effective classroom teaching, in school year 2009-2010, the Bill and Melinda Gates Foundation announced four Intensive Partnership for Effective Teaching sites. The Intensive Partnerships Initiative is based on the premise that efforts to improve instruction can benefit from high-quality measures…
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Quality Of End-Of-Life Care Is Higher In The VA Compared To Care Paid For By Traditional Medicare.
Gidwani-Marszowski, Risha; Needleman, Jack; Mor, Vincent; Faricy-Anderson, Katherine; Boothroyd, Derek B; Hsin, Gary; Wagner, Todd H; Lorenz, Karl A; Patel, Manali I; Joyce, Vilija R; Murrell, Samantha S; Ramchandran, Kavitha; Asch, Steven M
2018-01-01
Congressional and Veterans Affairs (VA) leaders have recommended the VA become more of a purchaser than a provider of health care. Fee-for-service Medicare provides an example of how purchased care differs from the VA's directly provided care. Using established indicators of overly intensive end-of-life care, we compared the quality of care provided through the two systems to veterans dying of cancer in fiscal years 2010-14. The Medicare-reliant veterans were significantly more likely to receive high-intensity care, in the form of chemotherapy, hospital stays, admission to the intensive care unit, more days spent in the hospital, and death in the hospital. However, they were significantly less likely than VA-reliant patients to have multiple emergency department visits. Higher-intensity end-of-life care may be driven by financial incentives present in fee-for-service Medicare but not in the VA's integrated system. To avoid putting VA-reliant veterans at risk of receiving lower-quality care, VA care-purchasing programs should develop coordination and quality monitoring programs to guard against overly intensive end-of-life care.
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Kitazaki, Kazuyoshi; Fukushima, Atsushi; Nakabayashi, Ryo; Okazaki, Yozo; Kobayashi, Makoto; Mori, Tetsuya; Nishizawa, Tomoko; Reyes-Chin-Wo, Sebastian; Michelmore, Richard W; Saito, Kazuki; Shoji, Kazuhiro; Kusano, Miyako
2018-05-21
Light-emitting diodes (LEDs) are an artificial light source used in closed-type plant factories and provide a promising solution for a year-round supply of green leafy vegetables, such as lettuce (Lactuca sativa L.). Obtaining high-quality seedlings using controlled irradiation from LEDs is critical, as the seedling health affects the growth and yield of leaf lettuce after transplantation. Because key molecular pathways underlying plant responses to a specific light quality and intensity remain poorly characterised, we used a multi-omics-based approach to evaluate the metabolic and transcriptional reprogramming of leaf lettuce seedlings grown under narrow-band LED lighting. Four types of monochromatic LEDs (one blue, two green and one red) and white fluorescent light (control) were used at low and high intensities (100 and 300 μmol·m -2 ·s -1 , respectively). Multi-platform mass spectrometry-based metabolomics and RNA-Seq were used to determine changes in the metabolome and transcriptome of lettuce plants in response to different light qualities and intensities. Metabolic pathway analysis revealed distinct regulatory mechanisms involved in flavonoid and phenylpropanoid biosynthetic pathways under blue and green wavelengths. Taken together, these data suggest that the energy transmitted by green light is effective in creating a balance between biomass production and the production of secondary metabolites involved in plant defence.
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Implementing Pay-for-Performance in the Neonatal Intensive Care Unit
Profit, Jochen; Zupancic, John A. F.; Gould, Jeffrey B.; Petersen, Laura A.
2011-01-01
Pay-for-performance initiatives in medicine are proliferating rapidly. Neonatal intensive care is a likely target for these efforts because of the high cost, available databases, and relative strength of evidence for at least some measures of quality. Pay-for-performance may improve patient care but requires valid measurements of quality to ensure that financial incentives truly support superior performance. Given the existing uncertainty with respect to both the effectiveness of pay-for-performance and the state of quality measurement science, experimentation with pay-for-performance initiatives should proceed with caution and in controlled settings. In this article, we describe approaches to measuring quality and implementing pay-for-performance in the NICU setting. PMID:17473099
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NASA Astrophysics Data System (ADS)
Morgenstern, Uwe; Daughney, Christopher J.
2012-08-01
SummaryWe identified natural baseline groundwater quality and impacts caused by land use intensification by relating groundwater chemistry with water age. Tritium, the most direct tracer for groundwater dating, including the time of water passage through the unsaturated zone, was overwhelmed over the recent decades by contamination from bomb-tritium from nuclear weapons testing in the early 1960s. In the Southern Hemisphere, this situation has changed now with the fading of the bomb-tritium, and tritium has become a tool for accurate groundwater dating. Tritium dating will become efficient also in the Northern Hemisphere over the next decade. Plotting hydrochemistry and field parameters versus groundwater age allowed us to identify those parameters that have increasing concentrations with age and are therefore from geological sources. These indicators for natural groundwater evolution are: Na, HCO3, SiO2, F, PO4, the redox-sensitive elements and compounds Fe, Mn, NH4, CH4, and pH and conductivity. In young groundwater that was recharged after the intensification of agriculture, nitrate, sulphate, CFC-11 and CFC-12, and pesticides are the most representative indicators for the impact of land-use intensification on groundwater quality, with 66% of the sites showing such an impact. Elevated concentrations of nitrate in oxic groundwater allowed us to reconstruct the timing and magnitude of the impact of land-use intensification on groundwater which in New Zealand occurred in two stages. Old pristine groundwater reflects the natural baseline quality. A transition to slightly elevated concentration due to low-intensity land-use was observed in groundwater recharged since around 1880. A sharp increase in nitrate and other agrochemicals due to high-intensity agriculture was observed in groundwater recharged since 1955. The threshold concentrations that distinguish natural baseline quality water from low-intensity land-use water, and low-intensity from high intensity land-use water, are 0.25 and 2.5 mg/L NO3-N, respectively. The change in groundwater quality from pristine baseline to low-intensity impact around 1880 coincides with the start of the meat export industry. The change in groundwater quality from low to high intensity landuse impact around 1955 coincides with the start of industrialised agriculture. No elevated levels of phosphate, a main compound in agricultural fertilisers and, together with nitrogen, a trigger of algae blooms in lakes, were found in young groundwater. This implies that fertiliser phosphate from non-point sources is still retained in the soil and has not yet reached the saturated groundwater systems. The source of elevated PO4, observed only in old groundwater, is therefore due purely to natural geochemical factors.
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Marinova, Milka; Rauch, Maximilian; Mücke, Martin; Rolke, Roman; Gonzalez-Carmona, Maria A; Henseler, Jana; Cuhls, Henning; Radbruch, Lukas; Strassburg, Christian P; Zhang, Lian; Schild, Hans H; Strunk, Holger M
2016-11-01
Prognosis of patients with locally advanced pancreatic adenocarcinoma is extremely poor. They often suffer from cancer-related pain reducing their quality of life. This prospective observational study aimed to evaluate feasibility, local tumour response, and changes in quality of life and symptoms in Caucasian patients with locally advanced pancreatic cancer treated by ultrasound-guided high-intensity focused ultrasound (HIFU). Thirteen patients underwent HIFU, five with stage III, eight with stage IV UICC disease. Ten patients received simultaneous palliative chemotherapy. Postinterventional clinical assessment included evaluation of quality of life and symptom changes using standardized questionnaires. CT and MRI follow-up evaluated the local tumour response. HIFU was successfully performed in all patients. Average tumour reduction was 34.2 % at 6 weeks and 63.9 % at 3 months. Complete or partial relief of cancer-related pain was achieved in 10 patients (77 %), five of whom required less analgesics for pain control. Quality of life was improved revealing increased global health status and alleviated symptoms. HIFU treatment was well tolerated. Eight patients experienced transient abdominal pain directly after HIFU. HIFU ablation of pancreatic carcinoma is a feasible, safe and effective treatment with a crucial benefit in terms of reduction of tumour volume and pain intensity. • US-guided HIFU is feasible and safe for patients with unresectable pancreatic cancer. • HIFU can considerably reduce tumour volume and cancer-related pain. • Patients treated with HIFU experienced significant and lasting reduction of pain intensity. • HIFU has a crucial clinical benefit for patients with pancreatic cancer.
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Effect of intense short rainfall events on coastal water quality parameters from remote sensing data
NASA Astrophysics Data System (ADS)
Corbari, Chiara; Lassini, Fabio; Mancini, Marco
2016-07-01
Strong rainfall events, especially during summer, in small river basins cause spills in the sea that often compromise the quality of coastal waters. The goal of this paper is then to study the changes of coastal waters quality as a result of intense rainfall events during the bathing season through the use of remote sensing data. These analyses are performed at the outlets of small watersheds which are not usually affected by high sediment transport as in the case of large basins which are persistently affected by intense solid transport which does not allow retrieving a reliable correlation between rainfall events and water quality parameters. Four small watersheds in different Italian regions on the Mediterranean Sea are selected for this study. The remotely sensed parameters of turbidity, total suspend solids and secchi disk depth, are retrieved from MODIS data. Secchi disk depths are also compared to available ground data during the summer seasons between 2003 and 2006 showing good correlations. Then the spatial and temporal changes of these parameters are analyzed after intense short storm events. Increases of turbidity and total suspend solids are found to be around 35 NTU and 20 mg L-1 respectively depending on the intensity of the rainfall event and on the distance from the shoreline. Moreover the recovery of water quality after the rain event is reached after two or three days.
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[Update: studies in intensive care medicine. Results of the last 12 months].
Knapp, J; Marx, G; Weismüller, K; Steinebach, S; Lichtenstern, C; Popp, E; Mayer, K; Brunkhorst, F M; Weigand, M A; Bernhard, M
2011-11-01
Intensive care medicine plays an important role in the medical care of patients as well as the economic success of hospitals. Knowledge and implementation of recent relevant scientific evidence are prerequisites for high quality care in intensive care medicine. The aim of this review is to present an overview of the most important publications in intensive care medicine published in 2010 and the first half of the year 2011 and to comment on their attributable clinical relevance for intensive care practitioners. In 2010 and up to June 2011 many studies with high patient numbers have been published. The main topics were the treatment of respiratory failure, sepsis and investigations to improve analgosedation.
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Sano, Tomohito; Horie, Hideki; Matsunaga, Akiko; Hirono, Yuhei
2018-05-02
Use of covering cultivation to shade tea (Camellia sinensis L.) trees to produce high-quality, high-priced green tea has recently increased in Japan. Knowledge of shading effects on morphological and color traits, and chemical components of new tea shoots is important for product quality and productivity. We assessed these traits of tea shoots and their relationships under covering cultivation of various radiation intensities. Leaf thickness, LMA (leaf mass per area), and leaf density of new tea leaves were smaller under covering culture than under open-field culture. SPAD values and chlorophyll contents were larger under covering culture than under open culture. The derived exponential equation for estimating chlorophyll contents from SPAD values was improved by considering leaf thickness. Covering culture decreased EC (epicatechin) and EGC (epigallocatechin) contents, and increased theanine and caffeine contents. Principal component analysis on shoot and leaf traits indicated that LMA, and chlorophyll, EC, and EGC contents were strongly associated with shading effects. Morphological and color traits, and chemical components of new tea shoots and leaves varied depending on radiation intensity, shoot growth, and cropping season. These findings are useful for covering cultivation with high quality and high productivity in tea gardens. This article is protected by copyright. All rights reserved.
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NASA Astrophysics Data System (ADS)
Nakasu, Taizo; Sun, W.; Kobayashi, M.; Asahi, T.
2017-06-01
Zinc telluride layers were grown on highly-lattice-mismatched sapphire substrates by molecular beam epitaxy, and their crystallographic properties were studied by means of X-ray diffraction pole figures. The crystal quality of the ZnTe thin film was further studied by scanning electron microscopy, X-ray rocking curves and low-temperature photoluminescence measurements. These methods show that high-crystallinity (111)-oriented single domain ZnTe layers with the flat surface and good optical properties are realized when the beam intensity ratio of Zn and Te beams is adjusted. The migration of Zn and Te was inhibited by excess surface material and cracks were appeared. In particular, excess Te inhibited the formation of a high-crystallinity ZnTe film. The optical properties of the ZnTe layer revealed that the exciton-related features were dominant, and therefore the film quality was reasonably high even though the lattice constants and the crystal structures were severely mismatched.
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Comparative Analysis of Reconstructed Image Quality in a Simulated Chromotomographic Imager
2014-03-01
quality . This example uses five basic images a backlit bar chart with random intensity, 100 nm separation. A total of 54 initial target...compared for a variety of scenes. Reconstructed image quality is highly dependent on the initial target hypercube so a total of 54 initial target...COMPARATIVE ANALYSIS OF RECONSTRUCTED IMAGE QUALITY IN A SIMULATED CHROMOTOMOGRAPHIC IMAGER THESIS
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Recruiting High Quality Students through a Fifth Year Program: It Can Be Done.
ERIC Educational Resources Information Center
James, Terry L.; And Others
This paper describes the process of recruiting high quality liberal arts graduates into teacher preparation programs at Memphis State University, Tennessee. The two graduate programs, the Master of Arts in Teaching and the Lyndhurst, both require full-time attendance, have lock-step delivery systems and extended internships, and are intensive. In…
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Bacteriological water quality of Tulpehocken Creek basin, Berks and Lebanon Counties, Pennsylvania
Barker, James L.
1978-01-01
A four month intensive study of the bacteriological quality of water in the Tulpehocken Creek basin indicates that (1) the streams locally contain high densities of bacteria indicative of fecal contamination, (2) nonpoint waste sources, particularly livestock, are the dominant influence in the excessive bacteriological-indicator counts observed, and (3) retention time of water in the proposed Blue Marsh Lake is believed sufficient to reduce bacteria densities to acceptable levels except following intense rainfall and runoff events during normally low flow periods.
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A Novel Combination of Thermal Ablation and Heat-Inducible Gene Therapy for Breast Cancer Treatment
2008-04-01
focused ultrasound ( HIFU ) thermal ablation and HIFU -induced gene therapy represents a promising approach in improving the overall efficacy and quality...STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT High intensity focused ultrasound ...al., High intensity focused ultrasound -induced gene activation in solid tumors. Journal of the Acoustical Society of America, 2006. 120(1): p. 492
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Yang, Feng; Fan, Yuanfang; Wu, Xiaoling; Cheng, Yajiao; Liu, Qinlin; Feng, Lingyang; Chen, Junxu; Wang, Zhonglin; Wang, Xiaochun; Yong, Taiwen; Liu, Weiguo; Liu, Jiang; Du, Junbo; Shu, Kai; Yang, Wenyu
2018-01-01
The intensity and quality (red to far-red (R/Fr) ratio) of light directly affect growth of plant under shading. Gibberellins (GAs) and auxin [indole-3-acetic acid (IAA)] play important roles in mediating the shading adaptive responses of plants. Thus, the intensity and quality of the uncoupling light from shading were assessed to identify the influence of each component on the morphology and matter distribution of the leaf, stem, and petiole. This assessment was based on the changes in endogenous Gibberellin 1 (GA1) and IAA levels. Soybean plants were grown in a growth chamber with four treatments [normal (N), N+Fr, low (L), and L+Fr light]. Results revealed that the reductions in photosynthetically active radiation (PAR) and R/Fr ratio equally increased height and stem mass fractions (SMFs) of the soybean seedling. The light intensity significantly influenced the dry mass per unit area and mass fraction of soybean leaves, whereas the light quality regulated the petiole elongation and mass fraction. Low R/Fr ratio (high Fr light) increased the soybean biomass by improving the photosynthetic assimilation rate and quantum yield of photosystem II. In addition, the IAA and GA1 levels in the leaf, stem, and petiole did not reflect the growth response trends of each tissue toward light intensity and quality; however, trends of the IAA-to-GA1 content ratios were similar to those of the growth and matter allocation of each soybean tissue under different light environments. Therefore, the response of growth and matter allocation of soybean to light intensity and quality may be regulated by the IAA-to-GA1 content ratio in the tissues of the soybean plant. PMID:29441084
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[Assessment of farmland soil quality under different utilization intensity in arid area].
Gui, Dong-Wei; Mu, Gui-Jin; Lei, Jia-Qiang; Zeng, Fan-Jiang; Wang, Hui
2009-04-01
Based on the 2005-2007 experimental data in Cele oasis in the southern margin of Tarim Basin of Xinjiang, the soil quality of four typical types of farmland with different utilization intensity, i.e., farmland with high input, farmland with normal input, newly reclaimed farmland, and farmland in oasis' interior, was analyzed and assessed by using sustainable yield index, soil improvement index, and soil quality synthesis index. Among the farmlands, there were significant differences in the contents of soil organic matter, available nitrogen, and available phosphorus. Newly reclaimed farmland had the lowest level of soil quality, while the farmland in oasis' interior had relatively higher soil quality. This study could help the reasonable exploitation and utilization of farmlands in Cele oasis, and the protection of local farmland eco-environment.
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Yoon, Jean; Chang, Evelyn; Rubenstein, Lisa V; Park, Angel; Zulman, Donna M; Stockdale, Susan; Ong, Michael K; Atkins, David; Schectman, Gordon; Asch, Steven M
2018-06-05
Primary care models that offer comprehensive, accessible care to all patients may provide insufficient resources to meet the needs of patients with complex conditions who have the greatest risk for hospitalization. To assess whether augmenting usual primary care with team-based intensive management lowers utilization and costs for high-risk patients. Randomized quality improvement trial. (ClinicalTrials.gov: NCT03100526). 5 U.S. Department of Veterans Affairs (VA) medical centers. Primary care patients at high risk for hospitalization who had a recent acute care episode. Locally tailored intensive management programs providing care coordination, goals assessment, health coaching, medication reconciliation, and home visits through an interdisciplinary team, including a physician or nurse practitioner, a nurse, and psychosocial experts. Utilization and costs (including intensive management program expenses) 12 months before and after randomization. 2210 patients were randomly assigned, 1105 to intensive management and 1105 to usual care. Patients had a mean age of 63 years and an average of 7 chronic conditions; 90% were men. Of the patients assigned to intensive management, 487 (44%) received intensive outpatient care (that is, ≥3 encounters in person or by telephone) and 204 (18%) received limited intervention. From the pre- to postrandomization periods, mean inpatient costs decreased more for the intensive management than the usual care group (-$2164 [95% CI, -$7916 to $3587]). Outpatient costs increased more for the intensive management than the usual care group ($2636 [CI, $524 to $4748]), driven by greater use of primary care, home care, telephone care, and telehealth. Mean total costs were similar in the 2 groups before and after randomization. Sites took up to several months to contact eligible patients, limiting the time between treatment and outcome assessment. Only VA costs were assessed. High-risk patients with access to an intensive management program received more outpatient care with no increase in total costs. Veterans Health Administration Primary Care Services.
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Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act
Logani, Sachin; Green, Adam; Gasperino, James
2011-01-01
The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU) are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees) and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform. PMID:22110908
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Sehatzadeh, S
2015-01-01
Background After stroke, impairment of the upper and lower limb can limit patients’ motor function and ability to perform activities of daily living (ADL). Physiotherapy (PT) is an established clinical practice for stroke patients, playing an important role in improving limb function. Recently, several randomized trials have evaluated the effect of higher-intensity physiotherapy (increased duration and/or frequency) on patients’ functional ability. Objectives Our objective is to investigate whether an increased intensity of PT after stroke results in better outcomes for patients. Data Sources A literature search was performed on June 7, 2013, for English-language randomized controlled trials published from January 1, 2003, to June 7, 2013. Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews were searched. Review Methods We reviewed the full text of articles that compared 2 or more levels of PT intensity. Outcomes of interest included motor function, ADL, and quality of life (QOL). Results High-quality evidence showed that higher-intensity upper-limb PT and higher-intensity lower-limb PT both resulted in significantly greater improvements in motor function. Moderate-quality evidence showed that higher-intensity general PT did not. Moderate-quality evidence showed a significant improvement in ADL performance with higher-intensity upper-limb PT, but no improvement with higher-intensity general PT; no studies reported on ADL outcomes on lower-limb PT specifically. According to moderate-quality evidence, patient QOL did not change significantly after increased intensity of upper-limb, lower-limb, or general PT. When considering the results, one difference should be noted: Compared with the studies examining upper- and lower-limb PT, the studies examining general PT looked at a smaller increase—2 hours or less of additional therapy per week. Limitations This analysis is limited to the earlier post-stroke phase and is not equipped to comment on expected outcomes of later-stage PT. Conclusions Overall, this analysis found support for the use of more intensive PT to improve motor function and ability to perform ADL after stroke. PMID:26356355
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NASA Technical Reports Server (NTRS)
Cornwell, Donald M., Jr.; Saif, Babak N.
1991-01-01
The spatial pointing angle and far field beamwidth of a high-power semiconductor laser are characterized as a function of CW power and also as a function of temperature. The time-averaged spatial pointing angle and spatial lobe width were measured under intensity-modulated conditions. The measured pointing deviations are determined to be well within the pointing requirements of the NASA Laser Communications Transceiver (LCT) program. A computer-controlled Mach-Zehnder phase-shifter interferometer is used to characterize the wavefront quality of the laser. The rms phase error over the entire pupil was measured as a function of CW output power. Time-averaged measurements of the wavefront quality are also made under intensity-modulated conditions. The measured rms phase errors are determined to be well within the wavefront quality requirements of the LCT program.
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Ramirez-Campillo, Rodrigo; Diaz, Daniela; Martinez-Salazar, Cristian; Valdés-Badilla, Pablo; Delgado-Floody, Pedro; Méndez-Rebolledo, Guillermo; Cañas-Jamet, Rodrigo; Cristi-Montero, Carlos; García-Hermoso, Antonio; Celis-Morales, Carlos; Moran, Jason; Buford, Thomas W; Rodriguez-Mañas, Leocadio; Alonso-Martinez, Alicia M; Izquierdo, Mikel
2016-01-01
Objective This study aimed to compare the effects of two frequencies of high-speed resistance training (HSRT) on physical performance and quality of life of older women. Methods A total of 24 older women participated in a 12-week HSRT program composed of either two or three sessions/week (equated for volume and intensity). Women were randomized into three arms: a control group (CG, n=8), a resistance training group performing two sessions/week (RT2, n=8), and a resistance training group performing three sessions/week (RT3, n=8). The training program for both experimental groups included exercises that required high-speed concentric muscle actions. Results No baseline differences were observed among groups. Compared with the CG, both training groups showed similar small to moderate improvements (P<0.05) in muscle strength, power, functional performance, balance, and quality of life. Conclusion These results suggest that equated for volume and intensity, two and three training sessions/week of HSRT are equally effective for improving physical performance and quality of life of older women. PMID:28008239
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Ramirez-Campillo, Rodrigo; Diaz, Daniela; Martinez-Salazar, Cristian; Valdés-Badilla, Pablo; Delgado-Floody, Pedro; Méndez-Rebolledo, Guillermo; Cañas-Jamet, Rodrigo; Cristi-Montero, Carlos; García-Hermoso, Antonio; Celis-Morales, Carlos; Moran, Jason; Buford, Thomas W; Rodriguez-Mañas, Leocadio; Alonso-Martinez, Alicia M; Izquierdo, Mikel
2016-01-01
This study aimed to compare the effects of two frequencies of high-speed resistance training (HSRT) on physical performance and quality of life of older women. A total of 24 older women participated in a 12-week HSRT program composed of either two or three sessions/week (equated for volume and intensity). Women were randomized into three arms: a control group (CG, n=8), a resistance training group performing two sessions/week (RT2, n=8), and a resistance training group performing three sessions/week (RT3, n=8). The training program for both experimental groups included exercises that required high-speed concentric muscle actions. No baseline differences were observed among groups. Compared with the CG, both training groups showed similar small to moderate improvements ( P <0.05) in muscle strength, power, functional performance, balance, and quality of life. These results suggest that equated for volume and intensity, two and three training sessions/week of HSRT are equally effective for improving physical performance and quality of life of older women.
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Propagation of rotational Risley-prism-array-based Gaussian beams in turbulent atmosphere
NASA Astrophysics Data System (ADS)
Chen, Feng; Ma, Haotong; Dong, Li; Ren, Ge; Qi, Bo; Tan, Yufeng
2018-03-01
Limited by the size and weight of prism and optical assembling, Rotational Risley-prism-array system is a simple but effective way to realize high power and superior beam quality of deflecting laser output. In this paper, the propagation of the rotational Risley-prism-array-based Gaussian beam array in atmospheric turbulence is studied in detail. An analytical expression for the average intensity distribution at the receiving plane is derived based on nonparaxial ray tracing method and extended Huygens-Fresnel principle. Power in the diffraction-limited bucket is chosen to evaluate beam quality. The effect of deviation angle, propagation distance and intensity of turbulence on beam quality is studied in detail by quantitative simulation. It reveals that with the propagation distance increasing, the intensity distribution gradually evolves from multiple-petal-like shape into the pattern that contains one main-lobe in the center with multiple side-lobes in weak turbulence. The beam quality of rotational Risley-prism-array-based Gaussian beam array with lower deviation angle is better than its counterpart with higher deviation angle when propagating in weak and medium turbulent (i.e. Cn2 < 10-13m-2/3), the beam quality of higher deviation angle arrays degrades faster as the intensity of turbulence gets stronger. In the case of propagating in strong turbulence, the long propagation distance (i.e. z > 10km ) and deviation angle have no influence on beam quality.
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[Objective study of the voice quality following partial laryngectomy].
Remacle, M; Millet, B
1991-01-01
The high resolution frequency analyzer is used for the study of the vocal quality after partial laryngectomy. The post-operative plot after speech therapy is of good quality when respecting one vocal fold. On the contrary, the heard vocal sound does not correspond to the harmonics of the fundamental frequency but to intense noise from irregular vibrations of the residual laryngeal mucosa (ventricular folds, arytenoids). High resolution frequency analysis contributes to the follow-up of the partial laryngectomy.
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[Quality management in intensive care medicine].
Martin, J; Braun, J-P
2014-02-01
Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to external quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.
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[Quality management in intensive care medicine].
Martin, J; Braun, J-P
2013-09-01
Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.
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Zaenker, Pierre; Favret, Fabrice; Lonsdorfer, Evelyne; Muff, Guillaume; de Seze, Jérôme; Isner-Horobeti, Marie-Eve
2018-02-01
Numerous studies have shown that mild-to-moderate intensity or resistance exercise training improves physical capacities such as, peak oxygen consumption, maximal tolerated power and strength in multiple sclerosis patients. However, few studies have evaluated the effects of high-intensity interval training (HIIT) associated to with resistance training. Only few studies have analyzed difference between men and women before and after combined training. Moreover, the evaluation of exercise between ambulatory multiple sclerosis patients without disability (Expanded Disability Status Score [EDSS] 0-3) and patients with disabilities (EDSS 3.5-5) was not largely published. The main objective of our study was to determine if HIIT combined with resistance training improved aerobic and strength capacities as well as quality of life in multiple sclerosis patients and if gender and disabilities play a role in these changes. This study was an open-label uncontrolled study. The study was performed outside from conventional care facilities and including homebased training. Twenty-six multiple sclerosis patients have completed the program (19 women, 7 men; mean age 44.6±7.9 years, EDSS 2 [0-5]). We conducted a 12-week program of high-intensity interval training combined with resistance training at body weight. Peak oxygen consumption, maximal tolerated power, lactates, isokinetic strength of quadriceps and hamstrings (at 90°/s, 180°/s, and 240°/s) and quality of life were evaluated before and after the program. Peak oxygen consumption and maximum tolerated power improved by 13.5% and 9.4%, respectively. Isokinetic muscle strength increased in both quadriceps and hamstrings at each speed, with a rebalancing of strength between the two legs in quadriceps. Quality of life was also enhanced in three domains. Women showed better improvements than men in V̇O2peak, maximal tolerated power, lactates at the end of test, and heart rate peak, strength in both quadriceps and hamstrings mostly at low speed, and quality of life. The two EDSS groups increased V̇O2peak and strength. Our study has shown that HIIT combined with resistance exercise training induced an improvement in physical capacity and quality of life. Moreover, this study allowed patients, irrespective of their sex or EDSS score, to resume exercise autonomously. The results of the study showed that aerobic training at moderate intensity is not the single type of training tolerated by multiple sclerosis patients. High-intensity interval training is well tolerated too and can be used in clinical rehabilitation with resistance training, in both men and women with and without disabilities.
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ERIC Educational Resources Information Center
Scott, Patricia A.
This study compared students' learning experiences in a set of courses in British literature and a set of courses in marketing, in which each set included a course taught in an intensive format and a semester-long format with the same instructor and content. Data collection included participant observation, videotaped class sessions,…
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The synergistic effect of manure supply and extreme precipitation on surface water quality
NASA Astrophysics Data System (ADS)
Motew, Melissa; Booth, Eric G.; Carpenter, Stephen R.; Chen, Xi; Kucharik, Christopher J.
2018-04-01
Over-enrichment of phosphorus (P) in agroecosystems contributes to eutrophication of surface waters. In the Midwest US and elsewhere, climate change is increasing the frequency of high-intensity precipitation events, which can serve as a primary conduit of P transport within watersheds. Despite uncertainty in their estimates, process-based watershed models are important tools that help characterize watershed hydrology and biogeochemistry and scale up important mechanisms affecting water quality. Using one such model developed for an agricultural watershed in Wisconsin, we conducted a 2 × 2 factorial experiment to test the effects of (high/low) terrestrial P supply (PSUP) and (high/low) precipitation intensity (PREC) on surface water quality. Sixty-year simulations were conducted for each of the four runs, with annual results obtained for watershed average P yield and concentration at the field scale (220 × 220 m grid cells), P load and concentration at the stream scale, and summertime total P concentration (TP) in Lake Mendota. ANOVA results were generated for the 2 × 2 factorial design, with PSUP and PREC treated as categorical variables. The results showed a significant, positive interaction (p < 0.01) between the two drivers for dissolved P concentration at the field and stream scales, and total P concentration at the field, stream, and lake scales. The synergy in dissolved P was linked to nonlinear dependencies between P stored in manure and the daily runoff to rainfall ratio. The synergistic response of dissolved P loss may have important ecological consequences because dissolved P is highly bioavailable. Overall, the results suggest that high levels of terrestrial P supplied as manure can exacerbate water quality problems in the future as the frequency of high-intensity rainfall events increases with a changing climate. Conversely, lowering terrestrial manure P supply may help improve the resilience of surface water quality to extreme events.
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NASA Astrophysics Data System (ADS)
Bauer, Thomas; Strauss, Peter; Stiper, Katrin; Klipa, Vladimir; Popescu, Daniela; Winter, Silvia; Zaller, Johann G.
2016-04-01
Successful viticulture is mainly influenced by soil and climate. The availability of water during the growing season highly influences wine quality and quantity. To protect soil from being eroded most of the winegrowers keep the inter row zones of the vineyards green. Greening also helps to provide water-stress to the grapes for harvesting high quality wines. However, these greening strategies concerning the intensity of inter row management differ from farm to farm and are mainly based on personal experience of the winegrowers. However to what extent different inter row management practices affect soil physical properties are not clearly understood yet. To measure possible effects of inter row management in vineyards on soil physical parameters we selected paired vineyards with different inter row management in Austria and Romania. In total more than 7000 soil analysis were conducted for saturated and unsaturated hydraulic conductivity, soil water retention, water stable aggregates, total organic carbon, cation exchange capacity, potassium, phosphorous, soil texture, bulk density and water infiltration. The comparison between high intensity management with at least one soil disturbance per year, medium intensity with one soil disturbance every second inter row per year and low intensity management with no soil disturbance since at least 5 years indicates that investigated soil physical properties did not improve for the upper soil layer (3-8cm). This is in contrast to general perceptions of improved soil physical properties due to low intensity of inter row management, i.e. permanent vegetated inter rows. This may be attributed to long term and high frequency mechanical stress by agricultural machinery in inter rows.
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Liquid Metal Engineering by Application of Intensive Melt Shearing
NASA Astrophysics Data System (ADS)
Patel, Jayesh; Zuo, Yubo; Fan, Zhongyun
In all casting processes, liquid metal treatment is an essential step in order to produce high quality cast products. A new liquid metal treatment technology has been developed which comprises of a rotor/stator set-up that delivers high shear rate to the liquid melt. It generates macro-flow in a volume of melt for distributive mixing and intensive shearing for dispersive mixing. The high shear device exhibits significantly enhanced kinetics for phase transformations, uniform dispersion, distribution and size reduction of solid particles and gas bubbles, improved homogenisation of chemical composition and temperature fields and also forced wetting of usually difficult-to-wet solid particles in the liquid metal. Hence, it can benefit various casting processes to produce high quality cast products with refined microstructure and enhanced mechanical properties. Here, we report an overview on the application of the new high shear technology to the processing of light metal alloys.
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Effects of stress management program on the quality of nursing care and intensive care unit nurses
Pahlavanzadeh, Saied; Asgari, Zohreh; Alimohammadi, Nasrollah
2016-01-01
Background: High level of stress in intensive care unit nurses affects the quality of their nursing care. Therefore, this study aimed to determine the effects of a stress management program on the quality of nursing care of intensive care unit nurses. Materials and Methods: This study is a randomized clinical trial that was conducted on 65 nurses. The samples were selected by stratified sampling of the nurses working in intensive care units 1, 2, 3 in Al-Zahra Hospital in Isfahan, Iran and were randomly assigned to two groups. The intervention group underwent an intervention, including 10 sessions of stress management that was held twice a week. In the control group, placebo sessions were held simultaneously. Data were gathered by demographic checklist and Quality Patient Care Scale before, immediately after, and 1 month after the intervention in both groups. Then, the data were analyzed by Student's t-test, Mann–Whitney, Chi-square, Fisher's exact test, and analysis of variance (ANOVA) through SPSS software version 18. Results: Mean scores of overall and dimensions of quality of care in the intervention group were significantly higher immediately after and 1 month after the intervention, compared to pre-intervention (P < 0.001). The results showed that the quality of care in the intervention group was significantly higher immediately after and 1 month after the intervention, compared to the control group (P < 0.001). Conclusions: As stress management is an effective method to improve the quality of care, the staffs are recommended to consider it in improvement of the quality of nursing care. PMID:27186196
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O'Connor, Elizabeth A; Lin, Jennifer S; Burda, Brittany U; Henderson, Jillian T; Walsh, Emily S; Whitlock, Evelyn P
2014-12-16
Sexually transmitted infections (STIs) are common and preventable. To update a previous systematic review about the benefits and harms of sexual risk-reduction counseling to prevent STIs for the U.S. Preventive Services Task Force. Selected databases from January 2007 through October 2013, manual searches of references lists and gray literature, and studies from the previous review. English-language fair- or good-quality trials conducted in adolescents or adults. One investigator abstracted data and a second checked the abstraction. Study quality was dual-reviewed. 31 trials were included: 16 (n=56,110) were newly published and 15 (n=14,214) were from the previous review. Most trials targeted persons at increased risk for STIs based on sociodemographic characteristics, risky sexual behavior, or history of an STI. High-intensity (>2 hours) interventions reduced STI incidence in adolescents (odds ratio, 0.38 [95% CI, 0.24 to 0.60]) and adults (odds ratio, 0.70 [CI, 0.56 to 0.87]). Lower-intensity interventions were generally not effective in adults, but some approaches were promising. Although moderate-intensity interventions may be effective in adolescents, data were very sparse. Reported behavioral outcomes were heterogeneous and most likely to show a benefit with high-intensity interventions at 6 months or less. No consistent evidence was found that sexual risk-reduction counseling was harmful. Low-risk populations and male adolescents were underrepresented. Reliability of self-reported behavioral outcomes was unknown. High-intensity counseling on sexual risk reduction can reduce STIs in primary care and related settings, especially in sexually active adolescents and in adults at increased risk for STIs. Agency for Healthcare Research and Quality.
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NASA Astrophysics Data System (ADS)
Guo, Pengfei; Shen, Xia; Zhang, Baolong; Sun, Haibin; Zou, Zhijun; Yang, Wenchao; Gong, Ke; Luo, Yongsong
2018-05-01
A simple two-step CVD method is developed to realize the growth of high-quality tin-catalyzed CdSSe alloy nanowires. Microstructural characterizations demonstrate that these wires are high-quality crystalline nanostructures. Local photoluminescence investigation of these nanostructures shows a typical band edge emission at 656 nm with a full-width at half-maximum of 22.3 nm. Optical waveguide measurement along an individual nanowire indicates that the output signal of the guided light has a rapid linear decrease accompanied with maximum red-shift about 109 meV after the transmission of 102 μm. This obvious red-shift is caused by the intensive band-tail absorption during the optical transmission process. Moreover, optically pumped nanolasers are successfully realized at room temperature based on these unique wires, further demonstrating the achievement of stimulated emission from spontaneous emission, promoted by the pump power intensity. This work may find a simple route to the manufacture of superior nanowires for applications in waveguide and integrated photonic devices.
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Guo, Pengfei; Shen, Xia; Zhang, Baolong; Sun, Haibin; Zou, Zhijun; Yang, Wenchao; Gong, Ke; Luo, Yongsong
2018-05-04
A simple two-step CVD method is developed to realize the growth of high-quality tin-catalyzed CdSSe alloy nanowires. Microstructural characterizations demonstrate that these wires are high-quality crystalline nanostructures. Local photoluminescence investigation of these nanostructures shows a typical band edge emission at 656 nm with a full-width at half-maximum of 22.3 nm. Optical waveguide measurement along an individual nanowire indicates that the output signal of the guided light has a rapid linear decrease accompanied with maximum red-shift about 109 meV after the transmission of 102 μm. This obvious red-shift is caused by the intensive band-tail absorption during the optical transmission process. Moreover, optically pumped nanolasers are successfully realized at room temperature based on these unique wires, further demonstrating the achievement of stimulated emission from spontaneous emission, promoted by the pump power intensity. This work may find a simple route to the manufacture of superior nanowires for applications in waveguide and integrated photonic devices.
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Correlation of neonatal intensive care unit performance across multiple measures of quality of care.
Profit, Jochen; Zupancic, John A F; Gould, Jeffrey B; Pietz, Kenneth; Kowalkowski, Marc A; Draper, David; Hysong, Sylvia J; Petersen, Laura A
2013-01-01
To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Twenty-two regional NICUs in California. In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Pneumothorax, growth velocity, health care-associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations, 6 were significant (ρ < .05). Correlations between pairs of measures of quality of care were strong (ρ ≥ .5) for 1 pair, moderate (range, ρ ≥ .3 to ρ < .5) for 8 pairs, weak (range, ρ ≥ .1 to ρ < .3) for 5 pairs, and negligible (ρ < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care-associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest.
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Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care
Profit, J; Zupancic, JAF; Gould, JB; Pietz, K; Kowalkowski, MA; Draper, D; Hysong, SJ; Petersen, LA
2014-01-01
Objectives To examine whether high performance on one measure of quality is associated with high performance on others and to develop a data-driven explanatory model of neonatal intensive care unit (NICU) performance. Design We conducted a cross-sectional data analysis of a statewide perinatal care database. Risk-adjusted NICU ranks were computed for each of 8 measures of quality selected based on expert input. Correlations across measures were tested using the Pearson correlation coefficient. Exploratory factor analysis was used to determine whether underlying factors were driving the correlations. Setting Twenty-two regional NICUs in California. Patients In total, 5445 very low-birth-weight infants cared for between January 1, 2004, and December 31, 2007. Main Outcomes Measures Pneumothorax, growth velocity, health care–associated infection, antenatal corticosteroid use, hypothermia during the first hour of life, chronic lung disease, mortality in the NICU, and discharge on any human breast milk. Results The NICUs varied substantially in their clinical performance across measures of quality. Of 28 unit-level correlations only 6 were significant (P < .05). Correlations between pairs of quality measures were strong (ρ > .5) for 1 pair, moderate (.3 < |ρ| < .5) for 8 pairs, weak (.1 < |ρ| < .3) for 5 pairs and negligible (|ρ| < .1) for 14 pairs. Exploratory factor analysis revealed 4 underlying factors of quality in this sample. Pneumothorax, mortality in the NICU, and antenatal corticosteroid use loaded on factor 1; growth velocity and health care–associated infection loaded on factor 2; chronic lung disease loaded on factor 3; and discharge on any human breast milk loaded on factor 4. Conclusion In this sample, the ability of individual measures of quality to explain overall quality of neonatal intensive care was modest. PMID:23403539
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Naef, Rahel; Hediger, Hannele; Imhof, Lorenz; Mahrer-Imhof, Romy
2017-06-01
To determine subgroups of family carers based on family relational and caregiving variables and to explore group differences in relation to selected carer outcomes. Family caregiving in later life holds a myriad of positive and negative outcomes for family members' well-being. However, factors that constitute family carers' experience and explain variances are less well understood. A secondary data analysis using cross-sectional data from a controlled randomised trial with community-dwelling people 80 years or older and their families. A total of 277 paired data sets of older persons and their family carers were included into the analysis. Data were collected via mailed questionnaires and a geriatric nursing assessment. A two-step cluster analysis was performed to determine subgroups. To discern group differences, appropriate tests for differences with Bonferroni correction were used. Two family carer groups were identified. The low-intensity caregiver group (57% of carers) reported high relationship quality and self-perceived ease of caregiving. In contrast, the high-intensity caregiver group (43% of carers) experienced significantly lower relationship quality, felt less prepared and appraised caregiving as more difficult, time intensive and burdensome. The latter cared for older, frailer and more dependent octogenarians and had significantly lower levels of quality of life and self-perceived health compared to the low-intensity caregiver group. A combination of family relational and caregiving variables differentiates those at risk for adverse outcomes. Family carers of frailer older people tend to experience higher strain, lower relationship quality and ability to work together as a family. Nurses should explicitly assess family carer needs, in particular when older persons are frail. Family carer support interventions should address caregiving preparedness, demand and burden, as well as concerns situated in the relationship. © 2016 John Wiley & Sons Ltd.
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ERIC Educational Resources Information Center
Webb, Andrea S.; Wong, Tracy J.; Hubball, Harry T.
2013-01-01
Research-intensive universities around the world are increasingly drawing upon leading practitioners in professional fields as adjunct faculty to deliver high quality student learning experiences in diverse undergraduate and graduate program contexts. To support effective professional development in these contexts, many universities have developed…
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NASA Astrophysics Data System (ADS)
Liu, Xiao-Di; Xu, Lu; Liang, Xiao-Yan
2017-01-01
We theoretically analyzed output beam quality of broad bandwidth non-collinear optical parametric chirped pulse amplification (NOPCPA) in LiB3O5 (LBO) centered at 800 nm. With a three-dimensional numerical model, the influence of the pump intensity, pump and signal spatial modulations, and the walk-off effect on the OPCPA output beam quality are presented, together with conversion efficiency and the gain spectrum. The pump modulation is a dominant factor that affects the output beam quality. Comparatively, the influence of signal modulation is insignificant. For a low-energy system with small beam sizes, walk-off effect has to be considered. Pump modulation and walk-off effect lead to asymmetric output beam profile with increased modulation. A special pump modulation type is found to optimize output beam quality and efficiency. For a high-energy system with large beam sizes, the walk-off effect can be neglected, certain back conversion is beneficial to reduce the output modulation. A trade-off must be made between the output beam quality and the conversion efficiency, especially when the pump modulation is large since. A relatively high conversion efficiency and a low output modulation are both achievable by controlling the pump modulation and intensity.
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Read-across predictions require high quality measured data for source analogues. These data are typically retrieved from structured databases, but biomedical literature data are often untapped because current literature mining approaches are resource intensive. Our high-throughpu...
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Schmitt, Joachim; Lindner, Nathalie; Reuss-Borst, Monika; Holmberg, Hans-Christer; Sperlich, Billy
2016-02-01
To compare the effects of a 3-week multimodal rehabilitation involving supervised high-intensity interval training (HIIT) on female breast cancer survivors with respect to key variables of aerobic fitness, body composition, energy expenditure, cancer-related fatigue, and quality of life to those of a standard multimodal rehabilitation program. A randomized controlled trial design was administered. Twenty-eight women, who had been treated for cancer were randomly assigned to either a group performing exercise of low-to-moderate intensity (LMIE; n = 14) or a group performing high-intensity interval training (HIIT; n = 14) as part of a 3-week multimodal rehabilitation program. No adverse events related to the exercise were reported. Work economy improved following both HIIT and LMIE, with improved peak oxygen uptake following LMIE. HIIT reduced mean total body fat mass with no change in body mass, muscle or fat-free mass (best P < 0.06). LMIE increased muscle and total fat-free body mass. Total energy expenditure (P = 0.45) did not change between the groups, whereas both improved quality of life to a similar high extent and lessened cancer-related fatigue. This randomized controlled study demonstrates that HIIT can be performed by female cancer survivors without adverse health effects. Here, HIIT and LMIE both improved work economy, quality of life and cancer-related fatigue, body composition or energy expenditure. Since the outcomes were similar, but HIIT takes less time, this may be a time-efficient strategy for improving certain aspects of the health of female cancer survivors. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
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Garrido, José L; Brunet, Christophe; Rodríguez, Francisco
2016-12-01
Many studies on photoacclimation examine the pigment responses to changes in light intensity, but variations in light climate in the aquatic environment are also related to changes in spectral composition. We have employed a high-performance liquid chromatography method with improved resolution towards chlorophyll c and fucoxanthin-related xanthophylls to examine the pigment composition of Emiliania huxleyi CCMP 370 under different light intensities and spectral qualities. To maintain its photosynthetic performance, E. huxleyi CCMP370 promotes drastic pigment changes that can be either the interconversion of pigments in pools with the same basic chromophoric structure (Fucoxanthin type or chlorophyll c type), or the ex novo synthesis (Diatoxanthin). These changes are linked either to variations in light quality (Fucoxanthin related xanthophylls) or in light intensity (chlorophyll c 3 /Monovinyl chlorophyll c 3 , Diadinoxanthin/Diatoxanthin, β,ɛ-carotene/ β,β-carotene). Fucoxanthin and 19'-hexanoyloxyfucoxanthin proportions were highly dependent on spectral conditions. Whereas Fucoxanthin dominated in green and red light, 19'-hexanoyloxyfucoxanthin prevailed under blue spectral conditions. Our results suggest that the huge pigment diversity enhanced the photoacclimative capacities of E. huxleyi to efficiently perform under changing light environments. The ubiquity and success in the global ocean as well as the capacity of E. huxleyi to form large surface blooms might be associated to the plasticity described here. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.
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Claydon, Leica S; Chesterton, Linda S; Barlas, Panos; Sim, Julius
2011-09-01
To determine the hypoalgesic effects of transcutaneous electrical nerve stimulation (TENS) parameter combinations on experimental models in healthy humans. Searches were performed using the electronic databases Ovid MEDLINE, CINAHL, AMED, and Web of Science (from inception to December 2009). Manual searches of journals and reference lists of retrieved trials were also performed. Randomized controlled trials (RCTs) were included in the review if they compared the hypoalgesic effect of TENS relative with placebo and control, using an experimental pain model in healthy human participants. Two reviewers independently selected the trials, assessed their methodologic quality and extracted data. Forty-three RCTs were eligible for inclusion. A best evidence synthesis revealed: Overall "conflicting" (inconsistent findings in multiple RCTs) evidence of TENS efficacy on experimental pain irrespective of TENS parameters used. Overall intense TENS has "moderate" evidence of efficacy (1 high-quality and 2 low-quality trials). Conventional TENS has overall conflicting evidence of efficacy, this is derived from "strong" evidence of efficacy (generally consistent findings in multiple high-quality RCTs) on pressure pain but strong evidence of inefficacy on other pain models. "Limited" evidence (positive findings from 1 RCT) of hypoalgesia exists for some novel parameters. Low-intensity, low-frequency, local TENS has strong evidence of inefficacy. Inappropriate TENS (using "barely perceptible" intensities) has moderate evidence of inefficacy. The level of hypoalgesic efficacy of TENS is clearly dependent on TENS parameter combination selection (defined in terms of intensity, frequency, and stimulation site) and experimental pain model. Future clinical RCTs may consider these TENS dose responses.
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[The future of intensive medicine].
Palencia Herrejón, E; González Díaz, G; Mancebo Cortés, J
2011-05-01
Although Intensive Care Medicine is a young specialty compared with other medical disciplines, it currently plays a key role in the process of care for many patients. Experience has shown that professionals with specific training in Intensive Care Medicine are needed to provide high quality care to critically ill patients. In Europe, important steps have been taken towards the standardization of training programs of the different member states. However, it is now necessary to take one more step forward, that is, the creation of a primary specialty in Intensive Care Medicine. Care of the critically ill needs to be led by specialists who have received specific and complete training and who have the necessary professional competences to provide maximum quality care to their patients. The future of the specialty presents challenges that must be faced with determination, with the main objective of meeting the needs of the population. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.
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Male crickets adjust ejaculate quality with both risk and intensity of sperm competition.
Simmons, Leigh W; Denholm, Amy; Jackson, Chantelle; Levy, Esther; Madon, Ewa
2007-10-22
Sperm competition theory predicts that males should increase their expenditure on the ejaculate with increasing risk of sperm competition, but decrease their expenditure with increasing intensity. There is accumulating evidence for sperm competition theory, based on examinations of testes size and/or the numbers of sperm ejaculated. However, recent studies suggest that ejaculate quality can also be subject to selection by sperm competition. We used experimental manipulations of the risk and intensity of sperm competition in the cricket, Teleogryllus oceanicus. We found that males produced ejaculates with a greater percentage of live sperm when they had encountered a rival male prior to mating. However, when mating with a female that presented a high intensity of sperm competition, males did not respond to risk, but produced ejaculates with a reduced percentage of live sperm. Our data suggest that males exhibit a fine-tuned hierarchy of responses to these cues of sperm competition.
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Liu, Xiao-Kun; Xiao, Shui-Yuan; Zhou, Liang; Hu, Mi; Zhou, Wei; Liu, Hui-Ming
2018-01-01
The aims of this study were to investigate the distribution of sleep quality and its relationship with the prevalence of pain among rural Chinese people and to explore the association between sleep quality and pain intensity among the general population in real-life settings. This cross-sectional survey included a total of 2052 adults from rural areas in Liuyang, Hunan Province, recruited through random multistage sampling. The distributions of sleep quality and pain prevalence among the participants over a 4-week period were described. Because of multicollinearity among variables, the influence of self-rated sleep quality and psychosocial covariates on pain intensity was explored using a ridge regression model. The data showed that participants reporting all categories of sleep quality experienced some degree of pain. Sleep quality, along with physical and mental health, was a negative predictor of pain intensity among the general population. Symptoms of depression positively predicted pain intensity. Poor sleep quality increased pain intensity among the participants. Both previous research and the present data suggest that improving sleep quality may significantly decrease pain intensity in the general population. The relationship between sleep and pain may be bidirectional. This finding also suggests that treatment for sleep disorders and insomnia should be addressed in future efforts to alleviate pain intensity.
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Jaureguizar, Koldobika Villelabeitia; Vicente-Campos, Davinia; Bautista, Lorena Ruiz; de la Peña, Cesar Hernández; Gómez, María José Arriaza; Rueda, María José Calero; Fernández Mahillo, Ignacio
2016-01-01
There is strong evidence that exercise training has beneficial health effects in patients with cardiovascular disease. Most studies have focused on moderate continuous training (MCT); however, a body of evidence has begun to emerge demonstrating that high-intensity interval training (HIIT) has significantly better results in terms of morbidity and mortality. The aim of this study was to compare the effects of MCT versus HIIT on functional capacity and quality of life and to assess safety. Seventy-two patients with ischemic heart disease were assigned to either HIIT or MCT for 8 weeks. We analyzed cardiopulmonary exercise test data, quality of life, and adverse events. High-intensity interval training resulted in a significantly greater increase in (Equation is included in full-text article.)O2peak (4.5 ± 4.7 mL·kg·min) compared with MCT (2.5 ± 3.6 mL·kg·min) (P < .05). The aerobic threshold (VT1) increased by 21% in HIIT and 14% in MCT. Furthermore, there was a significant (P < .05) increase in the distance covered in the 6-minute walk distance test in the HIIT group (49.6 ± 6.3 m) when compared with the MCT group (29.6 ± 12.0 m). Both training protocols improved quality of life. No adverse events were reported in either of the groups. On the basis of the results of this study, HIIT should be considered for use in cardiac rehabilitation as it resulted in a greater increase in functional capacity compared with MCT. We also observed greater improvement in quality of life without any increase in cardiovascular risk.
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Making Great Kids Greater: Easing the Burden of Being Gifted
ERIC Educational Resources Information Center
Sisk, Dorothy
2008-01-01
On the surface, gifted children may appear to be well adjusted, but they are often highly sensitive, perfectionistic, and intense. They usually have an acute awareness of moral issues, with a unique perception of themselves and others and deeper feelings at an earlier age than their peers. Because of these intense qualities, they may suffer from…
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Private Tutoring Intensity in Schools: A Comparison between High and Low Socio-Economic Schools
ERIC Educational Resources Information Center
Addi-Raccah, Audrey; Dana, Oshra
2015-01-01
Private tutoring (PT) is becoming a worldwide phenomenon. In Israel too, about a third of elementary school students participate in PT. Based on sociological and school quality considerations, we examined school characteristics that are associated with PT intensity at school. The data encompassed a random state wide sample of 389 Israeli…
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Bray J. Beltran; Devendra M. Amatya; Martin Jones; R. Wayne Skaggs; William Neal P.E. Reynolds; Timothy J. Callahan; Jami E. Nettles
2008-01-01
Intensive plantation forestry will be increasingly important in the next 50 years to meet the high demand for domestic wood in the US. However, forestry management practices can substantially influence downstream water quality and ecology. In this study, the effect of fertilization on drainage water quality of a coastal pine plantation located in Carteret County, NC...
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Bray J. Beltran; Devendra M. Amatya; Martin Jones; R. Wayne Skaggs; William Neal Reynolds; Timothy J. Callahan; Jami E. Nettles
2008-01-01
Abstract. Intensive plantation forestry will be increasingly important in the next 50 years to meet the high demand for domestic wood in the US. However, forestry management practices can substantially influence downstream water quality and ecology. In this study, the effect of fertilization on drainage water quality of a coastal pine plantation located in Carteret...
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Impacts of fertilization on water quality of a drained pine plantation: a worse case scenario
Bray J. Beltran; Devendra M. Amatya; Mohamed Youssef; Martin Jones; Timothy J. Skaggs Callahan
2010-01-01
Intensive plantation forestry will be increasingly important in the next 50 yr to meet the high demand for domestic wood in the United States. However, forest management practices can substantially infl uence downstream water quality and ecology. Th is study analyses, the eff ect of fertilization on effl uent water quality of a low gradient drained coastal pine...
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Maree, Carin; Kekana, Poppy; van der Walt, Christa; Yazbek, Mariatha; Leech, Ronell
The introduction of family-centered care in the neonatal intensive care unit was identified as a high priority to facilitate bonding and attachment with potential positive outcomes for the parents and infants. The aim of the study was, therefore, to develop and implement a quality improvement initiative to foster family-centered care in a tertiary neonatal intensive care unit from birth onward. A pretest posttest intervention design was used using mixed methods over 3 phases to determine the perceived level of family-centered care according to healthcare professionals and parents using self-administered questionnaires; to develop and implement a quality improvement initiative to enhance family-centered care in a neonatal intensive care unit using a nominal group technique, followed by the quality improvement process; and to evaluate the outcomes of the initiative by repeating the self-administered questionnaires to parents and staff. Various activities were introduced as part of the initiative such as early breastfeeding, early introduction of parents to their infant, open visitation policy, and involvement in caring activities. The perceived level of care according to staff and parents increased. It is expected to enhance bonding and attachment between the infants and their parents, with consequential long-term positive outcomes.
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Soltani, S Abolfazi; Ingolfsson, Armann; Zygun, David A; Stelfox, Henry T; Hartling, Lisa; Featherstone, Robin; Opgenorth, Dawn; Bagshaw, Sean M
2015-11-12
The matching of critical care service supply with demand is fundamental for the efficient delivery of advanced life support to patients in urgent need. Mismatch in this supply/demand relationship contributes to "intensive care unit (ICU) capacity strain," defined as a time-varying disruption in the ability of an ICU to provide well-timed and high-quality intensive care support to any and all patients who are or may become critically ill. ICU capacity strain leads to suboptimal quality of care and may directly contribute to heightened risk of adverse events, premature discharges, unplanned readmissions, and avoidable death. Unrelenting strain on ICU capacity contributes to inefficient health resource utilization and may negatively impact the satisfaction of patients, their families, and frontline providers. It is unknown how to optimally quantify the instantaneous and temporal "stress" an ICU experiences due to capacity strain. We will perform a systematic review to identify, appraise, and evaluate quality and performance measures of strain on ICU capacity and their association with relevant patient-centered, ICU-level, and health system-level outcomes. Electronic databases (i.e., MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, and the Agency of Healthcare Research and Quality (AHRQ) - National Quality Measures Clearinghouse (NQMC)) will be searched for original studies of measures of ICU capacity strain. Selected gray literature sources will be searched. Search themes will focus on intensive care, quality, operations management, and capacity. Analysis will be primarily narrative. Each identified measure will be defined, characterized, and evaluated using the criteria proposed by the US Strategic Framework Board for a National Quality Measurement and Reporting System (i.e., importance, scientific acceptability, usability, feasibility). Our systematic review will comprehensively identify, define, and evaluate quality and performance measures of ICU capacity strain. This is a necessary step towards understanding the impact of capacity strain on quality and performance in intensive care and to develop innovative interventions aimed to improve efficiency, avoid waste, and better anticipate impending capacity shortfalls. PROSPERO, CRD42015017931.
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NASA Astrophysics Data System (ADS)
Lemaire, Gilles; Gastal, François; Franzluebbers, Alan; Chabbi, Abad
2015-11-01
A need to increase agricultural production across the world to ensure continued food security appears to be at odds with the urgency to reduce the negative environmental impacts of intensive agriculture. Around the world, intensification has been associated with massive simplification and uniformity at all levels of organization, i.e., field, farm, landscape, and region. Therefore, we postulate that negative environmental impacts of modern agriculture are due more to production simplification than to inherent characteristics of agricultural productivity. Thus by enhancing diversity within agricultural systems, it should be possible to reconcile high quantity and quality of food production with environmental quality. Intensification of livestock and cropping systems separately within different specialized regions inevitably leads to unacceptable environmental impacts because of the overly uniform land use system in intensive cereal areas and excessive N-P loads in intensive animal areas. The capacity of grassland ecosystems to couple C and N cycles through microbial-soil-plant interactions as a way for mitigating the environmental impacts of intensive arable cropping system was analyzed in different management options: grazing, cutting, and ley duration, in order to minimize trade-offs between production and the environment. We suggest that integrated crop-livestock systems are an appropriate strategy to enhance diversity. Sod-based rotations can temporally and spatially capture the benefits of leys for minimizing environmental impacts, while still maintaining periods and areas of intensive cropping. Long-term experimental results illustrate the potential of such systems to sequester C in soil and to reduce and control N emissions to the atmosphere and hydrosphere.
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Lemaire, Gilles; Gastal, François; Franzluebbers, Alan; Chabbi, Abad
2015-11-01
A need to increase agricultural production across the world to ensure continued food security appears to be at odds with the urgency to reduce the negative environmental impacts of intensive agriculture. Around the world, intensification has been associated with massive simplification and uniformity at all levels of organization, i.e., field, farm, landscape, and region. Therefore, we postulate that negative environmental impacts of modern agriculture are due more to production simplification than to inherent characteristics of agricultural productivity. Thus by enhancing diversity within agricultural systems, it should be possible to reconcile high quantity and quality of food production with environmental quality. Intensification of livestock and cropping systems separately within different specialized regions inevitably leads to unacceptable environmental impacts because of the overly uniform land use system in intensive cereal areas and excessive N-P loads in intensive animal areas. The capacity of grassland ecosystems to couple C and N cycles through microbial-soil-plant interactions as a way for mitigating the environmental impacts of intensive arable cropping system was analyzed in different management options: grazing, cutting, and ley duration, in order to minimize trade-offs between production and the environment. We suggest that integrated crop-livestock systems are an appropriate strategy to enhance diversity. Sod-based rotations can temporally and spatially capture the benefits of leys for minimizing environmental impacts, while still maintaining periods and areas of intensive cropping. Long-term experimental results illustrate the potential of such systems to sequester C in soil and to reduce and control N emissions to the atmosphere and hydrosphere.
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A novel type of very long baseline astronomical intensity interferometer
NASA Astrophysics Data System (ADS)
Borra, Ermanno F.
2013-12-01
This article presents a novel type of very long baseline astronomical interferometer that uses the fluctuations, as a function of time, of the intensity measured by a quadratic detector, which is a common type of astronomical detector. The theory on which the technique is based is validated by laboratory experiments. Its outstanding principal advantages comes from the fact that the angular structure of an astronomical object is simply determined from the visibility of the minima of the spectrum of the intensity fluctuations measured by the detector, as a function of the frequency of the fluctuations, while keeping the spacing between mirrors constant. This would allow a simple setup capable of high angular resolutions because it could use an extremely large baseline. Another major interest is that it allows for a more efficient use of telescope time because observations at a single baseline are sufficient, while amplitude and intensity interferometers need several observations at different baselines. The fact that one does not have to move the telescopes would also allow detecting faster time variations because having to move the telescopes sets a lower limit to the time variations that can be detected. The technique uses wave interaction effects and thus has some characteristics in common with intensity interferometry. A disadvantage of the technique, like in intensity interferometry, is that it needs strong sources if observing at high frequencies (e.g. the visible). This is a minor disadvantage in the radio region. At high frequencies, this disadvantage is mitigated by the fact that, like in intensity interferometry, the requirements of the optical quality of the mirrors used are far less severe than in amplitude interferometry so that poor quality large reflectors (e.g. Cherenkov telescopes) can be used in the optical region.
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Sosnovik, David E; Dai, Guangping; Nahrendorf, Matthias; Rosen, Bruce R; Seethamraju, Ravi
2007-08-01
To evaluate the use of a transmit-receive surface (TRS) coil and a cardiac-tailored intensity-correction algorithm for cardiac MRI in mice at 9.4 Tesla (9.4T). Fast low-angle shot (FLASH) cines, with and without delays alternating with nutations for tailored excitation (DANTE) tagging, were acquired in 13 mice. An intensity-correction algorithm was developed to compensate for the sensitivity profile of the surface coil, and was tailored to account for the unique distribution of noise and flow artifacts in cardiac MR images. Image quality was extremely high and allowed fine structures such as trabeculations, valve cusps, and coronary arteries to be clearly visualized. The tag lines created with the surface coil were also sharp and clearly visible. Application of the intensity-correction algorithm improved signal intensity, tissue contrast, and image quality even further. Importantly, the cardiac-tailored properties of the correction algorithm prevented noise and flow artifacts from being significantly amplified. The feasibility and value of cardiac MRI in mice with a TRS coil has been demonstrated. In addition, a cardiac-tailored intensity-correction algorithm has been developed and shown to improve image quality even further. The use of these techniques could produce significant potential benefits over a broad range of scanners, coil configurations, and field strengths. (c) 2007 Wiley-Liss, Inc.
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Danner, Lukas; Ristic, Renata; Johnson, Trent E; Meiselman, Herbert L; Hoek, Annet C; Jeffery, David W; Bastian, Susan E P
2016-11-01
This study investigated the effect of different contexts on consumers' mood, product-evoked emotions, liking and willingness to pay for wine. Three consumer trials (n=114, 115, and 120) examined 3 different sample sets of 4 Australian commercial Shiraz wines. Each sample set was comprised of a high, medium-high, medium-low and low quality wine as designated by an expert panel. Wine consumers evaluated the same set of wines in the three different contexts, ranging from a highly-controlled laboratory setting to more realistic restaurant and at-home settings. Results showed that high quality wines were liked more and elicited more intense emotions of positive valence compared to wines of lower quality. Context effects were observed on emotions, but not on liking, indicating that although emotions and liking are correlated, the measurement of emotions can deliver additional information over liking. Tasting wine in the restaurant context evoked more intense positive emotions compared to the home and laboratory contexts. Participants' mood before tasting the wines had a strong influence on consecutive product-evoked emotion ratings, but only weak influence on liking ratings. Furthermore, a strong relationship between wine-evoked emotions and willingness to pay was observed, showing that if a wine-evoked more intense emotion of positive valence e.g., contented, enthusiastic, happy, optimistic and passionate participants were willing to pay significantly more for a bottle. Additionally, the absence of negative emotions, even if typically evoked to a very weak extent, is a requirement for an increased willingness to pay. This study indicates it is worthwhile to consider context and emotions in wine testing and marketing. Copyright © 2016 Elsevier Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
Gómez-Paccard, M.; Chauvin, A.; Lanos, P.; Dufresne, P.; Kovacheva, M.; Hill, M. J.; Beamud, E.; Gutiérrez-Lloret, S.; Cañavate, V.; Blain, S.; Bouvier, A.; Oberlin, C.; Guibert, P.; Sapin, C.; Pringent, D.
2011-12-01
Available European data indicate that during the past 2500 years there have been periods of rapid intensity geomagnetic fluctuations interspersed with periods of little change. The challenge now is to precisely describe these rapid changes. The aim of this study is to obtain an improved description of the sharp geomagnetic intensity change that took place in Western Europe around 800 yrs AD as well as to investigate if this peak is observed at a continental scale. For this purpose 13 precisely dated early medieval Spanish pottery fragments, 4 archeological French kilns and a 3 collections of bricks used for the construction of different historical buildings from France and with ages ranging between 330 to 1290 AD have been studied. The material collected has been dated by archeological/historical constraints together with radiocarbon,thermoluminiscence (TL) and archeomagentic analysis. From classical Thellier experiments including TRM anisotropy and cooling rate corrections upon archeointensity estimates and conducted on 164 specimens (119 of them giving reliable results) ten new high-quality mean intensities have been obtained. The new intensity data together with a selection of the most reliable data from Western Europe have been relocated to the latitude of Paris and confirm the existence of an intensity maxima of ~85 μT centred at ~850 AD and related to intensity changes up to 20 μT per century. The results also indicate that a previous abrupt intensity change (reaching a maximum value of ~ 90 μT) took place in Western Europe around 650 AD. A selection of high-quality intensity data from Bulgaria, Italy and Greece indicate a very similar intensity trend for Eastern Europe. Although available data indicate that the duration of such periods of high intensities may be of less than one century more data are needed to infer the exact duration of these maximums. A comparison between the selected data and regional and global geomagnetic field models indicates that such models fail to reproduce the detailed evolution of geomagnetic intensity changes. These results highlight the need of new reliable and precisely dated archeointensity data if a refined description of geomagnetic field changes wants to be obtained.
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Kurosaki, Yoshitaka; Yoshida, Kazumichi; Fukuda, Hitoshi; Handa, Akira; Chin, Masaki; Yamagata, Sen
2017-01-01
Intraplaque hemorrhage, detected as a high-signal intensity on carotid MRI, is also strongly associated with ischemic events in symptomatic patients. However, in asymptomatic patients, the relationship of the T1-high intense plaque and the subsequent stroke is not clear. The aim of this study is to test the hypothesis that asymptomatic carotid T1-high intense plaque is a risk factor for a subsequent cerebrovascular ischemic event. Of the 1,353 consecutive patients, who underwent head and carotid MRI as part of their annual medical check-up, the imaging quality of 13 was poor and 150 did not present for follow-up examination, thus leaving 1,190 subjects for evaluation. Of the 1,190 patients, 96 patients had findings of high-signal intensity on carotid MRI and 1,094 patients did not. Cerebrovascular events were retrospectively evaluated. During a mean follow-up period of 53 months, 4 patients with high-signal intensities on carotid MRI (4%) and 3 with no findings (0.3%) had a cerebrovascular ischemic event, with the occurrences significantly higher in the high-signal-intensity group. (p < 0.01) Cox regression analysis indicated that the presence of the high-intense plaque on carotid MRI (hazard ratio [HR] 4.2; 95% CI 1.0-17.1; p = 0.04), age (HR 1.1; 95% CI 1.0-1.2; p = 0.003), and diabetes mellitus (HR 7.2; 95% CI 1.8-27.4; p = 0.004) were associated with the occurrence of subsequent ischemic cerebrovascular events. Asymptomatic carotid T1-high-intense plaque might be a potential high-risk factor for a subsequent cerebrovascular ischemic event. © 2017 S. Karger AG, Basel.
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Stalpers, Dewi; Van Der Linden, Dimitri; Kaljouw, Marian J; Schuurmans, Marieke J
2017-06-01
To examine nurse-perceived quality of care, controlling for overall job satisfaction among critical care nurses and to explore associations with work environment characteristics. Nurse-perceived quality of care and job satisfaction have been positively linked to quality outcomes for nurses and patients. Much evidence exists on factors contributing to job satisfaction. Understanding specific factors that affect nurse-perceived quality potentially enables for improvements of nursing care quality. A multicentre survey study was conducted in three Dutch intensive care units. The Dutch version of the Essentials of Magnetism II questionnaire was used; including the single-item indicators: (i) nurse-perceived quality of care; (ii) overall job satisfaction; and (iii) 58 statements on work environments. Data were collected between October 2013 - June 2014. The majority of 123 responding nurses (response rate 45%) were more than satisfied with quality of care (55%) and with their job (66%). No associations were found with nurse characteristics, besides differences in job satisfaction between the units. After controlling for job satisfaction, nurse-perceived quality was positively associated with the work environment characteristics: adequacy of staffing, patient-centeredness, competent peers and support for education. Patient-centeredness and autonomy were the most important predictors for overall job satisfaction. Factors that contribute to nurse-perceived quality of care in intensive care units, independent from the effects of overall job satisfaction, were identified. Hereby, offering opportunities to maximize high quality of care to critically ill patients. Research in a larger sample is needed to confirm our findings. © 2016 John Wiley & Sons Ltd.
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Scaling up Quality in Early Childhood Programs: New Jersey's Story
ERIC Educational Resources Information Center
Lauter, Nancy; Rice, Cynthia
2008-01-01
Preschool systems changed significantly in New Jersey in 1998 when the State's Supreme Court required the poorest school districts to implement high quality, intensive preschool programs for all three- and four-year-olds. Since the first year of implementation in 1999, New Jersey's Abbott districts have been providing preschoolers with access to…
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Quality of life in long-term survivors of intensive care.
Buckley, T A; Cheng, A Y; Gomersall, C D
2001-05-01
Traditionally, outcome from intensive care has focused on mortality. The cost of intensive care and the limited resources devoted to patients who have a poor prognosis also raises questions about the utilisation of such resources. There is increasing pressure for outcome evaluation of intensive care to incorporate assessment of long-term survival and the quality of life in survivors. The principal objectives of this article were to examine current methods of assessing quality of life measures in critically ill patients surviving intensive care and to determine the quality of life of these survivors. Direct and computerised search of published research articles. Measurement of quality of life after intensive care is not common practice. There is a lack of consensus concerning appropriate measuring instruments to be used and how best to interpret results. Despite the availability of general outcome tools and disease specific instruments, there is a paucity of studies in the literature which include assessments of quality of life following intensive care unit (ICU) care. Generic health indices suggest that the quality of life in ICU survivors is acceptable though in certain sub-groups, e.g. adult respiratory distress syndrome and sepsis, quality of life may be moderately impaired. ICU survivors appear to suffer less disability than chronic physical disease patients. Assessment of outcome after intensive care should include health related quality of life measurements. A unifying framework is required to enhance communication between clinicians, administrators and investigators of quality of life research and also to enable more rational and effective decision making at the bedside. Patients who survive intensive care appear to enjoy a reasonable standard of quality of life. While their health status may not be as good, subjectively patients find this acceptable.
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Measuring technical efficiency of output quality in intensive care units.
Junoy, J P
1997-01-01
Presents some examples of the implications derived from imposing the objective of maximizing social welfare, subject to limited resources, on ethical care patients management in respect of quality performance of health services. Conventional knowledge of health economics points out that critically ill patients are responsible for increased use of technological resources and that they receive a high proportion of health care resources. Attempts to answer, from the point of view of microeconomics, the question: how do we measure comparative efficiency in the management of intensive care units? Analyses this question through data from an international empirical study using micro-economic measures of productive efficiency in public services (data envelopment analysis). Results show a 28.8 per cent level of technical inefficiency processing data from 25 intensive care units in the USA.
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Rensen, Ans; van Mol, Margo M; Menheere, Ilse; Nijkamp, Marjan D; Verhoogt, Ellen; Maris, Bea; Manders, Willeke; Vloet, Lilian; Verharen, Lisbeth
2017-01-24
The quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient's relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index 'Relatives in Intensive Care Unit' (CQI 'R-ICU'). The CQI 'R-ICU' measures the perceived quality of care from the perspective of patients' relatives, and identifies aspects of care that need improvement. The CQI 'R-ICU' was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients' relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis. Twelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire's vocabulary. The response rate of patients' relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: 'Communication' (α = .80) and 'Participation' (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients' relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and involvement in decision-making on the medical treatment of the patient. The CQI 'R-ICU' evaluates quality of care from the perspective of relatives of intensive care patients and provides practical information for quality assurance and improvement programs. The development and psychometric evaluation of the CQI 'R-ICU' led to a draft questionnaire, sufficient to justify further research into the reliability, validity, and the discriminative power of the questionnaire.
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Blinova, E G; Kuchma, V R
2012-01-01
Socioeconomic transformations and the poor environment of an industrial megalopolis negatively affected quality of life and morbidity rates in students (n = 2160). Academic intensity contributed to an increase in overall morbidity and morbidity from nervous system involvement. The regional sociohygienic monitoring of high-school training conditions within the framework of the surveillance system substantiates programs to prevent worse health and life quality in high school students.
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Paul P. Kormanik; Shi-Jean S. Sung; Taryn L. Kormanik; Stanley J. Zarnoch; Scott E. Schlarbaum; Tom Tibbs
2002-01-01
There is intense concern among forest resource managers about the rapid decline in the northern red oak (NRO) component of high quality mesic sites throughout the United States. Currently this versatile oak species, so important for its lumber value as well as its dietary staple status for hundreds of wildlife species, is being replaced by hardwood species that lack...
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34 CFR 200.56 - Definition of “highly qualified teacher.”
Code of Federal Regulations, 2011 CFR
2011-07-01
... areas of the basic elementary school curriculum; or (3) At the public middle and high school levels, demonstrate a high level of competency by— (i) Passing a rigorous State test in each academic subject in which... teacher— (1) Receives high-quality professional development that is sustained, intensive, and classroom...
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34 CFR 200.56 - Definition of “highly qualified teacher.”
Code of Federal Regulations, 2014 CFR
2014-07-01
... areas of the basic elementary school curriculum; or (3) At the public middle and high school levels, demonstrate a high level of competency by— (i) Passing a rigorous State test in each academic subject in which... teacher— (1) Receives high-quality professional development that is sustained, intensive, and classroom...
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34 CFR 200.56 - Definition of “highly qualified teacher.”
Code of Federal Regulations, 2010 CFR
2010-07-01
... areas of the basic elementary school curriculum; or (3) At the public middle and high school levels, demonstrate a high level of competency by— (i) Passing a rigorous State test in each academic subject in which... teacher— (1) Receives high-quality professional development that is sustained, intensive, and classroom...
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34 CFR 200.56 - Definition of “highly qualified teacher.”
Code of Federal Regulations, 2012 CFR
2012-07-01
... areas of the basic elementary school curriculum; or (3) At the public middle and high school levels, demonstrate a high level of competency by— (i) Passing a rigorous State test in each academic subject in which... teacher— (1) Receives high-quality professional development that is sustained, intensive, and classroom...
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34 CFR 200.56 - Definition of “highly qualified teacher.”
Code of Federal Regulations, 2013 CFR
2013-07-01
... areas of the basic elementary school curriculum; or (3) At the public middle and high school levels, demonstrate a high level of competency by— (i) Passing a rigorous State test in each academic subject in which... teacher— (1) Receives high-quality professional development that is sustained, intensive, and classroom...
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Protecting the source: Tools to evaluate fuel treatment cost vs. water quality protection
Brian Cooke; William Elliot; Mary Ellen Miller; Mark Finney; Matthew Thompson
2016-01-01
High-intensity wildfires are one of the leading causes of severe soil erosion in western U.S. watersheds. This erosion can lead to disruptive deposits of sediment in reservoirs and water supply systems. Fuel treatments such as controlled burns and forest thinning can reduce wildfire intensity and help preserve topsoil. But while these treatments are generally...
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Zhu, Jing; Zhu, Hui; Mei, Zhechuan; Jin, Chengbing; Ran, Lifeng; Zhou, Kun; Yang, Wei; Zhang, Lian; She, Chaokun
2013-10-01
The purpose of this work was to preliminarily investigate the efficacy and safety of high-intensity focused ultrasound treatment of hepatocellular carcinoma and hypersplenism. Nine patients with hepatocellular carcinoma complicated by hypersplenism (5 male and 4 female; median age, 56 years; range, 51-66 years) were treated with ultrasound-guided high-intensity focused ultrasound. Complications were recorded. Laboratory examination and magnetic resonance imaging were used to evaluate the efficacy. After high-intensity focused ultrasound treatment, mean spleen ablation ± SD of 28.76% ± 6.1% was discovered; meanwhile, the white blood cell count, platelet count, and liver function of the patients were substantially improved during the follow-up period. In addition, symptoms such as epistaxis and gingival bleeding were ameliorated or even eliminated, and the quality of life was improved. Follow-up imaging showed a nonperfused volume in the spleen and an absence of a tumor blood supply at the treated lesions in the liver. For the first time to our knowledge, high-intensity focused ultrasound ablation was used to treat hepatocellular carcinoma complicated by hypersplenism. High-intensity focused ultrasound may be an effective and safe alternative for treatment of hepatocellular carcinoma complicated by hypersplenism, but further studies are necessary to clarify the mechanisms.
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Enhanced proton acceleration by intense laser interaction with an inverse cone target
NASA Astrophysics Data System (ADS)
Bake, Muhammad Ali; Aimidula, Aimierding; Xiaerding, Fuerkaiti; Rashidin, Reyima
2016-08-01
The generation and control of high-quality proton bunches using focused intense laser pulse on an inverse cone target is investigated with a set of particle-in-cell simulations. The inverse cone is a high atomic number conical frustum with a thin solid top and open base, where the laser impinges onto the top surface directly, not down the open end of the cone. Results are compared with a simple planar target, where the proton angular distribution is very broad because of transverse divergence of the electromagnetic fields behind the target. For a conical target, hot electrons along the cone wall surface induce a transverse focusing sheath field. This field can effectively suppress the spatial spreading of the protons, resulting in a high-quality small-emittance, low-divergence proton beam. A slightly lower proton beam peak energy than that of a conventional planar target was also found.
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Enhanced proton acceleration by intense laser interaction with an inverse cone target
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bake, Muhammad Ali; Aimidula, Aimierding, E-mail: amir@mail.bnu.edu.cn; Xiaerding, Fuerkaiti
The generation and control of high-quality proton bunches using focused intense laser pulse on an inverse cone target is investigated with a set of particle-in-cell simulations. The inverse cone is a high atomic number conical frustum with a thin solid top and open base, where the laser impinges onto the top surface directly, not down the open end of the cone. Results are compared with a simple planar target, where the proton angular distribution is very broad because of transverse divergence of the electromagnetic fields behind the target. For a conical target, hot electrons along the cone wall surface inducemore » a transverse focusing sheath field. This field can effectively suppress the spatial spreading of the protons, resulting in a high-quality small-emittance, low-divergence proton beam. A slightly lower proton beam peak energy than that of a conventional planar target was also found.« less
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Cuffney, T.F.; Meador, M.R.; Porter, S.D.; Gurtz, M.E.
2000-01-01
The condition of 25 stream sites in the Yakima River Basin, Washington, were assessed by the U.S. Geological Survey's National Water-Quality Assessment Program. Multimetric condition indices were developed and used to rank sites on the basis of physical, chemical, and biological characteristics. These indices showed that sites in the Cascades and Eastern Cascades ecoregions were largely unimpaired. In contrast, all but two sites in the Columbia Basin ecoregion were impaired, some severely. Agriculture (nutrients and pesticides) was the primary factor associated with impairment and all impaired sites were characterized by multiple indicators of impairment. All indices of biological condition (fish, invertebrates, and algae) declined as agricultural intensity increased. The response exhibited by invertebrates and algae suggested a threshold response with conditions declining precipitously at relatively low levels of agricultural intensity and little response at moderate to high levels of agricultural intensity. This pattern of response suggests that the success of mitigation will vary depending upon where on the response curve the mitigation is undertaken. Because the form of the community condition response is critical to effective water-quality management, the National Water-Quality Assessment Program is conducting studies to examine the response of biota to gradients of land-use intensity and the relevance of these responses to water-quality management. These land-use gradient pilot studies will be conducted in several urban areas starting in 1999.
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NASA Astrophysics Data System (ADS)
Martinsen, V.; Mulder, J.; Austrheim, G.; Mysterud, A.
2009-04-01
Summer farming in mountain areas of Norway (e.g. livestock grazing and logging of fire wood) has reduced during the last century; however the number of sheep stayed relatively unchanged implying a translocation of grazing impact. Herbivores may affect both vegetation dynamics and nutrient cycling. Much information exists about the impact of cession of grazing, but little is known about the ecological effect of different grazing intensities. Using a controlled grazing experiment organized as total randomized block design (starting 2001), with three levels of grazing intensities by sheep (high, low and no sheep), effects of different grazing pressure on soil organic matter (SOM) mineralization and amount and quality of POM was studied in a low alpine region of Southern Norway. In a parallel study in situ measurements were conducted to determine biomass production rate and the quality of litter input. Soil samples from the O-horizon were incubated (determining C and N mineralization) and fractionated (free light POM fraction, density <1,8 g cm-3, size 20-2000 µm). It was hypothesized that high levels of grazing would induce (1) higher C and N mineralization rates and (2) less POM, due to physical (trampling) and chemical (input of faeces and urea) impact of sheep in addition to observed changes in vegetation cover. Results indicate that the amount of POM was in the order low>no sheep>high, indicating that low grazing intensity build up a potential larger mineralizable fraction compared with high and no sheep. The C content of POM was in the order no sheep>low>high and the N content of POM in the order low>no sheep>high. The C content of POM at high grazing intensity was significantly lower than at low grazing intensity and no sheep (ns. different). The low C content of POM at high grazing intensities (but not the N content) was the main reason for the observed CN ratios of the POM fraction being lowest at high densities (no sheep>low>high). Initial analysis of C and N mineralization suggest that the amount of CO2 evolved per g soil is highest in soil samples from low grazing pressure; however respiration rates expressed per g POM do not differ between treatments. Ammonium is the dominant form of inorganic N mineralized from SOM. By contrast, there is little or no accumulation of nitrate, suggesting low nitrification potentials in these soils. Differences between treatments in the amount and quality of POM and in mineralization rates indicate that there is a non linear response of grazing activity. Thus, change in management practice may have important consequences for feedback mechanisms controlling above and below ground productivity. At the conference more data on C and N mineralization in addition to a coupled stoichiometri of selected plants and SOM will be presented.
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L-citrulline levels in watermelon cultivars from three locations
USDA-ARS?s Scientific Manuscript database
Producers of fresh fruit and vegetables face increasing production costs and more intense international market competition. Maximizing marketability by offering high quality produce that is also highly nutritious gives new market niches for some crops, such as watermelons, if appropriate germplasm ...
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Conn, Lesley Gotlib; Haas, Barbara; Cuthbertson, Brian H; Amaral, Andre C; Coburn, Natalie; Nathens, Avery B
2016-06-01
This ethnography explores communication around critically ill surgical patients in three surgical intensive care units (ICUs) in Canada. A boundary framework is used to articulate how surgeons', intensivists', and nurses' communication practices shape and are shaped by their respective disciplinary perspectives and experiences. Through 50 hours of observations and 43 interviews, these health care providers are found to engage in seven communication behaviors that either mitigate or magnify three contested symbolic boundaries: expertise, patient ownership, and decisional authority. Where these boundaries are successfully mitigated, experiences of collaborative, high-quality patient care are produced; by contrast, boundary magnification produces conflict and perceptions of unsafe patient care. Findings reveal that high quality and safe patient care are produced through complex social and cultural interactions among surgeons, intensivists, and nurses that are also expressions of knowledge and power. This enhances our understanding of why current quality improvement efforts targeting communication may be ineffective. © The Author(s) 2015.
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Yeo, Sin Yuin; Kim, Young-Sun; Lim, Hyo Keun; Rhim, Hyunchul; Jung, Sin-Ho; Hwang, Na Young
2017-12-01
To investigate the influence of a high-signal-intensity peripheral rim on T2-weighted MR images (i.e., T2-rim sign) on the immediate therapeutic responses of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. This retrospective study was approved by the institutional review board, and patient informed consent was obtained for MR-HIFU ablation. In total, 196 fibroids (diameter 6.2±2.6cm) in 123 women (age 43.4±5.0 years) who underwent MR-HIFU ablation from January 2013 to April 2016 were included. The effects of a T2-rim sign on the immediate therapeutic responses (non-perfused volume [NPV] ratio, ablation efficiency [NPV/treatment cell volume], ablation quality [grade 1-5, poor to excellent]) were investigated with univariable and multivariable analyses using generalized estimating equation (GEE) analysis. In multivariable analysis, T2 signal intensity ratio of fibroids-to-skeletal muscle, relative peak enhancement of fibroids, and subcutaneous fat thickness were also considered. The presence of a T2-rim sign significantly lowered the NPV ratio (54.0±28.0% vs. 83.7±17.7%), ablation efficiency (0.6±0.5 vs. 1.3±0.6), ablation quality (3.1±1.2 vs. 4.2±0.8), (P<0.0001). GEE analysis showed that the presence of a T2-rim sign was independently significant for ablation efficiency and ablation quality (P<0.05). Uterine fibroids with a T2-rim sign showed significantly poorer immediate therapeutic responses to MR-HIFU ablation. Copyright © 2017 Elsevier B.V. All rights reserved.
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Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R
2013-04-01
To evaluate the effect of body weight-supported progressive high-intensity locomotor training in Parkinson's disease (PD) on (1) clinical status; (2) quality of life; and (3) gait capacity. Open-label, fixed sequence crossover study. University motor control laboratory. Patients (N=13) with idiopathic PD (Hoehn and Yahr stage 2 or 3) and stable medication use. Patients completed an 8-week (3 × 1h/wk) training program on a lower-body positive-pressure treadmill. Body weight support was used to facilitate increased intensity and motor challenges during treadmill training. The training program contained combinations of (1) running and walking intervals, (2) the use of sudden changes (eg, in body weight support and speed), (3) different types of locomotion (eg, chassé, skipping, and jumps), and (4) sprints at 50 percent body weight. The Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parkinson's Disease Questionnaire-39 items (PDQ-39), and the six-minute walk test were conducted 8 weeks before and pre- and posttraining. At the end of training, statistically significant improvements were found in all outcome measures compared with the control period. Total MDS-UPDRS score changed from (mean ± 1SD) 58±18 to 47±18, MDS-UPDRS motor part score changed from 35±10 to 29±12, PDQ-39 summary index score changed from 22±13 to 13±12, and the six-minute walking distance changed from 576±93 to 637±90m. Body weight-supported progressive high-intensity locomotor training is feasible and well tolerated by patients with PD. The training improved clinical status, quality of life, and gait capacity significantly. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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Generation of monoenergetic ion beams via ionization dynamics (Conference Presentation)
NASA Astrophysics Data System (ADS)
Lin, Chen; Kim, I. Jong; Yu, Jinqing; Choi, Il Woo; Ma, Wenjun; Yan, Xueqing; Nam, Chang Hee
2017-05-01
The research on ion acceleration driven by high intensity laser pulse has attracted significant interests in recent decades due to the developments of laser technology. The intensive study of energetic ion bunches is particularly stimulated by wide applications in nuclear fusion, medical treatment, warm dense matter production and high energy density physics. However, to implement such compact accelerators, challenges are still existing in terms of beam quality and stability, especially in applications that require higher energy and narrow bandwidth spectra ion beams. We report on the acceleration of quasi-mono-energetic ion beams via ionization dynamics in the interaction of an intense laser pulse with a solid target. Using ionization dynamics model in 2D particle-in-cell (PIC) simulations, we found that high charge state contamination ions can only be ionized in the central spot area where the intensity of sheath field surpasses their ionization threshold. These ions automatically form a microstructure target with a width of few micron scale, which is conducive to generate mono-energetic beams. In the experiment of ultraintense (< 10^21 W/cm^2) laser pulses irradiating ultrathin targets each attracted with a contamination layer of nm-thickness, high quality < 100 MeV mono-energetic ion bunches are generated. The peak energy of the self-generated micro-structured target ions with respect to different contamination layer thickness is also examined This is relatively newfound respect, which is confirmed by the consistence between experiment data and the simulation results.
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A White Pine Provenance Study in the Southern Appalachians
Earl R. Sluder
1963-01-01
Intensive forest management demands high rates of return, and these are affected by such things as growth rate per acre and quality of wood produced. It is necessary therefore to use trees that grow rapidly and produce wood of the best possible quality in the specific characteristics desired. Such trees can be developed through genetic improvement of commercially...
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de Groot, L. V.; Biggin, A. J.; Dekkers, M. J.; Langereis, C. G.; Herrero-Bervera, E.
2013-01-01
The dominant dipolar component of the Earth’s magnetic field has been steadily weakening for at least the last 170 years. Prior to these direct measurements, archaeomagnetic records show short periods of significantly elevated geomagnetic intensity. These striking phenomena are not captured by current field models and their relationship to the recent dipole decay is highly unclear. Here we apply a novel multi-method archaeomagnetic approach to produce a new high-quality record of geomagnetic intensity variations for Hawaii, a crucial locality in the central Pacific. It reveals a short period of high intensity occurring ~1,000 years ago, qualitatively similar to behaviour observed 200 years earlier in Europe and 500 years later in Mesoamerica. We combine these records with one from Japan to produce a coherent picture that includes the dipole decaying steadily over the last millennium. Strong, regional, short-term intensity perturbations are superimposed on this global trend; their asynchronicity necessitates a highly non-dipolar nature. PMID:24177390
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NASA Astrophysics Data System (ADS)
Cheng, Tian-Le; Ma, Fengde D.; Zhou, Jie E.; Jennings, Guy; Ren, Yang; Jin, Yongmei M.; Wang, Yu U.
2012-01-01
Diffuse scattering contains rich information on various structural disorders, thus providing a useful means to study the nanoscale structural deviations from the average crystal structures determined by Bragg peak analysis. Extraction of maximal information from diffuse scattering requires concerted efforts in high-quality three-dimensional (3D) data measurement, quantitative data analysis and visualization, theoretical interpretation, and computer simulations. Such an endeavor is undertaken to study the correlated dynamic atomic position fluctuations caused by thermal vibrations (phonons) in precursor state of shape-memory alloys. High-quality 3D diffuse scattering intensity data around representative Bragg peaks are collected by using in situ high-energy synchrotron x-ray diffraction and two-dimensional digital x-ray detector (image plate). Computational algorithms and codes are developed to construct the 3D reciprocal-space map of diffuse scattering intensity distribution from the measured data, which are further visualized and quantitatively analyzed to reveal in situ physical behaviors. Diffuse scattering intensity distribution is explicitly formulated in terms of atomic position fluctuations to interpret the experimental observations and identify the most relevant physical mechanisms, which help set up reduced structural models with minimal parameters to be efficiently determined by computer simulations. Such combined procedures are demonstrated by a study of phonon softening phenomenon in precursor state and premartensitic transformation of Ni-Mn-Ga shape-memory alloy.
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Effects of inter row management intensity on soil physical properties in European vineyards.
NASA Astrophysics Data System (ADS)
Bauer, Thomas; Strauss, Peter; Kumpan, Monika; Guzmán, Gema; Gómez, Jose A.; Stiper, Katrin; Popescou, Daniela; Guernion, Muriel; Nicolai, Annegret; Winter, Silvia; Zaller, Johann G.
2017-04-01
Successful viticulture is mainly depending on soil, climate and management capabilities of vine growers. These factors influence on the availability of water during the growing season which in turn impacts on wine quality and quantity. To protect soil from being eroded many winegrowers try to keep the inter row zones of the vineyards green for as much time as possible. Greening also helps to provide water-stress to the grapes for harvesting high quality wines. However, the management strategies concerning the intensity of inter row management are widely different across Europe. They differ within regions, between regions and between countries and are mainly based on personal experience of the winegrowers. To measure possible effects of inter row management in vineyards on soil physical parameters we selected vineyards with different inter row management intensities in Austria, Romania, France and Spain. In total more than 700 undisturbed core samples (from 3 to 8 cm depth) out of 50 individual vineyards were analysed for saturated and unsaturated hydraulic conductivity, soil water retention, aggregate stability, total organic carbon, soil texture and bulk density. The comparison between high intensity management with at least one soil disturbance per year, medium intensity with less frequent soil disturbance and low intensity management with no soil disturbance since at least 5 years indicates that investigated soil physical properties did not necessarily improve for the upper soil layer in every region. The results indicate that the influence of long term and high frequency mechanical stress imposed on soil by use of agricultural machinery in inter rows as well as different fertilization strategies may in some cases exhibit higher impacts on soil physical properties than the different tillage strategies.
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Martinez-Calderon, Javier; Meeus, Mira; Struyf, Filip; Miguel Morales-Asencio, Jose; Gijon-Nogueron, Gabriel; Luque-Suarez, Alejandro
2018-01-01
Introduction Chronic shoulder pain is a very complex syndrome, and the mechanisms involved in its perpetuation remain unclear. Psychological factors appear to play a role in the perpetuation of symptoms in people with shoulder chronicity. The purpose of this systematic review is to examine the role of psychological factors in the perpetuation of symptoms (pain intensity and disability) in people with chronic shoulder pain. Methods and analysis A systematic search was performed on PubMed, AMED, CINAHL, PubPsych and EMBASE from inception to July 2017. Longitudinal studies with quantitative designs analysing the role of psychological factors on pain intensity, disability or both were included. The methodological quality of the included studies was evaluated with an adapted version of the Newcastle Ottawa Scale. The level of evidence per outcome was examined using the Grading of Recommendations Assessment, Development and Evaluation approach. Results A total of 27 articles were included with a sample of 11 176 people with chronic shoulder pain. The risk of bias ranges from 7/21 to 13/21 across the studies. The quality of the evidence was very low. High levels of self-efficacy, resilience and expectations of recovery were significantly associated with low levels of pain intensity and disability. Inversely, high levels of emotional distress, depressive symptoms, anxiety, preoperative concerns, fear-avoidance beliefs, somatisation and pain catastrophising were significantly associated with high levels of pain intensity and disability. Discussion Our results suggest that psychological factors may influence the perpetuation of pain intensity and disability, with very low evidence. A meta-analysis was not carried out due to the heterogeneity of the included studies so results should be interpreted with caution. PROSPERO trial registration number CRD42016036366. PMID:29654040
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Lake, Eileen T; Staiger, Douglas; Horbar, Jeffrey; Kenny, Michael J; Patrick, Thelma; Rogowski, Jeannette A
2015-01-01
Objective To determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics. Data Sources Nurse survey and VLBW infant registry data. Study Design Retrospective study of 8,252 VLBW infants in 98 Vermont Oxford Network hospital neonatal intensive care units (NICUs) nationally. NICUs were classified into three groups based on their percent of infants of black race. Two nurse-sensitive perinatal quality standards were studied: nosocomial infection and breast milk. Data Collection Primary nurse survey (N = 5,773, 77 percent response rate). Principal Findings VLBW infants born in high-black concentration hospitals had higher rates of infection and discharge without breast milk than VLBW infants born in low-black concentration hospitals. Nurse understaffing was higher and practice environments were worse in high-black as compared to low-black hospitals. NICU nursing features accounted for one-third to one-half of the hospital-level health disparities. Conclusions Poorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country. PMID:25250882
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Dynamic intensity-weighted region of interest imaging for conebeam CT
Pearson, Erik; Pan, Xiaochuan; Pelizzari, Charles
2017-01-01
BACKGROUND Patient dose from image guidance in radiotherapy is small compared to the treatment dose. However, the imaging beam is untargeted and deposits dose equally in tumor and healthy tissues. It is desirable to minimize imaging dose while maintaining efficacy. OBJECTIVE Image guidance typically does not require full image quality throughout the patient. Dynamic filtration of the kV beam allows local control of CT image noise for high quality around the target volume and lower quality elsewhere, with substantial dose sparing and reduced scatter fluence on the detector. METHODS The dynamic Intensity-Weighted Region of Interest (dIWROI) technique spatially varies beam intensity during acquisition with copper filter collimation. Fluence is reduced by 95% under the filters with the aperture conformed dynamically to the ROI during cone-beam CT scanning. Preprocessing to account for physical effects of the collimator before reconstruction is described. RESULTS Reconstructions show image quality comparable to a standard scan in the ROI, with higher noise and streak artifacts in the outer region but still adequate quality for patient localization. Monte Carlo modeling shows dose reduction by 10–15% in the ROI due to reduced scatter, and up to 75% outside. CONCLUSIONS The presented technique offers a method to reduce imaging dose by accepting increased image noise outside the ROI, while maintaining full image quality inside the ROI. PMID:27257875
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Structure of scintillations in Neptune's occultation shadow
NASA Technical Reports Server (NTRS)
Hubbard, W. B.; Lellouch, Emmanuel; Sicardy, Bruno; Brahic, Andre; Vilas, Faith
1988-01-01
An exceptionally high-quality data set from a Neptune occultation is used here to derive a number of new results about the statistical properties of the fluctuations of the intensity distribution in various parts of Neptune's occultation shadow. An approximate numerical ray-tracing model which successfully accounts for many of the qualitative aspects of the observed intensity fluctuation distribution is introduced. Strong refractive scintillation is simulated by including the effects of 'turbulence' with projected atmospheric properties allowed to vary in both the direction perpendicular and parallel to the limb, and an explicit two-dimensional picture of a typical intensity distribution throughout an occulting planet's shadow is presented. The results confirm the existence of highly anisotropic turbulence.
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Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk.
Fleg, Jerome L
2016-01-01
Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation.
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Salutary effects of high-intensity interval training in persons with elevated cardiovascular risk
Fleg, Jerome L.
2016-01-01
Although moderate-intensity continuous training (MICT) has been the traditional model for aerobic exercise training for over four decades, a growing body of literature has demonstrated equal if not greater improvement in aerobic capacity and similar beneficial effects on body composition, glucose metabolism, blood pressure, and quality of life from high-intensity interval training (HIIT). An advantage of HIIT over MICT is the shorter time required to perform the same amount of energy expenditure. The current brief review summarizes the effects of HIIT on peak aerobic capacity and cardiovascular risk factors in healthy adults and those with various cardiovascular diseases, including coronary artery disease, chronic heart failure, and post heart transplantation. PMID:27635241
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Using the Delphi method to develop nursing-sensitive quality indicators for the NICU.
Chen, Lin; Huang, Li-Hua; Xing, Mei-Yuan; Feng, Zhi-Xian; Shao, Le-Wen; Zhang, Mei-Yun; Shao, Rong-Ya
2017-02-01
To develop nursing-sensitive quality indicators consistent with current medical practices in Chinese neonatal intensive care units. The development of nursing-sensitive quality indicators has become a top priority in nursing management. To the best of our knowledge, there has been no objective, scientific and sensitive evaluation of the quality of neonatal intensive care unit nursing in China. A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of quality care in neonatal intensive care unit nursing. Based on a literature review, we identified 21 indicators of nursing-sensitive quality in the neonatal intensive care unit. Our group of 11 consultants chose 13 indicators to be discussed using the Delphi method. In October and November 2014, 39 neonatal intensive care unit experts in 18 tertiary hospitals spread across six provinces participated in two rounds of Delphi panels. Of the 13 indicators discussed, 11 were identified as indicators of nursing-sensitive quality in the neonatal intensive care unit: rate of nosocomial infections, rate of accidental endotracheal extubation, rate of errors in medication administration, rate of treatment for pain, rate of peripheral venous extravasation, rate of compliance with handwashing techniques, incidence of pressure ulcers, incidence of noise, the bed-to-care ratio, the proportion of nurses with greater than five years neonatal intensive care unit experience and incidence of retinopathy. The 11 neonatal intensive care unit nursing-sensitive indicators identified by the Delphi method integrated with basic Chinese practices provide a basis for nursing management and the monitoring of nursing quality. This study identified nursing-sensitive quality indicators for neonatal intensive care unit care that are suitable for current clinical practice in China. © 2016 John Wiley & Sons Ltd.
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Hospice Use and High-Intensity Care in Men Dying of Prostate Cancer
Bergman, Jonathan; Saigal, Christopher S.; Lorenz, Karl A.; Hanley, Janet; Miller, David C.; Gore, John L.; Litwin, Mark S.
2012-01-01
Background Hospice programs improve the quality of life and quality of death for men dying of cancer. We sought to characterize hospice use by men dying of prostate cancer and to compare the use of high-intensity care between those who did or did not enroll in hospice. Methods We used linked Surveillance, Epidemiology, and End Results–Medicare data to identify a cohort of Medicare beneficiaries who died of prostate cancer between 1992 and 2005. We created 2 multivariable logistic regression models, one to identify factors associated with hospice use and one to determine the association of hospice use with the receipt of diagnostic and interventional procedures and physician visits at the end of life. Results Of 14 521 men dying of prostate cancer, 7646 (53%) used hospice for a median of 24 days. Multivariable modeling demonstrated that African American ethnicity (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.68–0.88) and higher Charlson comorbidity index (OR, 0.49; 95% CI, 0.44–0.55) were associated with lower odds of hospice use, while having a partner (OR, 1.23; 95% CI, 1.14–1.32) and more recent year of death (OR, 1.12; 95% CI, 1.11–1.14) were associated with higher odds of hospice use. Men dying of prostate cancer who enrolled in hospice were less likely (OR, 0.82; 95% CI, 0.74–0.91) to receive high-intensity care, including intensive care unit admissions, inpatient stays, and multiple emergency department visits. Conclusions The proportion of individuals using hospice is increasing, but the timing of hospice referral remains poor. Those who enroll in hospice are less likely to receive high-intensity end-of-life care. PMID:20937914
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Eliciting the Intension of Drug Value Sets – Principles and Quality Assurance Applications
Bahr, Nathan J.; Nelson, Scott D.; Winnenburg, Rainer; Bodenreider, Olivier
2018-01-01
Value sets (VSs) used in electronic clinical quality measures are lists of codes from standard terminologies (“extensional” VSs), whose purpose (“intension”) is not always explicitly stated. We elicited the intension for the 09/01/2014 release of extensional medication value sets by comparison to drug classes from the October 2014 release of RxClass. Value sets matched drug classes if they shared common ingredients, as evidenced by Jaccard similarity score. We elicited the intension of 80 extensional value sets. The average Jaccard similarity was 0.65 for single classes and 0.80 for combination classes, with 34% (27/80) of the value sets having high similarity scores. Manual review by a pharmacist indicated 51% (41/80) of the drug classes selected as the best mapping for a value set matched the intension reflected in that value set name. This approach has the potential for facilitating the development and maintenance of medication value sets. PMID:29295218
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Heymans, Martijn W; de Vet, Henrica C W; Bongers, Paulien M; Knol, Dirk L; Koes, Bart W; van Mechelen, Willem
2006-05-01
Randomized controlled trial. To compare high- and low-intensity back schools with usual care in occupational health care. The content and intensity of back schools vary widely and the methodologic quality of randomized controlled trials is generally weak. Until now, no back school has proven to be superior for workers sick-listed because of subacute nonspecific low back pain. Workers (n = 299) sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain were recruited by the occupational physician and randomly assigned to a high-intensity back school, a low-intensity back school, or care as usual. Outcome measures were days until return to work, total days of sick-leave, pain, functional status, kinesiophobia, and perceived recovery and were assessed at baseline and at 3 and 6 months of follow-up. Principal analyses were performed according to the intention-to-treat principle. We randomly allocated 299 workers. Workers in the low-intensity back school returned to work faster compared with usual care and the high-intensity back school, with hazard ratios of 1.4 (P = 0.06) and 1.3 (P = 0.09), respectively. The comparison between high-intensity back school and usual care resulted in a hazard ratio of 1.0 (P = 0.83). The median number of sick-leave days was 68, 75, and 85 in the low-intensity back school, usual care, and high-intensity back school, respectively. Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school. No substantial differences on pain and perceived recovery were found between groups. The low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up.
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Physical qualities and activity profiles of sub-elite and recreational Australian football players.
Stein, Josh G; Gabbett, Tim J; Townshend, Andrew D; Dawson, Brian T
2015-11-01
To investigate the relationship between physical qualities and match activity profiles of recreational Australian football players. Prospective cohort study. Forty players from three recreational Australian football teams (Division One, Two and Three) underwent a battery of fitness tests (vertical jump, 10 and 40 m sprint, 6 m × 30 m repeated sprint test, Yo-Yo intermittent recovery level Two and 2-km time trial). The activity profiles of competitive match-play were quantified using 10-Hz Global Positioning System units. Division One players possessed greater maximum velocity, Yo-Yo level Two and 2-km time trial performances than Division Two and Three players. In addition, Division One players covered greater relative distance, and relative distances at moderate- and high-intensities during match-play than Division Two and Three players. Division Two players had better 2-km time trial performances than Division Three players. Positive associations (P < 0.05) were found between 10 m acceleration, maximum velocity, Yo-Yo level Two and 2-km time trial performances and relative distance, and relative distances covered at moderate- and high-intensities during match-play. Moderate relationships were found between vertical jump and relative distance and high-intensity running. Sub-elite Australian football players competing at a higher level exhibit greater physical qualities and match-play activity profiles than lesser-skilled recreational players. Acceleration and maximum velocity, 2-km time trial and Yo-Yo level Two performances discriminate between players of different playing levels, and are related to physical match performance in recreational Australian football. The development of these qualities is likely to contribute to improved match performance in recreational Australian football players. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
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Wang, Qian; Zhang, Qionghua; Dzakpasu, Mawuli; Lian, Bin; Wu, Yaketon; Wang, Xiaochang C
2018-03-01
Stormwater particles washed from road-deposited sediments (RDS) are traditionally characterized as either turbidity or total suspended solids (TSS). Although these parameters are influenced by particle sizes, neither of them characterizes the particle size distribution (PSD), which is of great importance in pollutant entrainment and treatment performance. Therefore, the ratio of turbidity to TSS (Tur/TSS) is proposed and validated as a potential surrogate for the bulk PSD and quality of stormwater runoff. The results show an increasing trend of Tur/TSS with finer sizes of both RDS and stormwater runoff. Taking heavy metals (HMs, including Cu, Pb, Zn, Cr, and Ni) as typical pollutants in stormwater runoff, the concentrations (mg/kg) were found to vary significantly during rainfall events and tended to increase significantly with Tur/TSS. Therefore, Tur/TSS is a valid parameter to characterize the PSD and quality of stormwater. The high negative correlations between Tur/TSS and rainfall intensity demonstrate that stormwater with higher Tur/TSS generates under low intensity and, thus, characterizes small volume, finer sizes, weak settleability, greater mobility, and bioavailability. Conversely, stormwater with lower Tur/TSS generates under high intensity and, thus, characterizes large volume, coarser sizes, good settleability, low mobility, and bioavailability. These results highlight the need to control stormwater with high Tur/TSS. Moreover, Tur/TSS can aid the selection of stormwater control measures with appropriate detention storage, pollution loading, and removal effectiveness of particles.
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Habchi, Baninia; Alves, Sandra; Jouan-Rimbaud Bouveresse, Delphine; Appenzeller, Brice; Paris, Alain; Rutledge, Douglas N; Rathahao-Paris, Estelle
2018-01-01
Due to the presence of pollutants in the environment and food, the assessment of human exposure is required. This necessitates high-throughput approaches enabling large-scale analysis and, as a consequence, the use of high-performance analytical instruments to obtain highly informative metabolomic profiles. In this study, direct introduction mass spectrometry (DIMS) was performed using a Fourier transform ion cyclotron resonance (FT-ICR) instrument equipped with a dynamically harmonized cell. Data quality was evaluated based on mass resolving power (RP), mass measurement accuracy, and ion intensity drifts from the repeated injections of quality control sample (QC) along the analytical process. The large DIMS data size entails the use of bioinformatic tools for the automatic selection of common ions found in all QC injections and for robustness assessment and correction of eventual technical drifts. RP values greater than 10 6 and mass measurement accuracy of lower than 1 ppm were obtained using broadband mode resulting in the detection of isotopic fine structure. Hence, a very accurate relative isotopic mass defect (RΔm) value was calculated. This reduces significantly the number of elemental composition (EC) candidates and greatly improves compound annotation. A very satisfactory estimate of repeatability of both peak intensity and mass measurement was demonstrated. Although, a non negligible ion intensity drift was observed for negative ion mode data, a normalization procedure was easily applied to correct this phenomenon. This study illustrates the performance and robustness of the dynamically harmonized FT-ICR cell to perform large-scale high-throughput metabolomic analyses in routine conditions. Graphical abstract Analytical performance of FT-ICR instrument equipped with a dynamically harmonized cell.
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Automated acoustic intensity measurements and the effect of gear tooth profile on noise
NASA Technical Reports Server (NTRS)
Atherton, William J.; Pintz, Adam; Lewicki, David G.
1987-01-01
Acoustic intensity measurements were made at NASA Lewis Research Center on a spur gear test apparatus. The measurements were obtained with the Robotic Acoustic Intensity Measurement System developed by Cleveland State University. This system provided dense spatial positioning, and was calibrated against a high quality acoustic intensity system. The measured gear noise compared gearsets having two different tooth profiles. The tests evaluated the sound field of the different gears for two speeds and three loads. The experimental results showed that gear tooth profile had a major effect on measured noise. Load and speed were found to have an effect on noise also.
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Anatomy and dry weight yields of two Populus clones grown under intensive culture.
John B. Crist; David H. Dawson
1975-01-01
Two Populus clones grown for short rotations at three dense planting spacings produced some extremely high yields of material of acceptable quality. However, variation in yields and quality illustrates that selection of genetic material and the cultured regime under which a species is growth are significant factors that must be determined in maximum-yield systems....
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NASA Astrophysics Data System (ADS)
Farid, Sidra; Stroscio, Michael A.; Dutta, Mitra
2018-03-01
Thermal evaporation growth technique is presented as a route to grow cost effective high quality CdS thin films. We have successfully grown high quality CdS thin films on ITO coated glass substrates by thermal evaporation technique and analyzed the effects of annealing and excitation dependent input of CdS thin film using Raman and photoluminescence spectroscopy. LO phonon modes have been analyzed quantitatively considering the contributions due to anneal induced effects on film quality using phonon spatial correlation model, line shape and defect state analysis. Asymmetry in the Raman line shape towards the low frequency side is related to the phonon confinement effects and is modeled by spatial correlation model. Calculations of width (FWHM), integrated intensity, and line shape for the longitudinal (LO) optical phonon modes indicate improved crystalline quality for the annealed films as compared to the as grown films. With increase in laser power, intensity ratio of 2-LO to 1-LO optical phonon modes is found to increase while multiple overtones upto fourth order are observed. Power dependent photoluminescence data indicates direct band-to-band transition in CdS thin films.
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Wood, Dora; Geoghegan, Sophie; Ramnarayan, Padmanabhan; Davis, Peter J; Pappachan, John V; Goodwin, Sarah; Wray, Jo
2018-05-01
Critically ill adolescents are usually treated on intensive care units optimised for much older adults or younger children. The way they access and experience health services may be very different to most adolescent service users, and existing quality criteria may not apply to them. The objectives of this pilot study were, firstly, to determine whether adolescents and their families were able to articulate their experiences of their critical care admission and secondly, to identify the factors that are important to them during their intensive care unit (ICU) or high dependency unit (HDU) stay. Participants were 14-17 year olds who had previously had an emergency admission to an adult or paediatric ICU/HDU in one of four UK hospitals (two adult, two paediatric) and their parents. Semi-structured interviews were conducted with eight mother-adolescent dyads and one mother. Interviews were transcribed and analysed using framework analysis. The main reported determinant of high-quality care was the quality of interaction with staff. The significance of these interactions and their environment depended on adolescents' awareness of their surroundings, which was often limited in ICU and changed significantly over the course of their illness. Qualitative interview methodology would be difficult to scale up for this group. What is known • Critically ill adolescents are usually treated on intensive care units optimised for older adults or younger children. • The way they access and experience health services may be different to most adolescent patients; existing quality criteria may not apply. What is new • Reported determinants of high-quality care were age-appropriateness of the environment, respectfulness and friendliness of staff, communication and inclusion in healthcare decisions. • The significance of these depended on adolescents' awareness of their surroundings, which was often limited and changed over the course of their illness.
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Randomized algorithms for high quality treatment planning in volumetric modulated arc therapy
NASA Astrophysics Data System (ADS)
Yang, Yu; Dong, Bin; Wen, Zaiwen
2017-02-01
In recent years, volumetric modulated arc therapy (VMAT) has been becoming a more and more important radiation technique widely used in clinical application for cancer treatment. One of the key problems in VMAT is treatment plan optimization, which is complicated due to the constraints imposed by the involved equipments. In this paper, we consider a model with four major constraints: the bound on the beam intensity, an upper bound on the rate of the change of the beam intensity, the moving speed of leaves of the multi-leaf collimator (MLC) and its directional-convexity. We solve the model by a two-stage algorithm: performing minimization with respect to the shapes of the aperture and the beam intensities alternatively. Specifically, the shapes of the aperture are obtained by a greedy algorithm whose performance is enhanced by random sampling in the leaf pairs with a decremental rate. The beam intensity is optimized using a gradient projection method with non-monotonic line search. We further improve the proposed algorithm by an incremental random importance sampling of the voxels to reduce the computational cost of the energy functional. Numerical simulations on two clinical cancer date sets demonstrate that our method is highly competitive to the state-of-the-art algorithms in terms of both computational time and quality of treatment planning.
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Mitchell, Duncan
2016-01-01
Pain burden is high in people living with HIV (PLWH), but the effect of this pain on functionality is equivocal. Resilience, the ability to cope with adversity, may promote adaptation to pain, so we hypothesised that higher resilience would correlate with less pain-related impairment of activity. We recruited 197 black South African PLWH, 99 with chronic pain (CP) and 98 patients without. We measured pain intensity and interference using the Brief Pain Inventory, and resilience using the Resilience Scale. Participants were generally highly resilient. Greater resilience correlated with better health-related quality of life, but not with pain intensity or interference. We also measured physical activity objectively, by actigraphy, in a subset of patients (37 with chronic pain and 31 without chronic pain), who wore accelerometers for two weeks. There was no difference in duration or intensity of activity between those with and without pain, and activity was not associated with resilience. In this sample, pain was not associated with altered physical activity. Resilience did not explain differences in pain intensity or pain interference but was associated with improved quality of life. Financial stresses and the fear of HIV stigma may have driven patients to conceal pain and to suppress its expected impairment of activity. PMID:27672513
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Art Therapy with an Oncology Care Team
ERIC Educational Resources Information Center
Nainis, Nancy A.
2005-01-01
Oncology nurses are particularly vulnerable to "burnout" syndrome due to the intensity of their work and the ongoing losses they experience while providing oncology care to their patients. High levels of stress in the workplace left untended lead to high job turnover, poor productivity, and diminished quality of care for patients.…
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Effect of a Brief Seated Massage on Nursing Student Attitudes Toward Touch for Comfort Care
Yearwood, Edilma L.; Friedmann, Erika
2014-01-01
Background: While massage has been removed from nursing curricula, studies have reported massage as safe and effective for stress reduction, relaxation, pain relief, fatigue, and quality of life. Objective: To compare the efficacy of two intensities of touch administered during two seated massages on the attitudes of nursing students toward touch for their self-care and patient care. Participants: Nursing students who volunteered gave institutional review board–approved written informed consent to undergo massage by a licensed massage therapist. Settings/location: A private room adjacent to the nursing lab in a school of nursing. Intervention: Brief seated massages of differing intensities. Each participant received low-intensity and high-intensity touch in a two-block, randomized order, within-subjects design. Linear mixed models nested within subject and random intercept analyses were used to test hypotheses in this two-treatment, two-sequence, two-period crossover design. Outcome measures: Health questionnaires/visual analogue scales pertaining to physical/affective/and attitudinal status were completed before and after each massage. Results: Twenty-nine participants (93% female, 83% single) completed the study. Before massage, the optimal intensity of touch anticipated for self-comfort was 6.6 (0=no pressure;10=most intense pressure imaginable). The mean touch intensities were 6.7 for high-intensity massage and 0.5 for low-intensity (p<0.001). The overall percentage differences (feeling better or worse) following massage were as follows: low intensity, 37.5% better; high intensity, 62.7% better (p<0.001). Significantly more improvement was reported for energy, pain, stress, and feeling physically uptight after high-intensity compared with low-intensity (p<0.03). Participants were more likely to both receive touch for self-care and provide touch for patient care after experiencing high- versus low-intensity massage (p<0.01). Conclusions: High-intensity seated massage was more efficacious than low-intensity massage and positively influenced nursing student attitudes toward the inclusion of massage in self-care/patient care. The role of touch for self-care/patient care in the nursing curricula merits reconsideration. PMID:25140587
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Kremeike, Kerstin; Eulitz, Nina; Sens, Brigitte; Geraedts, Max; Reinhardt, Dirk
2012-01-01
To provide comprehensive high-quality health care is a great challenge in the context of high specialisation and intensive costs. This problem becomes further aggravated in service areas with low patient numbers and low numbers of specialists. Therefore, a multidimensional approach to quality development was chosen in order to optimise the care of children and adolescents with life-limiting conditions in Lower Saxony, a German federal state with a predominantly rural infrastructure. Different service structures were implemented and a classification of service provider's specialisation was defined on the basis of existing references of professional associations. Measures to optimise care were implemented in a process-oriented manner. High-quality health care can be facilitated by carefully worded requirements concerning the quality of structures combined with optimally designed processes. Parts of the newly implemented paediatric palliative care structures are funded by the statutory health insurance. Copyright © 2012. Published by Elsevier GmbH.
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NASA Astrophysics Data System (ADS)
Zhou, Kenneth J.; Chen, Jun
2016-03-01
The current growing of food industry for low production costs and high efficiency needs for maintenance of high-quality standards and assurance of food safety while avoiding liability issues. Quality and safety of food depend on physical (texture, color, tenderness etc.), chemical (fat content, moisture, protein content, pH, etc.), and biological (total bacterial count etc.) features. There is a need for a rapid (less than a few minutes) and accurate detection system in order to optimize quality and assure safety of food. However, the fluorescence ranges for known fluorophores are limited to ultraviolet emission bands, which are not in the tissue near infrared (NIR) "optical window". Biological tissues excited by far-red or NIR light would exhibit strong emission in spectral range of 650-1,100 nm although no characteristic peaks show the emission from which known fluorophores. The characteristics of the auto-fluorescence emission of different types of tissues were found to be different between different tissue components such as fat, high quality muscle food. In this paper, NIR auto-fluorescence emission from different types of muscle food and fat was measured. The differences of fluorescence intensities of the different types of muscle food and fat emissions were observed. These can be explained by the change of the microscopic structure of physical, chemical, and biological features in meat. The difference of emission intensities of fat and lean meat tissues was applied to monitor food quality and safety using spectral polarized imaging, which can be detect deep depth fat under the muscle food up to several centimeter.
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Bromley Milton, Maria; Börsbo, Björn; Rovner, Graciela; Lundgren-Nilsson, Åsa; Stibrant-Sunnerhagen, Katharina; Gerdle, Björn
2013-01-01
Background Incorporating the patient's view on care and treatment has become increasingly important for health care. Patients describe the variety of consequences of their chronic pain conditions as significant pain intensity, depression, and anxiety. We hypothesised that intensities of common symptoms in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. This study has three aims: 1) to determine the importance of different symptoms with respect to participation and ill-health; 2) to identify subgroups based on data concerning important symptoms; and 3) to determine the secondary consequences for the identified subgroups with respect to participation and health factors. Methods and Subjects This study is based on a cohort of patients referred to a multidisciplinary pain centre at a university hospital (n = 4645, participation rate 88%) in Sweden. The patients answered a number of questionnaires concerning symptoms, participation, and health aspects as a part of the Swedish Quality Registry for Pain Rehabilitation (SQRP). Results Common symptoms (such as pain intensity, depression, and anxiety) in patients with chronic pain showed great variability across subjects and 60% of the cohort had normal values with respect to depressive and anxiety symptoms. Pain intensity more than psychological symptoms showed stronger relationships with participation and health. It was possible to identify subgroups based on pain intensity, depression, and anxiety. With respect to participation and health, high depressive symptomatology had greater negative consequences than high anxiety. Conclusions Common symptoms (such as pain intensity and depressive and anxiety symptoms) in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. PMID:23805183
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Johnson, Steven M.; Swanson, Robert B.
1994-01-01
Prototype stream-monitoring sites were operated during part of 1992 in the Central Nebraska Basins (CNBR) and three other study areas of the National Water-Quality Assessment (NAWQ) Program of the U.S. Geological Survey. Results from the prototype project provide information needed to operate a net- work of intensive fixed station stream-monitoring sites. This report evaluates operating procedures for two NAWQA prototype sites at Maple Creek near Nickerson and the Platte River at Louisville, eastern Nebraska. Each site was sampled intensively in the spring and late summer 1992, with less intensive sampling in midsummer. In addition, multiple samples were collected during two high- flow periods at the Maple Creek site--one early and the other late in the growing season. Water-samples analyses included determination of pesticides, nutrients, major ions, suspended sediment, and measurements of physical properties. Equipment and protocols for the water-quality sampling procedures were evaluated. Operation of the prototype stream- monitoring sites included development and comparison of onsite and laboratory sample-processing proce- dures. Onsite processing was labor intensive but allowed for immediate preservation of all sampled constituents. Laboratory processing required less field labor and decreased the risk of contamination, but allowed for no immediate preservation of the samples.
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NASA Astrophysics Data System (ADS)
Croghan, Danny; Van Loon, Anne; Bradley, Chris; Sadler, Jon; Hannnah, David
2017-04-01
Studies relating rainfall events to river water quality are frequently hindered by the lack of high resolution rainfall data. Local studies are particularly vulnerable due to the spatial variability of precipitation, whilst studies in urban environments require precipitation data at high spatial and temporal resolutions. The use of point-source data makes identifying causal effects of storms on water quality problematic and can lead to erroneous interpretations. High spatial and temporal resolution rainfall radar data offers great potential to address these issues. Here we use rainfall radar data with a 1km spatial resolution and 5 minute temporal resolution sourced from the UK Met Office Nimrod system to study the effects of storm events on water temperature (WTemp) in Birmingham, UK. 28 WTemp loggers were placed over 3 catchments on a rural-urban land use gradient to identify trends in WTemp during extreme events within urban environments. Using GIS, the catchment associated with each logger was estimated, and 5 min. rainfall totals and intensities were produced for each sub-catchment. Comparisons of rainfall radar data to meteorological stations in the same grid cell revealed the high accuracy of rainfall radar data in our catchments (<5% difference for studied months). The rainfall radar data revealed substantial differences in rainfall quantity between the three adjacent catchments. The most urban catchment generally received more rainfall, with this effect greatest in the highest intensity storms, suggesting the possibility of urban heat island effects on precipitation dynamics within the catchment. Rainfall radar data provided more accurate sub-catchment rainfall totals allowing better modelled estimates of storm flow, whilst spatial fluctuations in both discharge and WTemp can be simply related to precipitation intensity. Storm flow inputs for each sub-catchment were estimated and linked to changes in WTemp. WTemp showed substantial fluctuations (>1 °C) over short durations (<30 minutes) during storm events in urbanised sub-catchments, however WTemp recovery times were more prolonged. Use of the rainfall radar data allowed increased accuracy in estimates of storm flow timings and rainfall quantities at each sub-catchment, from which the impact of storm flow on WTemp could be quantified. We are currently using the radar data to derive thresholds for rainfall amount and intensity at which these storm deviations occur for each logger, from which the relative effects of land use and other catchment characteristics in each sub-catchment can be assessed. Our use of the rainfall radar data calls into question the validity of using station based data for small scale studies, particularly in urban areas, with high variation apparent in rainfall intensity both spatially and temporally. Variation was particularly high within the heavily urbanised catchment. For water quality studies, high resolution rainfall radar can be implemented to increase the reliability of interpretations of the response of water quality variables to storm water inputs in urban catchments.
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Wilkie, Joel R.; Matuszak, Martha M.; Feng, Mary; Moran, Jean M.; Fraass, Benedick A.
2013-01-01
Purpose: Plan degradation resulting from compromises made to enhance delivery efficiency is an important consideration for intensity modulated radiation therapy (IMRT) treatment plans. IMRT optimization and/or multileaf collimator (MLC) sequencing schemes can be modified to generate more efficient treatment delivery, but the effect those modifications have on plan quality is often difficult to quantify. In this work, the authors present a method for quantitative assessment of overall plan quality degradation due to tradeoffs between delivery efficiency and treatment plan quality, illustrated using comparisons between plans developed allowing different numbers of intensity levels in IMRT optimization and/or MLC sequencing for static segmental MLC IMRT plans. Methods: A plan quality degradation method to evaluate delivery efficiency and plan quality tradeoffs was developed and used to assess planning for 14 prostate and 12 head and neck patients treated with static IMRT. Plan quality was evaluated using a physician's predetermined “quality degradation” factors for relevant clinical plan metrics associated with the plan optimization strategy. Delivery efficiency and plan quality were assessed for a range of optimization and sequencing limitations. The “optimal” (baseline) plan for each case was derived using a clinical cost function with an unlimited number of intensity levels. These plans were sequenced with a clinical MLC leaf sequencer which uses >100 segments, assuring delivered intensities to be within 1% of the optimized intensity pattern. Each patient's optimal plan was also sequenced limiting the number of intensity levels (20, 10, and 5), and then separately optimized with these same numbers of intensity levels. Delivery time was measured for all plans, and direct evaluation of the tradeoffs between delivery time and plan degradation was performed. Results: When considering tradeoffs, the optimal number of intensity levels depends on the treatment site and on the stage in the process at which the levels are limited. The cost of improved delivery efficiency, in terms of plan quality degradation, increased as the number of intensity levels in the sequencer or optimizer decreased. The degradation was more substantial for the head and neck cases relative to the prostate cases, particularly when fewer than 20 intensity levels were used. Plan quality degradation was less severe when the number of intensity levels was limited in the optimizer rather than the sequencer. Conclusions: Analysis of plan quality degradation allows for a quantitative assessment of the compromises in clinical plan quality as delivery efficiency is improved, in order to determine the optimal delivery settings. The technique is based on physician-determined quality degradation factors and can be extended to other clinical situations where investigation of various tradeoffs is warranted. PMID:23822412
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Hoffmann, Kristine; Sobol, Nanna A; Frederiksen, Kristian S; Beyer, Nina; Vogel, Asmus; Vestergaard, Karsten; Brændgaard, Hans; Gottrup, Hanne; Lolk, Annette; Wermuth, Lene; Jacobsen, Søren; Laugesen, Lars P; Gergelyffy, Robert G; Høgh, Peter; Bjerregaard, Eva; Andersen, Birgitte B; Siersma, Volkert; Johannsen, Peter; Cotman, Carl W; Waldemar, Gunhild; Hasselbalch, Steen G
2016-01-01
Studies of physical exercise in patients with Alzheimer's disease (AD) are few and results have been inconsistent. To assess the effects of a moderate-to-high intensity aerobic exercise program in patients with mild AD. In a randomized controlled trial, we recruited 200 patients with mild AD to a supervised exercise group (60-min sessions three times a week for 16 weeks) or to a control group. Primary outcome was changed from baseline in cognitive performance estimated by Symbol Digit Modalities Test (SDMT) in the intention-to-treat (ITT) group. Secondary outcomes included changes in quality of life, ability to perform activities of daily living, and in neuropsychiatric and depressive symptoms. The ITT analysis showed no significant differences between intervention and control groups in change from baseline of SDMT, other cognitive tests, quality of life, or activities of daily living. The change from baseline in Neuropsychiatric Inventory differed significantly in favor of the intervention group (mean: -3.5, 95% confidence interval (CI) -5.8 to -1.3, p = 0.002). In subjects who adhered to the protocol, we found a significant effect on change from baseline in SDMT as compared with the control group (mean: 4.2, 95% CI 0.5 to 7.9, p = 0.028), suggesting a dose-response relationship between exercise and cognition. This is the first randomized controlled trial with supervised moderate-to-high intensity exercise in patients with mild AD. Exercise reduced neuropsychiatric symptoms in patients with mild AD, with possible additional benefits of preserved cognition in a subgroup of patients exercising with high attendance and intensity.
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Fast and accurate de novo genome assembly from long uncorrected reads
Vaser, Robert; Sović, Ivan; Nagarajan, Niranjan
2017-01-01
The assembly of long reads from Pacific Biosciences and Oxford Nanopore Technologies typically requires resource-intensive error-correction and consensus-generation steps to obtain high-quality assemblies. We show that the error-correction step can be omitted and that high-quality consensus sequences can be generated efficiently with a SIMD-accelerated, partial-order alignment–based, stand-alone consensus module called Racon. Based on tests with PacBio and Oxford Nanopore data sets, we show that Racon coupled with miniasm enables consensus genomes with similar or better quality than state-of-the-art methods while being an order of magnitude faster. PMID:28100585
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Leech, Kristan A.; Kinnaird, Catherine R.; Holleran, Carey L.; Kahn, Jennifer
2016-01-01
Background High-intensity stepping practice may be a critical component to improve gait following motor incomplete spinal cord injury (iSCI). However, such practice is discouraged by traditional theories of rehabilitation that suggest high-intensity locomotor exercise degrades gait performance. Accordingly, such training is thought to reinforce abnormal movement patterns, although evidence to support this notion is limited. Objective The purposes of this study were: (1) to evaluate the effects of short-term manipulations in locomotor intensity on gait performance in people with iSCI and (2) to evaluate potential detrimental effects of high-intensity locomotor training on walking performance. Design A single-day, repeated-measures, pretraining-posttraining study design was used. Methods Nineteen individuals with chronic iSCI performed a graded-intensity locomotor exercise task with simultaneous collection of lower extremity kinematic and electromyographic data. Measures of interest were compared across intensity levels of 33%, 67%, and 100% of peak gait speed. A subset of 9 individuals participated in 12 weeks of high-intensity locomotor training. Similar measurements were collected and compared between pretraining and posttraining evaluations. Results The results indicate that short-term increases in intensity led to significant improvements in muscle activity, spatiotemporal metrics, and joint excursions, with selected improvements in measures of locomotor coordination. High-intensity locomotor training led to significant increases in peak gait speed (0.64–0.80 m/s), and spatiotemporal and kinematic metrics indicate a trend for improved coordination. Limitations Measures of gait performance were assessed during treadmill ambulation and not compared with a control group. Generalizability of these results to overground ambulation is unknown. Conclusions High-intensity locomotor exercise and training does not degrade, but rather improves, locomotor function and quality in individuals with iSCI, which contrasts with traditional theories of motor dysfunction following neurologic injury. PMID:27313241
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Adams, Scott C; DeLorey, Darren S; Davenport, Margie H; Fairey, Adrian S; North, Scott; Courneya, Kerry S
2018-05-08
Testicular cancer survivors (TCS) are at increased risk of cancer-related fatigue (CRF), psychosocial impairment, and poor mental health-related quality of life (HRQoL). Here, we examine the effects of high-intensity interval training (HIIT) on patient-reported outcomes (PROs) in TCS. Secondarily, we explore cardiorespiratory fitness as a mediator of intervention effects and select baseline characteristics as moderators of intervention effects. TCS (n = 63) were randomly assigned to 12 weeks of supervised HIIT or usual care (UC). PROs included CRF, depression, anxiety, stress, self-esteem, sleep quality, and HRQoL assessed at baseline, post-intervention, and 3-month follow-up. TCS (median 7 years postdiagnosis) completed 99% of training sessions and achieved 98% of target training intensity. ANCOVA revealed that, compared to UC, HIIT significantly improved post-intervention CRF (p = 0.003), self-esteem (p = 0.029), and multiple HRQoL domains (ps ≤ 0.05). Effects on CRF (p = 0.031) and vitality (p = 0.015) persisted at 3-month follow-up. Cardiorespiratory fitness changes mediated CRF and HRQoL improvements. CRF effects were larger for TCS with an inactive lifestyle, lower fitness, higher testosterone, and clinical fatigue at baseline. HIIT significantly improves CRF and HRQoL in TCS. Mediation by cardiorespiratory fitness and moderation by clinical characteristics suggests opportunities for targeted exercise interventions to optimise PROs in TCS.
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Matuszak, Martha M; Steers, Jennifer M; Long, Troy; McShan, Daniel L; Fraass, Benedick A; Romeijn, H Edwin; Ten Haken, Randall K
2013-07-01
To introduce a hybrid volumetric modulated arc therapy/intensity modulated radiation therapy (VMAT/IMRT) optimization strategy called FusionArc that combines the delivery efficiency of single-arc VMAT with the potentially desirable intensity modulation possible with IMRT. A beamlet-based inverse planning system was enhanced to combine the advantages of VMAT and IMRT into one comprehensive technique. In the hybrid strategy, baseline single-arc VMAT plans are optimized and then the current cost function gradients with respect to the beamlets are used to define a metric for predicting which beam angles would benefit from further intensity modulation. Beams with the highest metric values (called the gradient factor) are converted from VMAT apertures to IMRT fluence, and the optimization proceeds with the mixed variable set until convergence or until additional beams are selected for conversion. One phantom and two clinical cases were used to validate the gradient factor and characterize the FusionArc strategy. Comparisons were made between standard IMRT, single-arc VMAT, and FusionArc plans with one to five IMRT∕hybrid beams. The gradient factor was found to be highly predictive of the VMAT angles that would benefit plan quality the most from beam modulation. Over the three cases studied, a FusionArc plan with three converted beams achieved superior dosimetric quality with reductions in final cost ranging from 26.4% to 48.1% compared to single-arc VMAT. Additionally, the three beam FusionArc plans required 22.4%-43.7% fewer MU∕Gy than a seven beam IMRT plan. While the FusionArc plans with five converted beams offer larger reductions in final cost--32.9%-55.2% compared to single-arc VMAT--the decrease in MU∕Gy compared to IMRT was noticeably smaller at 12.2%-18.5%, when compared to IMRT. A hybrid VMAT∕IMRT strategy was implemented to find a high quality compromise between gantry-angle and intensity-based degrees of freedom. This optimization method will allow patients to be simultaneously planned for dosimetric quality and delivery efficiency without switching between delivery techniques. Example phantom and clinical cases suggest that the conversion of only three VMAT segments to modulated beams may result in a good combination of quality and efficiency.
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Xiao Chen; Deborah Page-Dumroese; Ruiheng Lv; Weiwei Wang; Guolei Li; Yong Liu
2014-01-01
Thinning alters litter quality and microclimate under forests. Both of these two changes after thinning induce alterations of litter decomposition rates and nutrient cycling. However, a possible interaction between these two changes remains unclear. We placed two types of litter (LN, low N concentration litter; HN, high N concentration litter) in a Chinese pine (Pinus...
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Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus.
Fullerton, Birgit; Jeitler, Klaus; Seitz, Mirjam; Horvath, Karl; Berghold, Andrea; Siebenhofer, Andrea
2014-02-14
Clinical guidelines differ regarding their recommended blood glucose targets for patients with type 1 diabetes and recent studies on patients with type 2 diabetes suggest that aiming at very low targets can increase the risk of mortality. To assess the effects of intensive versus conventional glycaemic targets in patients with type 1 diabetes in terms of long-term complications and determine whether very low, near normoglycaemic values are of additional benefit. A systematic literature search was performed in the databases The Cochrane Library, MEDLINE and EMBASE. The date of the last search was December 2012 for all databases. We included all randomised controlled trials (RCTs) that had defined different glycaemic targets in the treatment arms, studied patients with type 1 diabetes, and had a follow-up duration of at least one year. Two review authors independently extracted data, assessed studies for risk of bias, with differences resolved by consensus. Overall study quality was evaluated by the 'Grading of Recommendations Assessment, Development, and Evaluation' (GRADE) system. Random-effects models were used for the main analyses and the results are presented as risk ratios (RR) with 95% confidence intervals (CI) for dichotomous outcomes. We identified 12 trials that fulfilled the inclusion criteria, including a total of 2230 patients. The patient populations varied widely across studies with one study only including children, one study only including patients after a kidney transplant, one study with newly diagnosed adult patients, and several studies where patients had retinopathy or microalbuminuria at baseline. The mean follow-up duration across studies varied between one and 6.5 years. The majority of the studies were carried out in the 1980s and all trials took place in Europe or North America. Due to the nature of the intervention, none of the studies could be carried out in a blinded fashion so that the risk of performance bias, especially for subjective outcomes such as hypoglycaemia, was present in all of the studies. Fifty per cent of the studies were judged to have a high risk of bias in at least one other category.Under intensive glucose control, the risk of developing microvascular complications was reduced compared to conventional treatment for a) retinopathy: 23/371 (6.2%) versus 92/397 (23.2%); RR 0.27 (95% CI 0.18 to 0.42); P < 0.00001; 768 participants; 2 trials; high quality evidence; b) nephropathy: 119/732 (16.3%) versus 211/743 (28.4%); RR 0.56 (95% CI 0.46 to 0.68); P < 0.00001; 1475 participants; 3 trials; moderate quality evidence; c) neuropathy: 29/586 (4.9%) versus 86/617 (13.9%); RR 0.35 (95% CI 0.23 to 0.53); P < 0.00001; 1203 participants; 3 trials; high quality evidence. Regarding the progression of these complications after manifestation, the effect was weaker (retinopathy) or possibly not existent (nephropathy: RR 0.79 (95% CI 0.37 to 1.70); P = 0.55; 179 participants with microalbuminuria; 3 trials; very low quality evidence); no adequate data were available regarding the progression of neuropathy. For retinopathy, intensive glucose control reduced the risk of progression in studies with a follow-up duration of at least two years (85/366 (23.2%) versus 154/398 (38.7%); RR 0.61 (95% CI 0.49 to 0.76); P < 0.0001; 764 participants; 2 trials; moderate quality evidence), while we found evidence for an initial worsening of retinopathy after only one year of intensive glucose control (17/49 (34.7%) versus 7/47 (14.9%); RR 2.32 (95% CI 1.16 to 4.63); P = 0.02; 96 participants; 2 trials; low quality evidence).Major macrovascular outcomes (stroke and myocardial infarction) occurred very rarely, and no firm evidence could be established regarding these outcome measures (low quality evidence).We found that intensive glucose control increased the risk for severe hypoglycaemia, however the results were heterogeneous and only the 'Diabetes Complications Clinical Trial' (DCCT) showed a clear increase in severe hypoglycaemic episodes under intensive treatment. A subgroup analysis according to the baseline haemoglobin A1c (HbA1c) of participants in the trials (low quality evidence) suggests that the risk of hypoglycaemia is possibly only increased for patients who started with relatively low HbA1c values (< 9.0%). Several of the included studies also showed a greater weight gain under intensive glucose control, and the risk of ketoacidosis was only increased in studies using insulin pumps in the intensive treatment group (very low quality evidence).Overall, all-cause mortality was very low in all studies (moderate quality evidence) except in one study investigating renal allograft as treatment for end-stage diabetic nephropathy. Health-related quality of life was only reported in the DCCT trial, showing no statistically significant differences between the intervention and comparator groups (moderate quality evidence). In addition, only the DCCT published data on costs, indicating that intensive glucose therapy control was highly cost-effective considering the reduction of potential diabetes complications (moderate quality evidence). Tight blood sugar control reduces the risk of developing microvascular diabetes complications. The evidence of benefit is mainly from studies in younger patients at early stages of the disease. Benefits need to be weighed against risks including severe hypoglycaemia, and patient training is an important aspect in practice. The effects of tight blood sugar control seem to become weaker once complications have been manifested. However, further research is needed on this issue. Furthermore, there is a lack of evidence from RCTs on the effects of tight blood sugar control in older patient populations or patients with macrovascular disease. There is no firm evidence for specific blood glucose targets and treatment goals need to be individualised taking into account age, disease progression, macrovascular risk, as well as the patient's lifestyle and disease management capabilities.
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ERIC Educational Resources Information Center
Holth, Per; Torsheim, Torbjorn; Sheidow, Ashli J.; Ogden, Terje; Henggeler, Scott W.
2011-01-01
This study was a cross-cultural replication of a study that investigated therapist adherence to behavioral interventions as a result of an intensive quality assurance system which was integrated into Multisystemic Therapy (MST). Thirty-three therapists and eight supervisors were block randomized to either an Intensive Quality Assurance or a…
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Rotation placements help students' understanding of intensive care.
Abbott, Lisa
2011-07-01
It is vital that children's nursing students are fit for practice when they qualify and are able to meet various essential skills as defined by the Nursing and Midwifery Council (NMC). To gain the knowledge and skills required, students need placements in areas where high dependency and potentially intensive care are delivered. Efforts to maximise the number of students experiencing intensive care as a placement have led to the development of the paediatric intensive care unit (PICU) rotation, increasing placements on the PICU from 5 to 40 per cent of the student cohort per year. The lecturer practitioner organises the rotation, providing credible links between university and practice areas, while supporting students and staff in offering a high-quality placement experience. Students say the rotation offers a positive insight into PICU nursing, helping them develop knowledge and skills in a technical area and creating an interest in this specialty.
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Care zoning in a psychiatric intensive care unit: strengthening ongoing clinical risk assessment.
Mullen, Antony; Drinkwater, Vincent; Lewin, Terry J
2014-03-01
To implement and evaluate the care zoning model in an eight-bed psychiatric intensive care unit and, specifically, to examine the model's ability to improve the documentation and communication of clinical risk assessment and management. Care zoning guides nurses in assessing clinical risk and planning care within a mental health context. Concerns about the varying quality of clinical risk assessment prompted a trial of the care zoning model in a psychiatric intensive care unit within a regional mental health facility. The care zoning model assigns patients to one of 3 'zones' according to their clinical risk, encouraging nurses to document and implement targeted interventions required to manage those risks. An implementation trial framework was used for this research to refine, implement and evaluate the impact of the model on nurses' clinical practice within the psychiatric intensive care unit, predominantly as a quality improvement initiative. The model was trialled for three months using a pre- and postimplementation staff survey, a pretrial file audit and a weekly file audit. Informal staff feedback was also sought via surveys and regular staff meetings. This trial demonstrated improvement in the quality of mental state documentation, and clinical risk information was identified more accurately. There was limited improvement in the quality of care planning and the documentation of clinical interventions. Nurses' initial concerns over the introduction of the model shifted into overall acceptance and recognition of the benefits. The results of this trial demonstrate that the care zoning model was able to improve the consistency and quality of risk assessment information documented. Care planning and evaluation of associated outcomes showed less improvement. Care zoning remains a highly applicable model for the psychiatric intensive care unit environment and is a useful tool in guiding nurses to carry out routine patient risk assessments. © 2013 John Wiley & Sons Ltd.
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Gao, Junqian; Gao, Dan; Liu, Hao; Cai, Jiajai; Zhang, Junqi; Qi, Zhengliang
2018-05-24
Excessive nitrite accumulation is a very tough issue for intensive aquaculture. A high efficient aerobic denitrifier Bacillus megaterium S379 with 91.71±0.17% of NO 2 - -N (65 mg L -1 ) removal was successfully isolated for solving the problem. Denitrification of S379 showed excellent environment adaptation that it kept high nitrite removal ratio (more than 85%) when temperature ranged from 25°C to 40°C and pH varied between 7.0 and 9.0, and could endure as high as 560 mg L -1 of NO 2 - -N. Immobilization of S379 could enhance denitrification even when NO 2 - -N adding amount got to 340 mg L -1 . Immobilized cells also showed well pollutants removal performance in aquaculture wastewater treatment. Moreover, S379 possessed positive hydrolase activities for starch, casein, cellulose and fat and bore more than 60 ppt of salinity. Totally, all the results revealed significant potentiality of immobilized S379 applied in aquaculture water quality management. Copyright © 2018 Elsevier Ltd. All rights reserved.
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The association between pregame snacks and exercise intensity, stress, and fatigue in children.
Sacheck, Jennifer M; Rasmussen, Helen M; Hall, Meghan M; Kafka, Tamar; Blumberg, Jeffrey B; Economos, Christina D
2014-05-01
To investigate the association between pregame snacks varying in macronutrient content and exercise intensity, physiological stress, and fatigue in young soccer players. One hour before a 50-min soccer game, children (n = 79; 9.1 ± 0.8 y) were randomly assigned to consume a raisin-, peanut-butter-, or cereal-based snack. Body mass index, blood glucose, and salivary measures of stress (cortisol and immunoglobulin A-IgA) were measured pre- and post-game. Exercise intensity was measured by accelerometry. Self-administered questionnaires were used to assess diet quality and fatigue. Analysis of covariance was used to examine the relationship between pregame snacks and biochemical outcomes. Postgame glucose and cortisol increased [12.9 ± 21.3 mg/dL (p < .001) and 0.04 ± 0.10 μg/dL (p < .05), respectively] and IgA decreased (-2.3 ± 9.6 μg/mL; p < .001) from pregame values. The pregame snack was not associated with exercise intensity or post-game outcome; however, children consuming the cereal-based (high-sugar and high-glycemic index (GI)) snack exercised more intensely than the 2 lower-GI snack groups (p < .05). Children who consumed the high-sugar, high-GI snack also reported more symptoms of fatigue (p < .05). A high-sugar, high-GI pregame snack was associated with exercise intensity and fatigue but not changes in blood sugar or stress biomarkers following a soccer game in children.
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Pascual-Guardia, Sergio; Wodja, Emil; Gorostiza, Amaya; López de Santamaría, Elena; Gea, Joaquim; Gáldiz, Juan B; Sliwinski, Pawel; Barreiro, Esther
2013-03-02
Despite the beneficial effects of exercise training in chronic obstructive pulmonary disease (COPD) patients, several studies have revealed functional and biological abnormalities in their peripheral muscles. The objective was to determine whether exercise training of high intensity and long duration modifies oxidative stress levels and structure of respiratory and peripheral muscles of severe COPD patients, while also improving their exercise capacity and quality of life. Multicenter study (Warsaw and Barakaldo) in which 25 severe COPD out-patients were recruited from the COPD clinics. In all patients, lung and muscle functions, exercise capacity (walking test and cycloergometer) and quality of life (QoL) were assessed, and open muscle biopsies from the vastus lateralis and external intercostals (n=14) were obtained before and after an exercise training program of high intensity (respiratory rehabilitation area, 70% maximal tolerated load in a cycloergometer) and long duration (10 weeks). Oxidative stress and muscle structural modifications were evaluated in all muscle biopsies using immunoblotting and immunohistochemistry. In all patients, after the training program, without any drop-outs, exercise capacity and QoL improved significantly, whereas oxidative stress, muscle damage and structure were not modified in their respiratory or limb muscles compared to baseline. In patients with severe COPD, exercise training of high intensity and long duration significantly improves their exercise capacity and QoL, without inducing significant modifications on oxidative stress levels or muscle structure in their respiratory or peripheral muscles. These results may have future clinical therapeutic implications. Copyright © 2011 Elsevier España, S.L. All rights reserved.
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Sperlich, Billy; Wallmann-Sperlich, Birgit; Zinner, Christoph; Von Stauffenberg, Valerie; Losert, Helena; Holmberg, Hans-Christer
2017-01-01
The effects of circuit-like functional high-intensity training (Circuit HIIT ) alone or in combination with high-volume low-intensity exercise (Circuit combined ) on selected cardio-respiratory and metabolic parameters, body composition, functional strength and the quality of life of overweight women were compared. In this single-center, two-armed randomized, controlled study, overweight women performed 9-weeks (3 sessions·wk -1 ) of either Circuit HIIT ( n = 11), or Circuit combined ( n = 8). Peak oxygen uptake and perception of physical pain were increased to a greater extent ( p < 0.05) by Circuit HIIT , whereas Circuit combined improved perception of general health more ( p < 0.05). Both interventions lowered body mass, body-mass-index, waist-to-hip ratio, fat mass, and enhanced fat-free mass; decreased ratings of perceived exertion during submaximal treadmill running; improved the numbers of push-ups, burpees, one-legged squats, and 30-s skipping performed, as well as the height of counter-movement jumps; and improved physical and social functioning, role of physical limitations, vitality, role of emotional limitations, and mental health to a similar extent (all p < 0.05). Either forms of these multi-stimulating, circuit-like, multiple-joint training can be employed to improve body composition, selected variables of functional strength, and certain dimensions of quality of life in overweight women. However, Circuit HIIT improves peak oxygen uptake to a greater extent, but with more perception of pain, whereas Circuit combined results in better perception of general health.
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Sperlich, Billy; Wallmann-Sperlich, Birgit; Zinner, Christoph; Von Stauffenberg, Valerie; Losert, Helena; Holmberg, Hans-Christer
2017-01-01
The effects of circuit-like functional high-intensity training (CircuitHIIT) alone or in combination with high-volume low-intensity exercise (Circuitcombined) on selected cardio-respiratory and metabolic parameters, body composition, functional strength and the quality of life of overweight women were compared. In this single-center, two-armed randomized, controlled study, overweight women performed 9-weeks (3 sessions·wk−1) of either CircuitHIIT (n = 11), or Circuitcombined (n = 8). Peak oxygen uptake and perception of physical pain were increased to a greater extent (p < 0.05) by CircuitHIIT, whereas Circuitcombined improved perception of general health more (p < 0.05). Both interventions lowered body mass, body-mass-index, waist-to-hip ratio, fat mass, and enhanced fat-free mass; decreased ratings of perceived exertion during submaximal treadmill running; improved the numbers of push-ups, burpees, one-legged squats, and 30-s skipping performed, as well as the height of counter-movement jumps; and improved physical and social functioning, role of physical limitations, vitality, role of emotional limitations, and mental health to a similar extent (all p < 0.05). Either forms of these multi-stimulating, circuit-like, multiple-joint training can be employed to improve body composition, selected variables of functional strength, and certain dimensions of quality of life in overweight women. However, CircuitHIIT improves peak oxygen uptake to a greater extent, but with more perception of pain, whereas Circuitcombined results in better perception of general health. PMID:28420999
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Cuffney, T.F.; Meador, M.R.; Porter, S.D.; Gurtz, M.E.
1997-01-01
Biological investigations were conducted in the Yakima River Basin, Washington, in conjunction with a pilot study for the U.S. Geological Survey's National Water-Quality Assessment Program. Ecological surveys were conducted at 25 sites in 1990 to (1) assess water-quality conditions based on fish, benthic invertebrate, and algal communities; (2) determine the hydrologic, habitat, and chemical factors that affect the distributions of these organisms; and (3) relate physical and chemical conditions to water quality. Results of these investigations showed that land uses and other associated human activities influenced the biological characteristics of streams and rivers and overall water-quality conditions. Fish communities of headwater streams in the Cascades and Eastern Cascades ecoregions of the Yakima River Basin were primarily composed of salmonids and sculpins, with cyprinids dominating in the rest of the basin. The most common of the 33 fish taxa collected were speckled dace, rainbow trout, and Paiute sculpin. The highest number of taxa (193) was found among the inverte- brates. Insects, particularly sensitive forms such as mayflies, stoneflies, and caddisflies (EPT--Ephemeroptera, Plecoptera, and Trichoptera fauna), formed the majority of the invertebrate communities of the Cascades and Eastern Cascades ecoregions. Diatoms dominated algal communities throughout the basin; 134 algal taxa were found on submerged rocks, but other stream microhabitats were not sampled as part of the study. Sensitive red algae and diatoms were predominant in the Cascades and Eastern Cascades ecoregions, whereas the abundance of eutrophic diatoms and green algae was large in the Columbia Basin ecoregion of the Yakima River Basin. Ordination of physical, chemical, and biological site characteristics indicated that elevation was the dominant factor accounting for the distribution of biota in the Yakima River Basin; agricultural intensity and stream size were of secondary importance. Ordination identified three site groups and three community types. Site groups consisted of (1) small streams of the Cascades and Eastern Cascades ecoregions, (2) small streams of the Columbia Basin ecoregions, and (3) large rivers of the Cascades and Columbia Basin ecoregions. The small streams of the Columbia Basin could be further subdivided into two groups--one where agricultural intensity was low and one where agricultural intensity was moderate to high. Dividing the basin into these three groups removed much of the influence of elevation and facilitated the analysis of land-use effects. Community types identified by ordination were (1) high elevation, cold-water communities associated with low agricultural intensity; (2) lower elevation, warm-water communities associated with low agricultural intensity, and (3) lower elevation, warm-water communities associated with moderate to high agricultural intensity. Multimetric community condition indices indicated that sites in the Cascades and Eastern Cascades site group were largely unimpaired. In contrast, all but two sites in the Columbia Basin site group were impaired, some severely. Agriculture (nutrients and pesticides) was the primary factor responsible for this impairment, and all impaired sites were characterized by multiple indicators of impairment. Three sites (Granger Drain, Moxee Drain, and Spring Creek) had high levels of impairment. Sites in the large-river site group were moderately to severely impaired downstream from the city of Yakima. High levels of impairment at large-river sites corresponded with high levels of pesticides in fish tissues and the occurrence of external anomalies. The response exhibited by invertebrates and algae to a gradient of agricultural intensity suggested a threshold response for sites in the Columbia Basin site group. Community condition declined precipitously at agricultural intensities above 50 (non-pesticide agricultural intensity index) and showed little respon
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Delivery of high intensity beams with large clad step-index fibers for engine ignition
NASA Astrophysics Data System (ADS)
Joshi, Sachin; Wilvert, Nick; Yalin, Azer P.
2012-09-01
We show, for the first time, that step-index silica fibers with a large clad (400 μm core and 720 μm clad) can be used to transmit nanosecond duration pulses in a way that allows reliable (consistent) spark formation in atmospheric pressure air by the focused output light from the fiber. The high intensity (>100 GW/cm2) of the focused output light is due to the combination of high output power (typical of fibers of this core size) with high output beam quality (better than that typical of fibers of this core size). The high output beam quality, which enables tight focusing, is due to the large clad which suppresses microbending-induced diffusion of modal power to higher order modes owing to the increased rigidity of the core-clad interface. We also show that extending the pulse duration provides a means to increase the delivered pulse energy (>20 mJ delivered for 50 ns pulses) without causing fiber damage. Based on this ability to deliver high energy sparks, we report the first reliable laser ignition of a natural gas engine including startup under typical procedures using silica fiber optics for pulse delivery.
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McIntosh, Nathalie; Oppel, Eva; Mohr, David; Meterko, Mark
2017-09-01
Improving patient care quality in intensive care units is increasingly important as intensive care unit services account for a growing proportion of hospital services. Organizational factors associated with quality of patient care in such units have been identified; however, most were examined in isolation, making it difficult to assess the relative importance of each. Furthermore, though most intensive care units now use a closed model, little research has been done in this specific context. To examine the relative importance of organizational factors associated with patient care quality in closed intensive care units. In a national exploratory, cross-sectional study focused on intensive care units at US Veterans Health Administration acute care hospitals, unit directors were surveyed about nurse and physician staffing, work resources and training, patient care coordination, rounding, and perceptions of patient care quality. Administrative records yielded data on patient volume and facility teaching status. Descriptive statistics, bivariate analyses, and regression modeling were used for data analysis. Sixty-nine completed surveys from directors of closed intensive care units were returned. Regression model results showed that better patient care coordination (β = 0.43; P = .01) and having adequate work resources (β = 0.26; P = .02) were significantly associated with higher levels of patient care quality in such units ( R 2 = 0.22). Augmenting work resources and/or focusing limited hospital resources on improving patient care coordination may be the most productive ways to improve patient care quality in closed intensive care units. ©2017 American Association of Critical-Care Nurses.
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The Sense of Quality of Life and Religious Strategies of Coping with Stress in Prison Inmates.
Talik, Elżbieta; Skowroński, Bartłomiej
2018-06-01
The aim of the presented research was to analyze differences in religious strategies of coping with stress in a group of prison inmates characterized by different levels of the sense of quality of life-general, psychophysical, psychosocial, personal, and metaphysical. The participants were 390 males, aged 19-68 years, serving sentences in prisons in Poland. The measures used were the Sense of Quality of Life Questionnaire by M. Straś-Romanowska and K. I. Pargament's RCOPE Questionnaire. As expected, individuals with a high sense of quality of life-both general and pertaining to specific dimensions-more often chose positive religious strategies, whereas participants with a low sense of quality of life more often chose negative strategies. The exception was the metaphysical aspect of the quality of life: individuals with a high intensity of this dimension more often chose some of the positive as well as negative religious strategies.
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Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D
2017-06-01
The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches' perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches' perspective which was not currently available in the research literature.
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Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D
2017-01-01
Abstract The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches’ perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches’ perspective which was not currently available in the research literature. PMID:28713467
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Fragmentation of care and the use of head computed tomography in patients with ischemic stroke.
Bekelis, Kimon; Roberts, David W; Zhou, Weiping; Skinner, Jonathan S
2014-05-01
Computed tomographic (CT) scans are central diagnostic tests for ischemic stroke. Their inefficient use is a negative quality measure tracked by the Centers for Medicare and Medicaid Services. We performed a retrospective analysis of Medicare fee-for-service claims data for adults admitted for ischemic stroke from 2008 to 2009, with 1-year follow-up. The outcome measures were risk-adjusted rates of high-intensity CT use (≥4 head CT scans) and risk- and price-adjusted Medicare expenditures in the year after admission. The average number of head CT scans in the year after admission, for the 327 521 study patients, was 1.94, whereas 11.9% had ≥4. Risk-adjusted rates of high-intensity CT use ranged from 4.6% (Napa, CA) to 20.0% (East Long Island, NY). These rates were 2.6% higher for blacks than for whites (95% confidence interval, 2.1%-3.1%), with considerable regional variation. Higher fragmentation of care (number of different doctors seen) was associated with high-intensity CT use. Patients living in the top quintile regions of fragmentation experienced a 5.9% higher rate of high-intensity CT use, with the lowest quintile as reference; the corresponding odds ratio was 1.77 (95% confidence interval, 1.71-1.83). Similarly, 1-year risk- and price-adjusted expenditures exhibited considerable regional variation, ranging from $31 175 (Salem, MA) to $61 895 (McAllen, TX). Regional rates of high-intensity CT scans were positively associated with 1-year expenditures (r=0.56; P<0.01). Rates of high-intensity CT use for patients with ischemic stroke reflect wide practice patterns across regions and races. Medicare expenditures parallel these disparities. Fragmentation of care is associated with high-intensity CT use. © 2014 American Heart Association, Inc.
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Schweizer, Don; Cisneros, Ricardo
2014-11-01
Management of fire is an important and controversial policy issue. Active fire suppression has led to a backlog of fuels, limited the ecological benefits of fire, and reduced short-term smoke impacts likely delaying these emissions to future generations over a larger spatial extent. Smoke impacts can be expected to increase as fire size and intensity increase and the fuel backlog is consumed; whether through reintroduction of fire under desirable conditions or through stand replacing fire. Land Management Agencies would like to increase the use of naturally ignited fires to burn during favorable conditions as a way to reduce catastrophic fires. This study provides information about the levels of air quality impacts expected from these types of fires and discusses some of the policy controversies of managed fire that propagate inconsistencies between agencies and enter the public discourse. The Lion Fire, a primarily low intensity 8,370 ha fire that was extensively monitored for Particulate Matter less than 2.5 microns (PM2.5), is used to quantify impacts to air quality. PM2.5 monitoring sites are used to assess exposure, public health impacts, and subsequently quantify annual air quality during a year with a fire that is within the historic normal fire size and intensity for this area. Ground level PM2.5 impacts were found to be localized with 99% of the hourly Air Quality Index readings in the moderate or good category for the sites impacted by the fire. PM2.5 concentrations at sites nearest the fire were below annual federal air quality standards for PM2.5 with annual 98th percentile at the most impacted sites (Johnsondale, Kernville, and Camp Nelson) of 35.0, 34.0, and 28.0 μg m(-3) respectively. Smoke impacts to PM2.5 concentrations were not found to reach the populated Central Valley. The findings suggest that this type of fire can be implemented with minimal public health impacts thus allowing an opportunity for air and fire managers to alter policy to allow additional burning in an area with severe anthropogenic air pollution and where frequent widespread fire is both beneficial and inevitable. The more extensive air quality impacts documented with large high intensity fire may be averted by embracing the use of fire to prevent unwanted high intensity burns. A widespread increase in the use of fire for ecological benefit may provide the resiliency needed in Sierra Nevada forests as well as be the most beneficial to public health through the reduction of single dose exposure to smoke and limiting impacts spatially. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Work environment for Chinese nurses in different types of ICUs: a multisite cross-sectional survey.
Bai, Jinbing; Zhang, Qing; Wang, Ying; Yu, Li-Ping; Pei, Xian-Bo; Cheng, Lei; Hsu, Lily
2015-05-01
To investigate the current nurse work environment, levels of job satisfaction and quality of patient care, and to identify intensive care units with a healthier work environment in mainland China. A healthy work environment is closely related to a higher nurse job satisfaction and a better patient care quality. The work environment has not been extensively explored among Chinese intensive care unit nurses. The Chinese version of the Essentials of Magnetism II was used to measure the nurse work environment and another two 0-10 single-item scales were used to assess nurses' overall job satisfaction and nurse-assessed quality of care. The study found that the eight essentials of Chinese version of the Essentials of Magnetism II were significantly correlated with each other and also correlated with overall job satisfaction and quality of care. Nurses from medical intensive care units had a healthier work environment with higher scores of overall job satisfaction and quality of care than other intensive care units, while surgical intensive care units showed the least healthy work environment with the lowest overall job satisfaction and quality of care scores identified. The essentials of Chinese version of the Essentials of Magnetism II, overall job satisfaction and quality of care were also correlated with nurses' work experience and their education level. Nurse administrators and health policy-makers should establish a healthy work environment for intensive care units nurses, especially for those from surgical intensive care units. © 2014 John Wiley & Sons Ltd.
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Chen, Xi; McElwain, Nancy L; Lansford, Jennifer E
2017-12-20
Using data from a subsample of 913 study children and their friends who participated in the NICHD Study of Early Child Care and Youth Development, the interactive contributions of child-reported attribution biases and teacher-reported child emotional intensity (EI) at Grade 4 (M = 9.9 years) to observed child-friend interaction at Grade 6 (M = 11.9 years) were examined. Study children's hostile attribution bias, combined with high EI, predicted more negative child-friend interaction. In contrast, benign attribution bias, combined with high EI, predicted more positive child-friend interaction. The findings are discussed in light of the "fuel" interpretation of EI, in which high-intensity emotions may motivate children to act on their cognitive biases for better or for worse. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.
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Stock, Susan R; Nicolakakis, Nektaria; Vézina, Nicole; Vézina, Michel; Gilbert, Louis; Turcot, Alice; Sultan-Taïeb, Hélène; Sinden, Kathryn; Denis, Marie-Agnès; Delga, Céline; Beaucage, Clément
2018-03-01
Objectives We sought to determine whether interventions that target work organization or the psychosocial work environment are effective in preventing or reducing work-related musculoskeletal disorders (WMSD) compared to usual work. Methods We systematically reviewed the 2000-2015 English- and French-language scientific literature, including studies evaluating the effectiveness of an organizational or psychosocial work intervention on incidence, prevalence or intensity of work-related musculoskeletal pain or disorders in the neck, shoulders, upper limbs and/or back or of work absence due to such problems, among non-sick-listed workers. We excluded rehabilitation and individual-level behavioral interventions and studies with >50% attrition. We analyzed medium- and high-quality studies and synthesized the evidence using the Grading of Recommendations Assessment, Development & Evaluation (GRADE) approach. An analysis of key workplace intervention elements supplemented the interpretation of results. Results We identified 884 articles; 28 met selection criteria, yielding 2 high-quality, 10 medium-quality and 16 low-quality studies. There was moderate evidence that supplementary breaks, compared to conventional break schedules, are effective in reducing symptom intensity in various body regions. Evidence was low-to-very-low quality for other interventions, primarily due to risk of bias related to study design, high attrition rates, co-interventions, and insensitive indicators. Most interventions lacked key intervention elements, such as work activity analysis and ergonomist guidance during implementation, but the relation of these elements to intervention effectiveness or ineffectiveness remains to be demonstrated. Conclusions Targeting work-rest cycles may reduce WMSD. Better quality studies are needed to allow definitive conclusions to be drawn on the effectiveness of other work organizational or psychosocial interventions to prevent or reduce WMSD.
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Schelling, Gustav; Richter, Markus; Roozendaal, Benno; Rothenhäusler, Hans-Bernd; Krauseneck, Till; Stoll, Christian; Nollert, Georg; Schmidt, Michael; Kapfhammer, Hans-Peter
2003-07-01
Up to 20% of patients do not show improvements in health-related quality of life (HRQL) after cardiac surgery, despite apparently successful surgical procedures. We sought to determine whether failed improvements in HRQL after cardiac surgery are associated with the development of traumatic memories and chronic stress states as a result of high perioperative stress exposure. Prospective cohort study. A 10-bed cardiovascular intensive care unit of a tertiary care university hospital. A total of 148 cardiac surgical patients. None. The patients were evaluated for traumatic memories from postoperative treatment in the cardiovascular intensive care unit (defined as the subjective recollection of pain, respiratory distress, anxiety/panic, and nightmares), symptoms of chronic stress, including those of posttraumatic stress disorder, and HRQL preoperatively (at baseline) and at 6 months after cardiac surgery. A state of chronic stress was defined as the development of posttraumatic stress disorder at 6 months after surgery. Factors predicting the decline in HRQL were determined by multivariable linear regression. Twenty-seven patients (18.2%) had posttraumatic stress disorder at 6 months after cardiac surgery; seven of these patients (4.8%) had evidence of preexisting posttraumatic stress disorder before undergoing cardiac surgery. Patients with new posttraumatic stress disorder at 6 months after cardiac surgery had a significantly higher number of traumatic memories from postoperative treatment in the cardiovascular intensive care unit (p =.01). A multiple regression model included the number of traumatic memories from the intensive care unit and stress symptom scores at 6 months after heart surgery as predictors for variations in physical HRQL outcome scores (R2 =.30, p <.04). Stress symptom scores were the most significant predictors of mental health HRQL outcomes (R2 =.52, p <.01). Exposure to high stress in the cardiovascular intensive care unit can have negative effects on HRQL outcomes of cardiac surgery.
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Enhancement of beam pulse controllability for a single-pulse formation system of a cyclotron.
Kurashima, Satoshi; Miyawaki, Nobumasa; Kashiwagi, Hirotsugu; Okumura, Susumu; Taguchi, Mitsumasa; Fukuda, Mitsuhiro
2015-07-01
The single-pulse formation technique using a beam chopping system consisting of two types of high-voltage beam kickers was improved to enhance the quality and intensity of the single-pulse beam with a pulse interval over 1 μs at the Japan Atomic Energy Agency cyclotron facility. A contamination rate of neighboring beam bunches in the single-pulse beam was reduced to less than 0.1%. Long-term purification of the single pulse beam was guaranteed by the well-controlled magnetic field stabilization system for the cyclotron magnet. Reduction of the multi-turn extraction number for suppressing the neighboring beam bunch contamination was achieved by restriction of a beam phase width and precise optimization of a particle acceleration phase. In addition, the single-pulse beam intensity was increased by a factor of two or more by a combination of two types of beam bunchers using sinusoidal and saw-tooth voltage waveforms. Provision of the high quality intense single-pulse beam contributed to improve the accuracy of experiments for investigation of scintillation light time-profile and for neutron energy measurement by a time-of-flight method.
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Enhancement of beam pulse controllability for a single-pulse formation system of a cyclotron
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kurashima, Satoshi, E-mail: kurashima.satoshi@jaea.go.jp; Miyawaki, Nobumasa; Kashiwagi, Hirotsugu
The single-pulse formation technique using a beam chopping system consisting of two types of high-voltage beam kickers was improved to enhance the quality and intensity of the single-pulse beam with a pulse interval over 1 μs at the Japan Atomic Energy Agency cyclotron facility. A contamination rate of neighboring beam bunches in the single-pulse beam was reduced to less than 0.1%. Long-term purification of the single pulse beam was guaranteed by the well-controlled magnetic field stabilization system for the cyclotron magnet. Reduction of the multi-turn extraction number for suppressing the neighboring beam bunch contamination was achieved by restriction of amore » beam phase width and precise optimization of a particle acceleration phase. In addition, the single-pulse beam intensity was increased by a factor of two or more by a combination of two types of beam bunchers using sinusoidal and saw-tooth voltage waveforms. Provision of the high quality intense single-pulse beam contributed to improve the accuracy of experiments for investigation of scintillation light time-profile and for neutron energy measurement by a time-of-flight method.« less
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Radiation dose reduction in a neonatal intensive care unit in computed radiography.
Frayre, A S; Torres, P; Gaona, E; Rivera, T; Franco, J; Molina, N
2012-12-01
The purpose of this study was to evaluate the dose received by chest x-rays in neonatal care with thermoluminescent dosimetry and to determine the level of exposure where the quantum noise level does not affect the diagnostic image quality in order to reduce the dose to neonates. In pediatric radiology, especially the prematurely born children are highly sensitive to the radiation because of the highly mitotic state of their cells; in general, the sensitivity of a tissue to radiation is directly proportional to its rate of proliferation. The sample consisted of 208 neonatal chest x-rays of 12 neonates admitted and treated in a Neonatal Intensive Care Unit (NICU). All the neonates were preterm in the range of 28-34 weeks, with a mean of 30.8 weeks. Entrance Surface Doses (ESD) values for chest x-rays are higher than the DRL of 50 μGy proposed by the National Radiological Protection Board (NRPB). In order to reduce the dose to neonates, the optimum image quality was achieved by determining the level of ESD where level noise does not affect the diagnostic image quality. The optimum ESD was estimated for additional 20 chest x-rays increasing kVp and reducing mAs until quantum noise affects image quality. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Morales-Sillero, Ana; García, José M
2015-09-01
Super-intensive cultivation facilitates olive mechanized harvesting, allowing substantial savings in the production cost of virgin olive oil (VOO). However, the number of varieties adapted to this type of cultivation is small. This study explores the impact that harvesting with a grape straddle harvester of 'Manzanilla de Sevilla' and 'Manzanilla Cacereña' olives grown in super-intensive cultivation has on the physiology of the fruit and the quality of the oil subsequently extracted. For both cultivars, fruits harvested mechanically showed higher respiration and ethylene production and lower firmness than fruits harvested by hand. Their oils exhibited lower phenol contents, lower oxidative stability and lower presence of positive sensory attributes. However, in these oils the values of parameters used to assess the level of quality of VOO remained within the limits required for the best commercial category. Mechanical harvesting of 'Manzanilla de Sevilla' and 'Manzanilla Cacereña' super-high-density hedgerows induced physiological alterations in the fruits and a reduction in the contents of natural antioxidants and flavour components in the oils, though it did not result in a loss of the 'Extra' level of quality. © 2014 Society of Chemical Industry.
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Room temperature linelists for CO2 asymmetric isotopologues with ab initio computed intensities
NASA Astrophysics Data System (ADS)
Zak, Emil J.; Tennyson, Jonathan; Polyansky, Oleg L.; Lodi, Lorenzo; Zobov, Nikolay F.; Tashkun, Sergei A.; Perevalov, Valery I.
2017-12-01
The present paper reports room temperature line lists for six asymmetric isotopologues of carbon dioxide: 16O12C18O (628), 16O12C17O (627), 16O13C18O (638),16O13C17O (637), 17O12C18O (728) and 17O13C18O (738), covering the range 0-8000 cm-1. Variational rotation-vibration wavefunctions and energy levels are computed using the DVR3D software suite and a high quality semi-empirical potential energy surface (PES), followed by computation of intensities using an ab initio dipole moment surface (DMS). A theoretical procedure for quantifying sensitivity of line intensities to minor distortions of the PES/DMS renders our theoretical model as critically evaluated. Several recent high quality measurements and theoretical approaches are discussed to provide a benchmark of our results against the most accurate available data. Indeed, the thesis of transferability of accuracy among different isotopologues with the use of mass-independent PES is supported by several examples. Thereby, we conclude that the majority of line intensities for strong bands are predicted with sub-percent accuracy. Accurate line positions are generated using an effective Hamiltonian, constructed from the latest experiments. This study completes the list of relevant isotopologues of carbon dioxide; these line lists are available to remote sensing studies and inclusion in databases.
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Creating a Highly Reliable Neonatal Intensive Care Unit Through Safer Systems of Care.
Panagos, Patoula G; Pearlman, Stephen A
2017-09-01
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology. Unplanned extubation is an example of a neonatal safety concern that can be reduced by employing quality improvement methodology. Copyright © 2017 Elsevier Inc. All rights reserved.
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Vos, Sjoerd B; Micallef, Caroline; Barkhof, Frederik; Hill, Andrea; Winston, Gavin P; Ourselin, Sebastien; Duncan, John S
2018-03-02
T2-FLAIR is the single most sensitive MRI contrast to detect lesions underlying focal epilepsies but 3D sequences used to obtain isotropic high-resolution images are susceptible to motion artefacts. Prospective motion correction (PMC) - demonstrated to improve 3D-T1 image quality in a pediatric population - was applied to high-resolution 3D-T2-FLAIR scans in adult epilepsy patients to evaluate its clinical benefit. Coronal 3D-T2-FLAIR scans were acquired with a 1mm isotropic resolution on a 3T MRI scanner. Two expert neuroradiologists reviewed 40 scans without PMC and 40 with navigator-based PMC. Visual assessment addressed six criteria of image quality (resolution, SNR, WM-GM contrast, intensity homogeneity, lesion conspicuity, diagnostic confidence) on a seven-point Likert scale (from non-diagnostic to outstanding). SNR was also objectively quantified within the white matter. PMC scans had near-identical scores on the criteria of image quality to non-PMC scans, with the notable exception that intensity homogeneity was generally worse. Using PMC, the percentage of scans with bad image quality was substantially lower than without PMC (3.25% vs. 12.5%) on the other five criteria. Quantitative SNR estimates revealed that PMC and non-PMC had no significant difference in SNR (P=0.07). Application of prospective motion correction to 3D-T2-FLAIR sequences decreased the percentage of low-quality scans, reducing the number of scans that need to be repeated to obtain clinically useful data. Copyright © 2018 The Authors. Published by Elsevier Masson SAS.. All rights reserved.
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Beef customer satisfaction: trained sensory panel ratings and Warner-Bratzler shear force values.
Lorenzen, C L; Miller, R K; Taylors, J F; Neely, T R; Tatum, J D; Wise, J W; Buyek, M J; Reagan, J O; Savell, J W
2003-01-01
Trained sensory panel ratings and Warner-Bratzler shear force (WBS) values from the Beef Customer Satisfaction study are reported. Carcasses were chosen to fit into USDA quality grades of Top Choice (upper two-thirds of USDA Choice), Low Choice, High Select, and Low Select. A trained, descriptive attribute panel evaluated top loin, top sirloin, and top round steaks for muscle fiber tenderness, connective tissue amount, overall tenderness, juiciness, flavor intensity, cooked beef flavor intensity, and cooked beef fat flavor intensity. Four steaks from each of the three cuts from each carcass were assigned randomly to one of four cooking endpoint temperature treatments (60, 65, 70, or 75 degrees C) for WBS determination. For all trained panel measures of tenderness and WBS, regardless of USDA quality grade, top loin steaks were rated higher than top sirloin steaks, which were rated higher than top round steaks (P < 0.05). There were significant interactions between USDA quality grade and cut for most of the trained sensory panel traits: USDA quality grade influenced ratings for top loin steaks more than ratings for top round steaks or top sirloin steaks. Three interactions were significant for WBS values: USDA quality grade x endpoint temperature (P = 0.02), USDA quality grade x cut (P = 0.0007), and cut x endpoint temperature (P = 0.0001). With the exception of High Select, WBS values increased (P < 0.05) for each grade with increasing endpoint temperature. Choice top loin and top round steaks had lower (P < 0.05) WBS values than Select steaks of the same cut; however, only Top Choice top sirloin steaks differed (P < 0.05) from the other USDA grades. As endpoint temperatures increased, WBS values for top sirloin steaks increased substantially compared to the other cuts. When cooked to 60 degrees C, top sirloin steaks were closer to top loin steaks in WBS values, when cooked to 75 degrees C, top sirloin steaks were closer to top round steaks in WBS values. Simple correlation coefficients between consumer ratings and trained sensory muscle fiber tenderness, connective tissue amount, overall tenderness, juiciness, flavor intensity, and cooked beef fat flavor were significant (P < 0.05), but values were low. While relationships exist between consumer and trained sensory measures, it is difficult to predict from objective data how consumers will rate meat at home.
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Giallauria, Francesco; Smart, Neil Andrew; Cittadini, Antonio; Vigorito, Carlo
2016-10-14
Exercise training (ET) is strongly recommended in patients with chronic heart failure (CHF). Moderate-intensity aerobic continuous ET is the best established training modality in CHF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. Basically, HIIT consists of repeated bouts of high-intensity exercise alternated with recovery periods. In CHF patients, HIIT exerts larger improvements in exercise capacity compared to moderate-continuous ET. These results are intriguing, mostly considering that better functional capacity translates into an improvement of symptoms and quality of life. Notably, HIIT did not reveal major safety issues; although CHF patients should be clinically stable, have had recent exposure to at least regular moderate-intensity exercise, and appropriate supervision and monitoring during and after the exercise session are mandatory. The impact of HIIT on cardiac dimensions and function and on endothelial function remains uncertain. HIIT should not replace other training modalities in heart failure but should rather complement them. Combining and tailoring different ET modalities according to each patient's baseline clinical characteristics (i.e. exercise capacity, personal needs, preferences and goals) seem the most astute approach to exercise prescription.
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Differences in Pain Location, Intensity and Quality by Pain Pattern in Outpatients with Cancer
Ngamkham, Srisuda; Holden, Janean E.; Wilkie, Diana J.
2013-01-01
Pain pattern represents how the individual’s pain changes temporally with activities or other factors. Understanding pain pattern is important for appropriate timing of pain interventions, but researchers have studied less the temporal aspects of cancer pain than pain location, intensity, and quality parameters. The study purpose was to explore differences in pain location, intensity, and quality by pattern groups in outpatients with cancer. We conducted a comparative, secondary data analysis of data collected from 1994 to 2007. 762 outpatients with cancer had completed the 0-to-10 Pain Intensity Number Scale and the McGill Pain Questionnaire to measure pain location, quality and pattern. From all possible combinations of the three types of pain patterns, we created seven pain pattern groups. The distribution of pain pattern was: pattern-1 (27%); pattern-2 (24%); pattern-3 (8%); pattern-4 (12%); pattern-5 (3%); pattern-6 (18%); and pattern-7 (8%). A statistically significant higher proportion of patients with continuous pain patterns (pattern 1, 4, 5, and 7) reported pain location in two or more sites. Patients with pattern 1, 4, and 7 reported statistically significant, higher worst pain mean scores than patients with pattern 2, 3, and 6 (not continuous descriptors). Patients with pattern7 reported statistically significant, higher mean scores (pain rating index-sensory and total number of words selected) than patients with pattern1, 2, 3, 4, and 6. Using pain pattern groups may help clinicians to understand temporal changes in cancer pain and to provide more effective pain management by recognizing the high risk if the pain is continuous. PMID:21512345
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Measuring the quality of therapeutic apheresis care in the pediatric intensive care unit.
Sussmane, Jeffrey B; Torbati, Dan; Gitlow, Howard S
2012-01-01
Our goal was to measure the quality of care provided in the Pediatric Intensive Care Unit (PICU) during Therapeutic Apheresis (TA). We described the care as a step by step process. We designed a flow chart to carefully document each step of the process. We then defined each step with a unique clinical indictor (CI) that represented the exact task we felt provided quality care. These CIs were studied and modified for 1 year. We measured our performance in this process by the number of times we accomplished the CI vs. the total number of CIs that were to be performed. The degree of compliance, with these clinical indicators, was analyzed and used as a metric for quality by calculating how close the process is running exactly as planned or "in control." The Apheresis Process was in control (compliance) for 47% of the indicators, as measured in the aggregate for the first observational year. We then applied the theory of Total Quality Management (TQM) through our Design, Measure, Analyze, Improve, and Control (DMAIC) model. We were able to improve the process and bring it into control by increasing the compliance to > 99.74%, in the aggregate, for the third and fourth quarter of the second year. We have implemented TQM to increase compliance, thus control, of a highly complex and multidisciplinary Pediatric Intensive Care therapy. We have shown a reproducible and scalable measure of quality for a complex clinical process in the PICU, without additional capital expenditure. Copyright © 2011 Wiley-Liss, Inc.
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ERIC Educational Resources Information Center
Lawrence, Nancy; Sanders, Felicia; Christman, Jolley Bruce; Duffy, Mark
2011-01-01
The Bill and Melinda Gates Foundation has invested in the development and dissemination of high-quality formative assessment tools to support teachers' incorporation of the Core Common State Standards (CCSS) into their classroom instruction. Lessons from the first generation of standards-based reforms suggest that intense attention to high quality…
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Timothy B. Harrington; Jeff Madsen
2005-01-01
Research and operational trials have identified methods of forest plantation establishment that promote high rates of survival and early growth of tree seedlings in the Pacific Northwest. Primary reasons for this success are the intensive control of competing vegetation provided by herbicide treatments and the planting of high quality seedlings. This paper discusses...
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Pedraza, Lizeth K; Sierra, Rodrigo O; Boos, Flávia Z; Haubrich, Josué; Quillfeldt, Jorge A; Alvares, Lucas de Oliveira
2016-03-01
Memory fades over time, becoming more schematic or abstract. The loss of contextual detail in memory may reflect a time-dependent change in the brain structures supporting memory. It has been well established that contextual fear memory relies on the hippocampus for expression shortly after learning, but it becomes hippocampus-independent at a later time point, a process called systems consolidation. This time-dependent process correlates with the loss of memory precision. Here, we investigated whether training intensity predicts the gradual decay of hippocampal dependency to retrieve memory, and the quality of the contextual memory representation over time. We have found that training intensity modulates the progressive decay of hippocampal dependency and memory precision. Strong training intensity accelerates systems consolidation and memory generalization in a remarkable timeframe match. The mechanisms underpinning such process are triggered by glucocorticoid and noradrenaline released during training. These results suggest that the stress levels during emotional learning act as a switch, determining the fate of memory quality. Moderate stress will create a detailed memory, whereas a highly stressful training will develop a generic gist-like memory. © 2015 Wiley Periodicals, Inc.
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Far-field coupling in nanobeam photonic crystal cavities
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rousseau, Ian, E-mail: ian.rousseau@epfl.ch; Sánchez-Arribas, Irene; Carlin, Jean-François
2016-05-16
We optimized the far-field emission pattern of one-dimensional photonic crystal nanobeams by modulating the nanobeam width, forming a sidewall Bragg cross-grating far-field coupler. By setting the period of the cross-grating to twice the photonic crystal period, we showed using three-dimensional finite-difference time-domain simulations that the intensity extracted to the far-field could be improved by more than three orders of magnitude compared to the unmodified ideal cavity geometry. We then experimentally studied the evolution of the quality factor and far-field intensity as a function of cross-grating coupler amplitude. High quality factor (>4000) blue (λ = 455 nm) nanobeam photonic crystals were fabricated out ofmore » GaN thin films on silicon incorporating a single InGaN quantum well gain medium. Micro-photoluminescence spectroscopy of sets of twelve identical nanobeams revealed a nine-fold average increase in integrated far-field emission intensity and no change in average quality factor for the optimized structure compared to the unmodulated reference. These results are useful for research environments and future nanophotonic light-emitting applications where vertical in- and out-coupling of light to nanocavities is required.« less
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Use of formwork systems in high-rise construction
NASA Astrophysics Data System (ADS)
Kurakova, Oksana
2018-03-01
Erection of high quality buildings and structures within a reasonable time frame is the crucial factor for the competitiveness of any construction organization. The main material used in high-rise construction is insitu reinforced concrete. The technology of its use is directly related to the use of formwork systems. Formwork systems and formwork technologies basically determine the speed of construction and labor intensity of concreting operations. Therefore, it is also possible to achieve the goal of reducing the construction time and labor intensity of works performed by improving the technology of formwork systems use. Currently there are unresolved issues in the area of implementation of monolithic technology projects, and problems related to the selection of a formwork technology, high labor intensity of works, poor quality of materials and structures, etc. are the main ones. The article presents organizational and technological measures, by means of which introduction it is possible to shorten the duration of construction. A comparison of operations performed during formwork installation according to the conventional technology and taking into account the implemented organizational and technological measures is presented. The results of a comparative analysis of economic efficiency assessments are also presented on the example of a specific construction project before and after the implementation of the above mentioned measures. The study showed that introduction of the proposed organizational and technological model taking into account optimization of reinforcing and concreting works significantly improves the efficiency of a high-rise construction project. And further improvement of technologies for the use of insitu reinforced concrete is a promising direction in the construction of high-rise buildings.
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Bringing quality improvement into the intensive care unit.
McMillan, Tracy R; Hyzy, Robert C
2007-02-01
During the last several years, many governmental and nongovernmental organizations have championed the application of the principles of quality improvement to the practice of medicine, particularly in the area of critical care. To review the breadth of approaches to quality improvement in the intensive care unit, including measures such as mortality and length of stay, and the use of protocols, bundles, and the role of large, multiple-hospital collaboratives. Several agencies have participated in the application of the quality movement to medicine, culminating in the development of standards such as the intensive care unit core measures of the Joint Commission on Accreditation of Healthcare Organizations. Although "zero defects" may not be possible in all measurable variables of quality in the intensive care unit, several measures, such as catheter-related bloodstream infections, can be significantly reduced through the implementation of improved processes of care, such as care bundles. Large, multiple-center, quality improvement collaboratives, such as the Michigan Keystone Intensive Care Unit Project, may be particularly effective in improving the quality of care by creating a "bandwagon effect" within a geographic region. The quality revolution is having a significant effect in the critical care unit and is likely to be facilitated by the transition to the electronic medical record.
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Su, Li-Chien; Hsu, Yi-Hsiang; Wang, Hsiang-Yu
2012-05-01
An alternating current was used to generate an electric field to enhance the fluorescent labeling of microalgae cellular lipids with Nile red and LipidTOX. The decay of the fluorescence intensity of Chlorella vulgaris cells in 0 V/cm was more than 50% after 10 min, and the intensity variation was as high as 7% in 20s. At 2000 V/cm, the decay rate decreased to 1.22% per minute and the intensity fluctuation was less than 1% for LipidTOX-labeled cells. For Spirulina sp. cells at 0 V/cm, the fluorescence intensity increased by 10% after 10 min, whereas at 2000 V/cm, labeling was more rapid and fluorescence intensity doubled. These results show that applying an electric field can improve the quality of fluorescence detection by alleviating decay and fluctuation or by enhancing signal intensity. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units.
Rochefort, Christian M; Clarke, Sean P
2010-10-01
This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses' perceptions of care rationing, job outcomes, and quality of care. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Over a 6-month period in 2007-2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). A total of 339 nurses (61.3%) completed questionnaires. Overall, 18.6% were dissatisfied with their job, 35.7% showed high emotional exhaustion, and 19.2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. © 2010 Blackwell Publishing Ltd.
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Amin, Amee A; Vankar, Jagdish R; Nimbalkar, Somashekhar M; Phatak, Ajay G
2015-11-01
To study the levels of perceived stress in Neonatal Intensive Care Unit (NICU) nurses and its association with professional quality of life domains viz. compassion satisfaction, burnout and secondary trauma. In this multicenter, cross sectional study, data was collected by surveying 129 nurses from nine NICUs across six cities of Gujarat, India using demographic questionnaire, Perceived Stress Scale (PSS14) and Professional Quality of Life Scale (ProQOL5) during July to September 2013. Descriptive statistics, correlation coefficient and multiple regression were used for analysis. The mean (SD) age of participants was 28.37 (8.20) y. Most were single, satisfied with salary benefits and reported 'good' to 'excellent' relationships at work. The mean (SD) duration of duty hours was 8.12 (0.76) h and 43.6% were attending to more than 4 patients/shift. The mean (SD) perceived stress level was 22.19 (7.17) [Range: 3 to 39]. High compassion satisfaction, high burnout, and high secondary traumatic stress were reported by 25 (19.4%), 30 (23.3%) and 30 (23.3%) nurses respectively. PSS14 was negatively correlated with compassion satisfaction (r = -0.28) and positively correlated with burnout (r = 0.43) and secondary traumatic stress (r = 0.24). Most of the nurses (91, 70.5%) were identified as perceiving moderate to high stress. Professional quality of life domains correlated with perceived stress. There is further need to study domains influencing NICU nurses' professional QOL. Identifying stress and QOL issues in NICU nurses can help formulate relevant policies.
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Santos, Eduardo; Cardoso, Daniela; Neves, Hugo; Cunha, Madalena; Rodrigues, Manuel; Apóstolo, João
2017-05-01
Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium. Patients with a predicted high risk of delirium, aged 18 years or over, and in intensive care units. Patients with a history of concurrent antipsychotic medication use were excluded. Haloperidol prophylaxis for preventing delirium. Experimental and epidemiological study designs. Primary outcome is the incidence of delirium. Secondary outcomes are duration of mechanical ventilation, incidence of re-intubation, incidence of unplanned/accidental removal of tubes/lines and catheters, intensive care unit and hospital length of stay, and re-admissions to both settings. An initial search of MEDLINE and CINAHL was undertaken, followed by a second search for published and unpublished studies from January 1967 to September 2015 in major healthcare-related electronic databases. Studies in English, Spanish and Portuguese were included. Two independent reviewers assessed the methodological quality of five studies using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. There was general agreement among the reviewers to exclude one relevant study due to methodological quality. Data were extracted using the JBI data extraction form for experimental studies and included details about the interventions, populations, study methods and outcomes of significance to the review questions. Significant differences were found between participants, interventions, outcome measures (clinical heterogeneity) and designs (methodological heterogeneity). For these reasons, we were unable to perform a meta-analysis. Therefore, the results have been described in a narrative format. Five studies met the inclusion criteria. One of these studies was excluded due to poor methodological quality. The remaining four original studies (total of 1142 patients) were included in this review. Three studies were randomized controlled trials and one was a cohort study.Two studies confirmed the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk of delirium. These studies showed that short-term prophylactic administration of low-dose intravenous haloperidol significantly decreased the incidence of delirium in elderly patients admitted to intensive care units after non-cardiac surgery and in general intensive care unit patients with a high risk of delirium.However, the two remaining studies showed contradictory results in mechanically ventilated critically ill adults, revealing that the administration of haloperidol reduced delirium prevalence, delayed its occurrence, and/or shorten its duration. The evidence related to the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk of delirium is contradictory. However, balancing the benefits and low side effects associated with haloperidol prophylaxis, this preventive intervention may be useful to reduce the incidence of delirium in critically ill adults in intensive care units.
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Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura
2016-01-01
Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use.
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Yasukawa, Ken; Knight, Richard L.; Skagen, Susan Knight
1987-01-01
We studied Red-winged Blackbird (Agelaius phoeniceus) behavior in marsh and prairie habitats to determine whether courting males provide cues of their nest defense, whether females prefer males that defend nests vigorously, and whether male nest defense affects nest success. We found no evidence that courtship behavior provides cues of male nest defense, or that females prefer males that court intensely. We found evidence that females nesting in marshes prefer males that defend nests intensely, but no evidence that intensely defending males in the prairie habitat achieve high nest success. We found differences, however, between marsh and prairie habitats that suggest a coarse-grained relationship between male parental quality and female choice of mate in this species.
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Correction of aeroheating-induced intensity nonuniformity in infrared images
NASA Astrophysics Data System (ADS)
Liu, Li; Yan, Luxin; Zhao, Hui; Dai, Xiaobing; Zhang, Tianxu
2016-05-01
Aeroheating-induced intensity nonuniformity effects severely influence the effective performance of an infrared (IR) imaging system in high-speed flight. In this paper, we propose a new approach to the correction of intensity nonuniformity in IR images. The basic assumption is that the low-frequency intensity bias is additive and smoothly varying so that it can be modeled as a bivariate polynomial and estimated by using an isotropic total variation (TV) model. A half quadratic penalty method is applied to the isotropic form of TV discretization. And an alternating minimization algorithm is adopted for solving the optimization model. The experimental results of simulated and real aerothermal images show that the proposed correction method can effectively improve IR image quality.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Liddell, Heather; Brueske, Sabine; Carpenter, Alberta
With their high strength-to-weight ratios, fiber-reinforced polymer (FRP) composites are important materials for lightweighting in structural applications; however, manufacturing challenges such as low process throughput and poor quality control can lead to high costs and variable performance, limiting their use in commercial applications. One of the most significant challenges for advanced composite materials is their high manufacturing energy intensity. This study explored the energy intensities of two lightweight FRP composite materials (glass- and carbon-fiber-reinforced polymers), with three lightweight metals (aluminum, magnesium, and titanium) and structural steel (as a reference material) included for comparison. Energy consumption for current typical and state-of-the-artmore » manufacturing processes were estimated for each material, deconstructing manufacturing process energy use by sub-process and manufacturing pathway in order to better understand the most energy intensive steps. Energy saving opportunities were identified and quantified for each production step based on a review of applied R&D technologies currently under development in order to estimate the practical minimum energy intensity. Results demonstrate that while carbon fiber reinforced polymer (CFRP) composites have the highest current manufacturing energy intensity of all materials considered, the large differences between current typical and state-of-the-art energy intensity levels (the 'current opportunity') and between state-of-the-art and practical minimum energy intensity levels (the 'R&D opportunity') suggest that large-scale energy savings are within reach.« less
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Intensive Exercise Training During Bed Rest Attenuates Deconditioning
NASA Technical Reports Server (NTRS)
Greenleaf, John E.
1997-01-01
Intensive exercise training during bed rest attenuates deconditioning. Med. Sci. Sports Exerc., Vol. 29, No. 2, pp. 207-215, 1997. A 30-d 6 deg head-down bed rest project was conducted to evaluate variable high-intensity, short-duration, isotonic cycle ergometer exercise (ITE) training and high-intensity intermittent resistive isokinetic exercise (IKE) training regimens designed to maintain peak VO2 and muscle mass, strength, and endurance at ambulatory control levels throughout prolonged bed rest. Other elements of the deconditioning (adaptive) syndrome, such as proprioception, psychological performance, hypovolemia, water balance, body composition, and orthostatic tolerance, were also measured. Major findings are summarized in this paper. Compared with response during bed rest of the no exercise (NOE) control group: the ITE training regimen (a) maintained work capacity (peak VO2), (b) maintained plasma and red cell volumes, (c) induced positive body water balance, (d) decreased quality of sleep and mental concentration, and (e) had no effect on the decrease in orthostatic tolerance; the IKE training regimen (f) attenuated the decrease in peak VO2 by 50%, (g) attenuated loss of red cell volume by 40% but had no effect on loss of plasma volume, (b) induced positive body water balance, (i) had no adverse effect on quality of sleep or concentration, and 0) had no effect on the decrease in orthostatic tolerance. These findings suggest that various elements of the deconditioning syndrome can be manipulated by duration and intensity of ITE or IKE training regimens and that several different training protocols will be required to maintain or restore physiological and psychological performance of individuals confined to prolonged bed rest.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Hong QIn, Ronald Davidson
2011-07-18
The Courant-Snyder (CS) theory and the Kapchinskij-Vladimirskij (KV) distribution for high-intensity beams in a uncoupled focusing lattice are generalized to the case of coupled transverse dynamics. The envelope function is generalized to an envelope matrix, and the envelope equation becomes a matrix envelope equation with matrix operations that are non-commutative. In an uncoupled lattice, the KV distribution function, first analyzed in 1959, is the only known exact solution of the nonlinear Vlasov-Maxwell equations for high-intensity beams including self-fields in a self-consistent manner. The KV solution is generalized to high-intensity beams in a coupled transverse lattice using the generalized CS invariant.more » This solution projects to a rotating, pulsating elliptical beam in transverse configuration space. The fully self-consistent solution reduces the nonlinear Vlasov-Maxwell equations to a nonlinear matrix ordinary differential equation for the envelope matrix, which determines the geometry of the pulsating and rotating beam ellipse. These results provide us with a new theoretical tool to investigate the dynamics of high-intensity beams in a coupled transverse lattice. A strongly coupled lattice, a so-called N-rolling lattice, is studied as an example. It is found that strong coupling does not deteriorate the beam quality. Instead, the coupling induces beam rotation, and reduces beam pulsation.« less
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Qin Hong; Department of Modern Physics, University of Science and Technology of China, Hefei, Anhui 230026; Davidson, Ronald C.
2011-05-15
The Courant-Snyder (CS) theory and the Kapchinskij-Vladimirskij (KV) distribution for high-intensity beams in an uncoupled focusing lattice are generalized to the case of coupled transverse dynamics. The envelope function is generalized to an envelope matrix, and the envelope equation becomes a matrix envelope equation with matrix operations that are noncommutative. In an uncoupled lattice, the KV distribution function, first analyzed in 1959, is the only known exact solution of the nonlinear Vlasov-Maxwell equations for high-intensity beams including self-fields in a self-consistent manner. The KV solution is generalized to high-intensity beams in a coupled transverse lattice using the generalized CS invariant.more » This solution projects to a rotating, pulsating elliptical beam in transverse configuration space. The fully self-consistent solution reduces the nonlinear Vlasov-Maxwell equations to a nonlinear matrix ordinary differential equation for the envelope matrix, which determines the geometry of the pulsating and rotating beam ellipse. These results provide us with a new theoretical tool to investigate the dynamics of high-intensity beams in a coupled transverse lattice. A strongly coupled lattice, a so-called N-rolling lattice, is studied as an example. It is found that strong coupling does not deteriorate the beam quality. Instead, the coupling induces beam rotation and reduces beam pulsation.« less
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NASA Astrophysics Data System (ADS)
Moonon, Altan-Ulzii; Hu, Jianwen; Li, Shutao
2015-12-01
The remote sensing image fusion is an important preprocessing technique in remote sensing image processing. In this paper, a remote sensing image fusion method based on the nonsubsampled shearlet transform (NSST) with sparse representation (SR) is proposed. Firstly, the low resolution multispectral (MS) image is upsampled and color space is transformed from Red-Green-Blue (RGB) to Intensity-Hue-Saturation (IHS). Then, the high resolution panchromatic (PAN) image and intensity component of MS image are decomposed by NSST to high and low frequency coefficients. The low frequency coefficients of PAN and the intensity component are fused by the SR with the learned dictionary. The high frequency coefficients of intensity component and PAN image are fused by local energy based fusion rule. Finally, the fused result is obtained by performing inverse NSST and inverse IHS transform. The experimental results on IKONOS and QuickBird satellites demonstrate that the proposed method provides better spectral quality and superior spatial information in the fused image than other remote sensing image fusion methods both in visual effect and object evaluation.
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Pereira, Michelle Jessica; Coombes, Brooke Kaye; Comans, Tracy Anne; Johnston, Venerina
2015-06-01
The aim of this study is to investigate the effects of onsite workplace health-enhancing physical activity (HEPA) programmes on worker productivity. The PROSPERO registration number is CRD42014008750. A search for controlled trials or randomised controlled trials (RCTs) that investigated the effects of onsite workplace HEPA programmes on productivity levels of working adults was performed. Risk of bias of included studies was assessed, and the inter-rater reliability of the quality assessment was analysed. Qualitative synthesis of available evidence is presented. Eight studies were included in the review. There is consistent evidence that onsite workplace HEPA programmes do not reduce levels of sick leave. There appears to be inconsistent evidence of the impact of onsite workplace HEPA programmes on worker productivity. A high-quality study of an onsite combination (aerobic, strengthening and flexibility) HEPA regime and a moderate-quality study of a Tai Chi programme improved worker productivity measured with questionnaires in female laundry workers and older female nurses, respectively. Two high-quality studies and four moderate-quality studies did not show benefit. Studies that showed benefit were mainly those designed with productivity measures as primary outcomes, delivered to occupations involved with higher physical loads, and had higher compliance and programme intensity. The small number of studies and the lack of consistency among studies limited further analyses. There is inconsistent evidence that onsite workplace HEPA programmes improve self-reported worker productivity. Future high-quality RCTs of onsite workplace HEPA programmes should be designed around productivity outcomes, target at-risk groups and investigate interventions of sufficient intensity. High attendance with improved recording is needed to achieve significant results in augmenting worker productivity. 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.
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Hopman, Joost; Donskey, Curtis J; Boszczowski, Icaro; Alfa, Michelle J
2018-05-23
The efficacy of discharge cleaning and disinfection of high-touch surfaces of intensive care unit patient rooms in Brazil, Canada, the Netherlands, and the United States was evaluated and the effect of an educational intervention was determined. Significant site-to-site differences in cleaning regimens and baseline cleanliness levels were observed using ATP levels, colony-forming units, and reflective surface marker removal percent pass rates. An educational intervention that includes rapid feedback of the ATP measurements could significantly improve the quality of the cleaning and disinfection regimens. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
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Flueckiger, Lavinia; Lieb, Roselind; Meyer, Andrea H; Witthauer, Cornelia; Mata, Jutta
2016-06-01
We investigated the potential stress-buffering effect of 3 health behaviors-physical activity, sleep quality, and snacking-on affect in the context of everyday life in young adults. In 2 intensive longitudinal studies with up to 65 assessment days over an entire academic year, students (Study 1, N = 292; Study 2, N = 304) reported stress intensity, sleep quality, physical activity, snacking, and positive and negative affect. Data were analyzed using multilevel regression analyses. Stress and positive affect were negatively associated; stress and negative affect were positively associated. The more physically active than usual a person was on a given day, the weaker the association between stress and positive affect (Study 1) and negative affect (Studies 1 and 2). The better than usual a person's sleep quality had been during the previous night, the weaker the association between stress and positive affect (Studies 1 and 2) and negative affect (Study 2). The association between daily stress and positive or negative affect did not differ as a function of daily snacking (Studies 1 and 2). On stressful days, increasing physical activity or ensuring high sleep quality may buffer adverse effects of stress on affect in young adults. These findings suggest potential targets for health-promotion and stress-prevention programs, which could help reduce the negative impact of stress in young adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
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Volatile composition and sensory quality of Spanish pomegranates (Punica granatum L.).
Calín-Sánchez, Angel; Martínez, Juan J; Vázquez-Araújo, Laura; Burló, Francisco; Melgarejo, Pablo; Carbonell-Barrachina, Angel A
2011-02-01
Pomegranate is highly valued for its health-promoting effects. Fruits of nine pomegranate cultivars were analysed for volatile compounds, antioxidant activity and quality parameters, including maturity index and CIEL*a*b* colour. Volatile compounds were isolated from fresh juices using hydrodistillation; extracts were analysed using gas chromatography/mass spectrometry. Fruit colour was influenced by cultivar and grouping of cultivars according to their taste (sweet, sour-sweet or sour), with sweet fruits having more intense red colour and higher lightness values. A total of 18 compounds were found in pomegranate aroma profiles, including monoterpenes, aldehydes, alcohols, monoterpenoids and linear hydrocarbons. The most abundant compound were trans-2-hexenal, 3-carene, α-terpinene and α-terpineol. The total concentration of volatiles ranged from 1.7 to 10.9 g kg(-1) . Overall consumer liking of pomegranate juices was associated with the presence of monoterpenes such as α-pinene, β-pinene, β-myrcene, limonene and γ-terpinene. The presence of aldehydes such as hexanol, hexanal and cis-3-hexenol was correlated with poor overall consumer liking. Fruits from the cultivar Mollar de Elche 2 were those most suited for juice processing because they had the highest total concentration of volatiles, which was related to high overall consumer liking, intense and acceptable fresh pomegranate odour and flavour (high scores of satisfaction degree), medium intensity of red colour and low sourness. 2010 Society of Chemical Industry.
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Performance of high intensity fed-batch mammalian cell cultures in disposable bioreactor systems.
Smelko, John Paul; Wiltberger, Kelly Rae; Hickman, Eric Francis; Morris, Beverly Janey; Blackburn, Tobias James; Ryll, Thomas
2011-01-01
The adoption of disposable bioreactor technology as an alternate to traditional nondisposable technology is gaining momentum in the biotechnology industry. Evaluation of current disposable bioreactors systems to sustain high intensity fed-batch mammalian cell culture processes needs to be explored. In this study, an assessment was performed comparing single-use bioreactors (SUBs) systems of 50-, 250-, and 1,000-L operating scales with traditional stainless steel (SS) and glass vessels using four distinct mammalian cell culture processes. This comparison focuses on expansion and production stage performance. The SUB performance was evaluated based on three main areas: operability, process scalability, and process performance. The process performance and operability aspects were assessed over time and product quality performance was compared at the day of harvest. Expansion stage results showed disposable bioreactors mirror traditional bioreactors in terms of cellular growth and metabolism. Set-up and disposal times were dramatically reduced using the SUB systems when compared with traditional systems. Production stage runs for both Chinese hamster ovary and NS0 cell lines in the SUB system were able to model SS bioreactors runs at 100-, 200-, 2,000-, and 15,000-L scales. A single 1,000-L SUB run applying a high intensity fed-batch process was able to generate 7.5 kg of antibody with comparable product quality. Copyright © 2011 American Institute of Chemical Engineers (AIChE).
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Influence of Exercise on Patients with Guillain-Barré Syndrome: A Systematic Review
Vincent, Pierre-Olivier; Yu, Bai He Shen; Bastien, Robin; Sweeney, Aaron
2016-01-01
Purpose: To evaluate the effects of exercise interventions on improving physical outcomes in patients with Guillain-Barré syndrome (GBS). Methods: The PubMed database was searched for articles published up to and including February 2015. Randomized controlled trials (RCTs), case reports, and quasi-experimental and single-subject designs published in English-language, peer-reviewed journals that assessed the impact of physical exercise on patients with GBS were included; study quality was assessed using Sackett's rules of evidence. Data are presented qualitatively and quantitatively using numerical values and percentages. Results: Seven articles were included in the systematic review. One RCT showed that high-intensity relative to lower intensity exercise significantly reduced disability in patients with GBS, as measured with the FIM (p<0.005, r=0.71). Overall, various types of exercise programmes improve physical outcomes such as functional mobility, cardiopulmonary function, isokinetic muscle strength, and work rate and reduce fatigue in patients with GBS. Conclusion: Because of insufficient high-quality literature, making confident conclusions about the effects of exercise interventions on physical outcomes in patients with GBS is not possible. Future research should consider using higher quality study designs to confirm the results outlined in this article. PMID:27904236
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A difference-matrix metaheuristic for intensity map segmentation in step-and-shoot IMRT delivery.
Gunawardena, Athula D A; D'Souza, Warren D; Goadrich, Laura D; Meyer, Robert R; Sorensen, Kelly J; Naqvi, Shahid A; Shi, Leyuan
2006-05-21
At an intermediate stage of radiation treatment planning for IMRT, most commercial treatment planning systems for IMRT generate intensity maps that describe the grid of beamlet intensities for each beam angle. Intensity map segmentation of the matrix of individual beamlet intensities into a set of MLC apertures and corresponding intensities is then required in order to produce an actual radiation delivery plan for clinical use. Mathematically, this is a very difficult combinatorial optimization problem, especially when mechanical limitations of the MLC lead to many constraints on aperture shape, and setup times for apertures make the number of apertures an important factor in overall treatment time. We have developed, implemented and tested on clinical cases a metaheuristic (that is, a method that provides a framework to guide the repeated application of another heuristic) that efficiently generates very high-quality (low aperture number) segmentations. Our computational results demonstrate that the number of beam apertures and monitor units in the treatment plans resulting from our approach is significantly smaller than the corresponding values for treatment plans generated by the heuristics embedded in a widely use commercial system. We also contrast the excellent results of our fast and robust metaheuristic with results from an 'exact' method, branch-and-cut, which attempts to construct optimal solutions, but, within clinically acceptable time limits, generally fails to produce good solutions, especially for intensity maps with more than five intensity levels. Finally, we show that in no instance is there a clinically significant change of quality associated with our more efficient plans.
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Intensity of Care at the End of Life Among Older Adults in Korea.
Kim, Su Hyun; Kang, Sangwook; Song, Mi-Kyung
2018-01-01
To examine the intensity of care at the end of life among older adults in Korea and to identify the individual and institutional factors associated with care intensity. This secondary data analysis included a sample of 6278 decedents aged 65 years or older who were identified from the 2009 to 2010 Korean National Health Insurance Service-National Sample Cohort Claims data. We examined the medical care received by the cohort in the last 30 days of their lives. Overall, 36.5% of the sample received at least 1 intensive care procedure in the last 30 days of their lives; 26.3% of patients experienced intensive care unit admission, with an average stay of 7.45 days, 19.5% received mechanical ventilation, 12.3% received cardiopulmonary resuscitation, and 15.5% had a feeding tube placement. A statistical analysis using a multiple logistic regression model with random effects showed that younger age, higher household income, primary diagnoses of diseases (ischemic heart disease, infectious disease, chronic lung disease, or chronic heart disease), and characteristics of care setting (large hospitals and facilities located in metropolitan areas) were significantly associated with the likelihood of receiving high-intensity care at the end of life. A substantial number of older adults in Korea experienced high-intensity end-of-life care. Both individual and institutional factors were associated with the likelihood of receiving high-intensity care. Gaining an understanding of the intensity of care at the end of life and the impact of the determinants would advance efforts to improve quality of care at the end of life for older adults in Korea.
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Biofield therapies: helpful or full of hype? A best evidence synthesis.
Jain, Shamini; Mills, Paul J
2010-03-01
Biofield therapies (such as Reiki, therapeutic touch, and healing touch) are complementary medicine modalities that remain controversial and are utilized by a significant number of patients, with little information regarding their efficacy. This systematic review examines 66 clinical studies with a variety of biofield therapies in different patient populations. We conducted a quality assessment as well as a best evidence synthesis approach to examine evidence for biofield therapies in relevant outcomes for different clinical populations. Studies overall are of medium quality, and generally meet minimum standards for validity of inferences. Biofield therapies show strong evidence for reducing pain intensity in pain populations, and moderate evidence for reducing pain intensity hospitalized and cancer populations. There is moderate evidence for decreasing negative behavioral symptoms in dementia and moderate evidence for decreasing anxiety for hospitalized populations. There is equivocal evidence for biofield therapies' effects on fatigue and quality of life for cancer patients, as well as for comprehensive pain outcomes and affect in pain patients, and for decreasing anxiety in cardiovascular patients. There is a need for further high-quality studies in this area. Implications and future research directions are discussed.
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Perez-Lloret, Santiago; Rojas, Gloria Meza; Menoni, Maria Celia; Ruiz, Gabriela; Velásquez, Carolina; Rodriguez, Hernán; Rey, María Verónica; Cardinali, And Daniel P
2012-01-01
Pregabalin (PGB) has been shown to improve sleep quality and health-related quality of life (HRQoL) as well as pain intensity in patients with neuropathic pain. The objective of the study was to explore the magnitude of the correlations between changes in pain intensity, sleep quality, and HRQoL after PGB treatment. One hundred thirty-eight patients with neuropathic pain of any origin and without an adequate response to analgesics received an 8-week treatment course of PGB in an open-label fashion. Pain intensity, sleep quality, and HRQoL outcomes were evaluated at baseline and at week 8 by means of an 11-point (0-10) numerical rating scale (NRS), the Pittsburgh Sleep Quality Index (PSQI), and the EuroQol health-state visuoanalogic scale (EQ-5D VAS) score, respectively. At week 8, mean PGB dose was 166.7 ± 7.8 mg/d. Pain intensity NRS score, PSQI total score, and EQ-5D VAS score were improved by 66.5% ± 1.9%, 40.0% ± 3.6%, and 26.4% ± 4.7% (all P < 0.01), respectively. Correlations between percent change from baseline in pain NRS score and PSQI total score or EQ-5D VAS scores were r = 0.36 (P < 0.01, R = 0.11) and r = -0.20 (P < 0.02, R = 0.05), respectively. A multivariate logistic regression analysis disclosed that PSQI score change below the median (ie, a better outcome) was related to higher EQ-5D VAS score change (odds ratio, 2.15; 95% confidence interval, 1.09-4.25), whereas pain intensity NRS score change below the median was not (odds ratio, 1.58; 95% confidence interval,0.78-3.23). In our study, PGB-related improvements in sleep quality and HRQoL were marginally related to reductions in pain intensity in patients with neuropathic pain. Improvement in sleep quality was a significant predictor of better HRQoL, whereas pain intensity reduction was not.
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Improvement of automatic control system for high-speed current collectors
NASA Astrophysics Data System (ADS)
Sidorov, O. A.; Goryunov, V. N.; Golubkov, A. S.
2018-01-01
The article considers the ways of regulation of pantographs to provide quality and reliability of current collection at high speeds. To assess impact of regulation was proposed integral criterion of the quality of current collection, taking into account efficiency and reliability of operation of the pantograph. The study was carried out using mathematical model of interaction of pantograph and catenary system, allowing to assess contact force and intensity of arcing at the contact zone at different movement speeds. The simulation results allowed us to estimate the efficiency of different methods of regulation of pantographs and determine the best option.
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Novel high-energy physics studies using intense lasers and plasmas
DOE Office of Scientific and Technical Information (OSTI.GOV)
Leemans, Wim P.; Bulanov, Stepan; Esarey, Eric
2015-06-29
In the framework of the project “Novel high-energy physics studies using intense lasers and plasmas” we conducted the study of ion acceleration and “flying mirrors” with high intensity lasers in order to develop sources of ion beams and high frequency radiation for different applications. Since some schemes of laser ion acceleration are also considered a good source of “flying mirrors”, we proposed to investigate the mechanisms of “mirror” formation. As a result we were able to study the laser ion acceleration from thin foils and near critical density targets. We identified several fundamental factors limiting the acceleration in the RPAmore » regime and proposed the target design to compensate these limitations. In the case of near critical density targets, we developed a concept for the laser driven ion source for the hadron therapy. Also we studied the mechanism of “flying mirror” generation during the intense laser interaction with thin solid density targets. As for the laser-based positron creation and capture we initially proposed to study different regimes of positron beam generation and positron beam cooling. Since the for some of these schemes a good quality electron beam is required, we studied the generation of ultra-low emittance electron beams. In order to understand the fundamental physics of high energy electron beam interaction with high intensity laser pulses, which may affect the efficient generation of positron beams, we studied the radiation reaction effects.« less
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Pork Production System and its Development in Mainland China
USDA-ARS?s Scientific Manuscript database
Livestock production and marketing have been driven by the growing consumer demand for high quality and low cost animal protein. As a result, intensive livestock industries have been rapidly developing globally. International trade creates new opportunities and challenges for U.S. animal agriculture...
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ERIC Educational Resources Information Center
Ontario Ministry of Colleges and Universities, Toronto.
Some of the qualities and quantities that must be juggled to produce good lighting for educational facilities are analyzed with photographs, tables, and drawings. The three categories of lamps used for school lighting (incandescent, fluorescent, and high intensity discharge) are described; a lamp selection guide gives the design characteristics of…
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Classroom Effects of an Early Childhood Educator Professional Development Partnership
ERIC Educational Resources Information Center
Algozzine, Bob; Babb, Julie; Algozzine, Kate; Mraz, Maryann; Kissel, Brian; Spano, Sedra; Foxworth, Kimberly
2011-01-01
We evaluated an Early Childhood Educator Professional Development (ECEPD) project that provided high-quality, sustained, and intensive professional development designed to support developmentally appropriate instruction for preschool-age children based on the best available research on early childhood pedagogy, child development, and preschool…
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[Research on stormwater runoff quality of mountain city by source area monitoring].
Li, Li-Qing; Shan, Bao-Qing; Zhao, Jian-Wei; Guo, Shu-Gang; Gao, Yong
2012-10-01
Stormwater runoff samples were collected from 10 source areas in Mountain City, Chongqing, during five rain events in an attempt to investigate the characteristics of runoff quality and influencing factors. The outcomes are expected to offer practical guidance of sources control of urban runoff pollution. The results indicated that the stormwater runoff of Mountain City presented a strong first flush for almost all events and constituents. The runoff quality indices were also influenced by the rainfall intensity. The concentration of TSS, COD, TN and TP decreased as the rainfall intensity increased. The concentrations of COD and TP in stormwater runoff were highly correlated with TSS concentrations. Suspended solid matter were not only the main pollutant of stormwater runoff but also served as the vehicle for transport of organic matter and phosphorus. Organic matter and phosphorus in stormwatrer runoff were mainly bound to particles, whereas nitrogen was predominantly dissolved, with ammonia and nitrate. A significant difference of stormwater runoff quality was observed among the ten monitored source areas. The highest magnitude of urban stormwater runoff pollution was expected in the commercial area and the first trunk road, followed by the minor road, residential area, parking lot and roof. Urban surface function, traffic volume, population density, and street sweeping practice are the main factors determining spatial differentiation of urban surface runoff quality. Commercial area, the first trunk road and residential area with high population density are the critical sources areas of urban stormwater runoff pollution.
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High-contrast multilayer imaging of biological organisms through dark-field digital refocusing.
Faridian, Ahmad; Pedrini, Giancarlo; Osten, Wolfgang
2013-08-01
We have developed an imaging system to extract high contrast images from different layers of biological organisms. Utilizing a digital holographic approach, the system works without scanning through layers of the specimen. In dark-field illumination, scattered light has the main contribution in image formation, but in the case of coherent illumination, this creates a strong speckle noise that reduces the image quality. To remove this restriction, the specimen has been illuminated with various speckle-fields and a hologram has been recorded for each speckle-field. Each hologram has been analyzed separately and the corresponding intensity image has been reconstructed. The final image has been derived by averaging over the reconstructed images. A correlation approach has been utilized to determine the number of speckle-fields required to achieve a desired contrast and image quality. The reconstructed intensity images in different object layers are shown for different sea urchin larvae. Two multimedia files are attached to illustrate the process of digital focusing.
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Individual behavioural counselling for smoking cessation.
Lancaster, Tim; Stead, Lindsay F
2017-03-31
Individual counselling from a smoking cessation specialist may help smokers to make a successful attempt to stop smoking. The review addresses the following hypotheses:1. Individual counselling is more effective than no treatment or brief advice in promoting smoking cessation.2. Individual counselling is more effective than self-help materials in promoting smoking cessation.3. A more intensive counselling intervention is more effective than a less intensive intervention. We searched the Cochrane Tobacco Addiction Group Specialized Register for studies with counsel* in any field in May 2016. Randomized or quasi-randomized trials with at least one treatment arm consisting of face-to-face individual counselling from a healthcare worker not involved in routine clinical care. The outcome was smoking cessation at follow-up at least six months after the start of counselling. Both authors extracted data in duplicate. We recorded characteristics of the intervention and the target population, method of randomization and completeness of follow-up. We used the most rigorous definition of abstinence in each trial, and biochemically-validated rates where available. In analysis, we assumed that participants lost to follow-up continued to smoke. We expressed effects as a risk ratio (RR) for cessation. Where possible, we performed meta-analysis using a fixed-effect (Mantel-Haenszel) model. We assessed the quality of evidence within each study using the Cochrane 'Risk of bias' tool and the GRADE approach. We identified 49 trials with around 19,000 participants. Thirty-three trials compared individual counselling to a minimal behavioural intervention. There was high-quality evidence that individual counselling was more effective than a minimal contact control (brief advice, usual care, or provision of self-help materials) when pharmacotherapy was not offered to any participants (RR 1.57, 95% confidence interval (CI) 1.40 to 1.77; 27 studies, 11,100 participants; I 2 = 50%). There was moderate-quality evidence (downgraded due to imprecision) of a benefit of counselling when all participants received pharmacotherapy (nicotine replacement therapy) (RR 1.24, 95% CI 1.01 to 1.51; 6 studies, 2662 participants; I 2 = 0%). There was moderate-quality evidence (downgraded due to imprecision) for a small benefit of more intensive counselling compared to brief counselling (RR 1.29, 95% CI 1.09 to 1.53; 11 studies, 2920 participants; I 2 = 48%). None of the five other trials that compared different counselling models of similar intensity detected significant differences. There is high-quality evidence that individually-delivered smoking cessation counselling can assist smokers to quit. There is moderate-quality evidence of a smaller relative benefit when counselling is used in addition to pharmacotherapy, and of more intensive counselling compared to a brief counselling intervention.
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Disease management: a leap of faith to lower-cost, higher-quality health care.
Short, Ashley; Mays, Glen; Mittler, Jessica
2003-10-01
With managed care's promise to reduce costs and improve quality waning, employers and health plans are exploring more targeted ways to control rapidly rising health costs. Disease management programs, which focus on patients with chronic conditions such as asthma and diabetes, are growing in popularity, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. In addition to condition-based disease management programs, some health plans and employers are using intensive case management services to coordinate care for high-risk patients with potentially costly and complex medical conditions. Despite high expectations, evidence of both disease management and case management programs' success in controlling costs and improving quality remains limited.
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Resonance Raman Spectroscopy of Chirality Enriched Semiconducting Carbon Nanotubes
NASA Astrophysics Data System (ADS)
Hight Walker, A. R.; Piao, Y.; Simpson, J. R.; Lindsay, M.; Streit, J. K.; Ao, G.; Zheng, M.; Fagan, J. A.
Relative intensities of resonant Raman RBM and G modes of 11 chirality-enriched SWCNT species were established under second-order excitation. Results demonstrate an under-recognized complexity in evaluation of Raman spectra for assignment of (n,m) population distributions. Strong chiral angle and mod dependencies affect the intensity ratio of RBM/G modes and can result in misleading interpretations. We report 5 new (n,m) values for chirality-dependent G+ and G- Raman peak positions and intensity ratios, extending the available data to cover smaller diameters down to (5,4). The Raman spectral library sufficiently decouples G peaks from multiple species and enables fundamental characterization in mixed chirality samples. Our results on dispersive properties of the D modes will also be discussed. Probing defects is crucial to evaluate SWCNT quality and to understand the photophysics behind defect-induced optoelectronic features. Using high-quality, chirality-enriched semiconducting SWCNTs and tunable lasers, our results show a non-dispersive D band throughout the resonant window within the same (n,m). Our results were validated by multiple (n,m) samples and intentional covalent surface functionalization generating D peaks with increased intensity, which remain non-dispersive.
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Evaluation of hydrochemical changes due to intensive aquifer exploitation: case studies from Mexico.
Esteller, M V; Rodríguez, R; Cardona, A; Padilla-Sánchez, L
2012-09-01
The impact of intensive aquifer exploitation has been observed in numerous places around the world. Mexico is a representative example of this problem. In 2010, 101 out of the 653 aquifers recognized in the country, showed negative social, economic, and environmental effects related to intensive exploitation. The environmental effects include, among others, groundwater level decline, subsidence, attenuation, and drying up of springs, decreased river flow, and deterioration of water quality. This study aimed at determining the hydrochemical changes produced by intensive aquifer exploitation and highlighting water quality modifications, taking as example the Valle de Toluca, Salamanca, and San Luis Potosi aquifers in Mexico's highlands. There, elements such as fluoride, arsenic, iron, and manganese have been detected, resulting from the introduction of older groundwater with longer residence times and distinctive chemical composition (regional flows). High concentrations of other elements such as chloride, sulfate, nitrate, and vanadium, as well as pathogens, all related to anthropogenic pollution sources (wastewater infiltration, irrigation return flow, and atmospheric pollutants, among others) were also observed. Some of these elements (nitrate, fluoride, arsenic, iron, and manganese) have shown concentrations above Mexican and World Health Organization drinking water standards.
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McEvoy, Phil; Escott, Diane; Bee, Penny
2011-01-01
This study is based on a formative evaluation of a case management service for high-intensity service users in Northern England. The evaluation had three main purposes: (i) to assess the quality of the organisational infrastructure; (ii) to obtain a better understanding of the key influences that played a role in shaping the development of the service; and (iii) to identify potential changes in practice that may help to improve the quality of service provision. The evaluation was informed by Gittell's relational co-ordination theory, which focuses upon cross-boundary working practices that facilitate task integration. The Assessment of Chronic Illness Care Survey was used to assess the organisational infrastructure and qualitative interviews with front line staff were conducted to explore the key influences that shaped the development of the service. A high level of strategic commitment and political support for integrated working was identified. However, the quality of care co-ordination was variable. The most prominent operational factor that appeared to influence the scope and quality of care co-ordination was the pattern of interaction between the case managers and their co-workers. The co-ordination of patient care was much more effective in integrated co-ordination networks. Key features included clearly defined, task focussed, relational workspaces with interactive forums where case managers could engage with co-workers in discussions about the management of interdependent care activities. In dispersed co-ordination networks with fewer relational workspaces, the case managers struggled to work as effectively. The evaluation concluded that the creation of flexible and efficient task focused relational workspaces that are systemically managed and adequately resourced could help to improve the quality of care co-ordination, particularly in dispersed networks. © 2010 Blackwell Publishing Ltd.
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NASA Astrophysics Data System (ADS)
Wang, Andong; Li, Xiaowei; Qu, Lianti; Lu, Yongfeng; Jiang, Lan
2017-03-01
Metal nanowire fabrication has drawn tremendous attention in recent years due to its wide application in electronics, optoelectronics, and plasmonics. However, conventional laser fabrication technologies are limited by diffraction limit thus the fabrication resolution cannot meet the increasingly high demand of modern devices. Herein we report on a novel method for high-resolution high-quality metal nanowire fabrication by using Hermite-Gaussian beam to ablate metal thin film. The nanowire is formed due to the intensity valley in the center of the laser beam while the surrounding film is ablated. Arbitrary nanowire can be generated on the substrate by dynamically adjusting the orientation of the intensity valley. This method shows obvious advantages compared to conventional methods. First, the minimum nanowire has a width of 60 nm (≍1/13 of the laser wavelength), which is much smaller than the diffraction limit. The high resolution is achieved by combining the ultrashort nature of the femtosecond laser and the low thermal conductivity of the thin film. In addition, the fabricated nanowires have good inside qualities. No inner nanopores and particle intervals are generated inside the nanowire, thus endowing the nanowire with good electronic characteristics: the conductivity of the nanowires is as high as 1.2×107 S/m (≍1/4 of buck material), and the maximum current density is up to 1.66×108 A/m2. Last, the nanowire has a good adhesion to the substrates, which can withstand ultrasonic bath for a long time. These advantages make our method a good approach for high-resolution high-quality nanowire fabrication as a complementary method to conventional lithography methods.
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Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians
Haik, Josef; Brown, Stav; Liran, Alon; Visentin, Denis; Sokolov, Amit; Zilinsky, Isaac; Kornhaber, Rachel
2017-01-01
Acute health care environments can be stressful settings with clinicians experiencing deleterious effects of burnout and compassion fatigue affecting their mental health. Subsequently, the quality of patient care and outcomes may be threatened if clinicians experience burnout or compassion fatigue. Therefore, the aim of this descriptive, cross-sectional study was to evaluate the prevalence of burnout and compassion fatigue among burn clinicians in Israel. Fifty-five clinicians from Burns, Plastics and Reconstruction Surgery and Intensive Care completed four validated surveys to assess burnout (Maslach Burnout Inventory), depression (PRIME-MD), health-related quality of life (SF-8), and compassion fatigue (Professional Quality of Life version 5). Burn clinicians were compared with Plastics and Reconstruction Surgery and Intensive Care clinicians. This study identified a high prevalence of burnout (38.2%) among Intensive Care, Plastics and Reconstruction and Burns clinicians, with Burns clinicians having a greatly increased prevalence of burnout compared to Intensive Care clinicians (OR =24.3, P=0.017). Additional factors contributing to compassion fatigue were those without children (P=0.016), divorced (P=0.035), of a younger age (P=0.019), and a registered nurse (P=0.05). Burnout increased clinicians’ risk of adverse professional and personal outcomes and correlated with less free time (P<0.001), increased risk of experiencing work-home disputes (P=0.05), increased depression (P=0.001) and decreased career satisfaction (P=0.01). Burnout was also associated with higher physical (mean difference =3.8, P<0.001) and lower mental (mean difference =−3.5, P<0.001) Quality of Life scores. Caring for burn survivors can lead to burnout, compassion fatigue, and vicarious trauma. Identifying strategies to abate these issues is essential to ensure improved clinicial environments and patient outcomes. PMID:28670122
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Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians.
Haik, Josef; Brown, Stav; Liran, Alon; Visentin, Denis; Sokolov, Amit; Zilinsky, Isaac; Kornhaber, Rachel
2017-01-01
Acute health care environments can be stressful settings with clinicians experiencing deleterious effects of burnout and compassion fatigue affecting their mental health. Subsequently, the quality of patient care and outcomes may be threatened if clinicians experience burnout or compassion fatigue. Therefore, the aim of this descriptive, cross-sectional study was to evaluate the prevalence of burnout and compassion fatigue among burn clinicians in Israel. Fifty-five clinicians from Burns, Plastics and Reconstruction Surgery and Intensive Care completed four validated surveys to assess burnout (Maslach Burnout Inventory), depression (PRIME-MD), health-related quality of life (SF-8), and compassion fatigue (Professional Quality of Life version 5). Burn clinicians were compared with Plastics and Reconstruction Surgery and Intensive Care clinicians. This study identified a high prevalence of burnout (38.2%) among Intensive Care, Plastics and Reconstruction and Burns clinicians, with Burns clinicians having a greatly increased prevalence of burnout compared to Intensive Care clinicians (OR =24.3, P =0.017). Additional factors contributing to compassion fatigue were those without children ( P =0.016), divorced ( P =0.035), of a younger age ( P =0.019), and a registered nurse ( P =0.05). Burnout increased clinicians' risk of adverse professional and personal outcomes and correlated with less free time ( P <0.001), increased risk of experiencing work-home disputes ( P =0.05), increased depression ( P =0.001) and decreased career satisfaction ( P =0.01). Burnout was also associated with higher physical (mean difference =3.8, P <0.001) and lower mental (mean difference =-3.5, P <0.001) Quality of Life scores. Caring for burn survivors can lead to burnout, compassion fatigue, and vicarious trauma. Identifying strategies to abate these issues is essential to ensure improved clinicial environments and patient outcomes.
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Tew, Garry A; Weston, Matthew; Kothmann, Elke; Batterham, Alan M; Gray, Joanne; Kerr, Karen; Martin, Denis; Nawaz, Shah; Yates, David; Danjoux, Gerard
2014-01-10
In patients with large abdominal aortic aneurysm (AAA), open surgical or endovascular aneurysm repair procedures are often used to minimise the risk of aneurysm-related rupture and death; however, aneurysm repair itself carries a high risk. Low cardiopulmonary fitness is associated with an increased risk of early post-operative complications and death following elective AAA repair. Therefore, fitness should be enhanced before aneurysm repair. High-intensity interval exercise training (HIT) is a potent, time-efficient strategy for enhancing cardiopulmonary fitness. Here, we describe a feasibility study for a definitive trial of a pre-operative HIT intervention to improve post-operative outcomes in patients undergoing elective AAA repair. A minimum of 50 patients awaiting elective repair of a 5.5-7.0 cm infrarenal AAA will be allocated by minimisation to HIT or usual care control in a 1:1 ratio. The patients allocated to HIT will complete three hospital-based exercise sessions per week, for 4 weeks. Each session will include 2 or 4 min of high-intensity stationary cycling followed by the same duration of easy cycling or passive recovery, repeated until a total of 16 min of high-intensity exercise is accumulated. Outcomes to be assessed before randomisation and 24-48 h before aneurysm repair include cardiopulmonary fitness, maximum AAA diameter and health-related quality of life. In the post-operative period, we will record destination (ward or critical care unit), organ-specific morbidity, mortality and the durations of critical care and hospital stay. Twelve weeks after the discharge, participants will be interviewed to reassess quality of life and determine post-discharge healthcare utilisation. The costs associated with the exercise intervention and healthcare utilisation will be calculated. Ethics approval was secured through Sunderland Research Ethics Committee. The findings of the trial will be disseminated through peer-reviewed journals, and national and international presentations. Current Controlled Trials ISRCTN09433624.
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Low, Walton H.
1997-01-01
In 1991, the U.S. Geological Survey (USGS) began a full-scale National Water-Quality Assessment (NAWQA) Program. The long-term goals of the NAWQA Program are to describe the status and trends in the water quality of a large part of the Nation's rivers and aquifers and to improve understanding of the primary natural and human factors that affect water-quality conditions. In meeting these goals, the program will produce water-quality, ecological, and geographic information that will be useful to policy makers and managers at the national, State, and local levels. A major component of the program is study-unit investigations, upon which national-level assessment activities are based. The program's 60 study-unit investigations are associated with principal river basins and aquifer systems throughout the Nation. Study units encompass areas from 1,200 to more than 65,000 mi2 (square miles) and incorporate about 60 to 70 percent of the Nation's water use and population served by public water supply. In 1991, the upper Snake River Basin was among the first 20 NAWQA study units selected for implementation. From 1991 to 1995, a high-intensity data-collection phase of the upper Snake River Basin study unit (fig. 1) was implemented and completed. Components of this phase are described in a report by Gilliom and others (1995). In 1997, a low-intensity phase of data collection began, and work continued on data analysis, report writing, and data documentation and archiving activities that began in 1996. Principal data-collection activities during the low-intensity phase will include monitoring of surface-water and ground-water quality, assessment of aquatic biological conditions, and continued compilation of environmental setting information.
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Meßler, Carolin Friederike; Holmberg, Hans-Christer; Sperlich, Billy
2018-06-01
To compare the effects of multimodal therapy including supervised high-intensity interval training (HIIT) with those of standard multimodal therapy (TRAD) concerning key variables of physical fitness (peak power and oxygen uptake), motor skills, social behavior, and quality of life in boys with ADHD. A single-center, two-arm randomized, controlled design was used, with 28 boys (8-13 years of age, IQ = 83-136) being randomly assigned to multimodal HIIT (three sessions/week, 4 × 4-min intervals at 95% of peak heart rate) or TRAD. The Movement Assessment Battery for Children II evaluated motor skills and the German version of the hyperkinetic disorder questionnaire for external evaluation by the guardians (FBB-HKS) or German version of the hyperkinetic disorder questionnaire for self-assessment by the children (SBB-HKS) and the KINDL-R questionnaires mental health and health-related quality of life. Both interventions enhanced peak power, and HIIT also reduced submaximal oxygen uptake. HIIT was more effective than TRAD in improving the total score for motor skills (including manual dexterity and ball skills; p < .05), self-esteem, friends, and competence ( p < .05) and, moreover, improved subjective ratings of attention. Three weeks of multimodal therapy including HIIT improved physical fitness, motor skills, certain aspects of quality of life, competence, and attention in boys with ADHD.
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UVB exposure does not accelerate rates of litter decomposition in a semiarid riparian ecosystem
USDA-ARS?s Scientific Manuscript database
Aboveground litter decomposition is controlled mainly by substrate quality and climate factors across terrestrial ecosystems, but photodegradation from exposure to high-intensity ultraviolet-B (UVB) radiation may also be important in arid and semi-arid environments. We investigated the interactive e...
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High optical quality GaN nanopillar arrays
NASA Astrophysics Data System (ADS)
Wang, Y. D.; Chua, S. J.; Tripathy, S.; Sander, M. S.; Chen, P.; Fonstad, C. G.
2005-02-01
GaN nanopillar arrays have been fabricated by inductively coupled plasma etching of GaN films using anodic aluminum oxide film as an etch mask. The average diameter and length of these pillars are 60-65nm and 350-400nm, respectively. Ultraviolet microphotoluminescence measurements indicate high photoluminescence intensity and stress relaxation in these GaN nanopillars as compared to the starting epitaxial GaN films. Evidence of good crystalline quality is also observed by micro-Raman measurements, wherein a redshift of the E2high mode from GaN nanopillars suggests partial relaxation of the compressive strain. In addition, breakdown of the polarization selection rules led to the appearance of symmetry-forbidden and quasipolar modes.
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Zemplényi, A T; Kaló, Z; Kovács, G; Farkas, R; Beöthe, T; Bányai, D; Sebestyén, Z; Endrei, D; Boncz, I; Mangel, L
2018-01-01
The aim of our analysis was to compare the cost-effectiveness of high-dose intensity-modulated radiation therapy (IMRT) and hypofractionated intensity-modulated radiation therapy (HF-IMRT) versus conventional dose three-dimensional radiation therapy (3DCRT) for the treatment of localised prostate cancer. A Markov model was constructed to calculate the incremental quality-adjusted life years and costs. Transition probabilities, adverse events and utilities were derived from relevant systematic reviews. Microcosting in a large university hospital was applied to calculate cost vectors. The expected mean lifetime cost of patients undergoing 3DCRT, IMRT and HF-IMRT were 7,160 euros, 6,831 euros and 6,019 euros respectively. The expected quality-adjusted life years (QALYs) were 5.753 for 3DCRT, 5.956 for IMRT and 5.957 for HF-IMRT. Compared to 3DCRT, both IMRT and HF-IMRT resulted in more health gains at a lower cost. It can be concluded that high-dose IMRT is not only cost-effective compared to the conventional dose 3DCRT but, when used with a hypofractionation scheme, it has great cost-saving potential for the public payer and may improve access to radiation therapy for patients. © 2016 John Wiley & Sons Ltd.
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Exercise-based cardiac rehabilitation in heart transplant recipients.
Anderson, Lindsey; Nguyen, Tricia T; Dall, Christian H; Burgess, Laura; Bridges, Charlene; Taylor, Rod S
2017-04-04
Heart transplantation is considered to be the gold standard treatment for selected patients with end-stage heart disease when medical therapy has been unable to halt progression of the underlying pathology. Evidence suggests that aerobic exercise training may be effective in reversing the pathophysiological consequences associated with cardiac denervation and prevent immunosuppression-induced adverse effects in heart transplant recipients. To determine the effectiveness and safety of exercise-based rehabilitation on the mortality, hospital admissions, adverse events, exercise capacity, health-related quality of life, return to work and costs for people after heart transplantation. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO) and Web of Science Core Collection (Thomson Reuters) to June 2016. We also searched two clinical trials registers and handsearched the reference lists of included studies. We included randomised controlled trials (RCTs) of parallel group, cross-over or cluster design, which compared exercise-based interventions with (i) no exercise control (ii) a different dose of exercise training (e.g. low- versus high-intensity exercise training); or (iii) an active intervention (i.e. education, psychological intervention). The study population comprised adults aged 18 years or over who had received a heart transplant. Two review authors independently screened all identified references for inclusion based on pre-specified inclusion criteria. Disagreements were resolved by consensus or by involving a third person. Two review authors extracted outcome data from the included trials and assessed their risk of bias. One review author extracted study characteristics from included studies and a second author checked them against the trial report for accuracy. We included 10 RCTs that involved a total of 300 participants whose mean age was 54.4 years. Women accounted for fewer than 25% of all study participants. Nine trials which randomised 284 participants to receive exercise-based rehabilitation (151 participants) or no exercise (133 participants) were included in the main analysis. One cross-over RCT compared high-intensity interval training with continued moderate-intensity training in 16 participants. We reported findings for all trials at their longest follow-up (median 12 weeks).Exercise-based cardiac rehabilitation increased exercise capacity (VO 2peak ) compared with no exercise control (MD 2.49 mL/kg/min, 95% CI 1.63 to 3.36; N = 284; studies = 9; moderate quality evidence). There was evidence from one trial that high-intensity interval exercise training was more effective in improving exercise capacity than continuous moderate-intensity exercise (MD 2.30 mL/kg/min, 95% CI 0.59 to 4.01; N = 16; 1 study). Four studies reported health-related quality of life (HRQoL) measured using SF-36, Profile of Quality of Life in the Chronically Ill (PLC) and the World Health Organization Quality Of Life (WHOQoL) - BREF. Due to the variation in HRQoL outcomes and methods of reporting we were unable to meta-analyse results across studies, but there was no evidence of a difference between exercise-based cardiac rehabilitation and control in 18 of 21 HRQoL domains reported, or between high and moderate intensity exercise in any of the 10 HRQoL domains reported. One adverse event was reported by one study.Exercise-based cardiac rehabilitation improves exercise capacity, but exercise was found to have no impact on health-related quality of life in the short-term (median 12 weeks follow-up), in heart transplant recipients whose health is stable.There was no evidence of statistical heterogeneity across trials for exercise capacity and no evidence of small study bias. The overall risk of bias in included studies was judged as low or unclear; more than 50% of included studies were assessed at unclear risk of bias with respect to allocation concealment, blinding of outcome assessors and declaration of conflicts of interest. Evidence quality was assessed as moderate according to GRADE criteria. We found moderate quality evidence suggesting that exercise-based cardiac rehabilitation improves exercise capacity, and that exercise has no impact on health-related quality of life in the short-term (median 12 weeks follow-up), in heart transplant recipients. Cardiac rehabilitation appears to be safe in this population, but long-term follow-up data are incomplete and further good quality and adequately-powered trials are needed to demonstrate the longer-term benefits of exercise on safety and impact on both clinical and patient-related outcomes, such as health-related quality of life, and healthcare costs.
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Attitude measurement: Judging the emotional intensity of likert-type science attitude statements
NASA Astrophysics Data System (ADS)
Shrigley, Robert L.; Koballa, Thomas R., Jr.
Emotional intensity, that readiness of a teacher to respond favorably or unfavorably toward such psychological objects as science or the teaching of science, is the quality that distinguishes the attitude concept from other related psychological concepts. It would seem, then, that valid attitude statements, if they are to reflect the definition of attitude, would evoke emotional intensity, responses in both a favorable and unfavorable direction by a group of teachers on each item on a science attitude scale. Science educators who design or modify science attitude scales should continue using item-total correlations and other quantitative techniques to test for emotional intensity, but qualitative judgments are necessary, too. In addition, the frequency distribution of data generated by each statement should be examined for skewness and high percentages of neutral responses, both of which can impair the emotional intensity of an item.
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Gabbett, Tim J; Abernethy, Bruce; Jenkins, David G
2012-02-01
The purpose of this study was to investigate the effect of changes in field size on the physiological and skill demands of small-sided games in elite junior and senior rugby league players. Sixteen elite senior rugby league players ([mean ± SE] age, 23.6 ± 0.5 years) and 16 elite junior rugby league players ([mean ± SE] age, 17.3 ± 0.3 years) participated in this study. On day 1, 2 teams played an 8-minute small-sided game on a small field (10-m width × 40-m length), whereas the remaining 2 teams played the small-sided game on a larger sized field (40-m width × 70-m length). On day 2, the groups were crossed over. Movement was recorded by a global positioning system unit sampling at 5 Hz. Games were filmed to count the number of possessions and the number and quality of disposals. The games played on a larger field resulted in a greater (p < 0.05) total distance covered, and distances covered in moderate, high, and very-high velocity movement intensities. Senior players covered more distance at moderate, high, and very-high intensities, and less distance at low and very-low intensities during small-sided games than junior players. Although increasing field size had no significant influence (p > 0.05) over the duration of recovery periods for junior players, larger field size significantly reduced (p < 0.05) the amount of short-, moderate-, and long-duration recovery periods in senior players. No significant between-group differences (p > 0.05) were detected for games played on a small or large field for the number or quality of skill involvements. These results suggest that increases in field size serve to increase the physiological demands of small-sided games but have minimal influence over the volume or quality of skill executions in elite rugby league players.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
NONE
The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrationsmore » with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32.« less
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Sandercock, D A; Nute, G R; Hocking, P M
2009-05-01
A multistrain experiment was conducted to quantify the extent of genetic differences in carcass and muscle yields, muscle quality, support organs, and taste panel assessments of cooked breast muscle of 296 birds from 37 lines of commercial broiler, layer, and traditional chickens. The birds were reared as broilers and 4 males from each line were slaughtered at 6 and 10 wk of age. The extent of genetic variation was measured as the intraclass correlation. The intraclass correlation for live weight; carcass yields; breast, drum, and wing portions; and associated muscle yields were high, whereas those for the thigh portion and yield were low. Broilers had more breast and thigh muscle but similar drum muscle as a proportion of carcass weight compared with layer and traditional lines. Genetic variation for muscle quality (plasma creatine kinase activity) was high; that for muscle color (L, a, and b) and hemorrhage score were moderate in size and were greater at 10 than at 6 wk of age. Broiler lines had greater creatine kinase activity indicative of greater muscle pathology; breast muscle was lighter, less red and yellow in color, and had a greater hemorrhage score than muscle from layer and traditional lines, which were similar. Intraclass correlations for taste panel scores were low and generally not significant except for texture, chicken flavor intensity, flavor liking, and overall liking at 6 wk of age. Significantly greater scores from broiler compared with layer and traditional lines for texture, chicken flavor intensity, and overall liking were observed. At 10 wk of age, chicken flavor intensity did not differ between broiler or layer birds but was significantly greater in both groups than traditional birds. Genetic variation for relative weight of abdominal fat, spleen, and heart was moderately high and greater at 10 than at 6 wk of age. Broiler carcasses had a relatively high proportion of abdominal fat and smaller spleen and heart weights.
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Urinary Incontinence in Physically Active Young Women: Prevalence and Related Factors.
Alves, Jessica Oliveira; Luz, Soraia Tonon Da; Brandão, Sofia; Da Luz, Clarissa Medeiros; Jorge, Renato Natal; Da Roza, Thuane
2017-11-01
This cross-sectional survey aims to (1) verify the prevalence of urinary incontinence and its impact on the quality of life among nulliparous fit women, and to (2) analyze whether urinary incontinence is influenced by the intensity of the sport (high- vs. low-impact) or by the volume of physical activity (minutes per week) performed. Two hundred forty-five nulliparous women (18-40 years) completed the International Consultation on Incontinence Questionnaire-Short Form, the Kings Health Questionnaire and a questionnaire regarding demographic and training variables. Overall 22.9% of the participants self-reported urinary incontinence, and among them, 60.7% had stress urinary incontinence. Incontinent women demonstrated worse quality of life than continent females (p=0.000). Women practicing high-impact sports presented higher frequency in loss of urine than those practicing low-impact sports (p=0.004). Regardless the intensity of the sport, the volume of exercise showed positive association with the frequency of loss of urine (p=0.005, r=0.475). In conclusion, almost one fourth of the women enrolled in this study reported symptoms of urinary incontinence and worse quality of life than those who were continent. Women who practice high-impact sports or who have higher volume of training should be aware of the symptoms associated with pelvic floor dysfunction, since they seem to predispose to urine leakage. © Georg Thieme Verlag KG Stuttgart · New York.
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TH-A-18C-10: Dynamic Intensity Weighted Region of Interest Imaging
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pearson, E; Pan, X; Pelizzari, C
2014-06-15
Purpose: For image guidance tasks full image quality is not required throughout the entire image. With dynamic filtration of the kV imaging beam the noise properties of the CT image can be locally controlled, providing a high quality image around the target volume with a lower quality surrounding region while providing substantial dose sparing to the patient as well as reduced scatter fluence on the detector. Methods: A dynamic collimation device with 3mm copper blades has been designed to mount in place of the bowtie filter on the On-Board Imager (Varian Medical Systems). The beam intensity is reduced by 95%more » behind the copper filters and the aperture is controlled dynamically to conformally illuminate a given ROI during a standard cone-beam CT scan. A data correction framework to account for the physical effects of the collimator prior to reconstruction was developed. Furthermore, to determine the dose savings and scatter reduction a monte carlo model was built in BEAMnrc with specifics from the Varian Monte Carlo Data Package. The MC model was validated with Gafchromic film. Results: The reconstructed image shows image quality comparable to a standard scan in the specified ROI, with higher noise and streaks in the outer region but still sufficient information for alignment to high contrast structures. The monte carlo modeling showed that the scatter-to-primary ratio was reduced from 1.26 for an unfiltered scan to 0.45 for an intensity weighted scan, suggesting that image quality may be improved in the inner ROI. Dose in the inner region was reduced 10–15% due to reduced scatter and by as much as 75% in the outer region. Conclusion: Dynamic intensity-weighted ROI imaging allows reduction of imaging dose to sensitive organs away from the target region while providing images that retain their utility for patient setup and procedure guidance. Funding was provided in part by Varian Medical Systems and NIH Grants 1RO1CA120540, T32EB002103, S10 RR021039 and P30 CA14599. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of any of the supporting organizations.« less
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Incorporating uncertainty and motion in Intensity Modulated Radiation Therapy treatment planning
NASA Astrophysics Data System (ADS)
Martin, Benjamin Charles
In radiation therapy, one seeks to destroy a tumor while minimizing the damage to surrounding healthy tissue. Intensity Modulated Radiation Therapy (IMRT) uses overlapping beams of x-rays that add up to a high dose within the target and a lower dose in the surrounding healthy tissue. IMRT relies on optimization techniques to create high quality treatments. Unfortunately, the possible conformality is limited by the need to ensure coverage even if there is organ movement or deformation. Currently, margins are added around the tumor to ensure coverage based on an assumed motion range. This approach does not ensure high quality treatments. In the standard IMRT optimization problem, an objective function measures the deviation of the dose from the clinical goals. The optimization then finds the beamlet intensities that minimize the objective function. When modeling uncertainty, the dose delivered from a given set of beamlet intensities is a random variable. Thus the objective function is also a random variable. In our stochastic formulation we minimize the expected value of this objective function. We developed a problem formulation that is both flexible and fast enough for use on real clinical cases. While working on accelerating the stochastic optimization, we developed a technique of voxel sampling. Voxel sampling is a randomized algorithms approach to a steepest descent problem based on estimating the gradient by only calculating the dose to a fraction of the voxels within the patient. When combined with an automatic sampling rate adaptation technique, voxel sampling produced an order of magnitude speed up in IMRT optimization. We also develop extensions of our results to Intensity Modulated Proton Therapy (IMPT). Due to the physics of proton beams the stochastic formulation yields visibly different and better plans than normal optimization. The results of our research have been incorporated into a software package OPT4D, which is an IMRT and IMPT optimization tool that we developed.
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Absolute versus relative intensity of physical activity in a dose-response context.
Shephard, R J
2001-06-01
To examine the importance of relative versus absolute intensities of physical activity in the context of population health. A standard computer-search of the literature was supplemented by review of extensive personal files. Consensus reports (Category D Evidence) have commonly recommended moderate rather than hard physical activity in the context of population health. Much of the available literature provides Category C Evidence. It has often confounded issues of relative intensity with absolute intensity or total weekly dose of exercise. In terms of cardiovascular health, there is some evidence for a threshold intensity of effort, perhaps as high as 6 METs, in addition to a minimum volume of physical activity. Decreases in blood pressure and prevention of stroke seem best achieved by moderate rather than high relative intensities of physical activity. Many aspects of metabolic health depend on the total volume of activity; moderate relative intensities of effort are more effective in mobilizing body fat, but harder relative intensities may help to increase energy expenditures postexercise. Hard relative intensities seem needed to augment bone density, but this may reflect an associated increase in volume of activity. Hard relative intensities of exercise induce a transient immunosuppression. The optimal intensity of effort, relative or absolute, for protection against various types of cancer remains unresolved. Acute effects of exercise on mood state also require further study; long-term benefits seem associated with a moderate rather than a hard relative intensity of effort. The importance of relative versus absolute intensity of effort depends on the desired health outcome, and many issues remain to be resolved. Progress will depend on more precise epidemiological methods of assessing energy expenditures and studies that equate total energy expenditures between differing relative intensities. There is a need to focus on gains in quality-adjusted life expectancy.
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Exploring societal solidarity in the context of extreme prematurity.
Hendriks, Manya J; Bucher, Hans Ulrich; Klein, Sabine D; Streuli, Jürg C; Baumann-Hölzle, Ruth; Fauchère, Jean-Claude
2017-03-21
Extreme prematurity can result in long-term disabilities. Its impact on society is often not taken into account and deemed controversial. Our study examined attitudes of the Swiss population regarding extreme prematurity and people's perspectives regarding the question of solidarity with disabled people. We conducted a nationwide representative anonymous telephone survey with 1210 Swiss residents aged 18 years or older. We asked how people estimate their own personal solidarity, the solidarity of their social environment and the solidarity across the country with disabled persons. Spearman's correlation calculations were used to assess if a correlation exists between solidarity and setting financial limits to intensive care and between solidarity and withholding neonatal intensive care. According to 36.0% of the respondents intensive medical care should not be withheld from extremely preterm infants, even if their chances for an acceptable quality of life were poor. For 28.8%, intensive care should be withheld from these infants, and 26.9% held an intermediate position depending on the situation. A total of 31.5% were against setting a financial limit to treatment of extremely preterm newborns with an uncertain future quality of life, 34.2% were in favour and 26.9% were deliberating. A majority (88.8%) considered their solidarity toward disabled people as substantial; the solidarity of their personal environment and of the society at large was estimated as high by 79.1% and 48.6%, respectively. The Swiss population expressed a high level of solidarity which may alleviate some pressure on parents and health care providers in the decision-making process in neonatal intensive care units. In addition, there was no relationship between solidarity and people's willingness to pay for the care or withholding treatment of extremely preterm babies.
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Measurements of relative photon emission intensities and nuclear decay data evaluation of 113Sn.
Luca, Aurelian; Lépy, Marie-Christine
2012-09-01
In the frame of a co-operation between CEA-LIST/LNE-LNHB (France) and IFIN-HH (Romania), the relative intensities of the photon emissions following the (113)Sn decay were accurately determined at the LNHB using high resolution X- and γ-ray spectrometers, characterized by excellent quality efficiency calibrations. Two series of measurements were carried out. The intensity of the 255 keV γ-ray relative to that of the 392 keV γ-ray was determined with an uncertainty lower than 1%. A new (113)Sn nuclear decay data evaluation was accomplished. The main results obtained are presented. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Evaluation of sleep quality in subjects with chronic nononcologic pain.
Covarrubias-Gomez, Alfredo; Mendoza-Reyes, Jonathan J
2013-08-01
A survey conducted by the National Sleep Foundation found that 20% of Americans have sleep disorders and 45% experience chronic pain. Several authors evaluated the interrelationship between these functions using various instruments such the Pittsburgh Sleep Quality Index (PSQI) and identified that 34% of subjects in the general population have a poor quality of sleep, but there are few studies that assess the quality of sleep in patients with chronic pain of nonmalignant origin. We undertook this study to evaluate the quality of sleep using the PSQI in patients with chronic pain unrelated to cancer. We conducted a clinical, nonrandomized, uncontrolled, descriptive, and prospective study, applying the PSQI through a direct one-time interview to 311 subjects with chronic pain unrelated to cancer. According to the categorization of the PSQI between good and poor sleepers, 89% of the subjects were poor sleepers (n = 276). There are significant differences in pain intensity according to the categorization of the PSQI, with a higher intensity shown in the "poor sleepers" (analysis of variance [ANOVA], P = .030). Using a linear regression model to estimate the curve, a higher score is rated on the PSQI global score (ANOVA, P = .000, R(2) = .46) with the increase of the intensity of the pain. We conclude that "poor sleepers" or those who considered their sleep as "poor quality" have significantly higher pain intensity. This suggests that intensity of pain plays a role in evaluating the quality of sleep in the subjective perception of sleep and instruments that assess quality.
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Inactivation of Microorganisms
NASA Astrophysics Data System (ADS)
Alzamora, Stella Maris; Guerrero, Sandra N.; Schenk, Marcela; Raffellini, Silvia; López-Malo, Aurelio
Minimal processing techniques for food preservation allow better retention of product flavor, texture, color, and nutrient content than comparable conventional treatments. A wide range of novel alternative physical factors have been intensely investigated in the last two decades. These physical factors can cause inactivation of microorganisms at ambient or sublethal temperatures (e.g., high hydrostatic pressure, pulsed electric fields, ultrasound, pulsed light, and ultraviolet light). These technologies have been reported to reduce microorganism population in foods while avoiding the deleterious effects of severe heating on quality. Among technologies, high-energy ultrasound (i.e., intensities higher than 1 W/cm2, frequencies between 18 and 100 kHz) has attracted considerable interest for food preservation applications (Mason et al., 1996; Povey and Mason, 1998).
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NASA Astrophysics Data System (ADS)
Xu, Xingyuan; Wu, Jiayang; Shoeiby, Mehrdad; Nguyen, Thach G.; Chu, Sai T.; Little, Brent E.; Morandotti, Roberto; Mitchell, Arnan; Moss, David J.
2018-01-01
An arbitrary-order intensity differentiator for high-order microwave signal differentiation is proposed and experimentally demonstrated on a versatile transversal microwave photonic signal processing platform based on integrated Kerr combs. With a CMOS-compatible nonlinear micro-ring resonator, high quality Kerr combs with broad bandwidth and large frequency spacings are generated, enabling a larger number of taps and an increased Nyquist zone. By programming and shaping individual comb lines' power, calculated tap weights are realized, thus achieving a versatile microwave photonic signal processing platform. Arbitrary-order intensity differentiation is demonstrated on the platform. The RF responses are experimentally characterized, and systems demonstrations for Gaussian input signals are also performed.
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The effect of low and moderate intensity aerobic exercises on sleep quality in men older adults.
Akbari Kamrani, Ahmad Ali; Shams, Amir; Shamsipour Dehkordi, Parvaneh; Mohajeri, Robabeh
2014-03-01
Sleep is an active and complex rhythmic state that may be affected by the aging process. The purpose of present research was to investigate the effect of low and moderate intensity aerobic exercises on sleep quality in older adults. The research method is quasi-experimental with pre-test and post-test design. The statistical sample included 45 volunteer elderly men with age range of 60-70 years-old that divided randomly in two experimental groups (aerobic exercise with low and moderate intensity) and one control group. In each group selected 15 older adults based on inclusion and exclusion criteria (such as, without sleep apnea, not smoking, and no taking hypnotic drugs). First, all subjects were evaluated by a doctor to confirm their physical and mental health. Also, the maximum heart rate (MaxHR) of subjects was obtained by subtracting one's age from 220. Furthermore, based on aerobic exercise type (40-50% MaxHR for low intensity group and 60-70% MaxHR for moderate intensity group) the target MaxHR was calculated for each subject. The exercise protocol consisted of 8 weeks aerobic exercises (2 sessions in per-week) based on Rockport one-mile walking/running test and the control group continued their daily activities. All subjects in per-test and post-test stages completed the Petersburg Sleep Quality Index (PSQI). In pre-test stage, results showed that there were no significant differences between control and experimental groups in sleep quality and its components (P>0.05). On the other hand, results in post-test stage showed that there were significant differences between control and experimental groups in these variables (P<0.05). Also, the Tukey Post Hoc showed that the moderate intensity group scores in total sleep quality and its components were better than other groups (P<0.05). Finally, the low intensity group scores in total sleep quality and its components were better than control group (P<0.05). Generally, the present research showed that the aerobic exercises with moderate intensity (60-70% MaxHR) have a positive and significant effect on sleep quality and its components. Thus, based on these findings, the aerobic exercises with moderate intensity is a useful to improve the sleep quality and its components among community older adults were recommended.
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Levine, Deena R; Baker, Justin N; Wolfe, Joanne; Lehmann, Leslie E; Ullrich, Christina
2017-09-01
In the intense, cure-oriented setting of hematopoietic stem-cell transplantation (HSCT), delivery of high-quality palliative and end-of-life care is a unique challenge. Although HSCT affords patients a chance for cure, it carries a significant risk of morbidity and mortality. During HSCT, patients usually experience high symptom burden and a significant decrease in quality of life that can persist for long periods. When morbidity is high and the chance of cure remote, the tendency after HSCT is to continue intensive medical interventions with curative intent. The nature of the complications and overall condition of some patients may render survival an unrealistic goal and, as such, continuation of artificial life-sustaining measures in these patients may prolong suffering and preclude patient and family preparation for end of life. Palliative care focuses on the well-being of patients with life-threatening conditions and their families, irrespective of the goals of care or anticipated outcome. Although not inherently at odds with HSCT, palliative care historically has been rarely offered to HSCT recipients. Recent evidence suggests that HSCT recipients would benefit from collaborative efforts between HSCT and palliative care services, particularly when initiated early in the transplantation course. We review palliative and end-of-life care in HSCT and present models for integrating palliative care into HSCT care. With open communication, respect for roles, and a spirit of collaboration, HSCT and palliative care can effectively join forces to provide high-quality, multidisciplinary care for these highly vulnerable patients and their families.
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The influence of tree stands and a noise barrier on near-roadway air quality
Prediction of air pollution exposure levels of people living near or commuting on roadways is still very problematic due to the highly localized nature of traffic intensity, fleet composition, and extremely complex air flow patterns in urban areas. Both modelling and field studie...
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Operations Management in the Design and Execution of MBA Programs
ERIC Educational Resources Information Center
Busing, Michael E.; Palocsay, Susan W.
2016-01-01
Master of business administration (MBA) programs are under intense pressure to improve efficiencies, lower tuition, and offer refreshed curriculum that is of high quality and regarded as relevant by the marketplace. In light of this environment, the authors propose a conceptual framework for effectively employing operations management (OM)…
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Speaking-Related Dyspnea in Healthy Adults
ERIC Educational Resources Information Center
Hoit, Jeannette D.; Lansing, Robert W.; Perona, Kristen E.
2007-01-01
Purpose: To reveal the qualities and intensity of speaking-related dyspnea in healthy adults under conditions of high ventilatory drive, in which the behavioral and metabolic control of breathing must compete. Method: Eleven adults read aloud while breathing different levels of inspired carbon dioxide (CO[subscript 2]). After the highest level,…
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USDA-ARS?s Scientific Manuscript database
A need to increase agricultural production across the world to ensure continued food security appears to be at odds with the urgency to reduce the negative environmental impacts of intensive agriculture. Around the world, intensification has been associated with massive simplification and uniformity...
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How to Teach Contrastive (Intercultural) Rhetoric: Some Ideas for Pedagogical Application
ERIC Educational Resources Information Center
Walker, Deron
2011-01-01
Background: Despite years of intense criticism of contrastive (intercultural) rhetoric, theoretical debate, and controversy, there has been a recent resurgence in the number of high quality pedagogical studies concerning the teaching of intercultural rhetoric in university writing classes for East-Asian (Chinese, Japanese, and Korean) writers.…
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Future of Software Engineering Standards
NASA Technical Reports Server (NTRS)
Poon, Peter T.
1997-01-01
In the new millennium, software engineering standards are expected to continue to influence the process of producing software-intensive systems which are cost-effetive and of high quality. These sytems may range from ground and flight systems used for planetary exploration to educational support systems used in schools as well as consumer-oriented systems.
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Krzemińska, Izabela; Piasecka, Agata; Nosalewicz, Artur; Simionato, Diana; Wawrzykowski, Jacek
2015-11-01
Chlorella protothecoides is a valuable source of lipids that may be used for biodiesel production. The present work shows analysis of the potential of photoheterotrophic cultivation of C. protothecoides under various light intensities aiming to identify the conditions with maximal biomass and lipid content. An increase in light intensity was associated with an increased specific growth rate and a shortened doubling time. Also, the relative total lipid content increased from 24.8% to 37.5% with increase of light intensity. The composition of fatty acid methyl esters was affected by light intensity with the C16-18 fatty acids increased from 76.97% to 90.24% of total fatty acids. However, the content of linolenic acids decreased with the increase of the culture irradiance. These studies indicate that cultures irradiated with high light intensities achieve the minimal specifications for biodiesel quality on linolenic acids and thus are suitable for biodiesel production. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Microstructural Evolution in Intensively Melt Sheared Direct Chill Cast Al-Alloys
NASA Astrophysics Data System (ADS)
Jones, S.; Rao, A. K. Prasada; Patel, J. B.; Scamans, G. M.; Fan, Z.
The work presented here introduces the novel melt conditioned direct chill casting (MC-DC) technology, where intensive melt shearing is applied to the conventional direct-chill casting process. MC-DC casting can successfully produce high quality Al-alloy billets. The results obtained from 80 mm diameter billets cast at speed of 200 mm/min show that MC-DC casting of Al-alloys, substantially refines the microstructure and reduces macro-segregation. In this paper, we present the preliminary results and discuss microstructural evolution during MC-DC casting of Al-alloys.
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A real-time monitoring system for night glare protection
NASA Astrophysics Data System (ADS)
Ma, Jun; Ni, Xuxiang
2010-11-01
When capturing a dark scene with a high bright object, the monitoring camera will be saturated in some regions and the details will be lost in and near these saturated regions because of the glare vision. This work aims at developing a real-time night monitoring system. The system can decrease the influence of the glare vision and gain more details from the ordinary camera when exposing a high-contrast scene like a car with its headlight on during night. The system is made up of spatial light modulator (The liquid crystal on silicon: LCoS), image sensor (CCD), imaging lens and DSP. LCoS, a reflective liquid crystal, can modular the intensity of reflective light at every pixel as a digital device. Through modulation function of LCoS, CCD is exposed with sub-region. With the control of DSP, the light intensity is decreased to minimum in the glare regions, and the light intensity is negative feedback modulated based on PID theory in other regions. So that more details of the object will be imaging on CCD and the glare protection of monitoring system is achieved. In experiments, the feedback is controlled by the embedded system based on TI DM642. Experiments shows: this feedback modulation method not only reduces the glare vision to improve image quality, but also enhances the dynamic range of image. The high-quality and high dynamic range image is real-time captured at 30hz. The modulation depth of LCoS determines how strong the glare can be removed.
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End-of-Life Care in the Intensive Care Unit
Engelberg, Ruth A.; Bensink, Mark E.; Ramsey, Scott D.
2012-01-01
The incidence and costs of critical illness are increasing in the United States at a time when there is a focus both on limiting the rising costs of healthcare and improving the quality of end-of-life care. More than 25% of healthcare costs are spent in the last year of life, and approximately 20% of deaths occur in the intensive care unit (ICU). Consequently, there has been speculation that end-of-life care in the ICU represents an important target for cost savings. It is unclear whether efforts to improve end-of-life care in the ICU could significantly reduce healthcare costs. Here, we summarize recent studies suggesting that important opportunities may exist to improve quality and reduce costs through two mechanisms: advance care planning for patients with life-limiting illness and use of time-limited trials of ICU care for critically ill patients. The goal of these approaches is to ensure patients receive the intensity of care that they would choose at the end of life, given the opportunity to make an informed decision. Although these mechanisms hold promise for increasing quality and reducing costs, there are few clearly described, effective methods to implement these mechanisms in routine clinical practice. We believe basic science in communication and decision making, implementation research, and demonstration projects are critically important if we are to translate these approaches into practice and, in so doing, provide high-quality and patient-centered care while limiting rising healthcare costs. PMID:22859524
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Holth, Per; Torsheim, Torbjørn; Sheidow, Ashli J; Ogden, Terje; Henggeler, Scott W
2011-01-01
This study was a crosscultural replication of a study that investigated therapist adherence to behavioral interventions as a result of an intensive quality assurance system which was integrated into Multisystemic Therapy. Thirty-three therapists and eight supervisors participated in the study and were block randomized to either an Intensive Quality Assurance or a Workshop Only condition. Twenty-one of these therapists treated 41 cannabis-abusing adolescents and their families. Therapist adherence and youth drug screens were collected during a five-month baseline period prior to the workshop on contingency management and during 12 months post workshop. The results replicated the previous finding that therapist adherence to the cognitive-behavioral interventions, but not to contingency management, showed a strong positive difference in trend in favor of the intensive quality assurance condition. While the clinical impact of such quality assurance may be delayed and remains to be demonstrated, cannabis abstinence increased as a function of time in therapy, and was more likely with stronger therapy adherence to contingency management, but did not differ across quality assurance interventions.
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Status of the R&D activity on diamond particle detectors
NASA Astrophysics Data System (ADS)
Adam, W.; Bellini, B.; Berdermann, E.; Bergonzo, P.; de Boer, W.; Bogani, F.; Borchi, E.; Brambilla, A.; Bruzzi, M.; Colledani, C.; Conway, J.; D'Angelo, P.; Dabrowski, W.; Delpierre, P.; Doroshenko, J.; Dulinski, W.; van Eijk, B.; Fallou, A.; Fischer, P.; Fizzotti, F.; Furetta, C.; Gan, K. K.; Ghodbane, N.; Grigoriev, E.; Hallewell, G.; Han, S.; Hartjes, F.; Hrubec, J.; Husson, D.; Kagan, H.; Kaplon, J.; Karl, C.; Kass, R.; Keil, M.; Knöpfle, K. T.; Koeth, T.; Krammer, M.; Logiudice, A.; Lu, R.; mac Lynne, L.; Manfredotti, C.; Marshall, R. D.; Meier, D.; Menichelli, D.; Meuser, S.; Mishina, M.; Moroni, L.; Noomen, J.; Oh, A.; Perera, L.; Pernicka, M.; Polesello, P.; Potenza, R.; Riester, J. L.; Roe, S.; Rudge, A.; Sala, S.; Sampietro, M.; Schnetzer, S.; Sciortino, S.; Stelzer, H.; Stone, R.; Sutera, C.; Trischuk, W.; Tromson, D.; Tuve, C.; Weilhammer, P.; Wermes, N.; Wetstein, M.; Zeuner, W.; Zoeller, M.; RD42 Collaboration
2003-09-01
Chemical Vapor Deposited (CVD) polycrystalline diamond has been proposed as a radiation-hard alternative to silicon in the extreme radiation levels occurring close to the interaction region of the Large Hadron Collider. Due to an intense research effort, reliable high-quality polycrystalline CVD diamond detectors, with up to 270 μm charge collection distance and good spatial uniformity, are now available. The most recent progress on the diamond quality, on the development of diamond trackers and on radiation hardness studies are presented and discussed.
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Effects of wildfire on source-water quality and aquatic ecosystems, Colorado Front Range
Writer, Jeffrey H.; McCleskey, R. Blaine; Murphy, Sheila F.; Stone, Mike; Collins, Adrian; Thoms, Martin C.
2012-01-01
Watershed erosion can dramatically increase after wildfire, but limited research has evaluated the corresponding influence on source-water quality. This study evaluated the effects of the Fourmile Canyon wildfire (Colorado Front Range, USA) on source-water quality and aquatic ecosystems using high- frequency sampling. Dissolved organic carbon (DOC) and nutrient loads in stream water were evaluated for a one-year period during different types of runoff events, including spring snowmelt, and both frontal and summer convective storms. DOC export from the burned watershed did not increase relative to the unburned watershed during spring snowmelt, but substantial increases in DOC export were observed during summer convective storms. Elevated nutrient export from the burned watershed was observed during spring snowmelt and summer convective storms, which increased the primary productivity of stream biofilms. Wildfire effects on source-water quality were shown to be substantial following high-intensity storms, with the potential to affect drinking-water treatment processes.
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Zhang, Jing; Yuan, Changan; Huang, Guohua; Zhao, Yinjun; Ren, Wenyi; Cao, Qizhi; Li, Jianying; Jin, Mingwu
2018-01-01
A snapshot imaging polarimeter using spatial modulation can encode four Stokes parameters allowing instantaneous polarization measurement from a single interferogram. However, the reconstructed polarization images could suffer a severe aliasing signal if the high-frequency component of the intensity image is prominent and occurs in the polarization channels, and the reconstructed intensity image also suffers reduction of spatial resolution due to low-pass filtering. In this work, a method using two anti-phase snapshots is proposed to address the two problems simultaneously. The full-resolution target image and the pure interference fringes can be obtained from the sum and the difference of the two anti-phase interferograms, respectively. The polarization information reconstructed from the pure interference fringes does not contain the aliasing signal from the high-frequency component of the object intensity image. The principles of the method are derived and its feasibility is tested by both computer simulation and a verification experiment. This work provides a novel method for spatially modulated imaging polarization technology with two snapshots to simultaneously reconstruct a full-resolution object intensity image and high-quality polarization components. PMID:29714224
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An improved multi-exposure approach for high quality holographic femtosecond laser patterning
NASA Astrophysics Data System (ADS)
Zhang, Chenchu; Hu, Yanlei; Li, Jiawen; Lao, Zhaoxin; Ni, Jincheng; Chu, Jiaru; Huang, Wenhao; Wu, Dong
2014-12-01
High efficiency two photon polymerization through single exposure via spatial light modulator (SLM) has been used to decrease the fabrication time and rapidly realize various micro/nanostructures, but the surface quality remains a big problem due to the speckle noise of optical intensity distribution at the defocused plane. Here, a multi-exposure approach which used tens of computer generate holograms successively loaded on SLM is presented to significantly improve the optical uniformity without losing efficiency. By applying multi-exposure, we found that the uniformity at the defocused plane was increased from ˜0.02 to ˜0.6 according to our simulation. The fabricated two series of letters "HELLO" and "USTC" under single-and multi-exposure in our experiment also verified that the surface quality was greatly improved. Moreover, by this method, several kinds of beam splitters with high quality, e.g., 2 × 2, 5 × 5 Daman, and complex nonseperate 5 × 5, gratings were fabricated with both of high quality and short time (<1 min, 95% time-saving). This multi-exposure SLM-two-photon polymerization method showed the promising prospect in rapidly fabricating and integrating various binary optical devices and their systems.
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NASA Astrophysics Data System (ADS)
Zhao, H. W.; Sun, L. T.; Guo, J. W.; Lu, W.; Xie, D. Z.; Hitz, D.; Zhang, X. Z.; Yang, Y.
2017-09-01
The superconducting electron cyclotron resonance ion source with advanced design in Lanzhou (SECRAL) is a superconducting-magnet-based electron cyclotron resonance ion source (ECRIS) for the production of intense highly charged heavy ion beams. It is one of the best performing ECRISs worldwide and the first superconducting ECRIS built with an innovative magnet to generate a high strength minimum-B field for operation with heating microwaves up to 24-28 GHz. Since its commissioning in 2005, SECRAL has so far produced a good number of continuous wave intensity records of highly charged ion beams, in which recently the beam intensities of 40Ar+ and 129Xe26+ have, for the first time, exceeded 1 emA produced by an ion source. Routine operations commenced in 2007 with the Heavy Ion accelerator Research Facility in Lanzhou (HIRFL), China. Up to June 2017, SECRAL has been providing more than 28,000 hours of highly charged heavy ion beams to the accelerator demonstrating its great capability and reliability. The great achievement of SECRAL is accumulation of numerous technical advancements, such as an innovative magnetic system and an efficient double-frequency (24 +18 GHz ) heating with improved plasma stability. This article reviews the development of SECRAL and production of intense highly charged ion beams by SECRAL focusing on its unique magnet design, source commissioning, performance studies and enhancements, beam quality and long-term operation. SECRAL development and its performance studies representatively reflect the achievements and status of the present ECR ion source, as well as the ECRIS impacts on HIRFL.
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Odour intensity learning in fruit flies
Yarali, Ayse; Ehser, Sabrina; Hapil, Fatma Zehra; Huang, Ju; Gerber, Bertram
2009-01-01
Animals' behaviour towards odours depends on both odour quality and odour intensity. While neuronal coding of odour quality is fairly well studied, how odour intensity is treated by olfactory systems is less clear. Here we study odour intensity processing at the behavioural level, using the fruit fly Drosophila melanogaster. We trained flies by pairing a MEDIUM intensity of an odour with electric shock, and then, at a following test phase, measured flies' conditioned avoidance of either this previously trained MEDIUM intensity or a LOWer or a HIGHer intensity. With respect to 3-octanol, n-amylacetate and 4-methylcyclohexanol, we found that conditioned avoidance is strongest when training and test intensities match, speaking for intensity-specific memories. With respect to a fourth odour, benzaldehyde, on the other hand, we found no such intensity specificity. These results form the basis for further studies of odour intensity processing at the behavioural, neuronal and molecular level. PMID:19586944
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Using PICO Methodology to Answer Questions About Smoking in COPD Patients.
Jiménez Ruiz, Carlos A; Buljubasich, Daniel; Riesco Miranda, Juan Antonio; Acuña Izcaray, Agustín; de Granda Orive, José Ignacio; Chatkin, José Miguel; Zabert, Gustavo; Guerreros Benavides, Alfredo; Paez Espinel, Nelson; Noé, Valeri; Sánchez-Angarita, Efraín; Núñez-Sánchez, Ingrid; Sansores, Raúl H; Casas, Alejandro; Palomar Lever, Andrés; Alfageme Michavila, Inmaculada
2017-11-01
The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer, by way of PICO methodology, different questions on health interventions for helping COPD patients to stop smoking. The main recommendations are: (i)moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease, as a motivational tool (particularly for showing evidence of lung age), a diagnostic tool, and for active case-finding; (ii)high-quality evidence and strong recommendation for using intensive dedicated behavioral counselling and drug treatment for helping COPD patients to stop smoking; (iii)high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge, and (iv)high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients, in view of the impact on health and health economics. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.
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Song, Ting; Li, Nan; Zarepisheh, Masoud; Li, Yongbao; Gautier, Quentin; Zhou, Linghong; Mell, Loren; Jiang, Steve; Cerviño, Laura
2016-01-01
Intensity-modulated radiation therapy (IMRT) currently plays an important role in radiotherapy, but its treatment plan quality can vary significantly among institutions and planners. Treatment plan quality control (QC) is a necessary component for individual clinics to ensure that patients receive treatments with high therapeutic gain ratios. The voxel-weighting factor-based plan re-optimization mechanism has been proved able to explore a larger Pareto surface (solution domain) and therefore increase the possibility of finding an optimal treatment plan. In this study, we incorporated additional modules into an in-house developed voxel weighting factor-based re-optimization algorithm, which was enhanced as a highly automated and accurate IMRT plan QC tool (TPS-QC tool). After importing an under-assessment plan, the TPS-QC tool was able to generate a QC report within 2 minutes. This QC report contains the plan quality determination as well as information supporting the determination. Finally, the IMRT plan quality can be controlled by approving quality-passed plans and replacing quality-failed plans using the TPS-QC tool. The feasibility and accuracy of the proposed TPS-QC tool were evaluated using 25 clinically approved cervical cancer patient IMRT plans and 5 manually created poor-quality IMRT plans. The results showed high consistency between the QC report quality determinations and the actual plan quality. In the 25 clinically approved cases that the TPS-QC tool identified as passed, a greater difference could be observed for dosimetric endpoints for organs at risk (OAR) than for planning target volume (PTV), implying that better dose sparing could be achieved in OAR than in PTV. In addition, the dose-volume histogram (DVH) curves of the TPS-QC tool re-optimized plans satisfied the dosimetric criteria more frequently than did the under-assessment plans. In addition, the criteria for unsatisfied dosimetric endpoints in the 5 poor-quality plans could typically be satisfied when the TPS-QC tool generated re-optimized plans without sacrificing other dosimetric endpoints. In addition to its feasibility and accuracy, the proposed TPS-QC tool is also user-friendly and easy to operate, both of which are necessary characteristics for clinical use. PMID:26930204
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Ultrashort electron pulses as a four-dimensional diagnosis of plasma dynamics.
Zhu, P F; Zhang, Z C; Chen, L; Li, R Z; Li, J J; Wang, X; Cao, J M; Sheng, Z M; Zhang, J
2010-10-01
We report an ultrafast electron imaging system for real-time examination of ultrafast plasma dynamics in four dimensions. It consists of a femtosecond pulsed electron gun and a two-dimensional single electron detector. The device has an unprecedented capability of acquiring a high-quality shadowgraph image with a single ultrashort electron pulse, thus permitting the measurement of irreversible processes using a single-shot scheme. In a prototype experiment of laser-induced plasma of a metal target under moderate pump intensity, we demonstrated its unique capability of acquiring high-quality shadowgraph images on a micron scale with a-few-picosecond time resolution.
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Phase-locking of annular-combination CO2 laser
NASA Astrophysics Data System (ADS)
Qi, Tingxiang; Chen, Mei; Zhang, Rongzhu; Xiao, Qianyi
2015-07-01
A new annular-combination resonator structure adopting the external-injection phase-locking technology is presented theoretically for that the beam quality of stable annular resonator is not satisfying. The phase-locking principle and feasibility are characterized by energy density of injection beam and coupling coefficient. Based on the diffraction theory, output mode of the resonator with phase-locking is deduced and simulated. Results also confirm that injection beam have a good control effect on output mode. The intensity distributions of output beam are studied briefly and indicate that this new resonator which is adaptable to annular gain media can produce high-power laser beam with high quality.
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Not Just Any Job Will Do: A Study on Employment Characteristics and Recidivism Risks After Release
Ramakers, Anke; Nieuwbeerta, Paul; Van Wilsem, Johan; Dirkzwager, Anja
2016-01-01
Ex-prisoners’ recidivism risks are high. Several theories state that employment can reduce these risks but emphasize that the protective role of employment is conditional on job qualities (work intensity, job duration, etc.). Longitudinal research on the role of employment in ex-prisoners’ recidivism patterns is scarce, and most existing work used a simplistic employment measure (i.e., employed vs. unemployed), leaving the topic of job quality underexplored. This study examines the association between employment characteristics and recidivism among Dutch ex-prisoners. Using longitudinal data of the Prison Project (n = 714), we found that not just any job, but particularly stable employment and jobs with a higher occupational level could help reduce crime rates among these high-risk offenders. Many ex-prisoners face a human capital deficit that complicates the guidance to high-quality jobs. It might, however, be possible to help place ex-prisoners in stable employment. PMID:26975405
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Mangiamarchi, Pedro; Caniuqueo, Alexis; Ramírez-Campillo, Rodrigo; Cárdenas, Patricio; Morales, Sylvana; Cano-Montoya, Johnattan; Bresciani, Guilherme; Álvarez, Cristian
2017-07-01
High-intensity interval training (HIIT) improves cardiometabolic markers, but its effects on the quality of life of patients with type 2 diabetes (T2D) is not well known. To determine the effects of a 12-week HIIT exercise program on cardiometabolic and quality of life variables of T2D patients. Nine T2D women were assigned to a HIIT + nutritional education (GE) and 10, to a nutritional education alone group (GC). At baseline and after each intervention, anthropometric and body composition parameters using bio-impedance were assessed, and a blood sample was obtained to measure serum lipid levels, blood glucose and glycated hemoglobin. Quality of life was assessed using the SF-12 questionnaire adapted for the Chilean population. There were no significant changes on the lipid profile variables in the GE group, although HDL cholesterol was increased significantly (p < 0.05) in the GC group. Total fat mass was decreased in the GE group from 43.5 ± 1.5 to 41.9 ± 1.5%, p < 0.01. Fasting glucose and glycated hemoglobin decreased in the GE group. There was a significant correlation between the decrease in total fat mass and that of glycated hemoglobin. There were significant increases in quality of life parameters; physical function, physical role, pain, general health, vitality, emotional role, mental health, and social function in the GE but not in the GC group. A 12-week program of HIIT plus nutritional education improves cardiometabolic and quality of life parameters on type 2 diabetics.
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McGill, Stuart; Frost, David; Lam, Thomas; Finlay, Tim; Darby, Kevin; Cannon, Jordan
2015-01-01
Elite police work has bursts of intense physically demanding work requiring high levels of fitness, or capacity, and movement competency; which are assumed to increase one's injury resilience. The purpose of this study was to follow members of an elite police force (N = 53) to test whether back injuries (N = 14) could be predicted from measures of fitness and movement quality. Measures of torso endurance, relative and absolute strength, hip ROM and movement quality using the Functional Movement Screen(TM) and other dynamic movement tests were obtained from every officer at baseline. When variables were grouped and considered holistically, rather than individually, back injury could be predicted. Seven variables best predicted those who would suffer a back injury (64% sensitivity and 95% specificity for an overall concordance of 87%). Overall, the ability to predict back injury was not high, suggesting that there is more complexity to this relationship than is explained with the variables tested here. Practitioner Summary: Members of elite police forces have exposure to intense physically demanding work. Increased levels of fitness and movement competency have been assumed to increase injury resilience. However, complexity in the interactions between exposure, movement competency, training, fitness and injury may occlude the true relationship between these variables.
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Enhanced laser absorption from radiation pressure in intense laser plasma interactions
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dollar, F.; Zulick, C.; Raymond, A.
The reflectivity of a short-pulse laser at intensities of 2 x 10 21Wcm -2 with ultra-high contrast (10 -15) on sub-micrometer silicon nitride foilswas studied experimentally using varying polarizations and target thicknesses. Furthermore, the reflected intensity and beam quality were found to be relatively constant with respect to intensity for bulk targets. For submicron targets, the measured reflectivity drops substantially without a corresponding increase in transmission, indicating increased conversion of fundamental to other wavelengths and particle heating. The experimental results and trends we observed in 3D particle-in-cell simulations emphasize the critical role of ion motion due to radiation pressure onmore » the absorption process. Ion motion during ultra-short pulses enhances the electron heating, which subsequently transfers more energy to the ions.« less
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NASA Astrophysics Data System (ADS)
Aida, S.; Matsuno, T.; Hasegawa, T.; Tsuji, K.
2017-07-01
Micro X-ray fluorescence (micro-XRF) analysis is repeated as a means of producing elemental maps. In some cases, however, the XRF images of trace elements that are obtained are not clear due to high background intensity. To solve this problem, we applied principal component analysis (PCA) to XRF spectra. We focused on improving the quality of XRF images by applying PCA. XRF images of the dried residue of standard solution on the glass substrate were taken. The XRF intensities for the dried residue were analyzed before and after PCA. Standard deviations of XRF intensities in the PCA-filtered images were improved, leading to clear contrast of the images. This improvement of the XRF images was effective in cases where the XRF intensity was weak.
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Enhanced laser absorption from radiation pressure in intense laser plasma interactions
Dollar, F.; Zulick, C.; Raymond, A.; ...
2017-06-06
The reflectivity of a short-pulse laser at intensities of 2 x 10 21Wcm -2 with ultra-high contrast (10 -15) on sub-micrometer silicon nitride foilswas studied experimentally using varying polarizations and target thicknesses. Furthermore, the reflected intensity and beam quality were found to be relatively constant with respect to intensity for bulk targets. For submicron targets, the measured reflectivity drops substantially without a corresponding increase in transmission, indicating increased conversion of fundamental to other wavelengths and particle heating. The experimental results and trends we observed in 3D particle-in-cell simulations emphasize the critical role of ion motion due to radiation pressure onmore » the absorption process. Ion motion during ultra-short pulses enhances the electron heating, which subsequently transfers more energy to the ions.« less
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Michaelidis, Constantinos I; Zimmerman, Richard K; Nowalk, Mary Patricia; Smith, Kenneth J
2014-07-15
There are disparities in influenza and pneumococcal vaccination rates among elderly minority groups and little guidance as to which intervention or combination of interventions to eliminate these disparities is likely to be most cost-effective. Here, we evaluate the cost-effectiveness of four hypothetical vaccination programs designed to eliminate disparities in elderly vaccination rates and differing in the number of interventions. We developed a Markov model in which we assumed a healthcare system perspective, 10-year vaccination program and lifetime time horizon. The cohort was the combined African-American and Hispanic 65 year-old birth cohort in the United States in 2009. We evaluated five different vaccination strategies: no vaccination program and four vaccination programs that varied from "low intensity" to "very high intensity" based on the number of interventions deployed in each program, their cumulative cost and their cumulative impact on elderly minority influenza and pneumococcal vaccination rates. The very high intensity vaccination program ($24,479/quality-adjusted life year; QALY) was preferred at willingness-to-pay-thresholds of $50,000 and $100,000/QALY and prevented 37,178 influenza cases, 342 influenza deaths, 1,158 invasive pneumococcal disease (IPD) cases and 174 IPD deaths over the birth cohort's lifetime. In one-way sensitivity analyses, the very high intensity program only became cost-prohibitive (>$100,000/QALY) at less likely values for the influenza vaccination rates achieved in year 10 of the high intensity (>73.5%) or very high intensity (<76.8%) vaccination programs. A practice-based vaccination program designed to eliminate disparities in elderly minority vaccination rates and including four interventions would be cost-effective.
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Estimation of Image Sensor Fill Factor Using a Single Arbitrary Image
Wen, Wei; Khatibi, Siamak
2017-01-01
Achieving a high fill factor is a bottleneck problem for capturing high-quality images. There are hardware and software solutions to overcome this problem. In the solutions, the fill factor is known. However, this is an industrial secrecy by most image sensor manufacturers due to its direct effect on the assessment of the sensor quality. In this paper, we propose a method to estimate the fill factor of a camera sensor from an arbitrary single image. The virtual response function of the imaging process and sensor irradiance are estimated from the generation of virtual images. Then the global intensity values of the virtual images are obtained, which are the result of fusing the virtual images into a single, high dynamic range radiance map. A non-linear function is inferred from the original and global intensity values of the virtual images. The fill factor is estimated by the conditional minimum of the inferred function. The method is verified using images of two datasets. The results show that our method estimates the fill factor correctly with significant stability and accuracy from one single arbitrary image according to the low standard deviation of the estimated fill factors from each of images and for each camera. PMID:28335459
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Bele, Irene Velsvik
2006-12-01
The current study concerns speaking voice quality in two groups of professional voice users, teachers (n = 35) and actors (n = 36), representing trained and untrained voices. The voice quality of text reading at two intensity levels was acoustically analyzed. The central concept was the speaker's formant (SPF), related to the perceptual characteristics "better normal voice quality" (BNQ) and "worse normal voice quality" (WNQ). The purpose of the current study was to get closer to the origin of the phenomenon of the SPF, and to discover the differences in spectral and formant characteristics between the two professional groups and the two voice quality groups. The acoustic analyses were long-term average spectrum (LTAS) and spectrographical measurements of formant frequencies. At very high intensities, the spectral slope was rather quandrangular without a clear SPF peak. The trained voices had a higher energy level in the SPF region compared with the untrained, significantly so in loud phonation. The SPF seemed to be related to both sufficiently strong overtones and a glottal setting, allowing for a lowering of F4 and a closeness of F3 and F4. However, the existence of SPF also in LTAS of the WNQ voices implies that more research is warranted concerning the formation of SPF, and concerning the acoustic correlates of the BNQ voices.
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High power parallel ultrashort pulse laser processing
NASA Astrophysics Data System (ADS)
Gillner, Arnold; Gretzki, Patrick; Büsing, Lasse
2016-03-01
The class of ultra-short-pulse (USP) laser sources are used, whenever high precession and high quality material processing is demanded. These laser sources deliver pulse duration in the range of ps to fs and are characterized with high peak intensities leading to a direct vaporization of the material with a minimum thermal damage. With the availability of industrial laser source with an average power of up to 1000W, the main challenge consist of the effective energy distribution and disposition. Using lasers with high repetition rates in the MHz region can cause thermal issues like overheating, melt production and low ablation quality. In this paper, we will discuss different approaches for multibeam processing for utilization of high pulse energies. The combination of diffractive optics and conventional galvometer scanner can be used for high throughput laser ablation, but are limited in the optical qualities. We will show which applications can benefit from this hybrid optic and which improvements in productivity are expected. In addition, the optical limitations of the system will be compiled, in order to evaluate the suitability of this approach for any given application.
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NASA Astrophysics Data System (ADS)
Hong, S. K.; Chen, Y.; Ko, H. J.; Wenisch, H.; Hanada, T.; Yao, T.
2001-06-01
This paper will address features of plasma-assisted molecular beam epitaxial growth of ZnO and related materials and their characteristics. Two-dimensional, layer-by-layer growth is achieved both on c-plane sampphire by employing MgO buffer layer growth and on (0001) GaN/Al2O3 template by predepositing a low-temperature buffer layer followed by high-temperature annealing. Such two-dimensional growth results in the growth of high-quality heteroepitaxial ZnO epilayers. Biexciton emission is obtained from such high quality epilayers The polarity of heteroepitaxial ZnO epilayers is controlled by engineering the heterointerfaces. We achieved selective growth of Zn-polar and O-polar ZnO heteroepitaxial layers. The origin of different polarities can be successfully explained by an interface bonding sequence model. N-type conductivity in Gadoped ZnO epilayers is successfully controlled. High conductivity, enough to be applicable to devices, is achieved. MgxZn1-xO/ZnO heterostructures are grown and emission from a ZnO quantum well is observed. Mg incorporation in a MgZnO alloy is determined by in-situ reflection high-energy electron diffraction intensity oscillations, which enables precise control of the composition. Homoepitaxy on commericial ZnO substrates has been examined. Reflection high-energy electron diffraction intensity oscillations during homoepitaxy growth are observed.
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Influence of pitting defects on quality of high power laser light field
NASA Astrophysics Data System (ADS)
Ren, Huan; Zhang, Lin; Yang, Yi; Shi, Zhendong; Ma, Hua; Jiang, Hongzhen; Chen, Bo; Yang, XiaoYu; Zheng, Wanguo; Zhu, Rihong
2018-01-01
With the split-step-Fourier-transform method for solving the nonlinear paraxial wave equation, the intensity distribution of the light field when the pits diameter or depth change is obtained by using numerical simulation, include the intensity distribution inside optical element, the beam near-field, the different distances behind the element and the beam far-field. Results show that with the increase of pits diameter or depth, the light field peak intensity and the contrast inside of element corresponding enhancement. The contrast of the intensity distribution of the rear surface of the element will increase slightly. The peak intensity produced by a specific location element downstream of thermal effect will continue to increase, the damage probability in optics placed here is greatly increased. For the intensity distribution of the far-field, increase the pitting diameter or depth will cause the focal spot intensity distribution changes, and the energy of the spectrum center region increase constantly. This work provide a basis for quantitative design and inspection for pitting defects, which provides a reference for the design of optical path arrangement.
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Reducing false asystole alarms in intensive care.
Dekimpe, Remi; Heldt, Thomas
2017-07-01
High rates of false monitoring alarms in intensive care can desensitize staff and therefore pose a significant risk to patient safety. Like other critical arrhythmia alarms, asystole alarms require immediate attention by the care providers as a true asystole event can be acutely life threatening. Here, it is illustrated that most false asystole alarms can be attributed to poor signal quality, and we propose and evaluate an algorithm to identify data windows of poor signal quality and thereby help suppress false asystole alarms. The algorithm combines intuitive signal-quality features (degree of signal saturation and baseline wander) and information from other physiological signals that might be available. Algorithm training and testing was performed on the MIMIC II and 2015 PhysioNet/Computing in Cardiology Challenge databases, respectively. The algorithm achieved an alarm specificity of 81.0% and sensitivity of 95.4%, missing only one out of 22 true asystole alarms. On a separate neonatal data set, the algorithm was able to reject 89.7% (890 out of 992) of false asystole alarms while keeping all 22 true events. The results show that the false asystole alarm rate can be significantly reduced through basic signal quality evaluation.
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Simons, Koen S; Boeijen, Enzio R K; Mertens, Marlies C; Rood, Paul; de Jager, Cornelis P C; van den Boogaard, Mark
2018-05-01
Exposure to bright light has alerting effects. In nurses, alertness may be decreased because of shift work and high work pressure, potentially reducing work performance and increasing the risk for medical errors. To determine whether high-intensity dynamic light improves cognitive performance, self-reported depressive signs and symptoms, fatigue, alertness, and well-being in intensive care unit nurses. In a single-center crossover study in an intensive care unit of a teaching hospital in the Netherlands, 10 registered nurses were randomly divided into 2 groups. Each group worked alternately for 3 to 4 days in patients' rooms with dynamic light and 3 to 4 days in control lighting settings. High-intensity dynamic light was administered through ceiling-mounted fluorescent tubes that delivered bluish white light up to 1700 lux during the daytime, versus 300 lux in control settings. Cognitive performance, self-reported depressive signs and symptoms, fatigue, and well-being before and after each period were assessed by using validated cognitive tests and questionnaires. Cognitive performance, self-reported depressive signs and symptoms, and fatigue did not differ significantly between the 2 light settings. Scores of subjective well-being were significantly lower after a period of working in dynamic light. Daytime lighting conditions did not affect intensive care unit nurses' cognitive performance, perceived depressive signs and symptoms, or fatigue. Perceived quality of life, predominantly in the psychological and environmental domains, was lower for nurses working in dynamic light. © 2018 American Association of Critical-Care Nurses.
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An investigation of turbulence structure in a low-Reynolds-number incompressible turbulent boundary
NASA Technical Reports Server (NTRS)
White, B. R.; Strataridakis, C. J.
1987-01-01
An existing high turbulence intensity level (5%) atmospheric boundary-layer wind tunnel has been successfully converted to a relatively low level turbulence (0.3%) wind tunnel through extensive modification, testing, and calibration. A splitter plate was designed, built, and installed into the wind-tunnel facility to create thick, mature, two-dimensional turbulent boundary layer flow at zero pressure gradient. Single and cross hot-wire measurements show turbulent boundary layer characteristics of good quality with unusually large physical size, i.e., viscous sublayer of the order of 1 mm high. These confirm the potential ability of the tunnel to be utilized for future high-quality near-wall turbulent boundary layer measurements. It compares very favorably with many low turbulence research tunnels.
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High Efficiency InP Solar Cells from Low Toxicity Tertiarybutylphosphine
NASA Technical Reports Server (NTRS)
Hoffman, Richard W., Jr.; Fatemi, Navid S.; Wilt, David M.; Jenkins, Phillip P.; Brinker, David J.; Scheiman, David A.
1994-01-01
Large scale manufacture of phosphide based semiconductor devices by organo-metallic vapor phase epitaxy (OMVPE) typically requires the use of highly toxic phosphine. Advancements in phosphine substitutes have identified tertiarybutylphosphine (TBP) as an excellent precursor for OMVPE of InP. High quality undoped and doped InP films were grown using TBP and trimethylindium. Impurity doped InP films were achieved utilizing diethylzinc and silane for p and n type respectively. 16 percent efficient solar cells under air mass zero, one sun intensity were demonstrated with Voc of 871 mV and fill factor of 82.6 percent. It was shown that TBP could replace phosphine, without adversely affecting device quality, in OMVPE deposition of InP thus significantly reducing toxic gas exposure risk.
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Quality Improvement Process in a Large Intensive Care Unit: Structure and Outcomes.
Reddy, Anita J; Guzman, Jorge A
2016-11-01
Quality improvement in the health care setting is a complex process, and even more so in the critical care environment. The development of intensive care unit process measures and quality improvement strategies are associated with improved outcomes, but should be individualized to each medical center as structure and culture can differ from institution to institution. The purpose of this report is to describe the structure of quality improvement processes within a large medical intensive care unit while using examples of the study institution's successes and challenges in the areas of stat antibiotic administration, reduction in blood product waste, central line-associated bloodstream infections, and medication errors. © The Author(s) 2015.
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2017-03-29
AFRL-AFOSR-VA-TR-2017-0072 12. DISTRIBUTION/ AVAILABILITY STATEMENT DISTRIBUTION A: Distribution approved for public release. 13. SUPPLEMENTARY NOTES...ablation, high intensity 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON PARRA, ENRIQUE...Leibniz Universitat Hannover. These additions have significantly strengthened our team, as evidenced by the high quality publications by those
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Scotti, Dennis J; Harmon, Joel
2014-01-01
The delivery of high-quality service, rendered by health service professionals who interact with customers (patients), increases the likelihood that customers will form positive evaluations of the quality of their service encounters as well as high levels of customer satisfaction. Using linkage theory to develop our conceptual framework, we identify four clusters of variables which contribute to a chain of sequential events that connect organization climate to personal and operational work outcomes. We then examine the perceptual differences of service professionals, grouped by intensity of customer contact, with respect to these variables. National data for this project were obtained from multiple sources made available by the Veterans Healthcare Administration (VHA). Cross-group differences were tested using a series of variance analyses. The results indicate that level of customer-contact intensity plays a significant role in explaining variation in perceptions of support staff, clinical practitioners, and nurses at the multivariate and univariate levels of analysis. Contact intensity appears to be a core determinant of the nature of work performed by health service professionals as well as their psychological responses to organizational and customer-related dynamics. Health service professionals are important resources because of their specialized knowledge, labor expense, and scarcity. Based on findings from our research, managers are advised to survey employees' perceptions of their organizational environment and design practices that respond to the unique viewpoints of each of the professional groups identified in this study. Such tailoring should help executives maximize the value of investments in human resources by underwriting patient satisfaction and financial sustainability.
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Hajizadeh Maleki, Behzad; Tartibian, Bakhtyar; Chehrazi, Mohammad
2017-02-01
The aim of this study was to investigate the effects of moderate-intensity continuous training (MICT), high-intensity continuous training (HICT) and high-intensity interval training (HIIT) on markers of male reproduction including seminal markers of oxidative stress and inflammation as well as semen quality and sperm DNA integrity in healthy human subjects. A total of 397 healthy male volunteers were screened and 280 were randomly assigned to one of the MICT (n = 70), HICT (n = 70), HIIT (n = 70) and non-exercise (NON-EX, n = 70) groups. Subjects had inflammatory markers (IL-1β, IL-6, IL-8 and TNF-α), oxidants (ROS, MDA and 8-isoprostane), antioxidants (SOD, catalase and TAC), semen parameters and sperm DNA damage measured at baseline (T 1 ), the end of week 12 (T 2 ), the end of week 24 (T 3 ), and 7 (T 4 ) and 30 days (T 5 ) after training. Chronic MICT, HICT and HIIT attenuated seminal markers of oxidative stress and inflammation with different kinetics for the three types of exercise (P < 0.05), and these changes were correlated with favorable improvements in semen quality parameters and sperm DNA integrity (P < 0.05). MICT was superior to HICT and HIIT in the improvements of markers of male reproductive function (P < 0.05). In conclusion, different exercise modalities favorably affect markers of male reproduction with different kinetics, suggesting intensity-, duration- and type-dependent adaptations to exercise training in healthy human subjects. © 2017 Society for Reproduction and Fertility.
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Miranda-Fuentes, Antonio; Rodríguez-Lizana, Antonio; Gil, Emilio; Agüera-Vega, J; Gil-Ribes, Jesús A
2015-12-15
Olive is a key crop in Europe, especially in countries around the Mediterranean Basin. Optimising the parameters of a spray is essential for sustainable pesticide use, especially in high-input systems, such as the super-intensive hedgerow system. Parameters may be optimised by adjusting the applied volume and airflow rate of sprays, in addition to the liquid to air proportion and the relationship between air velocity and airflow rate. Two spray experiments using a commercial airblast sprayer were conducted in a super-intensive orchard to study how varying the liquid volume rate (testing volumes of 182, 619, and 1603 l ha(-1)) and volumetric airflow rate (with flow rates of 11.93, 8.90, and 6.15 m(3) s(-1)) influences the coverage parameters and the amount and distribution of deposits in different zones of the canopy.. Our results showed that an increase in the application volume raised the mean deposit and percentage coverage, but decreased the application efficiency, spray penetration, and deposit homogeneity. Furthermore, we found that the volumetric airflow rate had a lower influence on the studied parameters than the liquid volume; however, an increase in the airflow rate improved the application efficiency and homogeneity to a certain threshold, after which the spray quality decreased. This decrease was observed in the high-flow treatment. Our results demonstrate that intermediate liquid volume rates and volumetric airflow rates are required for the optimal spraying of pesticides on super-intensive olive crops, and would reduce current pollution levels. Copyright © 2015 Elsevier B.V. All rights reserved.
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Paradiso, Roberta; De Pascale, Stefania
2014-01-01
Mediterranean greenhouses for cultivation of Phalaenopsis orchids reproduce the warm, humid, and shaded environment of tropical underbrush. Heating represents the highest production cost, due to the high thermal requirements and the long unproductive phase of juvenility, in which plants attain the critical size for flowering. Our researches aimed to investigate the effect of plant size, temperature, and light intensity, during the phase of flower induction, on flowering of modern genotypes selected for Mediterranean greenhouses. Three experiments were carried out to compare (i) plant size: reduced size versus size considered optimal for flowering (hybrids "Sogo Yukidian," "Chain Xen Diamond," and "Pinlong"); (ii) temperature: moderate reduction of temperature versus standard thermal regime (hybrid "Premium"); (iii) light intensity: supplemental lighting versus reference light intensity (hybrid "Premium"). The premature exposure of plants to the inductive treatment delayed the beginning of flowering and reduced the flower stem quality, in all the tested hybrids. In "Premium," the lower temperature did not affect flowering earliness and commercial quality of flower stems compared to the standard regime, whereas it promoted stem branching. In the same hybrid, supplemental lighting anticipated flowering and promoted the emission of the second stem and the stem branching, compared to the reference light regime.
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Li, Yun-Fei; Dong, Feng-Xi; Chen, Yang; Zhang, Xu-Lin; Wang, Lei; Bi, Yan-Gang; Tian, Zhen-Nan; Liu, Yue-Feng; Feng, Jing; Sun, Hong-Bo
2016-01-01
The transfer-free fabrication of the high quality graphene on the metallic nanostructures, which is highly desirable for device applications, remains a challenge. Here, we develop the transfer-free method by direct chemical vapor deposition of the graphene layers on copper (Cu) nanoparticles (NPs) to realize the hybrid nanostructures. The graphene as-grown on the Cu NPs permits full electric contact and strong interactions, which results in a strong localization of the field at the graphene/copper interface. An enhanced intensity of the localized surface plasmon resonances (LSPRs) supported by the hybrid nanostructures can be obtained, which induces a much enhanced fluorescent intensity from the dye coated hybrid nanostructures. Moreover, the graphene sheets covering completely and uniformly on the Cu NPs act as a passivation layer to protect the underlying metal surface from air oxidation. As a result, the stability of the LSPRs for the hybrid nanostructures is much enhanced compared to that of the bare Cu NPs. The transfer-free hybrid nanostructures with enhanced intensity and stability of the LSPRs will enable their much broader applications in photonics and optoelectronics. PMID:27872494
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Implications of the focal beam profile in serial femtosecond crystallography
DOE Office of Scientific and Technical Information (OSTI.GOV)
Galli, Lorenzo; Chapman, Henry N.; Metcalf, Peter
The photon density profile of an X-ray free-electron laser (XFEL) beam at the focal position is a critical parameter for serial femtosecond crystallography (SFX), but is difficult to measure because of the destructive power of the beam. A novel high intensity radiation induced phasing method (HIRIP) has been proposed as a general experimental approach for protein structure determination, but has proved to be sensitive to variations of the X-ray intensity, with uniform incident fluence desired for best performance. Here we show that experimental SFX data collected at the nano-focus chamber of the Coherent X-ray Imaging end-station at the Linac Coherentmore » Light Source using crystals with a limited size distribution suggests an average profile of the X-ray beam that has a large variation of intensity. We propose a new method to improve the quality of high fluence data for HI-RIP, by identifying and removing diffraction patterns from crystals exposed to the low intensity region of the beam. The method requires crystals of average size comparable to the width of the focal spot.« less
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NASA Astrophysics Data System (ADS)
Zhao, W.; Zhu, X.
2015-12-01
Water contamination in rivers embedded in urbanizing areas is increasingly affected by anthropogenic factors. The impacts may vary with location, time and water variables particularly in rapidly growing areas with clear urbanization gradients. Therefore, characterizing the temporal trend and identifying responsible divers to water quality changes in areas with different urbanization intensity could greatly improve our knowledge about human-water interactions. We employed geographically weighted regression (GWR) to interpret the determinants of river water quality changes in four urban development zones, i.e. central urban, suburban, central county and rural areas. Monitoring data of 8 variables- permanganate (CODMn), biochemical oxygen demand (BOD), ammonium (NH3-N), petroleum (oil), volatile phenol (VP), phosphorus (TP), mercury (Hg) and lead (Pb) from 33 stations were collected from 2004, 2008 and 2010. Five determinants were identified: urban land use intensity, environmental policies, industrial zone expansion, land use composition, and gross domestic product (GDP). Relationships between these identified determinants and water quality changes showed great variations due to their different nature and sensitivity. Typically, for zones with higher urbanization intensity located in central cities and central counties, urban land use had positive impacts on river water quality improvement. However, in less urbanized areas, rapid urban expansion indicated rapid river water degradation. Environmental policies had distinct influences on river pollution control in highly-urbanized areas, but led to unexpected negative impacts in areas beyond the management priorities. Industrial activities were the major contributor to heavy metal pollution in suburban areas while boosted N, P decrease in central cities. Our study highlighted the importance of "local" management instead of one-size-fits-all system in mitigating undesirable impacts of urbanization on water environment.
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Meta-analysis of transcutaneous electrical nerve stimulation for relief of spinal pain.
Resende, L; Merriwether, E; Rampazo, É P; Dailey, D; Embree, J; Deberg, J; Liebano, R E; Sluka, K A
2018-04-01
We conducted a systematic review and meta-analysis analysing the existing data on transcutaneous electrical nerve stimulation (TENS) or interferential current (IFC) for chronic low back pain (CLBP) and/or neck pain (CNP) taking into account intensity and timing of stimulation, examining pain, function and disability. Seven electronic databases were searched for TENS or IFC treatment in non-specific CLBP or CNP. Four reviewers independently selected randomized controlled trials (RCTs) of TENS or IFC intervention in adult individuals with non-specific CLBP or CNP. Primary outcomes were for self-reported pain intensity and back-specific disability. Two reviewers performed quality assessment, and two reviewers extracted data using a standardized form. Nine RCTs were selected (eight CLBP; one CNP), and seven studies with complete data sets were included for meta-analysis (655 participants). For CLBP, meta-analysis shows TENS/IFC intervention, independent of time of assessment, was significantly different from placebo/control (p < 0.02). TENS/IFC intervention was better than placebo/control, during therapy (p = 0.02), but not immediately after therapy (p = 0.08), or 1-3 months after therapy (p = 0.99). Analysis for adequate stimulation parameters was not significantly different, and there was no effect on disability. This systematic review provides inconclusive evidence of TENS benefits in low back pain patients because the quality of the studies was low, and adequate parameters and timing of assessment were not uniformly used or reported. Without additional high-quality clinical trials using sufficient sample sizes and adequate parameters and outcome assessments, the outcomes of this review are likely to remain unchanged. These data highlight the need for additional high-quality RCTs to examine the effects of TENS in CLBP. Trials should consider intensity of stimulation, timing of outcome assessment and assessment of pain, disability and function. © 2017 European Pain Federation - EFIC®.
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Kim, Young-sun; Lim, Hyo Keun; Park, Min Jung; Rhim, Hyunchul; Jung, Sin-Ho; Sohn, Insuk; Kim, Tae-Joong; Keserci, Bilgin
2016-01-01
The aim of this study was to fit and validate screening magnetic resonance imaging (MRI)-based prediction models for assessing immediate therapeutic responses of uterine fibroids to MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation. Informed consent from all subjects was obtained for our institutional review board-approved study. A total of 240 symptomatic uterine fibroids (mean diameter, 6.9 cm) in 152 women (mean age, 43.3 years) treated with MR-HIFU ablation were retrospectively analyzed (160 fibroids for training, 80 fibroids for validation). Screening MRI parameters (subcutaneous fat thickness [mm], x1; relative peak enhancement [%] in semiquantitative perfusion MRI, x2; T2 signal intensity ratio of fibroid to skeletal muscle, x3) were used to fit prediction models with regard to ablation efficiency (nonperfused volume/treatment cell volume, y1) and ablation quality (grade 1-5, poor to excellent, y2), respectively, using the generalized estimating equation method. Cutoff values for achievement of treatment intent (efficiency >1.0; quality grade 4/5) were determined based on receiver operating characteristic curve analysis. Prediction performances were validated by calculating positive and negative predictive values. Generalized estimating equation analyses yielded models of y1 = 2.2637 - 0.0415x1 - 0.0011x2 - 0.0772x3 and y2 = 6.8148 - 0.1070x1 - 0.0050x2 - 0.2163x3. Cutoff values were 1.312 for ablation efficiency (area under the curve, 0.7236; sensitivity, 0.6882; specificity, 0.6866) and 4.019 for ablation quality (0.8794; 0.7156; 0.9020). Positive and negative predictive values were 0.917 and 0.500 for ablation efficiency and 0.978 and 0.600 for ablation quality, respectively. Screening MRI-based prediction models for assessing immediate therapeutic responses of uterine fibroids to MR-HIFU ablation were fitted and validated, which may reduce the risk of unsuccessful treatment.
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Influence of natural factors on the quality of midwestern streams and rivers
Porter, Stephen D.; Harris, Mitchell A.; Kalkhoff, Stephen J.
2001-01-01
Streams flowing through cropland in the Midwestern Corn Belt differ considerably in their chemical and ecological characteristics, even though agricultural land use is highly intensive throughout the entire region. These differences likely are attributable to differences in riparian vegetation, soil properties, and hydrology. This conclusion is based on results from a study of the upper Midwest region conducted during seasonally low-flow conditions in August 1997 by the U.S. Geological Survey (USGS) National Water Quality Assessment (NAWQA) Program. This report summarizes significant results from the study and presents some implications for the design and interpretation of water-quality monitoring and assessment studies based on these results.
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[Factors affecting the recovery in the intensive care unit].
Turkov, P N; Nikitin, V V; Antsupova, M A; Podkopaev, V N; Panfilova, R P; Ivanova, I N; Nesterova, L I
2013-01-01
Urgency of the problem is defined by economical, regulatory and legislative acts, regional social and moral factors. There is critical situation in Russian Pediatric Healthcare system. This situation is due to inadequate funding, high medical technologies inaccessibility for some Russian children, their adverse health state. The article presents a retrospective analysis of intensive therapy and resuscitation outcomes with technical equipment and work environment assessment in the intensive care unit of Tushinskaya city pediatric clinic for the period from 2007 to 2011. Anaesthetic and emergency care quality and safety depend on several factors: permanent equipment improvement, comprehensive analysis of every fatal case and full implementation of "Anti-epidemic (prophylactic) actions plan" and "Program of monitoring compliance with the sanitary norms".
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USDA-ARS?s Scientific Manuscript database
Multi-layer vertical production systems using sole-source (SS) lighting can be used for microgreen production; however, traditional SS lighting can consume large amounts of electrical energy. Light-emitting diodes (LEDs) offer many advantages over conventional light sources including: high photoelec...
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Light-emitting diode lighting for forest nursery seedling production
R. Kasten Dumroese; Jeremiah R. Pinto; Anthony S. Davis
2015-01-01
Crop lighting is an energy-intensive necessity for nursery production of high-quality native plants and forest tree seedlings. During the winter months (especially in northern USA latitudes) or overcast or cloudy days, the amount of solar radiation reaching greenhouse crops is insufficient resulting in growth cessation, early terminal bud formation, and failure of...
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Quantity-based versus quality-based pricing: Developing the niche pine seedling
Kirk D. Howell
2002-01-01
Demands placed on pine production in the southeastern part of the United States prompt managers to research and employ intensive cultural practices. Bareroot conifer seedling culture, like loblolly pine (Pinus taeda L.), is highly preferred in moderate regions of the South, since bareroot stock is relatively inexpensive to purchase, transporting and...
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Traditionally, the EPA has monitored aquatic ecosystems using statistically rigorous sample designs and intensive field efforts which provide high quality datasets. But by their nature they leave many aquatic systems unsampled, follow a top down approach, have a long lag between ...
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The Negro American and Higher Education.
ERIC Educational Resources Information Center
Howe, Harold II
Among the topics: (1) although high school is usually available to Negroes, quality is poor; (2) recent awareness that schools have failed, not children; (3) need to reach children younger, in school, home, and community; (4) low ratio of attendance of poor but able students at college; (5) intense desire of Negroes for higher education; (6) the…
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ERIC Educational Resources Information Center
Stanulis, Randi Nevins; Little, Sarah; Wibbens, Erin
2012-01-01
This study examines whether targeted mentoring can make a difference during the induction years. The effects of a mentoring intervention based on principles of instructional quality and effective professional development were studied. Learning to lead classroom discussions is a high-leverage practice related to effective teaching. Forty-two…
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van der Voort, P H J; van der Veer, S N; de Vos, M L G
2012-10-01
In the concept of total quality management that was originally developed in industry, the use of quality indicators is essential. The implementation of quality indicators in the intensive care unit to improve the quality of care is a complex process. This process can be described in seven subsequent steps of an indicator-based quality improvement (IBQI) cycle. With this IBQI cycle, a continuous quality improvement can be achieved with the use of indicator data in a benchmark setting. After the development of evidence-based indicators, a sense of urgency has to be created, registration should start, raw data must be analysed, feedback must be given, and interpretation and conclusions must be made, followed by a quality improvement plan. The last step is the implementation of changes that needs a sense of urgency, and this completes the IBQI cycle. Barriers and facilitators are found in each step. They should be identified and addressed in a multifaceted quality improvement strategy. © 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.
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NASA Astrophysics Data System (ADS)
Huang, Yushi; Nigam, Abhimanyu; Campana, Olivia; Nugegoda, Dayanthi; Wlodkowic, Donald
2016-12-01
Biomonitoring studies apply biological responses of sensitive biomonitor organisms to rapidly detect adverse environmental changes such as presence of physic-chemical stressors and toxins. Behavioral responses such as changes in swimming patterns of small aquatic invertebrates are emerging as sensitive endpoints to monitor aquatic pollution. Although behavioral responses do not deliver information on an exact type or the intensity of toxicants present in water samples, they could provide orders of magnitude higher sensitivity than lethal endpoints such as mortality. Despite the advantages of behavioral biotests performed on sentinel organisms, their wider application in real-time and near realtime biomonitoring of water quality is limited by the lack of dedicated and automated video-microscopy systems. Current behavioral analysis systems rely mostly on static test conditions and manual procedures that are time-consuming and labor intensive. Tracking and precise quantification of locomotory activities of multiple small aquatic organisms requires high-resolution optical data recording. This is often problematic due to small size of fast moving animals and limitations of culture vessels that are not specially designed for video data recording. In this work, we capitalized on recent advances in miniaturized CMOS cameras, high resolution optics and biomicrofluidic technologies to develop near real-time water quality sensing using locomotory activities of small marine invertebrates. We present proof-of-concept integration of high-resolution time-resolved video recording system and high-throughput miniaturized perfusion biomicrofluidic platform for optical tracking of nauplii of marine crustacean Artemia franciscana. Preliminary data demonstrate that Artemia sp. exhibits rapid alterations of swimming patterns in response to toxicant exposure. The combination of video-microscopy and biomicrofluidic platform facilitated straightforward recording of fast moving objects. We envisage that prospectively such system can be scaled up to perform high-throughput water quality sensing in a robotic biomonitoring facility.
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Lee, Yuna S H; Stone, Patricia W; Pogorzelska-Maziarz, Monika; Nembhard, Ingrid M
Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals. The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs). A cross-sectional study of hospital medical-surgical ICUs in the United States was done. Data on work environment and bundle compliance were obtained from the Prevention of Nosocomial Infections and Cost-Effectiveness Refined Survey completed in 2011 by infection prevention directors, and data on ICU and hospital characteristics were obtained from the National Healthcare Safety Network. Factor and multilevel regression analyses were conducted. Reasonable workload and prioritization of quality were positively associated with maximal CLABSI bundle compliance. High-quality relationships, although a significant predictor when evaluated apart from workload and prioritization of quality, had no significant effect after accounting for these two factors. Aspects of the staff work environment are associated with maximal CLABSI bundle compliance in ICUs. Our results suggest that hospitals can foster improvement in ensuring maximal CLABSI bundle compliance-a crucial precursor to reducing CLABSI infection rates-by establishing reasonable workloads and prioritizing quality.
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Low-Temperature Growth of Two-Dimensional Layered Chalcogenide Crystals on Liquid.
Zhou, Yubing; Deng, Bing; Zhou, Yu; Ren, Xibiao; Yin, Jianbo; Jin, Chuanhong; Liu, Zhongfan; Peng, Hailin
2016-03-09
The growth of high-quality two-dimensional (2D) layered chalcogenide crystals is highly important for practical applications in future electronics, optoelectronics, and photonics. Current route for the synthesis of 2D chalcogenide crystals by vapor deposition method mainly involves an energy intensive high-temperature growth process on solid substrates, often suffering from inhomogeneous nucleation density and grain size distribution. Here, we first demonstrate a facile vapor-phase synthesis of large-area high-quality 2D layered chalcogenide crystals on liquid metal surface with relatively low surface energy at a growth temperature as low as ∼100 °C. Uniform and large-domain-sized 2D crystals of GaSe and GaxIn1-xSe were grown on liquid metal surface even supported on a polyimide film. As-grown 2D GaSe crystals have been fabricated to flexible photodetectors, showing high photoresponse and excellent flexibility. Our strategy of energy-sustainable low-temperature growth on liquid metal surface may open a route to the synthesis of high-quality 2D crystals of Ga-, In-, Bi-, Hg-, Pb-, or Sn-based chalcogenides and halides.
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Exercise Training During Bed Rest Attenuates Deconditioning
NASA Technical Reports Server (NTRS)
Greenleaf, J. E.; Hargens, Alan R. (Technical Monitor)
1995-01-01
A 30-day 6 deg. head-down bed rest study was conducted to evaluate high-intensity, short-duration, alternating isotonic cycle ergometer exercise (ITE) training and high-intensity intermittent isokinetic exercise (IKE) training regiments designed to maintain peak VO2 and muscle mass, strength, and endurance at ambulatory control levels throughout prolonged bed rest. Other elements of the deconditioning (acclimation) syndrome, such as proprioception, psychological performance, hypovolemia, water balance, body composition, and orthostatic tolerance, were also measured. Compared with response during bed rest of the no exercise (NOE) control group: the ITE training regimen (a) maintained work capacity (peak VO2), (b) maintained plasma and red cell volume, (c) induced positive body water balance, (d) decreased quality of sleep and mental concentration, and (e) had no effect on the decrease in orthostatic tolerance; the IKE training regimen (a) attenuated the decrease in peak VO2 by 50%, (b) attenuated loss of red cell volume by 40%, but had no effect on loss of plasma volume, (c) induced positive body water balance, (d) had no adverse effect on quality of sleep or concentration, and (e) had no effect on the decrease in orthostatic tolerance. These findings suggest that various elements of the deconditioning syndrome can be manipulated by duration and intensity of ITE or IKE training regiments, and that several different training protocols will be required to maintain or restore physiological and psychological performance of individuals confined to prolonged bed rest.
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Wright, Clyde J; Sherlock, Laurie G; Sahni, Rakesh; Polin, Richard A
2018-06-01
Routine use of continuous positive airway pressure (CPAP) to support preterm infants with respiratory distress is an evidenced-based strategy to decrease incidence of bronchopulmonary dysplasia. However, rates of CPAP failure remain unacceptably high in very premature neonates, who are at high risk for developing bronchopulmonary dysplasia. Using the GRADE framework to assess the quality of available evidence, this article reviews strategies aimed at decreasing CPAP failure, starting with delivery room interventions and followed through to system-based efforts in the neonatal intensive care unit. Despite best efforts, some very premature neonates fail CPAP. Also reviewed are predictors of CPAP failure in this vulnerable population. Copyright © 2018 Elsevier Inc. All rights reserved.
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Pinkstaff, Sherry O
2015-01-01
There is a robust trove of scientific studies that support the positive physical and mental health benefits associated with aerobic exercise for healthy individuals. These recommendations suggest that more vigorous exercise can be performed on fewer days for the same benefit. High-intensity intermittent exercise (HIIE) training has begun to show promise. HIIE seems safe and improves physiology, quality of life, and functional capacity. This review defines HIIE, discusses its physiologic benefit for patients with heart failure, outlines the studies that have been conducted to date, and places it in the context of the current clinical environment of exercise training for these patients. Copyright © 2015 Elsevier Inc. All rights reserved.
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NASA Astrophysics Data System (ADS)
Vetrimurugan, E.; Brindha, K.; Elango, L.; Ndwandwe, Osman Muzi
2017-10-01
Drinking water containing heavy metals above the maximum permissible limits cause potential risk to human health. The aim of this study was to determine the groundwater suitability for drinking use based on heavy metal concentration and the associated human exposure risk in an intensively irrigated part of the Cauvery river basin, Tamil Nadu, India. Sixteen heavy metals analysed were in the order of dominance of chromium < zinc < copper < cadmium < cobalt < iron < aluminium < nickel < titanium < zirconium < boron < silver < manganese < lead < lithium < silicon in groundwater. Chromium and zinc were within permissible limits of the Bureau of Indian Standards for drinking water quality, and silver, lead and nickel were above limits in all the groundwater samples. In less than 50 % of the groundwater samples, aluminium, boron, cadmium, copper, iron and manganese exceeded their individual permissible limits. Heavy metal pollution index based on 11 heavy metals indicated that groundwater quality of this area is poor-to-unsuitable. Non-carcinogenic risk for humans due to ingestion of groundwater through drinking water pathway was very high for infants, children and adults. Silver, lead, nickel, cadmium and manganese largely contributed to the health hazard. Sources of heavy metals were identified to be geological and from human activities, i.e., application of fertilizers in agricultural fields, seawater intrusion due to intensive pumping for agriculture and wastewater from industries. Groundwater and surface water in this area pose large threat due to high levels of heavy metals, and it is necessary to avoid this water for drinking due to potential risk of health hazard. This study also demonstrated the application of HPI and human exposure hazard index to study the groundwater quality based on heavy metals' concentration.
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Yoo, Boyeol; Son, Kihong; Pua, Rizza; Kim, Jinsung; Solodov, Alexander; Cho, Seungryong
2016-10-01
With the increased use of computed tomography (CT) in clinics, dose reduction is the most important feature people seek when considering new CT techniques or applications. We developed an intensity-weighted region-of-interest (IWROI) imaging method in an exact half-fan geometry to reduce the imaging radiation dose to patients in cone-beam CT (CBCT) for image-guided radiation therapy (IGRT). While dose reduction is highly desirable, preserving the high-quality images of the ROI is also important for target localization in IGRT. An intensity-weighting (IW) filter made of copper was mounted in place of a bowtie filter on the X-ray tube unit of an on-board imager (OBI) system such that the filter can substantially reduce radiation exposure to the outer ROI. In addition to mounting the IW filter, the lead-blade collimation of the OBI was adjusted to produce an exact half-fan scanning geometry for a further reduction of the radiation dose. The chord-based rebinned backprojection-filtration (BPF) algorithm in circular CBCT was implemented for image reconstruction, and a humanoid pelvis phantom was used for the IWROI imaging experiment. The IWROI image of the phantom was successfully reconstructed after beam-quality correction, and it was registered to the reference image within an acceptable level of tolerance. Dosimetric measurements revealed that the dose is reduced by approximately 61% in the inner ROI and by 73% in the outer ROI compared to the conventional bowtie filter-based half-fan scan. The IWROI method substantially reduces the imaging radiation dose and provides reconstructed images with an acceptable level of quality for patient setup and target localization. The proposed half-fan-based IWROI imaging technique can add a valuable option to CBCT in IGRT applications.
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Borello-France, Diane F; Downey, Patricia A; Zyczynski, Halina M; Rause, Christine R
2008-12-01
Few studies have examined the effectiveness of pelvic-floor muscle (PFM) exercises to reduce female stress urinary incontinence (SUI) over the long term. This study: (1) evaluated continence and quality-of-life outcomes of women 6 months following formalized therapy and (2) determined whether low- and high-frequency maintenance exercise programs were equivalent in sustaining outcomes. Thirty-six women with SUI who completed an intensive PFM exercise intervention trial were randomly assigned to perform a maintenance exercise program either 1 or 4 times per week. Urine leaks per week, volume of urine loss, quality of life (Incontinence Impact Questionnaire [IIQ] score), PFM strength (Brink score), and prevalence of urodynamic stress incontinence (USI) were measured at a 6-month follow-up for comparison with postintervention status. Parametric and nonparametric statistics were used to determine differences in outcome status over time and between exercise frequency groups. Twenty-eight women provided follow-up data. Postintervention status was sustained at 6 months for all outcomes (mean [SD] urine leaks per week=1.2+/-2.1 versus 1.4+/-3.1; mean [SD] urine loss=0.2+/-0.5 g versus 0.2+/-0.8 g; mean [SD] IIQ score=17+/-20 versus 22+/-30; mean [SD] Brink score=11+/-1 versus 11+/-1; and prevalence of USI=48% versus 35%). Women assigned to perform exercises once or 4 times per week similarly sustained their postintervention status. Benefits of an initial intensive intervention program for SUI were sustained over 6 months. However, only 15 of the 28 women provided documentation of their exercise adherence, limiting conclusions regarding the need for continued PFM exercise during follow-up intervals of
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Reliability of a visual scoring system with fluorescent tracers to assess dermal pesticide exposure.
Aragon, Aurora; Blanco, Luis; Lopez, Lylliam; Liden, Carola; Nise, Gun; Wesseling, Catharina
2004-10-01
We modified Fenske's semi-quantitative 'visual scoring system' of fluorescent tracer deposited on the skin of pesticide applicators and evaluated its reproducibility in the Nicaraguan setting. The body surface of 33 farmers, divided into 31 segments, was videotaped in the field after spraying with a pesticide solution containing a fluorescent tracer. A portable UV lamp was used for illumination in a foldaway dark room. The videos of five farmers were randomly selected. The scoring was based on a matrix with extension of fluorescent patterns (scale 0-5) on the ordinate and intensity (scale 0-5) on the abscissa, with the product of these two ranks as the final score for each body segment (0-25). Five medical students rated and evaluated the quality of 155 video images having undergone 4 h of training. Cronbach alpha coefficients and two-way random effects intraclass correlation coefficients (ICC) with absolute agreement were computed to assess inter-rater reliability. Consistency was high (Cronbach alpha = 0.96), but the scores differed substantially between raters. The overall ICC was satisfactory [0.75; 95% confidence interval (CI) = 0.62-0.83], but it was lower for intensity (0.54; 95% CI = 0.40-0.66) and higher for extension (0.80; 95% CI = 0.71-0.86). ICCs were lowest for images with low scores and evaluated as low quality, and highest for images with high scores and high quality. Inter-rater reliability coefficients indicate repeatability of the scoring system. However, field conditions for recording fluorescence should be improved to achieve higher quality images, and training should emphasize a better mechanism for the reading of body areas with low contamination.
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Riessen, R; Hermes, C; Bodmann, K-F; Janssens, U; Markewitz, A
2018-02-01
The reimbursement of intensive care and nursing services in the German health system is based on the diagnosis-related groups (G-DRG) system. Due to the lack of a central hospital planning, the G‑DRG system has become the most important influence on the development of the German health system. Compared to other countries, intensive care in Germany is characterized by a high number of intensive care beds, a low nurse-to-patient ratio, no official definition of the level of care, and a minimal available data set from intensive care units (ICUs). Under the given circumstances, a shortage of qualified intensive care nurses and physicians is currently the largest threat for intensive care in Germany. To address these deficiencies, we suggest the following measures: (1) Integration of ICUs into the levels of care which are currently developed for emergency centers at hospitals. (2) Mandatory collection of structured data sets from all ICUs including quality criteria. (3) A reform of intensive care and nursing reimbursement under consideration of adequate staffing in the individual ICU. (4) Actions to improve ICU staffing and qualification.
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Use of graph theory measures to identify errors in record linkage.
Randall, Sean M; Boyd, James H; Ferrante, Anna M; Bauer, Jacqueline K; Semmens, James B
2014-07-01
Ensuring high linkage quality is important in many record linkage applications. Current methods for ensuring quality are manual and resource intensive. This paper seeks to determine the effectiveness of graph theory techniques in identifying record linkage errors. A range of graph theory techniques was applied to two linked datasets, with known truth sets. The ability of graph theory techniques to identify groups containing errors was compared to a widely used threshold setting technique. This methodology shows promise; however, further investigations into graph theory techniques are required. The development of more efficient and effective methods of improving linkage quality will result in higher quality datasets that can be delivered to researchers in shorter timeframes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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Verma, Ajay; Baishya, Bikash
2016-05-01
"Pure shift" NMR spectra display singlet peak per chemical site. Thus, high resolution is offered at the cost of valuable J-coupling information. In the present work, real-time BIRD (BIlinear Rotation Decoupling) is applied to the absorptive-mode 2D J-spectroscopy to provide pure shift spectrum in the direct dimension and J-coupling information in the indirect dimension. Quite often in metabolomics, proton NMR spectra from complex bio-fluids display tremendous signal overlap. Although conventional J-spectroscopy in principle overcomes this problem by separating the multiplet information from chemical shift information, however, only magnitude mode of the experiment is practical, sacrificing much of the potential high resolution that could be achieved. Few J-spectroscopy methods have been reported so far that produce high-resolution pure shift spectrum along with J-coupling information for crowded spectral regions. In the present work, high-quality J-resolved spectrum from important metabolomic mixture such as tissue extract from rat cortex is demonstrated. Many low-intensity metabolite peaks which are obscured by the broad dispersive tails from high-intensity metabolite peaks in regular magnitude mode J-spectrum can be clearly identified in real-time BIRD J-resolved spectrum. The general practice of removing such spectral overlap is tedious and time-consuming as it involves repeated sample preparation to change the pH of the tissue extract sample and subsequent spectra recording. Copyright © 2016 Elsevier Inc. All rights reserved.
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NASA Astrophysics Data System (ADS)
Verma, Ajay; Baishya, Bikash
2016-05-01
;Pure shift; NMR spectra display singlet peak per chemical site. Thus, high resolution is offered at the cost of valuable J-coupling information. In the present work, real-time BIRD (BIlinear Rotation Decoupling) is applied to the absorptive-mode 2D J-spectroscopy to provide pure shift spectrum in the direct dimension and J-coupling information in the indirect dimension. Quite often in metabolomics, proton NMR spectra from complex bio-fluids display tremendous signal overlap. Although conventional J-spectroscopy in principle overcomes this problem by separating the multiplet information from chemical shift information, however, only magnitude mode of the experiment is practical, sacrificing much of the potential high resolution that could be achieved. Few J-spectroscopy methods have been reported so far that produce high-resolution pure shift spectrum along with J-coupling information for crowded spectral regions. In the present work, high-quality J-resolved spectrum from important metabolomic mixture such as tissue extract from rat cortex is demonstrated. Many low-intensity metabolite peaks which are obscured by the broad dispersive tails from high-intensity metabolite peaks in regular magnitude mode J-spectrum can be clearly identified in real-time BIRD J-resolved spectrum. The general practice of removing such spectral overlap is tedious and time-consuming as it involves repeated sample preparation to change the pH of the tissue extract sample and subsequent spectra recording.
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Predictors of physical activity in patients with heart failure: a questionnaire study.
Chien, Hui-Chin; Chen, Hsing-Mei; Garet, Martin; Wang, Ruey-Hsia
2014-07-01
Adequate physical activity is believed to help decrease readmission and improve quality of life for patients with heart failure (HF). The aim of this study was to explore the predictors of physical activity level 1 month after discharge from hospital in Taiwanese patients with HF. A prospective research design was used. Overall, 111 patients with HF from a medical center in Southern Taiwan were recruited. Symptomatic distress, self-efficacy for physical activity, physical activity knowledge, and demographic and disease characteristics of patients with HF were collected at their discharge. One month later, patients' total daily energy expenditure (DEE), DEE for low-intensity physical activities (PA(low) DEE; strictly <3 metabolic equivalents [METs]), DEE for high-intensity physical activities (PA(high) DEE; 3-5 METs), and DEE for intensive-intensity physical activities (PA(intensive) DEE; strictly >5 METs) were collected. The mean total DEE was 8175.85 ± 2595.12 kJ 24 h, of which 19.12% was for PAlow DEE, 7.20% was for PA(high) DEE, and only 1.42% was for PA(intensive) DEE. Body mass index (BMI), age, self-efficacy for instrumental activities of daily living, and educational level were predictors of total DEE of patients with HF 1 month after discharge. Self-efficacy for instrumental activities of daily living, gender, and BMI were predictors of PA(high) DEE. Age, BMI, and symptom distress were predictors of PA(intensive) DEE. Taiwanese patients with HF practiced lower intensity physical activities. Factors related to physical activity of patients with HF in Taiwan were similar to those of Western countries. Nurses should emphasize the importance of physical activity to patients with HF who are male, of older age, with lower educational level, or with lower BMI. Improving self-efficacy for instrumental activities and decreasing symptom distress should be incorporated into discharge planning programs for patients with HF.
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Image analysis for dental bone quality assessment using CBCT imaging
NASA Astrophysics Data System (ADS)
Suprijanto; Epsilawati, L.; Hajarini, M. S.; Juliastuti, E.; Susanti, H.
2016-03-01
Cone beam computerized tomography (CBCT) is one of X-ray imaging modalities that are applied in dentistry. Its modality can visualize the oral region in 3D and in a high resolution. CBCT jaw image has potential information for the assessment of bone quality that often used for pre-operative implant planning. We propose comparison method based on normalized histogram (NH) on the region of inter-dental septum and premolar teeth. Furthermore, the NH characteristic from normal and abnormal bone condition are compared and analyzed. Four test parameters are proposed, i.e. the difference between teeth and bone average intensity (s), the ratio between bone and teeth average intensity (n) of NH, the difference between teeth and bone peak value (Δp) of NH, and the ratio between teeth and bone of NH range (r). The results showed that n, s, and Δp have potential to be the classification parameters of dental calcium density.
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Cheng, Xinfeng; Zhang, Min; Xu, Baoguo; Adhikari, Benu; Sun, Jincai
2015-11-01
Ultrasonic processing is a novel and promising technology in food industry. The propagation of ultrasound in a medium generates various physical and chemical effects and these effects have been harnessed to improve the efficiency of various food processing operations. Ultrasound has also been used in food quality control as diagnostic technology. This article provides an overview of recent developments related to the application of ultrasound in low temperature and closely related processes such as freezing, thawing, freeze concentration and freeze drying. The applications of high intensity ultrasound to improve the efficiency of freezing process, to control the size and size distribution of ice crystals and to improve the quality of frozen foods have been discussed in considerable detail. The use of low intensity ultrasound in monitoring the ice content and to monitor the progress of freezing process has also been highlighted. Copyright © 2015 Elsevier B.V. All rights reserved.
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The Influence of the Environment and Clothing on Human Exposure to Ultraviolet Light
Liu, Jin; Zhang, Wei
2015-01-01
Objection The aim of this study is to determine the effect of clothing and the environment on human exposure to ultraviolet light. Methods The ultraviolet (ultraviolet A and ultraviolet B) light intensity was measured, and air quality parameters were recorded in 2014 in Beijing, China. Three types of clothing (white polyester cloth, pure cotton white T-shirt, and pure cotton black T-shirt) were individually placed on a mannequin. The ultraviolet (ultraviolet A and ultraviolet B) light intensities were measured above and beneath each article of clothing, and the percentage of ultraviolet light transmission through the clothing was calculated. Results (1) The ultraviolet light transmission was significantly higher through white cloth than through black cloth; the transmission was significantly higher through polyester cloth than through cotton. (2) The weather significantly influenced ultraviolet light transmission through white polyester cloth; transmission was highest on clear days and lowest on overcast days (ultraviolet A: P=0.000; ultraviolet B: P=0.008). (3) Air quality parameters (air quality index and particulate matter 2.5 and 10) were inversely related to the ultraviolet light intensity that reached the earth’s surface. Ultraviolet B transmission through white polyester cloth was greater under conditions of low air pollution compared with high air pollution. Conclusion Clothing color and material and different types of weather affected ultraviolet light transmission; for one particular cloth, the transmission decreased with increasing air pollution. PMID:25923778
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The influence of the environment and clothing on human exposure to ultraviolet light.
Liu, Jin; Zhang, Wei
2015-01-01
The aim of this study is to determine the effect of clothing and the environment on human exposure to ultraviolet light. The ultraviolet (ultraviolet A and ultraviolet B) light intensity was measured, and air quality parameters were recorded in 2014 in Beijing, China. Three types of clothing (white polyester cloth, pure cotton white T-shirt, and pure cotton black T-shirt) were individually placed on a mannequin. The ultraviolet (ultraviolet A and ultraviolet B) light intensities were measured above and beneath each article of clothing, and the percentage of ultraviolet light transmission through the clothing was calculated. (1) The ultraviolet light transmission was significantly higher through white cloth than through black cloth; the transmission was significantly higher through polyester cloth than through cotton. (2) The weather significantly influenced ultraviolet light transmission through white polyester cloth; transmission was highest on clear days and lowest on overcast days (ultraviolet A: P=0.000; ultraviolet B: P=0.008). (3) Air quality parameters (air quality index and particulate matter 2.5 and 10) were inversely related to the ultraviolet light intensity that reached the earth's surface. Ultraviolet B transmission through white polyester cloth was greater under conditions of low air pollution compared with high air pollution. Clothing color and material and different types of weather affected ultraviolet light transmission; for one particular cloth, the transmission decreased with increasing air pollution.
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[Improving patient safety through voluntary peer review].
Kluge, S; Bause, H
2015-01-01
The intensive care unit (ICU) is one area of the hospital in which processes and communication are of primary importance. Errors in intensive care units can lead to serious adverse events with significant consequences for patients. Therefore quality and risk-management are important measures when treating critically ill patients. A pragmatic approach to support quality and safety in intensive care is peer review. This approach has gained significant acceptance over the past years. It consists of mutual visits by colleagues who conduct standardised peer reviews. These reviews focus on the systematic evaluation of the quality of an ICU's structure, its processes and outcome. Together with different associations, the State Chambers of Physicians and the German Medical Association have developed peer review as a standardized tool for quality improvement. The common goal of all stakeholders is the continuous and sustainable improvement in intensive care with peer reviews significantly increasing and improving communication between professions and disciplines. Peer reviews secure the sustainability of planned change processes and consequently lead the way to an improved culture of quality and safety.
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Non-invasive brain stimulation techniques for chronic pain.
O'Connell, Neil E; Marston, Louise; Spencer, Sally; DeSouza, Lorraine H; Wand, Benedict M
2018-03-16
This is an updated version of the original Cochrane Review published in 2010, Issue 9, and last updated in 2014, Issue 4. Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS) and reduced impedance non-invasive cortical electrostimulation (RINCE). To evaluate the efficacy of non-invasive cortical stimulation techniques in the treatment of chronic pain. For this update we searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, LILACS and clinical trials registers from July 2013 to October 2017. Randomised and quasi-randomised studies of rTMS, CES, tDCS, RINCE and tRNS if they employed a sham stimulation control group, recruited patients over the age of 18 years with pain of three months' duration or more, and measured pain as an outcome. Outcomes of interest were pain intensity measured using visual analogue scales or numerical rating scales, disability, quality of life and adverse events. Two review authors independently extracted and verified data. Where possible we entered data into meta-analyses, excluding studies judged as high risk of bias. We used the GRADE system to assess the quality of evidence for core comparisons, and created three 'Summary of findings' tables. We included an additional 38 trials (involving 1225 randomised participants) in this update, making a total of 94 trials in the review (involving 2983 randomised participants). This update included a total of 42 rTMS studies, 11 CES, 36 tDCS, two RINCE and two tRNS. One study evaluated both rTMS and tDCS. We judged only four studies as low risk of bias across all key criteria. Using the GRADE criteria we judged the quality of evidence for each outcome, and for all comparisons as low or very low; in large part this was due to issues of blinding and of precision.rTMSMeta-analysis of rTMS studies versus sham for pain intensity at short-term follow-up (0 to < 1 week postintervention), (27 studies, involving 655 participants), demonstrated a small effect with heterogeneity (standardised mean difference (SMD) -0.22, 95% confidence interval (CI) -0.29 to -0.16, low-quality evidence). This equates to a 7% (95% CI 5% to 9%) reduction in pain, or a 0.40 (95% CI 0.53 to 0.32) point reduction on a 0 to 10 pain intensity scale, which does not meet the minimum clinically important difference threshold of 15% or greater. Pre-specified subgroup analyses did not find a difference between low-frequency stimulation (low-quality evidence) and rTMS applied to the prefrontal cortex compared to sham for reducing pain intensity at short-term follow-up (very low-quality evidence). High-frequency stimulation of the motor cortex in single-dose studies was associated with a small short-term reduction in pain intensity at short-term follow-up (low-quality evidence, pooled n = 249, SMD -0.38 95% CI -0.49 to -0.27). This equates to a 12% (95% CI 9% to 16%) reduction in pain, or a 0.77 (95% CI 0.55 to 0.99) point change on a 0 to 10 pain intensity scale, which does not achieve the minimum clinically important difference threshold of 15% or greater. The results from multiple-dose studies were heterogeneous and there was no evidence of an effect in this subgroup (very low-quality evidence). We did not find evidence that rTMS improved disability. Meta-analysis of studies of rTMS versus sham for quality of life (measured using the Fibromyalgia Impact Questionnaire (FIQ) at short-term follow-up demonstrated a positive effect (MD -10.80 95% CI -15.04 to -6.55, low-quality evidence).CESFor CES (five studies, 270 participants) we found no evidence of a difference between active stimulation and sham (SMD -0.24, 95% CI -0.48 to 0.01, low-quality evidence) for pain intensity. We found no evidence relating to the effectiveness of CES on disability. One study (36 participants) of CES versus sham for quality of life (measured using the FIQ) at short-term follow-up demonstrated a positive effect (MD -25.05 95% CI -37.82 to -12.28, very low-quality evidence).tDCSAnalysis of tDCS studies (27 studies, 747 participants) showed heterogeneity and a difference between active and sham stimulation (SMD -0.43 95% CI -0.63 to -0.22, very low-quality evidence) for pain intensity. This equates to a reduction of 0.82 (95% CI 0.42 to 1.2) points, or a percentage change of 17% (95% CI 9% to 25%) of the control group outcome. This point estimate meets our threshold for a minimum clinically important difference, though the lower confidence interval is substantially below that threshold. We found evidence of small study bias in the tDCS analyses. We did not find evidence that tDCS improved disability. Meta-analysis of studies of tDCS versus sham for quality of life (measured using different scales across studies) at short-term follow-up demonstrated a positive effect (SMD 0.66 95% CI 0.21 to 1.11, low-quality evidence).Adverse eventsAll forms of non-invasive brain stimulation and sham stimulation appear to be frequently associated with minor or transient side effects and there were two reported incidences of seizure, both related to the active rTMS intervention in the included studies. However many studies did not adequately report adverse events. There is very low-quality evidence that single doses of high-frequency rTMS of the motor cortex and tDCS may have short-term effects on chronic pain and quality of life but multiple sources of bias exist that may have influenced the observed effects. We did not find evidence that low-frequency rTMS, rTMS applied to the dorsolateral prefrontal cortex and CES are effective for reducing pain intensity in chronic pain. The broad conclusions of this review have not changed substantially for this update. There remains a need for substantially larger, rigorously designed studies, particularly of longer courses of stimulation. Future evidence may substantially impact upon the presented results.
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Non-invasive brain stimulation techniques for chronic pain.
O'Connell, Neil E; Marston, Louise; Spencer, Sally; DeSouza, Lorraine H; Wand, Benedict M
2018-04-13
This is an updated version of the original Cochrane Review published in 2010, Issue 9, and last updated in 2014, Issue 4. Non-invasive brain stimulation techniques aim to induce an electrical stimulation of the brain in an attempt to reduce chronic pain by directly altering brain activity. They include repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS) and reduced impedance non-invasive cortical electrostimulation (RINCE). To evaluate the efficacy of non-invasive cortical stimulation techniques in the treatment of chronic pain. For this update we searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, LILACS and clinical trials registers from July 2013 to October 2017. Randomised and quasi-randomised studies of rTMS, CES, tDCS, RINCE and tRNS if they employed a sham stimulation control group, recruited patients over the age of 18 years with pain of three months' duration or more, and measured pain as an outcome. Outcomes of interest were pain intensity measured using visual analogue scales or numerical rating scales, disability, quality of life and adverse events. Two review authors independently extracted and verified data. Where possible we entered data into meta-analyses, excluding studies judged as high risk of bias. We used the GRADE system to assess the quality of evidence for core comparisons, and created three 'Summary of findings' tables. We included an additional 38 trials (involving 1225 randomised participants) in this update, making a total of 94 trials in the review (involving 2983 randomised participants). This update included a total of 42 rTMS studies, 11 CES, 36 tDCS, two RINCE and two tRNS. One study evaluated both rTMS and tDCS. We judged only four studies as low risk of bias across all key criteria. Using the GRADE criteria we judged the quality of evidence for each outcome, and for all comparisons as low or very low; in large part this was due to issues of blinding and of precision.rTMSMeta-analysis of rTMS studies versus sham for pain intensity at short-term follow-up (0 to < 1 week postintervention), (27 studies, involving 655 participants), demonstrated a small effect with heterogeneity (standardised mean difference (SMD) -0.22, 95% confidence interval (CI) -0.29 to -0.16, low-quality evidence). This equates to a 7% (95% CI 5% to 9%) reduction in pain, or a 0.40 (95% CI 0.53 to 0.32) point reduction on a 0 to 10 pain intensity scale, which does not meet the minimum clinically important difference threshold of 15% or greater. Pre-specified subgroup analyses did not find a difference between low-frequency stimulation (low-quality evidence) and rTMS applied to the prefrontal cortex compared to sham for reducing pain intensity at short-term follow-up (very low-quality evidence). High-frequency stimulation of the motor cortex in single-dose studies was associated with a small short-term reduction in pain intensity at short-term follow-up (low-quality evidence, pooled n = 249, SMD -0.38 95% CI -0.49 to -0.27). This equates to a 12% (95% CI 9% to 16%) reduction in pain, or a 0.77 (95% CI 0.55 to 0.99) point change on a 0 to 10 pain intensity scale, which does not achieve the minimum clinically important difference threshold of 15% or greater. The results from multiple-dose studies were heterogeneous and there was no evidence of an effect in this subgroup (very low-quality evidence). We did not find evidence that rTMS improved disability. Meta-analysis of studies of rTMS versus sham for quality of life (measured using the Fibromyalgia Impact Questionnaire (FIQ) at short-term follow-up demonstrated a positive effect (MD -10.80 95% CI -15.04 to -6.55, low-quality evidence).CESFor CES (five studies, 270 participants) we found no evidence of a difference between active stimulation and sham (SMD -0.24, 95% CI -0.48 to 0.01, low-quality evidence) for pain intensity. We found no evidence relating to the effectiveness of CES on disability. One study (36 participants) of CES versus sham for quality of life (measured using the FIQ) at short-term follow-up demonstrated a positive effect (MD -25.05 95% CI -37.82 to -12.28, very low-quality evidence).tDCSAnalysis of tDCS studies (27 studies, 747 participants) showed heterogeneity and a difference between active and sham stimulation (SMD -0.43 95% CI -0.63 to -0.22, very low-quality evidence) for pain intensity. This equates to a reduction of 0.82 (95% CI 0.42 to 1.2) points, or a percentage change of 17% (95% CI 9% to 25%) of the control group outcome. This point estimate meets our threshold for a minimum clinically important difference, though the lower confidence interval is substantially below that threshold. We found evidence of small study bias in the tDCS analyses. We did not find evidence that tDCS improved disability. Meta-analysis of studies of tDCS versus sham for quality of life (measured using different scales across studies) at short-term follow-up demonstrated a positive effect (SMD 0.66 95% CI 0.21 to 1.11, low-quality evidence).Adverse eventsAll forms of non-invasive brain stimulation and sham stimulation appear to be frequently associated with minor or transient side effects and there were two reported incidences of seizure, both related to the active rTMS intervention in the included studies. However many studies did not adequately report adverse events. There is very low-quality evidence that single doses of high-frequency rTMS of the motor cortex and tDCS may have short-term effects on chronic pain and quality of life but multiple sources of bias exist that may have influenced the observed effects. We did not find evidence that low-frequency rTMS, rTMS applied to the dorsolateral prefrontal cortex and CES are effective for reducing pain intensity in chronic pain. The broad conclusions of this review have not changed substantially for this update. There remains a need for substantially larger, rigorously designed studies, particularly of longer courses of stimulation. Future evidence may substantially impact upon the presented results.
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Driessen, Maurice T; Proper, Karin I; van Tulder, Maurits W; Anema, Johannes R; Bongers, Paulien M; van der Beek, Allard J
2010-04-01
Ergonomic interventions (physical and organisational) are used to prevent or reduce low back pain (LBP) and neck pain among workers. We conducted a systematic review of randomised controlled trials (RCTs) on the effectiveness of ergonomic interventions. A total of 10 RCTs met the inclusion criteria. There was low to moderate quality evidence that physical and organisational ergonomic interventions were not more effective than no ergonomic intervention on short and long term LBP and neck pain incidence/prevalence, and short and long term LBP intensity. There was low quality evidence that a physical ergonomic intervention was significantly more effective for reducing neck pain intensity in the short term (ie, curved or flat seat pan chair) and the long term (ie, arm board) than no ergonomic intervention. The limited number of RCTs included make it difficult to answer our broad research question and the results should be interpreted with care. This review, however, provides a solid overview of the high quality epidemiological evidence on the (usually lack of) effectiveness of ergonomic interventions on LBP and neck pain.
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Weigl, M; Schneider, A; Hoffmann, F; Angerer, P
2015-09-01
Poor hospital work environments affect physicians' work stress. With a focus on hospital pediatricians, we sought to investigate associations between work stress, burnout, and quality of care. A cross-sectional study was conducted in N = 96 pediatricians of a German academic children's hospital (response rate = 73.8 %). All variables were assessed with standardized questionnaires. Multivariate regression analyses were applied to investigate associations after adjusting for potential confounders. Critically high work stress (effort/reward ratio, ERR > 1.0) was reported by N = 25 (28.4 %) participants. Pediatricians in inpatient wards had significantly more work stress than their colleagues in intensive care units and outpatient wards; 10.2 % of surveyed pediatricians reported critically high burnout. Again, inpatient ward staff reported significantly increased emotional exhaustion. After controlling for several confounders, we found that pediatricians with high work stress and emotional exhaustion reported reduced quality of care. Mediation analyses revealed that especially pediatricians' emotional exhaustion partially mediated the effect of work stress on quality of care. Results demonstrate close relationships between increased work stress and burnout as well as diminished quality of care. High work stress environments in pediatric care influence mental health of pediatricians as well as quality of patient care. • The quality of pediatricians' work environment in the hospital is associated with their work stress and burnout. • The consequences of pediatricians' work life for the quality of care need to be addressed in order to inform interventions to improve work life and care quality. • Our study shows associations between increased work stress and burnout with mitigated quality of care. • Beyond indirect effects of work stress through emotional exhaustion on quality of care we also observed direct detrimental effects of pediatricians' work stress on mitigated care quality.
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Improving the baking quality of bread wheat by genomic selection in early generations.
Michel, Sebastian; Kummer, Christian; Gallee, Martin; Hellinger, Jakob; Ametz, Christian; Akgöl, Batuhan; Epure, Doru; Güngör, Huseyin; Löschenberger, Franziska; Buerstmayr, Hermann
2018-02-01
Genomic selection shows great promise for pre-selecting lines with superior bread baking quality in early generations, 3 years ahead of labour-intensive, time-consuming, and costly quality analysis. The genetic improvement of baking quality is one of the grand challenges in wheat breeding as the assessment of the associated traits often involves time-consuming, labour-intensive, and costly testing forcing breeders to postpone sophisticated quality tests to the very last phases of variety development. The prospect of genomic selection for complex traits like grain yield has been shown in numerous studies, and might thus be also an interesting method to select for baking quality traits. Hence, we focused in this study on the accuracy of genomic selection for laborious and expensive to phenotype quality traits as well as its selection response in comparison with phenotypic selection. More than 400 genotyped wheat lines were, therefore, phenotyped for protein content, dough viscoelastic and mixing properties related to baking quality in multi-environment trials 2009-2016. The average prediction accuracy across three independent validation populations was r = 0.39 and could be increased to r = 0.47 by modelling major QTL as fixed effects as well as employing multi-trait prediction models, which resulted in an acceptable prediction accuracy for all dough rheological traits (r = 0.38-0.63). Genomic selection can furthermore be applied 2-3 years earlier than direct phenotypic selection, and the estimated selection response was nearly twice as high in comparison with indirect selection by protein content for baking quality related traits. This considerable advantage of genomic selection could accordingly support breeders in their selection decisions and aid in efficiently combining superior baking quality with grain yield in newly developed wheat varieties.
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Characterization of a Structural Transformation of Carbon Nanotube Materials by Raman Spectroscopy
NASA Technical Reports Server (NTRS)
Cui, Y.; Burger, A.; Zhu, S.; Su, C.-H.; Lehoczky, S. L.; Whitaker, Ann F. (Technical Monitor)
2001-01-01
Raman spectra of carbon nanotubes and carbon microstructure materials synthesized on Si substrates by pulsed laser vaporization have been measured in the range of 50/cm to 4500/cm with the excitation of He-Ne laser. It is found that the formation of nanotubes depends strongly on the growth temperatures and high quality multi-wall and single-wall nanotubes were produced at 700 and 990 C, respectively. The Raman spectra of one sample grown at 700 C were found to be dependent on the excitation intensity. The spectra of the sample suggest that the structure is similar to that of multi-wall nanotubes at low excitation intensity (2.5 kW/sq cm) and it converts to the structure of single-wall nanotubes at higher intensity (25 kW/sq cm). Measurements taken while cycling the light intensity indicate a reversible structural transition.
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Risky business: human factors in critical care.
Laussen, Peter C; Allan, Catherine K; Larovere, Joan M
2011-07-01
Remarkable achievements have occurred in pediatric cardiac critical care over the past two decades. The specialty has become well defined and extremely resource intense. A great deal of focus has been centered on optimizing patient outcomes, particularly mortality and early morbidity, and this has been achieved through a focused and multidisciplinary approach to management. Delivering high-quality and safe care is our goal, and during the Risky Business symposium and simulation sessions at the Eighth International Conference of the Pediatric Cardiac Intensive Care Society in Miami, December 2010, human factors, systems analysis, team training, and lessons learned from malpractice claims were presented.
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Advances in radiation oncology for the management of oropharyngeal tumors.
Gunn, G Brandon; Frank, Steven J
2013-08-01
The major benefits of modern radiation therapy (eg, intensity-modulated [x-ray] radiation therapy [IMRT]) for oropharyngeal cancer are reduced xerostomia and better quality of life. Intensity-modulated proton therapy may provide additional advantages over IMRT by reducing radiation beam-path toxicities. Several acute and late treatment-related toxicities and symptom constellations must be kept in mind when designing and comparing future treatment strategies, particularly because currently most patients with oropharyngeal carcinoma present with human papillomavirus-positive disease and are expected to have a high probability of long-term survival after treatment. Copyright © 2013 Elsevier Inc. All rights reserved.
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A scientifically based nationwide assessment of groundwater quality in the United States
Alley, W.M.; Cohen, P.
1991-01-01
Beginning in 1986, the U.S. Geological Survey began an effort to develop a National Water-Quality Assessment Program. The basic premise underlying this initiative is that a better understanding of the quality of water resources across the country, both surface- and groundwater, is needed to develop effective programs and policies to meet the nation's water-quality concerns. The program will focus on water-quality conditions that are prevalent or large in scale, such as occur from nonpoint sources of pollution or from a high density of point sources. The design of the program is substantially different from the traditional approach of a diffuse national monitoring network. The major activities of the assessment program will be clustered within a set of hydrologic systems (river basins and aquifer systems), referred to as study units. In aggregate, the study units will account for a large part of the nation's water use and represent a wide range of settings across the country. Unique attributes of the program include: (1) the use of consistent study approaches, field and laboratory methods, water-quality measurements, and ancillary data measurements for all study units; (2) the development of a progressive understanding of water-quality conditions and trends in each study unit through long-term studies that rotate periods of intensive data collection and analysis with periods during which the assessment activities are less intensive; and (3) the focus of considerable effort on synthesizing results from among the study units to provide information on regional and national water-quality issues. ?? 1991 Springer-Verlag New York Inc.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Courtois, C.; Compant La Fontaine, A.; Bazzoli, S.
2013-08-15
Results of an experiment to characterise a MeV Bremsstrahlung x-ray emission created by a short (<10 ps) pulse, high intensity (1.4 × 10{sup 19} W/cm{sup 2}) laser are presented. X-ray emission is characterized using several diagnostics; nuclear activation measurements, a calibrated hard x-ray spectrometer, and dosimeters. Results from the reconstructed x-ray energy spectra are consistent with numerical simulations using the PIC and Monte Carlo codes between 0.3 and 30 MeV. The intense Bremsstrahlung x-ray source is used to radiograph an image quality indicator (IQI) heavily filtered with thick tungsten absorbers. Observations suggest that internal features of the IQI can bemore » resolved up to an external areal density of 85 g/cm{sup 2}. The x-ray source size, inferred by the radiography of a thick resolution grid, is estimated to be approximately 400 μm (full width half maximum of the x-ray source Point Spread Function)« less
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Seasonal and spatial variations of water quality and trophic status in Daya Bay, South China Sea.
Wu, Mei-Lin; Wang, You-Shao; Wang, Yu-Tu; Sun, Fu-Lin; Sun, Cui-Ci; Cheng, Hao; Dong, Jun-De
2016-11-15
Coastal water quality and trophic status are subject to intensive environmental stress induced by human activities and climate change. Quarterly cruises were conducted to identify environmental characteristics in Daya Bay in 2013. Water quality is spatially and temporally dynamic in the bay. Cluster analysis (CA) groups 12 monitoring stations into two clusters. Cluster I consists of stations (S1, S2, S4-S7, S9, and S12) located in the central, eastern, and southern parts of the bay, representing less polluted regions. Cluster II includes stations (S3, S8, S10, and S11) located in the western and northern parts of the bay, indicating the highly polluted regions receiving a high amount of wastewater and freshwater discharge. Principal component analysis (PCA) identified that water quality experience seasonal change (summer, winter, and spring-autumn seasons) because of two monsoons in the study area. Eutrophication in the bay is graded as high by Assessment of Estuarine Trophic Status (ASSETS). Copyright © 2016 Elsevier Ltd. All rights reserved.
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An improved multi-exposure approach for high quality holographic femtosecond laser patterning
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Chenchu; Hu, Yanlei, E-mail: huyl@ustc.edu.cn, E-mail: jwl@ustc.edu.cn; Li, Jiawen, E-mail: huyl@ustc.edu.cn, E-mail: jwl@ustc.edu.cn
High efficiency two photon polymerization through single exposure via spatial light modulator (SLM) has been used to decrease the fabrication time and rapidly realize various micro/nanostructures, but the surface quality remains a big problem due to the speckle noise of optical intensity distribution at the defocused plane. Here, a multi-exposure approach which used tens of computer generate holograms successively loaded on SLM is presented to significantly improve the optical uniformity without losing efficiency. By applying multi-exposure, we found that the uniformity at the defocused plane was increased from ∼0.02 to ∼0.6 according to our simulation. The fabricated two series ofmore » letters “HELLO” and “USTC” under single-and multi-exposure in our experiment also verified that the surface quality was greatly improved. Moreover, by this method, several kinds of beam splitters with high quality, e.g., 2 × 2, 5 × 5 Daman, and complex nonseperate 5 × 5, gratings were fabricated with both of high quality and short time (<1 min, 95% time-saving). This multi-exposure SLM-two-photon polymerization method showed the promising prospect in rapidly fabricating and integrating various binary optical devices and their systems.« less
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High-Order Model and Dynamic Filtering for Frame Rate Up-Conversion.
Bao, Wenbo; Zhang, Xiaoyun; Chen, Li; Ding, Lianghui; Gao, Zhiyong
2018-08-01
This paper proposes a novel frame rate up-conversion method through high-order model and dynamic filtering (HOMDF) for video pixels. Unlike the constant brightness and linear motion assumptions in traditional methods, the intensity and position of the video pixels are both modeled with high-order polynomials in terms of time. Then, the key problem of our method is to estimate the polynomial coefficients that represent the pixel's intensity variation, velocity, and acceleration. We propose to solve it with two energy objectives: one minimizes the auto-regressive prediction error of intensity variation by its past samples, and the other minimizes video frame's reconstruction error along the motion trajectory. To efficiently address the optimization problem for these coefficients, we propose the dynamic filtering solution inspired by video's temporal coherence. The optimal estimation of these coefficients is reformulated into a dynamic fusion of the prior estimate from pixel's temporal predecessor and the maximum likelihood estimate from current new observation. Finally, frame rate up-conversion is implemented using motion-compensated interpolation by pixel-wise intensity variation and motion trajectory. Benefited from the advanced model and dynamic filtering, the interpolated frame has much better visual quality. Extensive experiments on the natural and synthesized videos demonstrate the superiority of HOMDF over the state-of-the-art methods in both subjective and objective comparisons.
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NASA Astrophysics Data System (ADS)
Xu, E.
2015-12-01
Land use is closely related to hydrological and biochemical processes influencing the water quality. Quantifying relationship between both of them can help effectively manage land use to improve water quality. Previous studies majorly utilized land use quantity as an indicator to link water quality parameters, which lacked an insight to the influence of land use intensity. Taking upper catchment of Miyun Reservoir as a case study, we proposed a method of aggregating land use quantity and intensity to build a new land use indicator and investigated its explanation empower on water quality. Six nutrient concentrations from 52 sub-watersheds covering the whole catchment were used to characterize spatial distributions of water eutrophication. Based on spatial techniques and empirical conversion coefficients, combined remote sensing with socio-economic statistical data, land use intensity was measured and mapped visually. Then the new land use indicator was calculated and linked to nutrient concentrations by Pearson correlation coefficients. Results demonstrated that our new land use indicator incorporating intensity information can quantify the potential different nutrients exporting abilities from land uses. Comparing to traditional indicators only characterized by land use quantity, most Pearson correlation coefficients between new indicator and water nutrient concentrations increased. New information enhanced the explanatory power of land use on water nutrient concentrations. Then it can help better understand the impact of land use on water quality and guide land use management for supporting decision making.
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Talmor, Daniel; Shapiro, Nathan; Greenberg, Dan; Stone, Patricia W; Neumann, Peter J
2006-11-01
Receiving care in an intensive care unit can greatly influence patients' survival and quality of life. Such treatments can, however, be extremely resource intensive. Therefore, it is increasingly important to understand the costs and consequences associated with interventions aimed at reducing mortality and morbidity of critically ill patients. Cost-effectiveness analyses (CEAs) have become increasingly common to aid decisions about the allocation of scarce healthcare resources. To identify published original CEAs presenting cost/quality-adjusted life year or cost/life-year ratios for treatments used in intensive care units, to summarize the results in an accessible format, and to identify areas in critical care medicine that merit further economic evaluation. We conducted a systematic search of the English-language literature for original CEAs of critical care interventions published from 1993 through 2003. We collected data on the target population, therapy or program, study results, analytic methods employed, and the cost-effectiveness ratios presented. We identified 19 CEAs published through 2003 with 48 cost-effectiveness ratios pertaining to treatment of severe sepsis, acute respiratory failure, and general critical care interventions. These ratios ranged from cost saving to 958,423 US dollars/quality-adjusted life year and from 1,150 to 575,054 US dollars/life year gained. Many studies reported favorable cost-effectiveness profiles (i.e., below 50,000 US dollars/life year or quality-adjusted life year). Specific interventions such as activated protein C for patients with severe sepsis have been shown to provide good value for money. However, overall there is a paucity of CEA literature on the management of the critically ill, and further high-quality CEA is needed. In particular, research should focus on costly interventions such as 24-hr intensivist availability, early goal-directed therapy, and renal replacement therapy. Recent guidelines for the conduct of CEAs in critical care may increase the number and improve the quality of future CEAs.
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Xanthos, Paul D; Gordon, Brett A; Kingsley, Michael I C
2017-03-01
Resistance training has demonstrated efficacy in cardiac rehabilitation programs, but the optimal prescription of resistance training is unknown. This systematic review with meta-analysis compared the effectiveness of cardiac rehabilitation consisting of resistance training either alone (RT) or in combination with aerobic training (CT) with aerobic training only (AT) on outcomes of physical function. Further, resistance training intensity and intervention duration were examined to identify if these factors moderate efficacy. Six electronic databases were searched to identify studies investigating RT, coronary heart disease and physical function. The overall quality of evidence was assessed using the GRADE approach. Meta-analyses were performed when possible and qualitative analysis was performed for the remaining data. Improvements in peak oxygen uptake (WMD: 0.61, 95% CI: 0.20-1.10), peak work capacity (SMD: 0.38, 95% CI: 0.11-0.64) and muscular strength (SMD: 0.65, 95% CI: 0.43-0.87) significantly favoured CT over AT with moderate quality evidence. There was no evidence of a difference in effect when comparing RT and AT. Shorter duration CT was superior to shorter duration AT for improving peak oxygen uptake and muscular strength (low quality evidence) while longer duration CT was only superior to longer duration AT in improving muscular strength (moderate quality evidence). CT is more beneficial than AT alone for improving physical function. Although preliminary findings are promising, more high-quality evidence is required to determine the efficacy of high intensity resistance training. Shorter duration interventions that include resistance training might allow patients to return to their normal activities of daily living earlier. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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High-intensity Interval Training Frequency: Cardiometabolic Effects and Quality of Life.
Stavrinou, Pinelopi S; Bogdanis, Gregory C; Giannaki, Christoforos D; Terzis, Gerasimos; Hadjicharalambous, Marios
2018-02-01
The effects of high intensity interval training (HIIT) frequency on cardiometabolic health and quality of life were examined in 35 healthy inactive adults (age: 31.7±2.6 yrs, VO 2 peak: 32.7±7.4 ml·: kg -1 ·: min -1 ). Participants were randomly assigned to a control (CON) and two training groups, which performed 10×60-s cycling at ~83% of peak power, two (HIIT-2) or three times per week (HIIT-3) for eight weeks. Compared with CON, both training regimes resulted in similar improvements in VO 2 peak (HIIT-2: 10.8%, p=0.048, HIIT-3: 13.6%, p=0.017), waist circumference (HIIT-2: -1.4 cm, p=0.048, HIIT-3: -2.4 cm, p=0.028), thigh cross-sectional area (HIIT-2: 11.4 cm 2 , p=0.001, HIIT-3: 9.3 cm 2 , p=0.001) and the physical health component of quality of life (HIIT-2: 8.4, p=0.001, HIIT-3: 12.2, p=0.001). However, HIIT-3 conferred additional health-related benefits by reducing total body and trunk fat percentage (p<0.05, compared with CON), total cholesterol and low-density lipoprotein-cholesterol (p<0.02, compared with CON) and by improving the mental component of quality of life (p=0.045, compared with CON). In conclusion, performing HIIT only twice per week is effective in promoting cardiometabolic health-related adaptations and quality of life in inactive adults. However, higher HIIT frequency is required for an effect on fat deposits, cholesterol and mental component of well-being. © Georg Thieme Verlag KG Stuttgart · New York.
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Factors affecting family satisfaction with inpatient end-of-life care.
Sadler, Erin; Hales, Brigette; Henry, Blair; Xiong, Wei; Myers, Jeff; Wynnychuk, Lesia; Taggar, Ru; Heyland, Daren; Fowler, Robert
2014-01-01
Little data exists addressing satisfaction with end-of-life care among hospitalized patients, as they and their family members are systematically excluded from routine satisfaction surveys. It is imperative that we closely examine patient and institution factors associated with quality end-of-life care and determine high-priority target areas for quality improvement. Between September 1, 2010 and January 1, 2012 the Canadian Health care Evaluation Project (CANHELP) Bereavement Questionnaire was mailed to the next-of-kin of recently deceased inpatients to seek factors associated with satisfaction with end-of-life care. The primary outcome was the global rating of satisfaction. Secondary outcomes included rates of actual versus preferred location of death, associations between demographic factors and global satisfaction, and identification of targets for quality improvement. Response rate was 33% among 275 valid addresses. Overall, 67.4% of respondents were very or completely satisfied with the overall quality of care their relative received. However, 71.4% of respondents who thought their relative did not die in their preferred location favoured an out-of-hospital location of death. A common location of death was the intensive care unit (45.7%); however, this was not the preferred location of death for 47.6% of such patients. Multivariate Poisson regression analysis showed respondents who believed their relative died in their preferred location were 1.7 times more likely to be satisfied with the end-of-life care that was provided (p = 0.001). Items identified as high-priority targets for improvement included: relationships with, and characteristics of health care professionals; illness management; communication; and end-of-life decision-making. Nearly three-quarters of recently deceased inpatients would have preferred an out-of-hospital death. Intensive care units were a common, but not preferred, location of in-hospital deaths. Family satisfaction with end-of-life care was strongly associated with their relative dying in their preferred location. Improved communication regarding end-of-life care preferences should be a high-priority quality improvement target.
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Water-quality response to a high-elevation wildfire in the Colorado Front Range
Mast, M. Alisa; Murphy, Sheila F.; Clow, David W.; Penn, Colin A.; Sexstone, Graham A.
2016-01-01
Water quality of the Big Thompson River in the Front Range of Colorado was studied for 2 years following a high-elevation wildfire that started in October 2012 and burned 15% of the watershed. A combination of fixed-interval sampling and continuous water-quality monitors was used to examine the timing and magnitude of water-quality changes caused by the wildfire. Prefire water quality was well characterized because the site has been monitored at least monthly since the early 2000s. Major ions and nitrate showed the largest changes in concentrations; major ion increases were greatest in the first postfire snowmelt period, but nitrate increases were greatest in the second snowmelt period. The delay in nitrate release until the second snowmelt season likely reflected a combination of factors including fire timing, hydrologic regime, and rates of nitrogen transformations. Despite the small size of the fire, annual yields of dissolved constituents from the watershed increased 20–52% in the first 2 years following the fire. Turbidity data from the continuous sensor indicated high-intensity summer rain storms had a much greater effect on sediment transport compared to snowmelt. High-frequency sensor data also revealed that weekly sampling missed the concentration peak during snowmelt and short-duration spikes during rain events, underscoring the challenge of characterizing postfire water-quality response with fixed-interval sampling.
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Siddiqui, Khurram M; Billia, Michele; Arifin, Andrew; Li, Fan; Violette, Philippe; Chin, Joseph L
2017-01-01
In this prospective registry we prospectively assessed the oncologic, functional and safety outcomes of salvage high intensity focused ultrasound for radiorecurrent prostate cancer. A total of 81 men were prospectively recruited and evaluated at regular scheduled study visits to 6 months after high intensity focused ultrasound and thereafter as per standard of care. Transrectal ultrasound guided biopsy was performed at 6 months. The primary end point was absence or histological persistence of disease at 6-month biopsy. Secondary end points included quality of life, biochemical recurrence-free survival, overall survival, cancer specific survival and progression to androgen deprivation therapy. Survival analysis was performed according to the Kaplan-Meier method and multivariate analysis was performed using the log rank (Mantel-Cox) test. Mean ± SD prostate specific antigen before high intensity focused ultrasound was 4.06 ± 2.88 ng/ml. At 6 months 63 men underwent biopsy, of whom 22 (35%) had residual disease. At a mean followup of 53.5 ± 31.6 months median biochemical recurrence-free survival was 63 months. The 5-year overall and cancer specific survival rates were 88% and 94.4%, respectively. Nadir prostate specific antigen less than 0.5 ng/ml was a significant predictor of biochemical recurrence-free survival (p=0.014, 95% CI 1.22-5.87). I-PSS significantly increased (p <0.001) while IIEF-5 scores decreased and the SF-36 score did not change significantly. The rate of rectal fistulization and severe incontinence was 3.7% each. A total of 223 complications were recorded in the 180 days after high intensity focused ultrasound (Clavien-Dindo grade 1-195, grade II-20, grade III-7, grade IVa-1). Salvage high intensity focused ultrasound appears to be a viable treatment option for radiorecurrent prostate cancer, with acceptable morbidity. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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NASA Astrophysics Data System (ADS)
Kwon, Seyong; Cho, Chang Hyun; Kwon, Youngmee; Lee, Eun Sook; Park, Je-Kyun
2017-04-01
Immunohistochemistry (IHC) plays an important role in biomarker-driven cancer therapy. Although there has been a high demand for standardized and quality assured IHC, it has rarely been achieved due to the complexity of IHC testing and the subjective validation-based process flow of IHC quality control. We present here a microfluidic immunostaining system for the standardization of IHC by creating a microfluidic linearly graded antibody (Ab)-staining device and a reference cell microarray. Unlike conventional efforts, our system deals primarily with the screening of biomarker staining conditions for quantitative quality assurance testing in IHC. We characterized the microfluidic matching of Ab staining intensity using three HER2 Abs produced by different manufacturers. The quality of HER2 Ab was also validated using tissues of breast cancer patients, demonstrating that our system is an efficient and powerful tool for the standardization and quality assurance of IHC.
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Enhancing mathematics teachers' quality through Lesson Study.
Lomibao, Laila S
2016-01-01
The efficiency and effectivity of the learning experience is dependent on the teacher quality, thus, enhancing teacher's quality is vital in improving the students learning outcome. Since, the usual top-down one-shot cascading model practice for teachers' professional development in Philippines has been observed to have much information dilution, and the Southeast Asian Ministers of Education Organization demanded the need to develop mathematics teachers' quality standards through the Southeast Asia Regional Standards for Mathematics Teachers (SEARS-MT), thus, an intensive, ongoing professional development model should be provided to teachers. This study was undertaken to determine the impact of Lesson Study on Bulua National High School mathematics teachers' quality level in terms of SEARS-MT dimensions. A mixed method of quantitative-qualitative research design was employed. Results of the analysis revealed that Lesson Study effectively enhanced mathematics teachers' quality and promoted teachers professional development. Teachers positively perceived Lesson Study to be beneficial for them to become a better mathematics teacher.
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ERIC Educational Resources Information Center
Fisher, Amy Killen; Simmons, Christopher; Allen, Susan C.
2016-01-01
This study evaluates an intensive experiential exercise designed to facilitate the provision of high-quality supervision in social work. Data from 46 BSW and MSW students suggest that the exercise can be an effective learning tool. Both quantitative and qualitative findings indicated that the students formed a supervisory working alliance; BSW…
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ERIC Educational Resources Information Center
Helfeldt, John P.; Capraro, Robert M.; Capraro, Mary Margaret; Foster, Elizabeth; Carter, Norvella
2009-01-01
This article describes a full-time teaching internship program, where, in lieu of student teaching, interns serve as classroom teachers in urban area schools. Through a partnership between a university and participating school districts, all interns received intensive mentoring and induction during their first year. Among the program results, were…
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ERIC Educational Resources Information Center
Pagano, Rosane; Paucar-Caceres, Alberto
2013-01-01
Providing high quality formative feedback to large and very diverse cohorts of students taking short intensive blocks of teaching (block release) has become crucial in management education provision. The paper proposes the exploitation of classroom response technology (CRT) to evaluate learning activities of students taking block release modules.…
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ERIC Educational Resources Information Center
Gosper, Maree; Malfroy, Janne; McKenzie, Jo
2013-01-01
The pace of technological change accompanied by an evolution in social, work-based and study behaviours and norms poses particular challenges for universities as they strive to develop high quality and sustainable technology-rich learning environments. Maintaining currency with the latest advances is resource intensive, hence the costs incurred in…
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Controlling flooding and water pollution with upland and streamside vegetation systems
Michael Dosskey
2003-01-01
Substantial research and development effort in the U.S. is being spent on developing strategies that address flooding and water pollution problems in agricultural areas. Concerns have been raised about the costs of flood damage, degradation of productive farm land, and declining water quality that are now recognized as unintended consequences of intensive, high-yield...
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Compassion satisfaction, burnout, and secondary traumatic stress in heart and vascular nurses.
Young, Jennifer L; Derr, Denise M; Cicchillo, Vikki J; Bressler, Sonya
2011-01-01
Objectives for this project were to determine the prevalence of compassion satisfaction (CS), burnout, and secondary traumatic stress (STS) in heart and vascular nurses to confirm whether differences exist between intensive care and intermediate care nurses. The Professional Quality of Life Scale Compassion Satisfaction and Compassion Fatigue: Version 5 developed by Stamm (2009) was used. Results showed that nurses who work in the heart and vascular intermediate care unit had average to high scores of CS, low to average levels of burnout, and low to average levels of STS. Nurses who work in the heart and vascular intensive care unit had average to high levels of CS, low to average levels of burnout, and low to average levels of STS. These findings suggest that leadership should be aware of the prevalence of STS and burnout in heart and vascular nurses. Raising awareness of STS and burnout in intensive care and intermediate care nurses can help in targeting more specific strategies that may prevent the onset of developing these symptoms.
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NASA Astrophysics Data System (ADS)
Piriaei, D.; Yousefi, H. R.; Mahabadi, T. D.; SalarElahi, A.; Ghoranneviss, M.
2017-08-01
In this research, the effects of pre-ionization using a shunt resistor on reproducibility of x-ray emission in a Mather type plasma focus device have been studied. This technique increased the intensities of the emitted x-rays from argon as the filling gas of the device and made the x-ray yields with similar intensities reproducible. A Mirnov coil was also used to record the variations of the plasma's magnetic field, and the wavelet spectrums of these recorded signals showed the reduced instabilities due to the application of the pre-ionization technique. Moreover, it was demonstrated that this technique was capable of reducing the number of initial runaway electrons that could increase the impurities and instabilities inside the plasma. In addition to the above-mentioned features, this technique could improve the uniform formation of the current sheath during the breakdown phase that might later lead to a high quality pinch and high intensity emitted x-rays.
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Fatigue in Intensive Care Nurses and Related Factors.
Çelik, Sevim; Taşdemir, Nurten; Kurt, Aylin; İlgezdi, Ebru; Kubalas, Özge
2017-10-01
Fatigue negatively affects the performance of intensive care nurses. Factors contributing to the fatigue experienced by nurses include lifestyle, psychological status, work organization and sleep problems. To determine the level of fatigue among nurses working in intensive care units and the related factors. This descriptive study was conducted with 102 nurses working in intensive care units in the West Black Sea Region of Turkey. Data were collected between February and May 2014 using a personal information form, the Visual Analogue Scale for Fatigue (VAS-F), the Hospital Anxiety and Depression Scale and the Pittsburg Sleep Quality Index. The intensive care nurses in the study were found to be experiencing fatigue. Significant correlations were observed between scores on the VAS-F Fatigue and anxiety (p=0.01), depression (p=0.002), and sleep quality (p<0.001). Anxiety, depression and quality of sleep were significantly affected by the intensive care nurses' levels of fatigue. These results can be of benefit in taking measures which may be used to reduce fatigue in nurses, especially the fatigue related to work organization and social life.
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Influence of Number of Contact Efforts on Running Performance During Game-Based Activities.
Johnston, Rich D; Gabbett, Tim J; Jenkins, David G
2015-09-01
To determine the influence the number of contact efforts during a single bout has on running intensity during game-based activities and assess relationships between physical qualities and distances covered in each game. Eighteen semiprofessional rugby league players (age 23.6 ± 2.8 y) competed in 3 off-side small-sided games (2 × 10-min halves) with a contact bout performed every 2 min. The rules of each game were identical except for the number of contact efforts performed in each bout. Players performed 1, 2, or 3 × 5-s wrestles in the single-, double-, and triple-contact game, respectively. The movement demands (including distance covered and intensity of exercise) in each game were monitored using global positioning system units. Bench-press and back-squat 1-repetition maximum and the 30-15 Intermittent Fitness Test (30-15IFT) assessed muscle strength and high-intensity-running ability, respectively. There was little change in distance covered during the single-contact game (ES = -0.16 to -0.61), whereas there were larger reductions in the double- (ES = -0.52 to -0.81) and triple-contact (ES = -0.50 to -1.15) games. Significant relationships (P < .05) were observed between 30-15IFT and high-speed running during the single- (r = .72) and double- (r = .75), but not triple-contact (r = .20) game. There is little change in running intensity when only single contacts are performed each bout; however, when multiple contacts are performed, greater reductions in running intensity result. In addition, high-intensity-running ability is only associated with running performance when contact demands are low.
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Tarrant, Carolyn; Sutton, Elizabeth; Angell, Emma; Aldridge, Cassie P; Boyal, Amunpreet; Bion, Julian
2017-04-05
It is now well-recognised that patients admitted to hospital on weekends are at higher risk of death than those admitted during weekdays. However, the causes of this 'weekend effect' are poorly understood. Some contend that there is a deficit of medical staff on weekends resulting in poorer quality care, whereas others find that patients admitted to hospital on weekends are sicker and therefore at higher risk of adverse outcomes. Clarifying the causal pathway is clearly important in order to identify effective solutions. In this article we describe an ethnographic approach to evaluating the organisation and delivery of medical care on weekends compared with weekdays, with a specific focus on the role of medical staff as part of National Health Service England's plan to implement 7-day services. We will conduct an ethnographic study of 20 acute hospitals in England between April 2016 and March 2018 as part of the High-intensity Specialist-Led Acute Care project (www.hislac.org). Data will be collected through observations and shadowing, and interviews with staff, in 10 hospitals with higher intensity specialist (consultant) staffing on weekends and 10 with lower intensity specialist staffing. Interviews will be conducted with up to 20 patients sampled from two high-intensity and two low-intensity sites. We will coordinate, compare and contrast observations across our team of ethnographers. Analysis will be both in-depth and cross-cutting, exploring specific features within individual sites and making comparisons between them. We outline how data collection and analysis will be facilitated and organised. The project has received ethics approval from the South West Wales Research Ethics Committee: Reference 13/WA/0372. Informed consent will be obtained for all interview participants. The findings will be disseminated through peer-reviewed publications in high-quality journals and at national and international conferences. © 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.
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Fowles, Eileen R; Stang, Jamie; Bryant, Miranda; Kim, Sunghun
2012-10-01
Maternal diet quality influences birth outcomes. Yet, little research exists that assesses women's diet quality during the first trimester of pregnancy, a crucial time of placental and fetal development. This cross-sectional study, describing diet quality and its relationship with stress, depression, social support, and eating habits in the first trimester, may identify low-income women needing intensive dietary intervention. Seventy-one low-income women completed validated instruments measuring stress, depression, social support, and eating habits; had their height and weight measured; received training on portion-size estimation; and completed three 24-hour dietary recalls (1 weekend day and 2 nonconsecutive weekdays) from July 2009 to February 2010. Comparative and correlational analyses were done. Women with diet quality scores below the median (n=35) had more depression (9.6±5.1 vs 6.7±5.1) and stress (22.1±5.4 vs 19.3±4.8) and less control over meal preparation (5.0±1.5 vs 4.2±1.5) and support from others (52.0±12.0 vs 57.4±7.2) than did women with high diet quality scores (n=36). Diet quality was negatively related to depression (r=-0.41), stress (r=-0.35), skipping meals (r=-0.41), and control over meal preparation (r=-0.33), and positively related to support from others (r=0.38). Low-income women experiencing life stressors represent an at-risk group for low diet quality and may need intensive dietary intervention before and during pregnancy. More research designed to improve diet quality in low-income pregnant women is needed. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
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An Ethnographic Study of Health Information Technology Use in Three Intensive Care Units.
Leslie, Myles; Paradis, Elise; Gropper, Michael A; Kitto, Simon; Reeves, Scott; Pronovost, Peter
2017-08-01
To identify the impact of a full suite of health information technology (HIT) on the relationships that support safety and quality among intensive care unit (ICU) clinicians. A year-long comparative ethnographic study of three academic ICUs was carried out. A total of 446 hours of observational data was collected in the form of field notes. A subset of these observations-134 hours-was devoted to job-shadowing individual clinicians and conducting a time study of their HIT usage. Significant variation in HIT implementation rates and usage was noted. Average HIT use on the two "high-use" ICUs was 49 percent. On the "low-use" ICU, it was 10 percent. Clinicians on the high-use ICUs experienced "silo" effects with potential safety and quality implications. HIT work was associated with spatial, data, and social silos that separated ICU clinicians from one another and their patients. Situational awareness, communication, and patient satisfaction were negatively affected by this siloing. HIT has the potential to accentuate social and professional divisions as clinical communications shift from being in-person to electronically mediated. Socio-technically informed usability testing is recommended for those hospitals that have yet to implement HIT. For those hospitals already implementing HIT, we suggest rapid, locally driven qualitative assessments focused on developing solutions to identified gaps between HIT usage patterns and organizational quality goals. © Health Research and Educational Trust.
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Palgan, I; Caminiti, I M; Muñoz, A; Noci, F; Whyte, P; Morgan, D J; Cronin, D A; Lyng, J G
2011-02-01
High Intensity Light Pulses (HILP) represent an emerging processing technology which uses short (100-400 μs) light pulses (200-1100 nm) for product decontamination. In this study, model and real foods of differing transparencies (maximum recovery diluent (MRD), apple and orange juices and milk) were exposed to HILP in a batch system for 0, 2, 4 or 8 s at a frequency of 3 Hz. After treatment, inactivation of Escherichia coli or Listeria innocua was evaluated in pre-inoculated samples. Sensory and other quality attributes (colour, pH, Brix, titratable acidity, non-enzymatic browning, total phenols and antioxidant capacity (TEAC)) were assessed in apple juice. Microbial kill decreased with decreasing transparency of the medium. In apple juice (the most transparent beverage) E. coli decreased by 2.65 and 4.5 after exposure times of 2 or 4 s, respectively. No cell recovery was observed after 48 h storage at 4°C. No significant differences were observed in quality parameters, excepting TEAC and flavour score, where 8 s exposure caused a significant decrease (p<0.05). Based on these results, HILP with short exposure times could represent a potential alternative to thermal processing to eliminate undesirable microorganisms, while maintaining product quality, in transparent fruit juices. Copyright © 2010 Elsevier Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
O, Ryong-Sok; Takamura, Makoto; Furukawa, Kazuaki; Nagase, Masao; Hibino, Hiroki
2015-03-01
We report on the effects of UV light intensity on the photo assisted electrochemical wet etching of SiC(0001) underneath an epitaxially grown graphene for the fabrication of suspended structures. The maximum etching rate of SiC(0001) was 2.5 µm/h under UV light irradiation in 1 wt % KOH at a constant current of 0.5 mA/cm2. The successful formation of suspended structures depended on the etching rate of SiC. In the Raman spectra of the suspended structures, we did not observe a significant increase in the intensity of the D peak, which originates from defects in graphene sheets. This is most likely explained by the high quality of the single-crystalline graphene epitaxially grown on SiC.
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Presence of indicator plant species as a predictor of wetland vegetation integrity
Stapanian, Martin A.; Adams, Jean V.; Gara, Brian
2013-01-01
We fit regression and classification tree models to vegetation data collected from Ohio (USA) wetlands to determine (1) which species best predict Ohio vegetation index of biotic integrity (OVIBI) score and (2) which species best predict high-quality wetlands (OVIBI score >75). The simplest regression tree model predicted OVIBI score based on the occurrence of three plant species: skunk-cabbage (Symplocarpus foetidus), cinnamon fern (Osmunda cinnamomea), and swamp rose (Rosa palustris). The lowest OVIBI scores were best predicted by the absence of the selected plant species rather than by the presence of other species. The simplest classification tree model predicted high-quality wetlands based on the occurrence of two plant species: skunk-cabbage and marsh-fern (Thelypteris palustris). The overall misclassification rate from this tree was 13 %. Again, low-quality wetlands were better predicted than high-quality wetlands by the absence of selected species rather than the presence of other species using the classification tree model. Our results suggest that a species’ wetland status classification and coefficient of conservatism are of little use in predicting wetland quality. A simple, statistically derived species checklist such as the one created in this study could be used by field biologists to quickly and efficiently identify wetland sites likely to be regulated as high-quality, and requiring more intensive field assessments. Alternatively, it can be used for advanced determinations of low-quality wetlands. Agencies can save considerable money by screening wetlands for the presence/absence of such “indicator” species before issuing permits.
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Lozano López, C; Mesa Jiménez, J; de la Hoz Aizpurúa, J L; Pareja Grande, J; Fernández de Las Peñas, C
2016-01-01
To study the efficacy of manual therapy in the treatment of tension-type headache (TTH) by assessing the quality of randomized control trials (RCTs) published from the year 2000 to April 2013. A search was performed in the following databases: MEDLINE, EBSCO, CINAHL, SCOPUS, PEDRO and OVID. An analysis was made of RCT including patients with TTH receiving any manual therapy, and assessing outcome measures including the intensity, and frequency or duration of the headache. Two independent referees reviewed the methodological quality of RCTs using the Jadad scale. Data from the studies were extracted by two different reviewers. A total of fourteen RCTs were selected. Twelve studies showed acceptable quality (Jadad scale ≥3), and the remaining 2 had low quality (Jadad=2). The studies showed positive results, including reduction in headache intensity and/or frequency, reduction of medication consumption, and improvement in quality of life. The effectiveness of manual therapy for TTH cannot be completely assessed due to the heterogeneity in study design, outcome measures, and different treatments. Nevertheless, the results suggest patients with TTH receiving manual therapies showed better progress than those receiving conventional treatment or placebo. Further studies of high quality using manual therapy protocols, and also including standardized outcome measures, are now needed to clarify the efficacy of manual therapy in the management of TTH. Copyright © 2013 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.
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Castelli, Lorys; Tesio, Valentina; Colonna, Fabrizio; Molinaro, Stefania; Leombruni, Paolo; Bruzzone, Maria; Fusaro, Enrico; Sarzi-Puttini, Piercarlo; Torta, Riccardo
2012-01-01
Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with other symptoms like fatigue, stiffness, non-restorative sleep and psychological distress that strongly affects the quality of life in FM patients. While the psychological distress has been widely explored in FM, only a few studies investigated alexithymia, an emotional dysregulation trait. Evaluate the prevalence of alexithymia and psychological distress and their impact on patients quality of life. A battery of tests assessing alexithymia, depression, anxiety, emotional distress symptoms and the health related quality of life (HRQoL) was filled out by 55 female FM patients. After having analysed their prevalence, two regression analyses were performed in order to evaluate the role that alexithymia, depression, anxiety, emotional distress and pain characteristics have on quality of life of FM patients. Results showed that a clinically relevant level of psychological distress was present in more than half of our sample, whereas alexithymic traits were present in 20% of the patients. Regression analyses showed that pain intensity, depression and current pain were the variables that best contribute to explain the physical component of the HRQoL while anxiety, depression and pain intensity were the variables that mainly contributed to explain the mental component of quality of life. These results underline the high prevalence of alexithymia in FM patients and the great impact of psychological symptoms on FM patients HRQoL. Wholistic care of FM patients which addresses both physical and psychological symptoms is needed.
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Wojdyło, Aneta; Figiel, Adam; Legua, Pilar; Lech, Krzysztof; Carbonell-Barrachina, Ángel A; Hernández, Francisca
2016-09-15
The aim of this study was to determine the effect of different dying methods, such as convective drying (CD: 50, 60, 70 °C), vacuum-microwave drying (VMD: 120, 480, 480-120 W), a combination of convective pre-drying and vacuum-microwave finish drying [(CPD (60 °C)-VMFD (480-120 W)], and freeze-drying (FD) on key quality parameters of dried jujube fruits (cv. "GAL", "MSI", and "PSI"). The parameters studied included bioactive compounds (flavan-3-ols and flavonols, identified by LC-PDA-MS, and vitamin C), antioxidant capacity (ABTS and FRAP), and sensory attributes (e.g. hardness, jujube-ID, and sweetness). The best quality of the dried product (high contents of bioactive compounds and high intensity of key sensory attributes) was found in fruits treated by FD and VMD 480-120 W. The best cultivars were "PSI" and "GAL" from the point of view of bioactive content and sensory quality, respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Hospital Quality And Intensity Of Spending: Is There An Association?
Yasaitis, Laura; Fisher, Elliott S.; Skinner, Jonathan S.
2009-01-01
Numerous studies in the United States have examined the association between quality and spending at the regional level. In this paper we evaluate this relationship at the level of individual hospitals, which are a more natural unit of analysis for reporting on and improving accountability. For all of the quality indicators studied, the association with spending is either nil or negative. The absence of positive correlations suggests that some institutions achieve exemplary performance on quality measures in settings that feature lower intensity of care. This finding highlights the need for reporting information on both quality and spending. PMID:19460774
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Market variations in intensity of Medicare service use and beneficiary experiences with care.
Mittler, Jessica N; Landon, Bruce E; Fisher, Elliot S; Cleary, Paul D; Zaslavsky, Alan M
2010-06-01
Examine associations between patient experiences with care and service use across markets. Medicare fee-for-service (FFS) and managed care (Medicare Advantage [MA]) beneficiaries in 306 markets from the 2003 Consumer Assessments of Healthcare Providers and Systems (CAHPS) surveys. Resource use intensity is measured by the 2003 end-of-life expenditure index. We estimated correlations and linear regressions of eight measures of case-mix-adjusted beneficiary experiences with intensity of service use across markets. We merged CAHPS data with service use data, excluding beneficiaries under 65 years of age or receiving Medicaid. Overall, higher intensity use was associated (p<.05) with worse (seven measures) or no better care experiences (two measures). In higher-intensity markets, Medicare FFS and MA beneficiaries reported more problems getting care quickly and less helpful office staff. However, Medicare FFS beneficiaries in higher-intensity markets reported higher overall ratings of their personal physician and main specialist. Medicare MA beneficiaries in higher-intensity markets also reported worse quality of communication with physicians, ability to get needed care, and overall ratings of care. Medicare beneficiaries in markets characterized by high service use did not report better experiences with care. This trend was strongest for those in managed care.
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Team working in intensive care: current evidence and future endeavors.
Richardson, Joanne; West, Michael A; Cuthbertson, Brian H
2010-12-01
It has recently been argued that the future of intensive care medicine will rely on high quality management and teamwork. Therefore, this review takes an organizational psychology perspective to examine the most recent research on the relationship between teamwork, care processes, and patient outcomes in intensive care. Interdisciplinary communication within a team is crucial for the development of negotiated shared treatment goals and short-team patient outcomes. Interventions for maximizing team communication have received substantial interest in recent literature. Intensive care coordination is not a linear process, and intensive care teams often fail to discuss how to implement goals, trigger and align activities, or reflect on their performance. Despite a move toward interdisciplinary team working, clinical decision-making is still problematic and continues to be perceived as a top-down and authoritative process. The topic of team leadership in intensive care is underexplored and requires further research. Based on findings from the most recent research evidence in medicine and management, four principles are identified for improving the effectiveness of team working in intensive care: engender professional efficacy, create stable teams and leaders, develop trust and participative safety, and enable frequent team reflexivity.
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Untreated runoff quality from roof and road surfaces in a low intensity rainfall climate.
Charters, Frances J; Cochrane, Thomas A; O'Sullivan, Aisling D
2016-04-15
Sediment and heavy metals in stormwater runoff are key pollutants of urban waterways, and their presence in stormwater is driven by climatic factors such as rainfall intensity. This study describes the total suspended solids (TSS) and heavy metal concentrations found in runoff from four different urban surfaces within a residential/institutional catchment, in a climate where rainfall is typically of low intensity (<5.1mm·h(-1)). The results were compared to untreated runoff quality from a compilation of international studies. The road runoff had the highest TSS concentrations, while copper and galvanized roof runoff had the highest copper and zinc concentrations, respectively. Pollutant concentrations were found to be significantly different between surfaces; quantification and prediction of pollutant contributions from urban surfaces should thus take account of the different surface materials, instead of being aggregated into more generalized categories such as land use. The TSS and heavy metal concentrations were found to be at the low to medium end of ranges observed internationally, except for total copper and zinc concentrations generated by dissolution of copper and galvanized roofing material respectively; these concentrations were at least as high as those reported internationally. TSS wash-off from the roofs was seen to be a source-limited process, where all available TSS is washed off during the rain event despite the low intensity rainfall, whereas both road TSS and heavy metals wash-off from roof and road surfaces appeared to all be transport-limited and therefore some carryover of pollutants occurs between rain events. A first flush effect was seen from most surfaces for TSS, but not for heavy metals. This study demonstrates that in low intensity rainfall climates, quantification of untreated runoff quality from key individual surface types in a catchment are needed to enable development of targeted and appropriately sized stormwater treatment systems. Copyright © 2016 Elsevier B.V. All rights reserved.
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Calman, Lynn; Beaver, Kinta; Hind, Daniel; Lorigan, Paul; Roberts, Chris; Lloyd-Jones, Myfanwy
2011-12-01
The burden of lung cancer is high for patients and carers. Care after treatment may have the potential to impact on this. We reviewed the published literature on follow-up strategies intended to improve survival and quality of life. We systematically reviewed studies comparing follow-up regimes in lung cancer. Primary outcomes were overall survival (comparing more intensive versus less intensive follow-up) and survival comparing symptomatic with asymptomatic recurrence. Quality of life was identified as a secondary outcome measure. Hazard ratios (HRs) and 95% confidence intervals from eligible studies were synthesized. Nine studies that examined the role of more intensive follow-up for patients with lung cancer were included (eight observational studies and one randomized controlled trial). The studies of curative resection included patients with non-small cell lung cancer Stages I to III disease, and studies of palliative treatment follow-up included limited and extensive stage patients with small cell lung cancer. A total of 1669 patients were included in the studies. Follow-up programs were heterogeneous and multifaceted. A nonsignificant trend for intensive follow-up to improve survival was identified, for the curative intent treatment subgroup (HR: 0.83; 95% confidence interval: 0.66-1.05). Asymptomatic recurrence was associated with increased survival, which was statistically significant HR: 0.61 (0.50-0.74) (p < 0.01); quality of life was only assessed in one study. This meta-analysis must be interpreted with caution due to the potential for bias in the included studies: observed benefit may be due to systematic differences in outcomes rather than intervention effects. Some benefit was noted from intensive follow-up strategies. More robust data, in the form of randomized controlled trials, are needed to confirm these findings as the review is based primarily on observational studies. Future research should also include patient-centered outcomes to investigate the impact of follow-up regimes on living with lung cancer and psychosocial well-being.
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Rendon, Marta; Dibernardo, Barry; Bruce, Suzanne; Lucas-Anthony, Chere; Watson, Joanne
2013-01-01
Objective: To evaluate treating epidermal melasma using a 4% hydroquinone skin care system plus tretinoin 0.05% cream. Design: Multicenter open-label study with all patients receiving above-mentioned treatment for up to 24 weeks. Setting: Private dermatology and plastic surgery clinics and clinical research facilities. Participants: Thirty-seven adult females with moderate or marked epidermal melasma, melasma pigmentation of mild-to-marked intensity and Fitzpatrick skin type III to VI. Measurements: Melasma severity melasma pigmentation intensity melasma improvement, patient satisfaction, quality-of-life measures, erythema, dryness, peeling, burning/stinging. Results: No patient discontinued due to lack of efficacy or treatment-related adverse events. Treatment was associated with a significant reduction from baseline in melasma severity and melasma pigmentation intensity from Week 4 onward (P≤0.001), and 100 percent of patients showed improvement from Week 8 onward. At Week 24, 100 percent of patients were “satisfied” or “very satisfied” with the overall effectiveness of their treatment. Patients’ quality of life also improved (e.g., the proportion of patients feeling embarrassed or self-conscious about their skin “a lot” or “very much” declined from 78 percent at baseline to four percent at Week 24). Mean and median scores for erythema, dryness, peeling, and burning/stinging did not exceed trace levels. Conclusion: Treating moderate-to-severe melasma using the 4% hydroquinone skin care system plus 0.05% tretinoin can significantly reduce the severity of melasma and the intensity of melasma pigmentation within four weeks. Treatment was generally well tolerated and associated with an improved quality of life and high levels of patient satisfaction. PMID:24307923
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Data Curation: Improving Environmental Health Data Quality.
Yang, Lin; Li, Jiao; Hou, Li; Qian, Qing
2015-01-01
With the growing recognition of the influence of climate change on human health, scientists' attention to analyzing the relationship between meteorological factors and adverse health effects. However, the paucity of high quality integrated data is one of the great challenges, especially when scientific studies rely on data-intensive computing. This paper aims to design an appropriate curation process to address this problem. We present a data curation workflow that: (i) follows the guidance of DCC Curation Lifecycle Model; (ii) combines manual curation with automatic curation; (iii) and solves environmental health data curation problem. The workflow was applied to a medical knowledge service system and showed that it was capable of improving work efficiency and data quality.
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Hunchak-Kariouk, Kathryn
1999-01-01
The influence of land use on the water quality of four tributaries to the Toms River, which drains nearly one-half of the Barnegat Bay wateshed, was studied during the initial phase of a multiyear investigation. Water samples were collected from and streamflows were measured in Long Swamp Creek, Wrangel Brook, Davenport Branch, and Jakes Creek during periods of base flow and stormflow in the growing and nongrowing seasons during May 1994 to October 1995. The drainage areas upstream from the seven measurement sites were characterized as highly developed, moderately developed, slightly developed, or undeveloped. Concentrations were determined and area-normalized instantaneous loads (yields) were estimated for total nitrogen, ammonia, nitrate, organic nitrogen, hydrolyzable phosphorus plus orthosphosphorus, orthophosphorus, total suspended solids, and fecal-coliform bacteria in the water samples. Specific conductance, pH, temperature, and dissolved oxygen were measured. Yields of total nitrogen, nitrate, and organic nitrogen at sites on Wrangel Brook, which drains moderately developed areas, were either larger than or similar to yields at the site on Long Swamp Creek, which drains a highly developed area. The magnitude of these yields probably was not related directly to the intensity of land development, but more likely was influenced by the type of development, the amount of base flow, and historical land use in the basin. The large concentrations of total nitrogen and nitrate in base flow in Wrangel Brook could have resulted from fertilizers that were applied to high-maintenance lawns and from agricultural runoff that has remained in the ground water since the 1950's and eventually was discharged to streams. Yields of ammonia appear to be partly related to the intensity of land development and storm runoff. Yields of ammonia at the site on Long Swamp Creek (a highly developed area) were either larger than or similar to yields at sites on Wrangel Brook (moderately developed areas). Yields were smallest at the site on Davenport Branch, which drains a slightly developed area. Yields of hydrolyzable phosphorus plus orthophosphorus and yields of orthophosphorus appear to be related to the intensity of development. Concentrations of hydrolyzable phosphorus plus orthophosphorus were greater in Long Swamp Creek (highly developed areas) than in Wrangel Brook (moderately developed areas). Concentrations of orthophosphorus were largest in Wrangel Brook (moderately developed) and Long Swamp Creek (highly developed). Total suspended solids and bacteria were somewhat related to intensity of development. Yields of total suspended solids were greater at sites downstream from highly and moderately developed areas than from slightly developed areas. Yields of bacteria were strongly related to streamflow and season. Specific conductance appears to be related to streamflow. pH probably was related to intensity of land development; pH was greater (more basic) in streams draining highly developed areas than in those draining other areas. Concentrations of dissolved oxygen were affected more by water temperature than by intensity of development or streamflow.
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NASA Astrophysics Data System (ADS)
An, Yu-Ying; Wang, Jian; Zhou, Wen-Ming; Jin, Hong-Xia; Li, Jian-Feng; Wang, Cheng-Wei
2018-07-01
The high quality anodic aluminum oxide (AAO) defective photonic crystals (DPCs) have been successfully prepared by using a modified periodic pulse anodization technique including an effective voltage compensating strategy. The test results confirmed that the AAO DPCs were with a perfect regular layered-structure and had a narrow defective photonic band gap (DPBG) with a high quality defective mode. When the rhodamine B (rhB) was absorbed onto the pore walls of the AAO DPCs, it was found that the DPBG blue edge and localized defective mode inside could significantly enhance the photoluminescence (PL) intensity of rhodamine B (rhB), while they were carefully regulated to match with the emission peak position of rhB respectively. Even more intriguing was that the localized defective peak in DPBG had more notable effect on rhB's photoluminescence, 3.1 times higher than that of the control samples under the same conditions. The corresponding mechanism for photoluminescence enhancement was also discussed in detail.
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Burnout syndrome--assessment of a stressful job among intensive care staff.
Cubrilo-Turek, Mirjana; Urek, Roman; Turek, Stjepan
2006-03-01
The purpose of the study was to investigate the degree of burnout experienced by intensive care staff particularly, in Medical (MICU) and Surgical Intensive Care Units (SICU) General Hospital "Sveti Duh", Zagreb. A sample group of 41 emergency physicians and nurses from MICU and 30 from SICU was tested. The survey included demographic data and Maslach Burnout Inventory (MBI) scoring test identified by the three main components associated with burnout: emotional exhaustion (MBI-EE), depersonalization (MBI-DEP), and personal accomplishment (MBI-PA) were assessed using 22-item questionnaire. The degrees of burnout were stratified into low, moderate, and high range. Mean total MBI (X +/- SD) were high in both groups: higher for the MICU (65.5 +/- 6.7) than for SICU staff (55.7 +/- 3.8, p < 0.05). MICU staff showed moderate degree of MBI-EE (24.9 +/- 11.2), MBI-DEP (6.0 +/- 5.6), and as well as MBI-PA (34.4 +/- 8.8). The same parameters showed better results among SICU staff: low degree of MBI-EE (17.1 +/- 5.2), as well as low level of MBI-DEP (5.2 +/- 5.0), and moderate degree of MBI-PA (33.7 +/- 9.8). The differences between the groups was statistically significant only for the total MBI, and for MBI-EE (p < 0.05). There were no significant differences between MICU and SICU staff for MBI-DEP or MBI-PA parameters. Overall job burnout represented in a moderate degree. The presence of burnout is a serious phenomenon, because it can lead to psychosomatic complaints, work-associated withdrawal behaviour, and a lower quality of care at intensive care units. Early recognition of burnout phenomenon as a result of prolonged stress and frustration among intensive care staff, contributes to better professional behavior, organizational structure changes in the work environment and better health care quality for critically ill patients.
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Gomes Neto, Mansueto; Durães, André Rodrigues; Conceição, Lino Sergio Rocha; Saquetto, Micheli Bernardone; Ellingsen, Øyvind; Carvalho, Vitor Oliveira
2018-06-15
The aim of this study was to investigate the effects of high intensity interval training (HIIT) versus moderate intensity continuous training (MICT) in heart failure patients with reduced ejection fraction (HFrEF). Despite the well-known positive effects of exercise in heart failure patients, the best mode of exercise is still under discussion. We searched Pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (from the earliest date available to October 2017) for randomized controlled trials that evaluated the effects of HIIT versus MICT in HFrEF patients. Weighted mean differences (WMD) with 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I 2 test. 13 studies met the study criteria, including 411 patients. Compared to MICT, HIIT resulted in improvement in Peak VO 2 WMD (1.35 mL·kg -1 ·min -1 95% CI: 0.03 to 2.64 N = 411). HIIT resulted in no difference in VE/VCO 2 slope WMD (-1.21 95% CI: -3.0 to 0.58 N = 135), and quality of life measured by Minnesota Living with Heart Failure questionnaire WMD (1.19 95% CI: -5.81 to 8.19 N = 79). Sub-group analyses comparing studies with and without isocaloric exercise training protocol also showed a nonsignificant difference in peak VO 2 for participants in the HIIT group compared with MICT group. HIIT improves peak VO 2 and should be considered as a component of care of HFrEF patients. However, its superiority versus MICT disappears when isocaloric protocols are compared. An important caveat is uncertainty and variation of actual training intensities compared to program targets. Copyright © 2018 Elsevier B.V. All rights reserved.
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a Novel Ihs-Ga Fusion Method Based on Enhancement Vegetated Area
NASA Astrophysics Data System (ADS)
Niazi, S.; Mokhtarzade, M.; Saeedzadeh, F.
2015-12-01
Pan sharpening methods aim to produce a more informative image containing the positive aspects of both source images. However, the pan sharpening process usually introduces some spectral and spatial distortions in the resulting fused image. The amount of these distortions varies highly depending on the pan sharpening technique as well as the type of data. Among the existing pan sharpening methods, the Intensity-Hue-Saturation (IHS) technique is the most widely used for its efficiency and high spatial resolution. When the IHS method is used for IKONOS or QuickBird imagery, there is a significant color distortion which is mainly due to the wavelengths range of the panchromatic image. Regarding the fact that in the green vegetated regions panchromatic gray values are much larger than the gray values of intensity image. A novel method is proposed which spatially adjusts the intensity image in vegetated areas. To do so the normalized difference vegetation index (NDVI) is used to identify vegetation areas where the green band is enhanced according to the red and NIR bands. In this way an intensity image is obtained in which the gray values are comparable to the panchromatic image. Beside the genetic optimization algorithm is used to find the optimum weight parameters in order to gain the best intensity image. Visual and statistical analysis proved the efficiency of the proposed method as it significantly improved the fusion quality in comparison to conventional IHS technique. The accuracy of the proposed pan sharpening technique was also evaluated in terms of different spatial and spectral metrics. In this study, 7 metrics (Correlation Coefficient, ERGAS, RASE, RMSE, SAM, SID and Spatial Coefficient) have been used in order to determine the quality of the pan-sharpened images. Experiments were conducted on two different data sets obtained by two different imaging sensors, IKONOS and QuickBird. The result of this showed that the evaluation metrics are more promising for our fused image in comparison to other pan sharpening methods.
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Besada, Cristina; Gil, Rebeca; Bonet, Luis; Quiñones, Ana; Intrigliolo, Diego; Salvador, Alejandra
2016-03-01
In recent years many hectares planted with persimmon trees in E Spain have been diagnosed with chloride toxicity. An effect of this abiotic stress on fruit quality has been reported in different crops. However, the impact of chloride stress on persimmon fruit quality is unknown. The harvest and postharvest quality of persimmons harvested from trees that manifest different intensities of chloride toxicity foliar symptoms was evaluated herein. Our results revealed that fruits from trees under chloride stress conditions underwent chloride accumulation in the calyx, which was more marked the greater the salt stress intensity trees were exposed to. Increased chloride concentrations in the calyx stimulated ethylene production in this tissue. In the fruits affected by slight and moderate chloride stress, calyx ethylene production accelerated the maturity process, as reflected by increased fruit colour and diminished fruit firmness. In the fruits under severe chloride stress, the high ethylene levels in the calyx triggered autocatalytic ethylene production in other fruit tissues, which led fruit maturity to drastically advance. In these fruits effectiveness of CO2 deastringency treatment was not complete and fruit softening enhanced during the postharvest period. Moreover, chloride stress conditions had a marked effect on reducing fruit weight, even in slightly stressed trees. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
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Vocal Tract Discomfort and Voice-Related Quality of Life in Wind Instrumentalists.
Cappellaro, Juliane; Beber, Bárbara Costa
2018-05-01
This study aimed to investigate vocal tract discomfort and quality of life in the voice of wind instrumentalists. It is a cross-sectional study. The sample was composed of 37 musicians of the orchestra of Caxias do Sul city, RS, Brazil. The participants answered a nonstandard questionnaire about demographic and professional information, the Voice-Related Quality of Life (V-RQOL), the Vocal Tract Discomfort (VTD) scale, and additional items about fatigue after playing the instrument and pain in the cervical muscles. Correlation analyses were performed using Spearman correlation test. The most frequent symptoms mentioned by musicians in the VTD, for both frequency and intensity of occurrence, were dryness, ache, irritability, and cervical muscle pain, in addition to the frequency of occurrence of fatigue after playing. The musicians showed high scores in the V-RQOL survey. Several symptoms evaluated by the VTD had a negative correlation with the musicians' years of orchestra membership and with V-RQOL scores. Symptoms of vocal tract discomfort are present in wind instrumentalists in low frequency and intensity of occurrence. However, these symptoms affect the musicians' voice-related quality of life, and they occur more in musicians with fewer years of orchestra membership. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
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Parent-child interaction in motor speech therapy.
Namasivayam, Aravind Kumar; Jethava, Vibhuti; Pukonen, Margit; Huynh, Anna; Goshulak, Debra; Kroll, Robert; van Lieshout, Pascal
2018-01-01
This study measures the reliability and sensitivity of a modified Parent-Child Interaction Observation scale (PCIOs) used to monitor the quality of parent-child interaction. The scale is part of a home-training program employed with direct motor speech intervention for children with speech sound disorders. Eighty-four preschool age children with speech sound disorders were provided either high- (2×/week/10 weeks) or low-intensity (1×/week/10 weeks) motor speech intervention. Clinicians completed the PCIOs at the beginning, middle, and end of treatment. Inter-rater reliability (Kappa scores) was determined by an independent speech-language pathologist who assessed videotaped sessions at the midpoint of the treatment block. Intervention sensitivity of the scale was evaluated using a Friedman test for each item and then followed up with Wilcoxon pairwise comparisons where appropriate. We obtained fair-to-good inter-rater reliability (Kappa = 0.33-0.64) for the PCIOs using only video-based scoring. Child-related items were more strongly influenced by differences in treatment intensity than parent-related items, where a greater number of sessions positively influenced parent learning of treatment skills and child behaviors. The adapted PCIOs is reliable and sensitive to monitor the quality of parent-child interactions in a 10-week block of motor speech intervention with adjunct home therapy. Implications for rehabilitation Parent-centered therapy is considered a cost effective method of speech and language service delivery. However, parent-centered models may be difficult to implement for treatments such as developmental motor speech interventions that require a high degree of skill and training. For children with speech sound disorders and motor speech difficulties, a translated and adapted version of the parent-child observation scale was found to be sufficiently reliable and sensitive to assess changes in the quality of the parent-child interactions during intervention. In developmental motor speech interventions, high-intensity treatment (2×/week/10 weeks) facilitates greater changes in the parent-child interactions than low intensity treatment (1×/week/10 weeks). On one hand, parents may need to attend more than five sessions with the clinician to learn how to observe and address their child's speech difficulties. On the other hand, children with speech sound disorders may need more than 10 sessions to adapt to structured play settings even when activities and therapy materials are age-appropriate.
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Liu, Jianpeng; Li, Xin; Chen, Shuo; Zhang, Sichao; Xie, Shanshan; Xu, Chen; Chen, Yifang; Deng, Biao; Mao, Chenwen
2017-05-01
In the development of full-field transmission X-ray microscopy for basic study in science and technology, a condenser capable of providing intense illumination with high uniformity and stability on tested specimens in order to achieve high-quality images is essential. The latest design of a square-shaped condenser based on diffractive gratings has demonstrated promising uniformity in illumination. This paper describes in more detail the development of such a beam shaper for hard X-rays at 10 keV with regard to its design, manufacture and optical characterization. The effect of the grating profile on the diffracted intensity has been theoretically predicted by numerical simulation using the finite-difference time-domain method. Based on this, the limitations of the grating-based condenser are discussed.
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Rivera, Manuel; Rahaman, Mostafizur; Zhou, Andrew F.; Mohammed Alzuraiqi, Waleed; Feng, Peter
2017-01-01
High-quality two-dimensional (2D) crystalline boron nitride nanosheets (BNNSs) were grown on silicon wafers by using pulsed plasma beam deposition techniques. Self-powered deep ultraviolet (DUV) photodetectors (PDs) based on BNNSs with Schottky contact structures are designed and fabricated. By connecting the fabricated DUV photodetector to an ammeter, the response strength, response time and recovery time to different DUV wavelengths at different intensities have been characterized using the output short circuit photocurrent without a power supply. Furthermore, effects of temperature and plasma treatment on the induced photocurrent response of detectors have also been investigated. The experimental data clearly indicate that plasma treatment would significantly improve both induced photocurrent and response time. The BNNS-based DUV photodetector is demonstrated to possess excellent performance at a temperature up to 400 °C, including high sensitivity, high signal-to-noise ratio, high spectral selectivity, high speed, and high stability, which is better than almost all reported semiconducting nanomaterial-based self-powered photodetectors. PMID:29257098
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Banić, Nikola; Lončarić, Sven
2015-11-01
Removing the influence of illumination on image colors and adjusting the brightness across the scene are important image enhancement problems. This is achieved by applying adequate color constancy and brightness adjustment methods. One of the earliest models to deal with both of these problems was the Retinex theory. Some of the Retinex implementations tend to give high-quality results by performing local operations, but they are computationally relatively slow. One of the recent Retinex implementations is light random sprays Retinex (LRSR). In this paper, a new method is proposed for brightness adjustment and color correction that overcomes the main disadvantages of LRSR. There are three main contributions of this paper. First, a concept of memory sprays is proposed to reduce the number of LRSR's per-pixel operations to a constant regardless of the parameter values, thereby enabling a fast Retinex-based local image enhancement. Second, an effective remapping of image intensities is proposed that results in significantly higher quality. Third, the problem of LRSR's halo effect is significantly reduced by using an alternative illumination processing method. The proposed method enables a fast Retinex-based image enhancement by processing Retinex paths in a constant number of steps regardless of the path size. Due to the halo effect removal and remapping of the resulting intensities, the method outperforms many of the well-known image enhancement methods in terms of resulting image quality. The results are presented and discussed. It is shown that the proposed method outperforms most of the tested methods in terms of image brightness adjustment, color correction, and computational speed.
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Production of a high-velocity water slug using an impacting technique.
Dehkhoda, S; Bourne, N K
2014-02-01
A pulsed water jet consists of a series of discrete water slugs travelling at high velocity. Immediately after striking a target, these slugs apply high-intensity, short-duration transient stress pulses reaching an amplitude known as the water hammer pressure, followed by low-intensity, long-duration stationary stress at a lower stagnation pressure. The magnitude and duration of the water hammer and stagnation pressures are controlled by the size and quality of the water slugs. The use of water jets for rock cutting in mining operations is a centuries-old technology; however, practical methods for producing high-energy water slugs repeatedly have proven difficult. This can be partly due to the fact that the geometrical properties of a jet and so its effectiveness in creating damage is controlled and influenced by the method that is employed to generate the water slugs. This paper investigates the quality of a single water slug produced using an impacting technique where a hammer strikes a piston, resting on top of a water-filled chamber. The coherence and integrity of the jet core was of concern in this study. The impact impulse of the formed water jet was measured in a Kel-F target material using an embedded PVDF (Polyvinylidene fluoride) shock gauge. The recorded stress waveform was then used to determine the unity and endurance of the water slug stream once travelled through air.
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Production of a high-velocity water slug using an impacting technique
NASA Astrophysics Data System (ADS)
Dehkhoda, S.; Bourne, N. K.
2014-02-01
A pulsed water jet consists of a series of discrete water slugs travelling at high velocity. Immediately after striking a target, these slugs apply high-intensity, short-duration transient stress pulses reaching an amplitude known as the water hammer pressure, followed by low-intensity, long-duration stationary stress at a lower stagnation pressure. The magnitude and duration of the water hammer and stagnation pressures are controlled by the size and quality of the water slugs. The use of water jets for rock cutting in mining operations is a centuries-old technology; however, practical methods for producing high-energy water slugs repeatedly have proven difficult. This can be partly due to the fact that the geometrical properties of a jet and so its effectiveness in creating damage is controlled and influenced by the method that is employed to generate the water slugs. This paper investigates the quality of a single water slug produced using an impacting technique where a hammer strikes a piston, resting on top of a water-filled chamber. The coherence and integrity of the jet core was of concern in this study. The impact impulse of the formed water jet was measured in a Kel-F target material using an embedded PVDF (Polyvinylidene fluoride) shock gauge. The recorded stress waveform was then used to determine the unity and endurance of the water slug stream once travelled through air.
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NASA Astrophysics Data System (ADS)
Chun-Lin, Louis Chang
Rare-earth-doped fiber lasers and amplifiers are relatively easy to efficiently produce a stable and high quality laser beam in a compact, robust, and alignment-free configuration. Recently, high power fiber laser systems have facilitated wide spread applications in academics, industries, and militaries in replacement of bulk solid-state laser systems. The master oscillator power amplifier (MOPA) composed of a highly-controlled seed, high-gain preamplifiers, and high-efficiency power amplifiers are typically utilized to scale up the pulse energy, peak power, or average power. Furthermore, a direct-current-modulated nanosecond diode laser in single transverse mode can simply provide a compact and highly-controlled seed to result in the flexible output parameters, such as repetition rate, pulse duration, and even temporal pulse shape. However, when scaling up the peak power for high intensity applications, such a versatile diode-seeded nanosecond MOPA laser system using rare-earth-doped fibers is unable to completely save its own advantages compared to bulk laser systems. Without a strong seeding among the amplifiers, the guided amplified spontaneous amplification is easy to become dominant during the amplification, leading to the harmful self-lasing or pulsing effects, and the difficulty of the quantitative numerical comparison. In this dissertation, we study a high-efficiency and intense nanosecond ytterbium fiber MOPA system with good beam quality and stability for high intensity applications. The all-PM-fiber structure is achieved with the output extinction ratio of >12 dB by optimizing the interconnection of high power optical fibers. The diode-seeded MOPA configuration without parasitic stimulated amplification (PAS) is implemented using the double-pass scheme to extract energy efficiently for scaling peak power. The broadband PAS was studied experimentally, which matches well with our numerical simulation. The 1064-nm nanosecond seed was a direct-current-modulated Fabry-Perot diode laser associated with a weak and pulsed noise spanning from 1045 to 1063 nm. Even though the contribution of input noise pulse is only <5%, it becomes a significant transient spike during amplification. The blue-shifted pulsed noise may be caused by band filling effect for quantum-well seed laser driven by high peak current. The study helps the development of adaptive pulse shaping for scaling peak power or energy at high efficiency. On the other hand, the broadband spike with a 3-dB bandwidth of 8.8 nm can support pulses to seed the amplifier for sub-nanosecond giant pulse generation. Because of the very weak seed laser, the design of high-gain preamplifier becomes critical. The utilization of single-mode core-pumped fiber preamplifier can not only improve the mode contrast without fiber coiling effect but also significantly suppress the fiber nonlinearity. The double-pass scheme was therefore studied both numerically and experimentally to improve energy extraction efficiency for the lack of attainable seed and core-pumped power. As a result, a record-high peak power of > 30 kW and energy of > 0.23 mJ was successfully achieved to the best of our knowledge from the output of clad-pumped power amplifier with a beam quality of M2 ˜1.1 in a diode-seeded 15-microm-core fiber MOPA system. After the power amplifier, the MOPA conversion efficiency can be dramatically improved to >56% for an energy gain of >63 dB at a moderate repetition rate of 20 kHz with a beam quality of M 2 <1.5. The output energy of >1.1 mJ with a pulse duration of ˜6.1 ns can result in a peak power up to >116 kW which is limited by fiber fuse in long-term operation. Such a condition able to generate the on-target laser intensity of > 60 GW/cm2 for applications is qualified to preliminarily create a laser-plasma light source. Moreover, the related simulation results also reveal the double-passed power amplifier can further simplify MOPA. Such an intense clad-pumped power amplifier can further become a nonlinear fiber amplifier in all-normal dispersion instead of a nonlinear passive fiber. The combination of laser amplification and nonlinear conversion together can therefore overcome the significant pump depletion during the propagation along the passive fiber for power scaling. As a result, an intense spectrum spanning from 980 to 1600 nm as a high-power nanosecond supercontinuum source can be successfully generated with a conversion efficiency of >65% and a record-high peak power of >116 kW to the best of our knowledge. Because of MOPA structure, the influence of input parameters of nonlinear fiber amplifier on supercontinuum parameters can also be studied. The onset and interplay of fiber nonlinearities can be revealed stage by stage. Such an unique and linearly-polarized light source composed of an intense pump and broad sideband seed is beneficial for efficiently driving the broadband tunable optical parametric amplification free from the bulkiness and timing jitter. Keywords: High power fiber laser and amplifier, ytterbium fiber, master oscillator power amplification, parasitic stimulated amplification, multi-pass fiber amplification, peak power/pulse energy scaling, fiber nonlinear optics, supercontinuum generation.
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Chen, Hao-ling; Lin, Keh-chung; Liing, Rong-jiuan; Wu, Ching-yi; Chen, Chia-ling
2015-09-21
Kinematic analysis has been used to objectively evaluate movement patterns, quality, and strategies during reaching tasks. However, no study has investigated whether kinematic variables during unilateral and bilateral reaching tasks predict a patient's perceived arm use during activities of daily living (ADL) after an intensive intervention. Therefore, this study investigated whether kinematic measures during unilateral and bilateral reaching tasks before an intervention can predict clinically meaningful improvement in perceived arm use during ADL after intensive poststroke rehabilitation. The study was a secondary analysis of 120 subjects with chronic stroke who received 90-120 min of intensive intervention every weekday for 3-4 weeks. Reaching kinematics during unilateral and bilateral tasks and the Motor Activity Log (MAL) were evaluated before and after the intervention. Kinematic variables explained 22 and 11 % of the variance in actual amount of use (AOU) and quality of movement (QOM), respectively, of MAL improvement during unilateral reaching tasks. Kinematic variables also explained 21 and 31 % of the variance in MAL-AOU and MAL-QOM, respectively, during bilateral reaching tasks. Selected kinematic variables, including endpoint variables, trunk involvement, and joint recruitment and interjoint coordination, were significant predictors for improvement in perceived arm use during ADL (P < 0.05). Arm-trunk kinematics may be used to predict clinically meaningful improvement in perceived arm use during ADL after intensive rehabilitation. Involvement of interjoint coordination and trunk control variables as predictors in bilateral reaching models indicates that a high level of motor control (i.e., multijoint coordination) and trunk stability may be important in obtaining treatment gains in arm use, especially for bilateral daily activities, in intensive rehabilitation after stroke.
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Exclusion of Residents From Surgery-Intensive Care Team Communication: A Qualitative Study.
Gotlib Conn, Lesley; Haas, Barbara; Rubenfeld, Gordon D; Scales, Damon C; Amaral, Andre C; Ferguson, Niall D; Nathens, Avery B
2016-01-01
Communication competency is an important aspect of postgraduate training and patient care delivery in all specialties and clinical domains. This study explored staff surgeon and intensivist perceptions of and experiences with residents' communication with a view toward fostering high quality interspecialty team communication in the surgical intensive care unit. A qualitative study using semistructured interviews. Data were analyzed iteratively and inductively as per standard qualitative thematic approach. University of Toronto, Toronto, Canada. A total of 15 staff surgeons and intensivists who collaborate in patient care in the surgical intensive care unit. The phenomenon of "resident bypass" emerged, resulting from staff surgeon and intensivist perceptions that residents threaten the quality of interspecialty team communication. Clear patterns and preferences for resident exclusion from this communication were present. A total of 5 interrelated drivers of resident bypass were discovered: lack of trust, lack of specialized knowledge, poor system design, need for timely communication, and residents' inadequate contribution to decision-making. Surgical and intensive care staff were dissatisfied with the structure of residents' roles in interspecialty team communication. Concerns about communication gaps, patient care continuity, and patient safety were expressed. Surgical and intensive care staff exclude residents from interspecialty team communication for the benefit of patient safety and care continuity, but this limits opportunities for residents to develop communication skill and competence. Efforts are needed to effectively integrate surgery and intensive care residents in interspecialty attending-resident communication in ways that are meaningful for both patient care and postgraduate training. The implications for medical education are discussed. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Application of a three-lens slit spatial filter in high power lasers
NASA Astrophysics Data System (ADS)
Xiong, Han
2018-07-01
Combined with partial parameters in National Ignition Facility, the conceptual design of off-axial four-pass main laser optical system with a three-lens slit spatial filter has been discussed. Since the three-lens slit spatial filter can decline the focal intensity by about 3 orders of magnitudes than that in NIF system, the cutoff frequency in main amplifier cavity can be reduced from 51 × DL to 39 × DL for better beam quality. The main laser system for single beam line can be shortened from 174.7 m to 155.7 m and the spatial filter in high vacuum becomes 60 m instead of the original 83.5 m. Additionally, the pinhole closure could be avoided since the declining of focal intensity in slit spatial filter and the absence of pinhole aperture in the other (pinhole) spatial filter, which provides new ideas for the future high-power lasers.
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Fusion of multi-spectral and panchromatic images based on 2D-PWVD and SSIM
NASA Astrophysics Data System (ADS)
Tan, Dongjie; Liu, Yi; Hou, Ruonan; Xue, Bindang
2016-03-01
A combined method using 2D pseudo Wigner-Ville distribution (2D-PWVD) and structural similarity(SSIM) index is proposed for fusion of low resolution multi-spectral (MS) image and high resolution panchromatic (PAN) image. First, the intensity component of multi-spectral image is extracted with generalized IHS transform. Then, the spectrum diagrams of the intensity components of multi-spectral image and panchromatic image are obtained with 2D-PWVD. Different fusion rules are designed for different frequency information of the spectrum diagrams. SSIM index is used to evaluate the high frequency information of the spectrum diagrams for assigning the weights in the fusion processing adaptively. After the new spectrum diagram is achieved according to the fusion rule, the final fusion image can be obtained by inverse 2D-PWVD and inverse GIHS transform. Experimental results show that, the proposed method can obtain high quality fusion images.
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Steganography based on pixel intensity value decomposition
NASA Astrophysics Data System (ADS)
Abdulla, Alan Anwar; Sellahewa, Harin; Jassim, Sabah A.
2014-05-01
This paper focuses on steganography based on pixel intensity value decomposition. A number of existing schemes such as binary, Fibonacci, Prime, Natural, Lucas, and Catalan-Fibonacci (CF) are evaluated in terms of payload capacity and stego quality. A new technique based on a specific representation is proposed to decompose pixel intensity values into 16 (virtual) bit-planes suitable for embedding purposes. The proposed decomposition has a desirable property whereby the sum of all bit-planes does not exceed the maximum pixel intensity value, i.e. 255. Experimental results demonstrate that the proposed technique offers an effective compromise between payload capacity and stego quality of existing embedding techniques based on pixel intensity value decomposition. Its capacity is equal to that of binary and Lucas, while it offers a higher capacity than Fibonacci, Prime, Natural, and CF when the secret bits are embedded in 1st Least Significant Bit (LSB). When the secret bits are embedded in higher bit-planes, i.e., 2nd LSB to 8th Most Significant Bit (MSB), the proposed scheme has more capacity than Natural numbers based embedding. However, from the 6th bit-plane onwards, the proposed scheme offers better stego quality. In general, the proposed decomposition scheme has less effect in terms of quality on pixel value when compared to most existing pixel intensity value decomposition techniques when embedding messages in higher bit-planes.
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The Nutritional Content of Prey Affects the Foraging of a Generalist Arthropod Predator
Schmidt, Jason M.; Sebastian, Peter; Wilder, Shawn M.; Rypstra, Ann L.
2012-01-01
While foraging theory predicts that predatory responses should be determined by the energy content and size of prey, it is becoming increasingly clear that carnivores regulate their intake of specific nutrients. We tested the hypothesis that prey nutrient composition and predator nutritional history affects foraging intensity, consumption, and prey selection by the wolf spider, Pardosa milvina. By altering the rearing environment for fruit flies, Drosophila melanogaster, we produced high quality flies containing more nitrogen and protein and less lipid than low quality fruit flies. In one experiment, we quantified the proportion of flies taken and consumption across a range of densities of either high or low quality flies and, in a second experiment, we determined the prey capture and consumption of spiders that had been maintained on contrasting diets prior to testing. In both cases, the proportion of prey captured declined with increasing prey density, which characterizes the Type II functional response that is typical of wolf spiders. Spiders with similar nutritional histories killed similar numbers of each prey type but consumed more of the low quality prey. Spiders provided high quality prey in the weeks prior to testing killed more prey than those on the low quality diet but there was no effect of prior diet on consumption. In the third experiment, spiders were maintained on contrasting diets for three weeks and then allowed to select from a mixture of high and low quality prey. Interestingly, feeding history affected prey preferences: spiders that had been on a low quality diet showed no preference but those on the high quality diet selected high quality flies from the mixture. Our results suggest that, even when prey size and species identity are controlled, the nutritional experience of the predator as well as the specific content of the prey shapes predator-prey interactions. PMID:23145130
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[Influence of environmental noise on sleep quality and sleeping disorders-implications for health].
Kohlhuber, M; Bolte, G
2011-12-01
Environmental noise is a well-known risk factor influencing sleep-wake behavior and sleep quality. Epidemiologic studies have shown that environmental noise is regarded as the most annoying environmental factor. Noise causes modifications in physiologic and mental functions and may result in health outcomes like elevated blood pressure and ischemic heart disease. Reactions to high sound levels during sleep are decreased sleep intensity, arousals, and increased stress hormone secretion. Effects of poor sleep quality are reduced cognitive performance, tiredness, and psychosomatic symptoms. Long-term consequences of recurrent sleep loss due to environmental noise may be heart disease and increased medication intake. Arousals occur especially due to single noise events and intermittent noise. Laboratory and field studies showed no habituation of physiologic parameters to high sound levels. Sleep is especially sensitive to noise; therefore, sound levels during nighttime should be much lower than during daytime.
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Chen, Binyao; Gao, Enting; Chen, Haoyu; Yang, Jianling; Shi, Fei; Zheng, Ce; Zhu, Weifang; Xiang, Dehui; Chen, Xinjian; Zhang, Mingzhi
2016-01-01
To investigate the profile and determinants of retinal optical intensity in normal subjects using 3D spectral domain optical coherence tomography (SD OCT). A total of 231 eyes from 231 healthy subjects ranging in age from 18 to 80 years were included and underwent a 3D OCT scan. Forty-four eyes were randomly chosen to be scanned by two operators for reproducibility analysis. Distribution of optical intensity of each layer and regions specified by the Early Treatment of Diabetic Retinopathy Study (ETDRS) were investigated by analyzing the OCT raw data with our automatic graph-based algorithm. Univariate and multivariate analyses were performed between retinal optical intensity and sex, age, height, weight, spherical equivalent (SE), axial length, image quality, disc area and rim/disc area ratio (R/D area ratio). For optical intensity measurements, the intraclass correlation coefficient of each layer ranged from 0.815 to 0.941, indicating good reproducibility. Optical intensity was lowest in the central area of retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and photoreceptor layer, except for the retinal pigment epithelium (RPE). Optical intensity was positively correlated with image quality in all retinal layers (0.553<β<0.851, p<0.01), and negatively correlated with age in most retinal layers (-0.362<β<-0.179, p<0.01), except for the RPE (β = 0.456, p<0.01), outer nuclear layer and photoreceptor layer (p>0.05). There was no relationship between retinal optical intensity and sex, height, weight, SE, axial length, disc area and R/D area ratio. There was a specific pattern of distribution of retinal optical intensity in different regions. The optical intensity was affected by image quality and age. Image quality can be used as a reference for normalization. The effect of age needs to be taken into consideration when using OCT for diagnosis.
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Fröhlich, Martin R; Boksberger, Heidi; Barfuss-Schneider, Claudia; Liem, Esther; Petry, Heidi
2017-01-01
Background: Between 4 to 45 % of intensive care patients suffer from prolonged ventilator dependence. Due to impeded weaning, verbal communication is impossible. The tracheal cannula affects breathing and swallowing. The Passy Muir speaking valve (PMV) allows patients on ventilators to speak. It counteracts pharyngeal as well as laryngeal desensitization and prevents an insufficient swallowing reflex. Aim and methods: To implement the PMV, we conducted a multiprofessional practice- and quality development project. The objective was to ensure safe swallowing and communicating for ventilated patients with tracheostoma. Results: Intensive care nurses, doctors and physiotherapists assessed patient safety as being high. In nine patients with 51 PMV applications, we observed three undesirable events in terms of dyspnea and oxygen desaturation. On one occasion, it was necessary to remove the PMV. Conclusion: A combination of mandatory training for the entire treatment team, presence of two professionals during PMV application, and a newly developed guiding document resulted in a high level of patient safety. By means of PMV, ventilated intensive care patients are able to communicate verbally and to swallow better. Complications can be identified early and solved effectively.
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High quality digital holographic reconstruction on analog film
NASA Astrophysics Data System (ADS)
Nelsen, B.; Hartmann, P.
2017-05-01
High quality real-time digital holographic reconstruction, i.e. at 30 Hz frame rates, has been at the forefront of research and has been hailed as the holy grail of display systems. While these efforts have produced a fascinating array of computer algorithms and technology, many applications of reconstructing high quality digital holograms do not require such high frame rates. In fact, applications such as 3D holographic lithography even require a stationary mask. Typical devices used for digital hologram reconstruction are based on spatial-light-modulator technology and this technology is great for reconstructing arbitrary holograms on the fly; however, it lacks the high spatial resolution achievable by its analog counterpart, holographic film. Analog holographic film is therefore the method of choice for reconstructing highquality static holograms. The challenge lies in taking a static, high-quality digitally calculated hologram and effectively writing it to holographic film. We have developed a theoretical system based on a tunable phase plate, an intensity adjustable high-coherence laser and a slip-stick based piezo rotation stage to effectively produce a digitally calculated hologram on analog film. The configuration reproduces the individual components, both the amplitude and phase, of the hologram in the Fourier domain. These Fourier components are then individually written on the holographic film after interfering with a reference beam. The system is analogous to writing angularly multiplexed plane waves with individual component phase control.
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Effects of exercise intensity and duration on nocturnal heart rate variability and sleep quality.
Myllymäki, Tero; Rusko, Heikki; Syväoja, Heidi; Juuti, Tanja; Kinnunen, Marja-Liisa; Kyröläinen, Heikki
2012-03-01
Acute physical exercise may affect cardiac autonomic modulation hours or even days during the recovery phase. Although sleep is an essential recovery period, the information on nocturnal autonomic modulation indicated by heart rate variability (HRV) after different exercises is mostly lacking. Therefore, this study investigated the effects of exercise intensity and duration on nocturnal HR, HRV, HR, and HRV-based relaxation, as well as on actigraphic and subjective sleep quality. Fourteen healthy male subjects (age 36 ± 4 years, maximal oxygen uptake 49 ± 4 ml/kg/min) performed five different running exercises on separate occasions starting at 6 p.m. with HR guidance at home. The effect of intensity was studied with 30 min of exercises at intensities corresponding to HR level at 45% (easy), 60% (moderate) and 75% (vigorous) of their maximal oxygen uptake. The effect of duration was studied with 30, 60, and 90 min of moderate exercises. Increased exercise intensity elevated nocturnal HR compared to control day (p < 0.001), but it did not affect nocturnal HRV. Nocturnal HR was greater after the day with 90- than 30- or 60-min exercises (p < 0.01) or control day (p < 0.001). Nocturnal HRV was lower after the 90-min exercise day compared to control day (p < 0.01). Neither exercise intensity nor duration had any impact on actigraphic or subjective sleep quality. The results suggest that increased exercise intensity and/or duration cause delayed recovery of nocturnal cardiac autonomic modulation, although long exercise duration was needed to induce changes in nocturnal HRV. Increased exercise intensity or duration does not seem to disrupt sleep quality.
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De Nardi, Angélica Trevisan; Tolves, Tainara; Lenzi, Thatiane Larissa; Signori, Luis Ulisses; Silva, Antônio Marcos Vargas da
2018-03-01
To compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on functional capacity and cardiometabolic markers in individuals prediabetes and type 2 diabetes (T2D). The search was performed in PubMed (MEDLINE), EMBASE, PEDro, CENTRAL, Scopus, LILACS database, and Clinical Trials from the inception to July 2017, included randomized clinical trials that compared the use of HIIT and MICT in prediabetes and T2D adults. The risk of bias was defined by Cochrane Handbook and quality of evidence by GRADE. From 818 relevant records, seven studies were included in systematic review (64 prediabetes and 120 T2D patients) and five with T2D were meta-analyzed. HIIT promoted significantly increased of 3.02 mL/kg/min (CI95% 1.42-4.61) of VO 2 max, measured for functional capacity, compared to MICT. No differences were found between two modalities of exercises considering the outcomes HbA1c, systolic and diastolic blood pressure, total cholesterol, HDL and LDL cholesterol, triglycerides, BMI, and waist-to-hip ratio. Most of the studies presented unclear risk of bias, and low and very low quality of evidence. HIIT induces cardiometabolic adaptations similar to those of MICT in prediabetes and T2D, and provides greater benefits to functional capacity in patients with T2D. CRD42016047151. Copyright © 2018 Elsevier B.V. All rights reserved.
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Transparent air filter for high-efficiency PM2.5 capture.
Liu, Chong; Hsu, Po-Chun; Lee, Hyun-Wook; Ye, Meng; Zheng, Guangyuan; Liu, Nian; Li, Weiyang; Cui, Yi
2015-02-16
Particulate matter (PM) pollution has raised serious concerns for public health. Although outdoor individual protection could be achieved by facial masks, indoor air usually relies on expensive and energy-intensive air-filtering devices. Here, we introduce a transparent air filter for indoor air protection through windows that uses natural passive ventilation to effectively protect the indoor air quality. By controlling the surface chemistry to enable strong PM adhesion and also the microstructure of the air filters to increase the capture possibilities, we achieve transparent, high air flow and highly effective air filters of ~90% transparency with >95.00% removal of PM2.5 under extreme hazardous air-quality conditions (PM2.5 mass concentration >250 μg m(-3)). A field test in Beijing shows that the polyacrylonitrile transparent air filter has the best PM2.5 removal efficiency of 98.69% at high transmittance of ~77% during haze occurrence.
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Transparent air filter for high-efficiency PM2.5 capture
NASA Astrophysics Data System (ADS)
Liu, Chong; Hsu, Po-Chun; Lee, Hyun-Wook; Ye, Meng; Zheng, Guangyuan; Liu, Nian; Li, Weiyang; Cui, Yi
2015-02-01
Particulate matter (PM) pollution has raised serious concerns for public health. Although outdoor individual protection could be achieved by facial masks, indoor air usually relies on expensive and energy-intensive air-filtering devices. Here, we introduce a transparent air filter for indoor air protection through windows that uses natural passive ventilation to effectively protect the indoor air quality. By controlling the surface chemistry to enable strong PM adhesion and also the microstructure of the air filters to increase the capture possibilities, we achieve transparent, high air flow and highly effective air filters of ~90% transparency with >95.00% removal of PM2.5 under extreme hazardous air-quality conditions (PM2.5 mass concentration >250 μg m-3). A field test in Beijing shows that the polyacrylonitrile transparent air filter has the best PM2.5 removal efficiency of 98.69% at high transmittance of ~77% during haze occurrence.
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A new method of creating high intensity neutron source
NASA Astrophysics Data System (ADS)
Masuda, T.; Yoshimi, A.; Yoshimura, M.
We propose a new scheme of producing an intense neutron beam whose yields may exceed those of the existing facilities by a few to several orders of magnitude in the sub-eV region. This scheme employs a MeV gamma beam extracted from circulating quantum ions, which has been recently proposed. The gamma beam is directed to a deuteron target and the photo-disintegration process generates a neutron beam. The calculated neutron energy spectrum is nearly flat down to the neV range, and thus there exists a possibility to utilize a good quality of neutrons especially in sub-eV energy region without using a moderator.
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Douglas N. Swanston
1980-01-01
Natural events affecting vegetative cover and the hydrology and stability of a stream and its parent watershed are key factors influencing the quality of anadromous fish habitat. High intensity storms, drought, soil mass movement, and fire have the greatest impacts. Wind, stream icing, and the influence of insects and disease are important locally...
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ERIC Educational Resources Information Center
Fabiano, Gregory A.; Vujnovic, Rebecca K.; Waschbusch, Daniel A.; Yu, Jihnhee; Mashtare, Terry; Pariseau, Meaghan E.; Pelham, William E.; Parham, Brittany R.; Smalls, Kalima J.
2013-01-01
Effective behavior support is an important component of high-quality and nurturing early childhood classroom settings. At present, there are few studies that investigate the best way to train and support teachers in these strategies. The present study compared two different training approaches: (1) a workshop that included a one-day…
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D. Craig Rudolph; Charles A. Ely; Richard R. Schaefer; J. Howard Williamson; Ronald E. Thill
2006-01-01
The Diana fritillary (Speyerio diana), a species of conservation concern throughout its range, and the great spangled fritillary (S. cybele) both occur in the Ouachita Mountains of west-central Arkansas and eastern Oklahoma. Both species depend on abundant, high quality nectar resources to support populations. Decades of intense...
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ERIC Educational Resources Information Center
Page, Janelle; Meehan-Andrews, Terri; Weerakkody, Nivan; Hughes, Diane L.; Rathner, Joseph A.
2017-01-01
Evidence shows that factors contributing to success in physiology education for allied health students at universities include not only their high school achievement and background but also factors such as confidence with their teachers and quality of their learning experience, justifying intensive and continued survey of students' perceptions of…
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Contribution of wetlands to nitrate removal at the watershed scale
NASA Astrophysics Data System (ADS)
Hansen, Amy T.; Dolph, Christine L.; Foufoula-Georgiou, Efi; Finlay, Jacques C.
2018-02-01
Intensively managed row crop agriculture has fundamentally changed Earth surface processes within the Mississippi River basin through large-scale alterations of land cover, hydrology and reactive nitrogen availability. These changes have created leaky landscapes where excess agriculturally derived nitrate degrades riverine water quality at local, regional and continental scales. Individually, wetlands are known to remove nitrate but the conditions under which multiple wetlands meaningfully reduce riverine nitrate concentration have not been established. Only one region of the Mississippi River basin—the 44,000 km2 Minnesota River basin—still contains enough wetland cover within its intensively agriculturally managed watersheds to empirically address this question. Here we combine high-resolution land cover data for the Minnesota River basin with spatially extensive repeat water sampling data. By clearly isolating the effect of wetlands from crop cover, we show that, under moderate-high streamflow, wetlands are five times more efficient per unit area at reducing riverine nitrate concentration than the most effective land-based nitrogen mitigation strategies, which include cover crops and land retirement. Our results suggest that wetland restorations that account for the effects of spatial position in stream networks could provide a much greater benefit to water quality then previously assumed.
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NASA Astrophysics Data System (ADS)
Liansheng, Sui; Yin, Cheng; Bing, Li; Ailing, Tian; Krishna Asundi, Anand
2018-07-01
A novel computational ghost imaging scheme based on specially designed phase-only masks, which can be efficiently applied to encrypt an original image into a series of measured intensities, is proposed in this paper. First, a Hadamard matrix with a certain order is generated, where the number of elements in each row is equal to the size of the original image to be encrypted. Each row of the matrix is rearranged into the corresponding 2D pattern. Then, each pattern is encoded into the phase-only masks by making use of an iterative phase retrieval algorithm. These specially designed masks can be wholly or partially used in the process of computational ghost imaging to reconstruct the original information with high quality. When a significantly small number of phase-only masks are used to record the measured intensities in a single-pixel bucket detector, the information can be authenticated without clear visualization by calculating the nonlinear correlation map between the original image and its reconstruction. The results illustrate the feasibility and effectiveness of the proposed computational ghost imaging mechanism, which will provide an effective alternative for enriching the related research on the computational ghost imaging technique.
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Distance learning in the public health workplace.
Patel, M
2000-09-01
The Master of Applied Epidemiology (MAE) Program implemented in Canberra to produce public health practitioners with specified competencies in the control of communicable diseases. Twenty one of the 24 months of training is distance learning defined as, 'where the learner is physically remote from the training institution'. During this time the trainees are in supervised employment in Public Health centres across the country. Here they learn directly from first hand experiences in the work place. They return to Canberra for short, intensive periods of interactive sessions with their peers and supervisors. Lessons learnt from conducting this program are discussed in this article. They include: all trainees are not suited to this form of training; the quality of support from the field supervisors is highly variable and their role in modelling crucial to the trainees performance; demands on the academic staff is high; and the frequency of contact between trainee and academic supervisor varies considerably. To date this program has made major contributions by enhancing communicable disease surveillance and control but it demands intensive resources to sustain, quality training, and support. This model of distance learning can be adapted in the Pacific both for graduate degree courses and also for continuing education for all levels of health professionals.
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Miller, David C; McSparron, Jakob I; Clardy, Peter F; Sullivan, Amy M; Hayes, Margaret M
2016-09-01
Effective communication between providers and patients and their surrogates in the intensive care unit (ICU) is crucial for delivery of high-quality care. Despite the identification of communication as a key education focus by the American Board of Internal Medicine, little emphasis is placed on teaching trainees how to effectively communicate in the ICU. Data are conflicting on the best way to teach residents, and institutions vary on their emphasis of communication as a key skill. There needs to be a cultural shift surrounding the education of medical residents in the ICU: communication must be treated with the same emphasis, precision, and importance as placing a central venous catheter in the ICU. We propose that high-stakes communications between physicians and patients or their surrogates must be viewed as a medical procedure that can be taught, assessed, and quality controlled. Medical residents require training, observation, and feedback in specific communication skill sets with the goal of achieving mastery. It is only through supervised training, practice in real time, observation, and feedback that medical residents can become skillful practitioners of communication in the ICU.
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High rate composting of herbal pharmaceutical industry solid waste.
Ali, M; Duba, K S; Kalamdhad, A S; Bhatia, A; Khursheed, A; Kazmi, A A; Ahmed, N
2012-01-01
High rate composting studies of hard to degrade herbal wastes were conducted in a 3.5 m(3) capacity rotary drum composter. Studies were spread out in four trials: In trial 1 and 2, one and two turns per day rotation was observed, respectively, by mixing of herbal industry waste with cattle (buffalo) manure at a ratio of 3:1 on wet weight basis. In trial 3 inocula was added in raw waste to enhance the degradation and in trial 4 composting of a mixture of vegetable market waste and herbal waste was conducted at one turn per day. Results demonstrated that the operation of the rotary drum at one turn a day (trial 1) could provide the most conducive composting conditions and co-composting (trial 4) gave better quality compost in terms of temperature, moisture, nitrogen, and Solvita maturity index. In addition a FT-IR study also revealed that trial 1 and trial 4 gave quality compost in terms of stability and maturity due to the presence of more intense peaks in the aromatic region and less intense peaks were found in the aliphatic region compared with trial 2 and trial 3.
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NASA Astrophysics Data System (ADS)
Rust, A.; Knipper, K. R.; Randall, J.; Hogue, T. S.
2014-12-01
Forest fires affect water quality in the disrupted watershed, which can devastate the aquatic ecosystem including sensitive trout (Salmonidae) and macroinvertebrate species. The West Fork Fire Complex consumed 88,724 acres of forest in the state of Colorado during the summer of 2013. The majority (88%) of the burn area was comprised of Engelmann spruce (Picea engelmanii) trees killed previously by Spruce Beetle (Ips spp.). Damage to the soils was of moderate to high severity in the majority of the area (60%). The recent fire surrounded the Rio Grande, affecting water quality and habitat critical to insects and fish. The water quality of the Rio Grande (above and below the burn) and some of the effected tributaries is currently being monitored for both quality and quantity. Parameters important to the survival of aquatic life, such as flow, temperature, dissolved oxygen, pH, conductivity, total dissolved solids, total suspended solids, turbidity, nutrients, and suspended and dissolved metals are being monitored along the Rio Grande and in tributaries. Macroinvertebrate and fish populations are sampled in the same locations. First year observations showed the ecosystem to be relatively resilient, with stable water quality and survival of insects and fish. However, an intense monsoon season this summer is driving extensive sediments into tributaries from steep, severely burned hillslopes. These monsoon events have caused acute and dramatic fish kills, where hundreds of trout were reported killed in one tributary in a single day event. Turbidity was observed as high as 488 NTU in the impacted stream with fish kill, whereas the turbidity was 25 NTU in a neighboring tributary outside of the burn area. Salmonids can be negatively impacted by relatively low turbidity, with prior studies noting that the turbidity threshold for rainbow trout is 70 NTU. Continued monitoring of water quality, macroinvertebrate populations, and fish populations is being undertaken to determine the key drivers of the acute fish kill events. This presentation will highlight the role of burn severity, steepness of slope, hill aspect, and storm intensity on water quality and aquatic response of fire-impacted streams of the Upper Rio Grande.
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Annual Report on Electronics Research at the University of Texas at Austin
1993-02-14
Order Phase Transition in a Laser Threshold," AppI. Phys. Lett. 60 3081-3083 (22 June, 1992). 16. K. Sadra and B.G. Streetman, "’The Coupled Hole... beam epitaxy (MBE) to grow stacks of very high quality epitaxial layers. In order to achieve high reflectiviry, both the thickness and composition of...shifts in intense femtosecond laser pulses." Journal of the Optical Society of America B 9, 2032-2040 (1992). II. LIST OF CONFERENCE PROCEEDINGS
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Prevalence and quality of clinical pathways in Swedish intensive care units: a national survey.
Bjurling-Sjöberg, Petronella; Jansson, Inger; Wadensten, Barbro; Engström, Gabriella; Pöder, Ulrika
2014-02-01
To identify the prevalence of clinical pathways (CPs) in Swedish intensive care units (ICUs) and to explore the quality, content and evidence base of the documents. A descriptive and explorative survey of all Swedish ICUs (N84) and a review of submitted examples of CPs (n12) were conducted. CPs were in use at 20% of the Swedish ICUs. There was a significant geographic variation but no relationship between the use of CPs and category of hospital, type of ICU, size of ICU or type of health record applied. In total, 56 CPs were reported within a range of scopes and extensions. The content of the ICUs' CPs, as well as the degree to which they were interprofessional, evidence based, and renewed varied. Progress has been made in relation to CPs in recent years, but there is potential for further improvements. None of the ICUs had CPs that contained all key characteristics of a high-quality, interprofessional and evidence-based CP identified in the literature. Greater knowledge sharing and cooperation within the field would be beneficial, and further research is needed. © 2013 John Wiley & Sons, Ltd.
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Embedding intensity image into a binary hologram with strong noise resistant capability
NASA Astrophysics Data System (ADS)
Zhuang, Zhaoyong; Jiao, Shuming; Zou, Wenbin; Li, Xia
2017-11-01
A digital hologram can be employed as a host image for image watermarking applications to protect information security. Past research demonstrates that a gray level intensity image can be embedded into a binary Fresnel hologram by error diffusion method or bit truncation coding method. However, the fidelity of the retrieved watermark image from binary hologram is generally not satisfactory, especially when the binary hologram is contaminated with noise. To address this problem, we propose a JPEG-BCH encoding method in this paper. First, we employ the JPEG standard to compress the intensity image into a binary bit stream. Next, we encode the binary bit stream with BCH code to obtain error correction capability. Finally, the JPEG-BCH code is embedded into the binary hologram. By this way, the intensity image can be retrieved with high fidelity by a BCH-JPEG decoder even if the binary hologram suffers from serious noise contamination. Numerical simulation results show that the image quality of retrieved intensity image with our proposed method is superior to the state-of-the-art work reported.
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Chang, C F; Williams, R C; Grano, D A; Downing, K H; Glaeser, R M
1983-01-01
This study investigates the causes of the apparent differences between the optical diffraction pattern of a micrograph of a Tobacco Mosaic Virus (TMV) particle, the optical diffraction pattern of a ten-fold photographically averaged image, and the computed diffraction pattern of the original micrograph. Peak intensities along the layer lines in the transform of the averaged image appear to be quite unlike those in the diffraction pattern of the original micrograph, and the diffraction intensities for the averaged image extend to unexpectedly high resolution. A carefully controlled, quantitative comparison reveals, however, that the optical diffraction pattern of the original micrograph and that of the ten-fold averaged image are essentially equivalent. Using computer-based image processing, we discovered that the peak intensities on the 6th layer line have values very similar in magnitude to the neighboring noise, in contrast to what was expected from the optical diffraction pattern of the original micrograph. This discrepancy was resolved by recording a series of optical diffraction patterns when the original micrograph was immersed in oil. These patterns revealed the presence of a substantial phase grating effect, which exaggerated the peak intensities on the 6th layer line, causing an erroneous impression that the high resolution features possessed a good signal-to-noise ratio. This study thus reveals some pitfalls and misleading results that can be encountered when using optical diffraction patterns to evaluate image quality.
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Verification of intensity modulated profiles using a pixel segmented liquid-filled linear array.
Pardo, J; Roselló, J V; Sánchez-Doblado, F; Gómez, F
2006-06-07
A liquid isooctane (C8H18) filled ionization chamber linear array developed for radiotherapy quality assurance, consisting of 128 pixels (each of them with a 1.7 mm pitch), has been used to acquire profiles of several intensity modulated fields. The results were compared with film measurements using the gamma test. The comparisons show a very good matching, even in high gradient dose regions. The volume-averaging effect of the pixels is negligible and the spatial resolution is enough to verify these regions. However, some mismatches between the detectors have been found in regions where low-energy scattered photons significantly contribute to the total dose. These differences are not very important (in fact, the measurements of both detectors are in agreement using the gamma test with tolerances of 3% and 3 mm in most of those regions), and may be associated with the film energy dependence. In addition, the linear array repeatability (0.27% one standard deviation) is much better than the film one ( approximately 3%). The good repeatability, small pixel size and high spatial resolution make the detector ideal for the real time profile verification of high gradient beam profiles like those present in intensity modulated radiation therapy and radiosurgery.
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NASA Astrophysics Data System (ADS)
Zhang, Rongxiao; Jee, Kyung-Wook; Cascio, Ethan; Sharp, Gregory C.; Flanz, Jacob B.; Lu, Hsiao-Ming
2018-01-01
Proton radiography, which images patients with the same type of particles as those with which they are to be treated, is a promising approach to image guidance and water equivalent path length (WEPL) verification in proton radiation therapy. We have shown recently that proton radiographs could be obtained by measuring time-resolved dose rate functions (DRFs) using an x-ray amorphous silicon flat panel. The WEPL values were derived solely from the root-mean-square (RMS) of DRFs, while the intensity information in the DRFs was filtered out. In this work, we explored the use of such intensity information for potential improvement in WEPL accuracy and imaging quality. Three WEPL derivation methods based on, respectively, the RMS only, the intensity only, and the intensity-weighted RMS were tested and compared in terms of the quality of obtained radiograph images and the accuracy of WEPL values. A Gammex CT calibration phantom containing inserts made of various tissue substitute materials with independently measured relative stopping powers (RSP) was used to assess the imaging performances. Improved image quality with enhanced interfaces was achieved while preserving the accuracy by using intensity information in the calibration. Other objects, including an anthropomorphic head phantom, a proton therapy range compensator, a frozen lamb’s head and an ‘image quality phantom’ were also imaged. Both the RMS only and the intensity-weighted RMS methods derived RSPs within ± 1% for most of the Gammex phantom inserts, with a mean absolute percentage error of 0.66% for all inserts. In the case of the insert with a titanium rod, the method based on RMS completely failed, whereas that based on the intensity-weighted RMS was qualitatively valid. The use of intensity greatly enhanced the interfaces between different materials in the obtained WEPL images, suggesting the potential for image guidance in areas such as patient positioning and tumor tracking by proton radiography.
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NASA Astrophysics Data System (ADS)
Wu, Z.; Luo, Z.; Zhang, Y.; Guo, F.; He, L.
2018-04-01
A Modulation Transfer Function (MTF)-based fuzzy comprehensive evaluation method was proposed in this paper for the purpose of evaluating high-resolution satellite image quality. To establish the factor set, two MTF features and seven radiant features were extracted from the knife-edge region of image patch, which included Nyquist, MTF0.5, entropy, peak signal to noise ratio (PSNR), average difference, edge intensity, average gradient, contrast and ground spatial distance (GSD). After analyzing the statistical distribution of above features, a fuzzy evaluation threshold table and fuzzy evaluation membership functions was established. The experiments for comprehensive quality assessment of different natural and artificial objects was done with GF2 image patches. The results showed that the calibration field image has the highest quality scores. The water image has closest image quality to the calibration field, quality of building image is a little poor than water image, but much higher than farmland image. In order to test the influence of different features on quality evaluation, the experiment with different weights were tested on GF2 and SPOT7 images. The results showed that different weights correspond different evaluating effectiveness. In the case of setting up the weights of edge features and GSD, the image quality of GF2 is better than SPOT7. However, when setting MTF and PSNR as main factor, the image quality of SPOT7 is better than GF2.
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MASQOT: a method for cDNA microarray spot quality control
Bylesjö, Max; Eriksson, Daniel; Sjödin, Andreas; Sjöström, Michael; Jansson, Stefan; Antti, Henrik; Trygg, Johan
2005-01-01
Background cDNA microarray technology has emerged as a major player in the parallel detection of biomolecules, but still suffers from fundamental technical problems. Identifying and removing unreliable data is crucial to prevent the risk of receiving illusive analysis results. Visual assessment of spot quality is still a common procedure, despite the time-consuming work of manually inspecting spots in the range of hundreds of thousands or more. Results A novel methodology for cDNA microarray spot quality control is outlined. Multivariate discriminant analysis was used to assess spot quality based on existing and novel descriptors. The presented methodology displays high reproducibility and was found superior in identifying unreliable data compared to other evaluated methodologies. Conclusion The proposed methodology for cDNA microarray spot quality control generates non-discrete values of spot quality which can be utilized as weights in subsequent analysis procedures as well as to discard spots of undesired quality using the suggested threshold values. The MASQOT approach provides a consistent assessment of spot quality and can be considered an alternative to the labor-intensive manual quality assessment process. PMID:16223442
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Comparison of CIGS solar cells made with different structures and fabrication techniques
Mansfield, Lorelle M.; Garris, Rebekah L.; Counts, Kahl D.; ...
2016-11-03
Cu(In, Ga)Se2 (CIGS)-based solar cells from six fabricators were characterized and compared. The devices had differing substrates, absorber deposition processes, buffer materials, and contact materials. The effective bandgaps of devices varied from 1.05 to 1.22 eV, with the lowest optical bandgaps occurring in those with metal-precursor absorber processes. Devices with Zn(O, S) or thin CdS buffers had quantum efficiencies above 90% down to 400 nm. Most voltages were 250-300 mV below the Shockley-Queisser limit for their bandgap. Electroluminescence intensity tracked well with the respective voltage deficits. Fill factor (FF) was as high as 95% of the maximum for each device'smore » respective current and voltage, with higher FF corresponding to lower diode quality factors (~1.3). An in-depth analysis of FF losses determined that diode quality reflected in the quality factor, voltage-dependent photocurrent, and, to a lesser extent, the parasitic resistances are the limiting factors. As a result, different absorber processes and device structures led to a range of electrical and physical characteristics, yet this investigation showed that multiple fabrication pathways could lead to high-quality and high-efficiency solar cells.« less
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Comparison of CIGS solar cells made with different structures and fabrication techniques
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mansfield, Lorelle M.; Garris, Rebekah L.; Counts, Kahl D.
Cu(In, Ga)Se2 (CIGS)-based solar cells from six fabricators were characterized and compared. The devices had differing substrates, absorber deposition processes, buffer materials, and contact materials. The effective bandgaps of devices varied from 1.05 to 1.22 eV, with the lowest optical bandgaps occurring in those with metal-precursor absorber processes. Devices with Zn(O, S) or thin CdS buffers had quantum efficiencies above 90% down to 400 nm. Most voltages were 250-300 mV below the Shockley-Queisser limit for their bandgap. Electroluminescence intensity tracked well with the respective voltage deficits. Fill factor (FF) was as high as 95% of the maximum for each device'smore » respective current and voltage, with higher FF corresponding to lower diode quality factors (~1.3). An in-depth analysis of FF losses determined that diode quality reflected in the quality factor, voltage-dependent photocurrent, and, to a lesser extent, the parasitic resistances are the limiting factors. As a result, different absorber processes and device structures led to a range of electrical and physical characteristics, yet this investigation showed that multiple fabrication pathways could lead to high-quality and high-efficiency solar cells.« less
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Bach, Vibe; Mikkelsen, Laerke; Kidmose, Ulla; Edelenbos, Merete
2015-07-01
Beetroot is a diverse vegetable available in different shapes and colours. The objectives of this study were to evaluate sensory qualities, and sugar and dry matter content of five beetroot varieties in relationship to the appropriateness for raw, boiled and pan-fried preparation. Sensory evaluation by descriptive sensory analysis and consumer tests showed clear distinctions between red varieties Taunus, Rocket and Pablo, and the pink-white striped Chioggia and yellow Burpee's Golden in raw preparations. However, variety delimination was more difficult after boiling and pan-frying. Different sensory qualities were important for beetroot appropriateness in raw, boiled and pan-fried preparations. Appropriateness of raw beetroots was associated with high sensory scores in beetroot flavour, crispness and juiciness, and low scores in bitterness. Appropriateness of boiled beetroots was related to high scores in beetroot and earthy flavours. Pan-fried beetroot appropriateness was associated with high scores in beetroot flavour, colour intensity and crispness. This study showed that the quality of raw materials is integral in culinary preparations. These results can be used to guide consumers in the use of beetroot in culinary preparations and subsequently increase consumption. © 2014 Society of Chemical Industry.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Dollar, Franklin; Matsuoka, Takeshi; McGuffey, Christopher
2010-11-04
Recent simulations show that an idealized, high intensity, short pulse laser can generate quasi-monoenergetic proton beams with energies over 100 MeV in an interaction with a thin film. However, most short pulse laser facilities with sufficient intensity have difficulty controlling the nanosecond and picosecond contrast necessary to realize such a regime. Experiments were performed to investigate proton and ion acceleration from a high contrast, short pulse laser by employing dual plasma mirrors along with a deformable mirror at the HERCULES laser facility at the Center for Ultrafast Optical Sciences, University of Michigan. Plasma mirrors were characterized, allowing a 50% throughputmore » with an intensity contrast increase of 105. The focal spot quality was also exceptional, showing a 1.1 micron full width at half maximum (FWHM) focal diameter. Experiments were done using temporally cleaned 30 TW, 32 fs pulses to achieve an intensity of up to 10{sup 21} Wcm{sup -2} on Si{sub 3}N{sub 4} and Mylar targets with thicknesses ranging 50 nm to 13 microns. Proton beams with energy spreads below 2 MeV were observed from all thicknesses, peaking with energies up to 10.3 MeV and an energy spread of 0.8 MeV. Similar narrow energy spreads were observed for oxygen, nitrogen, and carbon at the silicon nitride thickness of 50 nm with energies up to 24 MeV with an energy spread of 3 MeV, whereas the energy spread is greatly increased at a larger thickness. Maximum energies were confirmed with CR39 track detectors, while a Thomson ion spectrometer was used to gauge the monoenergetic nature of the beam.« less
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Hellard, Philippe; Avalos, Marta; Millet, Gregoire; Lacoste, Lucien; Barale, Frederic; Chatard, Jean-Claude
2005-02-01
The aim of this study was to model the residual effects of training on the swimming performance and to compare a model that includes threshold saturation (MM) with the Banister model (BM). Seven Olympic swimmers were studied over a period of 4 +/- 2 years. For 3 training loads (low-intensity w(LIT), high-intensity w(HIT), and strength training w(ST)), 3 residual training effects were determined: short-term (STE) during the taper phase (i.e., 3 weeks before the performance [weeks 0, 1, and 2]), intermediate-term (ITE) during the intensity phase (weeks 3, 4, and 5), and long-term (LTE) during the volume phase (weeks 6, 7, and 8). ITE and LTE were positive for w(HIT) and w(LIT), respectively (p < 0.05). Low-intensity training load during taper was related to performances by a parabolic relationship (p < 0.05). Different quality measures indicated that MM compares favorably with BM. Identifying individual training thresholds may help individualize the distribution of training loads.
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Design of High Quality Chemical XOR Gates with Noise Reduction.
Wood, Mackenna L; Domanskyi, Sergii; Privman, Vladimir
2017-07-05
We describe a chemical XOR gate design that realizes gate-response function with filtering properties. Such gate-response function is flat (has small gradients) at and in the vicinity of all the four binary-input logic points, resulting in analog noise suppression. The gate functioning involves cross-reaction of the inputs represented by pairs of chemicals to produce a practically zero output when both are present and nearly equal. This cross-reaction processing step is also designed to result in filtering at low output intensities by canceling out the inputs if one of the latter has low intensity compared with the other. The remaining inputs, which were not reacted away, are processed to produce the output XOR signal by chemical steps that result in filtering at large output signal intensities. We analyze the tradeoff resulting from filtering, which involves loss of signal intensity. We also discuss practical aspects of realizations of such XOR gates. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
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[Chronic noncancer pain and patient education: a place for e-learning?].
Braillard, Olivia; Cedraschi, Christine; Jesaimani, Ameena; Piguet, Valérie
2015-06-24
Chronic non cancerous pain considerably limits the patients' quality of life. Yet, chronic non cancerous pain has a prevalence as high as 25% to 35%, Therapeutic education allows to work on the knowledge and know-how about the disease, the treatment, the management of health resources and health behaviors. E-learning uses new technologies of communication to improve the quality of learning by facilitating access to the resources and favoring the interactivity. It is attractive by its wide accessibility and its limited logistic needs. The level of proof of its efficacy is weak, mainly because of methodological limitations. Some good quality studies are promising, with a positive effect of e-learning programs on pain intensity, disability, autonomy and medication misuse.
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Metal and nutrient dynamics on an aged intensive green roof.
Speak, A F; Rothwell, J J; Lindley, S J; Smith, C L
2014-01-01
Runoff and rainfall quality was compared between an aged intensive green roof and an adjacent conventional roof surface. Nutrient concentrations in the runoff were generally below Environmental Quality Standard (EQS) values and the green roof exhibited NO3(-) retention. Cu, Pb and Zn concentrations were in excess of EQS values for the protection of surface water. Green roof runoff was also significantly higher in Fe and Pb than on the bare roof and in rainfall. Input-output fluxes revealed the green roof to be a potential source of Pb. High concentrations of Pb within the green roof soil and bare roof dusts provide a potential source of Pb in runoff. The origin of the Pb is likely from historic urban atmospheric deposition. Aged green roofs may therefore act as a source of legacy metal pollution. This needs to be considered when constructing green roofs with the aim of improving pollution remediation. Copyright © 2013 Elsevier Ltd. All rights reserved.
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NASA Astrophysics Data System (ADS)
Izyumskaya, N.; Okur, S.; Zhang, F.; Monavarian, M.; Avrutin, V.; Özgür, Ü.; Metzner, S.; Karbaum, C.; Bertram, F.; Christen, J.; Morkoç, H.
2014-03-01
Nonpolar m-plane GaN layers were grown on patterned Si (112) substrates by metal-organic chemical vapor deposition (MOCVD). A two-step growth procedure involving a low-pressure (30 Torr) first step to ensure formation of the m-plane facet and a high-pressure step (200 Torr) for improvement of optical quality was employed. The layers grown in two steps show improvement of the optical quality: the near-bandedge photoluminescence (PL) intensity is about 3 times higher than that for the layers grown at low pressure, and deep emission is considerably weaker. However, emission intensity from m-GaN is still lower than that of polar and semipolar (1 100 ) reference samples grown under the same conditions. To shed light on this problem, spatial distribution of optical emission over the c+ and c- wings of the nonpolar GaN/Si was studied by spatially resolved cathodoluminescence and near-field scanning optical microscopy.
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Water-cooled, high-intensity ultrasound surgical applicators with frequency tracking.
Martin, Roy W; Vaezy, Shahram; Proctor, Andrew; Myntti, Terrence; Lee, Janelle B J; Crum, Lawrence A
2003-10-01
High-intensity, focused ultrasound (HIFU) applicators have been developed for arresting bleeding with the ultimate intent of use in surgery. The design uses a tapered titanium component for transmission coupling of the ultrasound energy from a spherically curved transducer to biological tissues. The nominal operating frequency is 5.5 MHz, in a highly resonant mode (quality factor of 327 with water load). Liquid cooling is used to remove energy loss important at net applied power greater than 18 W/cm2 at the surface of the piezoelectric element. A downward resonance frequency shift (>20 kHz) occurs, even with cooling, as the applicator warms with normal operation. A feedback technique is used for maintaining the excitation near optimum resonance. Standing wave ratios of the applied power of 1.6 or less are thus sustained. The system and applicators have been found to be highly robust, effective in achieving hemostasis in the hemorrhaging liver, spleen, lung, or blood vessels in rabbit and pig experiments. One unit has been operated for over 1.7 hours in treating organ hemorrhage in blunt trauma experiments with nine swine with electrical net power of up to 158 W (31 W/cm2 across the transducer) and intensity of 2560 W/cm2 at focus.
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Smith, Thomas J
2012-01-01
This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.
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Changing personnel behavior to promote quality care practices in an intensive care unit
Cooper, Dominic; Farmery, Keith; Johnson, Martin; Harper, Christine; Clarke, Fiona L; Holton, Phillip; Wilson, Susan; Rayson, Paul; Bence, Hugh
2005-01-01
The delivery of safe high quality patient care is a major issue in clinical settings. However, the implementation of evidence-based practice and educational interventions are not always effective at improving performance. A staff-led behavioral management process was implemented in a large single-site acute (secondary and tertiary) hospital in the North of England for 26 weeks. A quasi-experimental, repeated-measures, within-groups design was used. Measurement focused on quality care behaviors (ie, documentation, charting, hand washing). The results demonstrate the efficacy of a staff-led behavioral management approach for improving quality-care practices. Significant behavioral change (F [6, 19] = 5.37, p < 0.01) was observed. Correspondingly, statistically significant (t-test [t] = 3.49, df = 25, p < 0.01) reductions in methicillin-resistant Staphylococcus aureus (MRSA) were obtained. Discussion focuses on implementation issues. PMID:18360574
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Effects of radiation quality, intensity, and duration on photosynthesis and growth
NASA Technical Reports Server (NTRS)
Bugbee, Bruce
1994-01-01
Differences in radiation quality from the six most common electric lamps have little effect on photosynthetic rate. Radiation quality primarily alters growth because of changes in branching or internode elongation, which change radiation absorption. Growth and yield in wheat appear to be insensitive to radiation quality. Growth and yield in soybeans can be slightly increased under high pressure sodium (HPS) lamps compared to metal halide lamps, in spite of greatly reduced chlorophyll concentrations under HPS lamps. Daily integrated photosynthetic photon flux (mol m(exp -2)d(exp -1)) most directly determines leaf anatomy and growth. Photosynthetic photon flux (PPF) levels of 800 (mu)mol m(exp -2)s(exp -1) are adequate to simulate field daily-integrated PPF levels for both short and long day plants, but plant canopies can benefit from much higher PPF levels.
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Effects of radiation quality, intensity, and duration on photosynthesis and growth
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bugbee, B.
1994-12-31
Differences in radiation quality from the six most common electric lamps have little effect on photosynthetic rate. Radiation quality primarily alters growth because of changes in branching or internode elongation, which change radiation absorption. Growth and yield in wheat appear to be insensitive to radiation quality. Growth and yield in soybeans can be slightly increased under high pressure sodium lamps compared to metal halide lamps, in spite of greatly reduced chlorophyll concentrations under HPS lamps. Daily integrated photosynthetic photon flux (mol m{sup -2} d{sup -1}) most directly determines leaf anatomy and growth. Photosynthetic photon flux levels of 800 {mu}mol m{supmore » -2} s{sup -1} are adequate to simulate field daily-integrated PPF levels for both short and long day plants, but plant canopies can benefit from much higher PPF levels.« less
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Haddock, Luis J; Kim, David Y; Mukai, Shizuo
2013-01-01
Purpose. We describe in detail a relatively simple technique of fundus photography in human and rabbit eyes using a smartphone, an inexpensive app for the smartphone, and instruments that are readily available in an ophthalmic practice. Methods. Fundus images were captured with a smartphone and a 20D lens with or without a Koeppe lens. By using the coaxial light source of the phone, this system works as an indirect ophthalmoscope that creates a digital image of the fundus. The application whose software allows for independent control of focus, exposure, and light intensity during video filming was used. With this app, we recorded high-definition videos of the fundus and subsequently extracted high-quality, still images from the video clip. Results. The described technique of smartphone fundus photography was able to capture excellent high-quality fundus images in both children under anesthesia and in awake adults. Excellent images were acquired with the 20D lens alone in the clinic, and the addition of the Koeppe lens in the operating room resulted in the best quality images. Successful photodocumentation of rabbit fundus was achieved in control and experimental eyes. Conclusion. The currently described system was able to take consistently high-quality fundus photographs in patients and in animals using readily available instruments that are portable with simple power sources. It is relatively simple to master, is relatively inexpensive, and can take advantage of the expanding mobile-telephone networks for telemedicine.
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ISO 9001 in a neonatal intensive care unit (NICU).
Vitner, Gad; Nadir, Erez; Feldman, Michael; Yurman, Shmuel
2011-01-01
The aim of this paper is to present the process for approving and certifying a neonatal intensive care unit to ISO 9001 standards. The process started with the department head's decision to improve services quality before deciding to achieve ISO 9001 certification. Department processes were mapped and quality management mechanisms were developed. Process control and performance measurements were defined and implemented to monitor the daily work. A service satisfaction review was conducted to get feedback from families. In total, 28 processes and related work instructions were defined. Process yields showed service improvements. Family satisfaction improved. The paper is based on preparing only one neonatal intensive care unit to the ISO 9001 standard. The case study should act as an incentive for hospital managers aiming to improve service quality based on the ISO 9001 standard. ISO 9001 is becoming a recommended tool to improve clinical service quality.
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Marta, Ilda Estefani Ribeiro; Baldan, Sueli Santiago; Berton, Ani Fabiana; Pavam, Michele; da Silva, Maria Júlia Paes
2010-12-01
This research aimed to check the effectiveness of Therapeutic Touch on decreased pain intensity, depression self-assessment scores and improved sleep quality. A clinical before-after trial is presented. The study was carried out at a Basic Health Unit in Fernandópolis, SP-Brazil, involving 30 elderly patients with chronic non-oncologic pain who received 8 sessions of Therapeutic Touch in accordance with the Krieger-Kunz method. The Visual Analogue Scale for pain was applied before and after each session, and Beck Depression Inventory and the Pittsburgh Sleep Quality Index before the first and after the last session. Data analysis showed a significant decrease (p < 0.05) in pain intensity, depression self-assessment scores and the sleep quality index. It is concluded that the Therapeutic Touch was effective to decrease pain intensity and depressive attitudes and symptoms, as well as to improve sleep quality.
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Direct generation of all-optical random numbers from optical pulse amplitude chaos.
Li, Pu; Wang, Yun-Cai; Wang, An-Bang; Yang, Ling-Zhen; Zhang, Ming-Jiang; Zhang, Jian-Zhong
2012-02-13
We propose and theoretically demonstrate an all-optical method for directly generating all-optical random numbers from pulse amplitude chaos produced by a mode-locked fiber ring laser. Under an appropriate pump intensity, the mode-locked laser can experience a quasi-periodic route to chaos. Such a chaos consists of a stream of pulses with a fixed repetition frequency but random intensities. In this method, we do not require sampling procedure and external triggered clocks but directly quantize the chaotic pulses stream into random number sequence via an all-optical flip-flop. Moreover, our simulation results show that the pulse amplitude chaos has no periodicity and possesses a highly symmetric distribution of amplitude. Thus, in theory, the obtained random number sequence without post-processing has a high-quality randomness verified by industry-standard statistical tests.
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Phase-shifting point diffraction interferometer
Medecki, H.
1998-11-10
Disclosed is a point diffraction interferometer for evaluating the quality of a test optic. In operation, the point diffraction interferometer includes a source of radiation, the test optic, a beam divider, a reference wave pinhole located at an image plane downstream from the test optic, and a detector for detecting an interference pattern produced between a reference wave emitted by the pinhole and a test wave emitted from the test optic. The beam divider produces separate reference and test beams which focus at different laterally separated positions on the image plane. The reference wave pinhole is placed at a region of high intensity (e.g., the focal point) for the reference beam. This allows reference wave to be produced at a relatively high intensity. Also, the beam divider may include elements for phase shifting one or both of the reference and test beams. 8 figs.
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Phase-shifting point diffraction interferometer
Medecki, Hector
1998-01-01
Disclosed is a point diffraction interferometer for evaluating the quality of a test optic. In operation, the point diffraction interferometer includes a source of radiation, the test optic, a beam divider, a reference wave pinhole located at an image plane downstream from the test optic, and a detector for detecting an interference pattern produced between a reference wave emitted by the pinhole and a test wave emitted from the test optic. The beam divider produces separate reference and test beams which focus at different laterally separated positions on the image plane. The reference wave pinhole is placed at a region of high intensity (e.g., the focal point) for the reference beam. This allows reference wave to be produced at a relatively high intensity. Also, the beam divider may include elements for phase shifting one or both of the reference and test beams.
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Elez-Martínez, Pedro; Soliva-Fortuny, Robert; Martín-Belloso, Olga
2009-05-01
Novel non-thermal processing technologies such as high-intensity pulsed electric field (HIPEF) treatments may be applied to pasteurize plant-based liquid foods as an alternative to conventional heat treatments. In recent years, there has been an increasing interest in HIPEF as a way of preserving and extending the shelf-life of liquid products without the quality damage caused by heat treatments. However, less attention has been paid to the effects of HIPEF on minor constituents of these products, namely bioactive compounds. This review is a state-of-the-art update on the effects of HIPEF treatments on health-related compounds in plants of the Mediterranean diet such as fruit juices, and Spanish gazpacho. The relevance of HIPEF-processing parameters on retaining plant-based bioactive compounds will be discussed.
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7 CFR 29.1006 - Color intensity.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 7 Agriculture 2 2011-01-01 2011-01-01 false Color intensity. 29.1006 Section 29.1006 Agriculture... Type 92) § 29.1006 Color intensity. The varying degree of saturation or chroma. Color intensity as applied to tobacco describes the strength or weakness of a specific color or hue. (See Elements of Quality...
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7 CFR 29.1006 - Color intensity.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 7 Agriculture 2 2013-01-01 2013-01-01 false Color intensity. 29.1006 Section 29.1006 Agriculture... Type 92) § 29.1006 Color intensity. The varying degree of saturation or chroma. Color intensity as applied to tobacco describes the strength or weakness of a specific color or hue. (See Elements of Quality...
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7 CFR 29.1006 - Color intensity.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 7 Agriculture 2 2012-01-01 2012-01-01 false Color intensity. 29.1006 Section 29.1006 Agriculture... Type 92) § 29.1006 Color intensity. The varying degree of saturation or chroma. Color intensity as applied to tobacco describes the strength or weakness of a specific color or hue. (See Elements of Quality...
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7 CFR 29.1006 - Color intensity.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 7 Agriculture 2 2014-01-01 2014-01-01 false Color intensity. 29.1006 Section 29.1006 Agriculture... Type 92) § 29.1006 Color intensity. The varying degree of saturation or chroma. Color intensity as applied to tobacco describes the strength or weakness of a specific color or hue. (See Elements of Quality...
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7 CFR 29.1006 - Color intensity.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 2 2010-01-01 2010-01-01 false Color intensity. 29.1006 Section 29.1006 Agriculture... Type 92) § 29.1006 Color intensity. The varying degree of saturation or chroma. Color intensity as applied to tobacco describes the strength or weakness of a specific color or hue. (See Elements of Quality...
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Core stability exercises for low back pain in athletes: a systematic review of the literature.
Stuber, Kent J; Bruno, Paul; Sajko, Sandy; Hayden, Jill A
2014-11-01
The aim of this study was to systematically review the evidence for the effectiveness of core stability exercises for treating athletes with low back pain (LBP). We searched several databases (Medline, AMED, CINAHL, SportDiscus, and EMBASE). Our eligibility criteria consisted of articles published in a peer-reviewed journal in English, using any prospective clinical study design, where athletes with nonspecific LBP were treated with core stability exercises in at least 1 study arm, and back pain intensity and/or disability were used as outcome measures. All included randomized controlled trials (RCTs) were assessed for risk of bias using the Cochrane Risk of Bias tool, whereas non-RCT studies were assessed for quality using the Downs and Black checklist. Five studies including 151 participants met the inclusion criteria, including 2 RCTs. The quality of the literature on this topic was deemed to be low overall, with only 1 non-RCT having a moderate quality score, and 1 RCT having a lower risk of bias. Four studies reported statistically significant decreases in back pain intensity in their core stability intervention group. The quantity and quality of literature on the use of core stability exercises for treating LBP in athletes is low. The existing evidence has been conducted on small and heterogeneous study populations using interventions that vary drastically with only mixed results and short-term follow-up. This precludes the formulation of strong conclusions, and additional high quality research is clearly needed.
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Healthcare professionals' views of smart glasses in intensive care: A qualitative study.
Romare, Charlotte; Hass, Ursula; Skär, Lisa
2018-04-01
The aim of this study was to describe healthcare professionals' views of smart glasses before their implementation in an intensive care unit, both regarding quality of use of the glasses and to identify possible intensive care situations where the glasses could be used to increase patient safety. Data were generated through focus group interviews and analysed using thematic content analysis. The findings describe participants' views of smart glasses divided into three categories; Smart glasses to facilitate work at intensive care unit; Quality of use and Utilisation. Participants assumed smart glasses to cause both effect and affect in intensive care. Participants' concern for patients arose recurrently and through their concern intention to work to promote patient safety. Smart glasses are suggested as a complement to existing monitoring and routines and cannot replace human presence in intensive care. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
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NASA Astrophysics Data System (ADS)
Prayogo; Rahardja, B. S.; Asshanti, A. N.; Dewi, N. N.; Santanumurti, M. B.
2018-04-01
Intensive African catfish culture in tarpaulin pond was popular in Banyuwangi, Indonesia since the government supported the fisheries sector. Unfortunately, the failure of African catfish culture still occurred since the waste from fish metabolite process and feed residue decreased the water quality. Bacteria in the water could be the solution to increase the success rate of aquaculture by improving the water quality. This study purpose was to obtained indigenous bacteria in intensive aquaculture system of African catfish to improve water quality. This study successfully isolated bacteria contained with amylase, protease and lipase characteristic. Isolated bacteria in this study were identified as Pseudomonas pseudomallei (97.81%), Bacillus subtilis (95.81%) and Pseudomonas stutzeri (61.21%).
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Gurses, Ayse P; Carayon, Pascale; Wall, Melanie
2009-01-01
Objectives To study the impact of performance obstacles on intensive care nurses‘ workload, quality and safety of care, and quality of working life (QWL). Performance obstacles are factors that hinder nurses‘ capacity to perform their job and that are closely associated with their immediate work system. Data Sources/Study Setting Data were collected from 265 nurses in 17 intensive care units (ICUs) between February and August 2004 via a structured questionnaire, yielding a response rate of 80 percent. Study Design A cross-sectional study design was used. Data were analyzed by correlation analyses and structural equation modeling. Principal Findings Performance obstacles were found to affect perceived quality and safety of care and QWL of ICU nurses. Workload mediated the impact of performance obstacles with the exception of equipment-related issues on perceived quality and safety of care as well as QWL. Conclusions Performance obstacles in ICUs are a major determinant of nursing workload, perceived quality and safety of care, and QWL. In general, performance obstacles increase nursing workload, which in turn negatively affect perceived quality and safety of care and QWL. Redesigning the ICU work system to reduce performance obstacles may improve nurses‘ work. PMID:19207589
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Baena-Beato, Pedro Ángel; Artero, Enrique G; Arroyo-Morales, Manuel; Robles-Fuentes, Alejandro; Gatto-Cardia, María Claudia; Delgado-Fernández, Manuel
2014-04-01
To determine the effects of a two-month intensive aquatic therapy programme on back pain, disability, quality of life, body composition and health-related fitness in sedentary adults with chronic low back pain. Controlled clinical trial. Community. Forty-nine sedentary patients with chronic low back pain. Patients were allocated into active group (n = 24, two months, five times/week) or waiting list, control group (n = 25) according to space on the programme. Outcomes variables were pain (visual analogue scale), disability (Oswestry Disability Index), quality of life (Quality Short-Form Health Survey 36), body composition (weight, body mass index, body fat percentage and skeletal muscle mass) and health-related fitness (sit-and-reach, handgrip strength, curl-up, Rockport 1-mile test). The active group significantly improved low back pain (-3.83 ± 0.35 mm on the visual analogue scale ), disability (-12.7 ± 1.3 points for the Oswestry Disability Index) and the standardized physical component (10.3 ± 1.4 points for the Quality Short-Form Health Survey 36) of quality-of-life domains (P < 0.001), with no significant changes on the standardized mental component (P = 0.114). In relation to body composition and fitness, the active group showed significant improvements (all P-values < 0.01). The control group presented no significant change in any parameter. A two-month intensive aquatic therapy programme of high-frequency (five times/week) decreases levels of back pain and disability, increases quality of life, and improves body composition and health-related fitness in sedentary adults with chronic low back pain.
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Different Polar Metabolites and Protein Profiles between High- and Low-Quality Japanese Ginjo Sake
Takahashi, Kei; Kohno, Hiromi
2016-01-01
Japanese ginjo sake is a premium refined sake characterized by a pleasant fruity apple-like flavor and a sophisticated taste. Because of technical difficulties inherent in brewing ginjo sake, off-flavors sometimes occur. However, the metabolites responsible for off-flavors as well as those present or absent in higher quality ginjo sake remain uncertain. Here, the relationship between 202 polar chemical compounds in sake identified using capillary electrophoresis coupled with time-of-flight mass spectrometry and its organoleptic properties, such as quality and off-flavor, was examined. First, we found that some off-flavored sakes contained higher total amounts of metabolites than other sake samples. The results also identified that levels of 2-oxoglutaric acid and fumaric acid, metabolites in the tricarboxylic acid cycle, were highly but oppositely correlated with ginjo sake quality. Similarly, pyridoxine and pyridoxamine, co-enzymes for amino transferase, were also highly but oppositely correlated with ginjo sake quality. Additionally, pyruvic acid levels were associated with good quality as well. Compounds involved in the methionine salvage cycle, oxidative glutathione derivatives, and amino acid catabolites were correlated with low quality. Among off-flavors, an inharmonious bitter taste appeared attributable to polyamines. Furthermore, protein analysis displayed that a diversity of protein components and yeast protein (triosephosphate isomerase, TPI) leakage was linked to the overall metabolite intensity in ginjo sake. This research provides insight into the relationship between sake components and organoleptic properties. PMID:26939054
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NASA Astrophysics Data System (ADS)
Tamura, Fumihiko; Hotchi, Hideaki; Schnase, Alexander; Yoshii, Masahito; Yamamoto, Masanobu; Ohmori, Chihiro; Nomura, Masahiro; Toda, Makoto; Shimada, Taihei; Hasegawa, Katsushi; Hara, Keigo
2015-09-01
The rapid cycling synchrotron (RCS) in the Japan Proton Accelerator Research Complex (J-PARC) was originally designed to accelerate two high intensity bunches, while some of neutron experiments in the materials and life science experimental facility and a muon experiment using main ring beams require a single bunch operation mode, in which one of the two rf buckets is filled and the other is empty. The beam intensity in the single bunch operation has been limited by longitudinal beam losses due to the rf bucket distortions by the wake voltage of the odd harmonics (h =1 ,3 ,5 ) in the wide band magnetic alloy cavities. We installed an additional rf feedforward system to compensate the wake voltages of the odd harmonics (h =1 ,3 ,5 ). The additional system has a similar structure as the existing feedforward system for the even harmonics (h =2 ,4 ,6 ). We describe the function of the feedforward system for the odd harmonics, the commissioning methodology, and the commissioning results. The longitudinal beam losses during the single bunch acceleration disappeared with feedforward for the odd harmonics. We also confirmed that the beam quality in the single bunch acceleration are similar to that of the normal operation with two bunches. Thus, high intensity single bunch acceleration at the intensity of 2.3 ×1013 protons per bunch has been achieved in the J-PARC RCS. This article is a follow-up of our previous article, Phys. Rev. ST Accel. Beams 14, 051004 (2011). The feedforward system extension for single bunch operation was successful.
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Space Network Ground Segment Sustainment (SGSS) Project: Developing a COTS-Intensive Ground System
NASA Technical Reports Server (NTRS)
Saylor, Richard; Esker, Linda; Herman, Frank; Jacobsohn, Jeremy; Saylor, Rick; Hoffman, Constance
2013-01-01
Purpose of the Space Network Ground Segment Sustainment (SGSS) is to implement a new modern ground segment that will enable the NASA Space Network (SN) to deliver high quality services to the SN community for the future The key SGSS Goals: (1) Re-engineer the SN ground segment (2) Enable cost efficiencies in the operability and maintainability of the broader SN.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Halavanau, A.; Eddy, N.; Edstrom, D.
Superconducting linacs are capable of producing intense, ultra-stable, high-quality electron beams that have widespread applications in Science and Industry. Many project are based on the 1.3-GHz TESLA-type superconducting cavity. In this paper we provide an update on a recent experiment aimed at measuring the transfer matrix of a TESLA cavity at the Fermilab Accelerator Science and Technology (FAST) facility. The results are discussed and compared with analytical and numerical simulations.
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ERIC Educational Resources Information Center
Association for Children of New Jersey, 2004
2004-01-01
In an attempt to better prepare young children for the challenges of kindergarten and first grade, the Supreme Court of New Jersey, in its 1998 landmark decision of "Abbott v. Burke" (Abbott V), required the State's poorest school districts to implement high quality, intensive preschool for all 3-and 4-year old children. To take…
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A.R. Weiskittel; S.M. Garber; G.P. Johnson; D.A. Maguire; R.A. Monserud
2007-01-01
Simulating the influence of intensive management and annual weather fluctuations on tree growth requires a shorter time step than currently employed by most regional growth models. High-quality data sets are available for several plantation species in the Pacific Northwest region of the United States, but the growth periods ranged from 2 to 12 years. Measurement...
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ERIC Educational Resources Information Center
Burgan, Mary
2005-01-01
Hiring new colleagues is a matter that engages individual faculty members intensely, for peer control of admission to the professoriate has been a highly successful source of academic quality in American higher education. "Super Stars and Rookies of the Year" analyzes the fixation on research acclaim as a negative version of academic hiring…
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Benda, Nathalie M M; Seeger, Joost P H; Stevens, Guus G C F; Hijmans-Kersten, Bregina T P; van Dijk, Arie P J; Bellersen, Louise; Lamfers, Evert J P; Hopman, Maria T E; Thijssen, Dick H J
2015-01-01
Physical fitness is an important prognostic factor in heart failure (HF). To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT). We comprehensively compared effects of HIT versus continuous training (CT) in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT. Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6%) were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload-alternated by 2.5 minutes at 30% maximal workload) or CT (30 minutes at 60-75% of maximal workload). Before and after intervention, we examined physical fitness (incremental cycling test), cardiac function and structure (echocardiography), vascular function and structure (ultrasound) and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ)). Training improved maximal workload, peak oxygen uptake (VO2peak) related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all P<0.05), whilst no differences were present between HIT and CT (N.S.). We found no major changes in resting cardiovascular function and structure. SF-36 physical function score improved after training (P<0.05), whilst SF-36 total score and MLHFQ did not change after training (N.S.). Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III. Nederlands Trial Register NTR3671.
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Structured Laguerre-Gaussian beams for mitigation of spherical aberration in tightly focused regimes
NASA Astrophysics Data System (ADS)
Haddadi, S.; Bouzid, O.; Fromager, M.; Hasnaoui, A.; Harfouche, A.; Cagniot, E.; Forbes, A.; Aït-Ameur, K.
2018-04-01
Many laser applications utilise a focused laser beam having a single-lobed intensity profile in the focal plane, ideally with the highest possible on-axis intensity. Conventionally, this is achieved with the lowest-order Laguerre-Gaussian mode (LG00), the Gaussian beam, in a tight focusing configuration. However, tight focusing often involves significant spherical aberration due to the high numerical aperture of the systems involved, thus degrading the focal quality. Here, we demonstrate that a high-order radial LG p0 mode can be tailored to meet and in some instances exceed the performance of the Gaussian. We achieve this by phase rectification of the mode using a simple binary diffractive optic. By way of example, we show that the focusing of a rectified LG50 beam is almost insensitive to a spherical aberration coefficient of over three wavelengths, in contrast with the usual Gaussian beam for which the intensity of the focal spot is reduced by a factor of two. This work paves the way towards enhanced focal spots using structured light.
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Integrating Markets to Bridge Supply and Demand for Knowledge Intensive Tasks
NASA Astrophysics Data System (ADS)
Overbeek, Sietse; Janssen, Marijn; van Bommel, Patrick
The advent of the knowledge-based economy has underlined the importance of intellectual capital that is possessed by knowledge intensive organizations. Three general observations of knowledge intensive work produced by actors working in such organizations served as the basis for the initiation of this research. First, knowledge intensive tasks become increasingly complex. Second, actors that perform such tasks experience an increase in cognitive load. Third, the desired quality of task performance and the produced task results are at stake due to the aforementioned two developments. In this research we investigate how supply and demand of intangible assets such as knowledge, cognitive characteristics, and quality factors can be matched based on market mechanisms.
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DOE Office of Scientific and Technical Information (OSTI.GOV)
Braly, Ian L.; Hillhouse, Hugh W.
The development of stable high-bandgap hybrid perovskites (HPs) with high optoelectronic quality may enable tandem solar cells with power conversion efficiencies approaching 30%. The halide composition of HPs has been observed to effect bandgap, carrier lifetime, and material stability. Here we report optoelectronic quality and stability under illumination of thousands of compositions ranging from the pure iodide (CH3NH3PbI3) to the diiodomonobromide (CH3NH3PbI2Br). Hyperspectral maps of steady-state absolute intensity photoluminescence (AIPL) are used to determine the quasi-Fermi level splitting (QFLS) at each point after synthesis. The QFLS upon first illumination increases with bandgap and reaches a maximum of 1.27 eV undermore » 1 sun illumination intensity for a bandgap of 1.75 eV. However, the optoelectronic quality (χ), defined as the ratio of the QFLS to the maximum theoretical QFLS for bandgap, decreases with bandgap from around 88% for 1.60 eV bandgap down to 82% for 1.84 eV bandgap. Further, we show that a reversible light induced defect forms that reduces the optoelectronic quality, particularly for high-bandgap materials. Composition analysis shows that the halide to lead ratio, (I + Br)/Pb, decreases from 3 for the pure iodide to 2.5 for the diiodomonobromide, suggesting a role of halide vacancies or halide substitution defects in the light-induced instability for this synthesis route. Even with the light-induced defect, a stable QFLS of about 1.17 eV is possible. Comparing our QFLS to Voc values from HP devices reported in the literature indicates that higher open circuit voltages are possible but may require optimization of band alignment. Further, the spectral shape of the PL emission is found to be more commensurate with Franz–Keldysh broadening from local electric fields or from a screened Thomas–Fermi density of states (as opposed to a joint density of states due to Urbach disorder).« less
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Biofield Therapies: Helpful or Full of Hype? A Best Evidence Synthesis
Mills, Paul J.
2009-01-01
Background Biofield therapies (such as Reiki, therapeutic touch, and healing touch) are complementary medicine modalities that remain controversial and are utilized by a significant number of patients, with little information regarding their efficacy. Purpose This systematic review examines 66 clinical studies with a variety of biofield therapies in different patient populations. Method We conducted a quality assessment as well as a best evidence synthesis approach to examine evidence for biofield therapies in relevant outcomes for different clinical populations. Results Studies overall are of medium quality, and generally meet minimum standards for validity of inferences. Biofield therapies show strong evidence for reducing pain intensity in pain populations, and moderate evidence for reducing pain intensity hospitalized and cancer populations. There is moderate evidence for decreasing negative behavioral symptoms in dementia and moderate evidence for decreasing anxiety for hospitalized populations. There is equivocal evidence for biofield therapies' effects on fatigue and quality of life for cancer patients, as well as for comprehensive pain outcomes and affect in pain patients, and for decreasing anxiety in cardiovascular patients. Conclusion There is a need for further high-quality studies in this area. Implications and future research directions are discussed. Electronic supplementary material The online version of this article (doi:10.1007/s12529-009-9062-4) contains supplementary material, which is available to authorized users. PMID:19856109
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A genetic-based algorithm for personalized resistance training
Kiely, J; Suraci, B; Collins, DJ; de Lorenzo, D; Pickering, C; Grimaldi, KA
2016-01-01
Association studies have identified dozens of genetic variants linked to training responses and sport-related traits. However, no intervention studies utilizing the idea of personalised training based on athlete's genetic profile have been conducted. Here we propose an algorithm that allows achieving greater results in response to high- or low-intensity resistance training programs by predicting athlete's potential for the development of power and endurance qualities with the panel of 15 performance-associated gene polymorphisms. To develop and validate such an algorithm we performed two studies in independent cohorts of male athletes (study 1: athletes from different sports (n = 28); study 2: soccer players (n = 39)). In both studies athletes completed an eight-week high- or low-intensity resistance training program, which either matched or mismatched their individual genotype. Two variables of explosive power and aerobic fitness, as measured by the countermovement jump (CMJ) and aerobic 3-min cycle test (Aero3) were assessed pre and post 8 weeks of resistance training. In study 1, the athletes from the matched groups (i.e. high-intensity trained with power genotype or low-intensity trained with endurance genotype) significantly increased results in CMJ (P = 0.0005) and Aero3 (P = 0.0004). Whereas, athletes from the mismatched group (i.e. high-intensity trained with endurance genotype or low-intensity trained with power genotype) demonstrated non-significant improvements in CMJ (P = 0.175) and less prominent results in Aero3 (P = 0.0134). In study 2, soccer players from the matched group also demonstrated significantly greater (P < 0.0001) performance changes in both tests compared to the mismatched group. Among non- or low responders of both studies, 82% of athletes (both for CMJ and Aero3) were from the mismatched group (P < 0.0001). Our results indicate that matching the individual's genotype with the appropriate training modality leads to more effective resistance training. The developed algorithm may be used to guide individualised resistance-training interventions. PMID:27274104
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Chung, Kuo-Piao; Yu, Tsung-Hsien
2015-08-14
The relationship between the scope and intensity of quality improvement (QI) activities and hospital performance remains unclear. This study investigated the relationship between performance, external environment, and the scope and intensity of QI activities in hospitals. The study used a longitudinal observation. Data regarding the scope and intensity of QI activities were collected using a questionnaire survey among the administrative deputy superintendents / directors of quality management center in 139 hospitals. Hospital performance indicators were abstracted from the 2000-2009 national hospitals profiles. We adopted year 2000 as the baseline, and divided the study period into three 3-year periods. The Generalized Estimating Equations (GEE) model was used for the statistical analysis. Seventy-two hospitals responded to the survey, giving a response rate of 52%. The results showed a significant increase in the scope and intensity of QI activities between 2000 and 2009. The results also showed that the scope and intensity of a hospital's QI activities were associated with the scope and intensity of its competitors' QI activities in the previous period and its own prior performance. The scope of QI activities in the previous period was not significantly related to the selected hospital performance measures. However, the intensity of QI activities in the previous period showed a significant and positive relationship with the number of inpatients and the turnover of beds. The study demonstrates that the intensity of QI activities is associated with the external environment and the hospital's own performance in the previous period. Furthermore, some performance measures are associated with the intensity of the QI activities in the previous period.
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Zhang, Kexin; Zhang, Rui; Yu, Yaxin; Sun, Shuqing
2012-04-01
In this paper, we report a facile method to synthesize high quality CdS: Eu nanocrystals (NCs) and CdS: Eu/ZnS NCs with strong photoluminescence (PL). The influence of various experimental variables including the concentration of Eu3+ ions, the reaction time and the reaction temperature were investigated systematically. In addition, the PL properties of CdS: Eu NCs exhibited pH sensitive. Under the acid condition, pH value of the CdS: Eu NCs solution played an important role in determining PL emission intensity. However, under the alkaline condition, the obtained CdS: Eu NCs exhibited a tunable PL emission wavelength (from 490 nm to 610 nm) when pH value was adjusted from pH 7 to 10. After coating with ZnS shell, the CdS: Eu/ZnS NCs showed enhanced PL intensity compare with one of the CdS: Eu NCs. The CdS: Eu NCs and CdS: Eu/ZnS NCs were characterized by X-ray diffraction (XRD) and high-resolution transmission electron microscopy (HRTEM). In addition, the biocompatibility of these NCs was measured by hemolytic test, which indicated that CdS: Eu/ZnS NCs were more biocompatible than CdS: Eu NCs at the same conditions. It can be expected that CdS: Eu/ZnS NCs are promising biolabeling materials.
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Caruthers, Allison S.; Van Ryzin, Mark J.; Dishion, Thomas J.
2013-01-01
Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up; FCU) were later assessed for the intervention’s effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N = 998 adolescents and their families) were randomly assigned to a family-centered intervention in 6th grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23% of the intervention families engaged in the FCU and approximately 18% engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Further, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed. PMID:23536124
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Chang, Evelyn T; Zulman, Donna M; Asch, Steven M; Stockdale, Susan E; Yoon, Jean; Ong, Michael K; Lee, Martin; Simon, Alissa; Atkins, David; Schectman, Gordon; Kirsh, Susan R; Rubenstein, Lisa V
2018-06-01
Patient-centered medical homes have made great strides providing comprehensive care for patients with chronic conditions, but may not provide sufficient support for patients at highest risk for acute care use. To address this, the Veterans Health Administration (VHA) initiated a five-site demonstration project to evaluate the effectiveness of augmenting the VA's Patient Aligned Care Team (PACT) medical home with PACT Intensive Management (PIM) teams for Veterans at highest risk for hospitalization. Researchers partnered with VHA leadership to design a mixed-methods prospective multi-site evaluation that met leadership's desire for a rigorous evaluation conducted as quality improvement rather than research. We conducted a randomized QI evaluation and assigned high-risk patients to participate in PIM and compared them with high-risk Veterans receiving usual care through PACT. The summative evaluation examines whether PIM: 1) decreases VHA emergency department and hospital use; 2) increases satisfaction with VHA care; 3) decreases provider burnout; and 4) generates positive returns on investment. The formative evaluation aims to support improved care for high-risk patients at demonstration sites and to inform future initiatives for high-risk patients. The evaluation was reviewed by representatives from the VHA Office of Research and Development and the Office of Research Oversight and met criteria for quality improvement. VHA aims to function as a learning organization by rapidly implementing and rigorously testing QI innovations prior to final program or policy development. We observed challenges and opportunities in designing an evaluation consistent with QI standards and operations priorities, while also maintaining scientific rigor. This trial was retrospectively registered at ClinicalTrials.gov on April 3, 2017: NCT03100526. Protocol v1, FY14-17. Copyright © 2018 Elsevier Inc. All rights reserved.
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Topical capsaicin (high concentration) for chronic neuropathic pain in adults.
Derry, Sheena; Rice, Andrew Sc; Cole, Peter; Tan, Toni; Moore, R Andrew
2017-01-13
This review is an update of 'Topical capsaicin (high concentration) for chronic neuropathic pain in adults' last updated in Issue 2, 2013. Topical creams with capsaicin are used to treat peripheral neuropathic pain. Following application to the skin, capsaicin causes enhanced sensitivity, followed by a period with reduced sensitivity and, after repeated applications, persistent desensitisation. High-concentration (8%) capsaicin patches were developed to increase the amount of capsaicin delivered; rapid delivery was thought to improve tolerability because cutaneous nociceptors are 'defunctionalised' quickly. The single application avoids noncompliance. Only the 8% patch formulation of capsaicin is available, with a capsaicin concentration about 100 times greater than conventional creams. High-concentration topical capsaicin is given as a single patch application to the affected part. It must be applied under highly controlled conditions, often following local anaesthetic, due to the initial intense burning sensation it causes. The benefits are expected to last for about 12 weeks, when another application might be made. To review the evidence from controlled trials on the efficacy and tolerability of topically applied, high-concentration (8%) capsaicin in chronic neuropathic pain in adults. For this update, we searched CENTRAL, MEDLINE, Embase, two clinical trials registries, and a pharmaceutical company's website to 10 June 2016. Randomised, double-blind, placebo-controlled studies of at least 6 weeks' duration, using high-concentration (5% or more) topical capsaicin to treat neuropathic pain. Two review authors independently searched for studies, extracted efficacy and adverse event data, and examined issues of study quality and potential bias. Where pooled analysis was possible, we used dichotomous data to calculate risk ratio and numbers needed to treat for one additional event, using standard methods.Efficacy outcomes reflecting long-duration pain relief after a single drug application were from the Patient Global Impression of Change (PGIC) at specific points, usually 8 and 12 weeks. We also assessed average pain scores over weeks 2 to 8 and 2 to 12 and the number of participants with pain intensity reduction of at least 30% or at least 50% over baseline, and information on adverse events and withdrawals.We assessed the quality of the evidence using GRADE and created a 'Summary of findings' table. We included eight studies, involving 2488 participants, two more studies and 415 more participants than the previous version of this review. Studies were of generally good methodological quality; we judged only one study at high risk of bias, due to small size. Two studies used a placebo control and six used 0.04% topical capsaicin as an 'active' placebo to help maintain blinding. Efficacy outcomes were inconsistently reported, resulting in analyses for most outcomes being based on less than complete data.For postherpetic neuralgia, we found four studies (1272 participants). At both 8 and 12 weeks about 10% more participants reported themselves much or very much improved with high-concentration capsaicin than with 'active' placebo, with point estimates of numbers needed to treat for an additional beneficial outcome (NNTs) of 8.8 (95% confidence interval (CI) 5.3 to 26) with high-concentration capsaicin and 7.0 (95% CI 4.6 to 15) with 'active' placebo (2 studies, 571 participants; moderate quality evidence). More participants (about 10%) had average 2 to 8-week and 2 to 12-week pain intensity reductions over baseline of at least 30% and at least 50% with capsaicin than control, with NNT values between 10 and 12 (2 to 4 studies, 571 to 1272 participants; very low quality evidence).For painful HIV-neuropathy, we found two studies (801 participants). One study reported the proportion of participants who were much or very much improved at 12 weeks (27% with high-concentration capsaicin and 10% with 'active' placebo). For both studies, more participants (about 10%) had average 2 to 12-week pain intensity reductions over baseline of at least 30% with capsaicin than control, with an NNT of 11 (very low quality evidence).For peripheral diabetic neuropathy, we found one study (369 participants). It reported about 10% more participants who were much or very much improved at 8 and 12 weeks. One small study of 46 participants with persistent pain following inguinal herniorrhaphy did not show a difference between capsaicin and placebo for pain reduction (very low quality evidence).We downgraded the quality of the evidence for efficacy outcomes by one to three levels due to sparse data, imprecision, possible effects of imputation methods, and susceptibility to publication bias.Local adverse events were common, but not consistently reported. Serious adverse events were no more common with active treatment (3.5%) than control (3.2%). Adverse event withdrawals did not differ between groups, but lack of efficacy withdrawals were somewhat more common with control than active treatment, based on small numbers of events (six to eight studies, 21 to 67 events; moderate quality evidence, downgraded due to few events). No deaths were judged to be related to study medication. High-concentration topical capsaicin used to treat postherpetic neuralgia, HIV-neuropathy, and painful diabetic neuropathy generated more participants with moderate or substantial levels of pain relief than control treatment using a much lower concentration of capsaicin. These results should be interpreted with caution as the quality of the evidence was moderate or very low. The additional proportion who benefited over control was not large, but for those who did obtain high levels of pain relief, there were usually additional improvements in sleep, fatigue, depression, and quality of life. High-concentration topical capsaicin is similar in its effects to other therapies for chronic pain.
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Integrity of high-velocity water slug generated by an impacting technique
NASA Astrophysics Data System (ADS)
Dehkhoda, Sevda; Bourne, Neil
2013-06-01
A pulsed water jet is a series of discrete water slugs travelling at high velocity. Immediately after striking a target, these slugs apply high-intensity, short-duration transient stress known as the water hammer pressure, followed by low-intensity, long-duration stationary stress at the stagnation pressure. The magnitude and duration of the water hammer and stagnation pressures are controlled by the size and quality of the water slugs. The use of water jets for rock cutting in mining operations is a centuries-old technology; however, practical methods for producing high-energy water slugs repeatedly have proven difficult. This can be partly due to the fact that the geometrical properties of a jet and so its effectiveness in creating damage is controlled and influenced by the method that is employed to generate the water slugs. This paper investigates the integrity of a single water slug produced using an impacting technique where a hammer strikes a piston, resting on top of a water-filled chamber. The coherence of the generated water pulse was of concern in this study. If repeated shock reflections within the chamber were transmitted or were carried into the internal geometry of nozzle, the emerging jet could pulsate. The impact impulse of the formed water jet was measured in a Kel-F target material using an embedded PVDF (Polyvinylidene fluoride) shock gauge. The recorded stress waveform was then used to study the quality and endurance of the water pulse stream as it travelled through air.
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Startsev, N; Dimov, P; Grosche, B; Tretyakov, F; Schüz, J; Akleyev, A
2015-01-01
To follow up populations exposed to several radiation accidents in the Southern Urals, a cause-of-death registry was established at the Urals Center capturing deaths in the Chelyabinsk, Kurgan and Sverdlovsk region since 1950. When registering deaths over such a long time period, quality measures need to be in place to maintain quality and reduce the impact of individual coders as well as quality changes in death certificates. To ensure the uniformity of coding, a method for semi-automatic coding was developed, which is described here. Briefly, the method is based on a dynamic thesaurus, database-supported coding and parallel coding by two different individuals. A comparison of the proposed method for organizing the coding process with the common procedure of coding showed good agreement, with, at the end of the coding process, 70 - 90% agreement for the three-digit ICD -9 rubrics. The semi-automatic method ensures a sufficiently high quality of coding by at the same time providing an opportunity to reduce the labor intensity inherent in the creation of large-volume cause-of-death registries.
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Hewner, Sharon; Wu, Yow-Wu Bill; Castner, Jessica
2016-01-01
Hospitalized adult Medicaid recipients with chronic disease are at risk for rehospitalization within 90 days of discharge, but most research has focused on the Medicare population. The purpose of this study is to examine the impact of population-based care management intensity on inpatient readmissions in Medicaid adults with pre-existing chronic disease. Retrospective analyses of 2,868 index hospital admissions from 2012 New York State Medicaid Data Warehouse claims compared 90-day post-discharge utilization in populations with and without transitional care management interventions. High intensity managed care organization interventions were associated with higher outpatient and lower emergency department post-discharge utilization than low intensity fee-for-service management. However, readmission rates were higher for the managed care cases. Shorter time to readmission was associated with managed care, diagnoses that include heart and kidney failure, shorter length of stay for index hospitalization, and male sex; with no relationship to age. This unexpected result flags the need to re-evaluate readmission as a quality indicator in the complex Medicaid population. Quality improvement efforts should focus on care continuity during transitions and consider population-specific factors that influence readmission. Optimum post-discharge utilization in the Medicaid population requires a balance between outpatient, emergency and inpatient services to improve access and continuity.
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NASA Astrophysics Data System (ADS)
Rauf, N.; Alam, D. Y.; Jamaluddin, M.; Samad, B. A.
2018-03-01
The Magnetic Resonance Imaging (MRI) is a medical imaging technique that uses the interaction between the magnetic field and the nuclear spins. MRI can be used to show disparity of pathology by transversal relaxation time (T2) weighted images. Some techniques for producing T2-weighted images are Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction (PROPELLER) and Fluid Attenuated Inversion Recovery (FLAIR). A comparison of T2 PROPELLER and T2 FLAIR parameters in MRI image has been conducted. And improve Image Quality the image by using RadiAnt DICOM Viewer and ENVI software with method of image segmentation and Region of Interest (ROI). Brain images were randomly selected. The result of research showed that Time Repetition (TR) and Time Echo (TE) values in all types of images were not influenced by age. T2 FLAIR images had longer TR value (9000 ms), meanwhile T2 PROPELLER images had longer TE value (100.75 - 102.1 ms). Furthermore, areas with low and medium signal intensity appeared clearer by using T2 PROPELLER images (average coefficients of variation for low and medium signal intensity were 0.0431 and 0.0705, respectively). As for areas with high signal intensity appeared clearer by using T2 FLAIR images (average coefficient of variation was 0.0637).
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Zhang, Yixiang; Liang, Xinqiang; Wang, Zhibo; Xu, Lixian
2015-01-01
High content of organic matter in the downstream of watersheds underscored the severity of non-point source (NPS) pollution. The major objectives of this study were to characterize and quantify dissolved organic matter (DOM) in watersheds affected by NPS pollution, and to apply self-organizing map (SOM) and parallel factor analysis (PARAFAC) to assess fluorescence properties as proxy indicators for NPS pollution and labor-intensive routine water quality indicators. Water from upstreams and downstreams was sampled to measure dissolved organic carbon (DOC) concentrations and excitation-emission matrix (EEM). Five fluorescence components were modeled with PARAFAC. The regression analysis between PARAFAC intensities (Fmax) and raw EEM measurements indicated that several raw fluorescence measurements at target excitation-emission wavelength region could provide similar DOM information to massive EEM measurements combined with PARAFAC. Regression analysis between DOC concentration and raw EEM measurements suggested that some regions in raw EEM could be used as surrogates for labor-intensive routine indicators. SOM can be used to visualize the occurrence of pollution. Relationship between DOC concentration and PARAFAC components analyzed with SOM suggested that PARAFAC component 2 might be the major part of bulk DOC and could be recognized as a proxy indicator to predict the DOC concentration. PMID:26526140
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Dias, Luciara Irene DE Nadai; Miranda, Eliana Cristina Martins; Toro, Ivan Felizardo Contrera; Mussi, Ricardo Kalaf
2016-01-01
to compare the intensity of reflex sweating with the degree of anxiety and its interference in the quality of life of patients undergoing Thoracoscopic (VATS) sympathectomy in the pre- and postoperative period. we evaluated 54 patients with a mean age of 26 years (16-49 years) undergoing sympathectomy in the R3-R4 level. We applied two questionnaires at three different times: "Quality of life in patients with primary hyperhidrosis" and "Scale for anxiety and depression". of the patients studied, 93% showed significant improvement in quality of life 30 days after surgery, the effects remaining after six months. There were no postoperative complications. The patient's level of anxiety is highly correlated with the intensity of reflex sweating after 30 and 180 days. Thoracoscopic sympathectomy improves quality of life of patients with primary hyperhidrosis, even with the emergence of reflex sweating. Anxiety directly relates to the intensity of reflex sweating, without compromising the degree of patient satisfaction. avaliar a intensidade de sudorese reflexa com o grau de ansiedade e sua interferência na qualidade de vida de indivíduos submetidos à simpatectomia por videotoracoscopia nos períodos pré e pós-operatório. foram avaliados 54 pacientes com média de idade de 26 anos (16 a 49 anos), submetidos à simpatectomia em nível R3-R4. Dois questionários foram aplicados em três momentos diferentes: "Qualidade de vida em pacientes com hiperidrose primária e "Escala para ansiedade e depressão". dos pacientes estudados, 93% mostrou melhora significativa na qualidade de vida após 30 dias da cirurgia, com os efeitos remanescentes após seis meses. Não houve complicações pós-operatórias. A análise mostrou que o nível de ansiedade do paciente é altamente correlacionado com a intensidade da sudorese reflexa após 30 e 180 dias. a simpatectomia torácica por videotoracoscopia melhora a qualidade de vida de pacientes com hiperidrose primária, mesmo com o surgimento de sudorese reflexa. A ansiedade está diretamente relacionada com a intensidade da sudorese reflexa, sem comprometer o grau de satisfação do paciente.
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Azmoon, Hiva; Dehghan, Habibollah; Akbari, Jafar; Souri, Shiva
2013-01-01
Environmental conditions such as lighting and thermal comfort are influencing factors on sleep quality and visual tiredness. The purpose of this study was the determination of the relationship between thermal comfort and light intensity with the sleep quality and eye fatigue in shift nurses. This cross-sectional research was conducted on 82 shift-work personnel of 18 nursing workstations in Isfahan Al-Zahra Hospital, Iran, in 2012. Heat stress monitoring (WBGT) and photometer (Hagner Model) were used for measuring the thermal conditions and illumination intensity, respectively. To measure the sleep quality, visual tiredness, and thermal comfort, Pittsburg sleep quality index, eye fatigue questionnaire, and thermal comfort questionnaire were used, respectively. The data were analyzed with descriptive statistics, Student's t-test, and Pearson correlation. Correlation between thermal comfort which was perceived from the self-reporting of people with eye tiredness was -0.38 (P = 0.002). Pearson correlation between thermal comfort and sleep quality showed a positive and direct relationship (r = 0.241, P = 0.33) but the correlation between thermal comfort, which was perceived from the self-reporting of shift nurses, and WBGT index was a weak relationship (r = 0.019). Based on the obtained findings, it can be concluded that a defect in environmental conditions such as thermal conditions and light intensity and also lack of appropriate managerial plan for night shift-work nurses are destructive and negative factors for the physical and mental health of this group of practitioners.
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Muñoz-Muñoz, Sonsoles; Muñoz-García, María T; Alburquerque-Sendín, Francisco; Arroyo-Morales, Manuel; Fernández-de-las-Peñas, César
2012-10-01
The purpose of this study was to investigate the presence of active myofascial trigger points (MTrPs) in a greater number of muscles than previous studies and the relation between the presence of MTrPs, the intensity of pain, disability, and sleep quality in mechanical neck pain. Fifteen patients with mechanical neck pain (80% women) and 12 comparable controls participated. Myofascial trigger points were bilaterally explored in the upper trapezius, splenius capitis, semispinalis capitis, sternocleidomastoid, levator scapulae, and scalene muscles in a blinded design. Myofascial trigger points were considered active if the subject recognized the elicited referred pain as a familiar symptom. Myofascial trigger points were considered latent if the elicited referred pain was not recognized as a symptom. Pain was collected with a numerical pain rate scale (0-10); disability was assessed with Neck Disability Index; and sleep quality, with the Pittsburgh Sleep Quality Index. Patients exhibited a greater disability and worse sleep quality than controls (P < .001). The Pittsburgh Sleep Quality Index score was associated with the worst intensity of pain (r = 0.589; P = .021) and disability (r = 0.552; P = .033). Patients showed a greater (P = .002) number of active MTrPs (mean, 2 ± 2) and similar number (P = .505) of latent MTrPs (1.6 ± 1.4) than controls (latent MTrPs, 1.3 ± 1.4). No significant association between the number of latent or active MTrPs and pain, disability, or sleep quality was found. The referred pain elicited by active MTrPs in the neck and shoulder muscles contributed to symptoms in mechanical neck pain. Patients exhibited higher disability and worse sleep quality than controls. Sleep quality was associated with pain intensity and disability. No association between active MTrPs and the intensity of pain, disability, or sleep quality was found. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.
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Low-intensity calibration source for optical imaging systems
NASA Astrophysics Data System (ADS)
Holdsworth, David W.
2017-03-01
Laboratory optical imaging systems for fluorescence and bioluminescence imaging have become widely available for research applications. These systems use an ultra-sensitive CCD camera to produce quantitative measurements of very low light intensity, detecting signals from small-animal models labeled with optical fluorophores or luminescent emitters. Commercially available systems typically provide quantitative measurements of light output, in units of radiance (photons s-1 cm-2 SR-1) or intensity (photons s-1 cm-2). One limitation to current systems is that there is often no provision for routine quality assurance and performance evaluation. We describe such a quality assurance system, based on an LED-illuminated thin-film transistor (TFT) liquid-crystal display module. The light intensity is controlled by pulse-width modulation of the backlight, producing radiance values ranging from 1.8 x 106 photons s-1 cm-2 SR-1 to 4.2 x 1013 photons s-1 cm-2 SR-1. The lowest light intensity values are produced by very short backlight pulses (i.e. approximately 10 μs), repeated every 300 s. This very low duty cycle is appropriate for laboratory optical imaging systems, which typically operate with long-duration exposures (up to 5 minutes). The low-intensity light source provides a stable, traceable radiance standard that can be used for routine quality assurance of laboratory optical imaging systems.
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Purge- and intensive-purge decontamination of dental units contaminated with biofilm
Kramer, Axel; Assadian, Ojan; Bachfeld, Danny; Meyer, Georg
2012-01-01
Introduction: During hygienic-microbiological monitoring of the water quality in dental units, the total bacterial colony count was found to exceed the limits for drinking water quality; in addition, mold contamination was detected. The presumed cause was irregular decontamination of the units through purging and intensive decontamination. Methods: To decontaminate the units, the manufacturer’s recommended program for cleaning and intensive decontamination was intensified by shortened intervals over a 2-week period. For Sirona units, instead of once a day, the automatic purge program was run every morning and evening for 20 min each time, and instead of once a month, intensive decontamination was performed every two weeks; this schedule has been maintained since then. For KaVo units, cleaning with the hydroclean function was carried out for 2.5 min every morning and evening. The automatic intensive decontamination was run daily instead of weekly. A maintenance log book was introduced, in which decontamination/cleaning was confirmed by the operator’s signature. Results: Within 5 weeks, all previously contaminated units were decontaminated. Discussion: By shortening the cleaning and intensive decontamination intervals in a 2-week period with subsequent control that the recommended maintenance intervals were kept, it was possible to guarantee drinking-water quality in the dental units of both manufacturers. PMID:22558045