Effect on lung function of continuous positive airway pressure administered either by infant flow driver or a single nasal prong.

PubMed

Kavvadia, V; Greenough, A; Dimitriou, G

2000-04-01

The aim of this study was to assess if continuous positive airways pressure (CPAP) delivered by an infant flow driver (IFD) was a more effective method of improving lung function than delivering CPAP by a single nasal prong. A total of 36 infants (median gestational age 29 weeks, range 25-35 weeks) were studied, 12 who received CPAP via an IFD, 12 who received CPAP via a single nasal prong and 12 without CPAP. CPAP was administered post extubation if apnoeas and bradycardias or a respiratory acidosis developed or electively if the infant was of birth weight <1.0 kg. Lung function was assessed by the supplementary oxygen requirement and measurement of compliance of the respiratory system using an occlusion technique. Assessments were made immediately prior to and after 24 h of CPAP administration and at similar postnatal ages in the non-CPAP group. The infants who did not require CPAP had better lung function (non significant) than the other two groups before they received CPAP. After 24 h, lung function had improved in both CPAP groups to the level of the non CPAP infants. The supplementary oxygen requirements of all three groups decreased over the 24 h period, but this only reached significance in the single nasal prong group (P<0.05). Four infants supported by the IFD, but none with a single nasal prong, became hyperoxic. Continuous positive airways pressure administration via the infant flow driver appears to offer no short-term advantage over a single nasal prong system when used after extubation in preterm infants.

APPARATUS FOR CONTROLLING THE POSITION OF AN ION BEAM IN A CALUTRON

DOEpatents

Lawrence, E.O.

1958-01-01

ABS>This patent relates to improvements in electric discharge devices of the calutron type for separation of the isotopes of an element from the freely occurring composition. The improvement constitutes means for the continuous control of the path of an ion beam to obtain maximum reception in a receiver compartment. Withdrawal of the ions from the source is accomplished by an accelerator electrode placed at a positive potential with respect to the receiver. The ions are projected through a magnetic field perpendicular to the direction of motion towards a receiver. In order to obtain a signal representative of the magnitude of ions received from a particular ion-beam in its compartment, an electrode is disposed in the compartment. The signal from the compartment electrode controls the voltage of the acccleratimg electrodc through appropriate circuitry to maintain the path of the particular ion beam optimum for maximum ion current in the compartment.

The stable microbubble test for determining continuous positive airway pressure (CPAP) success in very preterm infants receiving nasal CPAP from birth.

PubMed

Bhatia, Risha; Morley, Colin J; Argus, Brenda; Tingay, David G; Donath, Susan; Davis, Peter G

2013-01-01

Very preterm infants can be treated with nasal continuous positive airway pressure (CPAP) from birth, but some fail. A rapid test, such as the stable microbubble test (SMT) on gastric aspirate, may identify those who can be managed successfully using CPAP. To determine if SMT can identify soon after birth, very preterm infants who may be successfully managed on CPAP alone. Stable microbubbles (diameter <15 µm) were counted in gastric aspirates taken <1 h of age from infants <30 weeks' gestation, who received CPAP from birth. Infants failed CPAP if intubated at <72 h of age. Clinicians were masked to SMT results. A receiver operating characteristic curve was generated to determine the relationship between number of microbubbles/mm(2) and subsequent intubation. 68 infants of mean (SD) 28.1 (1.4) weeks' gestation received CPAP in the delivery room at a median (interquartile range) pressure 7 (6-8) cmH2O and FiO2 0.25 (0.21-0.3). Gastric aspirates were taken at a median (interquartile range) age of 0.5 (0.3-0.6) hours. The best cut-off point for predicting CPAP success or failure was a SMT count of 8 microbubbles/mm(2). The area under the receiver operating characteristic curve was 0.8 (95% CI 0.7-0.9). A SMT count ≥8 microbubbles/mm(2) had a sensitivity of 53%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 60% for predicting CPAP success. Infants treated with CPAP from birth, who had SMT counts ≥8 microbubbles/mm(2) on their gastric aspirate, did not fail CPAP. Copyright © 2013 S. Karger AG, Basel.

Solar receiver heliostat reflector having a linear drive and position information system

DOEpatents

Horton, Richard H.

1980-01-01

A heliostat for a solar receiver system comprises an improved drive and control system for the heliostat reflector assembly. The heliostat reflector assembly is controllably driven in a predetermined way by a light-weight drive system so as to be angularly adjustable in both elevation and azimuth to track the sun and efficiently continuously reflect the sun's rays to a focal zone, i.e., heat receiver, which forms part of a solar energy utilization system, such as a solar energy fueled electrical power generation system. The improved drive system includes linear stepping motors which comprise low weight, low cost, electronic pulse driven components. One embodiment comprises linear stepping motors controlled by a programmed, electronic microprocessor. Another embodiment comprises a tape driven system controlled by a position control magnetic tape.

Lessons Learned from Two Years of On-Orbit Global Positioning System Experience on International Space Station

NASA Technical Reports Server (NTRS)

Gomez, Susan F.; Lammers, Michael L.

2004-01-01

The Global Positioning System Subsystem (GPS) for International Space Station (ISS) was activated April 12,2002 following the installation of the SO truss segment that included the GPS antennas on Shuttle mission STS-110. The ISS GPS receiver became the primary source for position, velocity, and attitude information for ISS two days after activation. The GPS receiver also provides a time reference for manual control of ISS time, and will be used for automatic time updates after problems are resolved with the output from the receiver. After two years of on-orbit experience, the GPS continues to be used as the primary navigation source for ISS; however, enough problems have surfaced that the firmware in the GPS attitude code has had to be totally rewritten and new algorithms developed, the firmware that processed the time output from the GPS receiver had to be rewritten, while the GPS navigation code has had minor revisions. The factors contributing to the delivery of a GPS receiver for use on ISS that requires extensive operator intervention to function are discussed. Observations from two years worth of GPS solutions will also be discussed. The technical solutions to the anomalous GPS receiver behavior will be discussed.

Does decentralisation of tuberculosis care influence treatment outcomes? The case of Oromia Region, Ethiopia

PubMed Central

Raya, J.; Workineh, T.; Klinkenberg, E.; Enquselassie, F.

2014-01-01

Setting: Oromia Region, Ethiopia. Objective: To investigate the effect of decentralised care on anti-tuberculosis treatment outcomes and identify factors affecting outcome among new smear-positive tuberculosis (TB) patients. Design: This was a retrospective cohort study comparing patients treated in the community during the continuation phase with those managed throughout treatment in health facilities. Data were collected from TB registers and patient cards using a pre-tested data capture form. Results: Of the 2226 new smear-positive TB patients registered from July 2010 to June 2012 who were included in the study, 1599 (72.6%) received treatment in health facilities, and the rest in the community. Overall treatment success was 94.7%. Patients treated in the community had comparable treatment success with those managed in health facilities (aOR 1.7, 95%CI 0.80–3.57). Missing doses (OR 0.22, 95%CI 0.08–0.55), supervision during the continuation phase (OR 2.6, 95%CI 1.34–5.05), positive sputum at month 2 (OR 0.07, 95%CI 0.04–0.13) and human immunodeficiency virus infection (OR 0.25, 95%CI 0.13–0.46) were independent predictors of treatment success. Conclusion: Overall treatment success is high in new smear-positive TB patients in Oromia. Patients receiving treatment in the community during the continuation phase have treatment success comparable with that of patients managed in health facilities. PMID:26478507

Systematic review building a preceptor support system.

PubMed

Goss, Carol R

2015-01-01

This systematic review identifies the significance of the preceptor role in affecting new graduate nurse retention. Findings from 20 research studies provide support that nurse preceptors receiving continuing education and perceiving reward and recognition from the preceptor position positively affect new graduate nurse retention. Hospital administration, nurse managers, nurse educators, preceptors, and new graduate nurses each play a role in the successful implementation of a preceptor support system.

Method for producing size selected particles

DOEpatents

Krumdick, Gregory K.; Shin, Young Ho; Takeya, Kaname

2016-09-20

The invention provides a system for preparing specific sized particles, the system comprising a continuous stir tank reactor adapted to receive reactants; a centrifugal dispenser positioned downstream from the reactor and in fluid communication with the reactor; a particle separator positioned downstream of the dispenser; and a solution stream return conduit positioned between the separator and the reactor. Also provided is a method for preparing specific sized particles, the method comprising introducing reagent into a continuous stir reaction tank and allowing the reagents to react to produce product liquor containing particles; contacting the liquor particles with a centrifugal force for a time sufficient to generate particles of a predetermined size and morphology; and returning unused reagents and particles of a non-predetermined size to the tank.

The nursing care of the infant receiving bubble CPAP therapy.

PubMed

Bonner, Krista M; Mainous, Rosalie O

2008-04-01

There are increasing numbers of low birth-weight and premature infants surviving with conditions such as chronic lung disease or bronchopulmonary dysplasia due to complications of assisted mechanical ventilation and other factors. Continuous positive airway pressure (CPAP) has been used as an alternative respiratory treatment to prevent and manage lung disease in preterm infants since the 1970s. Evidence has demonstrated the usefulness of CPAP in the delivery room, as a rescue therapy, as an extubation tool, and a method for managing apnea of prematurity. Bubble CPAP is a unique, simple, inexpensive way of providing continuous positive pressure to infants. Some background and training in the setup, care, and evaluation of the infant on bubble CPAP is essential for positive outcomes.

Delivery room continuous positive airway pressure and early pneumothorax in term newborn infants.

PubMed

Clevenger, L; Britton, J R

2017-01-01

To assess the association between delivery room (DR) continuous positive airway pressure (CPAP) and pneumothorax (PT) in term newborns. Two studies performed in community hospitals used data extracted from computerized records of term newborns. Infants receiving positive pressure ventilation in the DR were excluded. Tabulated data included receipt of DR CPAP, PT on the day of birth, and gestational age (GA). In a case-control study from 2001-2013, infants with PT were compared to controls without PT but with respiratory distress or hypoxia persisting from birth for receipt of DR CPAP. In a cohort study from 2014-2016, infants receiving and not receiving DR CPAP were compared for the incidence of PT. In the case-control study, data were obtained for 169 cases and 850 controls. Compared to controls, PT infants were more likely to have received DR CPAP (16.8% vs. 40.2%, respectively, P < 0.001). Logistic regression revealed DR CPAP (Adjusted Odds Ratio [AOR] = 3.30, 95% confidence interval [CI] = 2.31, 4.72, P < 0.001) and GA (AOR = 1.21, 95% CI = 1.05, 1.39, P = 0.009) to be independent predictors of early PT.In the cohort study, PT was observed in 0.1% of 9255 control infants not receiving DR CPAP and 4.8% of 228 infants receiving DR CPAP (P < 0.001). In logistic regression analyses, DR CPAP significantly predicted PT (OR = 59.59, 95% CI = 23.34, 147.12, P < 0.001) and remained a significant predictor of PT after controlling for gestational age. Respiratory conditions treated with CPAP in delivery rooms are associated with increased risk of PT. A cause-and-effect relationship between CPAP and PT cannot be claimed in this study. Further research is needed to better understand this relationship.

Intermittent compared to continuous real-time fMRI neurofeedback boosts control over amygdala activation.

PubMed

Hellrung, Lydia; Dietrich, Anja; Hollmann, Maurice; Pleger, Burkhard; Kalberlah, Christian; Roggenhofer, Elisabeth; Villringer, Arno; Horstmann, Annette

2018-02-01

Real-time fMRI neurofeedback is a feasible tool to learn the volitional regulation of brain activity. So far, most studies provide continuous feedback information that is presented upon every volume acquisition. Although this maximizes the temporal resolution of feedback information, it may be accompanied by some disadvantages. Participants can be distracted from the regulation task due to (1) the intrinsic delay of the hemodynamic response and associated feedback and (2) limited cognitive resources available to simultaneously evaluate feedback information and stay engaged with the task. Here, we systematically investigate differences between groups presented with different variants of feedback (continuous vs. intermittent) and a control group receiving no feedback on their ability to regulate amygdala activity using positive memories and feelings. In contrast to the feedback groups, no learning effect was observed in the group without any feedback presentation. The group receiving intermittent feedback exhibited better amygdala regulation performance when compared with the group receiving continuous feedback. Behavioural measurements show that these effects were reflected in differences in task engagement. Overall, we not only demonstrate that the presentation of feedback is a prerequisite to learn volitional control of amygdala activity but also that intermittent feedback is superior to continuous feedback presentation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Intravenous parecoxib and continuous femoral block for postoperative analgesia after total knee arthroplasty. A randomized, double-blind, prospective trial.

PubMed

Sarridou, Despoina G; Chalmouki, Georgia; Braoudaki, Maria; Koutsoupaki, Anna; Mela, Argiro; Vadalouka, Athina

2015-01-01

Up until now, the optimal strategy for postoperative pain management after total knee arthroplasty (TKA) remains to be elucidated. The current investigation aimed to examine the analgesic efficacy and the opioid sparing effects of intravenous parecoxib in combination with continuous femoral blockade. Randomized, double-blind, prospective trial. University hospital in the United Kingdom. In total, 90 patients underwent TKA under subarachnoid anesthesia and received continuous femoral block initially as a bolus with 20 mL of ropivacaine 0.75%. Infusion of 0.2% on 10 mL/h followed. Patients were randomized into 2 groups. Group D and Group P received parecoxib and placebo, respectively at 12 hour time intervals. Visual analog scale (VAS) pain scores were obtained at different time intervals including 4, 8, 12, 24 and 36 hours. The pain scores were measured with patients in a resting position. Morphine could also be administered with a patient controlled analgesia (PCA) pump if the specified analgesia was deemed inadequate (VAS > 5). None of the patients were withdrawn from the study. Parecoxib provided greater relief than placebo following TKA. The VAS pain scores measured at rest were statistically significantly lower in parecoxib-treated patients compared to the placebo group (P = 0.007) at 4 (P = 0.044), 12 (P = 0.001), and 24 hours (P = 0.012), postoperatively. Patients receiving parecoxib consumed less morphine at all time intervals than patients receiving placebo, with borderline statistical significance (P = 0.054). In each time period, all patients receiving continuous femoral block irrespectively of the treatment group, required low morphine doses. Current protocol did not answer question as to functional recovery. According to our findings intravenous parecoxib in combination with continuous femoral block provided superior analgesic efficacy and opioid sparing effects in patients undergoing TKA.

Establishing health benefits of bioactive food components: a basic research scientist's perspective

USDA-ARS?s Scientific Manuscript database

Bioactive food components or functional foods have recently received significant attention because of their widely touted positive effects beyond basic nutrition. However, a question continues to lurk: are these 'super foods' backed by sound science or simply an exaggerated portrayal of very small '...

Health departments do it better: prenatal care site and prone infant sleep position.

PubMed

Lahr, Martin B; Rosenberg, Kenneth D; Lapidus, Jodi A

2005-06-01

Reduction of prone infant sleep position has been the main public health effort to reduce the incidence of Sudden Infant Death Syndrome (SIDS). Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) surveys a stratified random sample of women after a live birth. In 1998-1999, 1867 women completed the survey (64.0% unweighted response; 73.5% weighted response). Overall, 9.2% of all women "usually" chose prone infant sleep position, while 24.2% chose side and 66.5% chose supine position. Women receiving care from private physicians or HMOs more often chose prone position (10.6%) than women receiving prenatal care from health department clinics (2.5%), hospital clinics (6.1%) or other sites (8.3%). Compared to health department prenatal clinic patients, private prenatal patients were more likely to choose prone infant sleep position, adjusted odds ratio = 4.78 (95% confidence interval [CI] 1.64-13.92). Health Department clinics have done a better job than private physicians in educating mothers about putting infants to sleep on their backs. Providers-especially private providers-should continue to stress the importance of supine sleep position for infants.

GPS meteorology - Remote sensing of atmospheric water vapor using the Global Positioning System

NASA Technical Reports Server (NTRS)

Bevis, Michael; Businger, Steven; Herring, Thomas A.; Rocken, Christian; Anthes, Richard A.; Ware, Randolph H.

1992-01-01

We present a new approach to remote sensing of water vapor based on the Global Positioning System (GPS). Geodesists and geophysicists have devised methods for estimating the extent to which signals propagating from GPS satellites to ground-based GPS receivers are delayed by atmospheric water vapor. This delay is parameterized in terms of a time-varying zenith wet delay (ZWD) which is retrieved by stochastic filtering of the GPS data. Given surface temperature and pressure readings at the GPS receiver, the retrieved ZWD can be transformed with very little additional uncertainty into an estimate of the integrated water vapor (IWV) overlying that receiver. Networks of continuously operating GPS receivers are being constructed by geodesists, geophysicists, and government and military agencies, in order to implement a wide range of positioning capabilities. These emerging GPS networks offer the possibility of observing the horizontal distribution of IWV or, equivalently, precipitate water with unprecedented coverage and a temporal resolution of the order of 10 min. These measurements could be utilized in operational weather forecasting and in fundamental research into atmospheric storm systems, the hydrologic cycle, atmospheric chemistry, and global climate change.

Examining gender differences in received, provided, and invisible social control: an application of the dual-effects model.

PubMed

Lüscher, Janina; Ochsner, Sibylle; Knoll, Nina; Stadler, Gertraud; Hornung, Rainer; Scholz, Urte

2014-01-01

The dual-effects model of social control not only assumes that social control leads to better health practices but also arouses psychological distress. However, findings are inconsistent. The present study advances the current literature by examining social control from a dyadic perspective in the context of smoking. In addition, the study examines whether control, continuous smoking abstinence, and affect are differentially related for men and women. Before and three weeks after a self-set quit attempt, we examined 106 smokers (77 men, mean age: 40.67, average number of cigarettes smoked per day: 16.59 [SD=8.52, range=1-40] at baseline and 5.27 [SD=6.97, range=0-40] at follow-up) and their nonsmoking heterosexual partners, assessing received and provided control, continuous abstinence, and affect. With regard to smoker's affective reactions, partner's provided control was related to an increase in positive and to a decrease in negative affect, but only for female smokers. Moreover, the greater the discrepancy between smoker received and partner's provided control was the more positive affect increased and the more negative affect decreased, but again only for female smokers. These findings demonstrate that female smokers' well-being was raised over time if they were not aware of the control attempts of their nonsmoking partners, indicating positive effects of invisible social control. This study's results emphasize the importance of applying a dyadic perspective and taking gender differences in the dual-effects model of social control into account.

Effectiveness of prehospital continuous positive airway pressure in the management of acute pulmonary edema.

PubMed

Hubble, Michael W; Richards, Michael E; Jarvis, Roger; Millikan, Tori; Young, Dwayne

2006-01-01

To compare the effectiveness of continuous positive airway pressure (CPAP) with standard pharmacologic treatment in the management of prehospital acute pulmonary edema. Using a nonrandomized control group design, all consecutive patients presenting to two participating emergency medical services (EMS) systems with a field impression of acute pulmonary edema between July 1, 2004, and June 30, 2005, were included in the study. The control EMS system patients received standard treatment with oxygen, nitrates, furosemide, morphine, and, if indicated, endotracheal intubation. The intervention EMS system patients received CPAP via face mask at 10 cm H2O in addition to standard therapy. Ninety-five patients received standard therapy, and 120 patients received CPAP and standard therapy. Intubation was required in 8.9% of CPAP-treated patients compared with 25.3% in the control group (p = 0.003), and mortality was lower in the CPAP group than in the control group (5.4% vs. 23.2%; p = 0.000). When compared with the control group, the CPAP group had more improvement in respiratory rate (-4.55 vs. -1.81; p = 0.001), pulse rate (-4.77 vs. 0.82; p = 0.013), and dyspnea score (-2.11 vs. -1.36; p = 0.008). Using logistic regression to control for potential confounders, patients receiving standard treatment were more likely to be intubated (odds ratio, 4.04; 95% confidence interval, 1.64 to 9.95) and more likely to die (odds ratio, 7.48; 95% confidence interval, 1.96 to 28.54) than those receiving standard therapy and CPAP. The prehospital use of CPAP is feasible, may avert the need for endotracheal intubation, and may reduce short-term mortality.

Psychiatric and substance use disorders in HIV/hepatitis C virus (HCV)-coinfected patients: does HCV clearance matter? [Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) HEPAVIH CO13 cohort].

PubMed

Michel, L; Lions, C; Winnock, M; Lang, J-P; Loko, M-A; Rosenthal, E; Marchou, B; Valantin, M-A; Morlat, P; Roux, P; Sogni, P; Spire, B; Poizot-Martin, I; Lacombe, K; Lascoux-Combe, C; Duvivier, C; Neau, D; Dabis, F; Salmon-Ceron, D; Carrieri, M P

2016-11-01

The objective of this nested study was to assess the prevalence of psychiatric disorders in a sample of HIV/hepatitis C virus (HCV)-coinfected patients according to their HCV status. The nested cross-sectional study, untitled HEPAVIH-Psy survey, was performed in a subset of HIV/HCV-coinfected patients enrolled in the French Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS) CO13 HEPAVIH cohort. Psychiatric disorders were screened for using the Mini International Neuropsychiatric Interview (MINI 5.0.0). Among the 286 patients enrolled in the study, 68 (24%) had never received HCV treatment, 87 (30%) were treatment nonresponders, 44 (15%) were currently being treated and 87 (30%) had a sustained virological response (SVR). Of the 286 patients enrolled, 121 patients (42%) screened positive for a psychiatric disorder other than suicidality and alcohol/drug abuse/dependence, 40 (14%) screened positive for alcohol abuse/dependence, 50 (18%) screened positive for drug abuse/dependence, 50 (17.5%) were receiving an antidepressant treatment and 69 (24%) were receiving an anxiolytic. Patients with an SVR did not significantly differ from the other groups in terms of psychiatric disorders. Patients receiving HCV treatment screened positive less often for an anxiety disorder. The highest rate of drug dependence/abuse was among HCV treatment-naïve patients. Psychiatric disorders were frequent in HIV/HCV-coinfected patients and their rates were comparable between groups, even for patients achieving an SVR. Our results emphasize the need for continuous assessment and care of coinfected patients, even after HCV clearance. Drug addiction remains an obstacle to access to HCV treatment. Despite the recent advent and continued development of directly acting antiviral agents (DAAs), it is still crucial to offer screening and comprehensive care for psychiatric and addictive disorders. © 2016 British HIV Association.

Stereotactic Radiation Therapy can Safely and Durably Control Sites of Extra-Central Nervous System Oligoprogressive Disease in Anaplastic Lymphoma Kinase-Positive Lung Cancer Patients Receiving Crizotinib

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

Gan, Gregory N., E-mail: gregory.gan@ucdenver.edu; Weickhardt, Andrew J.; Scheier, Benjamin

Purpose: To analyze the durability and toxicity of radiotherapeutic local ablative therapy (LAT) applied to extra-central nervous system (eCNS) disease progression in anaplastic lymphoma kinase-positive non-small cell lung cancer (NSCLC) patients. Methods and Materials: Anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib and manifesting ≤4 discrete sites of eCNS progression were classified as having oligoprogressive disease (OPD). If subsequent progression met OPD criteria, additional courses of LAT were considered. Crizotinib was continued until eCNS progression was beyond OPD criteria or otherwise not suitable for further LAT. Results: Of 38 patients, 33 progressed while taking crizotinib. Of these, 14 had eCNS progressionmore » meeting OPD criteria suitable for radiotherapeutic LAT. Patients with eCNS OPD received 1-3 courses of LAT with radiation therapy. The 6- and 12-month actuarial local lesion control rates with radiation therapy were 100% and 86%, respectively. The 12-month local lesion control rate with single-fraction equivalent dose >25 Gy versus ≤25 Gy was 100% versus 60% (P=.01). No acute or late grade >2 radiation therapy-related toxicities were observed. Median overall time taking crizotinib among those treated with LAT versus those who progressed but were not suitable for LAT was 28 versus 10.1 months, respectively. Patients continuing to take crizotinib for >12 months versus ≤12 months had a 2-year overall survival rate of 72% versus 12%, respectively (P<.0001). Conclusions: Local ablative therapy safely and durably eradicated sites of individual lesion progression in anaplastic lymphoma kinase-positive NSCLC patients receiving crizotinib. A dose–response relationship for local lesion control was observed. The suppression of OPD by LAT in patients taking crizotinib allowed an extended duration of exposure to crizotinib, which was associated with longer overall survival.« less

Effects of escitalopram on symptoms and quality of life in patients with allergic rhinitis.

PubMed

Erkul, Evren; Cingi, Cemal; Özçelik Korkmaz, Müge; Çekiç, Tuğba; Çukurova, Ibrahim; Yaz, Aytekin; Erdoğmuş, Nagehan; Bal, Cengiz

2012-01-01

Insufficient response to treatment and declining quality of life illustrate the continuing need to find new treatment modalities for allergic rhinitis (AR). The purpose of this study was to assess how escitalopram affects symptoms and quality of life among AR patients. This study included 120 patients with AR, who were divided into four treatment groups of 30 patients each. Patients were assessed before treatment and at the end of the 3rd month based on nasal symptom scores, otorhinolaryngological examination, the Rhinoconjunctivitis Quality of Life Questionnaire, and the Beck Depression and Anxiety Inventory. All patients received standardized treatments. Group A patients with positive Beck Depression and Anxiety Inventory scores received escitalopram, and group B patients with positive Beck Depression and Anxiety Inventory scores received placebo. Group C patients with negative Beck Depression and Anxiety Inventory scores received escitalopram, and group D patients with negative Beck Depression and Anxiety Inventory scores received placebo. Anxiety scores pre- and posttreatment revealed a statistically significant reduction in groups A, C, and D. All four groups exhibited reduced posttreatment scores for sleep, nonnasal and noneye symptoms, eye symptoms, and emotions. A statistically significant difference appeared between groups A and B in terms of general complaints and nasal symptom scores. The positive effects of escitalopram on posttreatment quality of life in the Beck-positive patient group were a predictable outcome. Otolaryngologists should pay more attention to the moods of their patients with AR while they evaluate treatment during clinical follow-up visits.

Advancing Technology: GPS and GIS Outreach Training for Agricultural Producers

ERIC Educational Resources Information Center

Flynn, Allison; Arnold, Shannon

2010-01-01

The use of the Global Positioning System (GPS) and Global Information Systems (GIS) has made significant impacts on agricultural production practices. However, constant changes in the technologies require continuing educational updates. The outreach program described here introduces the operation, use, and applications of GPS receivers and GIS…

6-month versus 36-month isoniazid preventive treatment for tuberculosis in adults with HIV infection in Botswana: a randomised, double-blind, placebo-controlled trial.

PubMed

Samandari, Taraz; Agizew, Tefera B; Nyirenda, Samba; Tedla, Zegabriel; Sibanda, Thabisa; Shang, Nong; Mosimaneotsile, Barudi; Motsamai, Oaitse I; Bozeman, Lorna; Davis, Margarett K; Talbot, Elizabeth A; Moeti, Themba L; Moffat, Howard J; Kilmarx, Peter H; Castro, Kenneth G; Wells, Charles D

2011-05-07

In accordance with WHO guidelines, people with HIV infection in Botswana receive daily isoniazid preventive therapy against tuberculosis without obtaining a tuberculin skin test, but duration of prophylaxis is restricted to 6 months. We aimed to assess effectiveness of extended isoniazid therapy. In our randomised, double-blind, placebo-controlled trial we enrolled adults infected with HIV aged 18 years or older at government HIV-care clinics in Botswana. Exclusion criteria included current illness such as cough and an abnormal chest radiograph without antecedent tuberculosis or pneumonia. Eligible individuals were randomly allocated (1:1) to receive 6 months' open-label isoniazid followed by 30 months' masked placebo (control group) or 6 months' open-label isoniazid followed by 30 months' masked isoniazid (continued isoniazid group) on the basis of a computer-generated randomisation list with permuted blocks of ten at each clinic. Antiretroviral therapy was provided if participants had CD4-positive lymphocyte counts of fewer than 200 cells per μL. We used Cox regression analysis and the log-rank test to compare incident tuberculosis in the groups. Cox regression models were used to estimate the effect of antiretroviral therapy. The trial is registered at ClinicalTrials.gov, number NCT00164281. Between Nov 26, 2004, and July 3, 2009, we recorded 34 (3·4%) cases of incident tuberculosis in 989 participants allocated to the control group and 20 (2·0%) in 1006 allocated to the continued isoniazid group (incidence 1·26% per year vs 0·72%; hazard ratio 0·57, 95% CI 0·33-0·99, p=0·047). Tuberculosis incidence in those individuals receiving placebo escalated approximately 200 days after completion of open-label isoniazid. Participants who were tuberculin skin test positive (ie, ≥5 mm induration) at enrolment received a substantial benefit from continued isoniazid treatment (0·26, 0·09-0·80, p=0·02), whereas participants who were tuberculin skin test-negative received no significant benefit (0·75, 0·38-1·46, p=0·40). By study completion, 946 (47%) of 1995 participants had initiated antiretroviral therapy. Tuberculosis incidence was reduced by 50% in those receiving 360 days of antiretroviral therapy compared with participants receiving no antiretroviral therapy (adjusted hazard ratio 0·50, 95% CI 0·26-0·97). Severe adverse events and death were much the same in the control and continued isoniazid groups. In a tuberculosis-endemic setting, 36 months' isoniazid prophylaxis was more effective for prevention of tuberculosis than was 6-month prophylaxis in individuals with HIV infection, and chiefly benefited those who were tuberculin skin test positive. US Centers for Disease Control and Prevention and US Agency for International Development. Copyright © 2011 Elsevier Ltd. All rights reserved.

Predictors of persistence after a positive depression screen among adolescents.

PubMed

Richardson, Laura P; McCauley, Elizabeth; McCarty, Carolyn A; Grossman, David C; Myaing, Mon; Zhou, Chuan; Richards, Julie; Rockhill, Carol; Katon, Wayne

2012-12-01

To examine predictors of depression persistence after a positive screening test to inform management protocols for screened youth. We conducted a cohort study of 444 youth (aged 13-17 years) from a large health care delivery system. Youth with depressive symptoms, based on a 2-item depression screen, were oversampled for the baseline interview. Baseline assessments included the Patient Health Questionnaire 9-item (PHQ-9) depression screen as well as clinical factors that were hypothesized to influence depression persistence (family history of depression, functional impairment, perceived social support, anxiety symptoms, externalizing symptoms, and medical comorbidity). Logistic regression analysis was used to examine factors associated with the persistence of depression at 6 months postbaseline. Of 113 youth with a positive baseline screen (PHQ-9 ≥11), 47% and 35% continued to be positive at 6-week and 6-month follow-up, respectively. After controlling for treatment status, only 2 factors were significantly associated with depression persistence at 6 months: baseline depressive symptom score and continuing to have a positive screen at 6 weeks. For each 1-point increase on the PHQ-9 score at baseline, youth had a 16% increased odds of continuing to be depressed at 6 months (odds ratio: 1.16, 95% confidence interval: 1.01-1.34). Youth who continued to screen positive 6 weeks later had almost 3 times the odds of being depressed at 6 months (odds ratio: 2.89, 95% confidence interval: 1.09-7.61). Depressive symptom severity at presentation and continued symptoms at 6 weeks postscreening are the strongest predictors of depression persistence. Patients with high depressive symptom scores and continued symptoms at 6 weeks should receive active treatment.

Methods of practice and guidelines for using survey-grade global navigation satellite systems (GNSS) to establish vertical datum in the United States Geological Survey

USGS Publications Warehouse

Rydlund, Jr., Paul H.; Densmore, Brenda K.

2012-01-01

Geodetic surveys have evolved through the years to the use of survey-grade (centimeter level) global positioning to perpetuate and post-process vertical datum. The U.S. Geological Survey (USGS) uses Global Navigation Satellite Systems (GNSS) technology to monitor natural hazards, ensure geospatial control for climate and land use change, and gather data necessary for investigative studies related to water, the environment, energy, and ecosystems. Vertical datum is fundamental to a variety of these integrated earth sciences. Essentially GNSS surveys provide a three-dimensional position x, y, and z as a function of the North American Datum of 1983 ellipsoid and the most current hybrid geoid model. A GNSS survey may be approached with post-processed positioning for static observations related to a single point or network, or involve real-time corrections to provide positioning "on-the-fly." Field equipment required to facilitate GNSS surveys range from a single receiver, with a power source for static positioning, to an additional receiver or network communicated by radio or cellular for real-time positioning. A real-time approach in its most common form may be described as a roving receiver augmented by a single-base station receiver, known as a single-base real-time (RT) survey. More efficient real-time methods involving a Real-Time Network (RTN) permit the use of only one roving receiver that is augmented to a network of fixed receivers commonly known as Continually Operating Reference Stations (CORS). A post-processed approach in its most common form involves static data collection at a single point. Data are most commonly post-processed through a universally accepted utility maintained by the National Geodetic Survey (NGS), known as the Online Position User Service (OPUS). More complex post-processed methods involve static observations among a network of additional receivers collecting static data at known benchmarks. Both classifications provide users flexibility regarding efficiency and quality of data collection. Quality assurance of survey-grade global positioning is often overlooked or not understood and perceived uncertainties can be misleading. GNSS users can benefit from a blueprint of data collection standards used to ensure consistency among USGS mission areas. A classification of GNSS survey qualities provide the user with the ability to choose from the highest quality survey used to establish objective points with low uncertainties, identified as a Level I, to a GNSS survey for general topographic control without quality assurance, identified as a Level IV. A Level I survey is strictly limited to post-processed methods, whereas Level II, Level III, and Level IV surveys integrate variations of a RT approach. Among these classifications, techniques involving blunder checks and redundancy are important, and planning that involves the assessment of the overall satellite configuration, as well as terrestrial and space weather, are necessary to ensure an efficient and quality campaign. Although quality indicators and uncertainties are identified in post-processed methods using CORS, the accuracy of a GNSS survey is most effectively expressed as a comparison to a local benchmark that has a high degree of confidence. Real-time and post-processed methods should incorporate these "trusted" benchmarks as a check during any campaign. Global positioning surveys are expected to change rapidly in the future. The expansion of continuously operating reference stations, combined with newly available satellite signals, and enhancements to the conterminous geoid, are all sufficient indicators for substantial growth in real-time positioning and quality thereof.

Alternative Pathways in Family Child Care Quality Rating and Improvement Systems

ERIC Educational Resources Information Center

Kelton, Robyn E.; Talan, Teri N.; Bloom, Paula J.

2013-01-01

As research continues to underscore the positive impact high-quality early childhood programs have on young children, numerous states have implemented quality rating and improvement systems (QRIS) to measure and improve the services young children receive across a wide range of early learning settings. These state systems range from two to five…

An Exploration of Challenges Facing Principals in Leading Differentiated Teaching Practices

ERIC Educational Resources Information Center

Patton Corley, Myrna Loy

2017-01-01

The need to improve student academic performance and school reform continue to receive national attention, but there is limited empirical data that explicates the positive impact of programs that are designed to address this phenomenon. Educators are presented with seemingly herculean challenges in meeting the needs of students from cultural…

Indoor Map Aided Wi-Fi Integrated Lbs on Smartphone Platforms

NASA Astrophysics Data System (ADS)

Yu, C.; El-Sheimy, N.

2017-09-01

In this research, an indoor map aided INS/Wi-Fi integrated location based services (LBS) applications is proposed and implemented on smartphone platforms. Indoor map information together with measurements from an inertial measurement unit (IMU) and Received Signal Strength Indicator (RSSI) value from Wi-Fi are collected to obtain an accurate, continuous, and low-cost position solution. The main challenge of this research is to make effective use of various measurements that complement each other without increasing the computational burden of the system. The integrated system in this paper includes three modules: INS, Wi-Fi (if signal available) and indoor maps. A cascade structure Particle/Kalman filter framework is applied to combine the different modules. Firstly, INS position and Wi-Fi fingerprint position integrated through Kalman filter for estimating positioning information. Then, indoor map information is applied to correct the error of INS/Wi-Fi estimated position through particle filter. Indoor tests show that the proposed method can effectively reduce the accumulation positioning errors of stand-alone INS systems, and provide stable, continuous and reliable indoor location service.

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

Poerschke, Andrew; Rudd, Armin

This report investigates the feasibility of using a home-run manifold small-diameter duct system to provide space-conditioning air to individual thermal zones in a low-load home. This compact layout allows duct systems to easily be brought within conditioned space via interior partition walls. Centrally locating the air handling unit in the house significantly reduces duct lengths. The plenum box is designed so that each connected duct receives a similar amount of airflow—regardless of its position on the box. Furthermore, within a reasonable set of length restrictions each duct continues to receive similar airflow.

Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants.

PubMed

Patel, Ravi M; Zimmerman, Kanecia; Carlton, David P; Clark, Reese; Benjamin, Daniel K; Smith, P Brian

2017-11-01

To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, <1500 g) infants receiving continuous positive airway pressure (CPAP) therapy, is associated with a decreased risk of CPAP failure in the first week of life. Multicenter, observational cohort study in 366 US neonatal intensive care units. We evaluated inborn, VLBW infants discharged from 2000 to 2014, who received only CPAP therapy without surfactant treatment on day of life (DOL) 0, had a 5-minute Apgar ≥3, and received caffeine in the first week of life. We used multivariable conditional logistic regression to compare the risk of CPAP failure, defined as invasive mechanical ventilation or surfactant therapy on DOL 1-6, by timing of caffeine treatment as either early (initiation on DOL 0) or routine (initiation on DOL 1-6). We identified 11 133 infants; 4528 (41%) received early caffeine and 6605 (59%) received routine caffeine. Median gestational age was lower in the early caffeine group, 29 weeks (25th, 75th percentiles; 28, 30) vs the routine caffeine group, 30 weeks (29, 31); P < 0.001. The incidence of CPAP failure on DOL 1-6 was similar between the early and routine caffeine groups: 22% vs 21%; adjusted OR = 1.05 (95% CI: 0.93, 1.18). Early caffeine treatment on the day of birth was not associated with a decreased risk of CPAP failure in the first week of life for VLBW infants initially treated with CPAP. Copyright © 2017 Elsevier Inc. All rights reserved.

The Effects of Sleep Continuity Disruption on Positive Mood and Sleep Architecture in Healthy Adults

PubMed Central

Finan, Patrick H.; Quartana, Phillip J.; Smith, Michael T.

2015-01-01

Objective: The purpose of this study was to test an experimental model of the effects of sleep continuity disturbance on sleep architecture and positive mood in order to better understand the mechanisms linking insomnia and depression. Design: Participants were randomized to receive 3 consecutive nights of sleep continuity disruption via forced nocturnal awakenings (FA, n = 21), or one of two control conditions: restricted sleep opportunity (RSO, n = 17) or uninterrupted sleep (US, n = 24). Setting: The study was set in an inpatient clinical research suite. Participants: Healthy, good-sleeping men and women were included. Measurement and Results: Polysomnography was used to measure sleep architecture, and mood was assessed via self-report each day. Compared to restricted sleep opportunity controls, forced awakenings subjects had significantly less slow wave sleep (P < 0.05) after the first night of sleep deprivation, and significantly lower positive mood (P < 0.05) after the second night of sleep deprivation. The differential change in slow wave sleep statistically mediated the observed group differences in positive mood (P = 0.002). Conclusions: To our knowledge, this is the first human experimental study to demonstrate that, despite comparable reductions in total sleep time, partial sleep loss from sleep continuity disruption is more detrimental to positive mood than partial sleep loss from delaying bedtime, even when controlling for concomitant increases in negative mood. With these findings, we provide temporal evidence in support of a putative biologic mechanism (slow wave sleep deficit) that could help explain the strong comorbidity between insomnia and depression. Citation: Finan PH, Quartana PJ, Smith MT. The effects of sleep continuity disruption on positive mood and sleep architecture in healthy adults. SLEEP 2015;38(11):1735–1742. PMID:26085289

Continued investigation of potential application of Omega navigation to civil aviation

NASA Technical Reports Server (NTRS)

Baxa, E. G., Jr.

1978-01-01

Major attention is given to an analysis of receiver repeatability in measuring OMEGA phase data. Repeatability is defined as the ability of two like receivers which are co-located to achieve the same LOP phase readings. Specific data analysis is presented. A propagation model is described which has been used in the analysis of propagation anomalies. Composite OMEGA analysis is presented in terms of carrier phase correlation analysis and the determination of carrier phase weighting coefficients for minimizing composite phase variation. Differential OMEGA error analysis is presented for receiver separations. Three frequency analysis includes LOP error and position error based on three and four OMEGA transmissions. Results of phase amplitude correlation studies are presented.

Working beyond 65: predictors of late retirement for women and men MBAs.

PubMed

Frieze, Irene Hanson; Olson, Josephine E; Murrell, Audrey J

2011-01-01

Comparisons of those who planned to continue working after the age of 65 with those who did not were made for 145 women and 414 men working in managerial fields. All received MBA degrees between the years of 1973 and 1982. About 20% definitely wanted to work after age 65. More positive views of work were predictive of wanting to continue working as was having nontraditional gender-role attitudes. Men who planned to continue working were particularly likely to have a spouse wanting to work past the age of 65. Several other factors appeared to operate differently for women and men.

45 CFR 2522.250 - What other benefits do AmeriCorps participants serving in approved AmeriCorps positions receive?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE AMERICORPS... Care. Grantees must provide child care through an eligible provider or a child care allowance in an amount determined by the Corporation to those full-time participants who need child care in order to...

Texting Test Results Reduces the Time to Treatment for Sexually Transmitted Infections.

PubMed

Bilello, Lori A; Livingood, William C; Lukens-Bull, Katryne; Smotherman, Carmen; Choe, Ulyee

2018-06-07

Sexually transmitted infections (STIs) continue to be a major health problem and source of health disparities in the United States. With diminishing resources, public health agencies are challenged to limit inefficient STI practices and still maintain effective population health. The purpose of this study was to implement a text-messaging strategy to convey STI test results and to assess whether texting positive results was associated with a shorter treatment time frame. Quasi-experimental design. Six counties in Florida. Sexually transmitted infection clients in 6 county health departments. Clients tested for gonorrhea, chlamydia, and syphilis were given the option to receive their results by a text message or the regular notification process (phone or follow-up clinic visit). The time to treatment after a positive test result for those clients who received their results by a text message versus the regular notification process. Those who were presumptively treated were excluded from the analysis. Over a 10-month period, 4081 clients were offered the texting option and 47.8% agreed to participate. For the counties combined, there was a higher percentage of those who received treatment within 1 to 4 days who received their positive test results by text message (53.0%) versus those who received their results by traditional methods (42.0%). In addition, there was a lower percentage of those who either did not get treated or were treated 8 days or more who received their positive test results by text message (26.1%) versus those who received their results by traditional methods (35.2%). Providing a text-messaging option is a viable strategy for clinics to provide timely results to their clients, and these clients were more likely to be treated in 1 to 4 days. Important for public health quality improvement, and increased efficiency and adoption of emerging technologies.

The effects of integrated nursing education on quality of life and health-related outcomes among obstructive sleep apnea patients receiving continuous positive airway pressure therapy.

PubMed

Hu, Shui-Tao; Yu, Chung-Chieh; Liu, Chieh-Yu; Tsao, Lee-Ing

2017-12-01

This study sought to examine the effects of a nursing education program on quality of life and sleep disturbance among obstructive sleep apnea (OSA) patients receiving continuous positive airway pressure (CPAP) therapy. This study was a randomized controlled trial with an intervention group consisting of a nursing education program. The intervention group received the instruction of the CPAP nursing education program, and the control group received routine care. Data was collected for both groups before the intervention (pre-test), on the 7th day measurement after the intervention, and on the 30th day measurement after the intervention. The results showed, first, that the intervention group reported a significantly reduced level of disturbance from wearing CPAP compared with that of the control group after the intervention (β = -1.83, p = .040). Second, the Calgary sleep apnea quality of life index (SAQLI) total scores significantly improved after the intervention (β = 1.669, p = 0.014). Also, symptoms of the SAQLI sub-items were improved and significantly different (β = 5.69, p = 0.007) after the intervention in the intervention group. According to the results of the study, the disturbance from wearing CPAP, the total score of the SAQLI and the symptoms of the SAQLI were significantly improved after the nursing education intervention. Therefore, an adequate nursing education program is recommended for the initial period of CPAP use among OSA patients.

Automated daily processing of more than 1000 ground-based GPS receivers for studying intense ionospheric storms

NASA Astrophysics Data System (ADS)

Komjathy, Attila; Sparks, Lawrence; Wilson, Brian D.; Mannucci, Anthony J.

2005-12-01

As the number of ground-based and space-based receivers tracking the Global Positioning System (GPS) satellites steadily increases, it is becoming possible to monitor changes in the ionosphere continuously and on a global scale with unprecedented accuracy and reliability. As of August 2005, there are more than 1000 globally distributed dual-frequency GPS receivers available using publicly accessible networks including, for example, the International GPS Service and the continuously operating reference stations. To take advantage of the vast amount of GPS data, researchers use a number of techniques to estimate satellite and receiver interfrequency biases and the total electron content (TEC) of the ionosphere. Most techniques estimate vertical ionospheric structure and, simultaneously, hardware-related biases treated as nuisance parameters. These methods often are limited to 200 GPS receivers and use a sequential least squares or Kalman filter approach. The biases are later removed from the measurements to obtain unbiased TEC. In our approach to calibrating GPS receiver and transmitter interfrequency biases we take advantage of all available GPS receivers using a new processing algorithm based on the Global Ionospheric Mapping (GIM) software developed at the Jet Propulsion Laboratory. This new capability is designed to estimate receiver biases for all stations. We solve for the instrumental biases by modeling the ionospheric delay and removing it from the observation equation using precomputed GIM maps. The precomputed GIM maps rely on 200 globally distributed GPS receivers to establish the "background" used to model the ionosphere at the remaining 800 GPS sites.

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

PubMed

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

2016-01-01

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

Nasal Jet-CPAP (variable flow) versus Bubble-CPAP in preterm infants with respiratory distress: an open label, randomized controlled trial.

PubMed

Bhatti, A; Khan, J; Murki, S; Sundaram, V; Saini, S S; Kumar, P

2015-11-01

To compare the failure rates between Jet continuous positive airway pressure device (J-CPAP-variable flow) and Bubble continuous positive airway device (B-CPAP) in preterm infants with respiratory distress. Preterm newborns <34 weeks gestation with onset of respiratory distress within 6 h of life were randomized to receive J-CPAP (a variable flow device) or B-CPAP (continuous flow device). A standardized protocol was followed for titration, weaning and removal of CPAP. Pressure was monitored close to the nares in both the devices every 6 hours and settings were adjusted to provide desired CPAP. The primary outcome was CPAP failure rate within 72 h of life. Secondary outcomes were CPAP failure within 7 days of life, need for surfactant post-randomization, time to CPAP failure, duration of CPAP and complications of prematurity. An intention to treat analysis was done. One-hundred seventy neonates were randomized, 80 to J-CPAP and 90 to B-CPAP. CPAP failure rates within 72 h were similar in infants who received J-CPAP and in those who received B-CPAP (29 versus 21%; relative risks 1.4 (0.8 to 2.3), P=0.25). Mean (95% confidence intervals) time to CPAP failure was 59 h (54 to 64) in the Jet CPAP group in comparison with 65 h (62 to 68) in the Bubble CPAP group (log rank P=0.19). All other secondary outcomes were similar between the two groups. In preterm infants with respiratory distress starting within 6 h of life, CPAP failure rates were similar with Jet CPAP and Bubble CPAP.

Preparing patients with cancer who work and treatment responsiveness.

PubMed

Kamau, Caroline

2017-03-01

Many patients with life-limiting illnesses continue to work because of financial reasons and because work provides good psychosocial support. A lack of appropriate advice/support through patient education could, however, make having a job detrimental to well-being (eg, symptom worsening). This study investigated the frequency with which patients received information that empowers their understanding of their condition, treatment, side effects of treatment and the likely impact on occupational functioning. A cross-sectional study. An analysis of survey data from 3457 patients with cancer in employment. Logistic regression showed that patients who received information about the impact of cancer on work life or education are 1.72 times more likely to have a positive treatment outcome. Patients who receive written information about the type of cancer are 1.99 times more likely to have a positive treatment outcome. Also, patients who receive written information before a cancer-related operation are 1.90 times more likely to have a positive treatment outcome. Information about the side effects of cancer treatment produces worse odds of a positive treatment outcome (0.65-1). A stepwise logistic regression analysing the effects irrespective of current employment status in 6710 patients showed that preparing them produces nearly twice better odds of cancer treatment responsiveness. Palliative care teams should consider ways of actively advising patients who work. Whereas the results showed evidence of good practice in cancer care, there is a need to ensure that all working patients with potentially life-limiting illnesses receive similar support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Pneumocephalus with BiPAP use after transsphenoidal surgery☆,☆☆,★

PubMed Central

Kopelovich, Jonathan C.; de la Garza, Gabriel O.; Greenlee, Jeremy D.W.; Graham, Scott M.; Udeh, Chiedozie I.; O'Brien, Erin K.

2013-01-01

While the benefits of continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) for patients with obstructive sleep apnea are well described, reports in the literature of complications from its use are rare. A patient who received postoperative BiPAP after undergoing transsphenoidal craniopharyngioma resection developed severe pneumocephalus and unplanned intensive care unit admission. Although the pneumocephalus resolved with conservative management over two weeks, we propose caution in the use of CPAP postoperatively in patients undergoing procedures of the head and neck. PMID:22626688

GPS Data Analysis for Earth Orientation at the Jet Propulsion Laboratory

NASA Technical Reports Server (NTRS)

Zumberge, J.; Webb, F.; Lindqwister, U.; Lichten, S.; Jefferson, D.; Ibanez-Meier, R.; Heflin, M.; Freedman, A.; Blewitt, G.

1994-01-01

Beginning June 1992 and continuing indefinitely as part of our contribution to FLINN (Fiducial Laboratories for an International Natural Science Network), DOSE (NASA's Dynamics of the Solid Earth Program), and the IGS (International GPS Geodynamics Service), analysts at the Jet Propulsion Laboratory (JPL) have routinely been reducing data from a globally-distributed network of Rogue Global Positioning System (GPS) receivers.

Mothering and Professing in the Ivory Tower: A Review of the Literature and a Call for a Research Agenda

ERIC Educational Resources Information Center

Eversole, Barbara A. W.; Harvey, Ashley M.; Zimmerman, Toni S.

2007-01-01

Although women outnumber men in receiving PhDs, the pipeline to tenure track positions leaks, particularly for mothers. In fact, the leak continues into the granting of tenure and the achievement of promotion. While having children increases a man's chances at attaining tenure and advancement, mothering decreasing a woman's chances. Implications…

Reductions in Transmission Risk Behaviors in HIV-Positive Clients Receiving Prevention Case Management Services: Findings from a Community Demonstration Project

ERIC Educational Resources Information Center

Gasiorowicz, Mari; Llanas, Michelle R.; DiFranceisco, Wayne; Benotsch, Eric G.; Brondino, Michael J.; Catz, Sheryl L.; Hoxie, Neil J.; Reiser, William J.; Vergeront, James M.

2005-01-01

Prevention case management (PCM) for HIV-infected persons is an HIV risk reduction intervention designed to assist clients who are aware of their HIV infection and who continue to engage in risk transmission behaviors. PCM combines individual risk reduction counseling with case management to address the psychosocial factors affecting HIV…

Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Ventilated With Continuous Positive Airway Pressure vs. Mechanical Ventilation

PubMed Central

Thomas, Cameron W.; Meinzen-Derr, Jareen; Hoath, Steven B.; Narendran, Vivek

2012-01-01

OBJECTIVE To compare continuous positive airway pressure (CPAP) vs. traditional mechanical ventilation (MV) at 24 h of age as predictors of neurodevelopmental (ND) outcomes in extremely low birth weight (ELBW) infants at 18-22 mo corrected gestational age (CGA). METHODS Infants ≤ 1000g birth weight born from January 2000 through December 2006 at two hospitals at the Cincinnati site of the National Institute of Child Health and Human Development Neonatal Research Network were evaluated comparing CPAP (N = 198) vs. MV (N = 109). Primary outcomes included the Bayley Score of Infant Development Version II (BSID-II), presence of deafness, blindness, cerebral palsy, bronchopulmonary dysplasia and death. RESULTS Ventilatory groups were similar in gender, rates of preterm prolonged rupture of membranes, antepartum hemorrhage, use of antenatal antibiotics, steroids, and tocolytics. Infants receiving CPAP weighed more, were older, were more likely to be non-Caucasian and from a singleton pregnancy. Infants receiving CPAP had better BSID-II scores, and lower rates of BPD and death. CONCLUSIONS After adjusting for acuity differences, ventilatory strategy at 24 h of age independently predicts long-term neurodevelopmental outcome in ELBW infants. PMID:21853318

Continuous Positive Airway Pressure Versus Oxygen Therapy in the Cardiac Surgical Ward: A Randomized Trial.

PubMed

Olper, Luigi; Bignami, Elena; Di Prima, Ambra L; Albini, Santina; Nascimbene, Simona; Cabrini, Luca; Landoni, Giovanni; Alfieri, Ottavio

2017-02-01

Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors' aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improving oxygenation in patients who developed hypoxemic acute respiratory failure after being discharged from the intensive care unit. Randomized, open-label trial. University hospital. Sixty-four patients with hypoxemia (PaO 2 /F I O 2 ratio between 100 and 250) admitted to the main ward after cardiac surgery. Patients were randomized to receive standard treatment (oxygen, early mobilization, a program of breathing exercises and diuretics) or continuous positive airway pressure in addition to standard treatment. Continuous positive airway pressure was administered 3 times a day for 2 consecutive days. Every cycle lasted 1 to 3 hours. All patients completed their 1-year follow-up. Data were analyzed according to the intention-to-treat principle. The primary endpoint was the number of patients with PaO 2 /F I O 2 <200 48 hours after randomization. Continuous positive airway pressure use was associated with a statistically significant reduction in the number of patients with PaO 2 /F I O 2 <200 (4/33 [12%] v 14/31 [45%], p = 0.003). One patient in the control group died at the 30-day follow-up. Among patients with acute respiratory failure following cardiac surgery, administration of continuous positive airway pressure in the main ward was associated with improved respiratory outcome. This was the first study that was performed in the main ward of post-surgical patients with acute respiratory failure. Copyright © 2017 Elsevier Inc. All rights reserved.

Research on anti - interference based on GNSS

NASA Astrophysics Data System (ADS)

Yu, Huanran; Liu, Yijun

2017-05-01

Satellite Navigation System has been widely used in military and civil fields. It has all-functional, all-weather, continuity and real-time characteristics, can provide the precise position, velocity and timing information's for the users. The environments where the receiver of satellite navigation system works become more and more complex, and the satellite signals are susceptible to intentional or unintentional interferences, anti-jamming capability has become a key problem of satellite navigation receiver's ability to work normal. In this paper, we study a DOA estimation algorithm based on linear symmetric matrix to improve the anti-jamming capability of the satellite navigation receiver, has great significance to improve the performance of satellite navigation system in complex electromagnetic environment and enhance its applicability in various environments.

A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system.

PubMed

Trevisanuto, Daniele; Grazzina, Nicoletta; Doglioni, Nicoletta; Ferrarese, Paola; Marzari, Francesco; Zanardo, Vincenzo

2005-06-01

We compared the effectiveness of a new continuous positive airway pressure (CPAP) device (neonatal helmet CPAP) with a conventional nasal CPAP system in preterm neonates needing continuous distending pressure. Randomized, physiological, cross-over study in a tertiary referral, neonatal intensive care unit in a university teaching hospital. Twenty very low birth weight infants with a postnatal age greater than 24 h who were receiving nasal CPAP for apnea and/or mild respiratory distress were enrolled. CPAP delivered by neonatal helmet CPAP and nasal CPAP in random order for two subsequent 90-min periods. Were continuously measured the Neonatal Infant Pain Scale (NIPS) score, oxygen requirements, respiratory rate, heart rate, oxygen saturation, transcutaneous PO(2) (tcPO(2)) and PCO(2) (tcPCO(2)), blood pressure, and desaturations. NIPS scores were significantly lower when the infants were on the neonatal helmet CPAP than when they were on nasal CPAP (0.26+/-0.07 vs. 0.63+/-0.12). The other studied parameters did not differ between the two CPAP modes. The number of desaturations was reduced during the neonatal helmet CPAP treatment (18 vs. 32), although this difference was not significant. In this short-term physiological study the neonatal helmet CPAP appears to be as good as the golden standard for managing preterm infants needing continuous distending pressure, with enhanced tolerability. Further evaluation in a randomized clinical trial is needed to confirm these findings.

Mapping stream habitats with a global positioning system: Accuracy, precision, and comparison with traditional methods

USGS Publications Warehouse

Dauwalter, D.C.; Fisher, W.L.; Belt, K.C.

2006-01-01

We tested the precision and accuracy of the Trimble GeoXT??? global positioning system (GPS) handheld receiver on point and area features and compared estimates of stream habitat dimensions (e.g., lengths and areas of riffles and pools) that were made in three different Oklahoma streams using the GPS receiver and a tape measure. The precision of differentially corrected GPS (DGPS) points was not affected by the number of GPS position fixes (i.e., geographic location estimates) averaged per DGPS point. Horizontal error of points ranged from 0.03 to 2.77 m and did not differ with the number of position fixes per point. The error of area measurements ranged from 0.1% to 110.1% but decreased as the area increased. Again, error was independent of the number of position fixes averaged per polygon corner. The estimates of habitat lengths, widths, and areas did not differ when measured using two methods of data collection (GPS and a tape measure), nor did the differences among methods change at three stream sites with contrasting morphologies. Measuring features with a GPS receiver was up to 3.3 times faster on average than using a tape measure, although signal interference from high streambanks or overhanging vegetation occasionally limited satellite signal availability and prolonged measurements with a GPS receiver. There were also no differences in precision of habitat dimensions when mapped using a continuous versus a position fix average GPS data collection method. Despite there being some disadvantages to using the GPS in stream habitat studies, measuring stream habitats with a GPS resulted in spatially referenced data that allowed the assessment of relative habitat position and changes in habitats over time, and was often faster than using a tape measure. For most spatial scales of interest, the precision and accuracy of DGPS data are adequate and have logistical advantages when compared to traditional methods of measurement. ?? 2006 Springer Science+Business Media, Inc.

Refining the Use of Nasal High-Flow Therapy as Primary Respiratory Support for Preterm Infants.

PubMed

Manley, Brett J; Roberts, Calum T; Frøisland, Dag H; Doyle, Lex W; Davis, Peter G; Owen, Louise S

2018-05-01

To identify clinical and demographic variables that predict nasal high-flow (nHF) treatment failure when used as a primary respiratory support for preterm infants. This secondary analysis used data from a multicenter, randomized, controlled trial comparing nHF with continuous positive airway pressure as primary respiratory support in preterm infants 28-36 completed weeks of gestation. Treatment success or failure with nHF was determined using treatment failure criteria within the first 72 hours after randomization. Infants in whom nHF treatment failed received continuous positive airway pressure, and were then intubated if failure criteria were again met. There were 278 preterm infants included, with a mean gestational age (GA) of 32.0 ± 2.1 weeks and a birth weight of 1737 ± 580 g; of these, nHF treatment failed in 71 infants (25.5%). Treatment failure was moderately predicted by a lower GA and higher prerandomization fraction of inspired oxygen (FiO 2 ): area under a receiver operating characteristic curve of 0.76 (95% CI, 0.70-0.83). Nasal HF treatment success was more likely in infants born at ≥30 weeks GA and with prerandomization FiO 2 <0.30. In preterm infants ≥28 weeks' GA enrolled in a randomized, controlled trial, lower GA and higher FiO 2 before randomization predicted early nHF treatment failure. Infants were more likely to be successfully treated with nHF from soon after birth if they were born at ≥30 weeks GA and had a prerandomization FiO 2 <0.30. However, even in this select population, continuous positive airway pressure remains superior to nHF as early respiratory support in preventing treatment failure. Australian New Zealand Clinical Trials Registry: ACTRN12613000303741. Copyright © 2018 Elsevier Inc. All rights reserved.

96 weeks treatment of tenofovir alafenamide vs. tenofovir disoproxil fumarate for hepatitis B virus infection.

PubMed

Agarwal, Kosh; Brunetto, Maurizia; Seto, Wai Kay; Lim, Young-Suk; Fung, Scott; Marcellin, Patrick; Ahn, Sang Hoon; Izumi, Namiki; Chuang, Wan-Long; Bae, Ho; Sharma, Manoj; Janssen, Harry L A; Pan, Calvin Q; Çelen, Mustafa Kemal; Furusyo, Norihiro; Shalimar, Dr; Yoon, Ki Tae; Trinh, Huy; Flaherty, John F; Gaggar, Anuj; Lau, Audrey H; Cathcart, Andrea L; Lin, Lanjia; Bhardwaj, Neeru; Suri, Vithika; Mani Subramanian, G; Gane, Edward J; Buti, Maria; Chan, Henry L Y

2018-04-01

Tenofovir alafenamide (TAF) is a new prodrug of tenofovir developed to treat patients with chronic hepatitis B virus (HBV) infection at a lower dose than tenofovir disoproxil fumarate (TDF) through more efficient delivery of tenofovir to hepatocytes. In 48-week results from two ongoing, double-blind, randomized phase III trials, TAF was non-inferior to TDF in efficacy with improved renal and bone safety. We report 96-week outcomes for both trials. In two international trials, patients with chronic HBV infection were randomized 2:1 to receive 25 mg TAF or 300 mg TDF in a double-blinded fashion. One study enrolled HBeAg-positive patients and the other HBeAg-negative patients. We assessed efficacy in each study, and safety in the pooled population. At week 96, the differences in the rates of viral suppression were similar in HBeAg-positive patients receiving TAF and TDF (73% vs. 75%, respectively, adjusted difference -2.2% (95% CI -8.3 to 3.9%; p = 0.47), and in HBeAg-negative patients receiving TAF and TDF (90% vs. 91%, respectively, adjusted difference -0.6% (95% CI -7.0 to 5.8%; p = 0.84). In both studies the proportions of patients with alanine aminotransferase above the upper limit of normal at baseline, who had normal alanine aminotransferase at week 96 of treatment, were significantly higher in patients receiving TAF than in those receiving TDF. In the pooled safety population, patients receiving TAF had significantly smaller decreases in bone mineral density than those receiving TDF in the hip (mean % change -0.33% vs. -2.51%; p <0.001) and lumbar spine (mean % change -0.75% vs. -2.57%; p <0.001), as well as a significantly smaller median change in estimated glomerular filtration rate by Cockcroft-Gault method (-1.2 vs. -4.8 mg/dl; p <0.001). In patients with HBV infection, TAF remained as effective as TDF, with continued improved renal and bone safety, two years after the initiation of treatment. Clinicaltrials.gov number: NCT01940471 and NCT01940341. At week 96 of two ongoing studies comparing the efficacy and safety of tenofovir alafenamide (TAF) to tenofovir disoproxil fumarate (TDF) for the treatment of chronic hepatitis B patients, TAF continues to be as effective as TDF with continued improved renal and bone safety. Registration: Clinicaltrials.gov number: NCT01940471 and NCT01940341. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

The Effects of Sleep Continuity Disruption on Positive Mood and Sleep Architecture in Healthy Adults.

PubMed

Finan, Patrick H; Quartana, Phillip J; Smith, Michael T

2015-11-01

The purpose of this study was to test an experimental model of the effects of sleep continuity disturbance on sleep architecture and positive mood in order to better understand the mechanisms linking insomnia and depression. Participants were randomized to receive 3 consecutive nights of sleep continuity disruption via forced nocturnal awakenings (FA, n = 21), or one of two control conditions: restricted sleep opportunity (RSO, n = 17) or uninterrupted sleep (US, n = 24). The study was set in an inpatient clinical research suite. Healthy, good-sleeping men and women were included. Polysomnography was used to measure sleep architecture, and mood was assessed via self-report each day. Compared to restricted sleep opportunity controls, forced awakenings subjects had significantly less slow wave sleep (P < 0.05) after the first night of sleep deprivation, and significantly lower positive mood (P < 0.05) after the second night of sleep deprivation. The differential change in slow wave sleep statistically mediated the observed group differences in positive mood (P = 0.002). To our knowledge, this is the first human experimental study to demonstrate that, despite comparable reductions in total sleep time, partial sleep loss from sleep continuity disruption is more detrimental to positive mood than partial sleep loss from delaying bedtime, even when controlling for concomitant increases in negative mood. With these findings, we provide temporal evidence in support of a putative biologic mechanism (slow wave sleep deficit) that could help explain the strong comorbidity between insomnia and depression. © 2015 Associated Professional Sleep Societies, LLC.

Impact of Prophylactic Continuous Positive Airway Pressure on Transient Tachypnea of the Newborn and Neonatal Intensive Care Admission in Newborns Delivered by Elective Cesarean Section.

PubMed

Celebi, Miray Yilmaz; Alan, Serdar; Kahvecioglu, Dilek; Cakir, Ufuk; Yildiz, Duran; Erdeve, Omer; Arsan, Saadet; Atasay, Begum

2016-01-01

This study aims to evaluate the effect of the prophylactic continuous positive airway pressure (CPAP) administration in the delivery room to newborns who were delivered by elective cesarean section (CS). Inborn infants with gestational age between 34(0/7) to 38(6/7) and born by elective CS were prospectively randomized to receive either prophylactic CPAP for 20 minutes via face mask or standardized care without CPAP in the delivery room. Primary outcomes were the incidence of transient tachypnea of the newborn (TTN) and neonatal intensive care unit (NICU) admission due to respiratory distress. A total of 259 infants with a mean gestational age of 37.7 ± 0.8 weeks and birth weight of 3,244 ± 477 g were included. A total of 134 infants received prophylactic CPAP and 125 received control standard care. The rate of NICU admission was significantly lower in prophylactic CPAP group (p = 0.045). Although the rate of TTN was lower in the prophylactic CPAP group, the difference was not statistically significant (p = 0.059). The rate of NICU admission due to respiratory distress was significantly higher in late-preterm cohort than early-term cohort (p < 0.0001). Prophylactic CPAP administration decreases the rate of NICU admission without any side effect in late-preterm and early-term infants delivered by elective CS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Continuous measurement of breast tumor hormone receptor expression: a comparison of two computational pathology platforms

PubMed Central

Ahern, Thomas P.; Beck, Andrew H.; Rosner, Bernard A.; Glass, Ben; Frieling, Gretchen; Collins, Laura C.; Tamimi, Rulla M.

2017-01-01

Background Computational pathology platforms incorporate digital microscopy with sophisticated image analysis to permit rapid, continuous measurement of protein expression. We compared two computational pathology platforms on their measurement of breast tumor estrogen receptor (ER) and progesterone receptor (PR) expression. Methods Breast tumor microarrays from the Nurses’ Health Study were stained for ER (n=592) and PR (n=187). One expert pathologist scored cases as positive if ≥1% of tumor nuclei exhibited stain. ER and PR were then measured with the Definiens Tissue Studio (automated) and Aperio Digital Pathology (user-supervised) platforms. Platform-specific measurements were compared using boxplots, scatter plots, and correlation statistics. Classification of ER and PR positivity by platform-specific measurements was evaluated with areas under receiver operating characteristic curves (AUC) from univariable logistic regression models, using expert pathologist classification as the standard. Results Both platforms showed considerable overlap in continuous measurements of ER and PR between positive and negative groups classified by expert pathologist. Platform-specific measurements were strongly and positively correlated with one another (rho≥0.77). The user-supervised Aperio workflow performed slightly better than the automated Definiens workflow at classifying ER positivity (AUCAperio=0.97; AUCDefiniens=0.90; difference=0.07, 95% CI: 0.05, 0.09) and PR positivity (AUCAperio=0.94; AUCDefiniens=0.87; difference=0.07, 95% CI: 0.03, 0.12). Conclusion Paired hormone receptor expression measurements from two different computational pathology platforms agreed well with one another. The user-supervised workflow yielded better classification accuracy than the automated workflow. Appropriately validated computational pathology algorithms enrich molecular epidemiology studies with continuous protein expression data and may accelerate tumor biomarker discovery. PMID:27729430

Millimetre Level Accuracy GNSS Positioning with the Blind Adaptive Beamforming Method in Interference Environments.

PubMed

Daneshmand, Saeed; Marathe, Thyagaraja; Lachapelle, Gérard

2016-10-31

The use of antenna arrays in Global Navigation Satellite System (GNSS) applications is gaining significant attention due to its superior capability to suppress both narrowband and wideband interference. However, the phase distortions resulting from array processing may limit the applicability of these methods for high precision applications using carrier phase based positioning techniques. This paper studies the phase distortions occurring with the adaptive blind beamforming method in which satellite angle of arrival (AoA) information is not employed in the optimization problem. To cater to non-stationary interference scenarios, the array weights of the adaptive beamformer are continuously updated. The effects of these continuous updates on the tracking parameters of a GNSS receiver are analyzed. The second part of this paper focuses on reducing the phase distortions during the blind beamforming process in order to allow the receiver to perform carrier phase based positioning by applying a constraint on the structure of the array configuration and by compensating the array uncertainties. Limitations of the previous methods are studied and a new method is proposed that keeps the simplicity of the blind beamformer structure and, at the same time, reduces tracking degradations while achieving millimetre level positioning accuracy in interference environments. To verify the applicability of the proposed method and analyze the degradations, array signals corresponding to the GPS L1 band are generated using a combination of hardware and software simulators. Furthermore, the amount of degradation and performance of the proposed method under different conditions are evaluated based on Monte Carlo simulations.

Health, Social, and Economic Outcomes Experienced by Families as a Result of Receiving Assistance from a Community-Based Diaper Bank.

PubMed

Massengale, Kelley E C; Erausquin, Jennifer Toller; Old, Michelle

2017-10-01

Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers. Results Families experience regularly a range of challenges meeting basic needs. These difficulties include high unmet needs for transportation, food, and nonfood essentials such as personal hygiene items. Families experiencing the greatest difficulty in paying utility or medical bills were significantly more likely to have a high level of diaper need compared to families facing these challenges less often (AORs ranging from 3.40 to 9.39). As a result of receiving diapers, families reported positive health, social, and economic outcomes. Families reported positive changes in parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to divert household finances toward other basic needs, including utilities and medical care. Conclusions for Practice The monetary value of the supplemental provision of diapers is a small investment in affected families' economic, social, and health outcomes. The positive effects continue far longer than the diapers provided. We demonstrate the social value of such an operation, and recommend the expansion of federal, state, and local safety net programs to help low-income families secure a steady supply of diapers.

USAF Inorganic Coating Successes

DTIC Science & Technology

2012-08-01

Sodium dichromate solution, 50 parts per million Benchmark Permanganate Seal Candidate 1 Low Nickel Seal (with a hot water seal) Candidate 2A Low...requested by OO-ALC • Continue assisting OO-ALC with implementing permanganate sealer – Received approval from Engineering Review Board (ERB...to use the permanganate seal for Type II anodizing operations • Position OO-ALC for a completely Cr-free surface finishing operation – Anodizing

Ukraine: Current Issues and U.S. Policy

DTIC Science & Technology

2014-05-08

Ukrainian government committed to reforms. In May 2014, the Ukrainian government received the first installment of a $17 billion IMF loan. The European...sensitive position between Russia and NATO member states Poland, Slovakia, Hungary, and Romania adds to its geostrategic significance. Many Russian...continue their efforts at destabilization unhindered. After Ukraine re-launched an “anti-terrorist operation” on April 23 (after setbacks on a first

Pneumonitis: a serious adverse effect of PD-L1 inhibitors including pembrolizumab.

PubMed

Rickard, Frances; Hyams, Catherine; Low, Andrew T

2018-05-07

A 70-year-old man presented with breathlessness, cough and fever while receiving pembrolizumab for melanoma. A CT pulmonary angiogram demonstrated small bilateral upper lobe segmental pulmonary emboli with patchy ground-glass opacities and basal perilobular consolidation, in keeping with organising pneumonia. He was treated for community-acquired pneumonia and pulmonary emboli but rapidly deteriorated, with increasing hypoxia and dyspnoea. He was admitted to the intensive care unit for support with continuous positive airway pressure and high flow nasal oxygen. His clinical condition improved once he received high-dose intravenous methylprednisolone to treat pneumonitis. His treatment was continued with a weaning course of high-dose oral steroids, and he was discharged with a persistent oxygen requirement. The patient maintained a requirement for high doses of oral steroids and continued to deteriorate. He was referred to palliative care for symptom management and died a month following hospital discharge, as a result of pneumonitis due to pembrolizumab. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Solar central receiver heliostat reflector assembly

DOEpatents

Horton, Richard H.; Zdeb, John J.

1980-01-01

A heliostat reflector assembly for a solar central receiver system comprises a light-weight, readily assemblable frame which supports a sheet of stretchable reflective material and includes mechanism for selectively applying tension to and positioning the sheet to stretch it to optical flatness. The frame is mounted on and supported by a pipe pedestal assembly that, in turn, is installed in the ground. The frame is controllably driven in a predetermined way by a light-weight drive system so as to be angularly adjustable in both elevation and azimuth to track the sun and efficiently continuously reflect the sun's rays to a focal zone, i.e. central receiver, which forms part of a solar energy utilization system, such as a solar energy fueled electrical power generation system. The frame may include a built-in system for testing for optical flatness of the reflector. The preferable geometric configuration of the reflector is octagonal; however, it may be other shapes, such as hexagonal, pentagonal or square. Several different embodiments of means for tensioning and positioning the reflector to achieve optical flatness are disclosed. The reflector assembly is based on the stretch frame concept which provides an extremely light-weight, simple, low-cost reflector assembly that may be driven for positioning and tracking by a light-weight, inexpensive drive system.

Apparatus and method for continuous separation of magnetic particles from non-magnetic fluids

DOEpatents

Oder, Robin R.; Jamison, Russell E.

2010-02-09

A magnetic separator vessel (1) for separating magnetic particles from non-magnetic fluid includes a separation chamber having an interior and exterior wall, a top and bottom portion; a magnet (3) having first and second poles (2) positioned adjacent to the exterior wall, wherein the first pole is substantially diametrically opposed to the second pole; a inlet port (5) is directed into the top portion of the separation chamber, wherein the inlet port (5) is positioned adjacent to one of the first and second poles (2), wherein the inlet port (5) is adapted to transfer a mixture into the separation chamber; an underflow port (6) in communication with the bottom portion, wherein the underflow port (6) is adapted to receive the magnetic particles; and an overflow port (9) in communication with the separation chamber, wherein the overflow port (9) is adapted to receive the non-magnetic fluid.

Real-Time GPS Monitoring for Earthquake Rapid Assessment in the San Francisco Bay Area

NASA Astrophysics Data System (ADS)

Guillemot, C.; Langbein, J. O.; Murray, J. R.

2012-12-01

The U.S. Geological Survey Earthquake Science Center has deployed a network of eight real-time Global Positioning System (GPS) stations in the San Francisco Bay area and is implementing software applications to continuously evaluate the status of the deformation within the network. Real-time monitoring of the station positions is expected to provide valuable information for rapidly estimating source parameters should a large earthquake occur in the San Francisco Bay area. Because earthquake response applications require robust data access, as a first step we have developed a suite of web-based applications which are now routinely used to monitor the network's operational status and data streaming performance. The web tools provide continuously updated displays of important telemetry parameters such as data latency and receive rates, as well as source voltage and temperature information within each instrument enclosure. Automated software on the backend uses the streaming performance data to mitigate the impact of outages, radio interference and bandwidth congestion on deformation monitoring operations. A separate set of software applications manages the recovery of lost data due to faulty communication links. Displacement estimates are computed in real-time for various combinations of USGS, Plate Boundary Observatory (PBO) and Bay Area Regional Deformation (BARD) network stations. We are currently comparing results from two software packages (one commercial and one open-source) used to process 1-Hz data on the fly and produce estimates of differential positions. The continuous monitoring of telemetry makes it possible to tune the network to minimize the impact of transient interruptions of the data flow, from one or more stations, on the estimated positions. Ongoing work is focused on using data streaming performance history to optimize the quality of the position, reduce drift and outliers by switching to the best set of stations within the network, and automatically select the "next best" station to use as reference. We are also working towards minimizing the loss of streamed data during concurrent data downloads by improving file management on the GPS receivers.

Long-Term Prognostic Risk After Neoadjuvant Chemotherapy Associated With Residual Cancer Burden and Breast Cancer Subtype

PubMed Central

Wei, Caimiao; Gould, Rebekah; Yu, Xian; Zhang, Ya; Liu, Mei; Walls, Andrew; Bousamra, Alex; Ramineni, Maheshwari; Sinn, Bruno; Hunt, Kelly; Buchholz, Thomas A.; Valero, Vicente; Buzdar, Aman U.; Yang, Wei; Brewster, Abenaa M.; Moulder, Stacy; Pusztai, Lajos; Hatzis, Christos; Hortobagyi, Gabriel N.

2017-01-01

Purpose To determine the long-term prognosis in each phenotypic subset of breast cancer related to residual cancer burden (RCB) after neoadjuvant chemotherapy alone, or with concurrent human epidermal growth factor receptor 2 (HER2)–targeted treatment. Methods We conducted a pathologic review to measure the continuous RCB index (wherein pathologic complete response has RCB = 0; residual disease is categorized into three predefined classes of RCB index [RCB-I, RCB-II, and RCB-III]), and yp-stage of residual disease. Patients were prospectively observed for survival. Three patient cohorts received paclitaxel (T) followed by fluorouracil, doxorubicin, and cyclophosphamide (T/FAC): original development cohort (T/FAC-1), validation cohort (T/FAC-2), and independent validation cohort (T/FAC-3). Another validation cohort received FAC chemotherapy only, and a fifth cohort received concurrent trastuzumab (H) with sequential paclitaxel and fluorouracil, epirubicin, and cyclophosphamide (FEC; H+T/FEC). Phenotypic subsets were defined by hormone receptor (HR) and HER2 status at diagnosis, classified as HR-positive/HER2-negative, HER2-positive (HR-negative/HER2-positive or HR-positive/HER2-positive), or triple receptor–negative. Relapse-free survival estimates were determined from Kaplan-Meier analysis and compared using the log-rank test. Results Five cohorts (T/FAC-1 [n = 219], T/FAC-2 [n = 262], T/FAC-3 [n = 342], FAC [n = 132], and H+T/FEC [n = 203]) had median event-free follow-up of 13.5, 9.1, 6.8, 16.4, and 7.1 years, respectively. Continuous RCB index was prognostic within each phenotypic subset, independent of other clinical-pathologic variables. RCB classes stratified prognostic risk overall, within each phenotypic subset, and within yp-stage categories. Estimates of 10-year relapse-free survival rates in the four RCB classes (pathologic complete response, RCB-I, RCB-II, and RCB-III) were 86%, 81%, 55%, and 23% for triple receptor–negative; 83%, 97%, 74%, and 52% for HR-positive/HER2-negative in the combined T/FAC cohorts; and 95%, 77%, 47%, and 21% in the H+T/FEC cohort. Conclusion RCB was prognostic for long-term survival after neoadjuvant chemotherapy in all three phenotypic subsets of breast cancer. Our institutional findings should be externally validated. PMID:28135148

Comparison of the Effects of Intermittent Boluses to Simple Continuous Infusion on Patients' Global Perceived Effect in Intrathecal Therapy for Pain: A Randomized Double-Blind Crossover Study.

PubMed

Eldabe, Sam; Duarte, Rui V; Madzinga, Grace; Batterham, Alan M; Brookes, Morag E; Gulve, Ashish P; Perruchoud, Christophe; Raphael, Jon H; Lorenzana, David; Buchser, Eric

2017-05-01

Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. Eligible patients implanted with a programmable ITDD device were randomized to receive two weeks of either intermittent boluses or a simple continuous flow in period 1, followed by a crossover to the alternative mode of administration. The primary outcome measure was the Patients' Global Impression of Change (PGIC) scale. The mean proportion of positive responders (at least "minimally improved") was 38.4% in the continuous condition vs 37.3% in the bolus (difference in proportions = 1.1%, 95% confidence interval [CI] = -21.8-24.0%, P  = 0.93). The mean PGIC in the continuous condition was 3.8 vs 3.9 in the bolus (mean difference = -0.1, -0.6-0.4, P  = 0.72). Exploratory analyses revealed a tendency for the mean proportion of positive responders to be higher at low vs high flow rates for both bolus and continuous administrations. Two patients were withdrawn from the study due to adverse events during the bolus phase, both with symptoms of increased pain, and one patient with additional symptoms of numbness and urinary retention. The mean PGIC and proportion of positive responders was not substantially different after intermittent bolus vs continuous administration. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Faculty Science Positions Continue to Elude Women of Color: Oklahoma Professor's Study Finds Hiring, Tenure Remain Stumbling Blocks

ERIC Educational Resources Information Center

Hamilton, Kendra

2004-01-01

Women and underrepresented minorities are receiving the doctorate in record numbers these days. For example, women got 45 percent and minorities 19 percent of the 39,955 doctoral degrees awarded in 2000, and both figures were all-time highs. So it comes as something of a surprise to learn that senior academic women in science and engineering are…

Comparison of Image Processing Techniques using Random Noise Radar

DTIC Science & Technology

2014-03-27

detection UWB ultra-wideband EM electromagnetic CW continuous wave RCS radar cross section RFI radio frequency interference FFT fast Fourier transform...several factors including radar cross section (RCS), orientation, and material makeup. A single monostatic radar at some position collects only range and...Chapter 2 is to provide the theory behind noise radar and SAR imaging. Section 2.1 presents the basic concepts in transmitting and receiving random

SV40 T antigen alone drives karyotype instability that precedes neoplastic transformation of human diploid fibroblasts.

PubMed

Ray, F A; Peabody, D S; Cooper, J L; Cram, L S; Kraemer, P M

1990-01-01

To define the role of SV40 large T antigen in the transformation and immortalization of human cells, we have constructed a plasmid lacking most of the unique coding sequences of small t antigen as well as the SV40 origin of replication. The promoter for T antigen, which lies within the origin of replication, was deleted and replaced by the Rous sarcoma virus promoter. This minimal construct was co-electroporated into normal human fibroblasts of neonatal origin along with a plasmid containing the neomycin resistance gene (neo). Three G418-resistant, T antigen-positive clones were expanded and compared to three T antigen-positive clones that received the pSV3neo plasmid (capable of expressing large and small T proteins and having two origins of replication). Autonomous replication of plasmid DNA was observed in all three clones that received pSV3neo but not in any of the three origin minus clones. Immediately after clonal expansion, several parameters of neoplastic transformation were assayed. Low percentages of cells in T antigen-positive populations were anchorage independent or capable of forming colonies in 1% fetal bovine serum. The T antigen-positive clones generally exhibited an extended lifespan in culture but rarely became immortalized. Large numbers of dead cells were continually generated in all T antigen-positive, pre-crisis populations. Ninety-nine percent of all T antigen-positive cells had numerical or structural chromosome aberrations. Control cells that received the neo gene did not have an extended life span, did not have noticeable numbers of dead cells, and did not exhibit karyotype instability. We suggest that the role of T antigen protein in the transformation process is to generate genetic hypervariability, leading to various consequences including neoplastic transformation and cell death.

Continuous Positive Airway Pressure During Exercise Improves Walking Time in Patients Undergoing Inpatient Cardiac Rehabilitation After Coronary Artery Bypass Graft Surgery: A RANDOMIZED CONTROLLED TRIAL.

PubMed

Pantoni, Camila Bianca Falasco; Di Thommazo-Luporini, Luciana; Mendes, Renata Gonçalves; Caruso, Flávia Cristina Rossi; Mezzalira, Daniel; Arena, Ross; Amaral-Neto, Othon; Catai, Aparecida Maria; Borghi-Silva, Audrey

2016-01-01

Continuous positive airway pressure (CPAP) has been used as an effective support to decrease the negative pulmonary effects of coronary artery bypass graft (CABG) surgery. However, it is unknown whether CPAP can positively influence patients undergoing CABG during exercise. This study evaluated the effectiveness of CPAP on the first day of ambulation after CABG in patients undergoing inpatient cardiac rehabilitation (CR). Fifty-four patients after CABG surgery were randomly assigned to receive either inpatient CR and CPAP (CPG) or standard CR without CPAP (CG). Cardiac rehabilitation included walking and CPAP pressures were set between 10 to 12 cmH2O. Participants were assessed on the first day of walking at rest and during walking. Outcome measures included breathing pattern variables, exercise time in seconds (ETs), dyspnea/leg effort ratings, and peripheral oxygen saturation (SpO2). Twenty-seven patients (13 CPG vs 14 CG) completed the study. Compared with walking without noninvasive ventilation assistance, CPAP increased ETs by 43.4 seconds (P = .040) during walking, promoted better thoracoabdominal coordination, increased ventilation during walking by 12.5 L/min (P = .001), increased SpO2 values at the end of walking by 2.6% (P = .016), and reduced dyspnea ratings by 1 point (P = .008). Continuous positive airway pressure can positively influence exercise tolerance, ventilatory function, and breathing pattern in response to a single bout of exercise after CABG.

Influence of body position on the displacement of nasal prongs in preterm newborns receiving continuous positive airway pressure

PubMed Central

Brunherotti, Marisa Afonso Andrade; Martinez, Francisco Eulógio

2015-01-01

Abstract Objective: To evaluate the influence of body position on the displacement of nasal prongs in preterm infants. Methods: This prospective, randomized, crossover study enrolled infants born at a mean gestational age of 29.7±2 weeks, birth weight of 1353±280g and 2.9±2.2 days of life, submitted to continuous positive airway pressure by nasal prongs. The main outcome was the number of times that the nasal prongs were displaced following infant positioning in the following body positions: prone, right lateral, left lateral, and supine, according to a pre-established random order. Moreover, cardiorespiratory variables (respiratory rate, heart rate, and oxygen saturation) were evaluated for each body position. Data for each position were collected every 10 min, over a period of 60 min. An occurrence was defined when the nasal prongs were displaced from the nostrils after 3 min in the desired position, requiring intervention of the examiner. Results: Among the 16 studied infants, the occurrence of nasal prong displacement was only observed in the prone position (9 infants - 56.2%) and in the left lateral position (2 infants - 12.5%). The number of times that the prongs were displaced was 11 in the prone position (7 within the first 10min) and 2 in the left lateral position (1 within the first 10min). No clinically significant changes were observed in the cardiorespiratory variables. Conclusions: Maintenance of the nasal prongs to provide adequate noninvasive respiratory support was harder in the prone position. PMID:26116326

Evaluation of treatment-effect heterogeneity using biomarkers measured on a continuous scale: subpopulation treatment effect pattern plot.

PubMed

Lazar, Ann A; Cole, Bernard F; Bonetti, Marco; Gelber, Richard D

2010-10-10

The discovery of biomarkers that predict treatment effectiveness has great potential for improving medical care, particularly in oncology. These biomarkers are increasingly reported on a continuous scale, allowing investigators to explore how treatment efficacy varies as the biomarker values continuously increase, as opposed to using arbitrary categories of expression levels resulting in a loss of information. In the age of biomarkers as continuous predictors (eg, expression level percentage rather than positive v negative), alternatives to such dichotomized analyses are needed. The purpose of this article is to provide an overview of an intuitive statistical approach-the subpopulation treatment effect pattern plot (STEPP)-for evaluating treatment-effect heterogeneity when a biomarker is measured on a continuous scale. STEPP graphically explores the patterns of treatment effect across overlapping intervals of the biomarker values. As an example, STEPP methodology is used to explore patterns of treatment effect for varying levels of the biomarker Ki-67 in the BIG (Breast International Group) 1-98 randomized clinical trial comparing letrozole with tamoxifen as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer. STEPP analyses showed patients with higher Ki-67 values who were assigned to receive tamoxifen had the poorest prognosis and may benefit most from letrozole.

A Prospective, Longitudinal Study of the Impact of GJB2/GJB6 Genetic Testing on the Beliefs and Attitudes of Parents of Deaf and Hard-of-Hearing Infants

PubMed Central

Palmer, Christina G.S.; Martinez, Ariadna; Fox, Michelle; Zhou, Jin; Shapiro, Nina; Sininger, Yvonne; Grody, Wayne W.; Schimmenti, Lisa A.

2010-01-01

There are limited data on the impact of incorporating genetic counseling and testing into the newborn hearing screening process. We report on results from a prospective, longitudinal study to determine the impact of genetic counseling and GJB2/GJB6 genetic testing on parental knowledge, attitudes, and beliefs about genetic testing. One hundred thirty culturally hearing parents of 93 deaf or hard-of-hearing children ages 0 – 3 years primarily identified through newborn hearing screening received pre- and post-test genetic counseling for GJB2 and GJB6. Parents completed questionnaires following pre-test counseling, and 1- and 6-months post-test result disclosure. Results indicate that following pre-test counseling all parents perceived benefits to genetic testing. While parents who received positive results continued to perceive benefits from testing, perceived benefit declined among parents who received inconclusive or negative results. Parents did not perceive genetic testing as harmful following pre-test counseling or receipt of test results. Parents who received positive test results performed better in understanding recurrence and causation of their child’s deafness and indicated greater interest in prenatal genetic testing than those who received inconclusive or negative test results. Parents felt that pediatricians and audiologists should inform parents of genetic testing availability; however, there was no consensus on timing of this discussion. Thus culturally hearing parents do not perceive genetic testing of their deaf or hard-of-hearing infants/toddlers as harmful; they feel that primary care providers should discuss genetic testing with them; and positive genetic test results with genetic counseling give rise to better understanding and perceived benefit than negative or inconclusive results. PMID:19449415

A prospective, longitudinal study of the impact of GJB2/GJB6 genetic testing on the beliefs and attitudes of parents of deaf and hard-of-hearing infants.

PubMed

Palmer, Christina G S; Martinez, Ariadna; Fox, Michelle; Zhou, Jin; Shapiro, Nina; Sininger, Yvonne; Grody, Wayne W; Schimmenti, Lisa A

2009-06-01

There are limited data on the impact of incorporating genetic counseling and testing into the newborn hearing screening process. We report on results from a prospective, longitudinal study to determine the impact of genetic counseling and GJB2/GJB6 genetic testing on parental knowledge, attitudes, and beliefs about genetic testing. One hundred thirty culturally hearing parents of 93 deaf or hard-of-hearing children ages 0-3 years primarily identified through newborn hearing screening received pre- and post-test genetic counseling for GJB2 and GJB6. Parents completed questionnaires following pre-test counseling, and 1- and 6-month post-test result disclosure. Results indicate that following pre-test counseling all parents perceived benefits to genetic testing. While parents who received positive results continued to perceive benefits from testing, perceived benefit declined among parents who received inconclusive or negative results. Parents did not perceive genetic testing as harmful following pre-test counseling or receipt of test results. Parents who received positive test results performed better in understanding recurrence and causation of their child's deafness and indicated greater interest in prenatal genetic testing than those who received inconclusive or negative test results. Parents felt that pediatricians and audiologists should inform parents of genetic testing availability; however, there was no consensus on timing of this discussion. Thus culturally hearing parents do not perceive genetic testing of their deaf or hard-of-hearing infants/toddlers as harmful; they feel that primary care providers should discuss genetic testing with them; and positive genetic test results with genetic counseling give rise to better understanding and perceived benefit than negative or inconclusive results. (c) 2009 Wiley-Liss, Inc.

Distributed antenna system and method

NASA Technical Reports Server (NTRS)

Fink, Patrick W. (Inventor); Dobbins, Justin A. (Inventor)

2004-01-01

System and methods are disclosed for employing one or more radiators having non-unique phase centers mounted to a body with respect to a plurality of transmitters to determine location characteristics of the body such as the position and/or attitude of the body. The one or more radiators may consist of a single, continuous element or of two or more discrete radiation elements whose received signals are combined. In a preferred embodiment, the location characteristics are determined using carrier phase measurements whereby phase center information may be determined or estimated. A distributed antenna having a wide angle view may be mounted to a moveable body in accord with the present invention. The distributed antenna may be utilized for maintaining signal contact with multiple spaced apart transmitters, such as a GPS constellation, as the body rotates without the need for RF switches to thereby provide continuous attitude and position determination of the body.

Development and evaluation of a self-efficacy instrument for Japanese sleep apnea patients receiving continuous positive airway pressure treatment

PubMed Central

Saito, Ayako; Kojima, Shigeko; Sasaki, Fumihiko; Hayashi, Masamichi; Mieno, Yuki; Sakakibara, Hiroki; Hashimoto, Shuji

2015-01-01

The purpose of this study was to develop and evaluate a self-efficacy instrument for Japanese obstructive sleep apnea (OSA) patients treated with continuous positive airway pressure (CPAP). Analyzed subjects were 653 Japanese OSA patients (619 males and 34 females) treated with CPAP at a sleep laboratory in a respiratory clinic in a Japanese city. Based on Bandura’s social cognitive theory, the CPAP Self-Efficacy Questionnaire for Sleep Apnea in Japanese (CSESA-J) was developed by a focus group of experts, using a group interview of OSA patients for the items of two previous self-efficacy scales for Western sleep apnea patients receiving CPAP treatment. CSESA-J has two subscales, one for self-efficacy and the other for outcome expectancy, and consists of a total of 15 items. Content validity was confirmed by the focus group. Confirmatory factor analysis showed that the factor loadings of self-efficacy and outcome expectancy were 0.47–0.76 and 0.41–0.92, respectively, for the corresponding items. CSESA-J had a significant but weak positive association with the General Self-Efficacy Scale, and a strong positive association with “Self-efficacy scale on health behavior in patients with chronic disease.” Cronbach’s alpha coefficient was 0.85 for the self-efficacy subscale and 0.89 for the outcome expectancy subscale. The intraclass correlation coefficient using data from the first and second measurements with CSESA-J for a subset of 130 subjects was 0.93 for the self-efficacy and outcome expectancy subscales. These results support CSESA-J as a reliable and valid instrument for measuring the self-efficacy of Japanese OSA patients treated with CPAP. Further studies are warranted to confirm validity for female OSA patients and generalizability. PMID:25678832

Long-term recurrence-free survival after an unplanned reduction in radiotherapy for HPV-positive oropharyngeal SCC: Two cases and a review of the literature.

PubMed

Liu, Jason; Goldenberg, David; Almokadem, Salah; Crist, Henry; Mackley, Heath B

2017-07-01

There is currently no clear distinction between the treatment of HPV-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive OPSCC has been demonstrated to be more radiosensitive than its HPV-negative counterpart. Despite this, patients with HPV-positive OPSCC continue to receive a full dose of radiation (70 Gy) outside clinical trials. However, this high dose comes with considerable morbidities, including severe mucositis, dysphagia, and xerostomia. We describe the cases of 2 patients with HPV-positive OPSCC who received two cycles of high-dose cisplatin at 100 mg/m 2 on 3 separate days, along with concurrent radiotherapy at 50 Gy in 25 fractions for one and 46 Gy in 23 fractions for the other. During treatment, both patients experienced significant acute-phase toxicities-including grade 3 mucositis, grade 3 nausea, and grade 2 dermatitis-and their treatment regimen was stopped before its planned completion. Nevertheless, after a follow-up of 75 and 78 months, respectively, neither patient exhibited any evidence of disease. Late toxicities included grade 1 xerostomia, grade 1 pharyngeal-phase dysphagia, and grade 1 dysgeusia with some foods. We conclude that de-escalating the dose of radiation for HPV-positive patients by 30% and identifying which patients can safely be treated with this level of dose reduction warrants further study.

Landslide monitoring using Geocubes, a wireless network of low-cost GPS receivers

NASA Astrophysics Data System (ADS)

Benoit, Lionel; Thom, Christian; Martin, Olivier

2013-04-01

Many geophysical structures such as landslides, glaciers or even volcanoes are features characterized by small extend area and deformation rate in the order of 1 to 10cm per day. Their study needs ever more accurate positioning data with an increased space and time resolution. Using an ublox LEA-6T GPS receiver, the French national mapping agency IGN developed its own wireless multi-sensor geo-monitoring system named Geocube. The basic device is equipped with a GPS and a wireless communication media and can be completed with various sensor modules such as meteorological sensors, ground humidity and pressure or seismograph. Due to the low cost of each receiver, spatial dense surveying networks are deployed. Data are then continuously collected and transmitted to a processing computer in real-time as well as saved in situ on a Micro-SD card. Among them, raw GPS carrier phase data give access to real-time accurate relative positioning on all mesh nodes if small baselines are used. In order to achieve a high accuracy, a dedicated GPS data processing method based on a Kalman filter is proposed. It allows an epoch by epoch positioning providing a high time resolution. Special attention is paid on two points : adaptation to wireless networks of low-cost GPS and real-time ability. A first test of Geocubes usability under field conditions was carried out during summer 2012. A fifteen receivers network was deployed on the landslide of Super-Sauze (French Alps) for a two months trial. The experimental area, the deployed network and the acquisition protocol are presented. Position time series with a 30 seconds sampling rate are then derived from raw data for 10 mobile receivers on a forty days session. A sub-centimetric accuracy on an epoch by epoch positioning is reached despite difficult field conditions due to a 40° elevation mask in the south direction. Then, the measured deformations are compared with in situ rainfall measurements collected by a dedicated sensor added to a Geocube on a network's node.

Landslide monitoring using Geocubes, a wireless network of low-cost GPS receivers.

NASA Astrophysics Data System (ADS)

Benoit, Lionel; Thom, Christian; Martin, Olivier

2013-04-01

Many geophysical structures such as landslides, glaciers or even volcanoes are features characterized by small extend area and deformation rate in the order of 1 to 10cm per day. Their study needs ever more accurate positioning data with an increased space and time resolution. Using an Ublox LEA-6T GPS receiver, the French national mapping agency IGN developed its own wireless multi-sensor geo-monitoring system named Geocube. The basic device is equipped with a GPS and a wireless communication media and can be completed with various sensor modules such as meteorological sensors, ground humidity and pressure or seismograph. Due to the low cost of each receiver, spatial dense surveying networks are deployed. Data are then continuously collected and transmitted to a processing computer in real-time as well as saved in situ on a Micro-SD card. Among them, raw GPS carrier phase data give access to real-time accurate relative positioning on all mesh nodes if small baselines are used. In order to achieve a high accuracy, a dedicated GPS data processing method based on a Kalman filter is proposed. It allows an epoch by epoch positioning providing a high time resolution. Special attention is paid on two points : adaptation to wireless networks of low-cost GPS and real-time ability. A first test of Geocubes usability under field conditions was carried out during summer 2012. A fifteen receivers network was deployed on the landslide of Super-Sauze (French Alps) for a two months trial. The experimental area, the deployed network and the acquisition protocol are presented. Position time series with a 30 seconds sampling rate are then derived from raw data for 10 mobile receivers on a forty days session. A sub-centimetric accuracy on an epoch by epoch positioning is reached despite difficult field conditions due to a 40° elevation mask in the south direction. Then, the measured deformations are compared with in situ rainfall measurements collected by a dedicated sensor added to a Geocube on a network's node.

A resampling strategy based on bootstrap to reduce the effect of large blunders in GPS absolute positioning

NASA Astrophysics Data System (ADS)

Angrisano, Antonio; Maratea, Antonio; Gaglione, Salvatore

2018-01-01

In the absence of obstacles, a GPS device is generally able to provide continuous and accurate estimates of position, while in urban scenarios buildings can generate multipath and echo-only phenomena that severely affect the continuity and the accuracy of the provided estimates. Receiver autonomous integrity monitoring (RAIM) techniques are able to reduce the negative consequences of large blunders in urban scenarios, but require both a good redundancy and a low contamination to be effective. In this paper a resampling strategy based on bootstrap is proposed as an alternative to RAIM, in order to estimate accurately position in case of low redundancy and multiple blunders: starting with the pseudorange measurement model, at each epoch the available measurements are bootstrapped—that is random sampled with replacement—and the generated a posteriori empirical distribution is exploited to derive the final position. Compared to standard bootstrap, in this paper the sampling probabilities are not uniform, but vary according to an indicator of the measurement quality. The proposed method has been compared with two different RAIM techniques on a data set collected in critical conditions, resulting in a clear improvement on all considered figures of merit.

Update: Investigations of West Nile virus infections in recipients of organ transplantation and blood transfusion--Michigan, 2002.

PubMed

2002-10-04

On September 27, 2002, this report was posted on the MMWR website (http://www.cdc.gov/mmwr). CDC, the Food and Drug Administration (FDA), the Health Resources and Services Administration (HRSA), and state and local health departments continue to investigate West Nile virus (WNV) infections in recipients of organ transplantation and blood transfusion. This report summarizes two investigations of Michigan recipients of blood products, one of whom also received a liver transplant. Both persons tested positive for WNV infection after receiving blood products derived from a single blood donation subsequently found to have evidence of WNV. These investigations provide further evidence that WNV is transmitted through blood transfusion.

Disability and employee benefits receipt: evidence from the U.S. Vocational Rehabilitation Services Program.

PubMed

Sosulski, Marya R; Donnell, Chandra; Kim, Woo Jong

2012-01-01

Studies indicate positive effects of the U.S. Vocational Rehabilitation Services (VRS) in assisting people with disabilities to find independent employment. Underemployment continues to impact access to adequate health care and other benefits. Workers with disabilities receive fewer benefits, overall. With data from the Longitudinal Study of Vocational Rehabilitation Services Program (LSVRSP), the authors compare the rates of receipt of 6 types of benefits for people with physical, mental, and sensory impairments. Although those with physical disabilities are most likely to receive benefits, all groups lack adequate access to health care, sick leave, and vacation. The authors discuss implications for services provision in the current job market.

Results of the Ongoing Monitoring of the Position of a Geostationary Telecommunication Satellite by the Method of Spatially Separated Basis Receiving of Digital Satellite Television Signals

NASA Astrophysics Data System (ADS)

Bushuev, F.; Kaliuzhnyi, M.; Sybiryakova, Y.; Shulga, O.; Moskalenko, S.; Balagura, O.; Kulishenko, V.

2016-10-01

The results of the ongoing monitoring of the position of geostationary telecommunication satellite Eutelsat-13B (13° East) are presented in the article. The results were obtained using a radio engineering complex (RC) of four stations receiving digital satellite television and a data processing centre. The stations are located in Kyiv, Mukachevo, Kharkiv and Mykolaiv. The equipment of each station allows synchronous recording (by the GPS) of fragments of DVB-S signal from the quadrature detector output of the satellite television receiver. Samples of the complex signal are archived and sent to the data processing center through the Internet. Here three linearly independent slant range differences (Δr) for three pairs of the stations are determined as a result of correlation processing of received signals. Every second measured values of Δr are used to calculate Cartesian coordinates (XYZ) of the satellite in the coordinate system WGS84 by multilateration method. The time series of Δr, X, Y and Z obtained during continuous observations from March to May 2015 are presented in the article. Single-measurement errors of Δr, X, Y and Z are equal to 2.6 m, 3540 m, 705 m and 455 m, respectively. The complex is compared with known analogues. Ways of reduction of measurement errors of satellite coordinates are considered. The radio engineering complex could be considered a prototype of a system of independent ongoing monitoring of the position of geostationary telecommunication satellites.

Evaluating Pseudorange Multipath at CGPS Stations Spanning Mexico

NASA Astrophysics Data System (ADS)

Vazquez, G.; Bennett, R. A.; Spinler, J. C.

2013-12-01

A research study was conducted in order to quantify and analyze the amount of pseudorange multipath at continuous Global Positioning System (CGPS) stations spanning Mexico. These CGPS stations are administered by a variety of organizations, including government agencies and public universities, and thus serve a wide range of positioning needs. Despite the diversity of the networks and their intended audiences, a core function of all of the networks is to provide a stable framework for high-precision positioning in support of diverse commercial and scientific applications. CGPS data from a large number of publicly available networks located in Mexico were studied. These include the RGNA (National Active Geodetic Network) administered by INEGI (National Institute of Statistics and Geography), the PBO network (Plate Boundary Observatory) funded by the National Science Foundation (NSF) and operated by UNAVCO (University NAVstar Consortium), the Southern California Integrated GPS Network (SCIGN), which is a collaboration effort of the United States Geological Survey (USGS), Scripps Institution of Oceanography and the Jet Propulsion Laboratory (JPL), the UNAM network, operated by the National Seismological System (SSN) and the Institute of Geophysics of the National Autonomous University of Mexico (UNAM), the Suominet Geodetic Network (SNG) and the CORS (Continuously Operating Reference Station) network, operated by the Federal Aviation Administration (FAA). A total of 54 CGPS stations were evaluated, where dual-frequency geodetic-grade receivers collected GPS data continuously during the period from 1994 to 2013. It is usually assumed that despite carefully selected locations, all CGPS stations are to some extent, affected by the presence of signal multipath. In addition, the geographic distribution of stations provides a nation-wide access to the International Terrestrial Reference Frame (ITRF). For real-time kinematic (RTK) and rapid static applications that depend on the pseudo-range observable, the accuracy with which a roaming user may locate their assets with respect to the ITRF may be limited by site-specific multipath. The issue is particularly critical for users depending on pseudorange measurements for 'real-time' (or 'near-real-time') kinematic GPS positioning, where ambiguity resolution is a critical step. Therefore, to identify the most and the least affected GPS stations we analyzed the averaged daily root mean square pseudorange multipath variations (MP1-RMS and MP2-RMS) for all feasible satellites tracked by the CGPS networks. We investigated the sources of multipath, including changes associated with hardware replacement (i.e., receiver and antenna type) and receiver firmware upgrades.

Extended investigation into continuous laser scanning of underground mine workings by means of Landis inertial navigation system

NASA Astrophysics Data System (ADS)

Belyaev, E. N.

2017-10-01

The paper investigates the method of applying mobile scanning systems (MSSs) with inertial navigators in the underground conditions for carrying out the surveying tasks. The available mobile laser scanning systems cannot be used in the underground environment since Global Positioning System (GPS) signals cannot be received in mines. This signal not only is necessary for space positioning, but also operates as the main corrective signal for the primary navigation system - the inertial navigation system. The idea of the method described in this paper consists in using MSSs with a different correction of the inertial system than GPS is.

Navigating the Road to Reintegration: Status and Continuing Support of the U.S. Air Force's Wounded Warriors.

PubMed

Sims, Carra S; Vaughan, Christine Anne; Theologis, Haralambos; Boal, Ashley; Osilla, Karen Chan

2015-11-30

The U.S. Air Force, wanting to gain greater insight into the well-being of its members who have sustained mental or physical injuries in combat or combat-related situations, including their quality of life and the challenges they will confront in their reintegration following separation or retirement, asked the RAND Corporation for assistance in gauging the current status of the Air Force's wounded warriors, including their use of and satisfaction with Air Force programs designed to serve them. This article presents the baseline findings from a longitudinal analysis of enrollees in the Air Force Wounded Warrior (AFW2) program who were receiving benefits or undergoing evaluation to receive benefits, the majority of whom had a primary administrative diagnosis of post-traumatic stress disorder (PTSD). A high proportion of the Airmen in the sample screened positive for PTSD (roughly 78 percent) and major depressive disorder (MDD) (roughly 75 percent); 69 percent screened positive for both. Although more than 90 percent of those in the sample who screened positive for PTSD or MDD were receiving treatment, about half indicated that there was at least one instance during the past year in which they desired mental health treatment but did not receive it. Participants reported concerns about stigma, confidentiality, and the quality of available treatment as barriers to receiving mental health care, though the current data do not link these concerns to a particular treatment setting. About 10 percent of Airmen reported a financial situation that could be considered as living in poverty based on U.S. Department of Health and Human Services' poverty guidelines. Similarly, close to 15 percent of those in the labor force could be considered unemployed. Reserve and National Guard Airmen evidenced heightened challenges across examined domains. Respondents were overall satisfied with the services they received from the AFW2 and Air Force Recovery Care Coordinator programs.

Ondansetron in acute food protein-induced enterocolitis syndrome, a retrospective case-control study.

PubMed

Miceli Sopo, S; Bersani, G; Monaco, S; Cerchiara, G; Lee, E; Campbell, D; Mehr, S

2017-04-01

Therapy for moderate to severe acute food protein-induced enterocolitis syndrome (FPIES) typically consists of intravenous fluids and corticosteroids (traditional therapy). Ondansetron has been suggested as an adjunctive treatment. We aimed to evaluate the efficacy of the parenteral (intravenous or intramuscular) ondansetron vs traditional therapy to resolve the symptoms of acute FPIES. Cases of FPIES who had a positive oral food challenge (OFC) were retrospectively examined at two major hospitals over a two-year period (Rome, Italy; and Sydney, Australia). The efficacy of therapy, based on the percentage of cases who stopped vomiting, was compared in cases who received parenteral ondansetron and in cases who received traditional therapy or no pharmacological therapy. A total of 66 patients were included: 37 had parenteral ondansetron, 14 were treated with traditional therapy, and 15 did not receive any pharmacological therapy. Nineteen percentage of children treated with ondansetron continued vomiting after the administration of the therapy vs 93% of children who received traditional therapy (P < 0.05, relative risk = 0.2). Children who received ondansetron or no therapy were less likely to require an admission overnight compared with those who received traditional therapy (P < 0.05). Parenteral ondansetron is significantly more effective than traditional therapy in resolving acute symptoms of FPIES. The relative risk = 0.2 greatly reduces the bias linked to the lack of randomization. These findings suggest an effective treatment for vomiting in positive FPIES OFCs and allow for more confidence in performing OFCs. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Continuous measurement of breast tumour hormone receptor expression: a comparison of two computational pathology platforms.

PubMed

Ahern, Thomas P; Beck, Andrew H; Rosner, Bernard A; Glass, Ben; Frieling, Gretchen; Collins, Laura C; Tamimi, Rulla M

2017-05-01

Computational pathology platforms incorporate digital microscopy with sophisticated image analysis to permit rapid, continuous measurement of protein expression. We compared two computational pathology platforms on their measurement of breast tumour oestrogen receptor (ER) and progesterone receptor (PR) expression. Breast tumour microarrays from the Nurses' Health Study were stained for ER (n=592) and PR (n=187). One expert pathologist scored cases as positive if ≥1% of tumour nuclei exhibited stain. ER and PR were then measured with the Definiens Tissue Studio (automated) and Aperio Digital Pathology (user-supervised) platforms. Platform-specific measurements were compared using boxplots, scatter plots and correlation statistics. Classification of ER and PR positivity by platform-specific measurements was evaluated with areas under receiver operating characteristic curves (AUC) from univariable logistic regression models, using expert pathologist classification as the standard. Both platforms showed considerable overlap in continuous measurements of ER and PR between positive and negative groups classified by expert pathologist. Platform-specific measurements were strongly and positively correlated with one another (r≥0.77). The user-supervised Aperio workflow performed slightly better than the automated Definiens workflow at classifying ER positivity (AUC Aperio =0.97; AUC Definiens =0.90; difference=0.07, 95% CI 0.05 to 0.09) and PR positivity (AUC Aperio =0.94; AUC Definiens =0.87; difference=0.07, 95% CI 0.03 to 0.12). Paired hormone receptor expression measurements from two different computational pathology platforms agreed well with one another. The user-supervised workflow yielded better classification accuracy than the automated workflow. Appropriately validated computational pathology algorithms enrich molecular epidemiology studies with continuous protein expression data and may accelerate tumour biomarker discovery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Six-year follow-up on work force and finances of the United States anesthesiology training programs: 2000 to 2006.

PubMed

Kheterpal, Sachin; Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2009-01-01

In the mid 1990s, interest in the field of anesthesiology decreased significantly among medical students, resulting in a decreasing resident class size and, subsequently, fewer anesthesiologists entering the United States workforce. This apparent practitioner shortage was associated with increased salary demands, which placed anesthesiology training departments in financial jeopardy. Starting in 1999, a survey was sent to the department chairs of the United States anesthesiology training programs to assess the status of faculty and finances of their departments. Follow-up surveys have been conducted each year thereafter. We present the results of the 2006 survey and 7 yr trend data. Surveys were distributed by e-mail in September 2006 to anesthesiology department chairs of the United States training programs. The responses were received by e-mail. Descriptive statistics were performed on responder data. In addition, a linear regression model to predict institutional support was developed. One-hundred-eighteen departments were surveyed with a response rate of 61%. There were an average of 4 open faculty positions in the 71% of the departments reporting open faculty positions. This would imply an overall 5% open position rate, down from 10% in 2000. Of the 96% of departments who employ certified registered nurse anesthetists, 70% had an average of 4 open positions, or approximately 11% shortage. The average department received $5,500,000 in total institutional support annually ($120,000/faculty). When the portion of this support provided for certified registered nurse anesthetists was removed, the average amount received was $4,600,000 or $100,000/faculty. This is a 10% increase over the previous year and an approximate 300% increase over the year 2000. Faculty academic time averaged 18% (where 20% is 1 day per week). The departments billed an average of 12,200 U/faculty/year. The average anesthesia unit value collected was $31/unit, while departments would require $46/unit to meet expenses. In a linear regression model, clinical revenue per unit billed minus expenses per unit billed predicted faculty support per full-time equivalent. This current survey reveals a continuing need for institutional support to keep anesthesiology training departments financially solvent. The amount of support is associated with the reimbursement for anesthesia work. There is also a continuing, but decreasing, number of open faculty anesthesiologist positions nationwide.

Treatment, overall survival, and costs in patients with ALK-positive non-small-cell lung cancer after crizotinib monotherapy.

PubMed

Guérin, A; Sasane, M; Wakelee, H; Zhang, J; Culver, K; Dea, K; Nitulescu, R; Galebach, P; Macalalad, A R

2015-08-01

Limited post-crizotinib treatment options for ALK-positive non-small cell lung cancer (NSCLC) might lead to poor survival and high economic burden. To evaluate real-world treatment patterns, overall survival (OS), and costs following crizotinib discontinuation. This study used chart review and claims data. First, 27 participating US oncologists reviewed medical records of ALK-positive NSCLC patients who discontinued crizotinib monotherapy and reported patient demographic and clinical information, including post-crizotinib treatment and mortality. OS was estimated using Kaplan-Meier analyses. Second, three large administrative US claims databases were pooled. NSCLC patients were selected if they discontinued crizotinib monotherapy. Post-crizotinib costs were analyzed separately for patients who did or did not discontinue antineoplastic treatment after crizotinib monotherapy. All data were collected prior to ceritinib approval for this patient population. A total of 119 ALK-positive NSCLC patients discontinued crizotinib monotherapy. Upon discontinuation, 42% had no additional antineoplastic treatment and 13% received radiation therapy only. The median OS post-crizotinib was 61 days; patients with brain metastases had shorter OS than those who did not (44 vs. 69 days, P = 0.018), and patients without further antineoplastic treatment had shorter OS than those who did (17 vs. 180 days, P < 0.001). From claims data, 305 ALK-positive NSCLC patients discontinued crizotinib monotherapy. After discontinuation, 72% had no additional antineoplastic treatment. Among patients who continued antineoplastic treatment, monthly healthcare costs averaged $22,160, driven by pharmacy ($9202), inpatient ($6419), and outpatient radiotherapy ($2888) and imaging ($1179) costs. Among patients who discontinued any antineoplastic treatment, monthly healthcare costs averaged $3423, mostly driven by inpatient costs ($2074). After crizotinib monotherapy, most patients either received radiotherapy only or discontinued antineoplastic treatment altogether. OS after discontinuing crizotinib was poor and shorter among those with brain metastases than without, and among those without subsequent antineoplastic treatment than with. Patients who continued antineoplastic treatment incurred substantial healthcare costs.

[Analysis of the risky behaviors among HIV positive female sex workers].

PubMed

Wang, Jue; Jia, Manhong; Luo, Hongbing; Li, Youfang; Song, Lijun; Mei, Jingyuan; Ma, Yanling; Yang, Yanling; Lu, Ran; Wang, Ling; Zhang, Renzhong; Pan, Songfeng; Li, Zhiqing; Lu, Lin

2015-11-01

To analyze the characteristics of risky behaviors among different age groups of HIV positive female sex workers, and to explore the strengthening of their management. From January to June 2014, 22 814 female sex workers were investigated and tested HIV in 117 sentinel surveillance sites in Yunnan Province, and 181 were confirmed to be HIV antibody positive, who accepted questionnaire surveys. According to the age, the participants were divided into the < 35 years old age group and ≥ 35 years old age group. The demographic characteristics, knowledge about HIV/AIDS and related risk behaviors characteristics of the two groups were obtained via questionnaire surveys among 181 HIV positive female sex workers, and in-depth qualitative interviews were conducted from among 12 HIV positive sex workers. HIV antibody positive rate was 0.8% (181), the age of the 181 subjects were (35.83 ± 9.17) years old, 76 cases (42.0%) were < 35 years old, and 105 cases (58.0%) were ≥ 35 years old. The differences of marital status, workplace class, the last work site among two groups were statistically significant (χ(2) = 20.80, 28.32, 7.83; P < 0.001, P < 0.001, P = 0.020, respectively). Among 181 HIV, the proportion of AIDS awareness was 95.6% (173); the proportion of drug use among ≥ 35 years old age group was 51.4% (54), which was higher than that in < 35 years old age group (34.2%, 26/76) (χ(2) = 5.30, P = 0.021). 96.7% (175) received condom promotion or HIV counseling and testing in the past year. The proportion of continuing to engage in sexual services over 5 years after HIV infection was 48.5% (51/105) and the proportion of receiving antiretroviral treatment was 69.5% (73/105) in ≥ 35 years old age group, which were higher than those in the < 35 age group (30.2% (23/76), 52.6% (40/76); χ(2) = 12.26, 5.36; P = 0.002, 0.021, respectively). In-depth interviews among 12 HIV positive female sex workers found that regular clients, not consistent use of condoms were the main cause of no condom use. Economic and livelihood factors are important reasons for continuing to engage in sexual services among HIV positive sex workers. HIV positive sex workers still have high risk behaviors including continuing to engage in commercial sexual service and no condom use after knowing their HIV infection status, and the proportion of using drugs in the ≥ 35 years old group was higher than that in < 35 years old group.

Associations Between Peer Counseling and Breastfeeding Initiation and Duration: An Analysis of Minnesota Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

PubMed

McCoy, Marcia Burton; Geppert, Joni; Dech, Linda; Richardson, Michaela

2018-01-01

Background Peer counseling (PC) has been associated with increased breastfeeding initiation and duration, but few analyses have examined the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) model for peer counseling or the continuation of breastfeeding from birth through 12 months postpartum. Objectives Identify associations between Minnesota WIC Peer Breastfeeding Support Program services and breastfeeding initiation and continuation. Methods Retrospective analysis of observational data from the Minnesota WIC program's administrative database of women who gave birth in 2012 and accepted a PC program referral prenatally (n = 2219). Multivariate logistic regression and Cox regression models examined associations between peer services and breastfeeding initiation and continuation of any breastfeeding. Results Among women who accepted referral into a PC program, odds of initiation were significantly higher among those who received peer services (Odds Ratio (OR): 1.66; 95% CI 1.19-2.32), after adjusting for confounders. Women who received peer services had a significantly lower hazard of breastfeeding discontinuation from birth through 12 months postpartum than women who did not receive services. (Hazard Ratio (HR) month one: 0.45; 95% CI 0.33-0.61; months two through twelve: 0.33; 95% CI 0.18-0.60). The effect of peer counseling did not differ significantly by race and ethnicity, taking into account mother's country of origin. Conclusion for practice Receipt of peer services was positively associated with breastfeeding initiation and continued breastfeeding from birth through 12 months postpartum. Making peer services available to more women, especially in communities with low initiation and duration, could improve maternal and child health in Minnesota.

Not Light Enough to Get There, Not Heavy Enough to Win: The Case of US Light Infantry,

DTIC Science & Technology

1987-12-04

service rivalry for a greater share of the rapid deployment capability was evident in this maneuvering between the Marines for pre-positioned equipment and...The Army was continuing to receive less funding than the other services in the Defense Authorization bills.(77) Congress was concerned about force...projection and was funding the services which would enhance this capability. In the Defense Authorization Act of 1984 Congress defined the major missions

Positivity, discontinuity, finite resources, and nonzero error for arbitrarily varying quantum channels

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

Boche, H., E-mail: boche@tum.de, E-mail: janis.noetzel@tum.de; Nötzel, J., E-mail: boche@tum.de, E-mail: janis.noetzel@tum.de

2014-12-15

This work is motivated by a quite general question: Under which circumstances are the capacities of information transmission systems continuous? The research is explicitly carried out on finite arbitrarily varying quantum channels (AVQCs). We give an explicit example that answers the recent question whether the transmission of messages over AVQCs can benefit from assistance by distribution of randomness between the legitimate sender and receiver in the affirmative. The specific class of channels introduced in that example is then extended to show that the unassisted capacity does have discontinuity points, while it is known that the randomness-assisted capacity is always continuousmore » in the channel. We characterize the discontinuity points and prove that the unassisted capacity is always continuous around its positivity points. After having established shared randomness as an important resource, we quantify the interplay between the distribution of finite amounts of randomness between the legitimate sender and receiver, the (nonzero) probability of a decoding error with respect to the average error criterion and the number of messages that can be sent over a finite number of channel uses. We relate our results to the entanglement transmission capacities of finite AVQCs, where the role of shared randomness is not yet well understood, and give a new sufficient criterion for the entanglement transmission capacity with randomness assistance to vanish.« less

Comparison of GLONASS and GPS time transfers between two west European time laboratories and VNIIFTRI

NASA Technical Reports Server (NTRS)

Daly, P.; Koshelyaevsky, N. B.; Lewandowski, Wlodzimierz; Petit, Gerard; Thomas, Claudine

1992-01-01

The University of Leeds built a Global Positioning System/Global Orbiting Navigation Satellite System (GPS/GLONASS) receiver about five years ago and since then has provided continuous information about GLONASS time and its comparison with GPS time. For the last two years, VNIIFTRI (All Union Institute for Physical, Technical and Radiotechnical Measurements) and some other Soviet time laboratories have used Soviet built GLONASS navigation receivers for time comparisons. Since June 1991, VNIIFTIR has been operating a GPS time receiver on loan from the BIPM (Bureau International des Poids et Mesures). This offered, for the first time, an opportunity for direct comparison of time transfers using GPS and GLONASS. This experiment shows that even with relatively imprecise data recording and processing, in terms of time metrology, GLONASS can provide continental time transfer at a level of several tens of nanoseconds.

Creating continuity out of the disruption of a diagnosis of HIV during pregnancy.

PubMed

Kelly, Carmel; Alderdice, Fiona; Lohan, Maria; Spence, Dale

2012-06-01

To understand the uniqueness of the experience of testing HIV positive from the perspective of pregnant women. As more people learn of their HIV diagnosis through routine screening processes, it is timely to reflect on the impact of receiving an unexpected positive result. A prospective qualitative study. This paper draws on the case studies of four women who were participating in a larger prospective qualitative study of reproductive decision-making, pregnancy and childbirth following HIV diagnosis. Multiple interviews were conducted following diagnosis during pregnancy, and, after the birth of their babies. Thematic data analysis was undertaken. Drawing on Becker's theory of disruption, we document the 'sudden disjuncture' of their antenatal diagnosis and the embodied emotional struggle the women engaged in to create continuity in their lives. A diagnosis of HIV disrupted the women's biographies in terms of their health, relationships and social identity. As pregnant women, the threat of HIV was experienced most significantly in relation to their unborn child. However, their narratives also revealed how a diagnosis of HIV in the context of pregnancy, whilst traumatic, provided a focus for regaining continuity in their lives, as the baby became a metaphor for hope and orientation toward the future. As HIV testing becomes more 'routine', the findings of this study serve to remind health professionals that a positive diagnosis continues to constitute a major trauma to individuals and families. We propose that appropriately educated nursing and midwifery staff could facilitate the 'meaning making' process that is required for newly diagnosed HIV positive persons to find a subjective sense of well-being in their lives. © 2012 Blackwell Publishing Ltd.

Health-related quality of life improvement via telemedicine for epilepsy: printed versus SMS-based education intervention.

PubMed

Lua, Pei Lin; Neni, Widiasmoro Selamat

2013-10-01

Improving health-related quality of life (HRQoL) among people with epilepsy (PWE) has become the focus of various treatment programmes and behavioural interventions which continue to be challenging to both patients and healthcare professionals. To investigate the impact of SMS-based epilepsy education programme on PWE's HRQoL status and to determine the predictors for good HRQoL. Eligible epilepsy out-patients from three public hospitals in East Coast Peninsular Malaysia were randomized into two groups: intervention (IG) and control (CG). Patients in the CG were supplied with only printed epilepsy educational module, while those in the IG additionally received short message service (SMS) from the Mobile Epilepsy Educational System (MEES). The Malay Quality of Life in Epilepsy Inventory-30 (MQOLIE-30) was utilized for HRQoL assessment. Descriptive statistics, paired t test, analysis of covariance and multiple logistic regression were employed for data analyses (SPSS 16). One hundred and forty-four PWE were recruited for the study (age = 30.5 ± 11.8; unmarried = 60.4 %; education level ≤ SPM/Cambridge O' level = 76.4 %; illness duration > 5 years = 51.1 %). After controlling for possible confounders, IG exhibited positive changes in HRQoL profile compared to CG particularly in Seizure Worry, Overall Quality of Life, Emotional Well-Being, Social Functioning and Overall Score (p < 0.05). After adjusting for covariates, being employed and receiving additional SMS-based epilepsy education programme emerged as the significant predictors of good HRQoL among PWE. Receiving continuous SMS-based epilepsy information from the MEES seemed to generate positive impacts on PWE's overall HRQoL. This study has provided a basis for future innovations to inspire efforts in ensuring the welfare and HRQoL of PWE and their families.

The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea

PubMed Central

Czaban, Marcin; Berry, Marc P.; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D.; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

2018-01-01

Background Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Methods Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients’ compliance data were reviewed 2 and 6 weeks following CPAP initiation. Results We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, P<0.05); however, no differences were seen at 6 weeks. There were more dropouts in the control group than in either framed groups (Pos n=5; Neg n=8; Con n=11; P<0.05). Conclusions Positively framed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed. PMID:29445540

The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

PubMed

Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

2018-01-01

Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, P<0.05); however, no differences were seen at 6 weeks. There were more dropouts in the control group than in either framed groups (Pos n=5; Neg n=8; Con n=11; P<0.05). Positively framed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

GPS/GLONASS Time Transfer with 20-Channel Dual GNSS Receiver

NASA Technical Reports Server (NTRS)

Daly, P.; Riley, S.

1996-01-01

One of the world's two global navigation systems, the Global Positioning System (GPS), is already fully operational (April 1994) and the other, the Global Navigation Satellite System (GLONASS) will become operational by the end of 1995 or early 1996. Each will offer, independently of the other, precise location and time transfer continuously anywhere in the world and indeed in space itself. Many potential users, in particular the civil aviation community, are keenly interested in a joint GPS/GLONASS operation since it would offer substantial advantages in defining and maintaining the integrity of the navigation aid. Results are presented on the characterization of GPS/GLONASS time comparison using a 20-channel dual receiver developed and constructed at the University of Leeds, UK.

On Dreams and Motivation: Comparison of Freud's and Hobson's Views.

PubMed

Boag, Simon

2016-01-01

The merits of Freudian dream theory continue to be debated and both supporters and critics appeal to empirical evidence to support their respective positions. What receives much less attention is the theoretical coherency of either Freudian dream theory or alternative perspectives. This paper examines Freudian dream theory and J. Allan Hobson's alternative position by addressing the role of motivation in dreams. This paper first discusses motivation in Freudian theory and its relation to dreams and disguise-censorship. The role of motivation in Hobson's theory is then considered. Hobson's claim that dream plot and content selection is random and based on design error and functional imbalance is then discussed in relation to the protoconsciousness theory proposal that dreams serve an adaptive function. While there are apparent inconsistencies in Hobson's position, his appeal to emotions and instincts provides a preliminary platform for understanding the role of motivation in dreams that is consonant with the Freudian position.

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

Which strategies reduce breast cancer mortality most? Collaborative modeling of optimal screening, treatment, and obesity prevention.

PubMed

Mandelblatt, Jeanne; van Ravesteyn, Nicolien; Schechter, Clyde; Chang, Yaojen; Huang, An-Tsun; Near, Aimee M; de Koning, Harry; Jemal, Ahmedin

2013-07-15

US breast cancer mortality is declining, but thousands of women still die each year. Two established simulation models examine 6 strategies that include increased screening and/or treatment or elimination of obesity versus continuation of current patterns. The models use common national data on incidence and obesity prevalence, competing causes of death, mammography characteristics, treatment effects, and survival/cure. Parameters are modified based on obesity (defined as BMI  ≥  30 kg/m(2) ). Outcomes are presented for the year 2025 among women aged 25+ and include numbers of cases, deaths, mammograms and false-positives; age-adjusted incidence and mortality; breast cancer mortality reduction and deaths averted; and probability of dying of breast cancer. If current patterns continue, the models project that there would be about 50,100-57,400 (range across models) annual breast cancer deaths in 2025. If 90% of women were screened annually from ages 40 to 54 and biennially from ages 55 to 99 (or death), then 5100-6100 fewer deaths would occur versus current patterns, but incidence, mammograms, and false-positives would increase. If all women received the indicated systemic treatment (with no screening change), then 11,400-14,500 more deaths would be averted versus current patterns, but increased toxicity could occur. If 100% received screening plus indicated therapy, there would be 18,100-20,400 fewer deaths. Eliminating obesity yields 3300-5700 fewer breast cancer deaths versus continuation of current obesity levels. Maximal reductions in breast cancer deaths could be achieved through optimizing treatment use, followed by increasing screening use and obesity prevention. © 2013 American Cancer Society.

Global Ionosphere Perturbations Monitored by the Worldwide GPS Network

NASA Technical Reports Server (NTRS)

Ho, C. M.; Manucci, A. T.; Lindqwister, U. J.; Pi, X.

1996-01-01

For the first time, measurements from the Global Positioning System (GPS) worldwide network are employed to study the global ionospheric total electron content(TEC) changes during a magnetic storm (November 26, 1994). These measurements are obtained from more than 60 world-wide GPS stations which continuously receive dual-frequency signals. Based on the delays of the signals, we have generated high resolution global ionospheric maps (GIM) of TEC at 15 minute intervals. Using a differential method comparing storm time maps with quiet time maps, we find that significant TEC increases (the positive effect ) are the major feature in the winter hemisphere during this storm (the maximum percent change relative to quiet times is about 150 percent).

Kalman filter implementation for small satellites using constraint GPS data

NASA Astrophysics Data System (ADS)

Wesam, Elmahy M.; Zhang, Xiang; Lu, Zhengliang; Liao, Wenhe

2017-06-01

Due to the increased need for autonomy, an Extended Kalman Filter (EKF) has been designed to autonomously estimate the orbit using GPS data. A propagation step models the satellite dynamics as a two body with J2 (second zonal effect) perturbations being suitable for orbits in altitudes higher than 600 km. An onboard GPS receiver provides continuous measurement inputs. The continuity of measurements decreases the errors of the orbit determination algorithm. Power restrictions are imposed on small satellites in general and nanosatellites in particular. In cubesats, the GPS is forced to be shut down most of the mission’s life time. GPS is turned on when experiments like atmospheric ones are carried out and meter level accuracy for positioning is required. This accuracy can’t be obtained by other autonomous sensors like magnetometer and sun sensor as they provide kilometer level accuracy. Through simulation using Matlab and satellite tool kit (STK) the position accuracy is analyzed after imposing constrained conditions suitable for small satellites and a very tight one suitable for nanosatellite missions.

The 2010 Eyjafjallajökull and 2011 Grimsvötn ash plumes as seen by GPS

NASA Astrophysics Data System (ADS)

Grapenthin, R.; Hreinsdottir, S.; Gudmundsson, M. T.

2015-12-01

The injection of a volcanic plume introduces a dynamic, localized, short-term heterogeneity in the atmosphere. Satellite-imagery based remote sensing techniques provide good spatial coverage for the detection of such plumes, but slow satellite repeat times (>30 minutes) and cloud cover can delay, if not entirely prevent, the detection. GPS, in turn, provides excellent temporal coverage, but requires favorable satellite-station-geometry such that the signal propagates through the plume if it is to be used for plume detection and analysis. Two methods exist to detect / analyze ash plumes with GPS: (a) Ash-heavy plumes result in signal dispersion and hence a lowered signal-to-noise ratio (SNR). A lowered SNR, recorded by some receivers, can provide useful information about the plume, such as location and velocity of ascent. These data can be evaluated directly as they are recorded by the receiver; without the need of solving for a receiver's position. (b) Wet plumes refract the GPS signals piercing the plume and hence induce a propagation delay. When solving for a receiver position GPS analysis tools do not model this localized phase delay effect and solutions for plume-piercing satellites do not fit the data well. This can be exploited for plume analysis such as the estimation of changes to the atmospheric refractivity index. We analyze GPS data of the ~2 month 2010 Eyafjallajökull erption and the week-long 2011 Grímsvötn eruption to infer a first order estimate of plume geometry and its progression. Using SNR and phase delay information, we evaluate the evolution of the partitioning of wet versus dry parts of the plume. During the GPS processing we iteratively solve for phase-delay and position and fix other parameters, hence reducing the mapping of least-squares misfit into position estimates and other parameters. Nearly continuous webcam imagery provides independent observations of first-order plume characteristics for the Eyafjallajökull event.

A Map/INS/Wi-Fi Integrated System for Indoor Location-Based Service Applications

PubMed Central

Yu, Chunyang; Lan, Haiyu; Gu, Fuqiang; Yu, Fei; El-Sheimy, Naser

2017-01-01

In this research, a new Map/INS/Wi-Fi integrated system for indoor location-based service (LBS) applications based on a cascaded Particle/Kalman filter framework structure is proposed. Two-dimension indoor map information, together with measurements from an inertial measurement unit (IMU) and Received Signal Strength Indicator (RSSI) value, are integrated for estimating positioning information. The main challenge of this research is how to make effective use of various measurements that complement each other in order to obtain an accurate, continuous, and low-cost position solution without increasing the computational burden of the system. Therefore, to eliminate the cumulative drift caused by low-cost IMU sensor errors, the ubiquitous Wi-Fi signal and non-holonomic constraints are rationally used to correct the IMU-derived navigation solution through the extended Kalman Filter (EKF). Moreover, the map-aiding method and map-matching method are innovatively combined to constrain the primary Wi-Fi/IMU-derived position through an Auxiliary Value Particle Filter (AVPF). Different sources of information are incorporated through a cascaded structure EKF/AVPF filter algorithm. Indoor tests show that the proposed method can effectively reduce the accumulation of positioning errors of a stand-alone Inertial Navigation System (INS), and provide a stable, continuous and reliable indoor location service. PMID:28574471

A Map/INS/Wi-Fi Integrated System for Indoor Location-Based Service Applications.

PubMed

Yu, Chunyang; Lan, Haiyu; Gu, Fuqiang; Yu, Fei; El-Sheimy, Naser

2017-06-02

In this research, a new Map/INS/Wi-Fi integrated system for indoor location-based service (LBS) applications based on a cascaded Particle/Kalman filter framework structure is proposed. Two-dimension indoor map information, together with measurements from an inertial measurement unit (IMU) and Received Signal Strength Indicator (RSSI) value, are integrated for estimating positioning information. The main challenge of this research is how to make effective use of various measurements that complement each other in order to obtain an accurate, continuous, and low-cost position solution without increasing the computational burden of the system. Therefore, to eliminate the cumulative drift caused by low-cost IMU sensor errors, the ubiquitous Wi-Fi signal and non-holonomic constraints are rationally used to correct the IMU-derived navigation solution through the extended Kalman Filter (EKF). Moreover, the map-aiding method and map-matching method are innovatively combined to constrain the primary Wi-Fi/IMU-derived position through an Auxiliary Value Particle Filter (AVPF). Different sources of information are incorporated through a cascaded structure EKF/AVPF filter algorithm. Indoor tests show that the proposed method can effectively reduce the accumulation of positioning errors of a stand-alone Inertial Navigation System (INS), and provide a stable, continuous and reliable indoor location service.

What Happens If the Stars Go Out? U.S. Army Dependence on the Global Positioning System

DTIC Science & Technology

2009-12-11

line in the 1970s has continued to evolve with the technological advances in satellite power management , frequency encryption, and GPS receiver... manage his forces, limitations still exist. As stated by Giles Ebutt from Jane’s International Defense, ―These blue-force tracking (BFT) systems...complexity and thus there exists a need for close examination of the Army’s use, application, and management of GPS data. Chapter 3 guides the reader through

Airborne Pseudolites in a Global Positioning System (GPS) Degraded Environment

DTIC Science & Technology

2011-03-01

continuously two types of encoded pseudo-random noise (PRN) signals via using two center frequencies 4 in the L- band , namely L1 (1575.42 MHz) and L2...Jovanevic, Aleksandar, Nikhil Bhaita, Joseph Noronha, Brijesh Sirpatil, Michael Kirchner, and Deepak Saxena. “ Piercing the Veil ”. GPS World, 30–37, March...difficulties in receiver design. • Pseudolites can operate either at GPS L1, L2 and L5, or any other available frequency band . Similarly, other parameters to

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

Thompson, Deanna Lynn; Coleman, Matthew A; Lane, Stephen M

A hand-held portable microarray reader for biodetection includes a microarray reader engineered to be small enough for portable applications. The invention includes a high-powered light-emitting diode that emits excitation light, an excitation filter positioned to receive the excitation light, a slide, a slide holder assembly for positioning the slide to receive the excitation light from the excitation filter, an emission filter positioned to receive the excitation light from the slide, a lens positioned to receive the excitation light from the emission filter, and a CCD camera positioned to receive the excitation light from the lens.

Insertion side, body position and circuit life during continuous renal replacement therapy with femoral vein access.

PubMed

Kim, In Byung; Fealy, Nigel; Baldwin, Ian; Bellomo, Rinaldo

2011-01-01

Choice of insertion side and patient position during continuous renal replacement therapy (CRRT) with femoral vein vascular access may affect circuit life. We investigated if there is an association between choice of insertion side and body position and its changes and circuit life during CRRT with femoral vein access. We studied 50 patients receiving CRRT via femoral vein access with a sequential retrospective study in a tertiary intensive care unit. We defined two groups: patients with right or left femoral vein access. We then obtained information on age, gender, circuit life, total heparin dose, hemoglobin concentration and coagulation variables (platelet count, international normalized ratio, and activated partial thromboplastin time) and percentage of time each patient spent in the supine, left lying, right lying, and sitting position during treatment. We studied 341 circuits in 50 patients. Mean circuit life was 13.9 h. Of these circuits, 251 (73.6%) were treated with right femoral vein access. Mean circuit life in this group was significantly longer compared with left femoral vein access (15.0 ± 14.3 vs. 10.6 ± 7.4; p = 0.019). Percentage spent in a particular position during CRRT was not significantly different between two groups. On multivariable linear regression analysis, mean circuit life was significantly and positively correlated with right vascular access site (p = 0.03) and lower platelet count (p = 0.03), but not with patient position. Right-sided insertion but not time spent in a particular position significantly affects circuit life during CRRT with femoral vein access. Copyright © 2010 S. Karger AG, Basel.

Increasing retention in care of HIV-positive women in PMTCT services through continuous quality improvement-breakthrough (CQI-BTS) series in primary and secondary health care facilities in Nigeria: a cluster randomized controlled trial. The Lafiyan Jikin Mata Study.

PubMed

Oyeledun, Bolanle; Oronsaye, Frank; Oyelade, Taiwo; Becquet, Renaud; Odoh, Deborah; Anyaike, Chukwuma; Ogirima, Francis; Ameh, Bernice; Ajibola, Abiola; Osibo, Bamidele; Imarhiagbe, Collins; Abutu, Inedu

2014-11-01

Rates of retention in care of HIV-positive pregnant women in care programs in Nigeria remain generally poor with rates around 40% reported for specific programs. Poor quality of services in health facilities and long waiting times are among the critical factors militating against retention of these women in care. The aim of the interventions in this study is to assess whether a continuous quality improvement intervention using a Breakthrough Series approach in local district hospitals and primary health care clinics will lead to improved retention of HIV-positive women and mothers. A cluster randomized controlled trial with 32 health facilities randomized to receive a continuous quality improvement/Breakthrough Series intervention or not. The care protocol for HIV-infected pregnant women and mothers is the same in all sites. The quality improvement intervention started 4 months before enrollment of individual HIV-infected pregnant women and initially focused on reducing waiting times for women and also ensuring that antiretroviral drugs are dispensed on the same day as clinic attendance. The primary outcome measure is retention of HIV-positive mothers in care at 6 months postpartum. Results of this trial will inform whether quality improvement interventions are an effective means of improving retention in prevention of mother-to-child transmission of HIV programs and will also guide where health system interventions should focus to improve the quality of care for HIV-positive women. This will benefit policymakers and program managers as they seek to improve retention rates in HIV care programs.

Tension - Type - Headache treated by Positional Release Therapy: a case report.

PubMed

Mohamadi, Marzieh; Ghanbari, Ali; Rahimi Jaberi, Abbas

2012-10-01

Tension Type Headache (T.T.H) is the most prevalent headache. Myofascial abnormalities & trigger points are important in this type of headache which can be managed by Positional Release Therapy (PRT). This is a report of a 47 years old female patient with Tension Type Headache treated by Positional Release Therapy for her trigger points. She had a constant dull headache, which continued all the day for 9 months. A physiotherapist evaluated the patient and found active trigger points in her cervical muscles. Then, she received Positional Release Therapy for her trigger points. After 3 treatment sessions, the patient's headache stopped completely. During the 8 months following the treatment she was without pain, and did not use any medication. Positional Release Therapy was effective in treating Tension Type Headache. This suggests that PRT could be an alternative treatment to medication in patients with T.T.H if the effectiveness of that can be confirmed by further studies. Copyright © 2012 Elsevier Ltd. All rights reserved.

Investigating the need for scholarly communications positions in Association of Academic Health Sciences Libraries member institutions.

PubMed

Mears, Kim; Bandy, Sandra L

2017-04-01

The role of health sciences librarians has expanded in the scholarly communications landscape as a result of the increase in federal public access mandates and the continued expansion of publishing avenues. This has created the need to investigate whether academic health sciences libraries should have scholarly communications positions to provide education and services exclusively related to scholarly communication topics. A nine-question online survey was distributed through the Association of Academic Health Sciences Libraries (AAHSL) email discussion list to gather preliminary findings from and opinions of directors of health sciences libraries on the need for scholarly communications positions. The survey received a 38% response rate. The authors found that AAHSL members are currently providing scholarly communications services, and 46% of respondents expressed the need to devote a full-time position to this role. Our survey reveals a juxtaposition occurring in AAHSL member libraries. While administrators acknowledge the need to provide scholarly communications services, they often experience budget challenges in providing a full-time position for these services.

High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia

PubMed Central

Toussova, Olga V.; Verevochkin, Sergei V.; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P.

2011-01-01

The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting. PMID:18843531

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

20 CFR 404.2112 - Payment for VR services in a case where an individual continues to receive disability payments...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404... Payment for VR services in a case where an individual continues to receive disability payments based on...

Expanded experience with an intradermal skin test to predict for the presence or absence of carboplatin hypersensitivity.

PubMed

Markman, Maurie; Zanotti, Kristine; Peterson, Gertrude; Kulp, Barbara; Webster, Kenneth; Belinson, Jerome

2003-12-15

Carboplatin-associated hypersensitivity is increasingly recognized as a potentially serious toxicity when this agent is administered for more than six total cycles. Our group has used a predictive skin test in women with gynecologic cancers who have previously received more than six cumulative cycles of platinum-based chemotherapy. Thirty minutes before all subsequent carboplatin courses, a 0.02-mL aliquot from the solution prepared for treatment is injected intradermally. A positive test is considered to be a > or = 5-mm wheal, with a surrounding flare. From October 1998 through March 2003, 126 patients received a total of 717 carboplatin skin tests (median per patient, four tests; range, one to 54 tests). Of the 668 negative tests (93% of the total performed), 10 were associated with evidence of carboplatin hypersensitivity (1.5% false-negative rate; 95% CI, 0.6% to 2.4%), none of which were severe (eg, dyspnea, hypotension, cardiac/respiratory compromise). Of the 41 positive tests, the decision was made to not deliver the drug to 32 patients, although seven women ultimately underwent a future attempt at re-treatment with a platinum agent using a desensitization program. In seven episodes where patients received the carboplatin despite the finding of a positive test, six were associated with the development of symptoms of anaphylaxis (none severe). A negative carboplatin skin test seems to predict with reasonable reliability for the absence of a severe hypersensitivity reaction with the subsequent drug infusion. The implications of a positive test remain less certain, but limited experience with continued treatment suggests this approach must be undertaken with considerable caution.

Pediatric Ventilator-Associated Infections: The Ventilator-Associated INfection Study.

PubMed

Willson, Douglas F; Hoot, Michelle; Khemani, Robinder; Carrol, Christopher; Kirby, Aileen; Schwarz, Adam; Gedeit, Rainer; Nett, Sholeen T; Erickson, Simon; Flori, Heidi; Hays, Spencer; Hall, Mark

2017-01-01

Suspected ventilator-associated infection is the most common reason for antibiotics in the PICU. We sought to characterize the clinical variables associated with continuing antibiotics after initial evaluation for suspected ventilator-associated infection and to determine whether clinical variables or antibiotic treatment influenced outcomes. Prospective, observational cohort study conducted in 47 PICUs in the United States, Canada, and Australia. Two hundred twenty-nine pediatric patients ventilated more than 48 hours undergoing respiratory secretion cultures were enrolled as "suspected ventilator-associated infection" in a prospective cohort study, those receiving antibiotics of less than or equal to 3 days were categorized as "evaluation only," and greater than 3 days as "treated." Demographics, diagnoses, comorbidities, culture results, and clinical data were compared between evaluation only and treated subjects and between subjects with positive versus negative cultures. PICUs in 47 hospitals in the United States, Canada, and Australia. All patients undergoing respiratory secretion cultures during the 6 study periods. None. Treated subjects differed from evaluation-only subjects only in frequency of positive cultures (79% vs 36%; p < 0.0001). Subjects with positive cultures were more likely to have chronic lung disease, tracheostomy, and shorter PICU stay, but there were no differences in ventilator days or mortality. Outcomes were similar in subjects with positive or negative cultures irrespective of antibiotic treatment. Immunocompromise and higher Pediatric Logistic Organ Dysfunction scores were the only variables associated with mortality in the overall population, but treated subjects with endotracheal tubes had significantly lower mortality. Positive respiratory cultures were the primary determinant of continued antibiotic treatment in children with suspected ventilator-associated infection. Positive cultures were not associated with worse outcomes irrespective of antibiotic treatment although the lower mortality in treated subjects with endotracheal tubes is notable. The necessity of continuing antibiotics for a positive respiratory culture in suspected ventilator-associated infection requires further study.

Seafloor horizontal positioning from a continuously operating buoy-based GPS-acoustic array

NASA Astrophysics Data System (ADS)

Chadwell, C. D.; Brown, K. M.; Tryon, M. D.; Send, U.

2009-12-01

Seafloor horizontal positions in a global frame were estimated daily from an autonomous buoy operating continuously over several months. The buoy (GEOCE) was moored offshore San Diego in 100-m-deep waters above an array of 4 seafloor transponders. Dual-frequency GPS data were collected at 1-Hz at a main antenna on the buoy and at 3 shore stations to provide continuous 2-3 cm positions of the buoy main antenna. Two single-frequency antennas on the buoy along with the main antenna were used to estimate the buoy attitude and short-term velocity. At one minute intervals the two-way acoustic travel time was measured between the buoy and transponders. During this few second span when transmitting and receiving acoustic signals, 10-Hz attitude and velocity were collected to locate the position of the transducer mounted approximately 2 m below the water line. The GPS and acoustic data were recorded internally and transmitted to shore over a cell-phone link and/or a wireless Ethernet. GPS data were combined with the acoustic data to estimate the array location at 1 minute intervals. The 1-minute positions are combined to provide a daily estimate of the array position. The buoy is autonomous, solar-powered and in addition to the GPS and acoustic data collects air pressure, temperature, wind speed/direction as well as water level at the surface and conductivity and temperature along the mooring line from near the sea surface to just above the sea floor. Here we report results from the horizontal positioning effort from Phase I of the project in shallow waters. The project also includes a vertical deformation sensor and physical oceanographic monitoring. A deep water (nominally 1000 m) test is planned for 2010. This work is supported by NSF-OCE-0551363 of the Ocean Technology and Interdisciplinary Coordination Program.

Wetter for fine dry powder

DOEpatents

Hall, James E.; Williams, Everett H.

1977-01-01

A system for wetting fine dry powders such as bentonite clay with water or other liquids is described. The system includes a wetting tank for receiving water and a continuous flow of fine powder feed. The wetting tank has a generally square horizontal cross section with a bottom end closure in the shape of an inverted pyramid. Positioned centrally within the wetting tank is a flow control cylinder which is supported from the walls of the wetting tank by means of radially extending inclined baffles. A variable speed motor drives a first larger propeller positioned immediately below the flow control cylinder in a direction which forces liquid filling the tank to flow downward through the flow control cylinder and a second smaller propeller positioned below the larger propeller having a reverse pitch to oppose the flow of liquid being driven downward by the larger propeller.

A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

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

Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de; Nill, Simeon; Huber, Peter E.

Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on themore » basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant improvement of target volume coverage and continuous parotid sparing without treatment delays.« less

A clinical concept for interfractional adaptive radiation therapy in the treatment of head and neck cancer.

PubMed

Jensen, Alexandra D; Nill, Simeon; Huber, Peter E; Bendl, Rolf; Debus, Jürgen; Münter, Marc W

2012-02-01

To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant improvement of target volume coverage and continuous parotid sparing without treatment delays. Copyright © 2012 Elsevier Inc. All rights reserved.

Moho map of South America from receiver functions and surface waves

NASA Astrophysics Data System (ADS)

Lloyd, Simon; van der Lee, Suzan; FrançA, George Sand; AssumpçãO, Marcelo; Feng, Mei

2010-11-01

We estimate crustal structure and thickness of South America north of roughly 40°S. To this end, we analyzed receiver functions from 20 relatively new temporary broadband seismic stations deployed across eastern Brazil. In the analysis we include teleseismic and some regional events, particularly for stations that recorded few suitable earthquakes. We first estimate crustal thickness and average Poisson's ratio using two different stacking methods. We then combine the new crustal constraints with results from previous receiver function studies. To interpolate the crustal thickness between the station locations, we jointly invert these Moho point constraints, Rayleigh wave group velocities, and regional S and Rayleigh waveforms for a continuous map of Moho depth. The new tomographic Moho map suggests that Moho depth and Moho relief vary slightly with age within the Precambrian crust. Whether or not a positive correlation between crustal thickness and geologic age is derived from the pre-interpolation point constraints depends strongly on the selected subset of receiver functions. This implies that using only pre-interpolation point constraints (receiver functions) inadequately samples the spatial variation in geologic age. The new Moho map also reveals an anomalously deep Moho beneath the oldest core of the Amazonian Craton.

Improved survival of newborns receiving leukocyte transfusions for sepsis

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

Cairo, M.S.; Rucker, R.; Bennetts, G.A.

To determine the role of polymorphonuclear (PMN) leukocyte transfusions in neonates with sepsis, 23 consecutive newborns were prospectively randomly selected during an 18-month period in a treatment plan to receive polymorphonuclear leukocyte transfusions with supportive care or supportive care alone. Thirteen neonates received transfusions every 12 hours for a total of five transfusions. Each transfusion consisting of 15 mL/kg of polymorphonuclear leukocytes was subjected to 1,500 rads of radiation. The polymorphonuclear leukocytes were obtained by continuous-flow centrifugation leukapheresis and contained 0.5 to 1.0 X 10(9) granulocytes per 15 mL with less than 10% lymphocytes. Positive findings on blood cultures weremore » obtained in 14/23 patients and seven were randomly selected for each treatment group. Absolute granulocyte counts were less than 1,500/microL in 13 patients but tibial bone marrow examinations revealed that the neutrophil supply pool was depleted in only three patients. The survival was significantly greater in the treatment group compared with the group that did not receive transfusions.« less

The experience of receiving therapeutic touch.

PubMed

Samarel, N

1992-06-01

The purpose of this qualitative study was to describe the patient's experience of receiving therapeutic touch (TT) treatments. The design was informed by phenomenology in the sense that it was searching for a definition of the lived experience of the phenomenon of TT. Data were obtained through one open-ended interview and a second clarifying interview of each subject. All data were subjected to content analysis. For participants, the lived experience of TT was described as a linear process that began with the perceived need for and decision to seek treatment. It progressed through one or more treatments and continued to have an impact upon the participants' lives. These findings were examined within the context of Martha Rogers' conceptual system. This study has shown that, for 20 participants receiving treatment, TT was a fulfilling multidimensional experience that facilitated personal growth. Such as experience can only enrich the lives of those who receive treatment. Certainly, a nursing intervention that can achieve such a positive influence has potential for use in all areas of nursing care and needs to be explored further.

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

20 CFR 416.2212 - Payment for VR services in a case where an individual continues to receive disability or...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR... Provisions § 416.2212 Payment for VR services in a case where an individual continues to receive disability...

An automatic editing algorithm for GPS data

NASA Technical Reports Server (NTRS)

Blewitt, Geoffrey

1990-01-01

An algorithm has been developed to edit automatically Global Positioning System data such that outlier deletion, cycle slip identification, and correction are independent of clock instability, selective availability, receiver-satellite kinematics, and tropospheric conditions. This algorithm, called TurboEdit, operates on undifferenced, dual frequency carrier phase data, and requires the use of P code pseudorange data and a smoothly varying ionospheric electron content. TurboEdit was tested on the large data set from the CASA Uno experiment, which contained over 2500 cycle slips.Analyst intervention was required on 1 percent of the station-satellite passes, almost all of these problems being due to difficulties in extrapolating variations in the ionospheric delay. The algorithm is presently being adapted for real time data editing in the Rogue receiver for continuous monitoring applications.

Design studies for a technology assessment receiver for global positioning system

NASA Technical Reports Server (NTRS)

Painter, J. H.

1981-01-01

The operational conditions of a radio receiver - microprocessor for the global positioning system are studied. Navigation fundamentals and orbit characterization are reviewed. The global positioning system is described with emphasis upon signal structure and satellite positioning. Ranging and receiver processing techniques are discussed.

The effect of a school-based intervention on sunbed use in Danish pupils at continuation schools: a cluster-randomized controlled trial.

PubMed

Aarestrup, Cecilie; Bonnesen, Camilla T; Thygesen, Lau C; Krarup, Anne F; Waagstein, Anne B; Jensen, Poul D; Bentzen, Joan

2014-02-01

To examine the effect of an educational intervention on sunbed use and intentions and attitudes toward sunbed use in 14- to 18-year-olds at continuation schools. We randomized 33 continuation schools either to receive the educational intervention (n = 16) or to be controls (n = 17). Intervention schools received an e-magazine addressing the health risks of sunbed use. Information on behavior and intentions and attitudes toward sunbed use was gathered through self-administrated questionnaires before the intervention and at 6 months as a follow-up. The effect of the intervention was examined by multilevel linear regression and logistic regression. Sunbed use was significantly lower at follow-up among pupils at intervention schools versus pupils at control schools (girls: odds ratio .60, 95% confidence interval .42-.86; Boys: odds ratio .58, 95% confidence interval .35-.96). The intervention had no effect on intention to use sunbeds or attitudes toward sunbed use. The analyses revealed a significant impact of school on attitudes toward sunbed; the intraclass correlation coefficient was estimated to be 6.0% and 7.8% for girls and boys, respectively. The findings from the present study provide new evidence of a positive effect of an educational intervention on sunbed use among pupils aged 14-18 years at continuation schools. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Egnos Limitations over Central and Eastern Poland - Results of Preliminary Tests of Egnos-Eupos Integration Project

NASA Astrophysics Data System (ADS)

Jaworski, Leszek; Swiatek, Anna; Zdunek, Ryszard

2013-09-01

The problem of insufficient accuracy of EGNOS correction for the territory of Poland, located at the edge of EGNOS range is well known. The EEI PECS project (EGNOS EUPOS Integration) assumes improving the EGNOS correction by using the GPS observations from Polish ASG-EUPOS stations. One of the EEI project tasks was the identification of EGNOS performance limitations over Poland and services for EGNOSS-EUPOS combination. The two sets of data were used for those goals: statistical, theoretical data obtained using the SBAS simulator software, real data obtained during the measurements. The real measurements were managed as two types of measurements: static and dynamic. Static measurements are continuously managing using Septentrio PolaRx2 receiver. The SRC permanent station works in IMAGE/PERFECT project. Dynamic measurements were managed using the Mobile GPS Laboratory (MGL). Receivers (geodetic and navigation) were working in two modes: determining navigation position from standalone GPS, determining navigation position from GPS plus EGNOS correction. The paper presents results of measurements' analyses and conclusions based on which the next tasks in EEI project are completed

Children who screen positive for autism at 2.5 years and receive early intervention: a prospective naturalistic 2-year outcome study

PubMed Central

Spjut Jansson, Birgitta; Miniscalco, Carmela; Westerlund, Joakim; Kantzer, Anne-Katrin; Fernell, Elisabeth; Gillberg, Christopher

2016-01-01

Background Previous research has stressed the importance of early identification and intervention for children with autism spectrum disorders. Methods Children who had screened positive for autism at the age of 2.5 years in a general population screening and then received a diagnosis of autism spectrum disorder were enrolled in an intervention program provided by Swedish habilitation services. The following interventions were available: a comprehensive intervention based on Applied Behavior Analysis – Intensive Learning (IL) – in two settings, which included home- and preschool-based (IL Regular) and only home-based (IL Modified) and eclectic interventions. Results There was considerable variability in terms of outcome, but intervention group status was not associated with any of the chosen outcome variables. Conclusion The main finding was that the type of intervention was not critical for outcome of adaptive or global functioning. The variability in outcome demonstrates the need for continuous assessments and evaluation of the child’s function and behavior throughout the intervention period. PMID:27621636

The ex-Gaussian distribution of reaction times in adolescents with attention-deficit/hyperactivity disorder.

PubMed

Gu, Shoou-Lian Hwang; Gau, Susan Shur-Fen; Tzang, Shyh-Weir; Hsu, Wen-Yau

2013-11-01

We investigated the three parameters (mu, sigma, tau) of ex-Gaussian distribution of RT derived from the Conners' continuous performance test (CCPT) and examined the moderating effects of the energetic factors (the inter-stimulus intervals (ISIs) and Blocks) among these three parameters, especially tau, an index describing the positive skew of RT distribution. We assessed 195 adolescents with DSM-IV ADHD, and 90 typically developing (TD) adolescents, aged 10-16. Participants and their parents received psychiatric interviews to confirm the diagnosis of ADHD and other psychiatric disorders. Participants also received intelligence (WISC-III) and CCPT assessments. We found that participants with ADHD had a smaller mu, and larger tau. As the ISI/Block increased, the magnitude of group difference in tau increased. Among the three ex-Gaussian parameters, tau was positively associated with omission errors, and mu was negatively associated with commission errors. The moderating effects of ISIs and Blocks on tau parameters suggested that the ex-Gaussian parameters could offer more information about the attention state in vigilance task, especially in ADHD. Copyright © 2013 Elsevier Ltd. All rights reserved.

Parallel-wire grid assembly with method and apparatus for construction thereof

DOEpatents

Lewandowski, E.F.; Vrabec, J.

1981-10-26

Disclosed is a parallel wire grid and an apparatus and method for making the same. The grid consists of a generally coplanar array of parallel spaced-apart wires secured between metallic frame members by an electrically conductive epoxy. The method consists of continuously winding a wire about a novel winding apparatus comprising a plurality of spaced-apart generally parallel spindles. Each spindle is threaded with a number of predeterminedly spaced-apart grooves which receive and accurately position the wire at predetermined positions along the spindle. Overlying frame members coated with electrically conductive epoxy are then placed on either side of the wire array and are drawn together. After the epoxy hardens, portions of the wire array lying outside the frame members are trimmed away.

Parallel-wire grid assembly with method and apparatus for construction thereof

DOEpatents

Lewandowski, Edward F.; Vrabec, John

1984-01-01

Disclosed is a parallel wire grid and an apparatus and method for making the same. The grid consists of a generally coplanar array of parallel spaced-apart wires secured between metallic frame members by an electrically conductive epoxy. The method consists of continuously winding a wire about a novel winding apparatus comprising a plurality of spaced-apart generally parallel spindles. Each spindle is threaded with a number of predeterminedly spaced-apart grooves which receive and accurately position the wire at predetermined positions along the spindle. Overlying frame members coated with electrically conductive epoxy are then placed on either side of the wire array and are drawn together. After the epoxy hardens, portions of the wire array lying outside the frame members are trimmed away.

Women who receive continuous support during labour have reduced risk of caesarean, instrumental delivery or need for analgesia compared to usual care.

PubMed

McDonald, Susan

2013-04-01

Models of care supporting continuous support during labour were shown to be more likely to result in a spontaneous vaginal birth. Women receiving continuous support required less analgesia and were less likely to report negative feelings about the birth experience. Women receiving continuous support experienced shorter labours and their babies were less likely to have low 5-min Agpar scores. Therefore, such models of care should be considered for more extensive implementation in clinical practice settings.

Predictors of psychological well-being in a diverse sample of HIV-positive patients receiving highly active antiretroviral therapy.

PubMed

Safren, Steven A; Radomsky, Adam S; Otto, Michael W; Salomon, Elizabeth

2002-01-01

The purpose of the present study was to identify variables relevant to psychological well-being in HIV patients receiving highly active antiretroviral therapy (HAART). Multiple stressors accompany living with HIV while managing a HAART regimen. However, a variety of cognitive and behavioral variables can protect against or augment the deleterious effects of stress in this population. The authors hypothesized that satisfaction with social support, coping styles, and maladaptive attributions about HIV would explain more variance in psychological well-being than stressful life events per se. Participants were individuals with HIV receiving antiretroviral therapy-either starting a new HAART regimen or having difficulties adhering to their current regimen. Satisfaction with social support, coping styles, and punishment beliefs about HIV were uniquely associated with depression, quality of life, and self-esteem over and above the effects of stressful life events. These results provide support for continued psychosocial interventions that target these variables among patients with HIV.

Scintillation analysis of truncated Bessel beams via numerical turbulence propagation simulation.

PubMed

Eyyuboğlu, Halil T; Voelz, David; Xiao, Xifeng

2013-11-20

Scintillation aspects of truncated Bessel beams propagated through atmospheric turbulence are investigated using a numerical wave optics random phase screen simulation method. On-axis, aperture averaged scintillation and scintillation relative to a classical Gaussian beam of equal source power and scintillation per unit received power are evaluated. It is found that in almost all circumstances studied, the zeroth-order Bessel beam will deliver the lowest scintillation. Low aperture averaged scintillation levels are also observed for the fourth-order Bessel beam truncated by a narrower source window. When assessed relative to the scintillation of a Gaussian beam of equal source power, Bessel beams generally have less scintillation, particularly at small receiver aperture sizes and small beam orders. Upon including in this relative performance measure the criteria of per unit received power, this advantageous position of Bessel beams mostly disappears, but zeroth- and first-order Bessel beams continue to offer some advantage for relatively smaller aperture sizes, larger source powers, larger source plane dimensions, and intermediate propagation lengths.

Use of inpatient continuous passive motion versus no CPM in computer-assisted total knee arthroplasty.

PubMed

Alkire, Martha R; Swank, Michael L

2010-01-01

Continuous passive motion (CPM) has shown positive effects on tissue healing, edema, hemarthrosis, and joint function (L. Brosseau et al., 2004). CPM has also been shown to increase short-term early flexion and decrease length of stay (LOS) ( L. Brosseau et al., 2004; C. M. Chiarello, C. M. S. Gundersen, & T. O'Halloran, 2004). The benefits of CPM for the population of patients undergoing computer-assisted total knee arthroplasty (TKA) have not been examined. The primary objective of this study was to determine whether the use of CPM following computer-assisted TKA resulted in differences in range of motion, edema/drainage, functional ability, and pain. This was an experimental, prospective, randomized study of patients undergoing unilateral, computer-assisted TKA. The experimental group received CPM thrice daily and physical therapy (PT) twice daily during their hospitalization. The control group received PT twice daily and no CPM during the hospital stay. Both groups received PT after discharge. Measurement included Knee Society scores, Western Ontario McMaster Osteoarthritis Index values, range of motion, knee circumference, and HemoVac drainage. Data were collected at various intervals from preoperatively through 3 months. Although the control group was found to be higher functioning preoperatively, there was no statistically significant difference in flexion, edema or drainage, function, or pain between groups through the 3-month study period.

Indoor high precision three-dimensional positioning system based on visible light communication using modified genetic algorithm

NASA Astrophysics Data System (ADS)

Chen, Hao; Guan, Weipeng; Li, Simin; Wu, Yuxiang

2018-04-01

To improve the precision of indoor positioning and actualize three-dimensional positioning, a reversed indoor positioning system based on visible light communication (VLC) using genetic algorithm (GA) is proposed. In order to solve the problem of interference between signal sources, CDMA modulation is used. Each light-emitting diode (LED) in the system broadcasts a unique identity (ID) code using CDMA modulation. Receiver receives mixed signal from every LED reference point, by the orthogonality of spreading code in CDMA modulation, ID information and intensity attenuation information from every LED can be obtained. According to positioning principle of received signal strength (RSS), the coordinate of the receiver can be determined. Due to system noise and imperfection of device utilized in the system, distance between receiver and transmitters will deviate from the real value resulting in positioning error. By introducing error correction factors to global parallel search of genetic algorithm, coordinates of the receiver in three-dimensional space can be determined precisely. Both simulation results and experimental results show that in practical application scenarios, the proposed positioning system can realize high precision positioning service.

Effectiveness of inpatient withdrawal and residential rehabilitation interventions for alcohol use disorder: A national observational, cohort study in England.

PubMed

Eastwood, Brian; Peacock, Amy; Millar, Tim; Jones, Andrew; Knight, Jonathan; Horgan, Patrick; Lowden, Tim; Willey, Peter; Marsden, John

2018-05-01

This was a national English observational cohort study to estimate the effectiveness of inpatient withdrawal (IW) and residential rehabilitation (RR) interventions for alcohol use disorder (AUD) using administrative data. All adults commencing IW and/or RR intervention for AUD between April 1, 2014 and March 31, 2015 reported to the National Drug Treatment Monitoring System (n=3812). The primary outcome was successful completion of treatment within 12months of commencement, with no re-presentation (SCNR) in the subsequent six months, analysed by multi-level, mixed effects, multivariable logistic regression. The majority (70%, n=2682) received IW in their index treatment journey; one-quarter (24%, n=915) received RR; 6% (n=215) received both. Of treatment leavers, 59% achieved the SCNR outcome (IW: 57%; RR: 64%; IW/RR: 57%). Positive outcome for IW was associated with older age, being employed, and receiving community-based treatment prior to and subsequent to IW. Patients with housing problems were less likely to achieving the outcome. Positive outcome for RR was associated with paid employment, self/family/peer referral, longer duration of RR treatment, and community-based treatment following discharge. Community-based treatment prior to entering RR, and receiving IW during the same treatment journey as RR, were associated with lower likelihood of SCNR. In this first national effectiveness study of AUD in the English public treatment system for alcohol-use disorders, 59% of patients successfully completed treatment within 12months and did not represent for more treatment within six months. Longer duration of treatment and provision of structured continuing care is associated with better treatment outcomes. Copyright © 2018. Published by Elsevier Inc.

Effects of continuous midwifery labour support for women with severe fear of childbirth.

PubMed

Sydsjö, Gunilla; Blomberg, Marie; Palmquist, Sofie; Angerbjörn, Louise; Bladh, Marie; Josefsson, Ann

2015-05-15

Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC. A case-control pilot study with an index group of 14 women with severe FOC and a reference group of 28 women without FOC giving birth. In this study the index group received continuous support during childbirth. The women with severe FOC more often had an induction of labour. The parous women with severe FOC had a shorter duration of active labour compared to the parous reference women (p = 0.047). There was no difference in caesarean section frequency between the two groups. Women with severe FOC experienced a very high anxiety level during childbirth (OR = 20.000, 95% CI: 3.036-131.731). Women with severe FOC might benefit from continuous support by a midwife during childbirth. Midwives should acknowledge the importance of continuous support in order to enhance the experience of childbirth in women with severe FOC.

The Effects of Intrapartum Supportive Care on Fear of Delivery and Labor Outcomes: A Single-Blind Randomized Controlled Trial.

PubMed

İsbir, Gözde Gökçe; Serçekuş, Pinar

2017-04-01

Supportive care during labor, the primary role of intrapartum nurses and midwives, provides comfort to prepartum women and helps facilitate a positive labor experience. It has been argued that supportive care during labor reduces fear and anxiety as well as the resultant side effects. However, evidence supporting this argument is insufficient. The aim of this study was to assess the effects of intrapartum supportive care on fear of delivery and on the key parameters of the labor process. This study used a single-blind randomized controlled trial approach. Randomized block assignment was used to assign 72 participants to either the intervention group (n = 36) or the control group (n = 36). Three women in the intervention group and six in the control group were later excluded from the study because they received emergency cesarean delivery. The intervention group received continuous supportive care, and the control group received routine hospital care. No significant differences were identified between the two groups at baseline. The intervention group reported less fear of delivery during the active and transient phases of labor, higher perceived support and control during delivery, lower pain scores during the transient phase of labor, and a shorter delivery period than the control group (p < .05). However, no significant difference in the use of oxytocin during delivery between the two groups was reported. The results of this evidence-based study suggest that continuous support during labor has clinically meaningful benefits for women and that all women should receive this support throughout their labor and delivery process.

Intelligent Articulated Robot

NASA Astrophysics Data System (ADS)

Nyein, Aung Kyaw; Thu, Theint Theint

2008-10-01

In this paper, an articulated type of industrial used robot is discussed. The robot is mainly intended to be used in pick and place operation. It will sense the object at the specified place and move it to a desired location. A peripheral interface controller (PIC16F84A) is used as the main controller of the robot. Infrared LED and IR receiver unit for object detection and 4-bit bidirectional universal shift registers (74LS194) and high current and high voltage Darlington transistors arrays (ULN2003) for driving the arms' motors are used in this robot. The amount of rotation for each arm is regulated by the limit switches. The operation of the robot is very simple but it has the ability of to overcome resetting position after power failure. It can continue its work from the last position before the power is failed without needing to come back to home position.

Hyperchromatic lens for recording time-resolved phenomena

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

Frayer, Daniel K.

A method and apparatus for the capture of a high number of quasi-continuous effective frames of 2-D data from an event at very short time scales (from less than 10.sup.-12 to more than 10.sup.-8 seconds) is disclosed which allows for short recording windows and effective number of frames. Active illumination, from a chirped laser pulse directed to the event creates a reflection where wavelength is dependent upon time and spatial position is utilized to encode temporal phenomena onto wavelength. A hyperchromatic lens system receives the reflection and maps wavelength onto axial position. An image capture device, such as holography ormore » plenoptic imaging device, captures the resultant focal stack from the hyperchromatic lens system in both spatial (imaging) and longitudinal (temporal) axes. The hyperchromatic lens system incorporates a combination of diffractive and refractive components to maximally separate focal position as a function of wavelength.« less

Interim evaluation of the Tier 1 Program of Project P.A.T.H.S.: continuation of evidence.

PubMed

Shek, Daniel T L; Yu, Lu; Chan, Alex C W

2012-01-17

An interim evaluation study was conducted to understand the implementation of the Tier 1 Program of Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes) in the 2008/09 school year. One hundred and twenty-eight schools were randomly selected to provide information on the implementation details of the program via interviews, telephone interviews and self-completed questionnaires. Results showed that a majority of the workers perceived that the students had positive responses to the program and the program was helpful to the students. Program workers' views toward the implementation of the Tier 1 Program were positive across different grades and program implementation modes. In conjunction with previous studies, the present findings suggest that the Tier 1 Program of Project P.A.T.H.S. is well received by different stakeholders.

Criminal exposure.

PubMed

1999-09-03

In August, an HIV-positive man plead guilty to sexually assaulting a 14-year-old boy. The sleeping boy awoke to find [name removed] sexually assaulting him, while watching a pornographic video. [Name removed] plead guilty to the assault with intent to rape a child. In addition, [name removed] received three counts of indecent assault and battery on a child, and exposure of pornographic material to a minor. [Name removed] will remain on probation for five years, although the prosecution had recommended sentencing [name removed] to four or five years in prison. The boy continues to be tested for HIV.

A randomized controlled trial of post-extubation bubble continuous positive airway pressure versus Infant Flow Driver continuous positive airway pressure in preterm infants with respiratory distress syndrome.

PubMed

Gupta, Samir; Sinha, Sunil K; Tin, Win; Donn, Steven M

2009-05-01

To compare the efficacy and safety of bubble continuous positive airway pressure (CPAP) and Infant Flow Driver (IFD) CPAP for the post-extubation management of preterm infants with respiratory distress syndrome (RDS). A total of 140 preterm infants at 24 to 29 weeks' gestation or with a birth weight of 600 to 1500 g who were ventilated at birth for RDS were randomized to receive either IFD CPAP (a variable-flow device) or bubble CPAP (a continuous-flow device). A standardized protocol was used for extubation and CPAP. No crossover was allowed. The primary outcome was successful extubation maintained for at least 72 hours. Secondary outcomes included successful extubation maintained for 7 days, total duration of CPAP support, chronic lung disease, and complications of prematurity. Seventy-one infants were randomized to bubble CPAP, and 69 were randomized to IFD CPAP. Mean gestational age and birth weight were similar in the 2 groups, as were the proportions of infants who achieved successful extubation for 72 hours and for 7 days. However, the median duration of CPAP support was 50% shorter in the infants on bubble CPAP. Moreover, in the subset of infants who were ventilated for less than 14 days, the infants on bubble CPAP had a significantly lower extubation failure rate. There was no difference in the incidence of chronic lung disease or other complications between the 2 study groups. Bubble CPAP is as effective as IFD CPAP in the post-extubation management of infants with RDS; however, in infants ventilated for < or = 14 days, bubble CPAP is associated with a significantly higher rate of successful extubation. Bubble CPAP also is associated with a significantly reduced duration of CPAP support.

A New Indoor Positioning System Architecture Using GPS Signals.

PubMed

Xu, Rui; Chen, Wu; Xu, Ying; Ji, Shengyue

2015-04-29

The pseudolite system is a good alternative for indoor positioning systems due to its large coverage area and accurate positioning solution. However, for common Global Positioning System (GPS) receivers, the pseudolite system requires some modifications of the user terminals. To solve the problem, this paper proposes a new pseudolite-based indoor positioning system architecture. The main idea is to receive real-world GPS signals, repeat each satellite signal and transmit those using indoor transmitting antennas. The transmitted GPS-like signal can be processed (signal acquisition and tracking, navigation data decoding) by the general receiver and thus no hardware-level modification on the receiver is required. In addition, all Tx can be synchronized with each other since one single clock is used in Rx/Tx. The proposed system is simulated using a software GPS receiver. The simulation results show the indoor positioning system is able to provide high accurate horizontal positioning in both static and dynamic situations.

On Dreams and Motivation: Comparison of Freud’s and Hobson’s Views

PubMed Central

Boag, Simon

2017-01-01

The merits of Freudian dream theory continue to be debated and both supporters and critics appeal to empirical evidence to support their respective positions. What receives much less attention is the theoretical coherency of either Freudian dream theory or alternative perspectives. This paper examines Freudian dream theory and J. Allan Hobson’s alternative position by addressing the role of motivation in dreams. This paper first discusses motivation in Freudian theory and its relation to dreams and disguise-censorship. The role of motivation in Hobson’s theory is then considered. Hobson’s claim that dream plot and content selection is random and based on design error and functional imbalance is then discussed in relation to the protoconsciousness theory proposal that dreams serve an adaptive function. While there are apparent inconsistencies in Hobson’s position, his appeal to emotions and instincts provides a preliminary platform for understanding the role of motivation in dreams that is consonant with the Freudian position. PMID:28111554

Chloral hydrate enteral infusion for sedation in ventilated children: the CHOSEN pilot study.

PubMed

Joffe, Ari R; Hogan, Jessica; Sheppard, Cathy; Tawfik, Gerda; Duff, Jonathan P; Garcia Guerra, Gonzalo

2017-11-26

We aimed to test a novel method of delivery of chloral hydrate (CH) sedation in ventilated critically ill young children. Children < 12 years old, within 72 hours of admission, who were ventilated, receiving enteral tube-feeds, with intermittent CH ordered were enrolled after signed consent. Patients received a CH loading-dose of 10 mg/kg enterally, then a syringe-pump enteral infusion at 5 mg/kg/hour, increasing to a maximum of 9 mg/kg/hour. Cases were compared to historical controls matched for age group and Pediatric Risk of Mortality score (PRISM) category, using Fisher's exact test and the t test. The primary outcome was feasibility, defined as the use of an enteral CH continuous infusion without discontinuation attributable to a pre-specified potential harm. There were 21 patients enrolled, at age 11.4 (12.1) months, with bronchiolitis in 10 (48%), a mean Pediatric Logistic Organ Dysfunction (PELOD) score of 6.2 (5.2), and having received enteral CH continuous infusion for 4.5 (2.2) days. Infusion of CH was feasible in 20/21 (95%; 95% CI 76-99%) patients, with one (5%) adverse event of duodenal ulcer perforation on day 3 in a patient with croup receiving regular ibuprofen and dexamethasone. The CH infusion dose (mg/kg/h) on day 2 (n = 20) was 8.9 (IQR 5.9, 9), and on day 4 (n = 11) was 8.8 (IQR 7, 9). Days to titration of adequate sedation (defined as ≤ 3 PRN doses/shift) was 1 (IQR 0.5, 2.5), and hours to awakening for extubation was 5 (IQR 2, 9). Cases (versus controls) had less positive fluid balance at 48 h (-2 (45) vs. 26 (46) ml/kg, p = 0.051), and a decrease in number of PRN sedation doses from 12 h pre to 12 hours post starting CH (4.7 (3.3) to 2.6 (2.8), p = 0.009 versus 2.9 (3.9) to 3.4 (5), p = 0.74). There were no statistically significant differences between cases and controls in inotrope scores, signs or treatment of withdrawal, or PICU days. Delivering CH by continuous enteral infusion is feasible, effective, and may be associated with less positive fluid balance. Whether there is a risk of duodenal perforation requires further study.

Continuous alternating inhaled antibiotic therapy in CF: A single center retrospective analysis.

PubMed

Van de Kerkhove, C; Goeminne, P C; Kicinski, M; Nawrot, T S; Lorent, N; Van Bleyenbergh, P; De Boeck, K; Dupont, L J

2016-11-01

The efficacy of inhaled antibiotics to treat chronic Pseudomonas aeruginosa pulmonary infection in patients with cystic fibrosis (CF) has been well established. Few data are available on the value of continuous alternating inhaled antibiotic therapy (CAIT), a strategy increasingly used in the management of CF. To investigate the effect of CAIT on clinical outcome in adult CF patients treated at the University Hospital Leuven. Patients with a documented CF diagnosis who received inhaled antibiotics between March 2010 and January 2015 were retrospectively evaluated. In patients receiving CAIT patient characteristics, recorded spirometry data and number of IV antibiotic days were collected retrospectively at fixed time intervals, from 6months before to one year after the start of the 2nd inhaled antibiotic. For patients on inhaled antibiotic monotherapy (IAMT), the same data were obtained at similar intervals during the study period. A total of 49 of 89 patients using chronic inhaled antibiotic therapy received CAIT. Patients receiving CAIT had a lower baseline FEV 1 and were more likely to be homozygous for F508del compared to patients receiving IAMT. FEV 1 deteriorated on average by a factor of 0.904 per year (95% CI: 0.851-0.960) prior to the start of CAIT. The initiation of CAIT was associated with an average improvement in FEV 1 by a factor of 1.148 per year (95% CI: 1.068-1.236, p=0.0002). The analysis of specific types of antibiotics revealed evidence of positive effects of adding COLI to TOBI and COLI to AZLI. We found no effect of the initiation of CAIT on the number of IV antibiotic days (p=0.80). CF patients with more advanced lung disease are more likely to receive CAIT. In this patient group, CAIT was associated with a significant improvement in FEV 1 . Further data are warranted to identify the value of CAIT. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Self-referenced continuous-variable quantum key distribution

DOEpatents

Soh, Daniel B. S.; Sarovar, Mohan; Camacho, Ryan

2017-01-24

Various technologies for continuous-variable quantum key distribution without transmitting a transmitter's local oscillator are described herein. A receiver on an optical transmission channel uses an oscillator signal generated by a light source at the receiver's location to perform interferometric detection on received signals. An optical reference pulse is sent by the transmitter on the transmission channel and the receiver computes a phase offset of the transmission based on quadrature measurements of the reference pulse. The receiver can then compensate for the phase offset between the transmitter's reference and the receiver's reference when measuring quadratures of received data pulses.

Trastuzumab beyond progression in human epidermal growth factor receptor 2-positive advanced breast cancer: a german breast group 26/breast international group 03-05 study.

PubMed

von Minckwitz, Gunter; du Bois, Andreas; Schmidt, Marcus; Maass, Nicolai; Cufer, Tanja; de Jongh, Felix E; Maartense, Eduard; Zielinski, Christoph; Kaufmann, Manfred; Bauer, Wolfgang; Baumann, Klaus H; Clemens, Michael R; Duerr, Ralph; Uleer, Christoph; Andersson, Michael; Stein, Robert C; Nekljudova, Valentina; Loibl, Sibylle

2009-04-20

Trastuzumab shows clinical activity in human epidermal growth factor receptor 2 (HER-2)-positive early and advanced breast cancer. In the German Breast Group 26/Breast International Group 03-05 trial, we investigated if trastuzumab treatment should be continued beyond progression. Patients with HER-2-positive breast cancer that progresses during treatment with trastuzumab were randomly assigned to receive capecitabine (2,500 mg/m(2) body-surface area on days 1 through 14 [1,250 mg/m(2) semi-daily]) alone or with continuation of trastuzumab (6 mg/kg body weight) in 3-week cycles. The primary end point was time to progression. We randomly assigned 78 patients to capecitabine and 78 patients to capecitabine plus trastuzumab. Sixty-five events and 38 deaths in the capecitabine group and 62 events and 33 deaths in the capecitabine-plus-trastuzumab group occurred during 15.6 months of follow-up. Median times to progression were 5.6 months in the capecitabine group and 8.2 months in the capecitabine-plus-trastuzumab group with an unadjusted hazard ratio of 0.69 (95% CI, 0.48 to 0.97; two-sided log-rank P = .0338). Overall survival rates were 20.4 months (95% CI, 17.8 to 24.7) in the capecitabine group and 25.5 months (95% CI, 19.0 to 30.7) in the capecitabine-plus-trastuzumab group (P = .257). Overall response rates were 27.0% with capecitabine and 48.1% with capecitabine plus trastuzumab (odds ratio, 2.50; P = .0115). Continuation of trastuzumab beyond progression was not associated with increased toxicity. Continuation of trastuzumab plus capecitabine showed a significant improvement in overall response and time to progression compared with capecitabine alone in women with HER-2-positive breast cancer who experienced progression during trastuzumab treatment.

The Combined Effects of Alcohol, Caffeine and Expectancies on Subjective Experience, Impulsivity and Risk-Taking

PubMed Central

Heinz, Adrienne J.; de Wit, Harriet; Lilje, Todd C.; Kassel, Jon D.

2013-01-01

Caffeinated alcoholic beverage (CAB) consumption is a rapidly growing phenomenon among young adults and is associated with a variety of health-risk behaviors. The current study examined whether either caffeinated alcohol or the expectation of receiving caffeinated alcohol altered affective, cognitive and behavioral outcomes hypothesized to contribute to risk behavior. Young adult social drinkers (N=146) participated in a single session where they received alcohol (peak Breath Alcohol Content = .088 g/dL, SD = .019; equivalent to about 4 standard drinks) and were randomly assigned to one of four further conditions 1) no caffeine, no caffeine expectancy, 2) caffeine and caffeine expectancy, 3) no caffeine but caffeine expectancy, 4) caffeine but no caffeine expectancy. Participants’ habitual CAB consumption was positively correlated with measures of impulsivity and risky behavior, independently of study drugs. Administration of caffeine (mean dose = 220 mg, SD = 38; equivalent to about 2.75 Red Bulls) in the study reduced subjective ratings of intoxication and reversed the decrease in desire to continue drinking, regardless of expectancy. Caffeine also reduced the effect of alcohol on inhibitory reaction time (faster incorrect responses). Participants not expecting caffeine were less attentive after alcohol, whereas participants expecting caffeine were not, regardless of caffeine administration. Alcohol decreased response accuracy in all participants except those who both expected and received caffeine. Findings suggest that CABs may elevate risk for continued drinking by reducing perceived intoxication, and by maintaining the desire to continue drinking. Simply expecting to consume caffeine may reduce the effects of alcohol on inattention, and either expecting or consuming caffeine may protect against other alcohol-related performance decrements. Caffeine, when combined with alcohol, has both beneficial and detrimental effects on mechanisms known to contribute to risky behavior. PMID:23750693

Conditioned pharmacotherapeutic effects: a preliminary study.

PubMed

Ader, Robert; Mercurio, Mary Gail; Walton, James; James, Deborra; Davis, Michael; Ojha, Valerie; Kimball, Alexa Boer; Fiorentino, David

2010-02-01

To test the hypothesize that psoriasis patients treated under a partial schedule of pharmacologic (corticosteroid) reinforcement would show less severe symptoms and relapse than those given the same amount of drug under standard conditions. Behavioral conditioning as an inherent component of many pharmacotherapeutic protocols has never been examined. A double-blind, simple randomization intervention was conducted with 46 patients from California and New York. Initially, lesions were treated with 0.1% acetonide triamcinolone under standard treatment conditions. Thereafter, a Standard Therapy group continued on continuous reinforcement (active drug every treatment) with 100% of the initial dose; Partial Reinforcement patients received a full dose 25% to 50% of the time and placebo medication other times; Dose Control patients received continuous reinforcement with 25% to 50% of the initial dose. Severity of disease scores in California neither supported nor refuted the hypothesis. In New York, where there was no difference between Partial Reinforcement and Dose Control groups at baseline, partial reinforcement effected a greater reduction in lesion severity than Dose Control conditions and did not differ from Standard Therapy patients receiving two to four times more drug. For the entire population, the frequency of relapse under partial reinforcement (26.7%) was lower than in Dose Control patients (61.5%) and did not differ from full-dose treatment (22.2%). A partial schedule of pharmacotherapeutic reinforcement could maintain psoriasis patients with a cumulative amount of corticosteroid that was relatively ineffective when administered under standard treatment conditions. Conceivably, corticosteroid administration only one quarter or half as frequently as currently prescribed is sufficient to treat psoriasis. We posit, however, that these preliminary observations implicate conditioning processes in-and for the design of-regimens of pharmacotherapy.

Continuous pressure letdown system

DOEpatents

Sprouse, Kenneth M.; Matthews, David R.; Langowski, Terry

2010-06-08

A continuous pressure letdown system connected to a hopper decreases a pressure of a 2-phase (gas and solid) dusty gas stream flowing through the system. The system includes a discharge line for receiving the dusty gas from the hopper, a valve, a cascade nozzle assembly positioned downstream of the discharge line, a purge ring, an inert gas supply connected to the purge ring, an inert gas throttle, and a filter. The valve connects the hopper to the discharge line and controls introduction of the dusty gas stream into the discharge line. The purge ring is connected between the discharge line and the cascade nozzle assembly. The inert gas throttle controls a flow rate of an inert gas into the cascade nozzle assembly. The filter is connected downstream of the cascade nozzle assembly.

Inflation of Long Valley Caldera from 1 year of continuous GPS observations

NASA Technical Reports Server (NTRS)

Webb, Frank H.; Bursik, Marcus; Dixon, Timothy; Farina, Frederic; Marshall, Grant; Stein, Ross S.

1995-01-01

A permanent Global Positioning System (GPS) receiver at Casa Diablo Hot Springs, Long Valley Caldera, California was installed in January, 1993, and has operated almost continuously since then. The data have been transmitted daily to the Jet Propulsion Laboratory (JPL) for routine analysis with data from the Fiducial Laboratories for an International Natural sciences Network (FLINN) by the JPL FLINN analysis center. Results from these analyses have been used to interpret the on going deformation at Long Valley, with data excluded from periods when the antenna was covered under 2.5 meters of snow and from some periods when Anti Spoofing was enforced on the GPS signal. The remaining time series suggests that uplift of the resurgent dome of Long Valley Caldera during 1993 has been 2.5 +/- 1.1 cm/yr and horizontal motion has been 3.0 +/- 0.7 cm/yr at S53W in a no-net-rotation global reference frame, or 1.5 +/- 0.7 cm/yr at S14W relative to the Sierra Nevada block. These rates are consistent with uplift predicted from frequent horizontal strain measurements. Spectral analysis of the observations suggests that tidal forcing of the magma chamber is not a source of the variability in the 3 dimensional station location. These results suggest that remotely operated, continuously recording GPS receivers could prove to be a reliable tool for volcanic monitoring throughout the world.

Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work.

PubMed

Duijts, Saskia F A; van Egmond, Martine P; Gits, Maxime; van der Beek, Allard J; Bleiker, Eveline M

2017-10-01

Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.

The explanatory power of Schema Theory: theoretical foundations and future applications in Ergonomics.

PubMed

Plant, Katherine L; Stanton, Neville A

2013-01-01

Schema Theory is intuitively appealing although it has not always received positive press; critics of the approach argue that the concept is too ambiguous and vague and there are inherent difficulties associated with measuring schemata. As such, the term schema can be met with scepticism and wariness. The purpose of this paper is to address the criticisms that have been levelled at Schema Theory by demonstrating how Schema Theory has been utilised in Ergonomics research, particularly in the key areas of situation awareness, naturalistic decision making and error. The future of Schema Theory is also discussed in light of its potential roles as a unifying theory in Ergonomics and in contributing to our understanding of distributed cognition. We conclude that Schema Theory has made a positive contribution to Ergonomics and with continued refinement of methods to infer and represent schemata it is likely that this trend will continue. This paper reviews the contribution that Schema Theory has made to Ergonomics research. The criticisms of the theory are addressed using examples from the areas of situation awareness, decision making and error.

Evaluating nurse prescribers' education and continuing professional development for independent prescribing practice: findings from a national survey in England.

PubMed

Latter, Sue; Maben, Jill; Myall, Michelle; Young, Amanda

2007-10-01

The number of nurses able to independently prescribe medicines in England has risen steadily in recent years. To evaluate the adequacy of nurses' educational preparation for independent prescribing and to describe nurses' experiences of their continuing professional development as prescribers in practice. Postal questionnaire survey. Random sample of 246 nurses registered as nurse independent prescribers with the Nursing and Midwifery Council. The majority of nurses considered that the initial taught course element of their education programme met their needs, either to some extent (61% 151/246), or completely (22% 54/246). Most nurses (77% 190/246) received the specified 12 days support from their supervising medical practitioner and most were satisfied and positive about this experience. Nearly all of the nurses (>95%) reported that they were able to maintain a range of specified prescribing competencies in practice. Two thirds (62% 152/246) of the sample reported that they were receiving support/supervision for prescribing. Ninety five per cent (233/246) of the sample also reported that they engaged in self-directed informal continuing professional development, but only half of the sample had experience of formally provided professional development opportunities. Approximately half (52% 127/246) of the sample identified needs for continuing professional development. This first national survey of the education and professional development experiences of nurse independent prescribers in England provides evidence which highlights areas in which national policy is working well, and also points up issues which may need addressing as the roll out of nurse prescribing continues. The study also highlights characteristics and issues that health care policy makers and nurse educationalists internationally may wish to consider in developing and refining their own nurse prescriber education programmes.

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

Froemyr, E.; Berteussen, K.A.; Jahren, L.

Small scale seismic surveys have the potential of providing low-cost high resolution subsurface images of limited targets. Crucial to the success of this method is to understand the character and level of ambient noise. Based on this understanding appropriate source strength and receiver fold can be determined in order to obtain the necessary signal to noise ratio at target depth. Saga Petroleum a.s. and Read Well Services A/S performed a test off-shore Norway using geophones on the seabed. The receivers consisted of two small geophone arrays separated by 1 km. A 3 km line was host symmetrically above the receivermore » arrays. The line was shot in a non-continuous fashion by moving from one position to the next with 5 repetitive shots fired at each shot position. A small airgun array was used. A large proportion of the noise exhibits clear spatial coherence. The most significant noise sources are the receiver vessel and the shooting boat. Spectral and spatial analysis reveals that additional sources of noise are present including subsurface sources. The target reflector was top reservoir at approximately 2.1 sec. two-way time. With 4 geophones in each array and repetitive shooting, top reservoir is visible but weak. The area is in general complex but the authors may infer that reduce vessel noise coupled with increased source strength can provide a high resolution subsurface image revealing details not seen on the standard marine seismic section.« less

How a GNSS Receiver Is Held May Affect Static Horizontal Position Accuracy

PubMed Central

Weaver, Steven A.; Ucar, Zennure; Bettinger, Pete; Merry, Krista

2015-01-01

The static horizontal position accuracy of a mapping-grade GNSS receiver was tested in two forest types over two seasons, and subsequently was tested in one forest type against open sky conditions in the winter season. The main objective was to determine whether the holding position during data collection would result in significantly different static horizontal position accuracy. Additionally, we wanted to determine whether the time of year (season), forest type, or environmental variables had an influence on accuracy. In general, the F4Devices Flint GNSS receiver was found to have mean static horizontal position accuracy levels within the ranges typically expected for this general type of receiver (3 to 5 m) when differential correction was not employed. When used under forest cover, in some cases the GNSS receiver provided a higher level of static horizontal position accuracy when held vertically, as opposed to held at an angle or horizontally (the more natural positions), perhaps due to the orientation of the antenna within the receiver, or in part due to multipath or the inability to use certain satellite signals. Therefore, due to the fact that numerous variables may affect static horizontal position accuracy, we only conclude that there is weak to moderate evidence that the results of holding position are significant. Statistical test results also suggest that the season of data collection had no significant effect on static horizontal position accuracy, and results suggest that atmospheric variables had weak correlation with horizontal position accuracy. Forest type was found to have a significant effect on static horizontal position accuracy in one aspect of one test, yet otherwise there was little evidence that forest type affected horizontal position accuracy. Since the holding position was found in some cases to be significant with regard to the static horizontal position accuracy of positions collected in forests, it may be beneficial to have an understanding of antenna positioning within the receiver to achieve the greatest accuracy during data collection. PMID:25923667

How a GNSS Receiver Is Held May Affect Static Horizontal Position Accuracy.

PubMed

Weaver, Steven A; Ucar, Zennure; Bettinger, Pete; Merry, Krista

2015-01-01

The static horizontal position accuracy of a mapping-grade GNSS receiver was tested in two forest types over two seasons, and subsequently was tested in one forest type against open sky conditions in the winter season. The main objective was to determine whether the holding position during data collection would result in significantly different static horizontal position accuracy. Additionally, we wanted to determine whether the time of year (season), forest type, or environmental variables had an influence on accuracy. In general, the F4Devices Flint GNSS receiver was found to have mean static horizontal position accuracy levels within the ranges typically expected for this general type of receiver (3 to 5 m) when differential correction was not employed. When used under forest cover, in some cases the GNSS receiver provided a higher level of static horizontal position accuracy when held vertically, as opposed to held at an angle or horizontally (the more natural positions), perhaps due to the orientation of the antenna within the receiver, or in part due to multipath or the inability to use certain satellite signals. Therefore, due to the fact that numerous variables may affect static horizontal position accuracy, we only conclude that there is weak to moderate evidence that the results of holding position are significant. Statistical test results also suggest that the season of data collection had no significant effect on static horizontal position accuracy, and results suggest that atmospheric variables had weak correlation with horizontal position accuracy. Forest type was found to have a significant effect on static horizontal position accuracy in one aspect of one test, yet otherwise there was little evidence that forest type affected horizontal position accuracy. Since the holding position was found in some cases to be significant with regard to the static horizontal position accuracy of positions collected in forests, it may be beneficial to have an understanding of antenna positioning within the receiver to achieve the greatest accuracy during data collection.

Maintaining the potential of a psycho-educational program: efficacy of a booster session after an intervention offered family caregivers at disclosure of a relative's dementia diagnosis.

PubMed

Ducharme, Francine; Lachance, Lise; Lévesque, Louise; Zarit, Steven Howard; Kergoat, Marie-Jeanne

2015-01-01

Booster sessions as a means of maintaining the benefits of psycho-educational programs have received little attention in caregiving research. Caregivers were offered a booster session following participation in a program entitled Learning to Become a Family Caregiver (LBFC) intended to facilitate transition to the caregiver role after diagnostic disclosure of dementia in a relative. The 90-minute booster session served to review program content and afforded the opportunity to discuss and practice learned skills. This study sought to test the efficacy of the booster session in maintaining or recovering program effects at six months post-program. Participants in the program were randomly assigned to a group that received the booster session (n = 31) or a group that did not (n = 29). A third control group was also formed, which continued to receive only the usual care provided in memory clinics. Eligible participants - French-speaking primary caregivers of a relative diagnosed with Alzheimer's in the past nine months - were recruited in memory clinics in Quebec (Canada). Participants were blindly assessed before randomization and six months after the booster session on outcomes associated with a healthy role transition. Prediction analyses revealed one significant positive effect of the booster session: emergence of preparedness to provide care. Moreover, with or without the booster session, the program continued to have a positive effect on psychological distress and contributed to the emergence of self-efficacy in dealing with caregiving situations. The booster session had no significant effect on knowledge of services, planning for future care needs, use of reframing as a coping strategy, perceived informal support, and family conflicts. The limited effect observed is discussed in terms of the booster session's content and intensity. Recommendations are made for designing future research on the effect of booster sessions, including the importance of including a placebo booster group.

Micrococcus-associated central venous catheter infection in patients with pulmonary arterial hypertension.

PubMed

Oudiz, Ronald J; Widlitz, Allison; Beckmann, X Joy; Camanga, Daisy; Alfie, Jose; Brundage, Bruce H; Barst, Robyn J

2004-07-01

To determine the incidence of catheter-related infection in patients with pulmonary arterial hypertension (PAH) receiving epoprostenol (EPO), and to note an etiologic role for Micrococcus spp, which is rarely reported as a pathogen in the medical literature. Observational study. Two PAH specialty treatment centers, Harbor-UCLA Medical Center (Torrance, CA), and the College of Physicians and Surgeons, Columbia University (New York, NY). A total of 192 patients with PAH receiving continuous therapy with IV EPO. From 1987 to 2000, 192 patients with PAH received infusions of EPO via central venous catheter. Catheter care included regular dressing changes with dry gauze using a sterile procedure, without the use of flushes. Patients were asked to report on known infections and treatments, and symptoms. All infections were verified by a telephone call to the patient, care provider, and microbiology laboratory whenever possible. There were 335,285 catheter days (mean +/- SD, 1,325 +/- 974 catheter days). There were 88 clinical catheter infections with 51 blood culture-positive infections, necessitating catheter removal in 38 instances. The following pathogens were isolated: Staphylococcus aureus (25); Micrococcus spp (14); mixed flora (3); coagulase-negative Staphylococcus spp (2); Corynebacterium spp (2); Serratia marcessens (1); Enterobacter spp (1); Pseudomonas aeruginosa (1); enterococci (1); and unidentified Gram-positive cocci (1). The catheter infection rate was 0.26 per 1,000 catheter days. The use of long-term therapy with continuous EPO appears to be associated with a low incidence of catheter-related infections. Micrococcus spp were the second most common etiologic agent. Caregivers managing patients with PAH must be aware of the risk of catheter infection, as it may contribute to the morbidity and mortality associated with the use of EPO. When isolated, Micrococcus spp should not be viewed as a contaminant, but rather as a true pathogen that may require therapeutic intervention.

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2013 CFR

2013-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2012 CFR

2012-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2011 CFR

2011-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

Code of Federal Regulations, 2014 CFR

2014-04-01

... from regulated investment company. 1.854-1 Section 1.854-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Regulated Investment Companies and Real Estate Investment Trusts § 1.854-1 Limitations applicable to dividends received from...

Physician attitudes toward industry: a view across the specialties

PubMed Central

Korenstein, Deborah; Keyhani, Salomeh; Ross, Joseph S.

2010-01-01

Objectives Physician relationships with industry are receiving attention as government and professional organizations move toward restrictive policies and financial transparency. Our objective was to explore attitudes of physicians from all specialties toward gifts from and interactions with the pharmaceutical and device industries. Design Anonymous cross sectional survey. Setting Hospitals in the Mount Sinai School of Medicine consortium, in the New York City metro area Participants Faculty and trainee physicians from all clinical departments Main Outcome Measures Attitudes toward industry interactions and gifts and their appropriateness, measured on 4-point Likert scales. Results Five hundred ninety physicians and medical students completed the survey (response rate=67%); 59% were male, 39% were attendings, and 24% were from surgical specialties. Attitudes toward industry and gifts were generally positive. More than 65% found educational materials and sponsored lunches appropriate, whereas fewer than 25% considered vacations or large gifts appropriate. Surgeons, trainees, and those unfamiliar with institutional policies on industry interactions held more positive attitudes than others and were more likely to deem some gifts appropriate, including industry funding of residency programs and, among surgeons, receiving meals, travel expenses, and payments for attending lectures. Non-attendings held more positive attitudes toward meals in clinical settings, textbooks and samples. Conclusions Physicians continue to hold positive attitudes toward marketing-oriented activities of the pharmaceutical and device industries. Changes in medical culture and physician education focused on surgeons and trainees may align physician attitudes with current policy trends. PMID:20566978

"Something Extra on Chromosome 5": Parents' Understanding of Positive Prenatal Chromosomal Microarray Analysis (CMA) Results.

PubMed

Walser, Sarah A; Werner-Lin, Allison; Russell, Amita; Wapner, Ronald J; Bernhardt, Barbara A

2016-10-01

This study aims to explore how couples' understanding of the nature and consequences of positive prenatal chromosomal microarray analysis (CMA) results impacts decision-making and concern about pregnancy. We interviewed 28 women and 12 male partners after receiving positive results and analyzed the transcripts to assess their understanding and level of concern about the expected clinical implications of results. Participant descriptions were compared to the original laboratory interpretation. When diagnosed prenatally, couples' understanding of the nature and consequences of copy number variants (CNVs) impacts decision-making and concern. Findings suggest women, but less so partners, generally understand the nature and clinical implications of prenatal CMA results. Couples feel reassured, perhaps sometimes falsely so, when a CNV is inherited from a "normal" parent and experience considerable uncertainty when a CNV is de novo, frequently precipitating a search for additional information and guidance. Five factors influenced participants' concern including: the pattern of inheritance, type of possible phenotypic involvement, perceived manageability of outcomes, availability and strength of evidence about outcomes associated with the CNV, and provider messages about continuing the pregnancy. A good understanding of results is vital as couples decide whether or not to continue with their pregnancy and seek additional information to assist in pregnancy decision-making.

[Anesthetic management for cerebral aneurysm surgery in a patient with aortitis syndrome accompanied by lung edema].

PubMed

Maeda, Ryoko; Kohno, Yumiko; Hoshino, Hajime; Suzuki, Hideo; Hirabayashi, Yoshiyuki; Seo, Norimasa

2003-08-01

A 48-year-old woman with aortitis syndrome underwent clipping of dissecting aneurysm of the left posterior inferior cerebellar artery following subarachnoid hemorrhage. Preoperative echocardiography demonstrated moderate aortic regurgitation and pulmonary hypertension. Intravenous infusion (1900 ml.day-1) was performed to avoid cerebral vasospasm, but the patient developed lung edema. She received delayed surgical treatment after the improvement of lung symptoms. Anesthesia was induced with fentanyl (0.1 mg), propofol (90 mg) and vecuronium (6 mg). Radial arterial flow was judged to be insufficient for cannulation, and a cannulation was therefore performed on the dorsal pedis artery. During induction of anesthesia, there was a significant decrease in the arterial pressure, that required a total of 32 mg of intravenous ephedrine. Following tracheal intubation, a central venous catheter was inserted and dopamine was continuously administered. The patient was positioned in the park bench position. We thought that the placement of the introducer for Swan-Ganz catheter was difficult under the position and Swan-Ganz catheter was not inserted. Anesthesia was maintained with sevoflurane, air, and oxygen. We continuously monitored the central venous pressure as an indicator of fluid balance. In this case, we monitored dorsal pedis arterial pressure directly, which might not be sufficiently reliable to predict the decrease in cerebral blood flow.

Investigating the need for scholarly communications positions in Association of Academic Health Sciences Libraries member institutions

PubMed Central

Mears, Kim; Bandy, Sandra L.

2017-01-01

Background The role of health sciences librarians has expanded in the scholarly communications landscape as a result of the increase in federal public access mandates and the continued expansion of publishing avenues. This has created the need to investigate whether academic health sciences libraries should have scholarly communications positions to provide education and services exclusively related to scholarly communication topics. Methods A nine-question online survey was distributed through the Association of Academic Health Sciences Libraries (AAHSL) email discussion list to gather preliminary findings from and opinions of directors of health sciences libraries on the need for scholarly communications positions. Results The survey received a 38% response rate. The authors found that AAHSL members are currently providing scholarly communications services, and 46% of respondents expressed the need to devote a full-time position to this role. Discussion Our survey reveals a juxtaposition occurring in AAHSL member libraries. While administrators acknowledge the need to provide scholarly communications services, they often experience budget challenges in providing a full-time position for these services. PMID:28377677

26 CFR 1.243-1 - Deduction for dividends received by corporations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Deduction for dividends received by corporations... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Special Deductions for Corporations § 1.243-1 Deduction for dividends received by corporations. (a)(1) A corporation is allowed a deduction under section 243 for...

Apparatus and method for continuous electroplating. [Patent application

DOEpatents

Conlon, T.P. Jr.; Holmes, S.D.

1981-11-19

An apparatus and method are disclosed for performing a continuous electroplating process upon an elongate conductive stock article. A closed housing assembly retaining an electroplating solution and having a conductive housing body and flexible, nonconductive end walls is connected to the positive pole of a source of electromotive force. The end walls have an aperture for receiving the conducting stock article in sliding and sealing contact. The stock article is connected to the negative pole of the source of electromotive force. The conductive housing body and the section of the conductive stock article within the housing body are coextensive, coaxial and spaced a uniform distance apart. The housing body has an inlet at the bottom and an outlet at the top allowing the housing assembly to fill completely with plating solution. The inlet has a reduced nozzle to create turbulence and spiral circulating motion of the plating solution moved by a pump connected by nonconductive conduits. The solution is circulated through an open reservoir. A coolant may be conveyed through the interior in a hollow stock article to cool the surface being electroplated. Different sizes of coaxial metal insert sleeves may be telescopically received in the housing body.

Prenatal care services in the public and private arena.

PubMed

Blackwell, Deborah A

2002-12-01

This exploratory study described the prenatal care experience in the public and private arena from the perceptions of childbearing women using interpretive interactionism. A face-to-face interview comprised of eight open-ended questions was used to obtain pregnant women's perceptions of their prenatal care experience and prenatal care needs. The purposive sample consisted of six women who received private prenatal care and 14 women who received public prenatal care. Five essential elements of the prenatal care experience were identified. Prenatal care was viewed as a cooperative effort between informal self-care and formal care by health professionals. Issues related to individuality and normality were important considerations in the delivery of prenatal care. Controversy exists over the effectiveness of prenatal care in preventing poor outcomes, as the definition of what constitutes adequate prenatal care remains unclear. Advanced practice nurses (APNs) continue to play a pivotal role in the provision of prenatal care services. The expanded knowledge and skills possessed by APNs place them in a pivotal position to develop and implement individualized, developmentally appropriate prenatal care that the women in this study so desperately wanted. In addition, they can assist women in continuing the health promoting behaviors initiated prenatally through out their lifespan.

Continuous positive airway pressure improves sleep and daytime sleepiness in patients with Parkinson disease and sleep apnea.

PubMed

Neikrug, Ariel B; Liu, Lianqi; Avanzino, Julie A; Maglione, Jeanne E; Natarajan, Loki; Bradley, Lenette; Maugeri, Alex; Corey-Bloom, Jody; Palmer, Barton W; Loredo, Jose S; Ancoli-Israel, Sonia

2014-01-01

Obstructive sleep apnea (OSA), common in Parkinson disease (PD), contributes to sleep disturbances and daytime sleepiness. We assessed the effect of continuous positive airway pressure (CPAP) on OSA, sleep, and daytime sleepiness in patients with PD. This was a randomized placebo-controlled, crossover design. Patients with PD and OSA were randomized into 6 w of therapeutic treatment or 3 w of placebo followed by 3 w of therapeutic treatment. Patients were evaluated by polysomnography (PSG) and multiple sleep latency test (MSLT) pretreatment (baseline), after 3 w, and after 6 w of CPAP treatment. Analyses included mixed models, paired analysis, and within-group analyses comparing 3 w to 6 w of treatment. Sleep laboratory. Thirty-eight patients with PD (mean age = 67.2 ± 9.2 y; 12 females). Continuous positive airway pressure. PSG OUTCOME MEASURES: sleep efficiency, %sleep stages (N1, N2, N3, R), arousal index, apnea-hypopnea index (AHI), and % time oxygen saturation < 90% (%time SaO2 < 90%). MSLT outcome measures: mean sleep-onset latency (MSL). There were significant group-by-time interactions for AHI (P < 0.001), % time SaO2 < 90% (P = 0.02), %N2 (P = 0.015) and %N3 (P = 0.014). Subjects receiving therapeutic CPAP showed significant decrease in AHI, %time SaO2 < 90%, %N2, and significant increase in %N3 indicating effectiveness of CPAP in the treatment of OSA, improvement in nighttime oxygenation, and in deepening sleep. The paired sample analyses revealed that 3 w of therapeutic treatment resulted in significant decreases in arousal index (t = 3.4, P = 0.002). All improvements after 3 w were maintained at 6 w. Finally, 3 w of therapeutic CPAP also resulted in overall decreases in daytime sleepiness (P = 0.011). Therapeutic continuous positive airway pressure versus placebo was effective in reducing apnea events, improving oxygen saturation, and deepening sleep in patients with Parkinson disease and obstructive sleep apnea. Additionally, arousal index was reduced and effects were maintained at 6 weeks. Finally, 3 weeks of continuous positive airway pressure treatment resulted in reduced daytime sleepiness measured by multiple sleep latency test. These results emphasize the importance of identifying and treating obstructive sleep apnea in patients with Parkinson disease.

Experiences of caregivers of infants who have been on bubble continuous positive airway pressure at Queen Elizabeth Central Hospital, Malawi: A descriptive qualitative study.

PubMed

Gondwe, Mtisunge Joshua; Gombachika, Belinda; Majamanda, Maureen D

2017-03-01

An innovative, low-cost bubble continuous positive airway pressure (bCPAP) device has recently been introduced in Malawi for the treatment of respiratory distress in infants. While this novel bCPAP system has been shown to be safe and effective in reducing infant mortality, caregivers' experiences have not been investigated. The purpose of this study was to explore experiences of parents and guardians of infants who had been on bCPAP at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. This was a descriptive phenomenological study that was carried out at the Chatinkha nursery unit and the paediatric nursery ward at QECH, from January to February 2015. Purposive sampling was used to select participants for in-depth interviews. Data saturation was reached with 12 caregivers. Data were analysed using Colaizzi's framework. Caregivers received inadequate, inconsistent, and sporadic information about bCPAP. Student nurses and doctors were best able to answer caregivers' questions and concerns. When their infants were on bCPAP, caregivers felt anxious and fearful. However, upon implementation of bCPAP treatment for their children, the caregivers were satisfied with it. The main sources of psychological stress were limited parent-child interaction and the constraints of prescribed visiting hours. Family, friends, and caregiver involvement in the care of infants provided some psychological comfort. The results show gaps in the information and psychological support that mothers of infants on bCPAP receive in hospital. We recommend that psychological support be given to the mothers of infants on bCPAP at QECH.

Improvement in platelet count after 3rd-line and 4th-line eradication therapy for Helicobacter pylori in patients with immune thrombocytopenia.

PubMed

Jomen, Wataru; Sato, Takashi; Maesawa, Chihaya

2017-01-01

Case 1: A 78-year-old woman was diagnosed with H. pylori positive gastritis at a previous hospital in April 2012 and received 3rd-line H. pylori eradication therapy, which ended in failure. She was referred to our department due to oral hemorrhage, petechiae involving all four extremities, and thrombocytopenia in January 2016. She was hospitalized with a diagnosis of ITP and received inpatient treatment. While receiving outpatient prednisolone (PSL) treatment, we administered 4th-line eradication therapy in March. Her platelet levels have since returned to normal, and PSL treatment has been discontinued. She is currently followed without treatment. Case 2: A 65-year-old woman was diagnosed with ITP at a previous hospital in June 2013 and received 2nd-line eradication therapy, which ended in failure. Thereafter, PSL treatment was continued but she was later referred to our department in March 2016. Since 3rd-line eradication therapy was successful, her platelet count normalized and PSL treatment has been discontinued. She is currently followed without treatment. Based on our observations in these two cases, third-line H. pylori eradication therapy is potentially effective in ITP patients.

Familiar Phases: Receiver Function Study of the Lithospheric Structure Across the Eastern Margin of the Superior Craton

NASA Astrophysics Data System (ADS)

Levin, V. L.; Servali, A.; Dunham, B.; Klaser, M.

2015-12-01

A 1200 km long array of seismic observatories from James Bay to the Atlantic coast covers nearly 2 Ga in time, from the Archean Superior Province to the Paleozoic Appalachian Orogen. We use traditional (P-to-SV) receiver function analysis for detailed characterization of the lithospheric mantle along the array, focusing on the 5-15 s delay range where direct conversions from within the lithosphere and crustal multiples are expected.Superior craton sites show exceptionaly clear receiver functions dominated by the first crustal multiple. Also, a negative phase consistent with impedance decrease at the Mid-Lithospheric Discontinuity (~8 s delay) is observed north of 51°N, within the La Grande and Opinaca terranes of the Superior province. In the Opatica terrane further south we see a positive phase at similar delays instead. This implies a downward impedance increase 70-80 km deep within the lithosphere, consistent with the Hales discontinuity. In the Abitibi terrane just north of the Grenville Front we see evidence for two impedance drops in the 60-130 km depth range. Within the Proterozoic Grenvile province receiver functions vary with direction at individual sites, and lack regional consistency. Crustal multiples are noticeably weaker. South of 49°N we once again find negative phases in the 8-10 s delay range. While weak and directionally-dependent in the central Grenville province, these phases are clear near the Appalachian Front (AF), and are followed by positive phases, suggesting thin low-velocity layers in the lower part of the lithosphere. Similarity of receiver function signatures on opposite sides of the AF suggests continuity of the lithosphere beneath it.South of the AF and north of the Norumbega Fault Zone (NFZ) in Maine we find positive phases at ~10 s delays. The implied increase in impedance at ~75 km depth is puzzling. We also find previously-reported weak negative phases in the 6-8 s delay range. South of the NFZ a strong negative phase at ~9 s delay likely marks the bottom of the lithosphere.

A Spatial Division Clustering Method and Low Dimensional Feature Extraction Technique Based Indoor Positioning System

PubMed Central

Mo, Yun; Zhang, Zhongzhao; Meng, Weixiao; Ma, Lin; Wang, Yao

2014-01-01

Indoor positioning systems based on the fingerprint method are widely used due to the large number of existing devices with a wide range of coverage. However, extensive positioning regions with a massive fingerprint database may cause high computational complexity and error margins, therefore clustering methods are widely applied as a solution. However, traditional clustering methods in positioning systems can only measure the similarity of the Received Signal Strength without being concerned with the continuity of physical coordinates. Besides, outage of access points could result in asymmetric matching problems which severely affect the fine positioning procedure. To solve these issues, in this paper we propose a positioning system based on the Spatial Division Clustering (SDC) method for clustering the fingerprint dataset subject to physical distance constraints. With the Genetic Algorithm and Support Vector Machine techniques, SDC can achieve higher coarse positioning accuracy than traditional clustering algorithms. In terms of fine localization, based on the Kernel Principal Component Analysis method, the proposed positioning system outperforms its counterparts based on other feature extraction methods in low dimensionality. Apart from balancing online matching computational burden, the new positioning system exhibits advantageous performance on radio map clustering, and also shows better robustness and adaptability in the asymmetric matching problem aspect. PMID:24451470

A Hybrid Positioning Strategy for Vehicles in a Tunnel Based on RFID and In-Vehicle Sensors

PubMed Central

Song, Xiang; Li, Xu; Tang, Wencheng; Zhang, Weigong; Li, Bin

2014-01-01

Many intelligent transportation system applications require accurate, reliable, and continuous vehicle positioning. How to achieve such positioning performance in extended GPS-denied environments such as tunnels is the main challenge for land vehicles. This paper proposes a hybrid multi-sensor fusion strategy for vehicle positioning in tunnels. First, the preliminary positioning algorithm is developed. The Radio Frequency Identification (RFID) technology is introduced to achieve preliminary positioning in the tunnel. The received signal strength (RSS) is used as an indicator to calculate the distances between the RFID tags and reader, and then a Least Mean Square (LMS) federated filter is designed to provide the preliminary position information for subsequent global fusion. Further, to improve the positioning performance in the tunnel, an interactive multiple model (IMM)-based global fusion algorithm is developed to fuse the data from preliminary positioning results and low-cost in-vehicle sensors, such as electronic compasses and wheel speed sensors. In the actual implementation of IMM, the strong tracking extended Kalman filter (STEKF) algorithm is designed to replace the conventional extended Kalman filter (EKF) to achieve model individual filtering. Finally, the proposed strategy is evaluated through experiments. The results validate the feasibility and effectiveness of the proposed strategy. PMID:25490581

A hybrid positioning strategy for vehicles in a tunnel based on RFID and in-vehicle sensors.

PubMed

Song, Xiang; Li, Xu; Tang, Wencheng; Zhang, Weigong; Li, Bin

2014-12-05

Many intelligent transportation system applications require accurate, reliable, and continuous vehicle positioning. How to achieve such positioning performance in extended GPS-denied environments such as tunnels is the main challenge for land vehicles. This paper proposes a hybrid multi-sensor fusion strategy for vehicle positioning in tunnels. First, the preliminary positioning algorithm is developed. The Radio Frequency Identification (RFID) technology is introduced to achieve preliminary positioning in the tunnel. The received signal strength (RSS) is used as an indicator to calculate the distances between the RFID tags and reader, and then a Least Mean Square (LMS) federated filter is designed to provide the preliminary position information for subsequent global fusion. Further, to improve the positioning performance in the tunnel, an interactive multiple model (IMM)-based global fusion algorithm is developed to fuse the data from preliminary positioning results and low-cost in-vehicle sensors, such as electronic compasses and wheel speed sensors. In the actual implementation of IMM, the strong tracking extended Kalman filter (STEKF) algorithm is designed to replace the conventional extended Kalman filter (EKF) to achieve model individual filtering. Finally, the proposed strategy is evaluated through experiments. The results validate the feasibility and effectiveness of the proposed strategy.

Systolic Blood Pressure and Incident Heart Failure in the Elderly

PubMed Central

Butler, Javed; Kalogeropoulos, Andreas P.; Georgiopoulou, Vasiliki V.; Bibbins-Domingo, Kirsten; Najjar, Samer S.; Sutton-Tyrrell, Kim C.; Harris, Tamara B.; Kritchevsky, Stephen B.; Lloyd-Jones, Donald M.; Newman, Anne B.; Psaty, Bruce M.

2013-01-01

Objectives The exact form of the association between systolic blood pressure (SBP) and heart failure (HF) risk in the elderly remains incompletely defined, especially in individuals not receiving antihypertensive medications. Our aim was to examine the association between SBP and HF risk in the elderly. Design Competing-risks proportional hazards modeling of incident HF risk, utilizing 10-year follow-up data from two NIH-sponsored cohort studies; the Cardiovascular Health Study (inception: 1989-90 and 1992-93) and the Health ABC Study (inception: 1997-98). Setting Community-based cohorts. Participants 4408 participants (age, 72.8 [4.9] years; 53.1% women, 81.7% white; 18.3% black) without prevalent HF and not receiving antihypertensive medications at baseline. Main outcome measures Incident HF, defined as first adjudicated hospitalisation for HF. Results Over 10 years, 493 (11.1%) participants developed HF. Prehypertension (120-139 mmHg), stage 1 (140-159 mmHg), and stage 2 (≥160 mmHg) hypertension were associated with escalating HF risk; hazard ratios vs. optimal SBP (<120 mmHg) in competing-risks models controlling for clinical characteristics were 1.63 (95% CI, 1.23-2.16; P=0.001), 2.21 (95% CI, 1.65-2.96; P<0.001), and 2.60 (95% CI, 1.85-364; P<0.001), respectively. Overall 255 of 493 (51.7%) HF events occurred in participants with SBP <140 mm Hg at baseline. Increasing SBP was associated with higher HF risk in women than men; no race-SBP interaction was observed. In analyses with continuous SBP, HF risk had a continuous positive association with SBP to levels as low as 113 mmHg in men and 112 mmHg in women. Conclusions There is a continuous positive association between SBP and HF risk in the elderly for levels of SBP as low as <115 mmHg; over half of incident HF events occur in individuals with SBP <140 mmHg. PMID:21636845

Pulsed Dose Radiofrequency Before Ablation of Medial Branch of the Lumbar Dorsal Ramus for Zygapophyseal Joint Pain Reduces Post-procedural Pain.

PubMed

Arsanious, David; Gage, Emmanuel; Koning, Jonathon; Sarhan, Mazin; Chaiban, Gassan; Almualim, Mohammed; Atallah, Joseph

2016-01-01

One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease. This is a prospective, double-blinded, randomized, controlled trial. Patients who met all the inclusion criteria and were not subject to any of the exclusion criteria were required to have two positive diagnostic medial branch blocks prior to undergoing randomization, intervention, and analysis. University hospital. Eligible patients were randomized in a 1:1 ratio to either receive thermal radiofrequency ablation alone (standard group) or pulsed dose radiofrequency (PDRF) immediately followed by thermal radiofrequency ablation (investigational group), all of which were performed by a single Board Certified Pain Medicine physician. Post-procedural pain levels between the two groups were assessed using the numerical pain Scale (NPS), and patients were contacted by phone on post-procedural days 1 and 2 in the morning and afternoon regarding the amount of oral analgesic medications used in the first 48 hours following the procedure. Patients who received pulsed dose radiofrequency followed by continuous radiofrequency neurotomy reported statistically significantly lower post-procedural pain scores in the first 24 hours compared to patients who received thermal radiofrequency neurotomy alone. These patients also used less oral analgesic medication in the post-procedural period. These interventions were carried out by one board accredited pain physician at one center. The procedures were exclusively performed using one model of radiofrequency generator, at one setting for the PDRF and RFA. The difference in the number of levels of ablation was not considered in the analysis of the results. Treating patients with pulsed dose radiofrequency prior to continuous thermal radiofrequency ablation can provide patients with less post-procedural pain during the first 24 hours and also reduce analgesic requirements. Furthermore, the addition of PDRF to standard thermal RFA did not prolong the time of standard thermal radiofrequency ablation procedures, as it was performed during the typically allotted time for local anesthetic action. Low back pain, facet joint disease, medial branch block, Radiofrequency ablation, thermal radiofrequency, pulsed dose radiofrequency, PDRF, zygapophyseal joint.

Impact of education and training on type of care provided by community-based breastfeeding counselors: a cross-sectional study

PubMed Central

2011-01-01

Background Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide. Methods This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while bivariate analysis using χ2 test was used to examine the differences between CBBC education, training received and breastfeeding support skills used. Multivariate logistic regression was used to assess the independent determinants of specific breastfeeding support skills. Results The major findings from the research indicate that overall, educational attainment of CBBCs is not a significant predictor for the curriculum used in their training and type of support skills used during counseling sessions, but initial training duration was positively associated with the use of many breastfeeding support skills. Another major influence of counselor support to clients is the type of continuing education they receive after their initial training, with higher likelihood of use of desirable support skills associated with counselors continuing their breastfeeding education at conferences or trainings away from their job sites. Conclusions Our results show that different programs use different training curricula to train their CBBCs varying in duration and content. Counselor education is not a significant predictor of the type of training they receive. Continuing breastfeeding education is a significant determinant of type of counseling techniques used with clients. Further research is therefore needed to critically examine the content of the various training curricula of CBBC programs. This may show a need for a standardized training curriculum for all CBBC programs worldwide to make CBBCs more proficient and efficient, ensuring successful and optimum breastfeeding experiences for mothers and their newborns. PMID:21871062

Telemetry Tracking and Control Through Commercial LEO Satellites

NASA Technical Reports Server (NTRS)

Streich, Ronald C.; Morgan, Dwayne R.; Bull, Barton B.; Grant, Charles E.; Powers, Edward I. (Technical Monitor)

2001-01-01

Personnel from the Goddard Space Flight Center Wallops Flight Facility (GSFC/WFF in Virginia have successfully tested commercial LEO communications satellites for sounding rocket, balloon and aircraft flight TT&C. The Flight Modern became a GSFC/WFF Advanced Range Technology Initiative (ARTI) in an effort to streamline TT&C capability to the user community at low cost. Ground tests of the Flight Modem verified duplex communications quality of service and measured transmission latencies. These tests were completed last year and results reported in the John Hopkins University (JHU) Applied Physics Laboratory (APL) 4th International Symposium on Reducing Spacecraft Costs for Ground Systems and Operations. The second phase of the Flight Modem baseline test program was a demonstration of the ruggedized version of the WFF Flight Modem flown on a sounding rocket launched it the Swedish rocket range (Esrangc) near Kiruna, Sweden, with results contained in this paper. Aircraft flight tests have been and continue to be conducted. Flights of opportunity are being actively pursued with other centers, ranges and users at universities. The WFF Flight Modem contains a CPS receiver to provide vehicle position for tracking and vehicle recovery. The system architecture, which integrates antennas, CPS receiver, commercial satellite packet data modem and a single board computer with custom software, is described. Small satellite use of the WFF Flight Modem is also being investigated, The Flight Modem provides an independent vehicle position source for Range Safety applications. The LEO communication system contains a coarse position location system, which is compared to GPS ace acy. This comparison allows users, to determine the need for a CPS receiver in addition to the satellite packet data modem for their application.

Women's views and experiences of a mobile phone-based intervention to support post-abortion contraception in Cambodia.

PubMed

Smith, Chris; Ly, Sokhey; Uk, Vannak; Warnock, Ruby; Free, Caroline

2017-06-12

The MObile Technology for Improved Family Planning (MOTIF) trial assessed a mobile phone-based intervention comprising voice messages and counsellor support to increase post-abortion contraception at four Marie Stopes International clinics in Cambodia. The aim of this process evaluation was to assess women's views and experiences of receiving the MOTIF intervention, gain insights into the mechanism of action of the intervention and seek recommendations for improvements. We conducted a qualitative study comprising15 semi-structured interviews with women who had received the intervention and undertook a simple thematic analysis. We identified themes relating to communication via mobile phone, supporting contraception use, broader post-abortion care, interaction with family and friends and suggestions for improvement. The majority of women were positive about the mobile phone-based intervention to support contraception use and reported it to be a convenient way to ask questions or get advice without going to a health centre, although a few women found the voice messages intrusive. The intervention supported contraception use by provision of information, encouragement, reminders to return to clinic, reassurance and advice for problems and had a positive effect on contraceptive uptake and continuation. Women reported a sense of being cared for and received support for additional physical and emotional issues. Most women thought that the duration of the intervention and frequency of messages were acceptable. The majority of women were positive about the mobile phone-based intervention which provided support for contraception use as well as additional physical and emotional issues. The study provides some insights into how the intervention might have worked and considers how the intervention could be improved.

Social security work disability and its predictors in patients with fibromyalgia.

PubMed

Wolfe, Frederick; Walitt, Brian T; Katz, Robert S; Häuser, Winfried

2014-09-01

To determine prevalence and incidence of US Social Security Disability and Supplemental Security Income (SSD) in patients with fibromyalgia and to investigate prediction of SSD. Over a mean of 4 years (range 1-13 years), we studied 2,321 patients with physician-diagnosed fibromyalgia (prevalent cases) and applied modified American College of Rheumatology (ACR) 2010 research criteria to identify criteria-positive patients. During the study, 34.8% (95% confidence interval [95% CI] 32.9-36.8%) of fibromyalgia patients received SSD. The annual incidence of SSD among patients not receiving SSD at study enrollment was 3.4% (95% CI 3.0-3.9%), and 25% were estimated to be work disabled at 9.0 years of followup. By comparison, the prevalence of SSD in rheumatoid arthritis (RA) patients with concomitant fibromyalgia was 55.6% (95% CI 54.3-57.0%) and was 42.4% in osteoarthritis (OA). By study conclusion, 31.4% of SSD awardees were no longer receiving SSD. In univariate models, incident SSD in patients with fibromyalgia was predicted by sociodemographic measures and by symptom burden; but the strongest predictor was functional status (Health Assessment Questionnaire disability index [HAQ DI]). In multivariable models, the HAQ DI and the Short Form 36-item health survey physical and mental component summary scores, but no other variables, predicted SSD. Fibromyalgia criteria-positive patients had more SSD, but the continuous scale, polysymptomatic distress index derived from the ACR criteria was a substantially better predictor of SSD than a criteria-positive diagnosis. The prevalence of SSD is high in fibromyalgia, but not higher than in RA and OA patients who satisfy fibromyalgia criteria. The best predictors of work disability are functional status variables. Copyright © 2014 by the American College of Rheumatology.

Five-year follow-up on the work force and finances of United States anesthesiology training programs: 2000 to 2005.

PubMed

Tremper, Kevin K; Shanks, Amy; Morris, Michelle

2007-04-01

In the middle 1990s, there was a decrease in anesthesiology residency class sizes, which contributed to a nationwide shortage of anesthesiologists, resulting in a competitive market with increased salary demands. In 1999, a nationwide survey of the financial status of United States anesthesiology training programs was conducted. Follow-up surveys have been conducted each year thereafter. We present the results of the sixth survey in this series. Surveys were distributed by e-mail to the anesthesiology department chairs of the United States Training Programs. Responses were also received by e-mail. One hundred twenty-one departments were surveyed with a response rate of 60%. The 87% of departments seeking at least one additional faculty had an average of 2.8 faculty open positions (5.5% open positions overall which is down from 9.7% in 2000). Of the 96% of departments that employ certified registered nurse anesthetists (CRNAs) 89% were seeking additional CRNAs, averaging 3.6 open positions. The average department received $4.9 million (or $116,000/faculty) in institutional support. When the portion of this support allocated for CRNA salaries was removed, the average department received $4.1 million (or $95,000/faculty) in institutional support. This is a 16% increase over the previous year. Faculty academic time averaged 17% (where 20% is 1 d/wk). Departments billed an average of 11,320 anesthesia units/faculty/yr. Although the average anesthesia unit value collected was $31, departments required approximately $40/U to meet expenses. Medicaid payments averaged $15, ranging from $5 to $30/U. These results demonstrate the continuing need for institutional support to keep anesthesiology training departments financially stable.

Behavioral Health Services Following Implementation of Screening in Massachusetts Medicaid Children

PubMed Central

Penfold, Robert B.; Arsenault, Lisa N.; Zhang, Fang; Murphy, Michael; Wissow, Lawrence S.

2014-01-01

OBJECTIVES: To determine the relationship of child behavioral health (BH) screening results to receipt of BH services in Massachusetts Medicaid (MassHealth) children. METHODS: After a court decision, Massachusetts primary care providers were mandated to conduct BH screening at well-child visits and use a Current Procedural Terminology code along with a modifier indicating whether a BH need was identified. Using MassHealth claims data, a cohort of continuously enrolled (July 2007–June 2010) children was constructed. The salient visit (first use of the modifier, screening code, or claim in fiscal year 2009) was considered a reference point to examine BH history and postscreening BH services. Bivariate and multivariate logistic regression analyses were performed to determine predictors of postscreening BH services. RESULTS: Of 261 160 children in the cohort, 45% (118 464) were screened and 37% had modifiers. Fifty-seven percent of children screening positive received postscreening BH services compared with 22% of children screening negative. However, only 30% of newly identified children received BH services. The strongest predictors of postscreening BH services for children without a BH history were being in foster care (odds ratio, 10.38; 95% confidence interval, 9.22–11.68) and having a positive modifier (odds ratio, 3.79; 95% confidence interval, 3.53–4.06). CONCLUSIONS: Previous BH history, a positive modifier, and foster care predicted postscreening BH services. Only one-third of newly identified children received services. Thus although screening is associated with an increase in BH recognition, it may be insufficient to improve care. Additional strategies may be needed to enhance engagement in BH services. PMID:25225135

Combination of hyper-CVAD with ponatinib as first-line therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia: a single-centre, phase 2 study.

PubMed

Jabbour, Elias; Kantarjian, Hagop; Ravandi, Farhad; Thomas, Deborah; Huang, Xuelin; Faderl, Stefan; Pemmaraju, Naveen; Daver, Naval; Garcia-Manero, Guillermo; Sasaki, Koji; Cortes, Jorge; Garris, Rebecca; Yin, C Cameron; Khoury, Joseph D; Jorgensen, Jeffrey; Estrov, Zeev; Bohannan, Zachary; Konopleva, Marina; Kadia, Tapan; Jain, Nitin; DiNardo, Courtney; Wierda, William; Jeanis, Vicky; O'Brien, Susan

2015-11-01

Combination of chemotherapy with a tyrosine-kinase inhibitor is effective in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukaemia. Ponatinib is a more potent BCR-ABL1 inhibitor than all other tyrosine-kinase inhibitors and selectively suppresses the resistant T315I clones. We examined the activity and safety of combining chemotherapy with ponatinib for patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia in this continuing phase 2 trial. In this single-centre, phase 2, single-arm trial, adult patients with previously untreated Philadelphia chromosome-positive acute lymphoblastic leukaemia were sequentially enrolled. Patients who had received fewer than two courses of previous chemotherapy with or without tyrosine-kinase inhibitors were also eligible. Patients had to be aged 18 years or older, have an Eastern Cooperative Oncology Group performance status of 2 or less, have normal cardiac function (defined by ejection fraction above 50%), and have adequate organ function (serum bilirubin ≤3·0 mg/dL and serum creatinine ≤3·0 mg/dL, unless higher concentrations were believed to be due to a tumour). Patients received eight cycles of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) alternating with high-dose methotrexate and cytarabine every 21 days. Ponatinib 45 mg was given daily for the first 14 days of cycle 1 then continuously for the subsequent cycles. Patients in complete remission received maintenance with ponatinib 45 mg daily with vincristine and prednisone monthly for 2 years followed by ponatinib indefinitely. The primary endpoint for this study was event-free survival. The trial is registered at ClinicalTrials.gov, number NCT01424982. 37 patients were enrolled and treated from Nov 1, 2011, to Sept 1, 2013. 2-year event-free survival rate was 81% (95% CI 64-90). Grade 3 or more toxic effects included infections during induction (20 [54%] patients), increased aspartate aminotransferase and alanine aminotransferase concentration (14 [38%] patients), thrombotic events (three [8%]), myocardial infarction (three [8%]), hypertension (six [16%]), skin rash (eight [22%]), and pancreatitis (six [16%] patients). Two patients died from from myocardial infarction potentially related to treatment; another patient also died from myocardial infarction related to sepsis. Two further patients died, one from bleeding and another from infection, both deemed unrelated to treatment. The first results of this ongoing trial indicate that the combination of chemotherapy with ponatinib is effective in achieving early sustained remissions in patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukaemia. New strategies, including dosing titration of ponatinib and optimised control of vascular risk factors, might further improve outcomes. ARIAD Pharmaceuticals Inc. Copyright © 2015 Elsevier Ltd. All rights reserved.

Managing HIV/hepatitis positive patients: present approach of dental health care workers and students.

PubMed

Shinde, Nagesh; Baad, Rajendra; Nagpal, Deepak Kumar J; Prabhu, Prashant R; Surekha, L Chavan; Karande, Prasad

2012-11-01

People with HIV/HBsAg in India frequently encounter discrimination while seeking and receiving health care services. The knowledge and attitudes of health care workers (HCWs) influences the willingness and ability of people with HIV/HBsAg to access care, and the quality of the care they receive. The objective of this study was to asses HIV/HBsAg-related knowledge, attitudes and risk perception among students and dental HCWs. A cross-sectional survey was conducted on 250 students and 120 dental HCWs in the form of objective questionnaire. Information was gathered regarding demographic details (age, sex, duration of employment, job category); HIV/ HBsAg-related knowledge and attitudes; risk perception; and previous experience caring for HIV-positive patients. The HCWs in this study generally had a positive attitude to care for the people with HIV/HBsAg. However, this was tempered by substantial concerns about providing care, and the fear of occupational infection with HIV/HBsAg. A continuing dental education program was conducted to resolve all the queries found interfering to provide care to HIV/HBsAg patients. But even after the queries were resolved the care providing capability was not attained. These findings show that even with advanced knowledge and facilities the attitude of dental HCWs and students require more strategic training with regards to the ethics and moral stigma associated with the dreaded infectious diseases (HIV/HBsAg).

Circulating FABP4 and FABP5 levels are differently linked to OSA severity and treatment.

PubMed

Català, Raquel; Cabré, Anna; Hernández-Flix, Salvador; Ferré, Raimón; Sangenís, Sandra; Plana, Núria; Texidó, Anna; Masana, Lluís

2013-12-01

To evaluate circulating adipocyte and epidermal fatty acid-binding protein (FABP4 and FABP5) concentrations in patients with obstructive sleep apnea (OSA), as well as the effects of continuous positive airway pressure (CPAP) treatment. Our cross-sectional study included 125 patients. After polysomnography, 58 participants met the criteria for CPAP treatment and were included in a closed cohort study of 8 weeks of CPAP treatment. General anthropometric and biochemical data and circulating FABP4 and FABP5 levels were determined in all patients at baseline and after CPAP treatment in those receiving this therapy. Circulating FABP4 but not FABP5 levels were higher in patients with OSA (P = 0.003). FABP4 but not FABP5 values were associated with parameters of OSA severity independently of age, gender, adiposity and insulin resistance (P < 0.05). FABP4 but not FABP5 concentrations were determinants of OSA presence (OR: 1.11, P = 0.010) and severity (OR: 1.06, P = 0.020). After CPAP treatment, FABP4 levels decreased in the more severe patients (P = 0.019), while FABP5 levels increased in all patients (P < 0.001). FABP4 is directly associated with obstructive sleep apnea severity and did not change with continuous positive airway pressure treatment, while FABP5 was not associated with obstructive sleep apnea severity and increased with continuous positive airway pressure treatment. FABP4 and FABP5 have different associations with obstructive sleep apnea. FABP4 but not FABP5 could be considered a marker of metabolic alterations in obstructive sleep apnea patients.

ROCView: prototype software for data collection in jackknife alternative free-response receiver operating characteristic analysis

PubMed Central

Thompson, J; Hogg, P; Thompson, S; Manning, D; Szczepura, K

2012-01-01

ROCView has been developed as an image display and response capture (IDRC) solution to image display and consistent recording of reader responses in relation to the free-response receiver operating characteristic paradigm. A web-based solution to IDRC for observer response studies allows observations to be completed from any location, assuming that display performance and viewing conditions are consistent with the study being completed. The simplistic functionality of the software allows observations to be completed without supervision. ROCView can display images from multiple modalities, in a randomised order if required. Following registration, observers are prompted to begin their image evaluation. All data are recorded via mouse clicks, one to localise (mark) and one to score confidence (rate) using either an ordinal or continuous rating scale. Up to nine “mark-rating” pairs can be made per image. Unmarked images are given a default score of zero. Upon completion of the study, both true-positive and false-positive reports can be downloaded and adapted for analysis. ROCView has the potential to be a useful tool in the assessment of modality performance difference for a range of imaging methods. PMID:22573294

An evaluation of substance misuse treatment providers used by an employee assistance program.

PubMed

Miller, N A

1992-05-01

Structural measures of access, continuity, and quality of substance misuse treatment services were compared in 30 fee-for-service (FFS) facilities and nine health maintenance organizations (HMOs). Probit models related effects of the provider system (FFS or HMO) and the system's structural characteristics to 243 employees' access to and outcomes from treatment. Access was decreased in Independent Practice Association (IPA)/network HMOs and in all facilities which did not employ an addictionologist or provide coordinated treatment services. When bivariate correlations were examined, both use of copayments and imposing limits to the levels of treatment covered were negatively related to access, while a facility's provision of ongoing professional development was positively associated with access. These correlations did not remain significant in the multivariate probits. Receiving treatment in a staff model HMO and facing limits to the levels of treatment covered were negatively associated with attaining sufficient progress, while receiving treatment in a facility which provided ongoing professional development was positively related to progress: these effects did not remain significant in multivariate analyses. Implications for employee assistance program (EAP) staff in their role as case managers and for EAP staff and employers in their shared role as purchasers of treatment are discussed.

Your wish is my command! The influence of symbolic modelling on preschool children's delay of gratification.

PubMed

Kumst, S; Scarf, D

2015-01-01

The ability of children to delay gratification is correlated with a range of positive outcomes in adulthood, showing the potential impact of helping young children increase their competence in this area. This study investigated the influence of symbolic models on the self-control of 3-year old children. Eighty-three children were randomly assigned to one of three modelling conditions: personal storytelling, impersonal storytelling, and control. Children were tested on the delay-of-gratification maintenance paradigm both before and after being exposed to a symbolic model or control condition. Repeated measures ANOVA revealed no significant differences between the two storytelling groups and the control group, indicating that the symbolic models did not influence children's ability to delay gratification. A serendipitous finding showed a positive relationship between the ability of children to wait and their production and accurate use of temporal terms, which was more pronounced in girls than boys. This finding may be an indication that a higher temporal vocabulary is linked to a continuous representation of the self in time, facilitating a child's representation of the future-self receiving a larger reward than what the present-self could receive.

Your wish is my command! The influence of symbolic modelling on preschool children’s delay of gratification

PubMed Central

Kumst, S

2015-01-01

The ability of children to delay gratification is correlated with a range of positive outcomes in adulthood, showing the potential impact of helping young children increase their competence in this area. This study investigated the influence of symbolic models on the self-control of 3-year old children. Eighty-three children were randomly assigned to one of three modelling conditions: personal storytelling, impersonal storytelling, and control. Children were tested on the delay-of-gratification maintenance paradigm both before and after being exposed to a symbolic model or control condition. Repeated measures ANOVA revealed no significant differences between the two storytelling groups and the control group, indicating that the symbolic models did not influence children’s ability to delay gratification. A serendipitous finding showed a positive relationship between the ability of children to wait and their production and accurate use of temporal terms, which was more pronounced in girls than boys. This finding may be an indication that a higher temporal vocabulary is linked to a continuous representation of the self in time, facilitating a child’s representation of the future-self receiving a larger reward than what the present-self could receive. PMID:25737814

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia.

PubMed

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2013-10-01

To describe predictors of contraceptive method discontinuation and switching behaviours among HIV-positive couples receiving couples' voluntary HIV counselling and testing services in Lusaka, Zambia. Couples were randomized in a factorial design to two-family planning educational intervention videos, received comprehensive family planning services and were assessed every 3 months for contraceptive initiation, discontinuation and switching. We modelled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long-acting reversible contraceptive (LARC) methods, and that fertility goal based, LARC-focused family planning be offered as an integral part of HIV prevention services.

Numerical research of dynamic characteristics in tower solar cavity receiver based on step-change radiation flux

NASA Astrophysics Data System (ADS)

Chen, Zhengwei; Wang, Yueshe; Hao, Yun; Wang, Qizhi

2013-07-01

The solar cavity receiver is an important light-energy to thermal-energy convector in the tower solar thermal power plant system. The heat flux in the inner surface of the cavity will show the characteristics of non-continuous step change especially in non-normal and transient weather conditions, which may result in a continuous dynamic variation of the characteristic parameters. Therefore, the research of dynamic characteristics of the receiver plays a very important role in the operation and the control safely in solar cavity receiver system. In this paper, based on the non-continuous step change of radiation flux, a non-linear dynamic model is put forward to obtain the effects of the non-continuous step change radiation flux and step change feed water flow on the receiver performance by sequential modular approach. The subject investigated in our study is a 1MW solar power station constructed in Yanqing County, Beijing. This study has obtained the dynamic responses of the characteristic parameters in the cavity receiver, such as drum pressure, drum water level, main steam flow and main steam enthalpy under step change radiation flux. And the influence law of step-change feed water flow to the dynamic characteristics in the receiver also has been analyzed. The results have a reference value for the safe operation and the control in solar cavity receiver system.

Nasal bi-level positive airway pressure (BiPAP) versus nasal continuous positive airway pressure (CPAP) in preterm infants ≤32 weeks: A retrospective cohort study.

PubMed

Rong, Zhi-Hui; Li, Wen-Bin; Liu, Wei; Cai, Bao-Huan; Wang, Jing; Yang, Min; Li, Wei; Chang, Li-Wen

2016-05-01

To investigate whether Bi-level positive airway pressure (BiPAP), compared with nasal continuous positive airway pressure (CPAP), is a more effective therapeutic strategy in preterm infants ≤32 weeks. All inborn infants between 26(+1) and 32(+6) weeks' gestation, admitted to the neonatal intensive care unit (NICU ) of Tongji Medical Hospital between 1 January, 2010 and 31 December, 2011 (the 2010-2011 cohort or CPAP cohort) and between 1 January, 2012 and 31 December, 2013 (the 2012-2013 cohort or BiPAP cohort), were retrospectively identified. The primary outcome was intubation in infants < 72 h of age; secondary outcomes were mortality and the incidence of bronchopulmonary dysplasia (BPD). There were 213 in the 2010-2011 cohort and 243 infants in the 2012-2013 cohort. There were fewer infants intubated within the first 72 h of age in the 2012-2013 cohort than in the 2010-2011 cohort (15% vs. 23%, P < 0.05). Of the infants who received some form of positive airway pressure, 12/94 (13%) of infants on BiPAP versus 23/74 (31%) on CPAP were subsequently intubated (P < 0.01). There was no difference in the incidence of moderate and severe BPD between the two groups (7% vs. 8%, P=0.52). In this retrospective cohort study, we found BiPAP, compared with CPAP, reduced the need for intubation within the first 72 h of age. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Visible light communication and indoor positioning using a-SiCH device as receiver

NASA Astrophysics Data System (ADS)

Vieira, M. A.; Vieira, M.; Louro, P.; Vieira, P.; Fantoni, A.

2017-08-01

An indoor positioning system were trichromatic white LEDs are used both for illumination proposes and as transmitters and an optical processor, based on a-SiC:H technology, as mobile receiver is presented. OOK modulation scheme is used, and it provides a good trade-off between system performance and implementation complexity. The relationship between the transmitted data and the received digital output levels is decoded. The system topology for positioning is a self-positioning system in which the measuring unit is mobile. This unit receives the signals of several transmitters in known locations, and has the capability to compute its location based on the measured signals. LED bulbs work as transmitters, sending information together with different IDs related to their physical locations. A triangular topology for the unit cell is analysed. A 2D localization design, demonstrated by a prototype implementation is presented. Fine-grained indoor localization is tested. The received signal is used in coded multiplexing techniques for supporting communications and navigation concomitantly on the same channel. The position is estimated through the visible multilateration metodh using several non-collinear transmitters. The location and motion information is found by mapping position and estimates the location areas. Data analysis showed that by using a pinpin double photodiode based on a a-SiC:H heterostucture as receiver, and RBGLEDs as transmitters it is possible not only to determine the mobile target's position but also to infer the motion direction over time, along with the received information in each position.

Add-on clinical effects of selective antagonist of 5HT6 receptors AVN-211 (CD-008-0173) in patients with schizophrenia stabilized on antipsychotic treatment: pilot study.

PubMed

Morozova, Margarita A; Lepilkina, Taisiya A; Rupchev, Georgy E; Beniashvily, Allan G; Burminskiy, Denis S; Potanin, Sergey S; Bondarenko, Evgeny V; Kazey, Vasily I; Lavrovsky, Yan; Ivachtchenko, Alexandre V

2014-08-01

The serotoninergic system as a target for add-on treatment seems to be a promising approach in patients with schizophrenia. To clarify if selective 5HT-6 antagonist AVN-211 (CD-008-0173) adds clinical and cognitive effects to stable antipsychotic treatment. A randomized, double-blind, placebo-controlled, add-on, 4r-week trial in 47 schizophrenia patients (21 patients receiving study drug and 26 receiving placebo) who were stabilized on antipsychotic medication was performed. Seventeen patients from the study drug group and 25 patients from the placebo group completed the trial. Treatment effects were measured using clinical rating scales and attention tests. With no differences at baseline, there was a significant difference between the groups in Positive and Negative Syndrome Scale (PANSS) positive subscale score (p = 0.058) in favor of patients in the treatment group at the endpoint. The PANSS positive subscore (p = 0.0068) and Clinical Global Impression-Severity (CGI-S) (p = 0.048) score significantly changed only in the treatment group. Only in the placebo group were significant changes in Calgary Depression Rating Scale (CDRS) total score registered. The indices of attention tests at endpoint did not show differences between the groups, with the exception of the scope of change in the results of the subtest VIII of the Wechsler Adult Intelligence Scale (WAIS), which showed difference between the groups (p = 0.02) and was significantly larger in the treatment group. Only inside the study drug group, significant changes in selectivity and continuous attention were observed regarding total correct responses (p = 0.0038) and reaction time (p = 0.058) in the Continuous Attention Task (CAT) test. Selective 5HT6 antagonist AVN-211 (CD-008-0173) added antipsychotic and some procognitive (attention) effects to antipsychotic medication.

No relevant modulation of TRPV1-mediated trigeminal pain by intranasal carbon dioxide in healthy humans.

PubMed

Jürgens, Tim P; Reetz, Romy; May, Arne

2013-04-10

Nasal insufflation of CO2 has been shown to exert antinociceptive respectively antihyperalgesic effects in animal pain models using topical capsaicin with activation of TRPV1-receptor positive nociceptive neurons. Clinical benefit from CO2 inhalation in patients with craniofacial pain caused by a putative activation of TRPV1 receptor positive trigeminal neurons has also been reported. These effects are probably mediated via an activation of TRPV1 receptor - positive neurons in the nasal mucosa with subsequent central inhibitory effects (such as conditioned pain modulation). In this study, we aimed to examine the effects of intranasal CO2 on a human model of craniofacial pain elicited by nasal application of capsaicin. In a first experiment, 48 healthy volunteers without previous craniofacial pain received intranasal capsaicin to provoke trigeminal pain elicited by activation of TRVP1 positive nociceptive neurons. Then, CO2 or air was insufflated alternatingly into the nasal cavity at a flow rate of 1 l/min for 60 sec each. In the subsequent experiment, all participants were randomized into 2 groups of 24 each and received either continuous nasal insufflation of CO2 or placebo for 18:40 min after nociceptive stimulation with intranasal capsaicin. In both experiments, pain was rated on a numerical rating scale every 60 sec. Contrary to previous animal studies, the effects of CO2 on experimental trigeminal pain were only marginal. In the first experiment, CO2 reduced pain ratings only minimally by 5.3% compared to air if given alternatingly with significant results for the main factor GROUP (F1,47=4.438; p=0.041) and the interaction term TIME*GROUP (F2.6,121.2=3.3; p=0.029) in the repeated-measures ANOVA. However, these effects were abrogated after continuous insufflation of CO2 or placebo with no significant changes for the main factors or the interaction term. Although mild modulatory effects of low-flow intranasal CO2 could be seen in this human model of TRPV-1 mediated activation of nociceptive trigeminal neurons, utility is limited as observed changes in pain ratings are clinically non-significant.

East Pacific Rise axial structure from a joint tomographic inversion of traveltimes picked on downward continued and standard shot gathers collected by 3D MCS surveying

NASA Astrophysics Data System (ADS)

Newman, Kori; Nedimović, Mladen; Delescluse, Matthias; Menke, William; Canales, J. Pablo; Carbotte, Suzanne; Carton, Helene; Mutter, John

2010-05-01

We present traveltime tomographic models along closely spaced (~250 m), strike-parallel profiles that flank the axis of the East Pacific Rise at 9°41' - 9°57' N. The data were collected during a 3D (multi-streamer) multichannel seismic (MCS) survey of the ridge. Four 6-km long hydrophone streamers were towed by the ship along three along-axis sail lines, yielding twelve possible profiles over which to compute tomographic models. Based on the relative location between source-receiver midpoints and targeted subsurface structures, we have chosen to compute models for four of those lines. MCS data provide for a high density of seismic ray paths with which to constrain the model. Potentially, travel times for ~250,000 source-receiver pairs can be picked over the 30 km length of each model. However, such data density does not enhance the model resolution, so, for computational efficiency, the data are decimated so that ~15,000 picks per profile are used. Downward continuation of the shot gathers simulates an experimental geometry in which the sources and receivers are positioned just above the sea floor. This allows the shallowest sampling refracted arrivals to be picked and incorporated into the inversion whereas they would otherwise not be usable with traditional first-arrival travel-time tomographic techniques. Some of the far-offset deep-penetrating 2B refractions cannot be picked on the downward continued gathers due to signal processing artifacts. For this reason, we run a joint inversion by also including 2B traveltime picks from standard shot gathers. Uppermost velocity structure (seismic layer 2A thickness and velocity) is primarily constrained from 1D inversion of the nearest offset (<500 m) source-receiver travel-time picks for each downward continued shot gather. Deeper velocities are then computed in a joint 2D inversion that uses all picks from standard and downward continued shot gathers and incorporates the 1D results into the starting model. The resulting velocity models extend ~1 km into the crust. Preliminary results show thicker layer 2A and faster layer 2A velocities at fourth order ridge segment boundaries. Additionally, layer 2A thickens north of 9° 52' N, which is consistent with earlier investigations of this ridge segment. Slower layer 2B velocities are resolved in the vicinity of documented hydrothermal vent fields. We anticipate that additional analyses of the results will yield further insight into fine scale variations in near-axis mid-ocean ridge structure.

Predicting Volleyball Serve-Reception

PubMed Central

Paulo, Ana; Zaal, Frank T. J. M.; Fonseca, Sofia; Araújo, Duarte

2016-01-01

Serve and serve-reception performance have predicted success in volleyball. Given the impact of serve-reception on the game, we aimed at understanding what it is in the serve and receiver's actions that determines the selection of the type of pass used in serve-reception and its efficacy. Four high-level volleyball players received jump-float serves from four servers in two reception zones—zone 1 and 5. The ball and the receiver's head were tracked with two video cameras, allowing 3D world-coordinates reconstruction. Logistic-regression models were used to predict the type of pass used (overhand or underhand) and serve-reception efficacy (error, out, or effective) from variables related with the serve kinematics and related with the receiver's on-court positioning and movement. Receivers' initial position was different when in zone 1 and 5. This influenced the serve-related variables as well as the type of pass used. Strong predictors of using an underhand rather than overhand pass were higher ball contact of the server, reception in zone 1, receiver's initial position more to the back of the court and backward receiver movement. Receiver's larger longitudinal displacements and an initial position more to the back of the court had a strong relationship with the decreasing of the serve-reception efficacy. Receivers' positioning and movement were the factors with the largest impact on the type of pass used and the efficacy of the reception. Reception zone affected the variance in the ball's kinematics (with the exception of the ball's lateral displacement), as well as in the receivers' positioning (distances from the net and from the target). Also the reception zone was associated with the type of pass used by the receiver but not with reception efficacy. Given volleyball's rotation rule, the receiver needs to master receiving in the different reception zones; he/she needs to adapt to the diverse constraints of each zone to maintain performance efficacy. Thus, being able to flexibly vary positioning and passing, given local (zone) constraints, can yield an advantage in high-level volleyball serve-reception. Further, research needs to consider other serve modes (e.g., power-jump serve) and a full-court context of performance to support the present study's findings. PMID:27853442

Neuraxial analgesia effects on labor progression: facts, fallacies, uncertainties, and the future

PubMed Central

Grant, Erica N.; Tao, Weike; Craig, Margaret; McIntire, Donald; Leveno, Kenneth

2014-01-01

Approximately 60% of women who labor receive some form of neuraxial analgesia, but concerns have been raised regarding whether it negatively impacts the labor and delivery process. In this review, we attempt to clarify what has been established as truths, falsities, and uncertainties regarding the effects of this form of pain relief on labor progression, negative and/or positive. Additionally, although the term “epidural” has become synonymous with neuraxial analgesia, we discuss two other techniques, combined spinal-epidural and continuous spinal analgesia, that are gaining popularity, as well as their effects on labor progression. PMID:25088476

From diagnosis to birth: parents' experience when expecting a child with congenital anomaly.

PubMed

Askelsdóttir, Björk; Conroy, Sherrill; Rempel, Gwen

2008-12-01

Of 350,000 Canadian children born each year, 2% to 3% will have a serious congenital anomaly. Because of recent ultrasound diagnostic improvements and increased frequency of prenatal scans, many anomalies are determined prenatally, with more parents receiving disturbing, unanticipated news of an anomaly. This article highlights the experiences, concerns, and healthcare needs of parents who receive a prenatal diagnosis of congenital anomaly during routine ultrasound and choose to continue with the pregnancy. Examples from parent interviews describing their experience complement the sparse literature dealing with this phenomenon. Parents describe their experience from antenatal diagnosis and preparation for the child's birth and subsequent admission to the neonatal intensive care unit. Attention is paid to how neonatal nurses can positively influence this process by attending to parents' feelings or moods. The conclusion includes recommendations for neonatal nursing care for these vulnerable parents.

Relational Psychotherapy Mothers’ Group: A developmentally informed intervention for at-risk mothers

PubMed Central

Luthar, Suniya S.; Suchman, Nancy E.

2012-01-01

The Relational Psychotherapy Mothers’ Group (RPMG), a developmentally informed, supportive psychotherapy designed to serve heroin-addicted mothers with children up to 16 years of age, aims at addressing psychosocial vulnerabilities, and facilitating optimal parenting, among at-risk mothers. We present preliminary evidence on the efficacy of RPMG as an “add on” treatment in comparison with standard methadone counseling alone. At the end of the 24-week treatment period, mothers receiving RPMG plus standard methadone counseling demonstrated lower levels of risk for child maltreatment, greater involvement with their children, and more positive psychosocial adjustment than women who received methadone counseling alone. Children of RPMG participants also reflected fewer problems in multiple areas. At 6 months posttreatment, RPMG recipients continued to be at a relative advantage, although the magnitude of group differences was often attenuated. Notably, urinalyses indicated that RPMG mothers showed greater improvements in levels of opioid use over time than comparison mothers. PMID:10847626

Pediatric Inpatient Nurses' Perceptions of Child Maltreatment.

PubMed

Lavigne, Jenifer L; Portwood, Sharon G; Warren-Findlow, Jan; Brunner Huber, Larissa R

The purpose of this study was to explore the perceptions of child maltreatment among inpatient pediatric nurses. A cross-sectional survey was used to obtain responses to an online survey designed to examine perceptions of child maltreatment from inpatient pediatric nurses. Many nurses surveyed (41.25%) indicated that they had not received adequate training or had never received training on child maltreatment identification and many (40%) also indicated they were not familiar with the applicable reporting laws. Due to the serious immediate and long term effects of child maltreatment, it is imperative that pediatric inpatient nurses have adequate training on how to identify potential abuse and neglect cases, as well as legal reporting requirements, since they are in a unique position to identify potential cases of maltreatment. There is a continuing need for training on child maltreatment identification and reporting laws for inpatient pediatric nurses. Copyright © 2017 Elsevier Inc. All rights reserved.

Educate patients on billing policies to improve your bottom line.

PubMed

May, Jonathan

2006-01-01

In no other industry are the consumers of goods or services so unaware and uninvolved in the reimbursement for the goods or services received. The United States healthcare industry has created and allowed to perpetuate a "hands-off" compensation approach that has created a consumer mentality proving quite difficult to change. In this article, the author describes the origin of this outdated approach and suggests a restructured office and clear communication with patients as starting points to change this deep-rooted mind-set. He describes how an up-front approach to patients' financial responsibilities and proactive staff can help reduce miscommunication between provider, patient, and insurance carrier and improve your practice's cash flow. The author also suggests that the patient's financial burden will continue to increase and offers tips to maintain positive patient relationships, improve your accounts receivable management, and protect you financially.

Attachment Security Mediates the Longitudinal Association Between Child-Parent Psychotherapy and Peer Relations for Toddlers of Depressed Mothers

PubMed Central

Guild, Danielle J.; Toth, Sheree L.; Handley, Elizabeth D.; Rogosch, Fred A.; Cicchetti, Dante

2017-01-01

Numerous investigations have demonstrated that Child-Parent Psychotherapy (CPP) promotes secure attachment between mothers and offspring. However, the role of post-intervention attachment security as it relates to long-term child outcomes has never been evaluated. The present study therefore examined post-intervention attachment status as a mediator of the association between CPP for depressed mothers and their offspring and subsequent peer relations among offspring. Depressed mothers and their toddlers were randomized to receive CPP (n = 45) or to a control group (DC; n = 55). A prior investigation with this sample indicated that offpring who received CPP attained significantly higher rates of secure attachment post-intervention, wheras insecure attachment continued to predominate for offspring in the DC group. The present study examined follow-up data of teachers’ reports on participants’ competence with classroom peers when they were approximately 9 years old. Findings indicated that children who received CPP were more likely to evidence secure attachments at post-intervention, which in turn was associated with more positive peer relationships at age 9. PMID:28401848

Attachment security mediates the longitudinal association between child-parent psychotherapy and peer relations for toddlers of depressed mothers.

PubMed

Guild, Danielle J; Toth, Sheree L; Handley, Elizabeth D; Rogosch, Fred A; Cicchetti, Dante

2017-05-01

Numerous investigations have demonstrated that child-parent psychotherapy (CPP) promotes secure attachment between mothers and offspring. However, the role of postintervention attachment security as it relates to long-term child outcomes has never been evaluated. The present study therefore examined postintervention attachment status as a mediator of the association between CPP for depressed mothers and their offspring and subsequent peer relations among offspring. Depressed mothers and their toddlers were randomized to receive CPP (n = 45) or to a control group (n = 55). A prior investigation with this sample indicated that offspring who received CPP attained significantly higher rates of secure attachment postintervention, whereas insecure attachment continued to predominate for offspring in the control group. The present study examined follow-up data of teachers' reports on participants' competence with classroom peers when they were approximately 9 years old. Findings indicated that children who received CPP were more likely to evidence secure attachments at postintervention, which in turn was associated with more positive peer relationships at age 9.

Gap cycling for SWIFT.

PubMed

Corum, Curtis A; Idiyatullin, Djaudat; Snyder, Carl J; Garwood, Michael

2015-02-01

SWIFT (SWeep Imaging with Fourier Transformation) is a non-Cartesian MRI method with unique features and capabilities. In SWIFT, radiofrequency (RF) excitation and reception are performed nearly simultaneously, by rapidly switching between transmit and receive during a frequency-swept RF pulse. Because both the transmitted pulse and data acquisition are simultaneously amplitude-modulated in SWIFT (in contrast to continuous RF excitation and uninterrupted data acquisition in more familiar MRI sequences), crosstalk between different frequency bands occurs in the data. This crosstalk leads to a "bulls-eye" artifact in SWIFT images. We present a method to cancel this interband crosstalk by cycling the pulse and receive gap positions relative to the un-gapped pulse shape. We call this strategy "gap cycling." We carry out theoretical analysis, simulation and experiments to characterize the signal chain, resulting artifacts, and their elimination for SWIFT. Theoretical analysis reveals the mechanism for gap-cycling's effectiveness in canceling interband crosstalk in the received data. We show phantom and in vivo results demonstrating bulls-eye artifact free images. Gap cycling is an effective method to remove bulls-eye artifact resulting from interband crosstalk in SWIFT data. © 2014 Wiley Periodicals, Inc.

Midwifery students׳ experiences of an innovative clinical placement model embedded within midwifery continuity of care in Australia.

PubMed

Carter, Amanda G; Wilkes, Elizabeth; Gamble, Jenny; Sidebotham, Mary; Creedy, Debra K

2015-08-01

midwifery continuity of care experiences can provide high quality clinical learning for students but can be challenging to implement. The Rural and Private Midwifery Education Project (RPMEP) is a strategic government funded initiative to (1) grow the midwifery workforce within private midwifery practice and rural midwifery, by (2) better preparing new graduates to work in private midwifery and rural continuity of care models. this study evaluated midwifery students׳ experience of an innovative continuity of care clinical placement model in partnership with private midwifery practice and rural midwifery group practices. a descriptive cohort design was used. All students in the RPMEP were invited to complete an online survey about their experiences of clinical placement within midwifery continuity models of care. Responses were analysed using descriptive statistics. Correlations between total scale scores were examined. Open-ended responses were analysed using content analysis. Internal reliability of the scales was assessed using Cronbach׳s alpha. sixteen out of 17 completed surveys were received (94% response rate). Scales included in the survey demonstrated good internal reliability. The majority of students felt inspired by caseload approaches to care, expressed overall satisfaction with the mentoring received and reported a positive learning environment at their placement site. Some students reported stress related to course expectations and demands in the clinical environment (e.g. skill acquisition and hours required for continuity of care). There were significant correlations between scales on perceptions of caseload care and learning culture (r=.87 p<.001) and assessment (r=.87 p<.001). Scores on the clinical learning environment scale were significantly correlated with perceptions of the caseload model (rho=.86 p<.001), learning culture (rho=.94 p<.001) and assessment (rho=.65 p<.01) scales. embedding students within midwifery continuity of care models was perceived to be highly beneficial to learning, developed partnerships with women, and provided appropriate clinical skills development required for registration, while promoting students׳ confidence and competence. The flexible academic programme enabled students to access learning at any time and prioritise continuity of care experiences. Strategies are needed to better support students achieve a satisfactory work-life balance. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Safety and efficacy of neratinib in combination with capecitabine in patients with metastatic human epidermal growth factor receptor 2-positive breast cancer.

PubMed

Saura, Cristina; Garcia-Saenz, Jose A; Xu, Binghe; Harb, Wael; Moroose, Rebecca; Pluard, Timothy; Cortés, Javier; Kiger, Corinne; Germa, Caroline; Wang, Kongming; Martin, Miguel; Baselga, José; Kim, Sung-Bae

2014-11-10

Neratinib is a potent irreversible pan-tyrosine kinase inhibitor with antitumor activity and acceptable tolerability in patients with human epidermal growth factor receptor 2 (HER2) -positive breast cancer. A multinational, open-label, phase I/II trial was conducted to determine the maximum-tolerated dose (MTD) of neratinib plus capecitabine in patients with solid tumors (part one) and to evaluate the safety and efficacy of neratinib plus capecitabine in patients with HER2-positive metastatic breast cancer (part two). Part one was a 3 + 3 dose-escalation study in which patients with advanced solid tumors received oral neratinib once per day continuously plus capecitabine twice per day on days 1 to 14 of a 21-day cycle at predefined dose levels. In part two, patients with trastuzumab-pretreated HER2-positive metastatic breast cancer received neratinib plus capecitabine at the MTD. The primary end point in part two was objective response rate (ORR). In part one (n = 33), the combination of neratinib 240 mg per day plus capecitabine 1,500 mg/m(2) per day was defined as the MTD, which was further evaluated in part 2 (n = 72). The most common drug-related adverse events were diarrhea (88%) and palmar-plantar erythrodysesthesia syndrome (48%). In part two, the ORR was 64% (n = 39 of 61) in patients with no prior lapatinib exposure and 57% (n = 4 of 7) in patients previously treated with lapatinib. Median progression-free survival was 40.3 and 35.9 weeks, respectively. Neratinib in combination with capecitabine had a manageable toxicity profile and showed promising antitumor activity in patients with HER2-positive metastatic breast cancer pretreated with trastuzumab and lapatinib. © 2014 by American Society of Clinical Oncology.

Indoor positioning algorithm combined with angular vibration compensation and the trust region technique based on received signal strength-visible light communication

NASA Astrophysics Data System (ADS)

Wang, Jin; Li, Haoxu; Zhang, Xiaofeng; Wu, Rangzhong

2017-05-01

Indoor positioning using visible light communication has become a topic of intensive research in recent years. Because the normal of the receiver always deviates from that of the transmitter in application, the positioning systems which require that the normal of the receiver be aligned with that of the transmitter have large positioning errors. Some algorithms take the angular vibrations into account; nevertheless, these positioning algorithms cannot meet the requirement of high accuracy or low complexity. A visible light positioning algorithm combined with angular vibration compensation is proposed. The angle information from the accelerometer or other angle acquisition devices is used to calculate the angle of incidence even when the receiver is not horizontal. Meanwhile, a received signal strength technique with high accuracy is employed to determine the location. Moreover, an eight-light-emitting-diode (LED) system model is provided to improve the accuracy. The simulation results show that the proposed system can achieve a low positioning error with low complexity, and the eight-LED system exhibits improved performance. Furthermore, trust region-based positioning is proposed to determine three-dimensional locations and achieves high accuracy in both the horizontal and the vertical components.

Oral administration of erythrocyte membrane antigen does not suppress anti-Rh(D) antibody responses in humans.

PubMed Central

Barnes, R M; Duguid, J K; Roberts, F M; Risk, J M; Johnson, P M; Finn, R; Hardy, J; Napier, J A; Clarke, C A

1987-01-01

The effects of prior oral administration of erythrocyte membrane preparations (Oral Rh antigen) on the serum anti-Rh(D) antibody response has been evaluated in non-sensitized Rh(D)-negative male volunteers, and in female volunteers sensitized previously by Rh(D)-positive fetal blood during pregnancy. Sixty-one percent (11/18) of males who received oral Rh antigen (either D-positive or D-negative) before intravenous challenge with Rh(D)-positive cells produced detectable antibodies; of these 11, six received oral Rh(D)-negative antigen and five received oral Rh(D)-positive antigen. Seventy-two percent (13/18) of control males, who had received no prior oral Rh antigen, produced antibodies following challenge with Rh(D)-positive cells. Three out of six pre-sensitized females who received oral D-positive or D-negative Rh antigen for 4 weeks, but without intravenous challenge, increased their anti-Rh(D) antibody levels which peaked after 11-18 weeks: two had received Rh(D)-positive antigen, and one Rh(D)-negative antigen. These data indicate that administration of oral Rh antigen before parenteral immunization does not significantly suppress the anti-Rh(D) antibody response. Indeed, oral administration of either Rh(D)-positive or Rh(D)-negative antigen can boost systemic antibody in pre-sensitized females. These results do not support the rationale of treating Rh-sensitized pregnant women with oral Rh antigen. PMID:3113783

Associations of maternal nutrition during pregnancy and post-partum with maternal cognition and caregiving.

PubMed

Prado, Elizabeth L; Ashorn, Ulla; Phuka, John; Maleta, Kenneth; Sadalaki, John; Oaks, Brietta M; Haskell, Marjorie; Allen, Lindsay H; Vosti, Steve A; Ashorn, Per; Dewey, Kathryn G

2018-04-01

Pregnant and post-partum women require increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess (a) differences in maternal cognition and caregiving between women in Malawi who received different nutritional supplements, (b) 14 effect modifiers, and (c) associations of cognition and caregiving with biomarkers of iron, Vitamin A, B-vitamin, and fatty acid status. In a randomized controlled trial (n = 869), pregnant women daily received either multiple micronutrients (MMN), 20 g/day lipid-based nutrient supplements (LNS), or a control iron/folic acid (IFA) tablet. After delivery, supplementation continued in the MMN and LNS arms, and the IFA control group received placebo until 6 months post-partum, when cognition (n = 712), caregiving behaviour (n = 669), and biomarkers of nutritional status (n = 283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI [0.01, 0.39], p = .03) higher than the LNS arm in mental rotation. Among subgroups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than the IFA arm in verbal fluency. Breastmilk docosahexaenoic acid and Vitamin B12 concentrations were positively associated with verbal fluency and digit span forward (adjusting for covariates ps < .05). In this population in Malawi, maternal supplementation with MMN or LNS did not positively affect maternal cognition or caregiving. Maternal docosahexaenoic acid and B12 status may be important for post-partum attention and executive function. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Associations of maternal nutrition during pregnancy and post‐partum with maternal cognition and caregiving

PubMed Central

Ashorn, Ulla; Phuka, John; Maleta, Kenneth; Sadalaki, John; Oaks, Brietta M.; Haskell, Marjorie; Allen, Lindsay H.; Vosti, Steve A.; Ashorn, Per; Dewey, Kathryn G.

2017-01-01

Abstract Pregnant and post‐partum women require increased nutrient intake and optimal cognition, which depends on adequate nutrition, to enable reasoning and learning for caregiving. We aimed to assess (a) differences in maternal cognition and caregiving between women in Malawi who received different nutritional supplements, (b) 14 effect modifiers, and (c) associations of cognition and caregiving with biomarkers of iron, Vitamin A, B‐vitamin, and fatty acid status. In a randomized controlled trial (n = 869), pregnant women daily received either multiple micronutrients (MMN), 20 g/day lipid‐based nutrient supplements (LNS), or a control iron/folic acid (IFA) tablet. After delivery, supplementation continued in the MMN and LNS arms, and the IFA control group received placebo until 6 months post‐partum, when cognition (n = 712), caregiving behaviour (n = 669), and biomarkers of nutritional status (n = 283) were assessed. In the full group, only one difference was significant: the IFA arm scored 0.22 SD (95% CI [0.01, 0.39], p = .03) higher than the LNS arm in mental rotation. Among subgroups of women with baseline low hemoglobin, poor iron status, or malaria, those who received LNS scored 0.4 to 0.7 SD higher than the IFA arm in verbal fluency. Breastmilk docosahexaenoic acid and Vitamin B12 concentrations were positively associated with verbal fluency and digit span forward (adjusting for covariates ps < .05). In this population in Malawi, maternal supplementation with MMN or LNS did not positively affect maternal cognition or caregiving. Maternal docosahexaenoic acid and B12 status may be important for post‐partum attention and executive function. PMID:29098783

Financial Incentives for Linkage to Care and Viral Suppression Among HIV-Positive Patients: A Randomized Clinical Trial (HPTN 065).

PubMed

El-Sadr, Wafaa M; Donnell, Deborah; Beauchamp, Geetha; Hall, H Irene; Torian, Lucia V; Zingman, Barry; Lum, Garret; Kharfen, Michael; Elion, Richard; Leider, Jason; Gordin, Fred M; Elharrar, Vanessa; Burns, David; Zerbe, Allison; Gamble, Theresa; Branson, Bernard

2017-08-01

Achieving linkage to care and viral suppression in human immunodeficiency virus (HIV)-positive patients improves their well-being and prevents new infections. Current gaps in the HIV care continuum substantially limit such benefits. To evaluate the effectiveness of financial incentives on linkage to care and viral suppression in HIV-positive patients. A large community-based clinical trial that randomized 37 HIV test and 39 HIV care sites in the Bronx, New York, and Washington, DC, to financial incentives or standard of care. Participants at financial incentive test sites who had positive test results for HIV received coupons redeemable for $125 cash-equivalent gift cards upon linkage to care. HIV-positive patients receiving antiretroviral therapy at financial incentive care sites received $70 gift cards quarterly, if virally suppressed. Linkage to care: proportion of HIV-positive persons at the test site who linked to care within 3 months, as indicated by CD4+ and/or viral load test results done at a care site. Viral suppression: proportion of established patients at HIV care sites with suppressed viral load (<400 copies/mL), assessed at each calendar quarter. Outcomes assessed through laboratory test results reported to the National HIV Surveillance System. A total of 1061 coupons were dispensed for linkage to care at 18 financial incentive test sites and 39 359 gift cards were dispensed to 9641 HIV-positive patients eligible for gift cards at 17 financial incentive care sites. Financial incentives did not increase linkage to care (adjusted odds ratio, 1.10; 95% CI, 0.73-1.67; P = .65). However, financial incentives significantly increased viral suppression. The overall proportion of patients with viral suppression was 3.8% higher (95% CI, 0.7%-6.8%; P = .01) at financial incentive sites compared with standard of care sites. Among patients not previously consistently virally suppressed, the proportion virally suppressed was 4.9% higher (95% CI, 1.4%-8.5%; P = .007) at financial incentive sites. In addition, continuity in care was 8.7% higher (95% CI, 4.2%-13.2%; P < .001) at financial incentive sites. Financial incentives, as used in this study (HPTN 065), significantly increased viral suppression and regular clinic attendance among HIV-positive patients in care. No effect was noted on linkage to care. Financial incentives offer promise for improving adherence to treatment and viral suppression among HIV-positive patients. clinicaltrials.gov Identifier: NCT01152918.

Anti-alpha interferon immunization: safety and immunogenicity in asymptomatic HIV positive patients at high risk of disease progression.

PubMed

Gringeri, A; Santagostino, E; Mannucci, P M; Siracusano, L; Marinoni, A; Criscuolo, M; Carcagno, M; Fall, L S; M'Bika, J P; Bizzini, B

1995-05-01

A randomized, placebo-controlled trial was designed to evaluate safety and immunogenicity of an anti-cytokine vaccine in high risk HIV-positive patients. This strategy was aimed to modulate the impaired cytokine regulation in AIDS. Twelve asymptomatic patients on antiretroviral therapy for at least 1 year and with CD4 cell counts between 100-300/mm3 were randomized to receive adjuvanted formol-inactivated interferon alpha-2a (IFN alpha) and continue the current antiretroviral treatment, whatever it was, or to receive the adjuvant alone and the current antiretroviral treatment. All patients received 4 i.m. injections monthly, followed by booster injections every 3 months. Clinical status, immunology and virology were monitored. Immune response to vaccination was evaluated in term of antibody detection (ELISA) and serum anti-IFN alpha neutralizing capacity. Only local discomfort and transient fever were reported. All vaccines except one showed increased levels of anti-IFN alpha Abs and developed serum IFN alpha neutralizing capacity. Viral load did not increase in vaccinees while it remained unchanged or even increased in placebo-treated patients. None of them showed HIV-related symptoms and all had their CD4 cell counts stabilized over 18 months, whereas 2 placebo-treated patients developed full-blow AIDS. In conclusion, anti-IFN alpha vaccine was safe and immunogenic. Stable clinical and immunological status over 18 months was observed in vaccinees coupled to increased serum IFN alpha neutralizing capacity.

Novel, continuous monitoring of fine‐scale movement using fixed‐position radiotelemetry arrays and random forest location fingerprinting

USGS Publications Warehouse

Harbicht, Andrew B.; Castro-Santos, Theodore R.; Ardren, William R.; Gorsky, Dimitry; Fraser, Dylan

2017-01-01

Radio‐tag signals from fixed‐position antennas are most often used to indicate presence or absence of individuals, or to estimate individual activity levels from signal strength variation within an antenna's detection zone. The potential of such systems to provide more precise information on tag location and movement has not been explored in great detail in an ecological setting.By reversing the roles that transmitters and receivers play in localization methods common to the telecommunications industry, we present a new telemetric tool for accurately estimating the location of tagged individuals from received signal strength values. The methods used to characterize the study area in terms of received signal strength are described, as is the random forest model used for localization. The resulting method is then validated using test data before being applied to true data collected from tagged individuals in the study site.Application of the localization method to test data withheld from the learning dataset indicated a low average error over the entire study area (<1 m), whereas application of the localization method to real data produced highly probable results consistent with field observations.This telemetric approach provided detailed movement data for tagged fish along a single axis (a migratory path) and is particularly useful for monitoring passage along migratory routes. The new methods applied in this study can also be expanded to include multiple axes (x, y, z) and multiple environments (aquatic and terrestrial) for remotely monitoring wildlife movement.

Analgesia before a spinal block for femoral neck fracture: fascia iliaca compartment block.

PubMed

Yun, M J; Kim, Y H; Han, M K; Kim, J H; Hwang, J W; Do, S H

2009-11-01

In this prospective randomized study, the authors compared the analgesic effect of a fascia iliaca compartment (FIC) block with that of intravenous (i.v.) alfentanil when administered to facilitate positioning for spinal anaesthesia in elderly patients undergoing surgery for a femoral neck fracture. The 40 patients were randomly assigned to one of two groups, namely, the FIC group (fascia iliaca compartment block, n=20) and the IVA group (intravenous analgesia with alfentanil, n=20). Group IVA patients received a bolus dose of i.v. alfentanil 10 microg/kg, followed by a continuous infusion of alfentanil 0.25 microg/kg/min starting 2 min before the spinal block, and group FIC patients received a FIC block with 30 ml of ropivacaine 3.75 mg/ml (112.5 mg) 20 min before the spinal block. Visual analogue pain scale (VAS) scores, time to achieve spinal anaesthesia, quality of patient positioning, and patient acceptance were compared. VAS scores during positioning (mean and range) were lower in the FIC group than in the IVA group [2.0 (1-4) vs. 3.5 (2-6), P=0.001], and the mean (+/- SD) time to achieve spinal anaesthesia was shorter in the FIC group (6.9 +/- 2.7 min vs. 10.8 +/- 5.6 min; P=0.009). Patient acceptance (yes/no) was also better in the FIC group (19/1) than in the IVA group (12/8)(P=0.008). An FIC block is more efficacious than i.v. alfentanil in terms of facilitating the lateral position for spinal anaesthesia in elderly patients undergoing surgery for femoral neck fractures.

Modeling the Relationships Among Reading Instruction, Motivation, Engagement, and Achievement for Adolescents

PubMed Central

Guthrie, John T.; Klauda, Susan Lutz; Ho, Amy N.

2015-01-01

This study modeled the interrelationships of reading instruction, motivation, engagement, and achievement in two contexts, employing data from 1,159 seventh graders. In the traditional reading/language arts (R/LA) context, all students participated in traditional R/LA instruction. In the intervention R/LA context, 854 students from the full sample received Concept-Oriented Reading Instruction (CORI) while the remainder continued to receive traditional R/LA. CORI emphasizes support for reading motivation, reading engagement, and cognitive strategies for reading informational text. Seven motivation constructs were included: four motivations that are usually positively associated with achievement (intrinsic motivation, self-efficacy, valuing, and prosocial goals) and three motivations that are usually negatively associated with achievement (perceived difficulty, devaluing, and antisocial goals). Reading engagement was also represented by positive and negative constructs, namely dedication to and avoidance of reading. Gender, ethnicity, and income were statistically controlled in all analyses. In the traditional R/LA context, a total network model prevailed, in which motivation was associated with achievement both directly and indirectly through engagement. In contrast, in the intervention R/LA context, a dual-effects model prevailed, in which engagement and achievement were separate outcomes of instruction and motivation. The intervention R/LA context analyses revealed that CORI was associated with positive changes in motivation, engagement, and achievement relative to traditional R/LA instruction. The discussion explains why there were different relations in the two instructional contexts and demonstrates the importance of simultaneously examining both positive (affirming) and negative (undermining) forms of motivation and engagement. PMID:26412903

Use of the Modified Checklist for Autism, Revised with Follow up-Albanian to Screen for ASD in Albania

PubMed Central

Brennan, Laura; Fein, Deborah; Como, Ariel; Rathwell, Iris Carcani; Chen, Chi-Ming

2016-01-01

The Modified Checklist for Autism in Toddlers Revised-Albanian screener (M-CHAT-R/-A) was used to screen 2,594 toddlers, aged 16-30 months, at well-child visits. Two hundred fifty three (9.75%) screened positive; follow up on failed items were conducted by phone with 127 (50%); the remainder were lost to follow-up. Twenty-six toddlers (21%) continued to screen positive; 19 received full evaluations, which assessed for ASD with the Autism Diagnostic Observation Schedule and developmental delays with the Parents Assessment of Developmental Status – Developmental Milestones. All evaluated children had significant delays; 17 of the 19 met criteria for Autism/ASD. Removal of three items improved performance. Although Albania and the US are quite different in culture and language, key features of autism appeared very similar. PMID:27491423

Hepatitis B virus testing and linkage to care in a Canadian urban tertiary referral centre: a retrospective cohort study

PubMed Central

Lau, Keith C.K.; Shaheen, Abdel Aziz; Aspinall, Alexander A.; Ricento BA, Tazuko; Qureshi MBA, Kamran; Congly, Stephen E.; Borman, Meredith A.; Jayakumar, Saumya; Eksteen, Bertus; Lee, Samuel S.; Stinton, Laura; Swain, Mark G.; Burak, Kelly W.; Coffin, Carla S.

2017-01-01

Background: Despite universal vaccination, chronic hepatitis B virus (HBV) infection remains a public health concern in North America owing to immigration. We aimed to characterize the number of people with a positive result of testing for HBV surface antigen (HBsAg) in Calgary, a large urban Canadian health care region, and to assess whether recommended laboratory tests and specialist consultation were done for those identified as HBsAg-positive. Methods: Based on laboratory and Alberta Health Services administrative data, we identified all adults (age > 18 yr) with a positive HBsAg test result from Jan. 1 to Dec. 31, 2014 within the Calgary Zone. Demographic and relevant laboratory data were extracted within 6 months of a positive HBsAg test result, and referral to hepatology (2011-2014) was identified from data on referral to a centralized clinic. Parametric and nonparametric statistical methods were used for analyses. Results: We identified 1214 HBsAg-positive people (584 women [48.1%]; median age 44 [interquartile range (IQR) 36-55] yr). A total of 1192 people (98.2%) had alanine aminotransferase testing (median level 23 [IQR 16-34] U/L; 117 [9.8%] with elevated levels), 682 (56.2%) had testing for HBV DNA (median level 2.8 [IQR 2.1-3.8] logIU/mL), 630 (51.9%) had HBV e antigen testing (negative result in 548 [87.0%]), and 145 (11.9%) had HBV e antibody testing (positive result in 111 [76.6%]). Overall, 144 people (11.9%) received anti-HBV treatment, and 390 (32.1%) were referred to a hepatologist. Interpretation: Many HBsAg-positive people in Calgary did not receive the recommended laboratory assessments. The results highlight the necessity of continual public health efforts to screen for chronic HBV infection in Canada and to ensure adequate follow-up in order to reach the World Health Organization's goal of viral hepatitis elimination by 2030. PMID:28596186

Beyond seismic interferometry: imaging the earth's interior with virtual sources and receivers inside the earth

NASA Astrophysics Data System (ADS)

Wapenaar, C. P. A.; Van der Neut, J.; Thorbecke, J.; Broggini, F.; Slob, E. C.; Snieder, R.

2015-12-01

Imagine one could place seismic sources and receivers at any desired position inside the earth. Since the receivers would record the full wave field (direct waves, up- and downward reflections, multiples, etc.), this would give a wealth of information about the local structures, material properties and processes in the earth's interior. Although in reality one cannot place sources and receivers anywhere inside the earth, it appears to be possible to create virtual sources and receivers at any desired position, which accurately mimics the desired situation. The underlying method involves some major steps beyond standard seismic interferometry. With seismic interferometry, virtual sources can be created at the positions of physical receivers, assuming these receivers are illuminated isotropically. Our proposed method does not need physical receivers at the positions of the virtual sources; moreover, it does not require isotropic illumination. To create virtual sources and receivers anywhere inside the earth, it suffices to record the reflection response with physical sources and receivers at the earth's surface. We do not need detailed information about the medium parameters; it suffices to have an estimate of the direct waves between the virtual-source positions and the acquisition surface. With these prerequisites, our method can create virtual sources and receivers, anywhere inside the earth, which record the full wave field. The up- and downward reflections, multiples, etc. in the virtual responses are extracted directly from the reflection response at the surface. The retrieved virtual responses form an ideal starting point for accurate seismic imaging, characterization and monitoring.

The Perception of Art among Patients and Staff on a Renal Dialysis Unit.

PubMed

Corrigan, C; Peterson, L; McVeigh, C; Lavin, P J; Mellotte, G J; Wall, C; Baker Kerrigan, A; Barnes, L; O'Neill, D; Moss, H

2017-10-10

This study investigated the purpose and effectiveness of giving outpatients an opportunity to engage in art activities while receiving dialysis treatment. A mixed method study was conducted. 21 semi-structured interviews were conducted with outpatients attending the dialysis unit and 13 surveys of clinicians were completed. The principle reasons to partake in the art activity programme included: to pass time, to relieve boredom, to be creative, to try something new, distraction from concerns, to stay positive and to achieve something new. Patients who did not participate in the programme pass their time primarily by watching TV or sleeping. All staff who partook in the survey were satisfied with the programme and wanted it to continue. Our findings indicate that the creative arts programme is viewed positively by staff and patients alike, and might be useful in other hospital departments. Further in depth qualitative research would be useful to interrogate the potential effect of engagement in art on positive mental health and quality of life for patients with chronic conditions.

Indoor positioning using differential Wi-Fi lateration

NASA Astrophysics Data System (ADS)

Retscher, Guenther; Tatschl, Thomas

2017-12-01

For Wi-Fi positioning usually location fingerprinting or (tri)lateration are employed whereby the received signal strengths (RSSs) of the surrounding Wi-Fi Access Points (APs) are scanned on the mobile devices and used to perform localization. Within the scope of this study, the position of a mobile user is determined on the basis of lateration. Two new differential approaches are developed and compared to two common models, i.e., the one-slope and multi-wall model, for the conversion of the measured RSS of the Wi-Fi signals into ranges. The two novel methods are termed DWi-Fi as they are derived either from the well-known DGPS or VLBI positioning principles. They make use of a network of reference stations deployed in the area of interest. From continuous RSS observations on these reference stations correction parameters are derived and applied by the user in real-time. This approach leads to a reduced influence of temporal and spatial variations and various propagation effects on the positioning result. In practical use cases conducted in a multi-storey office building with three different smartphones, it is proven that the two DWi-Fi approaches outperform the common models as static positioning yielded to position errors of about 5 m in average under good spatial conditions.

GPS Ocean Reflection Experiment (GORE) Wind Explorer (WindEx) Instrument Design and Development

NASA Astrophysics Data System (ADS)

Ganoe, G.

2004-12-01

This paper describes the design and development of the WindEx instrument, and the technology implemented by it. The important design trades will be covered along with the justification for the options selected. An evaluation of the operation of the instrument, and plans for continued development and enhancements will also be given. The WindEx instrument consists of a processor that receives data from an included GPS Surface reflection receiver, and computes ocean surface wind speeds in real time utilizing an algorithm developed at LaRC by Dr. Stephen J. Katzberg. The WindEx performs a windspeed server function as well as acting as a repository for the client moving map applications, and providing a web page with instructions on the installation and use of the WindEx system. The server receives the GPS reflection data produced by the receiver, performs wind speed processing, then makes the wind speed data available as a moving map display to requesting client processors on the aircraft network. The client processors are existing systems used by the research personnel onboard. They can be configured to be WINDEX clients by downloading the Java client application from the WINDEX server. The client application provides a graphical display of a moving map that shows the aircraft position along with the position of the reflection point from the surface of the ocean where the wind speed is being estimated, and any coastlines within the field of view. Information associated with the reflection point includes the estimated wind speed, and a confidence factor that gives the researcher an idea about the reliability of the wind speed measurement. The instrument has been installed on one of NOAA's Hurricane Hunters, a Gulfstream IV, whose nickname is "Gonzo". Based at MacDill AFB, Florida, "Gonzo" flies around the periphery of the storm deploying GPS-based dropsondes which measure local winds. The dropsondes are the "gold-standard" for determining surface winds, but can only be deployed sparingly. The GPS WindEx system allows for a continuous map between dropsonde releases as well as monitoring the ocean surface for suspicious areas. The GPS technique is insensitive to clouds or rain and can give information concerning surface conditions not available to the flight crew.

Safety Management Status among Nurses Handling Anticancer Drugs: Nurse Awareness and Performance Following Safety Regulations.

PubMed

Jeong, Kyeong Weon; Lee, Bo-Young; Kwon, Myung Soon; Jang, Ji-Hye

2015-01-01

This study identified the actual conditions for safe anticancer drug management among nurses and the relationship between level of awareness and performance of anticancer drug safety regulations in terms of preparation, administration, and disposal. The respondents were 236 nurses working with chemotherapy in wards and outpatient clinics in five hospitals in and near Seoul. Safety regulations provided for the anticancer drug the Occupational Safety Health Administration (OSHA, 1999), as modified for an earlier study, were used. The results showed that the level of awareness and performance on the anticancer drug safety regulations indicate their preparation (3.38±0.55, 2.38±0.98), administration (3.52±0.46, 3.17±0.70), general handling and disposal (3.33±0.54, 2.42±0.90) on a scale 0 to 5. Also, there were significant differences in job positions, work experience, type of preparation, and continuing education and a positive relationship between the level of awareness and nursing performance. Thus, nurses should receive continuing education on the handling of anticancer drugs to improve the level of performance following safety regulations.

Variation of Static-PPP Positioning Accuracy Using GPS-Single Frequency Observations (Aswan, Egypt)

NASA Astrophysics Data System (ADS)

Farah, Ashraf

2017-06-01

Precise Point Positioning (PPP) is a technique used for position computation with a high accuracy using only one GNSS receiver. It depends on highly accurate satellite position and clock data rather than broadcast ephemeries. PPP precision varies based on positioning technique (static or kinematic), observations type (single or dual frequency) and the duration of collected observations. PPP-(dual frequency receivers) offers comparable accuracy to differential GPS. PPP-single frequency receivers has many applications such as infrastructure, hydrography and precision agriculture. PPP using low cost GPS single-frequency receivers is an area of great interest for millions of users in developing countries such as Egypt. This research presents a study for the variability of single frequency static GPS-PPP precision based on different observation durations.

Comparison of hypobaric, hyperbaric, and isobaric solutions of bupivacaine during continuous spinal anesthesia.

PubMed

Van Gessel, E F; Forster, A; Schweizer, A; Gamulin, Z

1991-06-01

This study was designed to compare the anesthetic properties of hypobaric bupivacaine with those of isobaric and hyperbaric solutions when administered in the supine position in an elderly population undergoing hip surgery using continuous spinal anesthesia. Plain bupivacaine (0.5%) was mixed with equal volumes of 10% dextrose (hyperbaric), 0.9% NaCl (isobaric), or distilled water (hypobaric) to obtain 0.25% solutions. In a double-blind fashion, all patients received 3 mL (7.5 mg) of their particular solution injected through the spinal catheter in the horizontal supine position. The sensory level obtained in the hyperbaric group (median, T4; range, T3-L3) was significantly higher than in both the isobaric (median, T11; range, T6-L1) and hypobaric (median, L1; range, T4-L3) groups. A motor blockade of grade 2 or 3 was obtained in 14 of 15 and 12 of 15 patients in, respectively, the hyperbaric and isobaric groups, but only in 8 of 15 patients in the hypobaric group. After the initial injection of 3 mL (7.5 mg), a sensory level of T10 and a motor blockade of grade 2 or 3 was obtained in 14 of 15, 5 of 15, and 3 of 15 patients in the hyperbaric, isobaric, and hypobaric groups, respectively. All remaining patients received 1 or 2 additional milliliters (2.5-5 mg) and achieved these required anesthetic conditions, except for one patient in the hyperbaric group and eight patients in the hypobaric group in whom anesthesia was achieved with hyperbaric tetracaine. The decrease in mean arterial pressure was significantly more severe in the hyperbaric (30%) than in either the isobaric (18%) or hypobaric (14%) groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Nasal Continuous Positive Airway Pressure in Bronchiolitis: A Randomized Controlled Trial.

PubMed

Lal, Sandeep Narayan; Kaur, Jaspreet; Anthwal, Pooja; Goyal, Kanika; Bahl, Pinky; Puliyel, Jacob M

2018-01-15

To evaluate the efficacy of nasal continuous positive airway pressure (nCPAP) in decreasing respiratory distress in bronchiolitis. Randomized controlled trial. Tertiary-care hospital in New Delhi, India. Participants: 72 infants (age <1y) hospitalized with a clinical diagnosis of bronchiolitis were randomized to receive standard care, or nCPAP in addition to standard care, in the first hour after admission. 23 parents refused to give consent for participation. 2 infants did not tolerate nCPAP. 72 infants (age <1y) hospitalized with a clinical diagnosis of bronchiolitis were randomized to receive standard care, or nCPAP in addition to standard care, in the first hour after admission. 23 parents refused to give consent for participation. 2 infants did not tolerate nCPAP. The outcome was assessed after 60 minutes. If nCPAP was not tolerated or the distress increased, the infant was switched to standard care. Analysis was done on intention-to-treat basis. Change in respiratory rate, Silverman-Anderson score and a Modified Pediatric Society of New Zealand Severity Score. 14 out of 32 in nCPAP group and 5 out of 35 in standard care group had change in respiratory rate ≥10 (P=0.008). The mean (SD) change in respiratory rate [8.0 (5.8) vs 5.1 (4.0), P=0.02] in Silverman-Anderson score [0.78 (0.87) vs 0.39 (0.73), P=0.029] and in Modified Pediatric Society of New Zealand Severity Score [2.5 (3.01) vs. 1.08 (1.3), P=0.012] were significantly different in the nCPAP and standard care groups, respectively. nCPAP helped reduce respiratory distress significantly compared to standard care.

Retention in medication-assisted treatment programs in Ukraine-Identifying factors contributing to a continuing HIV epidemic.

PubMed

Dumchev, Kostyantyn; Dvoryak, Sergii; Chernova, Olena; Morozova, Olga; Altice, Frederick L

2017-10-01

Opioid agonist treatments (OAT) are widely-used, evidence-based strategies for treating opioid dependence and reducing HIV transmission. The positive benefits of OAT are strongly correlated with time spent in treatment, making retention a key indicator for program quality. This study assessed patient retention and associated factors in Ukraine, where OAT was first introduced in 2004. Data from clinical records of 2916 patients enrolled in OAT at thirteen sites from 2005 to 2012 were entered into an electronic monitoring system. Survival analysis methods were used to determine the probability of retention and its correlates. Twelve-month retention was 65.8%, improving from 27.7% in 2005, to 70.9% in 2011. In multivariable analyses, the correlates of retention were receiving medium and high doses of medication (compared to low doses, dropout aHR=0.57 for both medium and high doses), having not been tested for HIV and tuberculosis (compared to not being tested, dropout aHR=4.44 and 3.34, respectively), and among those who were tested-a negative TB test result (compared to receiving a positive test result, dropout aHR=0.67). Retention in Ukrainian OAT programs, especially in recent years, is comparable to other countries. The results confirm the importance of adequate OAT dosing (≥60mg of methadone, ≥8mg of buprenorphine). Higher dosing, however, will require interventions that address negative attitudes toward OAT by patients and providers. Interruption of OAT, in the case developing tuberculosis, should incorporate continuity of OAT for TB patients through integrated care delivery systems. Copyright © 2017 Elsevier B.V. All rights reserved.

Trends in use of neonatal CPAP: a population-based study

PubMed Central

2011-01-01

Background Continuous positive airway pressure (CPAP) is used widely to provide respiratory support for neonates, and is often the first treatment choice in tertiary centres. Recent trials have demonstrated that CPAP reduces need for intubation and ventilation for infants born at 25-28 weeks gestation, and at > 32weeks, in non-tertiary hospitals, CPAP reduces need for transfer to NICU. The aim of this study was to examine recent population trends in the use of neonatal continuous positive airway pressure. Methods We undertook a population-based cohort study of all 696,816 liveborn neonates ≥24 weeks gestation in New South Wales (NSW) Australia, 2001-2008. Data were obtained from linked birth and hospitalizations records, including neonatal transfers. The primary outcome was CPAP without mechanical ventilation (via endotracheal intubation) between birth and discharge from the hospital system. Analyses were stratified by age ≤32 and > 32 weeks gestation. Results Neonates receiving any ventilatory support increased from 1,480 (17.9/1000) in 2001 to 2,486 (26.9/1000) in 2008, including 461 (5.6/1000) to 1,465 (15.8/1000) neonates who received CPAP alone. There was a concurrent decrease in mechanical ventilation use from 12.3 to 11.0/1000. The increase in CPAP use was greater among neonates > 32 weeks (from 3.2 to 11.8/1000) compared with neonates ≤32 weeks (from 18.1 to 32.7/1000). The proportion of CPAP > 32 weeks initiated in non-tertiary hospitals increased from 6% to 30%. Conclusions The use of neonatal CPAP is increasing, especially > 32 weeks gestation and among non-tertiary hospitals. Recommendations are required regarding which infants should be considered for CPAP, resources necessary for a unit to offer CPAP and monitoring of longer term outcomes. PMID:21999325

Trends in use of neonatal CPAP: a population-based study.

PubMed

Roberts, Christine L; Badgery-Parker, Tim; Algert, Charles S; Bowen, Jennifer R; Nassar, Natasha

2011-10-17

Continuous positive airway pressure (CPAP) is used widely to provide respiratory support for neonates, and is often the first treatment choice in tertiary centres. Recent trials have demonstrated that CPAP reduces need for intubation and ventilation for infants born at 25-28 weeks gestation, and at > 32 weeks, in non-tertiary hospitals, CPAP reduces need for transfer to NICU. The aim of this study was to examine recent population trends in the use of neonatal continuous positive airway pressure. We undertook a population-based cohort study of all 696,816 liveborn neonates ≥24 weeks gestation in New South Wales (NSW) Australia, 2001-2008. Data were obtained from linked birth and hospitalizations records, including neonatal transfers. The primary outcome was CPAP without mechanical ventilation (via endotracheal intubation) between birth and discharge from the hospital system. Analyses were stratified by age ≤32 and > 32 weeks gestation. Neonates receiving any ventilatory support increased from 1,480 (17.9/1000) in 2001 to 2,486 (26.9/1000) in 2008, including 461 (5.6/1000) to 1,465 (15.8/1000) neonates who received CPAP alone. There was a concurrent decrease in mechanical ventilation use from 12.3 to 11.0/1000. The increase in CPAP use was greater among neonates > 32 weeks (from 3.2 to 11.8/1000) compared with neonates ≤32 weeks (from 18.1 to 32.7/1000). The proportion of CPAP > 32 weeks initiated in non-tertiary hospitals increased from 6% to 30%. The use of neonatal CPAP is increasing, especially > 32 weeks gestation and among non-tertiary hospitals. Recommendations are required regarding which infants should be considered for CPAP, resources necessary for a unit to offer CPAP and monitoring of longer term outcomes.

26 CFR 1.956-3T - Certain trade or service receivables acquired from United States persons (temporary).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 10 2012-04-01 2012-04-01 false Certain trade or service receivables acquired from United States persons (temporary). 1.956-3T Section 1.956-3T Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Controlled Foreign Corporations § 1.956-3T Certain...

Winter course in physiology: a successful example of continuing education for secondary school teachers in Brazil.

PubMed

Café-Mendes, Cecília C; Righi, Luana L; Calil-Silveira, Jamile; Nunes, Maria Tereza; Abdulkader, Fernando

2016-12-01

In international surveys, Brazilian students have been consistently ranking low in science. Continuing education for secondary school teachers is certainly a way to change this situation. To update teachers and provide teaching and learning experiences for graduate students, our department organized a "Winter Course in Physiology" where schoolteachers had the opportunity to attend lectures that were offered by graduate students and participate in discussions on teaching and learning strategies and their applicability, considering different schools and student age groups. This work evaluated the ways in which the Winter Course in Physiology improves continuing education for secondary school teachers. Graduate students prepared, presented, and discussed with the audience the concepts, content, and topics of the program, which were previously presented to the organizing committee and a supervising professor. Potential participants were recruited based on their curriculum vitae and a letter of intent. During the course, they completed a questionnaire that graded different aspects of course organization and lectures. The results indicated that the Winter Course was positively evaluated. Most topics received a grade of ≥4.0, considering a range of 1.0 (low) to 5.0 (high). In a followup, both the participants and instructors reported positive impacts on their overall knowledge in physiology. Schoolteachers reported improvements in the performance and participation of their students. In conclusion, the results suggested that the Winter Course is a good way to promote continuing education for schoolteachers and promote university outreach. It also provided an important experience for graduate students to develop teaching skills. Copyright © 2016 The American Physiological Society.

Intraoperative recurrent laryngeal nerve monitoring: a useful method for patients with esophageal cancer.

PubMed

Zhong, D; Zhou, Y; Li, Y; Wang, Y; Zhou, W; Cheng, Q; Chen, L; Zhao, J; Li, X; Yan, X

2014-07-01

It is well accepted that recurrent laryngeal nerve paralysis is a severe complication of esophagectomy or lymphadenectomy performed adjacent to the recurrent laryngeal nerves. Herein, determination of the effectiveness of implementing continuous recurrent laryngeal nerve monitoring to reduce the incidence of recurrent laryngeal nerve paralysis after esophagectomy was sought. A total of 115 patients diagnosed with esophageal cancer were enrolled in the thoracic section of the Tangdu Hospital of the Fourth Military Medical University from April 2008 to April 2009. Clinical parameters of patients, the morbidity, and the mortality following esophageal resection were recorded and compared. After the surgery, a 2-year follow up was completed. It was found that recurrent laryngeal nerve paralysis and postoperative pneumonia were more frequently diagnosed in the patients that did not receive continuous recurrent laryngeal nerve monitoring (6/61 vs. 0/54). Furthermore, positive mediastinal lymph nodes (P = 0.015), total mediastinal lymph nodes (P < 0.001), positive total lymph nodes (P = 0.027), and total lymph nodes (P < 0.001) were more often surgically removed in the patients with continuous recurrent laryngeal nerve monitoring. These patients also had a higher 2-year survival rate (P = 0.038) after surgery. It was concluded that continuous intraoperative recurrent laryngeal nerve monitoring is technically safe and effectively identifies the recurrent laryngeal nerves. This may be a helpful method for decreasing the incidence of recurrent laryngeal nerve paralysis and postoperative pneumonia, and for improving the efficiency of lymphadenectomy. © 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Journey to confidence: women's experiences of pain in labour and relational continuity of care.

PubMed

Leap, Nicky; Sandall, Jane; Buckland, Sara; Huber, Ulli

2010-01-01

An evaluation carried out at King's College Hospital Foundation National Health Service Trust in London identified that women who received continuity of carer from the Albany Midwifery Practice were significantly less likely to use pharmacological pain relief when comparisons were made with eight other midwifery group practices and the local maternity service as a whole. This study was designed to explore women's views of this phenomenon. We conducted a thematic analysis of semistructured, audiotaped, in-depth interviews with 10 women who reflected on their experiences of preparation and support for pain in labour and midwifery continuity of carer with Albany midwives, using a qualitative descriptive methodological approach. Women reflected positively on how, throughout pregnancy and labour, their midwives promoted a sense of their ability to cope with the challenge of labour pain. This building of confidence was enabled through a relationship of trust that developed with their midwives and the value of hearing other women's stories during antenatal groups. These experiences enhanced women's ability to overcome fears and self-doubt about coping with pain and led to feelings of pride, elation, and empowerment after birth. Women valued being encouraged and supported to labour without using pharmacological pain relief by midwives with whom they developed a trusting relationship throughout pregnancy. Features of midwifery approaches to pain in labour and relational continuity of care have important implications for promoting normal birth and a positive experience of pregnancy, labour, and birth for women. Copyright (c) 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.

A study of ionospheric grid modification technique for BDS/GPS receiver

NASA Astrophysics Data System (ADS)

Liu, Xuelin; Li, Meina; Zhang, Lei

2017-07-01

For the single-frequency GPS receiver, ionospheric delay is an important factor affecting the positioning performance. There are many kinds of ionospheric correction methods, common models are Bent model, IRI model, Klobuchar model, Ne Quick model and so on. The US Global Positioning System (GPS) uses the Klobuchar coefficients transmitted in the satellite signal to correct the ionospheric delay error for a single frequency GPS receiver, but this model can only reduce the ionospheric error of about 50% in the mid-latitudes. In the Beidou system, the accuracy of the correction delay is higher. Therefore, this paper proposes a method that using BD grid information to correct GPS ionospheric delay to improve the ionospheric delay for the BDS/GPS compatible positioning receiver. In this paper, the principle of ionospheric grid algorithm is introduced in detail, and the positioning accuracy of GPS system and BDS/GPS compatible positioning system is compared and analyzed by the real measured data. The results show that the method can effectively improve the positioning accuracy of the receiver in a more concise way.

Insurance continuity and receipt of diabetes preventive care in a network of Federally Qualified Health Centers

PubMed Central

Gold, Rachel; DeVoe, Jennifer; Shah, Amit; Chauvie, Susan

2009-01-01

Background and Objectives Having health insurance is usually associated with better access to care and better health outcomes. For patients receiving care at Federally Qualified Health Centers (FQHCs), where care is provided regardless of insurance status, the role health insurance status plays in affecting receipt of services is less well understood. Research Design We used practice management data from a coalition of FQHCs in Oregon, and linked to Oregon’s electronic insurance data, to examine whether receipt of diabetes preventive care services was associated with continuity of insurance coverage among adult FQHC patients receiving diabetes care in 2005. Results About one-third (32%) of patients with diabetes received a flu vaccination in 2005, 36% an LDL screening, 54% at least one HbA1c screening, and 21% a nephropathy screening. Compared to the continuously insured, the continuously uninsured were less likely to receive an LDL screening, a flu vaccination, and/or a nephropathy screening; those with partial coverage were less likely than the continuously insured to receive a flu shot, at least one HbA1c screening, or an LDL screening. Conclusions Our results suggest that FQHCs do an excellent job in delivering most services to their uninsured and partially insured patients, but also underscore that for diabetic patients from underserved communities, having both an FQHC medical home and continuous health insurance plays a critical role in receiving optimal chronic disease management. Our study is one of the first to demonstrate how electronic administrative data from a network of FQHCs can be successfully used to gauge the state of healthcare delivery. PMID:19330890

Discharge prescribing of enteral opioids after initiation as a weaning strategy from continuous opioid infusions in the Intensive Care Unit.

PubMed

Kram, Bridgette; Weigel, Kylie M; Kuhrt, Michelle; Gilstrap, Daniel L

To evaluate the proportion of patients receiving a hospital discharge prescription for a scheduled enteral opioid following initiation as a weaning strategy from a continuous opioid infusion in the Intensive Care Unit (ICU). Retrospective, observational study. Five adult ICUs at a large, quaternary care academic medical center. Endotracheally intubated, opioid-naive adults receiving a continuous opioid infusion with a concomitant scheduled enteral opioid initiated. Exclusion criteria were receipt of fewer than two enteral opioid doses, documentation of a long-acting opioid as a home medication, the indication for the enteral opioid was not a weaning strategy, death during hospital admission or discharge to hospice. None. The proportion of ICU and hospital survivors who received a discharge prescription for a scheduled enteral opioid, total duration of continuous opioid infusion, duration of continuous opioid infusion after initiation of an enteral opioid therapy, total duration of enteral therapy, ICU and hospital length of stay. Of 62 included patients, 19 patients (30.6 percent) received a new prescription for a scheduled enteral opioid at hospital discharge. The median duration of enteral opioid therapy was longer for patients who received a discharge prescription compared to those who did not (20.09 vs 8.89 days, p = 0.02), though the remaining endpoints were not different. Utilizing scheduled enteral opioids as a weaning strategy from continuous opioid infusions may place patients at risk of ICU-acquired physical dependence on opioids.

Robot Position Sensor Fault Tolerance

NASA Technical Reports Server (NTRS)

Aldridge, Hal A.

1997-01-01

Robot systems in critical applications, such as those in space and nuclear environments, must be able to operate during component failure to complete important tasks. One failure mode that has received little attention is the failure of joint position sensors. Current fault tolerant designs require the addition of directly redundant position sensors which can affect joint design. A new method is proposed that utilizes analytical redundancy to allow for continued operation during joint position sensor failure. Joint torque sensors are used with a virtual passive torque controller to make the robot joint stable without position feedback and improve position tracking performance in the presence of unknown link dynamics and end-effector loading. Two Cartesian accelerometer based methods are proposed to determine the position of the joint. The joint specific position determination method utilizes two triaxial accelerometers attached to the link driven by the joint with the failed position sensor. The joint specific method is not computationally complex and the position error is bounded. The system wide position determination method utilizes accelerometers distributed on different robot links and the end-effector to determine the position of sets of multiple joints. The system wide method requires fewer accelerometers than the joint specific method to make all joint position sensors fault tolerant but is more computationally complex and has lower convergence properties. Experiments were conducted on a laboratory manipulator. Both position determination methods were shown to track the actual position satisfactorily. A controller using the position determination methods and the virtual passive torque controller was able to servo the joints to a desired position during position sensor failure.

Recording vocalizations with Bluetooth technology.

PubMed

Gaona-González, Andrés; Santillán-Doherty, Ana María; Arenas-Rosas, Rita Virginia; Muñoz-Delgado, Jairo; Aguillón-Pantaleón, Miguel Angel; Ordoñez-Gómez, José Domingo; Márquez-Arias, Alejandra

2011-06-01

We propose a method for capturing vocalizations that is designed to avoid some of the limiting factors found in traditional bioacoustical methods, such as the impossibility of obtaining continuous long-term registers or analyzing amplitude due to the continuous change of distance between the subject and the position of the recording system. Using Bluetooth technology, vocalizations are captured and transmitted wirelessly into a receiving system without affecting the quality of the signal. The recordings of the proposed system were compared to those obtained as a reference, which were based on the coding of the signal with the so-called pulse-code modulation technique in WAV audio format without any compressing process. The evaluation showed p < .05 for the measured quantitative and qualitative parameters. We also describe how the transmitting system is encapsulated and fixed on the animal and a way to video record a spider monkey's behavior simultaneously with the audio recordings.

Practical continuous-variable quantum key distribution without finite sampling bandwidth effects.

PubMed

Li, Huasheng; Wang, Chao; Huang, Peng; Huang, Duan; Wang, Tao; Zeng, Guihua

2016-09-05

In a practical continuous-variable quantum key distribution system, finite sampling bandwidth of the employed analog-to-digital converter at the receiver's side may lead to inaccurate results of pulse peak sampling. Then, errors in the parameters estimation resulted. Subsequently, the system performance decreases and security loopholes are exposed to eavesdroppers. In this paper, we propose a novel data acquisition scheme which consists of two parts, i.e., a dynamic delay adjusting module and a statistical power feedback-control algorithm. The proposed scheme may improve dramatically the data acquisition precision of pulse peak sampling and remove the finite sampling bandwidth effects. Moreover, the optimal peak sampling position of a pulse signal can be dynamically calibrated through monitoring the change of the statistical power of the sampled data in the proposed scheme. This helps to resist against some practical attacks, such as the well-known local oscillator calibration attack.

Unconditionally secure commitment in position-based quantum cryptography.

PubMed

Nadeem, Muhammad

2014-10-27

A new commitment scheme based on position-verification and non-local quantum correlations is presented here for the first time in literature. The only credential for unconditional security is the position of committer and non-local correlations generated; neither receiver has any pre-shared data with the committer nor does receiver require trusted and authenticated quantum/classical channels between him and the committer. In the proposed scheme, receiver trusts the commitment only if the scheme itself verifies position of the committer and validates her commitment through non-local quantum correlations in a single round. The position-based commitment scheme bounds committer to reveal valid commitment within allocated time and guarantees that the receiver will not be able to get information about commitment unless committer reveals. The scheme works for the commitment of both bits and qubits and is equally secure against committer/receiver as well as against any third party who may have interests in destroying the commitment. Our proposed scheme is unconditionally secure in general and evades Mayers and Lo-Chau attacks in particular.

Contributed Review: Source-localization algorithms and applications using time of arrival and time difference of arrival measurements

NASA Astrophysics Data System (ADS)

Li, Xinya; Deng, Zhiqun Daniel; Rauchenstein, Lynn T.; Carlson, Thomas J.

2016-04-01

Locating the position of fixed or mobile sources (i.e., transmitters) based on measurements obtained from sensors (i.e., receivers) is an important research area that is attracting much interest. In this paper, we review several representative localization algorithms that use time of arrivals (TOAs) and time difference of arrivals (TDOAs) to achieve high signal source position estimation accuracy when a transmitter is in the line-of-sight of a receiver. Circular (TOA) and hyperbolic (TDOA) position estimation approaches both use nonlinear equations that relate the known locations of receivers and unknown locations of transmitters. Estimation of the location of transmitters using the standard nonlinear equations may not be very accurate because of receiver location errors, receiver measurement errors, and computational efficiency challenges that result in high computational burdens. Least squares and maximum likelihood based algorithms have become the most popular computational approaches to transmitter location estimation. In this paper, we summarize the computational characteristics and position estimation accuracies of various positioning algorithms. By improving methods for estimating the time-of-arrival of transmissions at receivers and transmitter location estimation algorithms, transmitter location estimation may be applied across a range of applications and technologies such as radar, sonar, the Global Positioning System, wireless sensor networks, underwater animal tracking, mobile communications, and multimedia.

Impact of Swarm GPS receiver updates on POD performance

NASA Astrophysics Data System (ADS)

van den IJssel, Jose; Forte, Biagio; Montenbruck, Oliver

2016-05-01

The Swarm satellites are equipped with state-of-the-art Global Positioning System (GPS) receivers, which are used for the precise geolocation of the magnetic and electric field instruments, as well as for the determination of the Earth's gravity field, the total electron content and low-frequency thermospheric neutral densities. The onboard GPS receivers deliver high-quality data with an almost continuous data rate. However, the receivers show a slightly degraded performance when flying over the geomagnetic poles and the geomagnetic equator, due to ionospheric scintillation. Furthermore, with only eight channels available for dual-frequency tracking, the amount of collected GPS tracking data is relatively low compared with various other missions. Therefore, several modifications have been implemented to the Swarm GPS receivers. To optimise the amount of collected GPS data, the GPS antenna elevation mask has slowly been reduced from 10° to 2°. To improve the robustness against ionospheric scintillation, the bandwidths of the GPS receiver tracking loops have been widened. Because these modifications were first implemented on Swarm-C, their impact can be assessed by a comparison with the close flying Swarm-A satellite. This shows that both modifications have a positive impact on the GPS receiver performance. The reduced elevation mask increases the amount of GPS tracking data by more than 3 %, while the updated tracking loops lead to around 1.3 % more observations and a significant reduction in tracking losses due to severe equatorial scintillation. The additional observations at low elevation angles increase the average noise of the carrier phase observations, but nonetheless slightly improve the resulting reduced-dynamic and kinematic orbit accuracy as shown by independent satellite laser ranging (SLR) validation. The more robust tracking loops significantly reduce the large carrier phase observation errors at the geomagnetic poles and along the geomagnetic equator and do not degrade the observations at midlatitudes. SLR validation indicates that the updated tracking loops also improve the reduced-dynamic and kinematic orbit accuracy. It is expected that the Swarm gravity field recovery will benefit from the improved kinematic orbit quality and potentially also from the expected improvement of the kinematic baseline determination and the anticipated reduction in the systematic gravity field errors along the geomagnetic equator. Finally, other satellites that carry GPS receivers that encounter similar disturbances might also benefit from this analysis.

Multi-GNSS Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Al-Shaery, A.; Zhang, S.; Lim, S.; Rizos, C.

2012-04-01

The multi-GNSS era has began attracting more attention with the declaration of full operational capability of GLONASS , with a 24 satellites being set to 'healthy' on December 8th 2011 (IAC, 2011). This means that GPS is no longer the only GNSS that provides global positioning coverage. This status brings benefits for GNSS users in areas (e.g. 'urban canyon' environments or in deep open cut mines) where the number of visible satellites is limited because of shadowing effects. In such areas adding more functioning satellites, which is one of the aiding solutions, becomes easier, at no extra cost. The inclusion of GLONASS observations in positioning solutions will increase the available number of satellites and thus positioning accuracy may improve as a result of enhanced overall satellite geometry. Such an aiding solution is increasingly attractive due to the successful revitalisation of GLONASS. Another motivation is the availability of improved GLONASS orbits from the IGS and individual analysis centres of the IGS. The increasing availability of receivers with GPS/GLONASS tracking capability on the market is an additional motive. Consequently, most networks of continuously operating reference stations (CORS) are now equipped with receivers that can track both GPS and GLONASS satellite signals, and therefore network-based positioning with combined GPS and GLONASS observations is possible. However, adding GLONASS observations to GPS is not a straight forward process. This is attributable to a few system differences in reference frames for time and coordinates, and in signal structures. The first two differences are easy to deal with using well-defined conversion and transformation parameters (El-Mowafy, 2001). However, signal structure differences have some implications. The mathematical modelling of combined GPS/GLONASS observations is not performed as in the case of GPS-alone. Special care should be paid to such integration. Not only is the software part affected but also the hardware. Recent research has identified one of the challenges users may face if precise positioning is sought (Takac, 2009, Yamada et al., 2010, Wanninger, 2011). A user of heterogeneous receiver pairs will experience ambiguity fixing challenges due to inter-channel bias which cannot be cancelled by differencing GLONASS observations, pseudorange or carrier-phase. This paper outlines the opportunities and challenges of combining two currently fully operational GNSS systems (GPS and GLONASS) for precise positioning solutions. Discussion and analysis considering mathematical modelling challenges and users' selection of hardware constraints will be performed.

GPS/GLONASS Combined Precise Point Positioning with Receiver Clock Modeling

PubMed Central

Wang, Fuhong; Chen, Xinghan; Guo, Fei

2015-01-01

Research has demonstrated that receiver clock modeling can reduce the correlation coefficients among the parameters of receiver clock bias, station height and zenith tropospheric delay. This paper introduces the receiver clock modeling to GPS/GLONASS combined precise point positioning (PPP), aiming to better separate the receiver clock bias and station coordinates and therefore improve positioning accuracy. Firstly, the basic mathematic models including the GPS/GLONASS observation equations, stochastic model, and receiver clock model are briefly introduced. Then datasets from several IGS stations equipped with high-stability atomic clocks are used for kinematic PPP tests. To investigate the performance of PPP, including the positioning accuracy and convergence time, a week of (1–7 January 2014) GPS/GLONASS data retrieved from these IGS stations are processed with different schemes. The results indicate that the positioning accuracy as well as convergence time can benefit from the receiver clock modeling. This is particularly pronounced for the vertical component. Statistic RMSs show that the average improvement of three-dimensional positioning accuracy reaches up to 30%–40%. Sometimes, it even reaches over 60% for specific stations. Compared to the GPS-only PPP, solutions of the GPS/GLONASS combined PPP are much better no matter if the receiver clock offsets are modeled or not, indicating that the positioning accuracy and reliability are significantly improved with the additional GLONASS satellites in the case of insufficient number of GPS satellites or poor geometry conditions. In addition to the receiver clock modeling, the impacts of different inter-system timing bias (ISB) models are investigated. For the case of a sufficient number of satellites with fairly good geometry, the PPP performances are not seriously affected by the ISB model due to the low correlation between the ISB and the other parameters. However, the refinement of ISB model weakens the correlation between coordinates and ISB estimates and finally enhance the PPP performance in the case of poor observation conditions. PMID:26134106

Mobile Phone Middleware Architecture for Energy and Context Awareness in Location-Based Services

PubMed Central

Galeana-Zapién, Hiram; Torres-Huitzil, César; Rubio-Loyola, Javier

2014-01-01

The disruptive innovation of smartphone technology has enabled the development of mobile sensing applications leveraged on specialized sensors embedded in the device. These novel mobile phone applications rely on advanced sensor information processes, which mainly involve raw data acquisition, feature extraction, data interpretation and transmission. However, the continuous accessing of sensing resources to acquire sensor data in smartphones is still very expensive in terms of energy, particularly due to the periodic use of power-intensive sensors, such as the Global Positioning System (GPS) receiver. The key underlying idea to design energy-efficient schemes is to control the duty cycle of the GPS receiver. However, adapting the sensing rate based on dynamic context changes through a flexible middleware has received little attention in the literature. In this paper, we propose a novel modular middleware architecture and runtime environment to directly interface with application programming interfaces (APIs) and embedded sensors in order to manage the duty cycle process based on energy and context aspects. The proposed solution has been implemented in the Android software stack. It allows continuous location tracking in a timely manner and in a transparent way to the user. It also enables the deployment of sensing policies to appropriately control the sampling rate based on both energy and perceived context. We validate the proposed solution taking into account a reference location-based service (LBS) architecture. A cloud-based storage service along with online mobility analysis tools have been used to store and access sensed data. Experimental measurements demonstrate the feasibility and efficiency of our middleware, in terms of energy and location resolution. PMID:25513821

Contraceptive discontinuation and switching among couples receiving integrated HIV and family planning services in Lusaka, Zambia

PubMed Central

Haddad, Lisa; Wall, Kristin M; Vwalika, Bellington; Htee Khu, Naw; Brill, Ilene; Kilembe, William; Stephenson, Rob; Chomba, Elwyn; Vwalika, Cheswa; Tichacek, Amanda; Allen, Susan

2014-01-01

Objective To describe predictors of contraceptive method discontinuation and switching behaviors among HIV positive couples receiving couples' voluntary HIV counseling and testing services in Lusaka, Zambia. Design Couples were randomized in a factorial design to two family planning educational intervention videos, received comprehensive family planning services, and were assessed every 3-months for contraceptive initiation, discontinuation and switching. Methods We modeled factors associated with contraceptive method upgrading and downgrading via multivariate Andersen-Gill models. Results Most women continued the initial method selected after randomization. The highest rates of discontinuation/switching were observed for injectable contraceptive and intrauterine device users. Time to discontinuing the more effective contraceptive methods or downgrading to oral contraceptives or condoms was associated with the women's younger age, desire for more children within the next year, heavy menstrual bleeding, bleeding between periods, and cystitis/dysuria. Health concerns among women about contraceptive implants and male partners not wanting more children were associated with upgrading from oral contraceptives or condoms. HIV status of the woman or the couple was not predictive of switching or stopping. Conclusions We found complicated patterns of contraceptive use. The predictors of contraception switching indicate that interventions targeted to younger couples that address common contraception-related misconceptions could improve effective family planning utilization. We recommend these findings be used to increase the uptake and continuation of contraception, especially long acting reversible contraceptive (LARC) methods, and that fertility-goal based, LARC-focused family planning be offered as an integral part of HIV prevention services. PMID:24088689

Mobile phone middleware architecture for energy and context awareness in location-based services.

PubMed

Galeana-Zapién, Hiram; Torres-Huitzil, César; Rubio-Loyola, Javier

2014-12-10

The disruptive innovation of smartphone technology has enabled the development of mobile sensing applications leveraged on specialized sensors embedded in the device. These novel mobile phone applications rely on advanced sensor information processes, which mainly involve raw data acquisition, feature extraction, data interpretation and transmission. However, the continuous accessing of sensing resources to acquire sensor data in smartphones is still very expensive in terms of energy, particularly due to the periodic use of power-intensive sensors, such as the Global Positioning System (GPS) receiver. The key underlying idea to design energy-efficient schemes is to control the duty cycle of the GPS receiver. However, adapting the sensing rate based on dynamic context changes through a flexible middleware has received little attention in the literature. In this paper, we propose a novel modular middleware architecture and runtime environment to directly interface with application programming interfaces (APIs) and embedded sensors in order to manage the duty cycle process based on energy and context aspects. The proposed solution has been implemented in the Android software stack. It allows continuous location tracking in a timely manner and in a transparent way to the user. It also enables the deployment of sensing policies to appropriately control the sampling rate based on both energy and perceived context. We validate the proposed solution taking into account a reference location-based service (LBS) architecture. A cloud-based storage service along with online mobility analysis tools have been used to store and access sensed data. Experimental measurements demonstrate the feasibility and efficiency of our middleware, in terms of energy and location resolution.

The effect of continuing professional development on public complaints: a case-control study.

PubMed

Wenghofer, Elizabeth F; Campbell, Craig; Marlow, Bernard; Kam, Sophia M; Carter, Lorraine; McCauley, William

2015-03-01

This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise programme impact on physician performance at the population level. © 2015 John Wiley & Sons Ltd.

Neural control of computer cursor velocity by decoding motor cortical spiking activity in humans with tetraplegia

NASA Astrophysics Data System (ADS)

Kim, Sung-Phil; Simeral, John D.; Hochberg, Leigh R.; Donoghue, John P.; Black, Michael J.

2008-12-01

Computer-mediated connections between human motor cortical neurons and assistive devices promise to improve or restore lost function in people with paralysis. Recently, a pilot clinical study of an intracortical neural interface system demonstrated that a tetraplegic human was able to obtain continuous two-dimensional control of a computer cursor using neural activity recorded from his motor cortex. This control, however, was not sufficiently accurate for reliable use in many common computer control tasks. Here, we studied several central design choices for such a system including the kinematic representation for cursor movement, the decoding method that translates neuronal ensemble spiking activity into a control signal and the cursor control task used during training for optimizing the parameters of the decoding method. In two tetraplegic participants, we found that controlling a cursor's velocity resulted in more accurate closed-loop control than controlling its position directly and that cursor velocity control was achieved more rapidly than position control. Control quality was further improved over conventional linear filters by using a probabilistic method, the Kalman filter, to decode human motor cortical activity. Performance assessment based on standard metrics used for the evaluation of a wide range of pointing devices demonstrated significantly improved cursor control with velocity rather than position decoding. Disclosure. JPD is the Chief Scientific Officer and a director of Cyberkinetics Neurotechnology Systems (CYKN); he holds stock and receives compensation. JDS has been a consultant for CYKN. LRH receives clinical trial support from CYKN.

Efficacy and safety of ABP 980 compared with reference trastuzumab in women with HER2-positive early breast cancer (LILAC study): a randomised, double-blind, phase 3 trial.

PubMed

von Minckwitz, Gunter; Colleoni, Marco; Kolberg, Hans-Christian; Morales, Serafin; Santi, Patricia; Tomasevic, Zorica; Zhang, Nan; Hanes, Vladimir

2018-06-04

ABP 980 (Amgen Inc, Thousand Oaks, CA, USA) is a biosimilar of trastuzumab, with analytical, functional, and pharmacokinetic similarities. We compared the clinical safety and efficacy of ABP 980 with that of trastuzumab in women with HER2-positive early breast cancer. We did a randomised, multicentre, double-blind, active-controlled equivalence trial at 97 study centres in 20 countries, mainly in Europe and South America. Eligible women were aged 18 years or older, had histologically confirmed HER2-positive invasive early breast cancer, an Eastern Cooperative Oncology Group performance status score of 0 or 1, and were planning to have surgical resection of the breast tumour with sentinel or axillary lymph node dissection and neoadjuvant chemotherapy. After four cycles of run-in anthracycline-based chemotherapy, patients were assigned 1:1 to receive ABP 980 or trastuzumab with a permuted block design (blocks of four) computer-generated randomisation schedule. Patients received neoadjuvant therapy with a loading dose (8 mg/kg) of ABP 980 or trastuzumab plus paclitaxel 175 mg/m 2 in a 90 min intravenous infusion, followed by three cycles of 6 mg/kg intravenous ABP 980 or trastuzumab plus paclitaxel 175 mg/m 2 every 3 weeks in 30 min intravenous infusions (or 80 mg/m 2 paclitaxel once per week for 12 cycles if that was the local standard of care). Randomisation was stratified by T stage, node status, hormone receptor status, planned paclitaxel dosing schedule, and geographical region. Surgery was completed 3-7 weeks after the last dose of neoadjuvant treatment, after which adjuvant treatment with ABP 980 or trastuzumab was given every 3 weeks for up to 1 year after the first dose in the study. Patients had been randomly assigned at baseline to continue APB 980, continue trastuzumab, or switch from trastuzumab to APB 980 as their adjuvant treatment. The co-primary efficacy endpoints were risk difference and risk ratio (RR) of pathological complete response in breast tissue and axillary lymph nodes assessed at a local laboratory in all patients who were randomly assigned and received any amount of neoadjuvant investigational product and underwent surgery. We assessed safety in all patients who were randomly assigned and received any amount of investigational product. This trial is registered with ClinicalTrials.gov, number NCT01901146 and Eudra, number CT 2012-004319-29. Of 827 patients enrolled, 725 were randomly assigned to receive ABP 980 (n=364) or trastuzumab (n=361). The primary endpoint was assessable in 696 patients (358 who received ABP 980 and 338 who received trastuzumab). Pathological complete response was recorded in 172 (48%, 95% CI 43-53) of 358 patients in the ABP 980 group and 137 (41%, 35-46) of 338 in the trastuzumab group (risk difference 7·3%, 90% CI 1·2-13·4; RR 1·188, 90% CI 1·033-1·366), with the upper bounds of the CIs exceeding the predefined equivalence margins of 13% and 1·318, respectively. Pathological complete response in the central laboratory assessment was seen in 162 (48%) of 339 patients assigned to ABP 980 at baseline and 138 (42%) of 330 assigned to trastuzumab at baseline (risk difference 5·8%, 90% CI -0·5 to 12·0, and RR 1·142, 90% CI 0·993 to 1·312). Grade 3 or worse adverse events during the neoadjuvant phase occurred in 54 (15%) of 364 patients in the ABP 980 group and 51 (14%) of 361 patients in the trastuzumab group, of which the most frequent grade 3 or worse event of interest was neutropenia, occurring in 21 (6%) patients in both groups. In the adjuvant phase, grade 3 or worse adverse events occurred in 30 (9%) of 349 patients continuing ABP 980, 11 (6%) of 171 continuing trastuzumab, and 13 (8%) of 171 who switched from trastuzumab to ABP 980, the most frequent grade 3 or worse events of interest were infections and infestations (four [1%], two [1%], and two [1%]), neutropenia (three [1%], two [1%], and one [1%]), and infusion reactions (two [1%], two [1%], and three [2%]). Two patients died from adverse events judged to be unrelated to the investigational products: one died from pneumonia while receiving neoadjuvant ABP 980 and one died from septic shock while receiving adjuvant ABP 980 after trastuzumab. Although the lower bounds of the 90% CIs for RR and risk difference showed non-inferiority, the upper bounds exceeded the predefined equivalence margins when based on local laboratory review of tumour samples, meaning that non-superiority was non-conclusive. In our sensitivity analyses based on central laboratory evaluation of tumour samples, estimates for the two drugs were contained within the predefined equivalence margins, indicating similar efficacy. ABP 980 and trastuzumab had similar safety outcomes in both the neoadjuvant and adjuvant phases of the study. Amgen. Copyright © 2018 Elsevier Ltd. All rights reserved.

45 CFR 400.104 - Continued coverage of recipients who receive increased earnings from employment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Conditions of Eligibility for Refugee Medical Assistance § 400.104 Continued coverage of recipients who receive increased earnings from...

Laser Atmospheric Transmitter Receiver-Network (LAnTeRN): A new approach for active measurement of atmospheric greenhouse gases

NASA Astrophysics Data System (ADS)

Dobler, J. T.; Braun, M.; Zaccheo, T.

2012-12-01

The Laser Atmospheric Transmitter Receiver-Network (LAnTeRN) is a new measurement concept that will enable local, regional and continental determination of key greenhouse gases, with unparalleled accuracy and precision. This new approach will offer the ability to make low bias, high precision, quasi-continuous, measurements to the accuracies required for separating anthropogenic and biogenic sources and sinks. In 2004 ITT Exelis developed an airborne demonstration unit, based on an intensity modulated continuous wave (IM-CW) lidar approach, for actively measuring atmospheric CO2 and O2. The multi-functional fiber laser lidar (MFLL) system relies on low peak power, high reliability, and efficient telecom laser components to implement this unique measurement approach. While evaluating methods for discriminating against thin clouds for the MFLL instrument, a new measurement concept was conceived. LAnTeRN has several fundamental characteristics in common with the MFLL instrument, but is a fundamentally different implementation and capability. The key difference is that LAnTeRN operates in transmission rather than in the traditional backscatter lidar configuration, which has several distinct advantages. Operating as a forward scatter, bistatic lidar system, LAnTeRN enables consideration of continuous monitoring from a geostationary orbit to multiple locations on the ground. Having the receivers on the ground significantly lowers cost and risk compared to an all space based mission, and allows the transmitter subsystem to be implemented, near term, as a hosted payload. Furthermore, the LAnTeRN measurement approach is also applicable for ground to ground measurements where high precision measurements over a long open path is required, such as facilities monitoring, or monitoring of passive volcanoes and fault lines. Using narrow linewidth laser sources allows flexibility to select the position on the absorption feature being probed. This feature allows for weighting the absorption toward lower altitudes for the space implementation or to handle large dynamic range measurements as would be required for volcano monitoring. This presentation will discuss results from a detailed instrument performance analyses, retrieval simulations, and from initial testing of a proof of concept demonstration unit being developed by Exelis. Initial analysis indicate that measurements from a transmitter in geostationary orbit to 25 ground receivers in the eastern U.S. can retrieve column integrated CO2 values to a precision of <0.2 ppm on monthly averages and <0.06 ppm on yearly averages, using conservative estimates of cloud cover and aerosol loading. The capability for continuous monitoring over a fixed geometry makes it possible to independently characterize the atmospheric column, using existing capabilities (e.g. aircore, aircraft and in-situ instrumentation), for quantification of bias. Furthermore, the ability to selectively locate the ground receivers can enable focused studies for specific applications.

'Testing Together Challenges the Relationship': Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa.

PubMed

Tabana, Hanani; Doherty, Tanya; Rubenson, Birgitta; Jackson, Debra; Ekström, Anna Mia; Thorson, Anna

2013-01-01

We conducted qualitative individual and combined interviews with couples to explore their experiences since the time of taking an HIV test and receiving the test result together, as part of a home-based HIV counselling and testing intervention. This study was conducted in October 2011 in rural KwaZulu-Natal, South Africa, about 2 years after couples tested and received results together. Fourteen couples were purposively sampled: discordant, concordant negative and concordant positive couples. Learning about each other's status together challenged relationships of the couples in different ways depending on HIV status and gender. The mutual information confirmed suspected infidelity that had not been discussed before. Negative women in discordant partnerships remained with their positive partner due to social pressure and struggled to maintain their HIV negative status. Most of the couple relationships were characterized by silence and mistrust. Knowledge of sero-status also led to loss of sexual intimacy in some couples especially the discordant. For most men in concordant negative couples, knowledge of status was an awakening of the importance of fidelity and an opportunity for behaviour change, while for concordant positive and discordant couples, it was seen as proof of infidelity. Although positive HIV status was perceived as confirmation of infidelity, couples continued their relationship and offered some support for each other, living and managing life together. Sexual life in these couples was characterized by conflict and sometimes violence. In the concordant negative couples, trust was enhanced and behaviour change was promised. Findings suggest that testing together as couples challenged relationships in both negative and positive ways. Further, knowledge of HIV status indicated potential to influence behaviour change especially among concordant negatives. In the discordant and concordant positive couples, traditional gender roles exposed women's vulnerability and their lack of decision-making power.

Flipping the classroom to teach systematic reviews: the development of a continuing education course for librarians*

PubMed Central

Conte, Marisa L.; MacEachern, Mark P.; Mani, Nandita S.; Townsend, Whitney A.; Smith, Judith E.; Masters, Chase; Kelley, Caitlin

2015-01-01

Objective: The researchers used the flipped classroom model to develop and conduct a systematic review course for librarians. Setting: The research took place at an academic health sciences library. Method: A team of informationists developed and conducted a pilot course. Assessment informed changes to both course components; a second course addressed gaps in the pilot. Main Results: Both the pilot and subsequent course received positive reviews. Changes based on assessment data will inform future iterations. Conclusion: The flipped classroom model can be successful in developing and implementing a course that is well rated by students. PMID:25918484

MONARCH 2: Abemaciclib in Combination With Fulvestrant in Women With HR+/HER2- Advanced Breast Cancer Who Had Progressed While Receiving Endocrine Therapy.

PubMed

Sledge, George W; Toi, Masakazu; Neven, Patrick; Sohn, Joohyuk; Inoue, Kenichi; Pivot, Xavier; Burdaeva, Olga; Okera, Meena; Masuda, Norikazu; Kaufman, Peter A; Koh, Han; Grischke, Eva-Maria; Frenzel, Martin; Lin, Yong; Barriga, Susana; Smith, Ian C; Bourayou, Nawel; Llombart-Cussac, Antonio

2017-09-01

Purpose MONARCH 2 ( ClinicalTrials.gov identifier: NCT02107703) compared the efficacy and safety of abemaciclib, a selective cyclin-dependent kinase 4 and 6 inhibitor, plus fulvestrant with fulvestrant alone in patients with advanced breast cancer (ABC). Patients and Methods MONARCH 2 was a global, double-blind, phase III study of women with hormone receptor-positive and human epidermal growth factor receptor 2-negative ABC who had progressed while receiving neoadjuvant or adjuvant endocrine therapy (ET), ≤ 12 months from the end of adjuvant ET, or while receiving first-line ET for metastatic disease. Patients were randomly assigned 2:1 to receive abemaciclib or placebo (150 mg twice daily) on a continuous schedule and fulvestrant (500 mg, per label). The primary end point was investigator-assessed progression-free survival (PFS), and key secondary end points included overall survival, objective response rate (ORR), duration of response, clinical benefit rate, quality of life, and safety. Results Between August 2014 and December 2015, 669 patients were randomly assigned to receive abemaciclib plus fulvestrant (n = 446) or placebo plus fulvestrant (n = 223). Abemaciclib plus fulvestrant significantly extended PFS versus fulvestrant alone (median, 16.4 v 9.3 months; hazard ratio, 0.553; 95% CI, 0.449 to 0.681; P < .001). In patients with measurable disease, abemaciclib plus fulvestrant achieved an ORR of 48.1% (95% CI, 42.6% to 53.6%) compared with 21.3% (95% CI, 15.1% to 27.6%) in the control arm. The most common adverse events in the abemaciclib versus placebo arms were diarrhea (86.4% v 24.7%), neutropenia (46.0% v 4.0%), nausea (45.1% v 22.9%), and fatigue (39.9% v 26.9%). Conclusions Abemaciclib at 150 mg twice daily plus fulvestrant was effective, significantly improving PFS and ORR and demonstrating a tolerable safety profile in women with hormone receptor-positive and human epidermal growth factor receptor 2-negative ABC who progressed while receiving ET.

Hepatocellular adenoma in a woman who was undergoing testosterone treatment for gender identity disorder.

PubMed

Kato, Keizo; Abe, Hiroshi; Hanawa, Noriko; Fukuzawa, Junya; Matsuo, Ryota; Yonezawa, Takeshi; Itoh, Sadahiro; Sato, Yoshiyuki; Ika, Makiko; Shimizu, Shohei; Endo, Shinji; Hano, Hiroshi; Izu, Asami; Sugitani, Masahiko; Tsubota, Akihito

2018-03-27

A 32-year-old Japanese woman was admitted to our hospital for the diagnosis and treatment of multiple liver tumors. She had been receiving 125 mg testosterone enanthate every 2 weeks following female-to-male gender identity disorder (GID) diagnosis at 20 years of age. Ultrasonography, computed tomography, and magnetic resonance imaging showed 11 hepatic nodular tumors with a maximum diameter of 28 mm. Liver tumors with hepatocellular adenoma (HCA) were diagnosed with needle biopsy. Segmentectomy of the left lateral lobe including two lesions, subsegmentectomy of S6 including two lesions, enucleation of each tumor in S5 and S7, and open surgical radiofrequency ablation for each tumor in S4 and S7 were performed. Immunohistochemical specimens showed that the tumor cells were diffusely and strongly positive for glutamine synthetase and that the nuclei were ectopically positive for β-catenin. Thus, the tumors were diagnosed as β-catenin-activated HCA (b-HCA). Transcatheter arterial chemoembolization plus subsequent radiofrequency ablation was performed for the 3 residual lesions in S4 and S8. Although testosterone enanthate was being continued for GID, no recurrence was observed until at least 22 months after the intensive treatments. HCA development in such patients receiving testosterone should be closely monitored using image inspection.

Cost-effectiveness of active-passive prophylaxis and antiviral prophylaxis during pregnancy to prevent perinatal hepatitis B virus infection.

PubMed

Fan, Lin; Owusu-Edusei, Kwame; Schillie, Sarah F; Murphy, Trudy V

2016-05-01

In an era of antiviral treatment, reexamination of the cost-effectiveness of strategies to prevent perinatal hepatitis B virus (HBV) transmission in the United States is needed. We used a decision tree and Markov model to estimate the cost-effectiveness of the current U.S. strategy and two alternatives: (1) Universal hepatitis B vaccination (HepB) strategy: No pregnant women are screened for hepatitis B surface antigen (HBsAg). All infants receive HepB before hospital discharge; no infants receive hepatitis B immunoglobulin (HBIG). (2) Current strategy: All pregnant women are screened for HBsAg. Infants of HBsAg-positive women receive HepB and HBIG ≤12 hours of birth. All other infants receive HepB before hospital discharge. (3) Antiviral prophylaxis strategy: All pregnant women are screened for HBsAg. HBsAg-positive women have HBV-DNA load measured. Antiviral prophylaxis is offered for 4 months starting in the third trimester to women with DNA load ≥10(6) copies/mL. HepB and HBIG are administered at birth to infants of HBsAg-positive women, and HepB is administered before hospital discharge to infants of HBsAg-negative women. Effects were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICER). Compared to the universal HepB strategy, the current strategy prevented 1,006 chronic HBV infections and saved 13,600 QALYs (ICER: $6,957/QALY saved). Antiviral prophylaxis dominated the current strategy, preventing an additional 489 chronic infections, and saving 800 QALYs and $2.8 million. The results remained robust over a wide range of assumptions. The current U.S. strategy for preventing perinatal HBV remains cost-effective compared to the universal HepB strategy. An antiviral prophylaxis strategy was cost saving compared to the current strategy and should be considered to continue to decrease the burden of perinatal hepatitis B in the United States. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Switching from entecavir to PegIFN alfa-2a in patients with HBeAg-positive chronic hepatitis B: a randomised open-label trial (OSST trial).

PubMed

Ning, Qin; Han, Meifang; Sun, Yongtao; Jiang, Jiaji; Tan, Deming; Hou, Jinlin; Tang, Hong; Sheng, Jifang; Zhao, Mianzhi

2014-10-01

Durable post-treatment response is uncommon in chronic hepatitis B (CHB) patients on nucleos(t)ide analogue therapy. Response, response predictors and safety were assessed in patients who switched from long-term entecavir (ETV) to peginterferon alfa-2a. Hepatitis B e antigen (HBeAg)-positive CHB patients who had received ETV for 9-36 months, with HBeAg <100 PEIU/ml and HBV DNA ⩽1000 copies/ml, were randomised 1:1 to receive peginterferon alfa-2a 180 μg/week or ETV 0.5mg/day for 48 weeks. The primary endpoint was HBeAg seroconversion at week 48 (ClinicalTrials.gov: NCT00940485). 200 patients were randomised; 197 received ⩾1 study drug dose. Five patients who were anti-HBe-positive at baseline were excluded from the modified intention-to-treat population (peginterferon alfa-2a, n = 94; ETV, n = 98). Patients who switched to peginterferon alfa-2a achieved higher week 48 HBeAg seroconversion rates vs. those who continued ETV (14.9% vs. 6.1%; p = 0.0467). Only patients receiving peginterferon alfa-2a achieved HBsAg loss (8.5%). Among peginterferon alfa-2a-treated patients with HBeAg loss and HBsAg <1500 IU/ml at randomisation, 33.3% and 22.2% achieved HBeAg seroconversion and HBsAg loss, respectively. Early on-treatment HBsAg decline predicted response at week 48; highest rates were observed in patients with week 12 HBsAg <200 IU/ml (HBeAg seroconversion, 66.7%; HBsAg loss, 77.8%). Alanine aminotransferase elevations were not associated with viral rebound (n = 38). Peginterferon alfa-2a was well-tolerated. For patients who achieve virological suppression with ETV, switching to a finite course of peginterferon alfa-2a significantly increases rates of HBeAg seroconversion and HBsAg loss. A response-guided approach may identify patients with the greatest chance of success. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

26 CFR 1.956-3T - Certain trade or service receivables acquired from United States persons (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

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2010-04-01

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26 CFR 1.854-1 - Limitations applicable to dividends received from regulated investment company.

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2010-04-01

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34 CFR 691.15 - Eligibility to receive a grant.

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2013-07-01

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2012-07-01

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2011-07-01

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7 CFR 1776.14 - Eligibility to receive a HWWS loan.

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2011-01-01

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7 CFR 1776.5 - Eligibility to receive a HWWS grant.

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2010-01-01

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7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2012 CFR

2012-01-01

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7 CFR 1776.14 - Eligibility to receive a HWWS loan.

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2010-01-01

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7 CFR 1776.14 - Eligibility to receive a HWWS loan.

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2014-01-01

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7 CFR 1776.5 - Eligibility to receive a HWWS grant.

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2011-01-01

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7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

7 CFR 1776.5 - Eligibility to receive a HWWS grant.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Eligibility to receive a HWWS grant. 1776.5 Section 1776.5 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Grants § 1776.5...

7 CFR 1776.14 - Eligibility to receive a HWWS loan.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Eligibility to receive a HWWS loan. 1776.14 Section 1776.14 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM HWWS Loans § 1776.14...

34 CFR 379.54 - What are the reporting requirements for the compliance indicators?

Code of Federal Regulations, 2011 CFR

2011-07-01

... indicators? 379.54 Section 379.54 Education Regulations of the Offices of the Department of Education... INDUSTRY What Compliance Indicator Requirements Must a Grantee Meet To Receive Continuation Funding? § 379.54 What are the reporting requirements for the compliance indicators? (a) To receive continuation...

34 CFR 379.54 - What are the reporting requirements for the compliance indicators?

Code of Federal Regulations, 2010 CFR

2010-07-01

... indicators? 379.54 Section 379.54 Education Regulations of the Offices of the Department of Education... INDUSTRY What Compliance Indicator Requirements Must a Grantee Meet To Receive Continuation Funding? § 379.54 What are the reporting requirements for the compliance indicators? (a) To receive continuation...

PubMed Central

Bilodeau, Marcel; Roy, Joseph

1963-01-01

This paper describes the results obtained in 200 patients with bronchopulmonary suppurative diseases who received kanamycin aerosol therapy under intermittent positive pressure and in whom bacterial sensitivity study (antibiogram) was favourable. This method of treatment was well tolerated and was practically free of side effects. In most cases the improvement was rapid, was maintained and was often life-saving. The first series contained nine patients with pulmonary tuberculosis and a constant finding of sputum positive for Koch bacillus; four of these became negative after eight weeks of treatment. This suggested that kanamycin aerosol therapy had some effect on the Koch bacillus and that the study should be continued with a much larger group of patients with tuberculous suppurative pulmonary diseases to determine the efficacy of this antibiotic. ImagesFig. 1aFig. 1bFig. 2aFig. 2bFig. 3aFig. 3bFig. 4aFig. 4bFig. 5aFig. 5b PMID:14045345

Generation of Unbiased Ionospheric Corrections in Brazilian Region for GNSS positioning based on SSR concept

NASA Astrophysics Data System (ADS)

Monico, J. F. G.; De Oliveira, P. S., Jr.; Morel, L.; Fund, F.; Durand, S.; Durand, F.

2017-12-01

Mitigation of ionospheric effects on GNSS (Global Navigation Satellite System) signals is very challenging, especially for GNSS positioning applications based on SSR (State Space Representation) concept, which requires the knowledge of spatial correlated errors with considerable accuracy level (centimeter). The presence of satellite and receiver hardware biases on GNSS measurements difficult the proper estimation of ionospheric corrections, reducing their physical meaning. This problematic can lead to ionospheric corrections biased of several meters and often presenting negative values, which is physically not possible. In this contribution, we discuss a strategy to obtain SSR ionospheric corrections based on GNSS measurements from CORS (Continuous Operation Reference Stations) Networks with minimal presence of hardware biases and consequently physical meaning. Preliminary results are presented on generation and application of such corrections for simulated users located in Brazilian region under high level of ionospheric activity.

Diabetes education via mobile text messaging.

PubMed

Wangberg, Silje C; Arsand, Eirik; Andersson, Niklas

2006-01-01

Living with diabetes makes great educational demands on a family. We have tested the feasibility of using the mobile phone short message service (SMS) for reaching people with diabetes information. We also assessed user satisfaction and perceived pros and cons of the medium through interviews. Eleven parents of children with type 1 diabetes received messages for 11 weeks. The parents were positive about the system and said that they would like to continue to use it. The pop-up reminding effect of SMS messages in busy everyday life was noted as positive. Some parents experienced the messages as somewhat intrusive, arriving too often and at inconvenient times. The parents also noted the potential of the messages to facilitate communication with their adolescent children. The inability to store all of the messages or to print them out were seen as major disadvantages. Overall, the SMS seems to hold promise as means of delivering diabetes information.

Validity of police contacts as a performance indicator for the public mental health care system in Amsterdam: an open cohort study.

PubMed

Lauriks, S; Buster, M C A; de Wit, M A S; Arah, O A; Hoogendoorn, A W; Peen, J; Klazinga, N S

2018-06-01

The Public Mental Health Care (PMHC) system is a network of public services and care- and support institutions financed from public funds. Performance indicators based on the registration of police contacts could be a reliable and useful source of information for the stakeholders of the PMHC system to monitor performance. This study aimed to provide evidence on the validity of using police contacts as a performance indicator to assess the continuity of care in the PMHC system. Data on services received, police contacts and detention periods of 1928 people that entered the PMHC system in the city of Amsterdam were collected over a period of 51 months. Continuity of care was defined as receiving more than 90 days of uninterrupted service. The associations between police contacts and continuity were analyzed with multilevel Poisson and multivariate linear regression modeling. Clients had on average 2.12 police contacts per person-year. Clients with police contacts were younger, more often single, male, and more often diagnosed with psychiatric or substance abuse disorders than clients without police contacts. Incidence rates of police contacts were significantly lower for clients receiving continuous care than for clients receiving discontinuous care. The number of police contacts of clients receiving PMHC coordination per month was found to be a significant predictor of the percentage of clients in continuous care. The number of police contacts of clients can be used as a performance indicator for an urban PMHC system to evaluate the continuity of care in the PMHC system.

Fusion of Location Fingerprinting and Trilateration Based on the Example of Differential Wi-Fi Positioning

NASA Astrophysics Data System (ADS)

Retscher, G.

2017-09-01

Positioning of mobile users in indoor environments with Wireless Fidelity (Wi-Fi) has become very popular whereby location fingerprinting and trilateration are the most commonly employed methods. In both the received signal strength (RSS) of the surrounding access points (APs) are scanned and used to estimate the user's position. Within the scope of this study the advantageous qualities of both methods are identified and selected to benefit their combination. By a fusion of these technologies a higher performance for Wi-Fi positioning is achievable. For that purpose, a novel approach based on the well-known Differential GPS (DGPS) principle of operation is developed and applied. This approach for user localization and tracking is termed Differential Wi-Fi (DWi-Fi) by analogy with DGPS. From reference stations deployed in the area of interest differential measurement corrections are derived and applied at the mobile user side. Hence, range or coordinate corrections can be estimated from a network of reference station observations as it is done in common CORS GNSS networks. A low-cost realization with Raspberry Pi units is employed for these reference stations. These units serve at the same time as APs broadcasting Wi-Fi signals as well as reference stations scanning the receivable Wi-Fi signals of the surrounding APs. As the RSS measurements are carried out continuously at the reference stations dynamically changing maps of RSS distributions, so-called radio maps, are derived. Similar as in location fingerprinting this radio maps represent the RSS fingerprints at certain locations. From the areal modelling of the correction parameters in combination with the dynamically updated radio maps the location of the user can be estimated in real-time. The novel approach is presented and its performance demonstrated in this paper.

A simulation of GPS and differential GPS sensors

NASA Technical Reports Server (NTRS)

Rankin, James M.

1993-01-01

The Global Positioning System (GPS) is a revolutionary advance in navigation. Users can determine latitude, longitude, and altitude by receiving range information from at least four satellites. The statistical accuracy of the user's position is directly proportional to the statistical accuracy of the range measurement. Range errors are caused by clock errors, ephemeris errors, atmospheric delays, multipath errors, and receiver noise. Selective Availability, which the military uses to intentionally degrade accuracy for non-authorized users, is a major error source. The proportionality constant relating position errors to range errors is the Dilution of Precision (DOP) which is a function of the satellite geometry. Receivers separated by relatively short distances have the same satellite and atmospheric errors. Differential GPS (DGPS) removes these errors by transmitting pseudorange corrections from a fixed receiver to a mobile receiver. The corrected pseudorange at the moving receiver is now corrupted only by errors from the receiver clock, multipath, and measurement noise. This paper describes a software package that models position errors for various GPS and DGPS systems. The error model is used in the Real-Time Simulator and Cockpit Technology workstation simulations at NASA-LaRC. The GPS/DGPS sensor can simulate enroute navigation, instrument approaches, or on-airport navigation.

Do social functioning and symptoms improve with continuation antidepressant treatment of persistent depressive disorder? An observational study.

PubMed

Hellerstein, David J; Hunnicutt-Ferguson, Kallio; Stewart, Jonathan W; McGrath, Patrick J; Keller, Samantha; Peterson, Bradley S; Chen, Ying

2017-03-01

To determine efficacy of continued treatment with the serotonin norepinephrine reuptake inhibitor duloxetine on symptom reduction and functional improvement in outpatients with dysthymia. Fifty outpatients with DSM-IV-TR diagnosed dysthymia who had participated in a 10 week double-blind, placebo-controlled study of duloxetine received open treatment for three months. Nineteen duloxetine responders continued duloxetine, 24 patients initially treated with placebo started open duloxetine treatment, and 7 duloxetine non-responders were treated with desvenlafaxine or bupropion, selected by clinician choice. Patients continuing duloxetine maintained symptom improvement, 84% meeting response and 63% remission criteria at week 22. Patients initially treated with placebo showed similarly high levels of response (83%) and remission (62%) at week 22, and most duloxetine non-responders subsequently responded to other antidepressants. Duloxetine-continuation patients improved modestly between weeks 10 and 22 on measures of social and cognitive functioning and temperament. Despite this improvement concurrently across several functional domains, 66.7% of patients continuing duloxetine remained in the impaired range of functioning according to the Social Adjustment Scale (SAS). Continued duloxetine treatment appears to be effective in maintaining symptom response in dysthymic disorder, and has positive effects on social functioning. However, the majority of patients do not show normalization of functioning, even when controlling for remission status. Additional treatments should be considered to target residual impairments in social functioning in mood remitted patients with persistent depressive disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Prospective evaluation of patient-reported outcomes during treatment with deferasirox or deferoxamine for iron overload in patients with beta-thalassemia.

PubMed

Cappellini, Maria Domenica; Bejaoui, Mohamed; Agaoglu, Leyla; Porter, John; Coates, Thomas; Jeng, Michael; Lai, Maria Eliana; Mangiagli, Antonio; Strauss, Gabriele; Girot, Robert; Watman, Nora; Ferster, Alina; Loggetto, Sandra; Abish, Sharon; Cario, Holger; Zoumbos, Nicolaos; Vichinsky, Elliott; Opitz, Herbert; Ressayre-Djaffer, Catherine; Abetz, Linda; Rofail, Diana; Baladi, Jean-Francois

2007-05-01

Iron chelation therapy (ICT) with deferoxamine (DFO), the current standard for the treatment of iron overload in patients with transfusion-dependent disorders such as beta-thalassemia, requires regular subcutaneous or intravenous infusions. This can lead to reduced quality of life and poor adherence, resulting in increased morbidity and mortality in iron-overloaded patients with beta-thalassemia. Deferasirox is an orally administered iron chelator that has been approved for use in the United States, Switzerland, and other countries. This analysis was conducted to compare patient-reported outcomes (PROs) during receipt of DFO infusions or once-daily oral therapy with deferasirox (ICL670). PROs were prospectively evaluated as part of a randomized, Phase III study comparing the efficacy and safety profile of DFO 20 to 60 mg/kg per day with those of deferasirox 5 to 30 mg/kg per day in patients (age > or =2 years) with beta-thalassemia who were receiving regular transfusions and had a liver iron concentration of > or =2 mg/g dry weight. PRO questionnaires were completed by patients or a parent or legal guardian at baseline, week 4, week 24, and end of study (EOS). Patients assessed their level of satisfaction with study treatment (very satisfied, satisfied, neutral, dissatisfied, or very dissatisfied) and rated its convenience (very convenient, convenient, neutral, inconvenient, or very inconvenient). Time lost from normal activities due to ICT in the previous 4 weeks was recorded using a single global assessment. At week 4, patients who had previous experience with DFO were asked to indicate their preference for treatment (ICT received before the study, ICT received during the study, no preference, or no response) and the reason for that preference. At EOS, all patients were asked if they would be willing to continue using the ICT they had received during the study. All study analyses were performed in all patients who received at least 1 dose of study medication. Five hundred eighty-six patients (304 females, 282 males; age range, 2-53 years) received treatment with DFO (n = 290) or deferasirox (n = 296). Significantly more patients treated with deferasirox reported being very satisfied or satisfied with treatment compared with those treated with DFO (week 4: 92.0% vs 50.4%, respectively; week 24: 89.6% vs 44.0%; EOS: 85.1% vs 38.7%; all, P < 0.001). At the same time points, the majority of those treated with deferasirox reported that treatment was very convenient or convenient compared with those treated with DFO (95.5% vs 21.3%, 91.7% vs 17.4%, and 92.7% vs 11.3%, respectively; all, P < 0.001). Among patients who had previously taken DFO and were randomized to receive deferasirox during the study, 96.9% reported a preference for deferasirox over DFO. At EOS, the proportion of patients indicating a willingness to continue study therapy was significantly greater in those receiving deferasirox than in those receiving DFO (85.8% vs 13.8%; P < 0.001). In this study, patient-reported satisfaction and convenience were significantly higher for the once-daily, oral ICT deferasirox than for DFO infusions. Among patients who had received DFO before the study, the majority indicated a preference for deferasirox over DFO. Most patients receiving deferasirox indicated that they would be willing to continue taking it. These results suggest that deferasirox had a positive impact on patients' daily lives.

USGS Menlo Park GPS Data Processing Techniques and Derived North America Velocity Field (Invited)

NASA Astrophysics Data System (ADS)

Svarc, J. L.; Murray-Moraleda, J. R.; Langbein, J. O.

2010-12-01

The U.S. Geological Survey in Menlo Park routinely conducts repeated GPS surveys of geodetic markers throughout the western United States using dual-frequency geodetic GPS receivers. We combine campaign, continuous, and semi-permanent data to present a North America fixed velocity field for regions in the western United States. Mobile campaign-based surveys require less up-front investment than permanently monumented and telemetered GPS systems, and hence have achieved a broad and dense spatial coverage. The greater flexibility and mobility comes at the cost of greater uncertainties in individual daily position solutions. We also routinely process continuous GPS data collected at PBO stations operated by UNAVCO along with data from other continuous GPS networks such as BARD, PANGA, and CORS operated by other agencies. We have broken the Western US into several subnetworks containing approximately 150-250 stations each. The data are processed using JPL’s GIPSY-OASIS II release 5.0 software using a modified precise positioning strategy (Zumberge and others, 1997). We use the “ambizap” code provided by Geoff Blewitt (Blewitt, 2008) to fix phase ambiguities in continuous networks. To mitigate the effect of common mode noise we use the positions of stations in the network with very long, clean time series (i.e. those with no large outliers or offsets) to transform all position estimates into “regionally filtered” results following the approach of Hammond and Thatcher (2007). Velocity uncertainties from continuously operated GPS stations tend to be about 3 times smaller than those from campaign data. Langbein (2004) presents a maximum likelihood method for fitting a time series employing a variety of temporal noise models. We assume that GPS observations are contaminated by a combination of white, flicker, and random walk noise. For continuous and semi-permanent time series longer than 2 years we estimate these values, otherwise we fix the amplitudes of these processes to 0.85 mm, 1.7 mm/yr1/4, and 0.4 mm/yr1/2 respectively for the north components, 0.84 mm, 1.4 mm/yr1/4, and 0.6 mm/yr1/2 respectively for the east components and 3.2 mm, 6.4 mm/yr1/4, and 0.0 mm/yr1/2 respectively for the vertical. We have also deployed “semi-permanent” stations in selected regions of California. Semi-permanent stations have the advantage of increasing the density of coverage without the high cost of monumentation and telemetry associated with continuous GPS stations. Also, because of the increased temporal coverage of these stations, accurate estimates of station velocities can be achieved in a far shorter time period than from campaign mode surveys.

[Therapeutic efficacy of nootropil different doses in attention deficit hyperactivity disorder].

PubMed

Zavadenko, N N; Suvorinova, S Iu

2004-01-01

Attention Deficit Hyperactivity Disorder (ADHD) is the most common cause of behavioral and learning problems in childhood. Therapeutic efficiency of nootropil (piracetam) in two different doses has been evaluated in the open control study of 80 children with ADHD, 70 boys and 10 girls, aged 6-11 years, being divided into 3 groups. Two groups received nootropil, as a monotherapy, for a month: 1st group (30 patients)--in the dosage of 70 mg/kg daily and 2nd group (30 patients)--40 mg/kg daily orally. The control group of 20 patients did not receive any treatment. All children were examined twice with one month interval. A procedure of assessment included of structured questionnaire to parents, neurological examination with scored evaluation of subtle signs and psychological testing. Nootropil therapy in ADHD children resulted in the improvement of behavioral characteristics, motor coordination as well as continuous, selective and divided attention. A response rate was 60% in patients received 70 mg/kg of nootropil and 43% for nootropil dosage of 40 mg/kg. The results of the study suggest more considerable positive therapeutic effects of nootropil higher dose on behavioral, motor and attention characteristics in children with ADHD.

Peritoneal small solute transport rate is related to the malnutrition inflammation score in peritoneal dialysis patients.

PubMed

Sezer, Siren; Elsurer, Rengin; Afsar, Baris; Arat, Zubeyde; Ozdemir, Nurhan F; Haberal, Mehmet

2007-01-01

A high peritoneal membrane transport status and peritoneal albumin leakage are determinants of morbidity and mortality in patients receiving continuous ambulatory peritoneal dialysis. In this study, we analyzed the relationship between the malnutrition inflammation score, peritoneal transport status, and 24-hour peritoneal albumin leakage in patients receiving peritoneal dialysis. Sixty-six patients receiving peritoneal dialysis (male-female ratio 30/36; age 46.2 +/- 14.1 years; mean duration of peritoneal dialysis 32.4 +/- 23.9 months) who had experienced no attacks of peritonitis within the prior 6 months were included. The malnutrition inflammation score was positively correlated with the serum C-reactive protein concentration, dialysate/plasma creatinine ratio, and 24-hour peritoneal albumin leakage. Triceps and biceps skinfold thicknesses and serum concentrations of prealbumin, total cholesterol, and triglyceride were negatively correlated with the malnutrition inflammation score. Multiple linear regression analysis showed that the malnutrition inflammation score was independently associated with the dialysate/plasma creatinine ratio (p = 0.039) and 24-hour peritoneal albumin amount (p = 0.005). High peritoneal transport status and peritoneal albumin leakage are significantly associated with the malnutrition inflammation score. (c) 2007 S. Karger AG, Basel

Performance analysis of an IMU-augmented GNSS tracking system on board the MAIUS-1 sounding rocket

NASA Astrophysics Data System (ADS)

Braun, Benjamin; Grillenberger, Andreas; Markgraf, Markus

2018-05-01

Satellite navigation receivers are adequate tracking sensors for range safety of both orbital launch vehicles and suborbital sounding rockets. Due to high accuracy and its low system complexity, satellite navigation is seen as well-suited supplement or replacement of conventional tracking systems like radar. Having the well-known shortcomings of satellite navigation like deliberate or unintentional interferences in mind, it is proposed to augment the satellite navigation receiver by an inertial measurement unit (IMU) to enhance continuity and availability of localization. The augmented receiver is thus enabled to output at least an inertial position solution in case of signal outages. In a previous study, it was shown by means of simulation using the example of Ariane 5 that the performance of a low-grade microelectromechanical IMU is sufficient to bridge expected outages of some ten seconds, and still meeting the range safety requirements in effect. In this publication, these theoretical findings shall be substantiated by real flight data that were recorded on MAIUS-1, a sounding rocket launched from Esrange, Sweden, in early 2017. The analysis reveals that the chosen representative of a microelectromechanical IMU is suitable to bridge outages of up to thirty seconds.

Mindfulness and the attenuation of post-event processing in social phobia: an experimental investigation.

PubMed

Cassin, Stephanie E; Rector, Neil A

2011-01-01

The present experimental study examined the ability of metacognitive strategies to reduce the distress associated with post-event processing (PEP). Individuals with DSM-IV generalized social phobia (N = 57) were randomly allocated to receive brief training in mindfulness, distraction, or no training (control group). Next, they underwent an experimental PEP induction. Following the induction, they were instructed to apply the metacognitive strategy (mindfulness or distraction) they were taught or to continue thinking about the social event the way they typically would following such an event (control). Participants rated their distress on a visual analogue scale prior to the PEP induction, and then every minute for 5 min while applying the metacognitive strategy. They also rated their affect immediately after applying the metacognitive strategy. Results suggest that mindfulness reduces distress significantly over the post-event period and results in significantly more positive affect than when receiving no training. In contrast, distraction does not reduce distress over the post-event period performs comparable to receiving no training. The results of this experimental investigation suggest that mindfulness has the potential to reduce distress associated with PEP and provide further support for the clinical utility of mindfulness in the treatment of generalized social phobia.

Effect of prenatal vitamin supplementation on lower-genital levels of HIV type 1 and interleukin type 1 beta at 36 weeks of gestation.

PubMed

Fawzi, Wafaie; Msamanga, Gernard; Antelman, Gretchen; Xu, Chong; Hertzmark, Ellen; Spiegelman, Donna; Hunter, David; Anderson, Deborah

2004-03-01

Micronutrient status has been associated with shedding of human immunodeficiency virus type 1 (HIV-1) in the lower-genital tract in observational studies. We examined the effect of vitamin supplements on genital HIV-1 shedding and interleukin-1 beta (IL-1 beta ), a cytokine marker of vaginal inflammation and promotion of HIV-1 infection. Consenting HIV-1-infected pregnant women were randomized to receive daily supplementation with vitamin A and/or multivitamins B-complex, C, and E with use of a factorial design. Cervicovaginal lavage (CVL) specimens were obtained shortly before delivery. Significantly more women who received vitamin A had detectable levels of HIV-1 in CVL (74.8%), compared with those who did not receive vitamin A (65.1%) (P=.04, by multivariate analysis). Multivitamin B-complex, C, and E had no effect on the risk of viral shedding. Our results raise concern about the use of vitamin A supplements by HIV-1-infected women. Use of prenatal multivitamin supplements (including vitamins B-complex, C, and E) should be continued despite the lack of effect on HIV-1 transmission because of previously reported positive effects on maternal health and pregnancy outcomes.

The Experiences of School Nurses Caring for Students Receiving Continuous Subcutaneous Insulin Infusion Therapy

ERIC Educational Resources Information Center

Darby, Wendy

2006-01-01

Diabetes mellitus is the most common metabolic disorder in childhood. Today, children with diabetes are receiving new technologically advanced treatment options, such as continuous subcutaneous insulin infusion (CSII) therapy. School nurses are the primary health caregivers of children with diabetes during school hours. Therefore, it is important…

20 CFR 416.990 - When and how often we will conduct a continuing disability review.

Code of Federal Regulations, 2010 CFR

2010-04-01

... continuing disability review. 416.990 Section 416.990 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...(a) of the Social Security Act if you receive benefits based on disability or § 416.986 of this... and have received social security benefits as well as supplemental security income payments. (b) When...

29 CFR 1915.172 - Portable air receivers and other unfired pressure vessels.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Portable air receivers and other unfired pressure vessels. 1915.172 Section 1915.172 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT Portable, Unfired Pressure...

5 CFR 894.304 - Am I eligible to enroll if I'm retired or receiving workers' compensation?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Am I eligible to enroll if I'm retired or receiving workers' compensation? 894.304 Section 894.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

5 CFR 894.304 - Am I eligible to enroll if I'm retired or receiving workers' compensation?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Am I eligible to enroll if I'm retired or receiving workers' compensation? 894.304 Section 894.304 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

49 CFR 599.401 - Requirements and limitations for disposal facilities that receive trade-in vehicles under the...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Requirements and limitations for disposal facilities that receive trade-in vehicles under the CARS program. 599.401 Section 599.401 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED)...

20 CFR 416.990 - When and how often we will conduct a continuing disability review.

Code of Federal Regulations, 2012 CFR

2012-04-01

... continuing disability review. 416.990 Section 416.990 Employees' Benefits SOCIAL SECURITY ADMINISTRATION...(a) of the Social Security Act if you receive benefits based on disability or § 416.986 of this... and have received social security benefits as well as supplemental security income payments. (b) When...

Cheating following success and failure in heavy and moderate social drinkers.

PubMed

Corcoran, K J; Hankey, J

1989-07-01

Two groups of American undergraduates (moderate and heavy social drinkers) completed a matrix task and received either positive or negative feedback on their performance. Following this they were given a maze task, which was designed so that cheating could be detected. Heavy drinkers cheated more than moderate drinkers under success conditions (positive feedback). Heavy drinkers who received positive feedback also cheated more than heavy drinkers who received negative feedback. The results are interpreted in terms of self-handicapping theory.

Well-Being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support

PubMed Central

Kroemeke, Aleksandra; Gruszczynska, Ewa

2016-01-01

Background The aim of the study was to examine the cross-sectional and longitudinal effects of provided and received support on older adults’ subjective well-being (positive affect and depression) and to examine whether being a recipient of institutional care moderates these effects. Methods Social support (provided and received), positive affect, and depressive symptoms were assessed twice (at baseline and 1 month later) for 277 older adults (age 77.39 ± 9.20 years, 67.50% women, 65% residents of an institutional care facility). Findings Two structural equation models were analyzed: cross-sectional (at baseline) and longitudinal (after 1 month). The first model revealed a significant positive relationship between providing and receiving support and positive affect, and a negative relationship between receiving support and depression. However, being a recipient of institutional care appeared to be a significant moderator in the longitudinal model. Specifically, the findings indicated effects of both providing and receiving support on positive affect but only for noninstitutionalized older adults. Discussion Although both types of support may be beneficial for older adults, their effects depend on the nature of social exchange and the dimensions of well-being. This suggests that such factors should be systematically investigated in future research. PMID:27548721

Bayes to the Rescue: Continuous Positive Airway Pressure Has Less Mortality Than High-Flow Oxygen.

PubMed

Modesto I Alapont, Vicent; Khemani, Robinder G; Medina, Alberto; Del Villar Guerra, Pablo; Molina Cambra, Alfred

2017-02-01

The merits of high-flow nasal cannula oxygen versus bubble continuous positive airway pressure are debated in children with pneumonia, with suggestions that randomized controlled trials are needed. In light of a previous randomized controlled trial showing a trend for lower mortality with bubble continuous positive airway pressure, we sought to determine the probability that a new randomized controlled trial would find high-flow nasal cannula oxygen superior to bubble continuous positive airway pressure through a "robust" Bayesian analysis. Sample data were extracted from the trial by Chisti et al, and requisite to "robust" Bayesian analysis, we specified three prior distributions to represent clinically meaningful assumptions. These priors (reference, pessimistic, and optimistic) were used to generate three scenarios to represent the range of possible hypotheses. 1) "Reference": we believe bubble continuous positive airway pressure and high-flow nasal cannula oxygen are equally effective with the same uninformative reference priors; 2) "Sceptic on high-flow nasal cannula oxygen": we believe that bubble continuous positive airway pressure is better than high-flow nasal cannula oxygen (bubble continuous positive airway pressure has an optimistic prior and high-flow nasal cannula oxygen has a pessimistic prior); and 3) "Enthusiastic on high-flow nasal cannula oxygen": we believe that high-flow nasal cannula oxygen is better than bubble continuous positive airway pressure (high-flow nasal cannula oxygen has an optimistic prior and bubble continuous positive airway pressure has a pessimistic prior). Finally, posterior empiric Bayesian distributions were obtained through 100,000 Markov Chain Monte Carlo simulations. In all three scenarios, there was a high probability for more death from high-flow nasal cannula oxygen compared with bubble continuous positive airway pressure (reference, 0.98; sceptic on high-flow nasal cannula oxygen, 0.982; enthusiastic on high-flow nasal cannula oxygen, 0.742). The posterior 95% credible interval on the difference in mortality identified a future randomized controlled trial would be extremely unlikely to find a mortality benefit for high-flow nasal cannula oxygen over bubble continuous positive airway pressure, regardless of the scenario. Interpreting these findings using the "range of practical equivalence" framework would recommend rejecting the hypothesis that high-flow nasal cannula oxygen is superior to bubble continuous positive airway pressure for these children. For children younger than 5 years with pneumonia, high-flow nasal cannula oxygen has higher mortality than bubble continuous positive airway pressure. A future randomized controlled trial in this population is unlikely to find high-flow nasal cannula oxygen superior to bubble continuous positive airway pressure.

Environment Canada cuts threaten the future of science and international agreements

NASA Astrophysics Data System (ADS)

Thompson, Anne M.; Salawitch, Ross J.; Hoff, Raymond M.; Logan, Jennifer A.; Einaudi, Franco

2012-02-01

In August 2011, 300 Environment Canada scientists and staff working on environmental monitoring and protection learned that their jobs would be terminated, and an additional 400-plus Environment Canada employees received notice that their positions were targeted for elimination. These notices received widespread coverage in the Canadian media and international attention in Nature News. Environment Canada is a government agency responsible for meteorological services as well as environmental research. We are concerned that research and observations related to ozone depletion, tropospheric pollution, and atmospheric transport of toxic chemicals in the northern latitudes may be seriously imperiled by the budget cuts that led to these job terminations. Further, we raise the questions being asked by the international community, scientists, and policy makers alike: First, will Canada be able to meet its obligations to the monitoring and assessment studies that support the various international agreements inTable 1? Second, will Canada continue to be a leader in Arctic research.

Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients.

PubMed

Carmack Taylor, Cindy L; Demoor, Carl; Smith, Murray A; Dunn, Andrea L; Basen-Engquist, Karen; Nielsen, Ingrid; Pettaway, Curtis; Sellin, Rena; Massey, Pamela; Gritz, Ellen R

2006-10-01

Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients.

The use of adjuvant radiotherapy in elderly patients with early-stage breast cancer: changes in practice patterns after publication of Cancer and Leukemia Group B 9343.

PubMed

Palta, Manisha; Palta, Priya; Bhavsar, Nrupen A; Horton, Janet K; Blitzblau, Rachel C

2015-01-15

The Cancer and Leukemia Group B (CALGB) 9343 randomized phase 3 trial established lumpectomy and adjuvant therapy with tamoxifen alone, rather than both radiotherapy and tamoxifen, as a reasonable treatment course for women aged >70 years with clinical stage I (AJCC 7th edition), estrogen receptor-positive breast cancer. An analysis of the Surveillance, Epidemiology, and End Results (SEER) registry was undertaken to assess practice patterns before and after the publication of this landmark study. The SEER database from 2000 to 2009 was used to identify 40,583 women aged ≥70 years who were treated with breast-conserving surgery for clinical stage I, estrogen receptor-positive and/or progesterone receptor-positive breast cancer. The percentage of patients receiving radiotherapy and the type of radiotherapy delivered was assessed over time. Administration of radiotherapy was further assessed across age groups; SEER cohort; and tumor size, grade, and laterality. Approximately 68.6% of patients treated between 2000 and 2004 compared with 61.7% of patients who were treated between 2005 and 2009 received some form of adjuvant radiotherapy (P < .001). Coinciding with a decline in the use of external beam radiotherapy, there was an increase in the use of implant radiotherapy from 1.4% between 2000 and 2004 to 6.2% between 2005 to 2009 (P < .001). There were significant reductions in the frequency of radiotherapy delivery over time across age groups, tumor size, and tumor grade and regardless of laterality (P < .001 for all). Randomized phase 3 data support the omission of adjuvant radiotherapy in elderly women with early-stage breast cancer. Analysis of practice patterns before and after the publication of these data indicates a significant decline in radiotherapy use; however, nearly two-thirds of women continue to receive adjuvant radiotherapy. © 2014 American Cancer Society.

GPS Receiver On-Orbit Performance for the GOES-R Spacecraft

NASA Technical Reports Server (NTRS)

Winkler, Stephen; Ramsey, Graeme; Frey, Charles; Chapel, Jim; Chu, Donald; Freesland, Douglas; Krimchansky, Alexander; Concha, Marco

2017-01-01

This paper evaluates the on-orbit performance of the first civilian operational use of a Global Positioning System Receiver (GPSR) at a geostationary orbit (GEO). The GPSR is on-board the newly launched Geostationary Operational Environmental Satellite (GOES-R). GOES-R is the first of four next generation GEO weather satellites for NOAA, now in orbit GOES-R is formally identified as GOES-16. Among the pioneering technologies required to support its improved spatial, spectral and temporal resolution is a GPSR. The GOES-16 GPSR system is a new design that was mission critical and therefore received appropriate scrutiny. As ground testing of a GPSR for GEO can only be done by simulations with numerous assumptions and approximations regarding the current GPS constellation, this paper reveals what performance can be achieved in using on orbit data. Extremely accurate orbital position is achieved using GPS navigation at GEO. Performance results are shown demonstrating compliance with the1007575 meter and 6 cms radial/in-track/cross-track orbital position and velocity accuracy requirements of GOES-16. The aforementioned compliance includes station-keeping and momentum management maneuvers, contributing to no observational outages. This performance is achieved by a completely new system design consisting of a unique L1 GEOantenna, low-noise amplifier (LNA) assembly and a 12 channel GPSR capable of tracking the edge of the main beam and the side lobes of the GPS L1 signals. This paper presents the definitive answer that the GOES-16 GPSR solution exceeds all performance requirements tracking up to 12 satellites and achieving excellent carrier-to-noise density (C/N0). Additionally, these performance results show the practicality of this approach. This paper makes it clear that all future GEO Satellites should consider the addition of a GPSR in their spacecraft design, otherwise they may be sacrificing spacecraft capabilities and accuracy along with incurring increased and continual demand on ground support.

The first lady almoner: the appointment, position, and findings of Miss Mary Stewart at the Royal Free Hospital, 1895-99.

PubMed

Cullen, Lynsey T

2013-10-01

This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed "appropriate" received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations.

Extending the Capability of Mars Umbilical Technology Demonstrator

NASA Technical Reports Server (NTRS)

Houshangi, Nasser

2001-01-01

The objective of this project is to expand the capabilities of for the Mars Umbilical Technology Demonstrator (MUTD). The MUTD shall provide electrical power and fiber optic data cable connections between two simulated mars vehicles, 1000 in apart. ne wheeled mobile robot Omnibot is used to provide the mobile base for the system. The mate-to umbilical plate is mounted on a Cartesian robot, which is installed on the Omnibot mobile base. It is desirable to provide the operator controlling the Omnibot, the distance and direction to the target. In this report, an approach for finding the position and orientation of the mobile robot using inertial sensors and beacons is investigated. First phase of the project considered the Omnibot being on the flat surface. To deal with the uneven Mars environment, the orientation as well as position needs to be controlled. During local positioning, the information received from four ultrasonic sensors installed at the four corner of the mate-mi plate is used to identify the position of mate-to plate and mate the umbilical plates autonomously. The work proposed is the continuation of the principal investigator research effort as a participant in the 1999 NASA/ASEE Summer Faculty Fellowship Program.

Unique clinical and imaging findings in a first ever documented PCR positive rabies survival patient: A case report.

PubMed

M, Netravathi; V, Udani; Rs, Mani; V, Gadad; M A, Ashwini; M, Bhat; S, Mehta; A, Chowdhary; P K, Pal; S N, Madhusudana; P, Satishchandra

2015-09-01

Rabies is fatal encephalitis which is a major public health problem in Asian and African countries. Till date, only 12 cases have been reported who have survived after rabies. In this communication we report a patient who is unique as the first documented long term rabies survivor with PCR positivity even after 4½ years of illness. Child sustained dog bite following which he received adequate prophylaxis. Within two weeks, child developed encephalopathy requiring evaluation. Child continues to have persistent myoclonic jerks, seizures, is dependent on all activities with severe neurological deficits. Nested reverse transcriptase PCR (RT-PCR) specific for rabies nucleoprotein gene in CSF and nuchal skin biopsy were positive for rabies viral RNA. The nuchal skin biopsy was also positive for rabies nucleoprotein antigen by fluorescent antibody test (FAT). We describe the clinical evolution and sequential MRI brain changes in this child. Despite the uniformly dismal prognosis of human rabies, these unusual reports of survival of rabies patients may provide an impetus to explore newer therapeutic strategies for this otherwise fatal disease. Copyright © 2015 Elsevier B.V. All rights reserved.

The First Lady Almoner: The Appointment, Position, and Findings of Miss Mary Stewart at the Royal Free Hospital, 1895–99

PubMed Central

Cullen, Lynsey T.

2013-01-01

This article examines the professional roots of the hospital almoner, a position which has been widely neglected in medical history. The first almoner was Miss Mary Stewart, a former Charity Organization Society employee, appointed at the Royal Free Hospital of central London in 1895. The Royal Free was a charitable hospital which offered free medical treatment to patients considered morally deserving but unable to afford medical care elsewhere. The role expected of Stewart was to means test patients in order to ensure that only those deemed “appropriate” received free medical treatment, and to establish the extent to which the hospital was being abused by those who could afford to contribute toward their medical care. While in office, Stewart continually reshaped the role of almoner. She fashioned the position into that of a medical social worker and undertook such duties as referring patients to other means of medical and charitable assistance, visiting patients' homes, and training almoners for positions at other voluntary hospitals. Through the examination of Mary Stewart's Almoners Report Book, this article considers the circumstances of her appointment, the role she performed, and the findings of her investigations. PMID:22474098

Suspicion of Motives Predicts Minorities' Responses to Positive Feedback in Interracial Interactions.

PubMed

Major, Brenda; Kunstman, Jonathan W; Malta, Brenna D; Sawyer, Pamela J; Townsend, Sarah S M; Mendes, Wendy Berry

2016-01-01

Strong social and legal norms in the United States discourage the overt expression of bias against ethnic and racial minorities, increasing the attributional ambiguity of Whites' positive behavior to ethnic minorities. Minorities who suspect that Whites' positive overtures toward minorities are motivated more by their fear of appearing racist than by egalitarian attitudes may regard positive feedback they receive from Whites as disingenuous. This may lead them to react to such feedback with feelings of uncertainty and threat. Three studies examined how suspicion of motives relates to ethnic minorities' responses to receiving positive feedback from a White peer or same-ethnicity peer (Experiment 1), to receiving feedback from a White peer that was positive or negative (Experiment 2), and to receiving positive feedback from a White peer who did or did not know their ethnicity (Experiment 3). As predicted, the more suspicious Latinas were of Whites' motives for behaving positively toward minorities in general, the more they regarded positive feedback from a White peer who knew their ethnicity as disingenuous and the more they reacted with cardiovascular reactivity characteristic of threat/avoidance, increased feelings of stress, heightened uncertainty, and decreased self-esteem. We discuss the implications for intergroup interactions of perceptions of Whites' motives for nonprejudiced behavior.

Prevalence of hepatitis B among Afghan refugees living in Balochistan, Pakistan.

PubMed

Quddus, Arshad; Luby, Stephen P; Jamal, Zahid; Jafar, Tariq

2006-05-01

Continued civil war and political instability in Afghanistan have lead to a huge influx of refugees into the neighboring provinces in Pakistan. This study was conducted to estimate seroprevalence of hepatitis B and to identify potential risk factors for hepatitis B virus (HBV) transmission among the refugees living in the camps of Balochistan Province, Pakistan. A cross-sectional survey of hepatitis B surface antigen (HBsAg) was conducted during October 2003. We obtained the registration list to select families randomly from the refugee camps. A husband, wife and one of their children, selected at random, were enrolled in the study. Study subjects with positive laboratory results for HBsAg were compared with those who were negative for HBsAg. Field workers interviewed 301 families with a total of 903 study subjects. Blood specimens of 75 study subjects (8.3%, 95% CI 6.6-10.3) were positive for HBsAg. There were 37 husbands (12.3%, 95% CI 7.2-14.4) and 21 wives (7.0%, 95% CI 4.5-10.6) positive for HBsAg. Out of 301 children, 17 (5.6%, 95% CI 3.4-9.1) were positive for HBsAg. Receiving more than ten injections during the previous year increased the risk of HBV infection (OR 3.5, 95% CI 1.8-6.7). A child positive for HBsAg was more likely to have a positive parent compared to an HBsAg negative child (OR 5.7, 95% CI 2.0-16.5). Hepatitis B is highly endemic among Afghan refugees living in these camps. Unsafe injection practices will continue to cause a steady increase in the magnitude of this health problem until appropriate control measures are taken. The possibility of mother-to-child transmission underscores the need to include vaccination against hepatitis B as part of routine immunization in this population.

Single-frequency receivers as master permanent stations in GNSS networks: precision and accuracy of the positioning in mixed networks

NASA Astrophysics Data System (ADS)

Dabove, Paolo; Manzino, Ambrogio Maria

2015-04-01

The use of GPS/GNSS instruments is a common practice in the world at both a commercial and academic research level. Since last ten years, Continuous Operating Reference Stations (CORSs) networks were born in order to achieve the possibility to extend a precise positioning more than 15 km far from the master station. In this context, the Geomatics Research Group of DIATI at the Politecnico di Torino has carried out several experiments in order to evaluate the achievable precision obtainable with different GNSS receivers (geodetic and mass-market) and antennas if a CORSs network is considered. This work starts from the research above described, in particular focusing the attention on the usefulness of single frequency permanent stations in order to thicken the existing CORSs, especially for monitoring purposes. Two different types of CORSs network are available today in Italy: the first one is the so called "regional network" and the second one is the "national network", where the mean inter-station distances are about 25/30 and 50/70 km respectively. These distances are useful for many applications (e.g. mobile mapping) if geodetic instruments are considered but become less useful if mass-market instruments are used or if the inter-station distance between master and rover increases. In this context, some innovative GNSS networks were developed and tested, analyzing the performance of rover's positioning in terms of quality, accuracy and reliability both in real-time and post-processing approach. The use of single frequency GNSS receivers leads to have some limits, especially due to a limited baseline length, the possibility to obtain a correct fixing of the phase ambiguity for the network and to fix the phase ambiguity correctly also for the rover. These factors play a crucial role in order to reach a positioning with a good level of accuracy (as centimetric o better) in a short time and with an high reliability. The goal of this work is to investigate about the real effect and how is the contribute of L1 mass-market permanent stations to the CORSs Network both for geodetic and low-cost receivers; in particular is described how the use of the network products which are generated by the network (in real-time and post-processing) can improve the accuracy and precision of a rover 5, 10 and 15 km far from the nearest station. Some tests have been carried out considering different types of receivers (geodetic and mass market) and antennas (patch and geodetic). The tests have been conducted considering several positioning approaches (static, stop and go and real time) in order to make the analysis more complete. Good and interesting results were obtained: the followed approach will be useful for many types of applications (landslides monitoring, traffic control), especially where the inter-station distances of GNSS permanent station are greater than 30 km.

Tightly coupled integration of ionosphere-constrained precise point positioning and inertial navigation systems.

PubMed

Gao, Zhouzheng; Zhang, Hongping; Ge, Maorong; Niu, Xiaoji; Shen, Wenbin; Wickert, Jens; Schuh, Harald

2015-03-10

The continuity and reliability of precise GNSS positioning can be seriously limited by severe user observation environments. The Inertial Navigation System (INS) can overcome such drawbacks, but its performance is clearly restricted by INS sensor errors over time. Accordingly, the tightly coupled integration of GPS and INS can overcome the disadvantages of each individual system and together form a new navigation system with a higher accuracy, reliability and availability. Recently, ionosphere-constrained (IC) precise point positioning (PPP) utilizing raw GPS observations was proven able to improve both the convergence and positioning accuracy of the conventional PPP using ionosphere-free combined observations (LC-PPP). In this paper, a new mode of tightly coupled integration, in which the IC-PPP instead of LC-PPP is employed, is implemented to further improve the performance of the coupled system. We present the detailed mathematical model and the related algorithm of the new integration of IC-PPP and INS. To evaluate the performance of the new tightly coupled integration, data of both airborne and vehicle experiments with a geodetic GPS receiver and tactical grade inertial measurement unit are processed and the results are analyzed. The statistics show that the new approach can further improve the positioning accuracy compared with both IC-PPP and the tightly coupled integration of the conventional PPP and INS.

Compliance with and effectiveness of adaptive servoventilation versus continuous positive airway pressure in the treatment of Cheyne‐Stokes respiration in heart failure over a six month period

PubMed Central

Philippe, C; Stoïca‐Herman, M; Drouot, X; Raffestin, B; Escourrou, P; Hittinger, L; Michel, P‐L; Rouault, S; d'Ortho, M‐P

2006-01-01

Objective To compare compliance with and effectiveness of adaptive servoventilation (ASV) versus continuous positive airway pressure (CPAP) in patients with the central sleep apnoea syndrome (CSA) with Cheyne‐Stokes respiration (CSR) and with congestive heart failure in terms of the apnoea–hypopnoea index (AHI), quality of life, and left ventricular ejection fraction (LVEF) over six months. Methods 25 patients (age 28–80 years, New York Heart Association (NYHA) class II–IV) with stable congestive heart failure and CSA‐CSR were randomly assigned to either CPAP or ASV. At inclusion, both groups were comparable for NYHA class, LVEF, medical treatment, body mass index, and CSA‐CSR. Results Both ASV and CPAP decreased the AHI but, noticeably, only ASV completely corrected CSA‐CSR, with AHI below 10/h. At three months, compliance was comparable between ASV and CPAP; however, at six months compliance with CPAP was significantly less than with ASV. At six months, the improvement in quality of life was higher with ASV and only ASV induced a significant increase in LVEF. Conclusion These results suggest that patients with CSA‐CSR may receive greater benefit from treatment with ASV than with CPAP. PMID:15964943

The effect of sympathy on discriminatory attitudes toward persons living with HIV/AIDS in Puerto Rico: a hierarchical analysis of women living in public housing.

PubMed

Norman, Lisa R; Abreu, Silkha; Candelaria, Erika; Sala, Ana

2009-02-01

As the number of persons living with HIV/AIDS (PLWHA) continues to increase in Puerto Rico, it becomes increasingly important to address the issues of stigma and other discriminatory attitudes. Therefore, the objective of the present study is to examine the attitudes toward PLWHA of a large sample of women living in public housing in Puerto Rico, including sympathy and support for PLWHA in the workplace and in school. A total of 1138 women completed a self-administered 218-item survey made up of questions that measured HIV-related knowledge, attitudes and behaviors. Levels of sympathy varied depending upon the target group, with HIV-infected drug users receiving the least sympathy. Most women reported that HIV-positive teachers should be allowed to teach and that HIV-positive children should be allowed to attend school. However, a significantly lower percentage reported that HIV-infected nurses should be allowed to continue working. Women who were more sympathetic toward PLWHA were more tolerant of PLWHA in the workplace and school, while those with inaccurate knowledge concerning HIV transmission were less tolerant. Also, those who knew a PLWHA were more tolerant. Levels of discriminatory attitudes in Puerto Rico are high and warrant both individual- and societal-level interventions.

Impact of Nuclear Laboratory Personnel Credentials & Continuing Education on Nuclear Cardiology Laboratory Quality Operations.

PubMed

Malhotra, Saurabh; Sobieraj, Diana M; Mann, April; Parker, Matthew W

2017-12-22

Background/Objectives: The specific credentials and continuing education (CME/CE) of nuclear cardiology laboratory medical and technical staff are important factors in the delivery of quality imaging services that have not been systematically evaluated. Methods: Nuclear cardiology accreditation application data from the Intersocietal Accreditation Commission (IAC) was used to characterize facilities performing myocardial perfusion imaging by setting, size, previous accreditation and credentials of the medical and technical staff. Credentials and CME/CE were compared against initial accreditation decisions (grant or delay) using multivariable logistic regression. Results: Complete data were available for 1913 nuclear cardiology laboratories from 2011-2014. Laboratories with initial positive accreditation decisions had a greater prevalence of Certification Board in Nuclear Cardiology (CBNC) certified medical directors and specialty credentialed technical directors. Certification and credentials of the medical and technical directors, respectively, staff CME/CE compliance, and assistance of a consultant with the application were positively associated with accreditation decisions. Conclusion: Nuclear cardiology laboratories directed by CBNC-certified physicians and NCT- or PET-credentialed technologists were less likely to receive delay decisions for MPI. CME/CE compliance of both the medical and technical directors was associated with accreditation decision. Medical and technical directors' years of experience were not associated with accreditation decision. Copyright © 2017 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Monitoring and Prediction of Precipitable Water Vapor using GPS data in Turkey

NASA Astrophysics Data System (ADS)

Ansari, Kutubuddin; Althuwaynee, Omar F.; Corumluoglu, Ozsen

2016-12-01

Although Global Positioning System (GPS) primarily provide accurate estimates of position, velocity and time of the receiver, as the signals pass through the atmoshphere carrying its signatures, thus offers opportunities for atmoshpheric applications. Precipitable water vapor (PWV) is a vital component of the atmosphere and significantly influences atmospheric processes like rainfall and atmospheric temperature. The developing networks of continuously operating GPS can be used to efficiently estimate PWV. The Turkish Permanent GPS Network (TPGN) is employed to monitor PWV information in Turkey. This work primarily aims to derive long-term data of PWV by using atmospheric path delays observed through continuously operating TPGN from November 2014 to October 2015. A least square mathematical approach was then applied to establish the relation of the observed PWV to rainfall and temperature. The modeled PWV was correlated with PWV estimated from GPS data, with an average correlation of 67.10 %-88.60 %. The estimated root mean square error (RMSE) varied from 2.840 to 6.380, with an average of 4.697. Finally, data of TPGN, rainfall, and temperature were obtained for less than 2 months (November 2015 to December 2015) and assessed to validate the mathematical model. This study provides a basis for determining PWV by using rainfall and temperature data.

Motion Estimation Utilizing Range Detection-Enhanced Visual Odometry

NASA Technical Reports Server (NTRS)

Morris, Daniel Dale (Inventor); Chang, Hong (Inventor); Friend, Paul Russell (Inventor); Chen, Qi (Inventor); Graf, Jodi Seaborn (Inventor)

2016-01-01

A motion determination system is disclosed. The system may receive a first and a second camera image from a camera, the first camera image received earlier than the second camera image. The system may identify corresponding features in the first and second camera images. The system may receive range data comprising at least one of a first and a second range data from a range detection unit, corresponding to the first and second camera images, respectively. The system may determine first positions and the second positions of the corresponding features using the first camera image and the second camera image. The first positions or the second positions may be determined by also using the range data. The system may determine a change in position of the machine based on differences between the first and second positions, and a VO-based velocity of the machine based on the determined change in position.

Positron source position sensing detector and electronics

DOEpatents

Burnham, Charles A.; Bradshaw, Jr., John F.; Kaufman, David E.; Chesler, David A.; Brownell, Gordon L.

1985-01-01

A positron source, position sensing device, particularly with medical applications, in which positron induced gamma radiation is detected using a ring of stacked, individual scintillation crystals, a plurality of photodetectors, separated from the scintillation crystals by a light guide, and high resolution position interpolation electronics. Preferably the scintillation crystals are several times more numerous than the photodetectors with each crystal being responsible for a single scintillation event from a received gamma ray. The light guide will disperse the light emitted from gamma ray absorption over several photodetectors. Processing electronics for the output of the photodetectors resolves the location of the scintillation event to a fraction of the dimension of each photodetector. Because each positron absorption results in two 180.degree. oppositely traveling gamma rays, the detection of scintillation in pairs permits location of the positron source in a manner useful for diagnostic purposes. The processing electronics simultaneously responds to the outputs of the photodetectors to locate the scintillations to the source crystal. While it is preferable that the scintillation crystal include a plurality of stacked crystal elements, the resolving power of the processing electronics is also applicable to continuous crystal scintillators.

Inertial Pointing and Positioning System

NASA Technical Reports Server (NTRS)

Yee, Robert (Inventor); Robbins, Fred (Inventor)

1998-01-01

An inertial pointing and control system and method for pointing to a designated target with known coordinates from a platform to provide accurate position, steering, and command information. The system continuously receives GPS signals and corrects Inertial Navigation System (INS) dead reckoning or drift errors. An INS is mounted directly on a pointing instrument rather than in a remote location on the platform for-monitoring the terrestrial position and instrument attitude. and for pointing the instrument at designated celestial targets or ground based landmarks. As a result. the pointing instrument and die INS move independently in inertial space from the platform since the INS is decoupled from the platform. Another important characteristic of the present system is that selected INS measurements are combined with predefined coordinate transformation equations and control logic algorithms under computer control in order to generate inertial pointing commands to the pointing instrument. More specifically. the computer calculates the desired instrument angles (Phi, Theta. Psi). which are then compared to the Euler angles measured by the instrument- mounted INS. and forms the pointing command error angles as a result of the compared difference.

Everyday beliefs about sources of advice for the parents of difficult children.

PubMed

Sonuga-Barke, E J; Thompson, M; Balding, J

1993-01-01

Parents were asked which sources of advice families with difficult children should seek. The results suggested a similar hierarchy of agencies for both boys and girls with emotional and behavioural problems. Teachers, doctors, child psychiatrists and health visitors all received strong positive ratings, books about children with problems received moderate positive ratings, religious leaders received the strongest negative ratings and grandparents and friends received neutral ratings. Implications for service provision are discussed.

Comprehensive seismic monitoring of the Cascadia megathrust with real-time GPS

NASA Astrophysics Data System (ADS)

Melbourne, T. I.; Szeliga, W. M.; Santillan, V. M.; Scrivner, C. W.; Webb, F.

2013-12-01

We have developed a comprehensive real-time GPS-based seismic monitoring system for the Cascadia subduction zone based on 1- and 5-second point position estimates computed within the ITRF08 reference frame. A Kalman filter stream editor that uses a geometry-free combination of phase and range observables to speed convergence while also producing independent estimation of carrier phase biases and ionosphere delay pre-cleans raw satellite measurements. These are then analyzed with GIPSY-OASIS using satellite clock and orbit corrections streamed continuously from the International GNSS Service (IGS) and the German Aerospace Center (DLR). The resulting RMS position scatter is less than 3 cm, and typical latencies are under 2 seconds. Currently 31 coastal Washington, Oregon, and northern California stations from the combined PANGA and PBO networks are analyzed. We are now ramping up to include all of the remaining 400+ stations currently operating throughout the Cascadia subduction zone, all of which are high-rate and telemetered in real-time to CWU. These receivers span the M9 megathrust, M7 crustal faults beneath population centers, several active Cascades volcanoes, and a host of other hazard sources. To use the point position streams for seismic monitoring, we have developed an inter-process client communication package that captures, buffers and re-broadcasts real-time positions and covariances to a variety of seismic estimation routines running on distributed hardware. An aggregator ingests, re-streams and can rebroadcast up to 24 hours of point-positions and resultant seismic estimates derived from the point positions to application clients distributed across web. A suite of seismic monitoring applications has also been written, which includes position time series analysis, instantaneous displacement vectors, and peak ground displacement contouring and mapping. We have also implemented a continuous estimation of finite-fault slip along the Cascadia megathrust using a NIF-type approach. This currently operates on the terrestrial GPS data streams, but could readily be expanded to use real-time offshore geodetic measurements as well. The continuous slip distributions are used in turn to compute tsunami excitation and, when convolved with pre-computed, hydrodynamic Green functions calculated using the COMCOT tsunami modeling software, run-up estimates for the entire Cascadia coastal margin. Finally, a suite of data visualization tools has been written to allow interaction with the real-time position streams and seismic estimates based on them, including time series plotting, instantaneous offset vectors, peak ground deformation contouring, finite-fault inversions, and tsunami run-up. This suite is currently bundled within a single client written in JAVA, called ';GPS Cockpit,' which is available for download.

40 CFR 142.303 - Which size public water systems can receive a small system variance?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Which size public water systems can receive a small system variance? 142.303 Section 142.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances for Small System General...

17 CFR 275.204-1 - Amendments to application for registration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... you have received a continuing hardship exemption under § 275.203-3. (2) If you have received a... (CONTINUED) RULES AND REGULATIONS, INVESTMENT ADVISERS ACT OF 1940 § 275.204-1 Amendments to application for... a complete Part 1A of Form ADV on paper with the SEC by mailing it to FINRA. (c) Special rule for...

40 CFR 142.303 - Which size public water systems can receive a small system variance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Which size public water systems can receive a small system variance? 142.303 Section 142.303 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS IMPLEMENTATION Variances for Small System General...

Osteonecrosis of the jaw and the role of bisphosphonates: a critical review.

PubMed

Silverman, Stuart L; Landesberg, Regina

2009-02-01

Osteonecrosis of the jaw (ONJ), a condition characterized by necrotic exposed bone in the maxillofacial region, has been reported in patients with cancer receiving bisphosphonate therapy, and rarely in patients with postmenopausal osteoporosis or Paget disease of bone receiving such therapy. In the absence of a uniform definition, the American Academy of Oral and Maxillofacial Surgeons (AAOMS), the American Society for Bone and Mineral Research (ASBMR), and other groups have established similar diagnostic criteria for bisphosphonate-related ONJ, which is more commonly reported in patients with advanced malignancies with skeletal metastases who receive higher doses, and is more rarely reported in patients with osteoporosis and Paget disease who receive lower doses. However, a critical review of the literature reveals that the etiology of ONJ remains unknown, and to date no direct causal link to bisphosphonates has been established. Despite an increased awareness of ONJ and recent improvements in preventive strategies, patients and physicians alike continue to express concern about the potential risks of bisphosphonate treatment in both oncologic and nononcologic settings. Although much remains to be learned about this condition, including its true incidence in various patient populations, its pathophysiology, and optimal clinical management, evidence to date suggests that the positive benefits of bisphosphonates in patients with malignant bone disease, osteoporosis, or Paget disease outweigh the relatively small risk of ONJ.

Single photon imaging and timing array sensor apparatus and method

DOEpatents

Smith, R. Clayton

2003-06-24

An apparatus and method are disclosed for generating a three-dimension image of an object or target. The apparatus is comprised of a photon source for emitting a photon at a target. The emitted photons are received by a photon receiver for receiving the photon when reflected from the target. The photon receiver determines a reflection time of the photon and further determines an arrival position of the photon on the photon receiver. An analyzer is communicatively coupled to the photon receiver, wherein the analyzer generates a three-dimensional image of the object based upon the reflection time and the arrival position.

Audiological manifestations in HIV-positive adults.

PubMed

Matas, Carla Gentile; Angrisani, Rosanna Giaffredo; Magliaro, Fernanda Cristina Leite; Segurado, Aluisio Augusto Cotrim

2014-07-01

To characterize the findings of behavioral hearing assessment in HIV-positive individuals who received and did not receive antiretroviral treatment. This research was a cross-sectional study. The participants were 45 HIV-positive individuals (18 not exposed and 27 exposed to antiretroviral treatment) and 30 control-group individuals. All subjects completed an audiological evaluation through pure-tone audiometry, speech audiometry, and high-frequency audiometry. The hearing thresholds obtained by pure-tone audiometry were different between groups. The group that had received antiretroviral treatment had higher thresholds for the frequencies ranging from 250 to 3000 Hz compared with the control group and the group not exposed to treatment. In the range of frequencies from 4000 through 8000 Hz, the HIV-positive groups presented with higher thresholds than did the control group. The hearing thresholds determined by high-frequency audiometry were different between groups, with higher thresholds in the HIV-positive groups. HIV-positive individuals presented poorer results in pure-tone and high-frequency audiometry, suggesting impairment of the peripheral auditory pathway. Individuals who received antiretroviral treatment presented poorer results on both tests compared with individuals not exposed to antiretroviral treatment.

47 CFR 15.519 - Technical requirements for hand held UWB systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information to an associated receiver. The UWB intentional radiator shall cease transmission within 10 seconds... received. An acknowledgment of reception must continue to be received by the UWB intentional radiator at...

Inequality in Experiences of Physics Education: Secondary School Girls' and Boys' Perceptions of their Physics Education and Intentions to Continue with Physics After the Age of 16

NASA Astrophysics Data System (ADS)

Mujtaba, Tamjid; Reiss, Michael J.

2013-07-01

This paper explores the factors that are associated in England with 15-year-old students' intentions to study physics after the age of 16, when it is no longer compulsory. Survey responses were collated from 5,034 year 10 students as learners of physics during the academic year 2008-2009 from 137 England secondary schools. Our analysis uses individual items from the survey rather than constructs (aggregates of items) to explore what it is about physics teachers, physics lessons and physics itself that is most correlated with intended participation in physics after the age of 16. Our findings indicate that extrinsic material gain motivation in physics was the most important factor associated with intended participation. In addition, an item-level analysis helped to uncover issues around gender inequality in physics educational experiences which were masked by the use of construct-based analyses. Girls' perceptions of their physics teachers were similar to those of boys on many fronts. However, despite the encouragement individual students receive from their teachers being a key factor associated with aspirations to continue with physics, girls were statistically significantly less likely to receive such encouragement. We also found that girls had less positive experiences of their physics lessons and physics education than did boys.

Multi-modal cockpit interface for improved airport surface operations

NASA Technical Reports Server (NTRS)

Arthur, Jarvis J. (Inventor); Bailey, Randall E. (Inventor); Prinzel, III, Lawrence J. (Inventor); Kramer, Lynda J. (Inventor); Williams, Steven P. (Inventor)

2010-01-01

A system for multi-modal cockpit interface during surface operation of an aircraft comprises a head tracking device, a processing element, and a full-color head worn display. The processing element is configured to receive head position information from the head tracking device, to receive current location information of the aircraft, and to render a virtual airport scene corresponding to the head position information and the current aircraft location. The full-color head worn display is configured to receive the virtual airport scene from the processing element and to display the virtual airport scene. The current location information may be received from one of a global positioning system or an inertial navigation system.

Spatial Information Technology Center at Fulton-Montgomery Community College

NASA Technical Reports Server (NTRS)

2004-01-01

The Spatial Information Technology Center (SITC) at Fulton-Montgomery Community College (FMCC) continued to fulfill its mission and charter by successfully completing its fourth year of operations under Congressional funding and NASA sponsorship. Fourth year operations (01 Oct 03 - 30 Sep 04) have been funded and conducted utilizing an authorized Research Grant NAG 13-02053 (via a one-year no-cost extension expiring Sep 04). Drawdown and reporting of fiscal activities for SITC operations passes through the Institute for the Application of Geo-spatial Technology (IAGT) at Cayuga Community College in Auburn, New York. Fiscal activity of the Center is reported quarterly via SF 272 to IAGT, this report contains an overview and expenditures for the remaining funds of NAG 13-02053. NAG 13-02053, slated for operating costs for the fiscal year FY02-03, received a one-year no-cost extension. SITC also received permission to use remaining funds for salaries and benefits through December 31,2004. The IAGT receives no compensation for administrative costs. This report includes addendums for the NAG award as required by federal guidelines. Attached are the signed Report of New Technology/Inventions and a Final Property Report. As an academic, economic, and workforce development program, the Center has made significant strides in bringing the technology, knowledge and applications of the spatial information technology field to the region it serves. Through the mission of the Center, the region's communities have become increasingly aware of the benefits of Geospatial technology, particularly in the region s K-12 arena. SITC continues to positively affect the region's education, employment and economic development, while expanding its services and operations.

Handling and reporting of transperineal template prostate biopsy in Europe: a web-based survey by the European Network of Uropathology (ENUP).

PubMed

Kammerer-Jacquet, Solene-Florence; Compérat, Eva; Egevad, Lars; Hes, Ondra; Oxley, Jon; Varma, Murali; Kristiansen, Glen; Berney, Daniel M

2018-04-01

Transperineal template prostate biopsies (TTPB) are performed for assessments after unexpected negative transrectal ultrasound biopsies (TRUSB), correlation with imaging findings and during active surveillance. The impact of TTPBs on pathology has not been analysed. The European Network of Uropathology (ENUP) distributed a survey on TTPB, including how specimens were received, processed and analysed. Two hundred forty-four replies were received from 22 countries with TTPBs seen by 68.4% of the responders (n = 167). Biopsies were received in more than 12 pots in 35.2%. The number of cores embedded per cassette varied between 1 (39.5%) and 3 or more (39.5%). Three levels were cut in 48.3%, between 2 and 3 serial sections in 57.2% and unstained spare sections in 45.1%. No statistical difference was observed with TRUSB management. The number of positive cores was always reported and the majority gave extent per core (82.3%), per region (67.1%) and greatest involvement per core (69.4%). Total involvement in the whole series and continuous/discontinuous infiltrates were reported in 42.2 and 45.4%, respectively. The majority (79.4%) reported Gleason score in each site or core, and 59.6% gave an overall score. A minority (28.5%) provided a map or a diagram. For 19%, TTPB had adversely affected laboratory workload with only 27% managing to negotiate extra costs. Most laboratories process samples thoroughly and report TTPB similarly to TRUSB. Although TTPB have caused considerable extra work, it remains uncosted in most centres. Guidance is needed for workload impact and minimum standards of processing if TTPB work continues to increase.

Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease.

PubMed

Nitawaki, Tatsuya; Sakata, Yoshihiko; Kawamura, Kodai; Ichikado, Kazuya

2017-12-06

Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is a key drug for ALK rearranged lung adenocarcinoma. Interstitial lung disease (ILD) is an important adverse effect of alectinib, which generally requires termination of treatment. However, we treated two patients with drug-induced ILD who continued to receive alectinib. Patient 1 was a 57-year-old male with an ALK-rearranged Stage IV lung adenocarcinoma who was administered alectinib as first-line therapy. Computed tomography (CT) detected asymptomatic ground-glass opacity (GGO) on day 33 of treatment. Alectinib therapy was therefore discontinued for 7 days and then restarted. GGO disappeared, and the progression of ILD ceased. Patient 2 was a 64-year-old woman with an ALK-positive lung adenocarcinoma who was administered alectinib as third-line therapy. One year later, CT detected GGO; and she had a slight, nonproductive cough. Alectinib therapy was continued in the absence of other symptoms, and GGO slightly diminished after 7 days. Two months later, CT detected increased GGO, and alectinib therapy was continued. GGO diminished again after 7 days. The patient has taken alectinib for more than 2 years without progression of ILD. Certain patients with alectinib-induced ILD Grade 2 or less may continue alectinib therapy if they are closely managed.

Continuous wound infusion and local infiltration analgesia for postoperative pain and rehabilitation after total hip arthroplasty.

PubMed

Fusco, Pierfrancesco; Cofini, Vincenza; Petrucci, Emiliano; Scimia, Paolo; Fiorenzi, Maurizio; Paladini, Giuseppe; Behr, Astrid U; Borghi, Battista; Flamini, Stefano; Pizzoferrato, Renzo; Colafarina, Olivo; Di Francesco, Alexander; Tabacco, Tito; Necozione, Stefano; Marinangeli, Franco

2018-05-01

Total hip arthroplasty is one of the most common procedures in orthopedic surgery. We hypothesized that local infiltration of analgesia and continuous wound infusion of anesthetics in the first 72 hours after surgery could provide more effective postoperative analgesia with better rehabilitation. A double-blind, randomized, controlled study was conducted with 96 patients who underwent total hip arthroplasty. The patients were randomized to receive either a local infiltration analgesia and continuous wound infusion of anesthetics or a local infiltration analgesia and continuous wound infusion of saline solution. The patients in both groups received subarachnoid anesthesia and a local infiltration analgesia. A multihole catheter was placed next to the implant and connected to an electronic pump containing a 300-mL solution of 0.2% levobupivacaine (experimental group) or saline (control group). A total of 96 consecutive patients were enrolled and randomized. Of these, 48 patients received local infiltration analgesia and continuous wound infusion of local anesthetics, and the remainder received local infiltration analgesia and continuous wound infusion of saline solution. The analysis showed a significant main effect of treatment on the postoperative incident of pain (Ftreat(1,93)=22.62, P=0.000) and on resting pain during the post-surgery follow-up (Ftreat(1,93)=15.62, P=0.0002). The pain scores during the rehabilitation period were significantly less in the experimental group. Analgesic consumption was less in the experimental group. The addition of continuous wound infusion of anesthetics to local infiltration analgesia provided an extended analgesic effect associated with good rehabilitation performance.

Real-Time PPP Based on the Coupling Estimation of Clock Bias and Orbit Error with Broadcast Ephemeris.

PubMed

Pan, Shuguo; Chen, Weirong; Jin, Xiaodong; Shi, Xiaofei; He, Fan

2015-07-22

Satellite orbit error and clock bias are the keys to precise point positioning (PPP). The traditional PPP algorithm requires precise satellite products based on worldwide permanent reference stations. Such an algorithm requires considerable work and hardly achieves real-time performance. However, real-time positioning service will be the dominant mode in the future. IGS is providing such an operational service (RTS) and there are also commercial systems like Trimble RTX in operation. On the basis of the regional Continuous Operational Reference System (CORS), a real-time PPP algorithm is proposed to apply the coupling estimation of clock bias and orbit error. The projection of orbit error onto the satellite-receiver range has the same effects on positioning accuracy with clock bias. Therefore, in satellite clock estimation, part of the orbit error can be absorbed by the clock bias and the effects of residual orbit error on positioning accuracy can be weakened by the evenly distributed satellite geometry. In consideration of the simple structure of pseudorange equations and the high precision of carrier-phase equations, the clock bias estimation method coupled with orbit error is also improved. Rovers obtain PPP results by receiving broadcast ephemeris and real-time satellite clock bias coupled with orbit error. By applying the proposed algorithm, the precise orbit products provided by GNSS analysis centers are rendered no longer necessary. On the basis of previous theoretical analysis, a real-time PPP system was developed. Some experiments were then designed to verify this algorithm. Experimental results show that the newly proposed approach performs better than the traditional PPP based on International GNSS Service (IGS) real-time products. The positioning accuracies of the rovers inside and outside the network are improved by 38.8% and 36.1%, respectively. The PPP convergence speeds are improved by up to 61.4% and 65.9%. The new approach can change the traditional PPP mode because of its advantages of independence, high positioning precision, and real-time performance. It could be an alternative solution for regional positioning service before global PPP service comes into operation.

Real-Time PPP Based on the Coupling Estimation of Clock Bias and Orbit Error with Broadcast Ephemeris

PubMed Central

Pan, Shuguo; Chen, Weirong; Jin, Xiaodong; Shi, Xiaofei; He, Fan

2015-01-01

Satellite orbit error and clock bias are the keys to precise point positioning (PPP). The traditional PPP algorithm requires precise satellite products based on worldwide permanent reference stations. Such an algorithm requires considerable work and hardly achieves real-time performance. However, real-time positioning service will be the dominant mode in the future. IGS is providing such an operational service (RTS) and there are also commercial systems like Trimble RTX in operation. On the basis of the regional Continuous Operational Reference System (CORS), a real-time PPP algorithm is proposed to apply the coupling estimation of clock bias and orbit error. The projection of orbit error onto the satellite-receiver range has the same effects on positioning accuracy with clock bias. Therefore, in satellite clock estimation, part of the orbit error can be absorbed by the clock bias and the effects of residual orbit error on positioning accuracy can be weakened by the evenly distributed satellite geometry. In consideration of the simple structure of pseudorange equations and the high precision of carrier-phase equations, the clock bias estimation method coupled with orbit error is also improved. Rovers obtain PPP results by receiving broadcast ephemeris and real-time satellite clock bias coupled with orbit error. By applying the proposed algorithm, the precise orbit products provided by GNSS analysis centers are rendered no longer necessary. On the basis of previous theoretical analysis, a real-time PPP system was developed. Some experiments were then designed to verify this algorithm. Experimental results show that the newly proposed approach performs better than the traditional PPP based on International GNSS Service (IGS) real-time products. The positioning accuracies of the rovers inside and outside the network are improved by 38.8% and 36.1%, respectively. The PPP convergence speeds are improved by up to 61.4% and 65.9%. The new approach can change the traditional PPP mode because of its advantages of independence, high positioning precision, and real-time performance. It could be an alternative solution for regional positioning service before global PPP service comes into operation. PMID:26205276

The Brave New World of Real-time GPS for Hazards Mitigation

NASA Astrophysics Data System (ADS)

Melbourne, T. I.; Szeliga, W. M.; Santillan, V. M.; Scrivner, C. W.

2015-12-01

Over 600 continuously-operating, real-time telemetered GPS receivers operate throughout California, Oregon, Washington and Alaska. These receivers straddle active crustal faults, volcanoes and landslides, the magnitude-9 Cascadia and northeastern Alaskan subduction zones and their attendant tsunamigenic regions along the Pacific coast. Around the circum-Pacific, there are hundreds more and the number is growing steadily as real-time networks proliferate. Despite offering the potential for sub-cm positioning accuracy in real-time useful for a broad array of hazards mitigation, these GPS stations are only now being incorporated into routine seismic, tsunami, volcanic, land-slide, space-weather, or meterologic monitoring. We will discuss NASA's READI (Real-time Earthquake Analysis for DIsasters) initiative. This effort is focussed on developing all aspects of real-time GPS for hazards mitigation, from establishing international data-sharing agreements to improving basic positioning algorithms. READI's long-term goal is to expand real-time GPS monitoring throughout the circum-Pacific as overseas data become freely available, so that it may be adopted by NOAA, USGS and other operational agencies responsible for natural hazards monitoring. Currently ~100 stations are being jointly processed by CWU and Scripps Inst. of Oceanography for algorithm comparison and downstream merging purposes. The resultant solution streams include point-position estimates in a global reference frame every second with centimeter accuracy, ionospheric total electron content and tropospheric zenith water content. These solutions are freely available to third-party agencies over several streaming protocols to enable their incorporation and use in hazards monitoring. This number will ramp up to ~400 stations over the next year. We will also discuss technical efforts underway to develop a variety of downstream applications of the real-time position streams, including the ability to broadcast solutions to thousands of users in real time, earthquake finite-fault and tsunami excitation estimations, and several user interfaces, both stand-alone client and browser-based, that allow interaction with both real-time position streams and their derived products.

[Chronological analysis of individually linked data for patients with intractable disease receiving public financial aid for treatment].

PubMed

Shibazaki, Satomi; Nagai, Masaki; Fuchigami, Hiroshi; Nishina, Motoko; Ohta, Akiko; Kawamura, Takashi; Ohno, Yoshiyuki

2005-12-01

Nationwide surveys of intractable disease patients receiving public financial aid for treatment were performed by Research Committee for Epidemiology of Intractable Disease (Ministry of Health and Welfare, Japan) 4 times in the past, in 1984, 1988, 1992 and 1997. The purpose of the present study was to clarify the features of continuance with intractable disease patients receiving public financial aid for treatment. Individual information collected by each nationwide survey was linked using the disease, the residence, the sex, and the birth date. The proportion of intractable disease patients according to receipt duration, kind of medical insurance, sex and age was calculated with reference to the disease and an estimation of the receipt persistence rate was calculated for every year. Moreover, in consideration of variation in the data, average receipt persistence rates over years were also calculated. According to observation on individual patient's follow up, the proportion for which financial aid was discontinued within four years was 25%, while 70% continued receiving aid for at least four years and some 55% for eight or nine years. The proportion of those who continue receiving support long-term is high about the so-called autoimmune diseases, such as systemic lupus erythematosus, Behçet's disease, and the aortic syndrome. In contrast, with diseases having a poor prognosis, such as fulminant hepatitis, amyloidosis, and amyotrophic lateral sclerosis, periods of continuance are short. The proportion needing long-term continuation is higher in women than in men, especially with diseases which have long been eligible for support. However, with diseases for which receipt was started recently, there is a tendency for persistence to be higher in men than in women. With reform of insurance systems, including the medical system for intractable diseases, it is predicted that receipt continuation will change with alteration of social factors, and it is necessary to monitor receipt continuation carefully from now on.

The researchers have left the building: what contributes to sustaining school-based interventions following the conclusion of formal research support?

PubMed

Friend, Sarah; Flattum, Colleen F; Simpson, Danielle; Nederhoff, Dawn M; Neumark-Sztainer, Dianne

2014-05-01

This study examined the sustainability of New Moves, a school-based program aimed at decreasing weight-related problems in adolescent girls. The National Cancer Institute recognizes New Moves as a research-tested intervention program that produced positive behavioral and psychosocial outcomes. Ten schools participated in the sustainability study. Teachers completed a survey and interview, and research staff observed 1 physical education (PE) class within 2 years of the study's completion. Qualitative data were grouped by themes. Frequencies were calculated using quantitative data. All schools continued all-girls PE classes using New Moves components following the study period. Fewer schools continued the nutrition and social support classroom modules and individual coaching sessions while no schools continued lunch get-togethers. Program components were sustained in both New Moves intervention schools and control schools. Programs are most likely to be sustained if they (1) fit into the current school structure, (2) receive buy-in by teachers, and (3) require minimal additional funds or staff time. Providing control schools with minimal training and intervention resources was sufficient to continue program components if staff perceived the program was important for students' health and compatible within the school's existing infrastructure. © 2014, American School Health Association.

A Reappraisal of the Minimum Duration of Antibiotic Treatment Before Approval of Return to School for Children With Streptococcal Pharyngitis.

PubMed

Schwartz, Richard H; Kim, Danica; Martin, Michael; Pichichero, Michael E

2015-12-01

To determine whether a single dose of amoxicillin administered to a symptomatic child with confirmed strep throat might allow the child to return to school as little as 12 hours later. We enrolled 111 evaluable children with sore throat plus a positive streptococcal rapid antigen detection test (RADT) as well as a positive result for group A Streptococci (GAS). After throat swab specimens were obtained, all participants received a single dose of amoxicillin (50 mg/kg). Twelve to 23 hours after the first dose of amoxicillin, all participants returned in the morning of day 2 for a second throat swab specimen. At the day 2 visit, a nurse or medical assistant obtained an interval history, tympanic membrane temperature, and a pediatrician or nurse practitioner examined the oropharynx. On the morning of day 2, only 10 of 111 participants continued to have a positive RADT result, confirmed by overnight throat culture. GAS were not detectable on the day 2 throat specimen by RADT and also by culture in 91% of the study participants (confidence interval: 86-96%). Seven of 10 failures had a marked decrease in number of β-hemolytic colonies, which were 3+ to 4+ on the initial overnight culture plate and decreased to 1+ on the follow-up (obtained on day 2) throat culture plate. Two participants continued to have 3+ or 4+ GAS after incubation of the second throat culture specimen. Even in the late afternoon, a full dose of amoxicillin (50 mg/kg) administered after notification of positive RADT results for GAS resulted in nondetection of GAS in 91% of children the next morning. All children treated with amoxicillin for "strep throat" by 5 PM of day 1 may, if afebrile and improved, attend school on day 2.

Methods and Devices for Space Optical Communications Using Laser Beams

NASA Technical Reports Server (NTRS)

Goorjian, Peter M. (Inventor)

2018-01-01

Light is used to communicate between objects separated by a large distance. Light beams are received in a telescopic lens assembly positioned in front of a cat's-eye lens. The light can thereby be received at various angles to be output by the cat's-eye lens to a focal plane of the cat's-eye lens, the position of the light beams upon the focal plane corresponding to the angle of the beam received. Lasers and photodetectors are distributed along this focal plane. A processor receives signals from the photodetectors, and selectively signal lasers positioned proximate the photodetectors detecting light, in order to transmit light encoding data through the cat's-eye lens and also through a telescopic lens back in the direction of the received light beams, which direction corresponds to a location upon the focal plane of the transmitting lasers.

Continuous Space Estimation: Increasing WiFi-Based Indoor Localization Resolution without Increasing the Site-Survey Effort.

PubMed

Hernández, Noelia; Ocaña, Manuel; Alonso, Jose M; Kim, Euntai

2017-01-13

Although much research has taken place in WiFi indoor localization systems, their accuracy can still be improved. When designing this kind of system, fingerprint-based methods are a common choice. The problem with fingerprint-based methods comes with the need of site surveying the environment, which is effort consuming. In this work, we propose an approach, based on support vector regression, to estimate the received signal strength at non-site-surveyed positions of the environment. Experiments, performed in a real environment, show that the proposed method could be used to improve the resolution of fingerprint-based indoor WiFi localization systems without increasing the site survey effort.

Continuous Space Estimation: Increasing WiFi-Based Indoor Localization Resolution without Increasing the Site-Survey Effort †

PubMed Central

Hernández, Noelia; Ocaña, Manuel; Alonso, Jose M.; Kim, Euntai

2017-01-01

Although much research has taken place in WiFi indoor localization systems, their accuracy can still be improved. When designing this kind of system, fingerprint-based methods are a common choice. The problem with fingerprint-based methods comes with the need of site surveying the environment, which is effort consuming. In this work, we propose an approach, based on support vector regression, to estimate the received signal strength at non-site-surveyed positions of the environment. Experiments, performed in a real environment, show that the proposed method could be used to improve the resolution of fingerprint-based indoor WiFi localization systems without increasing the site survey effort. PMID:28098773

Academic Continuity and School Reentry Support as a Standard of Care in Pediatric Oncology.

PubMed

Thompson, Amanda L; Christiansen, Heather L; Elam, Megan; Hoag, Jennifer; Irwin, Mary Kay; Pao, Maryland; Voll, Megan; Noll, Robert B; Kelly, Katherine Patterson

2015-12-01

Clinicians agree that return to school after diagnosis promotes the positive adjustment of children and adolescents with cancer; however, the school reentry process can present challenges. The aim of this review was to critically evaluate the literature on school reentry support for youth with cancer. Seventeen publications were identified. School reentry services were well-received by families and educators; increased teacher and peer knowledge about childhood cancer; influenced peer and educator attitudes toward the patient; and improved communication and collaboration between patients/families, school, and the healthcare team. Evidence supports a strong recommendation for school reentry support for youth with cancer. © 2015 Wiley Periodicals, Inc.

47 CFR 87.151 - Special requirements for differential GPS receivers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Special requirements for differential GPS receivers. 87.151 Section 87.151 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND... differential GPS receivers. (a) The receiver shall achieve a message failure rate less than or equal to one...

Mental health treatment patterns in perinatally HIV-infected youth and controls.

PubMed

Chernoff, Miriam; Nachman, Sharon; Williams, Paige; Brouwers, Pim; Heston, Jerry; Hodge, Janice; Di Poalo, Vinnie; Deygoo, Nagamah Sandra; Gadow, Kenneth D

2009-08-01

Youths perinatally infected with HIV often receive psychotropic medication and behavioral treatment for emotional and behavioral symptoms. We describe patterns of intervention for HIV-positive youth and youth in a control group in the United States. Three hundred nineteen HIV-positive youth and 256 controls, aged 6 to 17 years, enrolled in the International Maternal Adolescent AIDS Clinical Trials 1055, a prospective, 2-year observational study of psychiatric symptoms. One hundred seventy-four youth in the control group were perinatally exposed to HIV, and 82 youth were uninfected children living in households with HIV-positive members. Youth and their primary caregivers completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-referenced symptom-rating scales. Children's medication and behavioral psychiatric intervention histories were collected at entry. We evaluated the association of past or current psychiatric treatment with HIV status, baseline symptoms, and impairment by using multiple logistic regression, controlling for potential confounders. HIV-positive youth and youth in the control group had a similar prevalence of psychiatric symptoms (61%) and impairment (14% to 15%). One hundred four (18%) participants received psychotropic medications (stimulants [14%], antidepressants [6%], and neuroleptic agents [4%]), and 127 (22%) received behavioral treatment. More HIV-positive youth than youth in the control group received psychotropic medication (23% vs 12%) and behavioral treatment (27% vs 17%). After adjusting for symptom class and confounders, HIV-positive children had twice the odds of children in the control group of having received stimulants and >4 times the odds of having received antidepressants. Caregiver-reported symptoms or impairment were associated with higher odds of intervention than reports by children alone. HIV-positive children are more likely to receive mental health interventions than control-group children. Pediatricians and caregivers should consider available mental health treatment options for all children living in families affected by HIV.

Impact of health education on the prevalence of enterobiasis in Korean preschool students.

PubMed

Kang, In-Soon; Kim, Dong-Hee; An, Hye-Gyung; Son, Hyun-Mi; Cho, Min Kyoung; Park, Mi-Kyung; Kang, Shin Ae; Kim, Bo Young; Yu, Hak Sun

2012-04-01

Health education has been shown to be effective in slowing the spread of the disease, infectious disease in particular. To evaluate the impact of health education on the prevalence and pattern of new infection of enterobiasis, children from 6 kindergartens in Ulsan city, South Korea, were recruited after undergoing a screening for enterobiasis, and then divided into three groups, including group medication (GM), education (Edu), and control group. All children in GM group received medical treatment with 500 mg albendazole twice, with 15 days interval. In the Edu group, only children diagnosed positive for Enterobius vermicularis eggs received medical treatment with 500 mg albendazole twice, with 15 days interval and all parents in the group received brochures providing information about enterobiasis. In the control group, only children diagnosed positive for E. vermicularis eggs received medical treatment with 500 mg albendazole twice, with 15 days interval, and no information about enterobiasis was provided to parents. Two post-treatment examinations were performed at three and six months after treatment. The infection rate in the GM group was dramatically decreased at 3 months, and this rate was almost the same as at 6 months after treatment. Infection rate of children in the Edu group was shown to drop from 9.9% to 3.0% at 3 months, and to 2.7% at 6 months after treatment; however, the infection rate in the control group continued to be higher than in the other two groups at both 3 and 6 months, with smaller change at 3 months compared to the other two groups. In addition, both new infection and re-infection cases in the Edu group were fewer, compared to those in the control group. In conclusion, although GM is the best method for eradication of enterobiasis, providing health information about enterobiasis to parents could reduce the prevalence, as well as the rate of new infection or re-infection with E. vermicularis in their children. Copyright © 2011 Elsevier B.V. All rights reserved.

Analgesic plasma concentrations of morphine in children with terminal malignancy receiving a continuous subcutaneous infusion of morphine sulfate to control severe pain.

PubMed

Nahata, M C; Miser, A W; Miser, J S; Reuning, R H

1984-02-01

Three children with terminal malignancy received a continuous subcutaneous infusion of morphine sulfate for the control of severe pain, the morphine dose being adjusted until the patient and/or parent reported complete freedom from pain. Analgesic plasma morphine concentrations at the steady state in these patients ranged from 12.9 to 57 ng/ml (median 19.6 ng/ml) while receiving morphine doses of 0.45-2.0 mg/h (0.034-0.06 mg/kg/h). One patient, who received 2 mg morphine per hour for 12 days demonstrated a 2-fold variation in steady-state plasma concentration during this period.

Pembrolizumab for HIV-Positive Patients with Recurrent or Refractory Cancer

Cancer.gov

In this phase I clinical trial, HIV-positive patients receiving combination antiretroviral therapy who have cancer that has recurred after or has not responded to previous treatment will receive the immune checkpoint inhibitor pembrolizumab.

Using the global positioning system to map disturbance patterns of forest harvesting machinery

Treesearch

T.P. McDonald; E.A. Carter; S.E. Taylor

2002-01-01

Abstract: A method was presented to transform sampled machine positional data obtained from a global positioning system (GPS) receiver into a two-dimensional raster map of number of passes as a function of location. The effect of three sources of error in the transformation process were investigated: path sampling rate (receiver sampling frequency);...

Child-Child Interactions and Positive Social Focus among Preschool Children

ERIC Educational Resources Information Center

Naerland, Terje; Martinsen, Harald

2011-01-01

This study is based on video-recorded observations of 64 children during free play at their nursery. A measure of "social focus" in the preschool, regarded as an indicator of social status, was constructed from the amount of positive and neutral contacts children received from their peers. Only six children often received positive or…

The OPTIMIST-A trial: evaluation of minimally-invasive surfactant therapy in preterm infants 25–28 weeks gestation

PubMed Central

2014-01-01

Background It is now recognized that preterm infants ≤28 weeks gestation can be effectively supported from the outset with nasal continuous positive airway pressure. However, this form of respiratory therapy may fail to adequately support those infants with significant surfactant deficiency, with the result that intubation and delayed surfactant therapy are then required. Infants following this path are known to have a higher risk of adverse outcomes, including death, bronchopulmonary dysplasia and other morbidities. In an effort to circumvent this problem, techniques of minimally-invasive surfactant therapy have been developed, in which exogenous surfactant is administered to a spontaneously breathing infant who can then remain on continuous positive airway pressure. A method of surfactant delivery using a semi-rigid surfactant instillation catheter briefly passed into the trachea (the “Hobart method”) has been shown to be feasible and potentially effective, and now requires evaluation in a randomised controlled trial. Methods/design This is a multicentre, randomised, masked, controlled trial in preterm infants 25–28 weeks gestation. Infants are eligible if managed on continuous positive airway pressure without prior intubation, and requiring FiO2 ≥ 0.30 at an age ≤6 hours. Randomisation will be to receive exogenous surfactant (200 mg/kg poractant alfa) via the Hobart method, or sham treatment. Infants in both groups will thereafter remain on continuous positive airway pressure unless intubation criteria are reached (FiO2 ≥ 0.45, unremitting apnoea or persistent acidosis). Primary outcome is the composite of death or physiological bronchopulmonary dysplasia, with secondary outcomes including incidence of death; major neonatal morbidities; durations of all modes of respiratory support and hospitalisation; safety of the Hobart method; and outcome at 2 years. A total of 606 infants will be enrolled. The trial will be conducted in >30 centres worldwide, and is expected to be completed by end-2017. Discussion Minimally-invasive surfactant therapy has the potential to ease the burden of respiratory morbidity in preterm infants. The trial will provide definitive evidence on the effectiveness of this approach in the care of preterm infants born at 25–28 weeks gestation. Trial registration Australia and New Zealand Clinical Trial Registry: ACTRN12611000916943; ClinicalTrials.gov: NCT02140580. PMID:25164872

Transition into and out of Special Education Services by Young Australian School Children between 2006 and 2010

ERIC Educational Resources Information Center

Dempsey, Ian

2014-01-01

The extent to which school students continue to receive special education services over time is largely unknown because longitudinal studies are rare in this area. The present study examined a large Australian longitudinal database to track the status of children who received special education support in 2006 and whether they continued to access…

5 CFR 894.305 - Am I eligible to enroll if I am a former spouse receiving an apportionment of annuity?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Am I eligible to enroll if I am a former spouse receiving an apportionment of annuity? 894.305 Section 894.305 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION...

5 CFR 894.305 - Am I eligible to enroll if I am a former spouse receiving an apportionment of annuity?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Am I eligible to enroll if I am a former spouse receiving an apportionment of annuity? 894.305 Section 894.305 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION...

20 CFR 404.1341 - Wage credits for a member of a uniformed service.

Code of Federal Regulations, 2010 CFR

2010-04-01

... continuous active duty or the full period that you were called to active duty to receive these wage credits... continuous active duty or the full period you were called or ordered to active duty to receive these wage... sum death payment) based on your wages while on active duty as a member of the uniformed service from...

20 CFR 404.1341 - Wage credits for a member of a uniformed service.

Code of Federal Regulations, 2011 CFR

2011-04-01

... continuous active duty or the full period that you were called to active duty to receive these wage credits... continuous active duty or the full period you were called or ordered to active duty to receive these wage... sum death payment) based on your wages while on active duty as a member of the uniformed service from...

Baseline albumin is associated with worsening renal function in patients with acute decompensated heart failure receiving continuous infusion loop diuretics.

PubMed

Clarke, Megan M; Dorsch, Michael P; Kim, Susie; Aaronson, Keith D; Koelling, Todd M; Bleske, Barry E

2013-06-01

To identify baseline predictors of worsening renal function (WRF) in an acute decompensated heart failure (ADHF) patient population receiving continuous infusion loop diuretics. Retrospective observational analysis. Academic tertiary medical center. A total of 177 patients with ADHF receiving continuous infusion loop diuretics from January 2006 through June 2009. The mean patient age was 61 years, 63% were male, ~45% were classified as New York Heart Association functional class III, and the median length of loop diuretic infusion was 4 days. Forty-eight patients (27%) developed WRF, and 34 patients (19%) died during hospitalization. Cox regression time-to-event analysis was used to determine the time to WRF based on different demographic and clinical variables. Baseline serum albumin 3 g/dl or less was the only significant predictor of WRF (hazard ratio [HR] 2.87, 95% confidence interval [CI] 1.60-5.16, p=0.0004), which remained significant despite adjustments for other covariates. Serum albumin 3 g/dl or less is a practical baseline characteristic associated with the development of WRF in patients with ADHF receiving continuous infusion loop diuretics. © 2013 Pharmacotherapy Publications, Inc.

Breast cancer health promotion in Qatar: a survey of community pharmacists' interests and needs.

PubMed

El Hajj, Maguy Saffouh; Hamid, Yousra

2013-06-01

Breast cancer is the most common cancer in women in Qatar. Despite the sustained efforts to increase breast cancer public awareness via campaigns and public screening programmes, breast cancer screening rate remains low. The involvement of community pharmacists in the communication and distribution of breast cancer screening information should have a significant positive impact. The objectives of this study were to determine the degree of community pharmacists' involvement in breast cancer health promotion activities in Qatar, to explore their attitudes towards the involvement in breast cancer health promotion, to assess their breast cancer knowledge, to gauge their interest in receiving breast cancer continuous education and to list their perceived barriers for including breast cancer health promotion activities into their daily practice. Community pharmacies in Qatar. The study objectives were addressed in a cross-sectional survey of all community pharmacists in Qatar. The extent of community pharmacists' involvement in breast cancer health promotion activities, the community pharmacists' interest and comfort in providing breast cancer health promotion, their breast cancer knowledge, their interest in receiving breast cancer continuous education, their attitudes and beliefs towards breast cancer health promotion and their perceived barriers for integrating breast cancer heath promotion activities into their daily practice. Over a 12-week period, we collected 195 surveys (60% response rate). Eighty-eight percent indicated that they never invited healthcare professionals to provide breast cancer education in the pharmacy, 78% said that they never distributed breast cancer educational materials, and 58% reported that they never counseled patients about breast cancer. Nevertheless, more than 60% were highly interested in being engaged in breast cancer health promotion activities. In addition, 87% believed that discussing breast cancer awareness with female patients in the pharmacy was beneficial to patients. Yet pharmacists perceived many barriers for integrating breast cancer health promotion into their daily practice including lack of educational materials (79%) and lack of public recognition (61%). Moreover, their breast cancer knowledge mean score was 63% with 77% expressing a high interest in receiving breast cancer continuous education. Despite their low involvement in breast cancer health promotion, the majority of pharmacists were interested in educating patients about breast cancer. However, low breast cancer knowledge and other barriers can prevent actualizing this role. Further work should focus on providing these pharmacists with breast cancer continuous education and overcoming all stated barriers.

Near Real-Time Processing and Archiving of GPS Surveys for Crustal Motion Monitoring

NASA Astrophysics Data System (ADS)

Crowell, B. W.; Bock, Y.

2008-12-01

We present an inverse instantaneous RTK method for rapidly processing and archiving GPS data for crustal motion surveys that gives positional accuracy similar to traditional post-processing methods. We first stream 1 Hz data from GPS receivers over Bluetooth to Verizon XV6700 smartphones equipped with Geodetics, Inc. RTD Rover software. The smartphone transmits raw receiver data to a real-time server at the Scripps Orbit and Permanent Array Center (SOPAC) running RTD Pro. At the server, instantaneous positions are computed every second relative to the three closest base stations in the California Real Time Network (CRTN), using ultra-rapid orbits produced by SOPAC, the NOAATrop real-time tropospheric delay model, and ITRF2005 coordinates computed by SOPAC for the CRTN stations. The raw data are converted on-the-fly to RINEX format at the server. Data in both formats are stored on the server along with a file of instantaneous positions, computed independently at each observation epoch. The single-epoch instantaneous positions are continuously transmitted back to the field surveyor's smartphone, where RTD Rover computes a median position and interquartile range for each new epoch of observation. The best-fit solution is the last median position and is available as soon as the survey is completed. We describe how we used this method to process 1 Hz data from the February, 2008 Imperial Valley GPS survey of 38 geodetic monuments established by Imperial College, London in the 1970's, and previously measured by SOPAC using rapid-static GPS methods in 1993, 1999 and 2000, as well as 14 National Geodetic Survey (NGS) monuments. For redundancy, each monument was surveyed for about 15 minutes at least twice and at staggered intervals using two survey teams operating autonomously. Archiving of data and the overall project at SOPAC is performed using the PGM software, developed by the California Spatial Reference Center (CSRC) for the National Geodetic Survey (NGS). The importation of raw receiver data, site metadata and antenna height information is performed using PGM client software running on the same PDA running RTD Rover or laptop, and uploaded to the PGM server where the raw data are converted to RINEX format. The campaign information is then published online, where all of the campaign information can be accessed such as start and stop times, equipment information, RINEX and solution SINEX files, observer information and baseline information for network adjustments.

Effects of drinking water treatment on susceptibility of laying hens to Salmonella enteritidis during forced molt.

PubMed

Kubena, L F; Byrd, J A; Moore, R W; Ricke, S C; Nisbet, D J

2005-02-01

Feed deprivation is used in the layer industry to induce molting and stimulate multiple egg-laying cycles in laying hens. Unfortunately, the stress involved increases susceptibility to Salmonella enteritidis (SE), the risk of SE-positive eggs, and incidence of SE in internal organs. Leghorn hens over 50 wk of age were divided into 4 treatment groups of 12 hens each in experiment 1 and 3 treatment groups of 12 hens in experiments 2 and 3; hens were placed in individual laying hen cages. Treatment groups were 1) nonmolted (NM) and received feed and distilled water for 9 d, 2) force molted by feed removal for 9 d and received distilled water, 3) force molted by feed removal for 9 d and received 0.5% lactic acid (LA) in distilled water. An additional group (4) in experiment 1 only was force molted by feed removal for 9 d and received 0.5% acetic acid in distilled water. Seven days before feed removal hens were exposed to an 8L:16D photoperiod, which was continued throughout the experiment. Individual hens among all treatments were challenged orally with 10(4) SE on d 4 of feed removal. When compared with the NM treatments, weight losses were significantly higher in the M treatments, regardless of water treatments. When compared with NM treatments, crop pH was significantly higher in the M treatment receiving distilled water. Crop pH was reduced to that of the NM controls by 0.5% acetic acid in the drinking water. No consistent significant changes were observed for volatile fatty acids. The number of hens positive for SE in crop and ceca after culture and the number of SE per crop and per gram of cecal contents were higher in the M treatments, when compared with the NM treatments, but there was no effect of addition of either of the acids to the drinking water. Additional research using different acid treatment regimens may provide a tool for reducing the incidence of SE in eggs and internal organs during and following molting of laying hens.

Robust GPS autonomous signal quality monitoring

NASA Astrophysics Data System (ADS)

Ndili, Awele Nnaemeka

The Global Positioning System (GPS), introduced by the U.S. Department of Defense in 1973, provides unprecedented world-wide navigation capabilities through a constellation of 24 satellites in global orbit, each emitting a low-power radio-frequency signal for ranging. GPS receivers track these transmitted signals, computing position to within 30 meters from range measurements made to four satellites. GPS has a wide range of applications, including aircraft, marine and land vehicle navigation. Each application places demands on GPS for various levels of accuracy, integrity, system availability and continuity of service. Radio frequency interference (RFI), which results from natural sources such as TV/FM harmonics, radar or Mobile Satellite Systems (MSS), presents a challenge in the use of GPS, by posing a threat to the accuracy, integrity and availability of the GPS navigation solution. In order to use GPS for integrity-sensitive applications, it is therefore necessary to monitor the quality of the received signal, with the objective of promptly detecting the presence of RFI, and thus provide a timely warning of degradation of system accuracy. This presents a challenge, since the myriad kinds of RFI affect the GPS receiver in different ways. What is required then, is a robust method of detecting GPS accuracy degradation, which is effective regardless of the origin of the threat. This dissertation presents a new method of robust signal quality monitoring for GPS. Algorithms for receiver autonomous interference detection and integrity monitoring are demonstrated. Candidate test statistics are derived from fundamental receiver measurements of in-phase and quadrature correlation outputs, and the gain of the Active Gain Controller (AGC). Performance of selected test statistics are evaluated in the presence of RFI: broadband interference, pulsed and non-pulsed interference, coherent CW at different frequencies; and non-RFI: GPS signal fading due to physical blockage and multipath. Results are presented which verify the effectiveness of these proposed methods. The benefits of pseudolites in reducing service outages due to interference are demonstrated. Pseudolites also enhance the geometry of the GPS constellation, improving overall system accuracy. Designs for pseudolites signals, to reduce the near-far problem associated with pseudolite use, are also presented.

Efficacy of continuous versus intermittent subglottic secretion drainage in preventing ventilator-associated pneumonia in patients requiring mechanical ventilation: A single-center randomized controlled trial.

PubMed

Fujimoto, Hiroko; Yamaguchi, Osamu; Hayami, Hajime; Shimosaka, Mika; Tsuboi, Sayaka; Sato, Mitsunori; Takebayashi, Shigeo; Morita, Satoshi; Saito, Mari; Goto, Takahisa; Kurahashi, Kiyoyasu

2018-03-23

Aspiration of subglottic secretion is a widely used intervention to prevent ventilator-associated pneumonia (VAP). This study aimed to compare the efficacy of continuous and intermittent subglottic secretion drainage (SSD) in preventing VAP. A single-center randomized controlled trial was conducted on adult postoperative patients who were expected to undergo mechanical ventilation for more than 48 hours. Primary outcome measure was incidence of VAP and secondary outcome measures were length of mechanical ventilation and intensive-care unit (ICU) stay. Fifty-nine patients received continuous SSD, while 60 patients received intermittent SSD. Of these 119 patients, 88 (74%) were excluded and 15 and 16 patients were allocated to receive continuous and intermittent SSD, respectively. VAP was detected in 4 (26.7%) and 7 (43.8%) patients in the continuous and intermittent groups, respectively, (p=0.320). The length of mechanical ventilation was significantly shorter (p=0.034) in the continuous group (99.5±47.1 h) than in the intermittent group (159.9±94.5 h). The length of ICU stay was also shorter (p=0.0097) in the continuous group (6.3±2.1 days) than the intermittent group (9.8±4.8 days). Although continuous SSD did not reduce the incidence of VAP, it reduced the length of mechanical ventilation and ICU stay when compared to intermittent SSD.

A new method for blood velocity measurements using ultrasound FMCW signals.

PubMed

Kunita, Masanori; Sudo, Masamitsu; Inoue, Shinya; Akahane, Mutsuhiro

2010-05-01

The low peak power of frequency-modulated continuous wave (FMCW) radar makes it attractive for various applications, including vehicle collision warning systems and airborne radio altimeters. This paper describes a new ultrasound Doppler measurement system that measures blood flow velocity based on principles similar to those of FMCW radar. We propose a sinusoidal wave for FM modulation and introduce a new demodulation technique for obtaining Doppler information with high SNR and range resolution. Doppler signals are demodulated with a reference FMCW signal to adjust delay times so that they are equal to propagation times between the transmitter and the receiver. Analytical results suggest that Doppler signals can be obtained from a selected position, as with a sample volume in pulse wave Doppler systems, and that the resulting SNR is nearly identical to that obtained with continuous wave (CW) Doppler systems. Additionally, clutter power is less than that of CW Doppler systems. The analytical results were verified by experiments involving electronic circuits and Doppler ultrasound phantoms.

An accuracy assessment of positions obtained using survey- and recreational-grade Global Positioning System receivers across a range of forest conditions within the Tanana Valley of interior Alaska

Treesearch

Hans-Erik Andersen; Tobey Clarkin; Ken Winterberger; Jacob Strunk

2009-01-01

The accuracy of recreational- and survey-grade global positioning system (GPS) receivers was evaluated across a range of forest conditions in the Tanana Valley of interior Alaska. High-accuracy check points, established using high-order instruments and closed-traverse surveying methods, were then used to evaluate the accuracy of positions acquired in different forest...

Comparison of the effects of conditional food and cash transfers of the Ethiopian Productive Safety Net Program on household food security and dietary diversity in the face of rising food prices: ways forward for a more nutrition-sensitive program.

PubMed

Baye, Kaleab; Retta, Negussie; Abuye, Cherinet

2014-09-01

In light of the continuing rise in food prices during and after the 2008 world food crisis, whether food and cash transfers are equally effective in improving food security and diet quality is debatable. To compare the effects of conditional food and cash transfers of the Ethiopian Productive Safety Net Program (PSNP) on household food security and dietary diversity. Data on household dietary diversity, child anthropometry, food security, and preference of transfer modalities (food, cash, or mixed) were generated from a cross-sectional survey of 195 PSNP beneficiary households (67 receiving food and 128 receiving cash) in Hawella Tulla District, Sidama, southern Ethiopia. Most beneficiaries (96%) reported food shortages, and 47% reported food shortages that exceeded 3 months. Households receiving cash had better household dietary diversity scores (p = .02) and higher consumption of oils and fats (p = .003) and vitamin A-rich foods (p = .002). Compared with households receiving food, households receiving cash were more affected by increases in food prices that forced them to reduce their number of daily meals (p < .001) and spend less on nonstaples (p < .001). While most households receiving food (82%) preferred to continue receiving food, households receiving cash (56%) preferred a mix of food and cash. Households receiving cash had better household dietary diversity than households receiving food, a result suggesting that cash transfers may be more effective. However, the continuing rise infood prices may offset these benefits unless cash transfers are index-linked to food price fluctuations.

Coherent detection of position errors in inter-satellite laser communications

NASA Astrophysics Data System (ADS)

Xu, Nan; Liu, Liren; Liu, De'an; Sun, Jianfeng; Luan, Zhu

2007-09-01

Due to the improved receiver sensitivity and wavelength selectivity, coherent detection became an attractive alternative to direct detection in inter-satellite laser communications. A novel method to coherent detection of position errors information is proposed. Coherent communication system generally consists of receive telescope, local oscillator, optical hybrid, photoelectric detector and optical phase lock loop (OPLL). Based on the system composing, this method adds CCD and computer as position error detector. CCD captures interference pattern while detection of transmission data from the transmitter laser. After processed and analyzed by computer, target position information is obtained from characteristic parameter of the interference pattern. The position errors as the control signal of PAT subsystem drive the receiver telescope to keep tracking to the target. Theoretical deviation and analysis is presented. The application extends to coherent laser rang finder, in which object distance and position information can be obtained simultaneously.

Training and action for patient safety: embedding interprofessional education for patient safety within an improvement methodology.

PubMed

Slater, Beverley L; Lawton, Rebecca; Armitage, Gerry; Bibby, John; Wright, John

2012-01-01

Despite an explosion of interest in improving safety and reducing error in health care, one important aspect of patient safety that has received little attention is a systematic approach to education and training for the whole health care workforce. This article describes an evaluation of an innovative multiprofessional, team-based training program that embeds patient safety within quality improvement methods. Kirkpatrick's "levels of evaluation" model was adopted to evaluate the program in health organizations across one city in the north of England. Questionnaires were used to assess reaction of participants to the program (Level 1). Improvements in patient safety knowledge and patient safety culture (Level 2) were assessed using a 12-item multiple-choice questionnaire and a culture questionnaire. Interviews and project-specific quantitative measurements were used to assess changes in professional practice and patient outcomes (Levels 3 and 4). All aspects of the program were positively received by participants. Few participants completed the MCQ at both time points, but those who did showed improvement in knowledge. There were some small but significant improvements in patient safety culture. Interviews revealed a number of additional benefits beyond the specific problems addressed. Most importantly, 8 of the 11 teams showed improvements in patient safety practices and/or outcomes. This program is an example of interprofessional education in practice and demonstrates that team-based learning using quality improvement methods is feasible and can be effective in improving patient safety, but requires time and space for participants. Alignment with continuing education arrangements could support mainstream adoption of this approach within organizations. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure.

PubMed

Wilson, Suprat Saely; Kwiatkowski, Gregory M; Millis, Scott R; Purakal, John D; Mahajan, Arushi P; Levy, Phillip D

2017-01-01

The purpose of this study was to compare health care resource utilization among patients who were given intravenous nitroglycerin for acute heart failure (AHF) in the emergency department (ED) by intermittent bolus, continuous infusion, or a combination of both. We retrospectively identified 395 patients that received nitroglycerin therapy in the ED for the treatment of AHF over a 5-year period. Patients that received intermittent bolus (n=124) were compared with continuous infusion therapy (n=182) and combination therapy of bolus and infusion (n=89). The primary outcomes were the frequency of intensive care unit (ICU) admission and hospital length of stay (LOS). On unadjusted analysis, rates of ICU admission were significantly lower in the bolus vs infusion and combination groups (48.4% vs 68.7% vs 83%, respectively; P<.0001) and median LOS (interquartile range) was shorter (3.7 [2.5-6.2 days]) compared with infusion (4.7 [2.9-7.1 days]) and combination (5.0 [2.9-6.7 days]) groups; P=.02. On adjusted regression models, the strong association between bolus nitroglycerin and reduced ICU admission rate remained, and hospital LOS was 1.9 days shorter compared with infusion therapy alone. Use of intubation (bolus [8.9%] vs infusion [8.8%] vs combination [16.9%]; P=.096) and bilevel positive airway pressure (bolus [26.6%] vs infusion [20.3%] vs combination [29.2%]; P=.21) were similar as was the incidence of hypotension, myocardial injury, and worsening renal function. In ED patients with AHF, intravenous nitroglycerin by intermittent bolus was associated with a lower ICU admission rate and a shorter hospital LOS compared with continuous infusion. Copyright © 2016 Elsevier Inc. All rights reserved.

Combination of corticosteroids and 5-aminosalicylates or corticosteroids alone for patients with moderate-severe active ulcerative colitis: A global survey of physicians' practice.

PubMed

Ben-Horin, Shomron; Andrews, Jane M; Katsanos, Konstantinos H; Rieder, Florian; Steinwurz, Flavio; Karmiris, Konstantinos; Cheon, Jae Hee; Moran, Gordon William; Cesarini, Monica; Stone, Christian D; Schwartz, Doron; Protic, Marijana; Roblin, Xavier; Roda, Giulia; Chen, Min-Hu; Har-Noy, Ofir; Bernstein, Charles N

2017-04-28

To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents. Respondents' agreement with stated treatment choices were assessed by standardized Likert scale. Background professional characteristics of respondents were analyzed for correlation with responses. Six hundred and sixty-four questionnaires were distributed and 349 received (52.6% response rate). Of 340 eligible respondents, 221 (65%) would continue 5ASA in a patient hospitalized for intravenous CS treatment due to a moderate-severe UC flare, while 108 (32%) would stop the 5ASA ( P < 0.001), and 11 (3%) are undecided. Similarly, 62% would continue 5ASA in an out-patient starting oral CS. However, only 140/340 (41%) would proactively start 5ASA in a hospitalized patient not receiving 5ASA before admission. Most (94%) physicians consider the safety profile of 5ASA as very good. Only 52% consider them inexpensive, 35% perceive them to be expensive and 12% are undecided. On multi-variable analysis, less years of practice and perception of a plausible additive mechanistic effect of 5ASA + CS were positively associated with the decision to continue 5ASA with CS. Despite the absence of data supporting its benefit, most gastroenterologists endorse combination of 5ASA + CS for patients with active moderate-to-severe UC. Randomized controlled trials are needed to assess if 5ASA confer any benefit for these patients.

[Variations in hyperbilirrubinemia in low birth weight newborns under phototherapy and continous or discontinous agar oral administration (author's transl)].

PubMed

Colomer, J; Moya, M; Marco, V; De Paredes, C; Escrivá, F; Vila, R

1975-06-01

Therapeutic attitude in hyperbilirrubinemia is always worth because other infrequent complications but not for this, less important. Phototherapy innocuousness, largely demonstrated, fosters its profilactic use at beginning and not only for those babies with serum bilirrubin over 10 mg % in the first day of life. Previously we have reported positive results with agar oral administration without collateral effects. On this grounds we have planned the following experience in a homogenous group of L.B.W.: one group was fed with agar previously to each formula administration; other group received the same amount of agar but divided in only three administrations in 24 hours; the last group received continuous phototherapy for 96 hours with a white cold fluorescent light from a source of 8-Vita-lite lamp of 40 watts with a intensity of 500 foot candle and 30 lumens. All of these babies weighed less than 2.500 g. and were between 10 and 90 percentil of Lubschenko diagram. They were fed with the same formula and same time table with no infusions, rejecting all that presented any type of pathology. Obstetric conditions were basically identical. This population was randomly divided in four groups. 1) Control group with no profilaxis, but with identical bilirrubin andhematocrit determinations. 2) Group with continuous agar oral administration, 125 mg. before each of the seven formula feeding. 3) Group with discontinuous agar administration, 250 mg. before three of the seven formula feeding. 4) Group with continuous phototherapy for 96 hours. These is initial identification of the groups with statistic signification, and after that a quantitative and sequential evolution of bilirrubin is analized in each group.

Estimating Effects of Multipath Propagation on GPS Signals

NASA Technical Reports Server (NTRS)

Byun, Sung; Hajj, George; Young, Lawrence

2005-01-01

Multipath Simulator Taking into Account Reflection and Diffraction (MUSTARD) is a computer program that simulates effects of multipath propagation on received Global Positioning System (GPS) signals. MUSTARD is a very efficient means of estimating multipath-induced position and phase errors as functions of time, given the positions and orientations of GPS satellites, the GPS receiver, and any structures near the receiver as functions of time. MUSTARD traces each signal from a GPS satellite to the receiver, accounting for all possible paths the signal can take, including all paths that include reflection and/or diffraction from surfaces of structures near the receiver and on the satellite. Reflection and diffraction are modeled by use of the geometrical theory of diffraction. The multipath signals are added to the direct signal after accounting for the gain of the receiving antenna. Then, in a simulation of a delay-lock tracking loop in the receiver, the multipath-induced range and phase errors as measured by the receiver are estimated. All of these computations are performed for both right circular polarization and left circular polarization of both the L1 (1.57542-GHz) and L2 (1.2276-GHz) GPS signals.

Study of a wireless power transmission system for an active capsule endoscope.

PubMed

Xin, Wenhui; Yan, Guozheng; Wang, Wenxin

2010-03-01

An active capsule endoscope (ACE) will consume much more energy than can be power by batteries. Its orientation and position are always undetermined when it continues the natural way down the gastrointestinal track. In order to deliver stable and sufficient energy to ACE safely, a wireless power transmission system based on inductive coupling is presented. The system consists of a Helmholtz primary coil outside and a multiple secondary coils inside the body. The Helmholtz primary coil is driven to generate a uniform alternating magnetic field covering the whole of the alimentary tract, and the multiple secondary coils receive energy regardless of the ACE's position and orientation relative to the generated magnetic field. The human tissue safety of the electromagnetic field generated by transmitting coil was evaluated, based on a high-resolution realistic human model. At least 310 mW usable power can be transmitted under the worst geometrical conditions. Outer dimensions of the power receiver, 10 mm diameter x 12 mm; transmitting power, 25 W; resonant frequency, 400 kHz. The maximum specific absorption rate (SAR) and current density of human tissues are 0.329 W/kg and 3.82 A/m(2), respectively, under the basic restrictions of the International Commission on Non-ionizing Radiation Protection (ICNIRP). The designed wireless power transmission is shown to be feasible and potentially safe in a future application. (c) 2010 John Wiley & Sons, Ltd.

Orbit determination performances using single- and double-differenced methods: SAC-C and KOMPSAT-2

NASA Astrophysics Data System (ADS)

Hwang, Yoola; Lee, Byoung-Sun; Kim, Haedong; Kim, Jaehoon

2011-01-01

In this paper, Global Positioning System-based (GPS) Orbit Determination (OD) for the KOrea-Multi-Purpose-SATellite (KOMPSAT)-2 using single- and double-differenced methods is studied. The requirement of KOMPSAT-2 orbit accuracy is to allow 1 m positioning error to generate 1-m panchromatic images. KOMPSAT-2 OD is computed using real on-board GPS data. However, the local time of the KOMPSAT-2 GPS receiver is not synchronized with the zero fractional seconds of the GPS time internally, and it continuously drifts according to the pseudorange epochs. In order to resolve this problem, an OD based on single-differenced GPS data from the KOMPSAT-2 uses the tagged time of the GPS receiver, and the accuracy of the OD result is assessed using the overlapping orbit solution between two adjacent days. The clock error of the GPS satellites in the KOMPSAT-2 single-differenced method is corrected using International GNSS Service (IGS) clock information at 5-min intervals. KOMPSAT-2 OD using both double- and single-differenced methods satisfies the requirement of 1-m accuracy in overlapping three dimensional orbit solutions. The results of the SAC-C OD compared with JPL’s POE (Precise Orbit Ephemeris) are also illustrated to demonstrate the implementation of the single- and double-differenced methods using a satellite that has independent orbit information available for validation.

Evaluation of predictive capacities of biomarkers based on research synthesis.

PubMed

Hattori, Satoshi; Zhou, Xiao-Hua

2016-11-10

The objective of diagnostic studies or prognostic studies is to evaluate and compare predictive capacities of biomarkers. Suppose we are interested in evaluation and comparison of predictive capacities of continuous biomarkers for a binary outcome based on research synthesis. In analysis of each study, subjects are often classified into two groups of the high-expression and low-expression groups according to a cut-off value, and statistical analysis is based on a 2 × 2 table defined by the response and the high expression or low expression of the biomarker. Because the cut-off is study specific, it is difficult to interpret a combined summary measure such as an odds ratio based on the standard meta-analysis techniques. The summary receiver operating characteristic curve is a useful method for meta-analysis of diagnostic studies in the presence of heterogeneity of cut-off values to examine discriminative capacities of biomarkers. We develop a method to estimate positive or negative predictive curves, which are alternative to the receiver operating characteristic curve based on information reported in published papers of each study. These predictive curves provide a useful graphical presentation of pairs of positive and negative predictive values and allow us to compare predictive capacities of biomarkers of different scales in the presence of heterogeneity in cut-off values among studies. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Frequency of respiratory deterioration after immunisation in preterm infants.

PubMed

Hacking, Douglas F; Davis, Peter G; Wong, Ester; Wheeler, Kevin; McVernon, Jodie

2010-12-01

To determine the relationship between the initiation of respiratory support and the first routine immunisation of neonates at 2 months of age during primary hospitalisation. An historical cohort study design was used to study the neonatal factors associated with the initiation of respiratory support within 7 days of immunisation in a cohort of 7629 preterm and term infants admitted to the Neonatal Unit of the Royal Women's Hospital between 2001 and 2008. The 411 infants who received their first immunisations in hospital were both very preterm and of extremely low birth weight (ELBW, below 1000 g). Twenty-two infants experienced post-immunisation apnoea of sufficient severity to warrant the initiation of either intermittent positive pressure ventilation (two cases) or continuous positive airway pressure (20 cases). Infants exhibiting a respiratory deterioration following immunisation had a higher incidence of previous septicaemia (Odds ratio 2.5, 95% confidence interval 1.0, 6.1; P = 0.04) and received CPAP for a longer period prior to vaccination (P = 0.03). Apnoea following immunisation may be an aetiological factor in the requirement of respiratory support in a small number of preterm, ELBW infants particularly those with significant lung disease and those who have previously experienced septicaemia. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Academic specialties in U.S. are shifting; hiring of women geoscientists is stagnating

NASA Astrophysics Data System (ADS)

Holmes, Mary Anne; O'Connell, Suzanne; Frey, Connie; Ongley, Lois K.

Women have been receiving a greater proportion of the bachelor's and master's degrees in the geosciences over the last 10 years, reaching near 40% in 2000 (latest data available), while receiving only 28% of the Ph.D.s that year. Women are now only 20% of assistant professors at Ph.D.-granting institutions, a proportion that has not changed in the last 4 years. As part of a larger study to find what key barriers continue to prevent larger numbers of women geoscientists from becoming academics, data have been compiled from the National Science Board [NSB, 2002] and the American Geological Institute's (AGI) Directory of Geoscience Departments [Claudy, 2001] on geoscience specialty by gender.The data are broken down by the specialty of the Ph.D., and compared to hiring rates at Ph.D.-granting institutions over the last 10 years. These institutions are the focus because they are the source of future Ph.D.s, and diversity of their faculty is critical to assuring diversity and consequent intellectual vigor and strength of our future academic workforce. The data reveal both a slight shift in the subdisciplines of all geoscientists employed in tenure-track positions at Ph.D.-granting institutions, and that hiring of women into tenure-track positions in specific subdisciplines has not kept pace with their Ph.D. production during that time.

Perspective: examining communication as macrocognition in STS.

PubMed

Keyton, Joann; Beck, Stephenson J

2010-04-01

There are significant points of alignment between a macrocognitive frame of teamwork and a communication perspective. This commentary explores these touch points in regard to use of teams in sociotechnical systems (STS). The macrocognitive framework emphasizes a team's shared mental models whereas a communication frame emphasizes that shared meaning among team members is more frequently implicitly than explicitly recorded in their messages. Both acknowledge that communication (in macrocognition) or messages (in communication) serve as an index of team members' goal-directed behavior. The two approaches differ in the role of communication: as information exchange in macrocognition as compared with verbal and nonverbal symbols composing messages for which senders and receivers co-construct meaning. This commentary uses relevant literature to explicate the communication position. From a communication perspective, individuals are simultaneously sending and receiving messages, communication is continual and processual, and meaning construction is dependent on relationship awareness and development among communication partners as well as the context. The authors posit that meaning cannot be constructed solely from messages, nor can meaning be constructed by one person. Furthermore, sharing information is not the same as communicating. Architects and users of STS should be interested in designing systems that improve team communication-a goal that is interdependent with understanding how communication fails in the use of such systems. Drilling down to the fundamental properties of communication is essential to understanding how and why meaning is created among team members (and subsequent action).

Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data.

PubMed

Owens, Christabel; Hansford, Lorraine; Sharkey, Siobhan; Ford, Tamsin

2016-03-01

Presentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood. To examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter. Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm. Participants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received 'treatment as usual', i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle. The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted. © The Royal College of Psychiatrists 2016.

Cutaneous toxicities associated with vemurafenib therapy in 107 patients with BRAF V600E mutation-positive metastatic melanoma, including recognition and management of rare presentations.

PubMed

Sinha, R; Larkin, J; Gore, M; Fearfield, L

2015-10-01

Vemurafenib significantly improved overall survival compared with dacarbazine in patients with metastatic or unresectable BRAF V600E-positive melanoma in the BRIM-3 trial. However, vemurafenib was associated with a number of skin-related adverse events (AEs). To investigate the incidence and management of vemurafenib-associated skin AEs. This retrospective, observational study included adult patients with stage IIIC or IV melanoma who received vemurafenib between March 2010 and August 2013. Patients received oral vemurafenib 960 mg twice daily, with dose interruptions and reductions allowed for AE management. In total 107 patients were treated with vemurafenib during the study period. The most frequent clinically important skin-related AEs were rash (64%), squamoproliferative growths (41%), photosensitivity (40%) and squamous cell carcinoma (SCC) or keratoacanthoma (KA; 20%). Rare cases of granulomatous dermatitis and cutaneous T-cell lymphoma were also found. Rash was manageable with corticosteroids and dose modifications; squamoproliferative growths and SCCs/KAs were treated with cryotherapy and surgical excision, respectively. Patients were counselled regarding phototoxicity. The uncontrolled nature and retrospective design of the study, and the small patient numbers are limitations. Vemurafenib appears to have a predictable and manageable AE profile. Proactive management can limit the impact of AEs on patients, allowing treatment to continue despite toxicities. © 2015 British Association of Dermatologists.

System and method for acquisition management of subject position information

DOEpatents

Carrender, Curt

2005-12-13

A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.

System and method for acquisition management of subject position information

DOEpatents

Carrender, Curt [Morgan Hill, CA

2007-01-23

A system and method for acquisition management of subject position information that utilizes radio frequency identification (RF ID) to store position information in position tags. Tag programmers receive position information from external positioning systems, such as the Global Positioning System (GPS), from manual inputs, such as keypads, or other tag programmers. The tag programmers program each position tag with the received position information. Both the tag programmers and the position tags can be portable or fixed. Implementations include portable tag programmers and fixed position tags for subject position guidance, and portable tag programmers for collection sample labeling. Other implementations include fixed tag programmers and portable position tags for subject route recordation. Position tags can contain other associated information such as destination address of an affixed subject for subject routing.

Low-Cost GNSS Receivers for Local Monitoring: Experimental Simulation, and Analysis of Displacements

PubMed Central

Biagi, Ludovico; Grec, Florin Cătălin; Negretti, Marco

2016-01-01

The geodetic monitoring of local displacements and deformations is often needed for civil engineering structures and natural phenomena like, for example, landslides. A local permanent GNSS (Global Navigation Satellite Systems) network can be installed: receiver positions in the interest area are estimated and monitored with respect to reference stations. Usually, GNSS geodetic receivers are adopted and provide results with accuracies at the millimeter level: however, they are very expensive and the initial cost and the risk of damage and loss can discourage this approach. In this paper the accuracy and the reliability of low-cost u-blox GNSS receivers are experimentally investigated for local monitoring. Two experiments are analyzed. In the first, a baseline (65 m long) between one geodetic reference receiver and one u-blox is continuously observed for one week: the data are processed by hourly sessions and the results provide comparisons between two processing packages and a preliminary accuracy assessment. Then, a network composed of one geodetic and two u-blox receivers is set up. One u-blox is installed on a device (slide) that allows to apply controlled displacements. The geodetic and the other u-blox (at about 130 m) act as references. The experiment lasts about two weeks. The data are again processed by hourly sessions. The estimated displacements of the u-blox on the slide are analyzed and compared with the imposed displacements. All of the results are encouraging: in the first experiment the standard deviations of the residuals are smaller than 5 mm both in the horizontal and vertical; in the second, they are slightly worse but still satisfactory (5 mm in the horizontal and 13 mm in vertical) and the imposed displacements are almost correctly identified. PMID:27983707

Association between frequency of telephonic contact and clinical testing for a large, geographically diverse diabetes disease management population.

PubMed

Coberley, Carter R; McGinnis, Matthew; Orr, Patty M; Coberley, Sadie S; Hobgood, Adam; Hamar, Brent; Gandy, Bill; Pope, James; Hudson, Laurel; Hara, Pam; Shurney, Dexter; Clarke, Janice L; Crawford, Albert; Goldfarb, Neil I

2007-04-01

Diabetes disease management (DM) programs strive to promote healthy behaviors, including obtaining hemoglobin A1c (A1c) and low-density lipoprotein (LDL) tests as part of standards of care. The purpose of this study was to examine the relationship between frequency of telephonic contact and A1c and LDL testing rates. A total of 245,668 members continuously enrolled in diabetes DM programs were evaluated for performance of an A1c or LDL test during their first 12 months in the programs. The association between the number of calls a member received and clinical testing rates was examined. Members who received four calls demonstrated a 24.1% and 21.5% relative increase in A1c and LDL testing rates, respectively, compared to members who received DM mailings alone. Response to the telephonic intervention as part of the diabetes DM programs was influenced by member characteristics including gender, age, and disease burden. For example, females who received four calls achieved a 27.7% and 23.6% increase in A1c and LDL testing, respectively, compared to females who received mailings alone; by comparison, males who were called achieved 21.2% and 19.9% relative increase in A1c and LDL testing, respectively, compared to those who received mailings alone. This study demonstrates a positive association between frequency of telephonic contact and increased performance of an A1c or LDL test in a large, diverse diabetes population participating in DM programs. The impact of member characteristics on the responsiveness to these programs provides DM program designers with knowledge for developing strategies to promote healthy behaviors and improve diabetes outcomes.

Low-Cost GNSS Receivers for Local Monitoring: Experimental Simulation, and Analysis of Displacements.

PubMed

Biagi, Ludovico; Grec, Florin Cătălin; Negretti, Marco

2016-12-15

The geodetic monitoring of local displacements and deformations is often needed for civil engineering structures and natural phenomena like, for example, landslides. A local permanent GNSS (Global Navigation Satellite Systems) network can be installed: receiver positions in the interest area are estimated and monitored with respect to reference stations. Usually, GNSS geodetic receivers are adopted and provide results with accuracies at the millimeter level: however, they are very expensive and the initial cost and the risk of damage and loss can discourage this approach. In this paper the accuracy and the reliability of low-cost u-blox GNSS receivers are experimentally investigated for local monitoring. Two experiments are analyzed. In the first, a baseline (65 m long) between one geodetic reference receiver and one u-blox is continuously observed for one week: the data are processed by hourly sessions and the results provide comparisons between two processing packages and a preliminary accuracy assessment. Then, a network composed of one geodetic and two u-blox receivers is set up. One u-blox is installed on a device (slide) that allows to apply controlled displacements. The geodetic and the other u-blox (at about 130 m) act as references. The experiment lasts about two weeks. The data are again processed by hourly sessions. The estimated displacements of the u-blox on the slide are analyzed and compared with the imposed displacements. All of the results are encouraging: in the first experiment the standard deviations of the residuals are smaller than 5 mm both in the horizontal and vertical; in the second, they are slightly worse but still satisfactory (5 mm in the horizontal and 13 mm in vertical) and the imposed displacements are almost correctly identified.

An examination of the factors affecting people's participation in future health examinations based on community health exam interventions.

PubMed

Tu, Shih-Kai; Liao, Hung-En

2014-01-01

Community-based intervention health examinations were implemented at a health care facility to comply with the government's primary health care promotion policy. The theory of planned behavior model was applied to examine the effect that community-based health examinations had on people's health concepts regarding seeking future health examinations. The research participants were individuals who had received a health examination provided at two branches of a hospital in central Taiwan in 2012. The hospital's two branches held a total of 14 free community-based health examination sessions. The hospital provided health examination equipment and staff to perform health examinations during public holidays. We conducted an exploratory questionnaire survey to collect data and implemented cross-sectional research based on anonymous self-ratings to examine the public's intention to receive future community-based or hospital-based health examinations. Including of 807 valid questionnaires, accounting for 89.4% of the total number of questionnaires distributed. The correlation coefficients of the second-order structural model indicate that attitudes positively predict behavioral intentions (γ = .66, p < .05), and subjective norms also positively predict behavioral intentions (γ = .66, p < .01). By contrast, perceived behavioral control has no significant relationship with behavioral intentions (γ = -.71, p > .05). The results of the first-order structural model indicated that the second-order constructs had a high explanatory power for the first-order constructs. People's health concepts regarding health examinations and their desire to continue receiving health examinations must be considered when promoting health examinations in the community. Regarding hospital management and the government's implementation of primary health care, health examination services should address people's medical needs to increase coverage and participation rates and reduce the waste of medical resources.

Influence of the ventilatory mode on acute adverse effects and facial thermography after noninvasive ventilation

PubMed Central

Pontes, Suzy Maria Montenegro; Melo, Luiz Henrique de Paula; Maia, Nathalia Parente de Sousa; Nogueira, Andrea da Nóbrega Cirino; Vasconcelos, Thiago Brasileiro; Pereira, Eanes Delgado Barros; Bastos, Vasco Pinheiro Diógenes; Holanda, Marcelo Alcantara

2017-01-01

ABSTRACT Objective: To compare the incidence and intensity of acute adverse effects and the variation in the temperature of facial skin by thermography after the use of noninvasive ventilation (NIV). Methods: We included 20 healthy volunteers receiving NIV via oronasal mask for 1 h. The volunteers were randomly divided into two groups according to the ventilatory mode: bilevel positive airway pressure (BiPAP) or continuous positive airway pressure (CPAP). Facial thermography was performed in order to determine the temperature of the face where it was in contact with the mask and of the nasal dorsum at various time points. After removal of the mask, the volunteers completed a questionnaire about adverse effects of NIV. Results: The incidence and intensity of acute adverse effects were higher in the individuals receiving BiPAP than in those receiving CPAP (16.1% vs. 5.6%). Thermographic analysis showed a significant cooling of the facial skin in the two regions of interest immediately after removal of the mask. The more intense acute adverse effects occurred predominantly among the participants in whom the decrease in the mean temperature of the nasal dorsum was lower (14.4% vs. 7.2%). The thermographic visual analysis of the zones of cooling and heating on the face identified areas of hypoperfusion or reactive hyperemia. Conclusions: The use of BiPAP mode was associated with a higher incidence and intensity of NIV-related acute adverse effects. There was an association between acute adverse effects and less cooling of the nasal dorsum immediately after removal of the mask. Cutaneous thermography can be an additional tool to detect adverse effects that the use of NIV has on facial skin. PMID:28538774

Self-Activating System and Method for Alerting When an Object or a Person is Left Unattended

NASA Technical Reports Server (NTRS)

Edwards, William Christopher (Inventor); Mack, Terry L. (Inventor); Modlin, Edward A. (Inventor)

2004-01-01

A system and method uses a wireless tether comprising a transmitter and a receiver to alert a caregiver that an object or person has been left unattended. A detector Senses the presence of the object, usually a child, located in a position such as a safety seat. The detector couples to the transmitter, which is located near the object. The transmitter transmits at least one wireless signal when the object is in the position. The receiver, which is remotely located from the transmitter, senses the at least one signal as long as the receiver is within a prescribed range of transmission. By performing a timing function, the receiver monitors the proximity of the caregiver, who maintains possession of the receiver, to the transmitter. The system communicates an alarm to the caregiver when the caregiver ventures outside the range of transmission without having removed the object/child from the position.

Self-activating System and Method for Alerting When an Object or a Person is Left Unattended

NASA Technical Reports Server (NTRS)

Edwards, William C. (Inventor); Mack, Terry L. (Inventor); Modlin, Edward A. (Inventor)

2006-01-01

A system and method use a wireless tether comprising a transmitter and a receiver to alert a caregiver that an object has been left unattended. A detector senses the presence of the object, usually a child, located in a position such as a safety seat. The detector is operatively coupled to the transmitter. which is located near the object. The transmitter transmits at least one wireless signal when the object is in the position. The receiver, which is remotely located from the transmitter, senses at least one signal as long as the receiver is within a prescribed range of transmission. By performing a timing function, the receiver monitors the proximity of the caregiver, who maintains possession of the receiver, to the transmitter. The system communicates an alarm to the caregiver when the caregiver ventures outside the range of transmission without having removed the object from the position.

Cognitive Improvement of Attention and Inhibition in the Late Afternoon in Children With Attention-Deficit Hyperactivity Disorder (ADHD) Treated With Osmotic-Release Oral System Methylphenidate.

PubMed

Slama, Hichem; Fery, Patrick; Verheulpen, Denis; Vanzeveren, Nathalie; Van Bogaert, Patrick

2015-07-01

Long-acting medications have been developed and approved for use in the treatment of attention-deficit hyperactivity disorder (ADHD). These compounds are intended to optimize and maintain symptoms control throughout the day. We tested prolonged effects of osmotic-release oral system methylphenidate on both attention and inhibition, in the late afternoon. A double-blind, randomized, placebo-controlled study was conducted in 36 boys (7-12 years) with ADHD and 40 typically developing children. The ADHD children received an individualized dose of placebo or osmotic-release oral system methylphenidate. They were tested about 8 hours after taking with 2 continuous performance tests (continuous performance test-X [CPT-X] and continuous performance test-AX [CPT-AX]) and a counting Stroop. A positive effect of osmotic-release oral system methylphenidate was present in CPT-AX with faster and less variable reaction times under osmotic-release oral system methylphenidate than under placebo, and no difference with typically developing children. In the counting Stroop, we found a decreased interference with osmotic-release oral system methylphenidate but no difference between children with ADHD under placebo and typically developing children. © The Author(s) 2014.

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

PubMed

Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

2018-01-01

To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

Improved Bone Safety of Tenofovir Alafenamide Compared to Tenofovir Disoproxil Fumarate Over 2 Years in Patients With Chronic HBV Infection.

PubMed

Seto, Wai-Kay; Asahina, Yasuhiro; Brown, Todd T; Peng, Cheng-Yuan; Stanciu, Carol; Abdurakhmanov, Dzhamal; Tabak, Fehmi; Nguyen, Tuan T; Chuang, Wan-Long; Inokuma, Tetsuro; Ikeda, Fusao; Santantonio, Teresa Antonia; Habersetzer, François; Ramji, Alnoor; Lau, Audrey H; Suri, Vithika; Flaherty, John F; Wang, Hongyuan; Gaggar, Anuj; Subramanian, G Mani; Mukewar, Shrikant; Brunetto, Maurizia R; Fung, Scott; Chan, Henry Lik-Yuen

2018-06-19

Long-term use of tenofovir disoproxil fumarate (TDF) reduces bone mineral density (BMD). Tenofovir alafenamide (TAF), a new prodrug of tenofovir, has shown non-inferior efficacy to TDF in patients with chronic hepatitis B virus (HBV) infection, with improved bone effects at 48 weeks. We performed a randomized trial to evaluate the bone safety of TAF compared with TDF over 2 years, assessing baseline risk factors for bone loss, were evaluated after 2 years of treatment. In a double-blind study, hepatitis B e antigen (HBeAg)-positive patients (n=873) and HBeAg-negative patients (n=425) were randomly assigned (2:1) to groups given TAF (25 mg, n=866) or TDF (300 mg, n=432) once daily. We assessed bone safety, including hip and spine BMD, using dual-energy X-ray absorptiometry and measured changes in serum markers of bone turnover over 96 weeks. At baseline, treatment groups were well matched. At week 96, patients receiving TAF had significantly smaller decreases in hip BMD (mean reduction of 0.33%) than patients receiving TDF (mean reduction of 2.51%) (P<.001) and spine BMD (reduction of 0.75% in patients receiving patients receiving TAF vs reduction of 2.57% in patients receiving TDF) (P<.001). For hip BMD, the magnitude of difference in bone loss between the TAF and TDF groups increased at week 96 compared to week 48 (P<.001). The TAF group had minimal changes in markers of bone turnover by 12 weeks of treatment, but the TDF group had significant changes, compared to baseline. Risk factors for bone loss had fewer effects in patients receiving TAF than TDF at week 96. In double-blind randomized trials, we found that after 2 years of treatment, patients receiving TAF had continued improvements in bone safety compared with patients receiving TDF. Clinicaltrial.gov no: NCT01940471 and NCT01940341. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

Sample-Clock Phase-Control Feedback

NASA Technical Reports Server (NTRS)

Quirk, Kevin J.; Gin, Jonathan W.; Nguyen, Danh H.; Nguyen, Huy

2012-01-01

To demodulate a communication signal, a receiver must recover and synchronize to the symbol timing of a received waveform. In a system that utilizes digital sampling, the fidelity of synchronization is limited by the time between the symbol boundary and closest sample time location. To reduce this error, one typically uses a sample clock in excess of the symbol rate in order to provide multiple samples per symbol, thereby lowering the error limit to a fraction of a symbol time. For systems with a large modulation bandwidth, the required sample clock rate is prohibitive due to current technological barriers and processing complexity. With precise control of the phase of the sample clock, one can sample the received signal at times arbitrarily close to the symbol boundary, thus obviating the need, from a synchronization perspective, for multiple samples per symbol. Sample-clock phase-control feedback was developed for use in the demodulation of an optical communication signal, where multi-GHz modulation bandwidths would require prohibitively large sample clock frequencies for rates in excess of the symbol rate. A custom mixedsignal (RF/digital) offset phase-locked loop circuit was developed to control the phase of the 6.4-GHz clock that samples the photon-counting detector output. The offset phase-locked loop is driven by a feedback mechanism that continuously corrects for variation in the symbol time due to motion between the transmitter and receiver as well as oscillator instability. This innovation will allow significant improvements in receiver throughput; for example, the throughput of a pulse-position modulation (PPM) with 16 slots can increase from 188 Mb/s to 1.5 Gb/s.

Conduit grinding apparatus

DOEpatents

Nachbar, Henry D.; Korytkowski, Alfred S.

1991-01-01

A grinding apparatus for grinding the interior portion of a valve stem receiving area of a valve. The apparatus comprises a faceplate, a plurality of cams mounted to an interior face of the faceplate, a locking bolt to lock the faceplate at a predetermined position on the valve, a movable grinder and a guide tube for positioning an optical viewer proximate the area to be grinded. The apparatus can either be rotated about the valve for grinding an area of the inner diameter of a valve stem receiving area or locked at a predetermined position to grind a specific point in the receiving area.

Performance Assessment of Integrated Sensor Orientation with a Low-Cost Gnss Receiver

NASA Astrophysics Data System (ADS)

Rehak, M.; Skaloud, J.

2017-08-01

Mapping with Micro Aerial Vehicles (MAVs whose weight does not exceed 5 kg) is gaining importance in applications such as corridor mapping, road and pipeline inspections, or mapping of large areas with homogeneous surface structure, e.g. forest or agricultural fields. In these challenging scenarios, integrated sensor orientation (ISO) improves effectiveness and accuracy. Furthermore, in block geometry configurations, this mode of operation allows mapping without ground control points (GCPs). Accurate camera positions are traditionally determined by carrier-phase GNSS (Global Navigation Satellite System) positioning. However, such mode of positioning has strong requirements on receiver's and antenna's performance. In this article, we present a mapping project in which we employ a single-frequency, low-cost (< 100) GNSS receiver on a MAV. The performance of the low-cost receiver is assessed by comparing its trajectory with a reference trajectory obtained by a survey-grade, multi-frequency GNSS receiver. In addition, the camera positions derived from these two trajectories are used as observations in bundle adjustment (BA) projects and mapping accuracy is evaluated at check points (ChP). Several BA scenarios are considered with absolute and relative aerial position control. Additionally, the presented experiments show the possibility of BA to determine a camera-antenna spatial offset, so-called lever-arm.

20 CFR 411.175 - What if a continuing disability review is begun before my ticket is in use?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ticket is in use, you may still assign the ticket and receive services from an EN or a State VR agency acting as an EN under the Ticket to Work program, or you may still receive services from a State VR agency that elects the VR cost reimbursement option. However, we will complete the continuing disability...

20 CFR 411.175 - What if a continuing disability review is begun before my ticket is in use?

Code of Federal Regulations, 2011 CFR

2011-04-01

... ticket is in use, you may still assign the ticket and receive services from an EN or a State VR agency acting as an EN under the Ticket to Work program, or you may still receive services from a State VR agency that elects the VR cost reimbursement option. However, we will complete the continuing disability...

20 CFR 408.234 - Can you continue to receive SVB payments if you stay in the United States for more than 1 full...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can you continue to receive SVB payments if...' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS SVB... family, a transportation strike, etc.); or (2) Are exercising your option to be personally present in the...

20 CFR 411.175 - What if a continuing disability review is begun before my ticket is in use?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ticket is in use, you may still assign the ticket and receive services from an EN or a State VR agency acting as an EN under the Ticket to Work program, or you may still receive services from a State VR agency that elects the VR cost reimbursement option. However, we will complete the continuing disability...

20 CFR 411.175 - What if a continuing disability review is begun before my ticket is in use?

Code of Federal Regulations, 2012 CFR

2012-04-01

... ticket is in use, you may still assign the ticket and receive services from an EN or a State VR agency acting as an EN under the Ticket to Work program, or you may still receive services from a State VR agency that elects the VR cost reimbursement option. However, we will complete the continuing disability...

20 CFR 411.175 - What if a continuing disability review is begun before my ticket is in use?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ticket is in use, you may still assign the ticket and receive services from an EN or a State VR agency acting as an EN under the Ticket to Work program, or you may still receive services from a State VR agency that elects the VR cost reimbursement option. However, we will complete the continuing disability...

Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies treated with anticancer therapy

PubMed Central

Law, Man Fai; Ho, Rita; Cheung, Carmen K M; Tam, Lydia H P; Ma, Karen; So, Kent C Y; Ip, Bonaventure; So, Jacqueline; Lai, Jennifer; Ng, Joyce; Tam, Tommy H C

2016-01-01

Hepatitis due to hepatitis B virus (HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximab-containing therapy for hematological malignancies and those receiving stem cell transplantation. All patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc). Patients found to be positive for HBsAg should be given prophylactic antiviral therapy to prevent HBV reactivation. For patients with resolved HBV infection, no standard strategy has yet been established to prevent HBV reactivation. There are usually two options. One is pre-emptive therapy guided by serial HBV DNA monitoring, whereby antiviral therapy is given as soon as HBV DNA becomes detectable. However, there is little evidence regarding the optimal interval and period of monitoring. An alternative approach is prophylactic antiviral therapy, especially for patients receiving high-risk therapy such as rituximab, newer generation of anti-CD20 monoclonal antibody, obinutuzumab or hematopoietic stem cell transplantation. This strategy may effectively prevent HBV reactivation and avoid the inconvenience of repeated HBV DNA monitoring. Entecavir or tenofovir are preferred over lamivudine as prophylactic therapy. Although there is no well-defined guideline on the optimal duration of prophylactic therapy, there is growing evidence to recommend continuing prophylactic antiviral therapy for at least 12 mo after cessation of chemotherapy, and even longer for those who receive rituximab or who had high serum HBV DNA levels before the start of immunosuppressive therapy. Many novel agents have recently become available for the treatment of hematological malignancies, and these agents may be associated with HBV reactivation. Although there is currently limited evidence to guide the optimal preventive measures, we recommend antiviral prophylaxis in HBsAg-positive patients receiving novel treatments, especially the Bruton tyrosine kinase inhibitors and the phosphatidylinositol 3-kinase inhibitors, which are B-cell receptor signaling modulators and reduce proliferation of malignant B-cells. Further studies are needed to clarify the risk of HBV reactivation with these agents and the best prophylactic strategy in the era of targeted therapy for hematological malignancies. PMID:27605883

From underplating to delamination-retreat in the northern Apennines

NASA Astrophysics Data System (ADS)

Chiarabba, C.; Giacomuzzi, G.; Bianchi, I.; Agostinetti, N. P.; Park, J.

2014-10-01

Recordings of teleseismic earthquakes from a dense set of temporary and permanent broadband seismic stations reveal the lithospheric structure of the northern Apennines and support the scenario of a retreating detachment within the mid-crust. Lithospheric delamination appears crucial to the formation and evolution of the Apennines orogen. Receiver-function (RF) stacks outline a continuous west-dipping Ps converted phase from a positive velocity jump that we interpret as the top of the lower crust and mantle of the Adria continental lithosphere, which is descending into the shallow mantle. The correlation of seismicity with two RF profiles across the northern Apennines suggests distinct stages of lithospheric delamination. Active penetration of the detachment into the Adria lithosphere seems evident in the south/east, with induced shallow-mantle flow facilitated by slab dehydration. Penetration of the detachment in the north/west seems to have arrested, and is possibly marked by crustal underplating. This layer atop the Apennines slab is visible only down to 80 km depth and suspends above an oppositely-dipping paired positive/negative Ps converted phase in stacked receiver functions. The break in the west-dipping Adria lithosphere conflicts with a westward-subduction scenario continuous from the Oligocene. Lateral changes of deep structure and seismicity along the northern Apennines suggest that underplating of crustal material and delamination-retreat are distinct mechanisms active today in the western and eastern sectors, respectively, of the northern Apennines. Negative Ps-pulses at 100-120 km depth help to define a seismic lithosphere-asthenosphere boundary (LAB), but cross-cut a volume of high-velocity mantle rock, as inferred from tomographic models. We hypothesize that this seismic LAB is a rheological discontinuity that affects the frequency band of seismic body waves, but not the long-term viscous response that governs the evolution and eventual detachment of the continental slab.

Extubation success in premature infants with respiratory distress syndrome treated with bi-level nasal continuous positive airway pressure versus nasal intermittent positive pressure ventilation.

PubMed

Thomas, Patricia E; LeFlore, Judy

2013-01-01

Infants born prematurely with respiratory distress syndrome are at high risk for complications from mechanical ventilation. Strategies are needed to minimize their days on the ventilator. The purpose of this study was to compare extubation success rates in infants treated with 2 different types of continuous positive airway pressure devices. A retrospective cohort study design was used. Data were retrieved from electronic medical records for patients in a large, metropolitan, level III neonatal intensive care unit. A sample of 194 premature infants with respiratory distress syndrome was selected, 124 of whom were treated with nasal intermittent positive pressure ventilation and 70 with bi-level variable flow nasal continuous positive airway pressure (bi-level nasal continuous positive airway pressure). Infants in both groups had high extubation success rates (79% of nasal intermittent positive pressure ventilation group and 77% of bi-level nasal continuous positive airway pressure group). Although infants in the bi-level nasal continuous positive airway pressure group were extubated sooner, there was no difference in duration of oxygen therapy between the 2 groups. Promoting early extubation and extubation success is a vital strategy to reduce complications of mechanical ventilation that adversely affect premature infants with respiratory distress syndrome.

Clinically significant anemia in HIV-infected pregnant women in India is not a major barrier to zidovudine use for prevention of maternal-to-child transmission.

PubMed

Sinha, Gita; Choi, Tou J; Nayak, Uma; Gupta, Amita; Nair, Sandeep; Gupte, Nikhil; Bulakh, Pandurang M; Sastry, Jayagowri; Deshmukh, Sanjay D; Khandekar, Medha M; Kulkarni, Vandana; Bhosale, Ramesh A; Bharucha, Kapila E; Phadke, Mrudula A; Kshirsagar, Anandini S; Bollinger, Robert C

2007-06-01

To determine the prevalence of anemia (serum hemoglobin <10 g/dL) and assess zidovudine use and toxicity in HIV-positive pregnant women in India. From 2002 through 2006, 24,105 pregnant women in Pune were screened for HIV and anemia. As part of an infant prevention of mother-to-child transmission (PMTCT) trial, enrolled HIV-positive women (n = 467) were assessed for anemia and associated outcomes, comparing women receiving zidovudine for >or=2 weeks versus no zidovudine. The prevalence of anemia was 38.7% in HIV-positive women. Anemic women were as likely as nonanemic women to receive zidovudine. At delivery, regardless of anemia status at enrollment, women receiving >or=2 weeks of zidovudine were 70% less likely to be anemic compared with women receiving no zidovudine (odds ratio = 0.28, 95% confidence interval: 0.14 to 0.57; P < 0.01), received iron and folic acid supplements for longer periods, and had no increased adverse delivery or newborn birth outcomes. A significant proportion of HIV-positive pregnant women in India present for antenatal care with anemia. With concurrent iron and folic acid supplementation, however, zidovudine use is not associated with persistent or worsening anemia or associated adverse outcomes. In Indian community settings, all pregnant HIV-positive women should receive early anemia treatment. Mild anemia should not limit zidovudine use for PMTCT in India.

Methods and Apparatus for Reducing Multipath Signal Error Using Deconvolution

NASA Technical Reports Server (NTRS)

Kumar, Rajendra (Inventor); Lau, Kenneth H. (Inventor)

1999-01-01

A deconvolution approach to adaptive signal processing has been applied to the elimination of signal multipath errors as embodied in one preferred embodiment in a global positioning system receiver. The method and receiver of the present invention estimates then compensates for multipath effects in a comprehensive manner. Application of deconvolution, along with other adaptive identification and estimation techniques, results in completely novel GPS (Global Positioning System) receiver architecture.

Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea

PubMed Central

Hack, M.; Davies, R.; Mullins, R.; Choi, S. J.; Ramdassingh-Dow, S.; Jenkinson, C.; Stradling, J.

2000-01-01

BACKGROUND—Obstructive sleep apnoea (OSA) impairs vigilance and may lead to an increased rate of driving accidents. In uncontrolled studies accident rates and simulated steering performance improve following treatment with nasal continuous positive airway pressure (NCPAP). This study seeks to confirm the improvement in steering performance in a randomised controlled trial using subtherapeutic NCPAP as a control treatment.
METHODS—Fifty nine men with OSA (Epworth Sleepiness Score (ESS) of ⩾10, and ⩾10/h dips in SaO2 of >4% due to OSA) received therapeutic or subtherapeutic NCPAP (≈1 cm H2O) for one month. Simulated steering performance over three 30-minute "drives" was quantified as: standard deviation (SD) of road position, deterioration in SD across the drive, length of drive before "crashing", and number of off-road events. The reaction times to peripheral target stimuli during the drive were also measured.
RESULTS—Subtherapeutic NCPAP did not improve overnight >4% SaO2 dips/h compared with baseline values, thus acting as a control. The SD of the steering position improved from 0.36 to 0.21 on therapeutic NCPAP, and from 0.35 to 0.30 on subtherapeutic NCPAP (p = 0.03). Deterioration in SD of the steering position improved from 0.18to 0.06 SD/h with therapeutic NCPAP and worsened from 0.18 to 0.24 with subtherapeutic NCPAP (p = 0.04). The reaction time to target stimuli was quicker after therapeutic than after subtherapeutic NCPAP (2.3 versus 2.7 seconds, p = 0.04).
CONCLUSIONS—Therapeutic NCPAP improves steering performance and reaction time to target stimuli in patients with OSA, lending further support to the hypothesis that OSA impairs driving, increases driving accident rates, and that these improve following treatment with NCPAP.

 PMID:10679542

An action research study; cultural differences impact how manufacturing organizations receive continuous improvement

NASA Astrophysics Data System (ADS)

Kattman, Braden R.

National culture and organizational culture impact how continuous improvement methods are received, implemented and deployed by suppliers. Previous research emphasized the dominance of national culture over organizational culture. The countries studied included Poland, Mexico, China, Taiwan, South Korea, Estonia, India, Canada, the United States, the United Kingdom, and Japan. The research found that Canada was most receptive to continuous improvement, with China being the least receptive. The study found that organizational culture was more influential than national culture. Isomorphism and benchmarking is driving continuous-improvement language and methods to be more universally known within business. Business and management practices are taking precedence in driving change within organizations.

The experiences of new graduate midwives working in midwifery continuity of care models in Australia.

PubMed

Cummins, Allison M; Denney-Wilson, E; Homer, C S E

2015-04-01

midwifery continuity of care has been shown to be beneficial to women through reducing interventions and other maternal and neonatal morbidity. In Australia, numerous government reports recognise the importance of midwifery models of care that provide continuity. Given the benefits, midwives, including new graduate midwives, should have the opportunity to work in these models of care. Historically, new graduates have been required to have a number of years׳ experience before they are able to work in these models of care although a small number have been able to move into these models as new graduates. to explore the experiences of the new graduate midwives who have worked in midwifery continuity of care, in particular, the support they received; and, to establish the facilitators and barriers to the expansion of new graduate positions in midwifery continuity of care models. a qualitative descriptive study was undertaken framed by the concept of continuity of care. the new graduate midwives valued the relationship with the women and with the group of midwives they worked alongside. The ability to develop trusting relationships, consolidate skills and knowledge, be supported by the group and finally feeling prepared to work in midwifery continuity of care from their degree were all sub-themes. All of these factors led to the participants feeling as though they were 'becoming a real midwife'. this is the first study to demonstrate that new graduate midwives value working in midwifery continuity of care - they felt well prepared to work in this way from their degree and were supported by midwives they worked alongside. The participants reported having more confidence to practice when they have a relationship with the woman, as occurs in these models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hepatitis B reactivation and rituximab: a new boxed warning and considerations for solid organ transplantation.

PubMed

Martin, S T; Cardwell, S M; Nailor, M D; Gabardi, S

2014-04-01

Use of rituximab, a chimeric monoclonal antibody directed at the CD20 antigen, continues to increase in solid organ transplantation (SOT) for several off-label uses. In September 2013, the United States Food and Drug Administration (FDA) issued a Drug Safety Communication to oncology, rheumatology and pharmacy communities outlining a new Boxed Warning for rituximab. Citing 109 cases of fatal hepatitis B virus (HBV) reactivation in persons receiving rituximab therapy with previous or chronic HBV infection documented in their Adverse Event Reporting System (AERS), the FDA recommends screening for HBV serologies in all patients planned to receive rituximab and antiviral prophylaxis in any patient with a positive history of HBV infection. There is a lack of data pertaining to this topic in the SOT population despite an increase in off-label indications. Previous reports suggest patients receiving rituximab, on average, were administered six doses prior to HBV reactivation. Recommendations on prophylaxis, treatment and re-challenging patients with therapy after resolution of reactivation remain unclear. Based on data from the FDA AERS and multiple analyses in oncology, SOT providers utilizing rituximab should adhere to the FDA warnings and recommendations regarding HBV reactivation until further data are available in the SOT population. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Autoshaped choice in artificial neural networks: implications for behavioral economics and neuroeconomics.

PubMed

Burgos, José E; García-Leal, Óscar

2015-05-01

An existing neural network model of conditioning was used to simulate autoshaped choice. In this phenomenon, pigeons first receive an autoshaping procedure with two keylight stimuli X and Y separately paired with food in a forward-delay manner, intermittently for X and continuously for Y. Then pigeons receive unreinforced choice test trials of X and Y concurrently present. Most pigeons choose Y. This preference for a more valuable response alternative is a form of economic behavior that makes the phenomenon relevant to behavioral economics. The phenomenon also suggests a role for Pavlovian contingencies in economic behavior. The model used, in contrast to others, predicts autoshaping and automaintenance, so it is uniquely positioned to predict autoshaped choice. The model also contemplates neural substrates of economic behavior in neuroeconomics, such as dopaminergic and hippocampal systems. A feedforward neural network architecture was designed to simulate a neuroanatomical differentiation between two environment-behavior relations X-R1 and Y-R2, [corrected] where R1 and R2 denote two different emitted responses (not unconditionally elicited by the reward). Networks with this architecture received a training protocol that simulated an autoshaped-choice procedure. Most networks simulated the phenomenon. Implications for behavioral economics and neuroeconomics, limitations, and the issue of model appraisal are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Patients' perceptions and experiences of using a mobile phone-based advanced symptom management system (ASyMS) to monitor and manage chemotherapy related toxicity.

PubMed

McCann, L; Maguire, R; Miller, M; Kearney, N

2009-03-01

Chemotherapy forms a core component of treatment for the majority patients with cancer. Recent changes in cancer services mean patients frequently receive such treatment as outpatients and are often required to manage side effects at home without direct support from oncology health professionals. Information technology continues to develop to support patients in the community; this study evaluated the impact of a mobile phone-based advanced symptom management system (ASyMS) on chemotherapy related toxicity in patients with lung, breast or colorectal cancer. One hundred and twelve patients were randomized from seven clinical sites across the UK; 56 patients used the mobile phone to record their symptoms, sending their reports directly to the nurses at their clinical site; 56 control group patients received standard care. Health professionals were alerted about any severe or life-threatening symptoms through the development of a chemotherapy symptom risk model. Patients' perceptions of ASyMS were evaluated pre and post participation. Patients reported many benefits of using ASyMS including improved communication with health professionals, improvements in the management of their symptoms, and feeling reassured their symptoms were being monitored while at home. ASyMS has the potential to positively impact on the management of symptoms in patients receiving chemotherapy treatment.

7 CFR 1956.71 - Settling uncollectible recapture receivables.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Settling uncollectible recapture receivables. 1956.71 Section 1956.71 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE... Multi-Family Housing § 1956.71 Settling uncollectible recapture receivables. The settlement of...

Comparison of the effects of continuous positive airway pressure and mandibular advancement devices on sleepiness in patients with obstructive sleep apnoea: a network meta-analysis.

PubMed

Bratton, Daniel J; Gaisl, Thomas; Schlatzer, Christian; Kohler, Malcolm

2015-11-01

Excessive daytime sleepiness is the most important symptom of obstructive sleep apnoea and can affect work productivity, quality of life, and the risk of road traffic accidents. We aimed to quantify the effects of the two main treatments for obstructive sleep apnoea (continuous positive airway pressure and mandibular advancement devices) on daytime sleepiness and to establish predictors of response to continuous positive airway pressure. We searched MEDLINE and the Cochrane Library from inception to May 31, 2015, to identify randomised controlled trials comparing the effects of continuous positive airway pressure, mandibular advancement devices or an inactive control (eg, placebo or no treatment) on the Epworth Sleepiness Scale (ESS, range 0-24 points) in patients with obstructive sleep apnoea. We did a network meta-analysis using multivariate random-effects meta-regression to assess the effect of each treatment on ESS. We used meta-regression to assess the association of the reported effects of continuous positive airway pressure versus inactive controls with the characteristics of trials and their risk of bias. We included 67 studies comprising 6873 patients in the meta-analysis. Compared with an inactive control, continuous positive airway pressure was associated with a reduction in ESS score of 2·5 points (95% CI 2·0-2·9) and mandibular advancement devices of 1·7 points (1·1-2·3). We estimated that, on average, continuous positive airway pressure reduced the ESS score by a further 0·8 points compared with mandibular advancement devices (95% CI 0·1-1·4; p=0·015). However, there was a possibility of publication bias in favour of continuous positive airway pressure that might have resulted in this difference. We noted no evidence that studies reporting higher continuous positive airway pressure adherence also reported larger treatment effects (p=0·70). Continuous positive airway pressure and mandibular advancement devices are effective treatments for reducing daytime sleepiness in patients with obstructive sleep apnoea. Continuous positive airway pressure seemed to be a more effective treatment than mandibular advancement devices, and had an increasingly larger effect in more severe or sleepier obstructive sleep apnoea patients when compared with inactive controls. However, mandibular advancement devices are an effective alternative treatment should continuous positive airway pressure not be tolerated. Swiss National Science Foundation and the University of Zurich Clinical Research Priority Program Sleep and Health. Copyright © 2015 Elsevier Ltd. All rights reserved.

How Compliance Measures, Behavior Modification, and Continuous Quality Improvement Led to Routine HIV Screening in an Emergency Department in Brooklyn, New York.

PubMed

Isaac, Jermel Kyri; Sanchez, Travis H; Brown, Emily H; Thompson, Gina; Sanchez, Christina; Fils-Aime, Stephany; Maria, Jose

2016-01-01

New York State adopted a new HIV testing law in 2010 requiring medical providers to offer an HIV test to all eligible patients aged 13-64 years during emergency room or ambulatory care visits. Since then, Wyckoff Heights Medical Center (WHMC) in Brooklyn, New York, began implementing routine HIV screening organization-wide using a compliance, behavior-modification, and continuous quality-improvement process. WHMC first implemented HIV screening in the emergency department (ED) and evaluated progress with the following monthly indicators: HIV tests offered, HIV tests accepted, HIV tests ordered (starting in December 2013), HIV tests administered, positive HIV tests, and linkage to HIV care. Compliance with the delivery of HIV testing was determined by the proportion of patients who, after accepting a test, received one. During August 2013 through July 2014, of 57,852 eligible patients seen in the WHMC ED, a total of 31,423 (54.3%) were offered an HIV test. Of those, 8,229 (26.2%) patients accepted a test. Of those, 6,114 (74.3%) underwent a test. A total of 26 of the 6,114 patients tested (0.4%) had a positive test, and 24 of the 26 HIV-positive patients were linked to HIV medical care. By July 2014, the monthly proportion of patients offered a test was 62%; the proportion of those offered a test who had a test ordered was 98%, and the proportion of those with a test ordered who were tested was 81%. Testing compliance increased substantially at the WHMC ED, from 77% in December 2013 to >98% in July 2014. Using compliance-monitoring, behavior-modification, and continuous quality-improvement processes produced substantial increases in offers and HIV test completion. WHMC is replicating this approach across departments, and other hospitals implementing routine HIV screening programs should consider this approach as well.

Circulating FABP4 and FABP5 Levels Are Differently Linked to OSA Severity and Treatment

PubMed Central

Català, Raquel; Cabré, Anna; Hernández-Flix, Salvador; Ferré, Raimón; Sangenís, Sandra; Plana, Núria; Texidó, Anna; Masana, Lluís

2013-01-01

Objective: To evaluate circulating adipocyte and epidermal fatty acid-binding protein (FABP4 and FABP5) concentrations in patients with obstructive sleep apnea (OSA), as well as the effects of continuous positive airway pressure (CPAP) treatment. Methods: Our cross-sectional study included 125 patients. After polysomnography, 58 participants met the criteria for CPAP treatment and were included in a closed cohort study of 8 weeks of CPAP treatment. General anthropometric and biochemical data and circulating FABP4 and FABP5 levels were determined in all patients at baseline and after CPAP treatment in those receiving this therapy. Results Circulating FABP4 but not FABP5 levels were higher in patients with OSA (P = 0.003). FABP4 but not FABP5 values were associated with parameters of OSA severity independently of age, gender, adiposity and insulin resistance (P < 0.05). FABP4 but not FABP5 concentrations were determinants of OSA presence (OR: 1.11, P = 0.010) and severity (OR: 1.06, P = 0.020). After CPAP treatment, FABP4 levels decreased in the more severe patients (P = 0.019), while FABP5 levels increased in all patients (P < 0.001). Conclusions FABP4 is directly associated with obstructive sleep apnea severity and did not change with continuous positive airway pressure treatment, while FABP5 was not associated with obstructive sleep apnea severity and increased with continuous positive airway pressure treatment. FABP4 and FABP5 have different associations with obstructive sleep apnea. FABP4 but not FABP5 could be considered a marker of metabolic alterations in obstructive sleep apnea patients. Citation: Català R; Cabré A; Hernández-Flix S; Ferré R; Sangenís S; Plana N; Texidó A; Masana L. Circulating FABP4 and FABP5 levels are differently linked to OSA severity and treatment. SLEEP 2013;36(12):1831-1837. PMID:24293757

Effectiveness and safety of a prehospital program of continuous positive airway pressure (CPAP) in an urban setting.

PubMed

Willmore, Andrew; Dionne, Richard; Maloney, Justin; Ouston, Ed; Stiell, Ian

2015-11-01

Continuous positive airway pressure (CPAP) is commonly used in the treatment of acute cardiogenic pulmonary edema (ACPE) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In-hospital evidence is robust: CPAP has been shown to improve respiratory status and to reduce intubation rates. There is less evidence on prehospital CPAP, although the emergency medical services (EMS) adoption of this modality is increasing. The objectives of this study were to 1) measure the effectiveness of prehospital CPAP on morbidity, mortality, and transport times; and 2) audit the selection of patients by medics for appropriateness and safety. We conducted a before-and-after study from August 1 to October 31 in 2010 and 2011, before and after the implementation of prehospital CPAP in a city of one million people with large rural areas. Medics were trained to apply CPAP to patients with respiratory distress and a presumed diagnosis of ACPE or AECOPD. Charts were selected using the search criteria of the chief complaint of shortness of breath, emergent transport to hospital, and any patients receiving CPAP in the field. Data extracted from ambulance call reports and hospital records were analysed with appropriate univariate statistics. A total of 373 patients enrolled (186 pre-non-invasive ventilation [NIV] and 187 post-NIV), mean age 71.5 years, female 51.4%, and final diagnoses of ACPE 18.9%, AECOPD 21.9%. In the post group of 84 patients meeting NIV criteria, 41.6% received NIV; and of 102 patients not meeting the criteria, 5.2% received NIV. There were 12 minor adverse events in 36 applications (33.3%) as per protocol. Comparing post versus pre, there were higher rates of emergency department (ED) NIV (20.0% v. 13.4%, p<0.0001) and higher overall mortality (18.8% v. 14.9%, p<0.0001). There were no differences in ED intubation (2.1% v. 2.3%, p<0.001) and length of stay (6.8 v. 8.7 days, p=0.24). Despite the robust in-hospital data supporting its use, we could not find benefit from CPAP in our prehospital setting with respect to morbidity, mortality, and length of stay. EMS must exercise caution in making the decision to invest in the equipment and training required to implement prehospital CPAP.

Friends, sisters, and wives: Social support and social risks in peer relationships among men who have sex with men (MSM) in India

PubMed Central

Tomori, Cecilia; Srikrishnan, Aylur K.; Ridgeway, Kathleen; Solomon, Sunil S.; Mehta, Shruti H.; Solomon, Suniti; Celentano, David D.

2016-01-01

Globally men who have sex with men (MSM) are at high risk for HIV. Many HIV-prevention efforts rely on community outreach and mobilization to engage MSM. This study examines peer relationships and their potential role in HIV-prevention through 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) with 363 MSM across 15 sites in India. Results indicate that MSM receive social support in friendships, sex-worker collaborations, constructed kin relationships, and romantic partnerships. Access to these relationships, however, is uneven across MSM, and can carry risks of disclosure of same-sex behavior and exclusion based on HIV-positive status. Positive peer relationships can serve as the basis of community empowerment, education and couple-based interventions for MSM, and peer counselors can also provide a buffer against the social risks of peer relationships and facilitate linkage to care and continued engagement in treatment. These insights can improve HIV-interventions for MSM in India and elsewhere. PMID:27459166

Current and planned use of the Navstar Global Positioning System by NASA

NASA Technical Reports Server (NTRS)

Theiss, Harold L.

1993-01-01

NASA was quick to realize the potential that the Global Positioning System (GPS) had to offer for its many diverse vehicles, experiments and platforms. Soon after the first Block 1 GPS satellites were launched, NASA began to use the tremendous capabilities that they had to offer. Even with a partial GPS constellation in place, important results have been obtained about the shape, orientation and rotation of the earth and calibration of the ionosphere and troposphere. These calibrations enhance geophysical science and facilitate the navigation of interplanetary spacecraft. Some very important results have been obtained in the continuing NASA program for aircraft terminal area operations. Currently, a large amount of activity is being concentrated on real time kinematic carrier phase tracking which has the potential to revolutionize aircraft navigation. This year marks the launch of the first GPS receiver equipped earth-orbiting NASA spacecraft: the Extreme Ultraviolet Explorer and the Ocean Topography Experiment (TOPEX/Poseidon). This paper describes a cross section of GPS-based research at NASA.

The Patient Protection and Affordable Care Act - The Role of the School Nurse: Position Statement.

PubMed

2015-07-01

It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) serves a vital role in the delivery of health care to our nation’s students within the health care system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as the Affordable Care Act (ACA). This law presents an opportunity to transform the health care system through three primary goals: expanding access, improving quality, and reducing cost (U.S. Government Printing Office, 2010). School nurses stand at the forefront of this system change and continue to provide evidence-based, quality interventions and preventive care that, according to recent studies, actually save health care dollars (Wang et al., 2014). NASN supports the concept that school nursing services receive the same financial parity as other health care providers to improve overall health outcomes, including insurance reimbursement for services provided to students.

Demonstration of precise estimation of polar motion parameters with the global positioning system: Initial results

NASA Technical Reports Server (NTRS)

Lichten, S. M.

1991-01-01

Data from the Global Positioning System (GPS) were used to determine precise polar motion estimates. Conservatively calculated formal errors of the GPS least squares solution are approx. 10 cm. The GPS estimates agree with independently determined polar motion values from very long baseline interferometry (VLBI) at the 5 cm level. The data were obtained from a partial constellation of GPS satellites and from a sparse worldwide distribution of ground stations. The accuracy of the GPS estimates should continue to improve as more satellites and ground receivers become operational, and eventually a near real time GPS capability should be available. Because the GPS data are obtained and processed independently from the large radio antennas at the Deep Space Network (DSN), GPS estimation could provide very precise measurements of Earth orientation for calibration of deep space tracking data and could significantly relieve the ever growing burden on the DSN radio telescopes to provide Earth platform calibrations.

Evaluation of adverse events noted in children receiving continuous infusions of dexmedetomidine in the intensive care unit.

PubMed

Honey, Brooke L; Harrison, Donald L; Gormley, Andrew K; Johnson, Peter N

2010-01-01

Dexmedetomidine is an α(2)-adrenergic receptor agonist with sedative and analgesic effects in mechanically ventilated adults and children. Safety and efficacy data are limited in children. The purpose of this study is to retrospectively identify the incidence and types of adverse events noted in children receiving continuous infusions of dexmedetomidine and evaluate potential risk factors for adverse events. Between July 1, 2006, and July 31, 2007, data were collected on all children (< 18 years) who received continuous infusions of dexmedetomidine. Data collection included demographics, dexmedetomidine regimen, and type/number of adverse events. The primary endpoint was the total number of adverse events noted, including: transient hypertension, hypotension, neurological manifestations, apnea, and bradycardia. Secondary endpoints included categorization of each type of adverse event and an assessment of risk factors. A logistic regression model was used to assess the relationship of adverse events with independent variables including length of ICU stay, cumulative dose, peak infusion rate, duration of therapy, PRISM III score, and bolus dose. Thirty-six patients received dexmedetomidine representing 41 infusions. The median age was 16 months (range, 0.1-204 months) and median PRISM III score was 2 (range, 0-18). Eighteen (43.9%) patients received a bolus dose of dexmedetomidine. The median cumulative dose (mcg/kg) and peak dose (mcg/kg/hr) were 8.5 (range, 2.2-193.7) and 0.5 (range, 0.2-0.7), respectively. Dexmedetomidine was continued for a median of 20 (range, 3-263) hours. Six (14.6%) patients were slowly tapered off the continuous infusions. Twenty-one adverse events were noted in 17 patients, including 4 neurologic manifestations. Fourteen patients required interventions for adverse events. ICU length of stay was the only independent risk factor (p=0.036) for development of adverse events. Several potential adverse events were noted with dexmedetomidine continuous infusions including possible neurological manifestations. Further studies are needed looking at adverse events associated with dexmedetomidine use in the pediatric population.

Leading by Example: Creating Motivation That Fosters Positive Change in Young People

ERIC Educational Resources Information Center

Aikens, Curtis G., Sr.

2013-01-01

It is not what one has in life; rather, what is left as the legacy. Personally I have received many awards. However, I feel so much better when I help people receive their own awards. Now, I want to use positive language and positive action to help motivate young people, encouraging them to achieve their own success, as well as foster success in…

Evaluation of Therapy Management and Patient Compliance in Postmenopausal Patients with Hormone Receptor-positive Breast Cancer Receiving Letrozole Treatment: The EvaluateTM Study

PubMed Central

Fasching, P. A.; Fehm, T.; Kellner, S.; de Waal, J.; Rezai, M.; Baier, B.; Baake, G.; Kolberg, H.-C.; Guggenberger, M.; Warm, M.; Harbeck, N.; Würstlein, R.; Deuker, J.-U.; Dall, P.; Richter, B.; Wachsmann, G.; Brucker, C.; Siebers, J. W.; Fersis, N.; Kuhn, T.; Wolf, C.; Vollert, H.-W.; Breitbach, G.-P.; Janni, W.; Landthaler, R.; Kohls, A.; Rezek, D.; Noesslet, T.; Fischer, G.; Henschen, S.; Praetz, T.; Heyl, V.; Kühn, T.; Krauß, T.; Thomssen, C.; Kümmel, S.; Hohn, A.; Tesch, H.; Mundhenke, C.; Hein, A.; Rauh, C.; Bayer, C. M.; Jacob, A.; Schmidt, K.; Belleville, E.; Hadji, P.; Wallwiener, D.; Grischke, E.-M.; Beckmann, M. W.; Brucker, S. Y.

2014-01-01

Introduction: The EvaluateTM study (Evaluation of therapy management and patient compliance in postmenopausal hormone receptor-positive breast cancer patients receiving letrozole treatment) is a prospective, non-interventional study for the assessment of therapy management and compliance in the routine care of postmenopausal women with invasive hormone receptor-positive breast cancer receiving letrozole. The parameters for inclusion in the study are presented and discussed here. Material and Methods: Between January 2008 and December 2009 a total of 5045 patients in 310 study centers were recruited to the EvaluateTM study. Inclusion criteria were hormone receptor-positive breast cancer and adjuvant treatment or metastasis. 373 patients were excluded from the analysis for various reasons. Results: A total of 4420 patients receiving adjuvant treatment and 252 patients with metastasis receiving palliative treatment were included in the study. For 4181 patients receiving adjuvant treatment, treatment with the aromatase inhibitor letrozole commenced immediately after surgery (upfront). Two hundred patients had initially received tamoxifen and started aromatase inhibitor treatment with letrozole at 1–5 years after diagnosis (switch), und 39 patients only commenced letrozole treatment 5–10 years after diagnosis (extended endocrine therapy). Patient and tumor characteristics were within expected ranges, as were comorbidities and concurrent medication. Conclusion: The data from the EvaluateTM study will offer a good overview of therapy management in the routine care of postmenopausal women with hormone receptor-positive breast cancer. Planned analyses will look at therapy compliance and patient satisfaction with how information is conveyed and the contents of the conveyed information. PMID:25568468

Determining Position Inside Non-industrial Buildings Using Ultrasound Transducers

PubMed Central

Escudero, Francesc; Margalef, Jordi; Luengo, Sonia; Alsina, Maria; Ribes, Josep M.; Pérez, Juan

2007-01-01

The position determination inside a building where no GPS signal is being received can be ascertained using laser transmitters in industrial situations where there are no people or using triangulation of the signal strength, normally electro-magnetic signals, if the required accuracy is more than a metre. Our solution is aimed at situations where people are present and where the required accuracy is less than 30 cm, such as in shopping precincts or supermarkets. To achieve this, a network of ultrasonic transmitters is fitted into the ceiling which receives a synchronised time signal. Each transmitter has a unique identifier code and emits its code with a delay with respect to the common time signal which is proportional to its code number with an ASK modulation over the ultrasonic band centred on 40 KHz. The receivers circulating beneath the transmitters receive the codes of those within their detection range, translate the time delays into distances and then obtain their position by triangulation since the receivers know the position of every transmitter. Since the receivers are not synchronised with the common time signal or the actual speed of the sound, whose value varies appreciably with temperature, relative humidity and atmospheric pressure, a consecutive approximation algorithm has been introduced. This is based on the fact that the Z coordinator of the receiver is known and constant and thus it is possible, with only three different identifiers received, to deduce the phase of the common time signal and estimate the speed of the sound with a fourth identifier. PMID:28903247

Effectiveness of a prevention of mother-to-child HIV transmission program in Guangdong province from 2007 to 2010

PubMed Central

2013-01-01

Background To achieve the goal of United Nations of elimination of new HIV infections, a program of prevention of mother-to-child transmission (PMTCT) was launched in Guangdong province. The objective of this study is to evaluate the effectiveness of the PMTCT program. Methods The retrospective cross-section analysis was conducted using the data of case reported cards of HIV positive mothers and their infants from 2007 to 2010 in Guangdong province, and 108 pairs of eligible subjects were obtained. We described the data and compared the rates of MTCT by various PMTCT interventions respectively. Results The overall rate of HIV MTCT was 13.89% (15) among 108 pairs of HIV positive mothers and their infants; 60.19% (65) of the mothers ever received ARVs, 80.56% (87) of infants born to HIV positive mothers ever received ARVs, but 16.67% (18) of the mothers and infants neither received ARVs. Among all the mothers and infants, who both received ARVs, received triple ARVs, mother received ARVs during pregnancy, and both received ARVs and formula feeding showed the lower rates of HIV MTCT, and the rates were 8.06%, 2.50%, 5.77%, and 6.67% respectively. In infants born to HIV positive mother, who received mixed feeding had a higher HIV MTCT up to 60.00%. Delivery mode might not relative to HIV MTCT. Conclusions The interventions of PMTCT program in Guangdong could effectively reduce the rate of HIV MTCT, but the effectiveness of the PMTCT program were heavily cut down by the lower availability of the PMTCT interventions. PMID:23773623

47 CFR 27.58 - Interference to BRS/EBS receivers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Interference to BRS/EBS receivers. 27.58 Section 27.58 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES MISCELLANEOUS WIRELESS COMMUNICATIONS SERVICES Technical Standards § 27.58 Interference to BRS/EBS receivers. (a...

Hazard Monitoring in a Spectrum-Challenged Future: US Department of Transportation Adjacent Band Compatibility Assessment of Interference on High-Precision GNSS Receivers

NASA Astrophysics Data System (ADS)

Blume, F.; Berglund, H. T.

2016-12-01

In 2012 the Federal Communications Commission (FCC) reversed its decision to allow communications company LightSquared to use GPS-adjacent spectrum for a ground based network after testing demonstrated harmful interference to GPS receivers. Now rebranded as Ligado, they have submitted modified application to use a smaller portion of the L-band spectrum at much lower power. Many GPS community stakeholders, including the hazard monitoring and EEW communities remain concerned that Ligado's proposed use could still cause harmful interference, causing signal degradation, real-time positioning errors, and total failure of GNSS hardware in widespread use in hazard monitoring networks. The Department of Transportation (DoT) has conducted hardware tests to determine adjacent-band transmitter power limit criteria that would prevent harmful interference from Ligado's operations. We present preliminary results produced from the data collected by the three UNAVCO receiver types tested: Trimble NetRS, Trimble NetR9, and Septentrio PolaRx5. In the first round of testing, simulated GNSS signals were broadcast in an anechoic chamber (pictured below) while interfering signals are broadcast simultaneously with varying amplitude and frequency. The older GPS-only NetRS receiver showed smaller reductions in SNR at frequencies adjacent to GPS L1 as compared to the other receivers, suggesting narrower L1 filter bandwidth in the RF frontend. The NetR9 showed greater decreases in observed SNR in the 1615 to 1625 MHz range when compared to the other two receivers. This suggests that the NetR9's L1 filter bandwidth has been increased to accommodate GNSS signals. Linearity tests were conducted to better relate SNR measurements between receiver types. The PolaRx5 receiver showed less SNR variation between tracking channels than both Trimble receivers. Our results show the power levels at which adjacent-band interference begins degrading receiver performance and eventually disables tracking. As the demand for spectrum for mobile applications increases, operators of hazard networks may need to consider the impact of RF interference on data quality and continuity. UNAVCO's participation ensures that our high precision GNSS community interests are represented in the future spectrum allocation decisions.

Automatic position calculating imaging radar with low-cost synthetic aperture sensor for imaging layered media

DOEpatents

Mast, J.E.

1998-08-18

An imaging system for analyzing structures comprises a radar transmitter and receiver connected to a timing mechanism that allows a radar echo sample to be taken at a variety of delay times for each radar pulse transmission. The radar transmitter and receiver are coupled to a position determining system that provides the x,y position on a surface for each group of samples measured for a volume from the surface. The radar transmitter and receiver are moved about the surface to collect such groups of measurements from a variety of x,y positions. Return signal amplitudes represent the relative reflectivity of objects within the volume and the delay in receiving each signal echo represents the depth at which the object lays in the volume and the propagation speeds of the intervening material layers. Successively deeper z-planes are backward propagated from one layer to the next with an adjustment for variations in the expected propagation velocities of the material layers that lie between adjacent z-planes. 10 figs.

Automatic position calculating imaging radar with low-cost synthetic aperture sensor for imaging layered media

DOEpatents

Mast, Jeffrey E.

1998-01-01

An imaging system for analyzing structures comprises a radar transmitter and receiver connected to a timing mechanism that allows a radar echo sample to be taken at a variety of delay times for each radar pulse transmission. The radar transmitter and receiver are coupled to a position determining system that provides the x,y position on a surface for each group of samples measured for a volume from the surface. The radar transmitter and receiver are moved about the surface to collect such groups of measurements from a variety of x,y positions. Return signal amplitudes represent the relative reflectivity of objects within the volume and the delay in receiving each signal echo represents the depth at which the object lays in the volume and the propagation speeds of the intervening material layers. Successively deeper z-planes are backward propagated from one layer to the next with an adjustment for variations in the expected propagation velocities of the material layers that lie between adjacent z-planes.

PHLUX: Photographic Flux Tools for Solar Glare and Flux

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

2010-12-02

A web-based tool to a) analytically and empirically quantify glare from reflected light and determine the potential impact (e.g., temporary flash blindness, retinal burn), and b) produce flux maps for central receivers. The tool accepts RAW digital photographs of the glare source (for hazard assessment) or the receiver (for flux mapping), as well as a photograph of the sun for intensity and size scaling. For glare hazard assessment, the tool determines the retinal irradiance (W/cm2) and subtended source angle for an observer and plots the glare source on a hazard spectrum (i.e., low-potential for flash blindness impact, potential for flashmore » blindness impact, retinal burn). For flux mapping, the tool provides a colored map of the receiver scaled by incident solar flux (W/m2) and unwraps the physical dimensions of the receiver while accounting for the perspective of the photographer (e.g., for a flux map of a cylindrical receiver, the horizontal axis denotes receiver angle in degrees and the vertical axis denotes vertical position in meters; for a flat panel receiver, the horizontal axis denotes horizontal position in meters and the vertical axis denotes vertical position in meters). The flux mapping capability also allows the user to specify transects along which the program plots incident solar flux on the receiver.« less

Tightly Coupled Integration of Ionosphere-Constrained Precise Point Positioning and Inertial Navigation Systems

PubMed Central

Gao, Zhouzheng; Zhang, Hongping; Ge, Maorong; Niu, Xiaoji; Shen, Wenbin; Wickert, Jens; Schuh, Harald

2015-01-01

The continuity and reliability of precise GNSS positioning can be seriously limited by severe user observation environments. The Inertial Navigation System (INS) can overcome such drawbacks, but its performance is clearly restricted by INS sensor errors over time. Accordingly, the tightly coupled integration of GPS and INS can overcome the disadvantages of each individual system and together form a new navigation system with a higher accuracy, reliability and availability. Recently, ionosphere-constrained (IC) precise point positioning (PPP) utilizing raw GPS observations was proven able to improve both the convergence and positioning accuracy of the conventional PPP using ionosphere-free combined observations (LC-PPP). In this paper, a new mode of tightly coupled integration, in which the IC-PPP instead of LC-PPP is employed, is implemented to further improve the performance of the coupled system. We present the detailed mathematical model and the related algorithm of the new integration of IC-PPP and INS. To evaluate the performance of the new tightly coupled integration, data of both airborne and vehicle experiments with a geodetic GPS receiver and tactical grade inertial measurement unit are processed and the results are analyzed. The statistics show that the new approach can further improve the positioning accuracy compared with both IC-PPP and the tightly coupled integration of the conventional PPP and INS. PMID:25763647

A biologically inspired neural net for trajectory formation and obstacle avoidance.

PubMed

Glasius, R; Komoda, A; Gielen, S C

1996-06-01

In this paper we present a biologically inspired two-layered neural network for trajectory formation and obstacle avoidance. The two topographically ordered neural maps consist of analog neurons having continuous dynamics. The first layer, the sensory map, receives sensory information and builds up an activity pattern which contains the optimal solution (i.e. shortest path without collisions) for any given set of current position, target positions and obstacle positions. Targets and obstacles are allowed to move, in which case the activity pattern in the sensory map will change accordingly. The time evolution of the neural activity in the second layer, the motor map, results in a moving cluster of activity, which can be interpreted as a population vector. Through the feedforward connections between the two layers, input of the sensory map directs the movement of the cluster along the optimal path from the current position of the cluster to the target position. The smooth trajectory is the result of the intrinsic dynamics of the network only. No supervisor is required. The output of the motor map can be used for direct control of an autonomous system in a cluttered environment or for control of the actuators of a biological limb or robot manipulator. The system is able to reach a target even in the presence of an external perturbation. Computer simulations of a point robot and a multi-joint manipulator illustrate the theory.

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

PubMed

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

2008-05-01

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

Improvement of Vehicle Positioning Using Car-to-Car Communications in Consideration of Communication Delay

NASA Astrophysics Data System (ADS)

Hontani, Hidekata; Higuchi, Yuya

In this article, we propose a vehicle positioning method that can estimate positions of cars even in areas where the GPS is not available. For the estimation, each car measures the relative distance to a car running in front, communicates the measurements with other cars, and uses the received measurements for estimating its position. In order to estimate the position even if the measurements are received with time-delay, we employed the time-delay tolerant Kalman filtering. For sharing the measurements, it is assumed that a car-to-car communication system is used. Then, the measurements sent from farther cars are received with larger time-delay. It follows that the accuracy of the estimates of farther cars become worse. Hence, the proposed method manages only the states of nearby cars to reduce computing effort. The authors simulated the proposed filtering method and found that the proposed method estimates the positions of nearby cars as accurate as the distributed Kalman filtering.

Learning a visuomotor rotation: simultaneous visual and proprioceptive information is crucial for visuomotor remapping.

PubMed

Shabbott, Britne A; Sainburg, Robert L

2010-05-01

Visuomotor adaptation is mediated by errors between intended and sensory-detected arm positions. However, it is not clear whether visual-based errors that are shown during the course of motion lead to qualitatively different or more efficient adaptation than errors shown after movement. For instance, continuous visual feedback mediates online error corrections, which may facilitate or inhibit the adaptation process. We addressed this question by manipulating the timing of visual error information and task instructions during a visuomotor adaptation task. Subjects were exposed to a visuomotor rotation, during which they received continuous visual feedback (CF) of hand position with instructions to correct or not correct online errors, or knowledge-of-results (KR), provided as a static hand-path at the end of each trial. Our results showed that all groups improved performance with practice, and that online error corrections were inconsequential to the adaptation process. However, in contrast to the CF groups, the KR group showed relatively small reductions in mean error with practice, increased inter-trial variability during rotation exposure, and more limited generalization across target distances and workspace. Further, although the KR group showed improved performance with practice, after-effects were minimal when the rotation was removed. These findings suggest that simultaneous visual and proprioceptive information is critical in altering neural representations of visuomotor maps, although delayed error information may elicit compensatory strategies to offset perturbations.

Long-term subcutaneous pulsatile low dose LH-RH administration for treatment of infertile men with secondary hypogonadotrophic hypogonadism.

PubMed

Skarin, G; Nillius, S J; Wide, L

1984-01-01

Chronic pulsatile subcutaneous low dose LH-RH treatment was given to three infertile men with longstanding (2-4 years) secondary hypothalamic pituitary failure. Before the therapy they had very low serum concentrations of gonadotrophins and testosterone. They were impotent and could not produce any ejaculate for sperm analysis. The pulsatile LH-RH treatment, which was continued up to 250 days, was given by means of a small portable automatically-timed infusion pump. Fifty microliter of the LH-RH solution was infused during one min every 90 min. The LH-RH doses were 1, 5 and 20 micrograms. The serum concentrations of the gonadotrophins and testosterone were normalized in the three patients within 10 days of pulsatile low dose LH-RH therapy. Libido and potency returned. The first ejaculates contained no sperms. With continued LH-RH treatment spermatogenesis was induced and normalized. Two of the men fertilized their wives. The pregnancy tests were positive after 181 and 230 days of treatment, respectively. Two healthy girls have been born. Paternity tests were positive. The third man is still receiving pulsatile LH-RH therapy. He has up till now been treated for four months. Chronic pulsatile s.c. low dose LH-RH administration is a very promising new therapy for those hypogonadal men who previously have required human gonadotrophin treatment to restore fertility.

Cost-effectiveness of Continuous Positive Airway Pressure Treatment in Moderate-Severe Obstructive Sleep Apnea Syndrome.

PubMed

Català, Raquel; Villoro, Renata; Merino, María; Sangenís, Sandra; Colomés, Lluís; Hernández Flix, Salvador; Pérez de Llano, Luis A

2016-09-01

The socioeconomic impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) is considerable. The aim of this study was to evaluate the cost-effectiveness of treating OSAHS with continuous positive airway pressure (CPAP) and the impact of CPAP compliance. This was a retrospective, case-crossover study of 373 patients with OSAHS receiving CPAP. We compared changes in costs, Epworth score and health-related quality of life (EQ-5D questionnaires) between the year before treatment and the year after treatment. The incremental cost-effectiveness ratio (ICER) for the first year of treatment was estimated, and projections were made for the second year, using different effectiveness and cost scenarios. The visual analog scale score for the EQ-5D questionnaire increased by 5 points and the Epworth score fell by 10 points during the year of CPAP treatment. Mean gain in quality-adjusted life years (QALY) was 0.05 per patient per year (P<.001): 0.07 among compliers and -0.04 among non-compliers. ICER was €51,147/QALY during the first year of CPAP treatment and €1,544/QALY during the second year. CPAP treatment in patients with moderate-severe OSAHS improves the quality of life of compliant patients, and is cost-effective as of the second year. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Estimation of precipitable water vapour using kinematic GNSS precise point positioning over an altitude range of 1 km

NASA Astrophysics Data System (ADS)

Webb, S. R.; Penna, N. T.; Clarke, P. J.; Webster, S.; Martin, I.

2013-12-01

The estimation of total precipitable water vapour (PWV) using kinematic GNSS has been investigated since around 2001, aiming to extend the use of static ground-based GNSS, from which PWV estimates are now operationally assimilated into numerical weather prediction models. To date, kinematic GNSS PWV studies suggest a PWV measurement agreement with radiosondes of 2-3 mm, almost commensurate with static GNSS measurement accuracy, but only shipborne experiments have so far been carried out. As a first step towards extending such sea level-based studies to platforms that operate at a range of altitudes, such as airplanes or land based vehicles, the kinematic GNSS estimation of PWV over an exactly repeated trajectory is considered. A data set was collected from a GNSS receiver and antenna mounted on a carriage of the Snowdon Mountain Railway, UK, which continually ascends and descends through 950 m of vertical relief. Static GNSS reference receivers were installed at the top and bottom of the altitude profile, and derived zenith wet delay (ZWD) was interpolated to the altitude of the train to provide reference values together with profile estimates from the 100 m resolution runs of the Met Office's Unified Model. We demonstrate similar GNSS accuracies as obtained from previous shipborne studies, namely a double difference relative kinematic GNSS ZWD accuracy within 14 mm, and a kinematic GNSS precise point positioning ZWD accuracy within 15 mm. The latter is a more typical airborne PWV estimation scenario i.e. without the reliance on ground-based GNSS reference stations. We show that the kinematic GPS-only precise point positioning ZWD estimation is enhanced by also incorporating GLONASS observations.

Care coordination experiences of people with disabilities enrolled in medicaid managed care.

PubMed

Bowers, Anne; Owen, Randall; Heller, Tamar

2017-10-01

To understand the impact of experience and contacts with care coordinators on Medicaid Managed Care (MMC) enrollees with disabilities. Primary data was collected from a random sample of 6000 out of the 100,000 people with disabilities enrolled in one state's mandatory MMC program. Surveys were conducted through the mail, telephone, and Internet; 1041 surveys were completed. The sample used for analysis included 442 MMC enrollees who received care coordination. Regression analyses were conducted with the outcomes of number of unmet health care needs and enrollee appraisal of the health services they received. Race, age, gender, and disability variables controlled for demographic differences, and the independent variables included enrollee experience with a care coordinator (coordinator knowledge of enrollee medical history and whether the coordinator took into account enrollee wishes and input) and frequency of contact with a care coordinator. Positive enrollee experiences with care coordinators significantly related to more positive enrollee health service appraisals and fewer unmet health care needs; frequency of contact did not have any significant impacts. People with mental health disabilities and intellectual/developmental disabilities had significantly lower health service appraisals. People with mental health disabilities had significantly more unmet needs. Quality of care coordination, but not frequency of contact alone, is associated with better health outcomes for MMC enrollees. Implications for rehabilitation Care coordination is a core component of managed care and facilitates effective healthcare management for people with complex chronic conditions and disabilities. Better experiences with care coordinators is related to fewer unmet healthcare needs and more positive health care service appraisals for Medicaid managed care enrollees. The continuous development of person-centered care coordination strategies and training programs emphasizing quality relationships between coordinators and consumers should be prioritized.

Helicobacter pylori eradication in patients with chronic immune thrombocytopenic purpura

PubMed Central

Noonavath, Ravinder Naik; Lakshmi, Chandrasekharan Padma; Dutta, Tarun Kumar; Kate, Vikram

2014-01-01

AIM: To assess the effect of Helicobacter pylori (H. pylori) eradication on platelet counts in patients with chronic immune thrombocytopenic purpura (cITP). METHODS: A total of 36 cITP patients were included in the study. The diagnosis of H. pylori was done by rapid urease test and Giemsa staining of the gastric biopsy specimen. All H. pylori positive patients received standard triple therapy for 14 d and were subjected for repeat endoscopy at 6 wk. Patients who continued to be positive for H. pylori on second endoscopy received second line salvage therapy. All the patients were assessed for platelet response at 6 wk, 3rd and 6th months. RESULTS: Of the 36 patients, 17 were positive for H. pylori infection and eradication was achieved in 16 patients. The mean baseline platelet count in the eradicated patients was 88615.38 ± 30117.93/mm3 and platelet count after eradication at 6 wk, 3 mo and 6 mo was 143230.77 ± 52437.51/mm3 (P = 0.003), 152562.50 ± 52892.3/mm3 (P = 0.0001), 150187.50 ± 41796.68/mm3 (P = 0.0001) respectively and in the negative patients, the mean baseline count was 71000.00 ± 33216.46/mm3 and at 6 wk, 3rd and 6th month follow up was 137631.58 ± 74364.13/mm3 (P = 0.001), 125578.95 ± 71472.1/mm3 (P = 0.005), 77210.53 ± 56892.28/mm3 (P = 0.684) respectively. CONCLUSION: Eradication of H. pylori leads to increase in platelet counts in patients with cITP and can be recommended as a complementary treatment with conventional therapy. PMID:24944483

Acceleration Disturbances onboard of Geodetic Precision Space Laboratories

NASA Astrophysics Data System (ADS)

Peterseim, Nadja; Jakob, Flury; Schlicht, Anja

Bartlomiej Oszczak, b@dgps.pl University of Warmia and Mazury in Olsztyn, Poland, Olsztyn, Poland Olga Maciejczyk, omaciejczyk@gmail.com Poland In this paper there is presented the study on the parameters of the ASG-EUPOS real-time RTK service NAWGEO such as: accuracy, availability, integrity and continuity. Author's model is used for tests. These parameters enable determination of the quality of received information and practical applications of the service. Paper includes also the subject related to the NAWGEO service and algorithms used in determination of mentioned parameters. The results of accuracy and precision analyses and study on availability demonstrated that NAWGEO service enables a user a position determination with a few centimeters accuracy with high probability in any moment of time.

Healthy satellites provide quality service

NASA Astrophysics Data System (ADS)

Margittai, Paul

The procedures used by Telesat Canada to ensure the performance of Anik satellites is described. At the Satellite Telemetry, Tracking and Command station, each Anik satellite has its own dedicated antenna. Telemetered information from the satellites is received, processed and forwarded to the Satellite Control Center. There the satellite controllers issue all commands to the satellites, and continually monitor the telemetered data. These data, describing the state of health of the satellites, are then analyzed by engineering specialists. The satellites are held in their precise orbital positions by means of specially developed software. The Anik C and D satellites employ travelling wave tube amplifiers (TWTAs) in the transpounder channels. The TWTA saturated flux density (SFD) and equivalent isotropic radiated power (EIRP) are regularly measured and their trends scrutinized. This ensures that customers receive the radio frequency power needed for high-quality service. The satellite electrical power is supplied by the solar cell array and batteries. Power system performance is evaluated regularly to ensure that power is available to operate the required number of TWTAs. In addition to rain-fades, short service interruptions can be caused by high voltage trip-offs of TWTAs, and by electrostatic discharge related anomalies. To minimize these interruptions, Telesat ensures that the satellite controllers are fully trained and prepared for any eventuality, and the relevant operational procedures are continually refined. A fully trained staff of satellite controllers keep interruptions caused by high voltage trip-offs of TWTAs and by electrostatic discharge to a minimum.

Gluconeogenesis continues in premature infants receiving total parenteral nutrition

USDA-ARS?s Scientific Manuscript database

To determine the contribution of total gluconeogenesis, to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rate, eight infants (0.955 +/- 0.066 kg, 26.5 - 0.5 wks, 4-1 d) were studied while receiving routine ...

Auto-positioning ultrasonic transducer system

NASA Technical Reports Server (NTRS)

Buchanan, Randy K. (Inventor)

2010-01-01

An ultrasonic transducer apparatus and process for determining the optimal transducer position for flow measurement along a conduit outer surface. The apparatus includes a transmitting transducer for transmitting an ultrasonic signal, said transducer affixed to a conduit outer surface; a guide rail attached to a receiving transducer for guiding movement of a receiving transducer along the conduit outer surface, wherein the receiving transducer receives an ultrasonic signal from the transmitting transducer and sends a signal to a data acquisition system; and a motor for moving the receiving transducer along the guide rail, wherein the motor is controlled by a controller. The method includes affixing a transmitting transducer to an outer surface of a conduit; moving a receiving transducer on the conduit outer surface, wherein the receiving transducer is moved along a guide rail by a motor; transmitting an ultrasonic signal from the transmitting transducer that is received by the receiving transducer; communicating the signal received by the receiving transducer to a data acquisition and control system; and repeating the moving, transmitting, and communicating along a length of the conduit.

Nondynamic Tracking Using The Global Positioning System

NASA Technical Reports Server (NTRS)

Yunck, T. P.; Wu, Sien-Chong

1988-01-01

Report describes technique for using Global Positioning System (GPS) to determine position of low Earth orbiter without need for dynamic models. Differential observing strategy requires GPS receiver on user vehicle and network of six ground receivers. Computationally efficient technique delivers decimeter accuracy on orbits down to lowest altitudes. New technique nondynamic long-arc strategy having potential for accuracy of best dynamic techniques while retaining much of computational simplicity of geometric techniques.

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009–2014

PubMed Central

Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R. Luke

2017-01-01

Objectives To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. Methods This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Results Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Conclusions Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons. PMID:29161069

Analyzing JAVAD TR-G2 GPS Receiver's Sensitivities to SLS Trajectory

NASA Technical Reports Server (NTRS)

Schuler, Tristan

2017-01-01

Automated guidance and navigation systems are an integral part to successful space missions. Previous researchers created Python tools to receive and parse data from a JAVAD TR-G2 space-capable GPS receiver. I improved the tool by customizing the output for plotting and comparing several simulations. I analyzed position errors, data loss, and signal loss by comparing simulated receiver data from an IFEN GPS simulator to ‘truth data’ from a proposed trajectory. By adjusting the trajectory simulation’s gain, attitude, and start time, NASA can assess the best time to launch the SLS, where to position the antennas on the Block 1-B, and which filter to use. Some additional testing has begun with the Novatel SpaceQuestGPS receiver as well as a GNSS SDR receiver.

Intra-gastric pressures in neonates receiving bubble CPAP.

PubMed

Tyagi, Prashant; Gupta, Neeraj; Jain, Akanksha; Upadhyay, Pramod; Puliyel, Jacob

2015-02-01

To study intra-gastric pressures in neonates receiving bubble continuous positive airway pressure (BCPAP) by nasopharyngeal prong. Twenty seven neonates were recruited for the study. BCPAP pressure of 6 cm water was used in all the neonates. A pressure sensor attached to orogastric tube, measured the intra-gastric pressure prior to starting BCPAP and again between 30 and 90 min of BCPAP. The clinical variables like Downe's score, oxygen saturation, venous blood gas pH, pCO(2) and abdominal girth were recorded alongside with pressure readings. BCPAP resulted in improvement (p < 0.05) in parameters of respiratory distress such as Downe's score (DS), oxygen saturation (SpO(2)) and venous blood gas parameters (pH, pCO(2)). There was no statistical significant increase in intra-gastric pressures (p = 0.834). There were no gastrointestinal complications; abdominal distention, necrotising enterocolitis or gastric perforation during the study. Nasopharyngeal BCPAP at 6 cm of water pressure is an effective modality of treating babies with respiratory distress and the present study shows that it is not associated with a significant rise in intra-gastric pressures.

AIDS chief says nonoxynol-9 not effective against HIV.

PubMed

According to Dr. Peter Piot, executive director of the Joint UN Programme on HIV/AIDS (UNAIDS), the international multi-site trial of the spermicide nonoxynol-9 in gel form has shown that it is not effective in protecting women from HIV infection. This large-scale Phase III efficacy trial was conducted among female sex workers in Benin, Cote d'Ivoire, South Africa, and Thailand. Apart from receiving the trial microbicide or a placebo, participants also received classical HIV prevention support, such as free condoms, free treatment for sexually transmitted infections, counseling, and peer support. One positive outcome of the trial is that fewer of the sex workers who participated became infected with HIV, compared with the sex workers who did not participate at all in the study. However, Piot states that even if the results of the trials are disappointing, the search for an effective microbicide continues. To this effect, at least 36 compounds are at the preclinical testing stage, while 20 are ready for early safety trials in human volunteers and three additional compounds are being considered for large-scale trials.

Superstar of the Sloan Minority Ph.D. Program.

PubMed

Greenwood, Ted

2013-01-01

In AY 1994-95 the Alfred P. Sloan Foundation launched a program, later known as the Minority Ph.D. Program, to increase the number of underrepresented minority students earning Ph.D.s in natural sciences, engineering and mathematics (SEM). This program emerged from a recognition that African Americans, Hispanic Americans and American Indians were very underrepresented at all levels and in all aspects of SEM disciplines and that, although undergraduate education had received and continued to received much attention by universities, private funders and government agencies, there was still relatively little attention being paid to the graduate and especially the Ph.D. level. Because earning the Ph.D. is a necessary milestone along the pathway to a faculty position and the effort to diversify the graduates of SEM disciplines depends, in large part, on diversifying the faculty at American universities, this relative lack of attention to Ph.D. education was, in the opinion of the Sloan Foundation, a significant deficiency of national efforts. As a Program Director at the Sloan Foundation, I initiated this Minority Ph.D. Program and ran it until my retirement in June 2011.

Effect of prophylactic CPAP in very low birth weight infants in South America.

PubMed

Zubizarreta, J R; Lorch, S A; Marshall, G; D'Apremont, I; Tapia, J L

2016-08-01

The objective of this study was to examine the effect of prophylactic continuous positive airway pressure (CPAP) on infants born in 25 South American neonatal intensive care units affiliated with the Neocosur Neonatal Network using novel multivariate matching methods. A prospective cohort was constructed of infants with a birth weight 500 to 1500 g born between 2005 and 2011 who clinically were eligible for prophylactic CPAP. Patients who received prophylactic CPAP were matched to those who did not on 23 clinical and sociodemographic variables (N=1268). Outcomes were analyzed using the McNemar's test. Infants not receiving prophylactic CPAP had higher mortality rates (odds ratio (OR)=1.69, 95% confidence interval (CI) 1.17, 2.46), need for any mechanical ventilation (OR=1.68, 95% CI 1.33, 2.14) and death or bronchopulmonary dysplasia (BPD) (OR=1.47, 95% CI 1.09, 1.98). The benefit of prophylactic CPAP varied by birth weight and gender. The implementation of this process was associated with a significant improvement in survival and survival free of BPD.

Method and apparatus for determining position using global positioning satellites

NASA Technical Reports Server (NTRS)

Ward, John (Inventor); Ward, William S. (Inventor)

1998-01-01

A global positioning satellite receiver having an antenna for receiving a L1 signal from a satellite. The L1 signal is processed by a preamplifier stage including a band pass filter and a low noise amplifier and output as a radio frequency (RF) signal. A mixer receives and de-spreads the RF signal in response to a pseudo-random noise code, i.e., Gold code, generated by an internal pseudo-random noise code generator. A microprocessor enters a code tracking loop, such that during the code tracking loop, it addresses the pseudo-random code generator to cause the pseudo-random code generator to sequentially output pseudo-random codes corresponding to satellite codes used to spread the L1 signal, until correlation occurs. When an output of the mixer is indicative of the occurrence of correlation between the RF signal and the generated pseudo-random codes, the microprocessor enters an operational state which slows the receiver code sequence to stay locked with the satellite code sequence. The output of the mixer is provided to a detector which, in turn, controls certain routines of the microprocessor. The microprocessor will output pseudo range information according to an interrupt routine in response detection of correlation. The pseudo range information is to be telemetered to a ground station which determines the position of the global positioning satellite receiver.

A continuous-wave ultrasound system for displacement amplitude and phase measurement.

PubMed

Finneran, James J; Hastings, Mardi C

2004-06-01

A noninvasive, continuous-wave ultrasonic technique was developed to measure the displacement amplitude and phase of mechanical structures. The measurement system was based on a method developed by Rogers and Hastings ["Noninvasive vibration measurement system and method for measuring amplitude of vibration of tissue in an object being investigated," U.S. Patent No. 4,819,643 (1989)] and expanded to include phase measurement. A low-frequency sound source was used to generate harmonic vibrations in a target of interest. The target was simultaneously insonified by a low-power, continuous-wave ultrasonic source. Reflected ultrasound was phase modulated by the target motion and detected with a separate ultrasonic transducer. The target displacement amplitude was obtained directly from the received ultrasound frequency spectrum by comparing the carrier and sideband amplitudes. Phase information was obtained by demodulating the received signal using a double-balanced mixer and low-pass filter. A theoretical model for the ultrasonic receiver field is also presented. This model coupled existing models for focused piston radiators and for pulse-echo ultrasonic fields. Experimental measurements of the resulting receiver fields compared favorably with theoretical predictions.

Small Dose Ketamine Improves Postoperative Analgesia and Rehabilitation After Total Knee Arthroplasty.

PubMed Central

Chauvin, Marcel; Manoir, Bertrand Du; Langlois, Mathieu; Sessler, Daniel I.; Fletcher, Dominique

2005-01-01

We designed this study to evaluate the effect of small-dose intravenous ketamine in combination with continuous femoral nerve block on postoperative pain and rehabilitation after total knee arthroplasty. Continuous femoral nerve block with ropivacaine was started before surgery and continued in the surgical ward for 48 h. Patients were randomly assigned to receive an initial bolus of 0.5 mg/kg ketamine followed by a continuous infusion of 3 μg·kg-1·min-1 during surgery and 1.5 μg·kg-1·min-1 for 48 h (Ketamine group) or an equal volume of saline (Control group). Additional postoperative analgesia was provided by patient-controlled intravenous morphine. Pain scores and morphine consumption were recorded over 48 hours. The maximal degree of active knee flexion tolerated was recorded daily until hospital discharge. Follow up was performed 6 weeks and 3 months after surgery. The Ketamine group required significantly less morphine than the Control group (45 ± 20 mg versus 69 ± 30 mg; P < 0.02). Patients in the Ketamine group reached 90° of active knee flexion more rapidly than those in the Control group (P < 0.02). Outcomes at 6 weeks and 3 months were similar in each group. These results confirm that ketamine is a useful analgesic adjuvant in perioperative multimodal analgesia with a positive impact on early knee mobilization. PMID:15673878

Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam

PubMed Central

Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah OA; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

2017-01-01

Background: A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. Methods: We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. Results: A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of effective self-study, and technical/language-based barriers may be potential explanations for intervention failure. Conclusion: As a form of mCME, daily text messages were well-received by community-level health care providers in Vietnam. This mCME approach appears very promising in low-resource environments or where traditional forms of CME are impractical. Future models might consider enhancements to foster linkages to relevant medical materials, improve interaction with medical experts, and tailor medical content to the daily activities of medical staff. PMID:28655802

Benefits and Limitations of Text Messages to Stimulate Higher Learning Among Community Providers: Participants' Views of an mHealth Intervention to Support Continuing Medical Education in Vietnam.

PubMed

Sabin, Lora L; Larson Williams, Anna; Le, Bao Ngoc; Herman, Augusta R; Viet Nguyen, Ha; Albanese, Rebecca R; Xiong, Wenjun; Shobiye, Hezekiah Oa; Halim, Nafisa; Tran, Lien Thi Ngoc; McNabb, Marion; Hoang, Hai; Falconer, Ariel; Nguyen, Tam Thi Thanh; Gill, Christopher J

2017-06-27

A randomized controlled trial was conducted in 2015 to evaluate a mobile continuing medical education (mCME) intervention that provided daily text messages to community-based physicians' assistants (CBPAs) in Thai Nguyen Province, Vietnam. Although the intervention failed to improve medical knowledge over a 6-month period, a companion qualitative study provided insights on the views and experiences of intervention participants. We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) among participants randomized to receive text messages containing either simple medical facts or quiz questions. Trained interviewers collected data immediately following the conclusion of the trial in December 2015. Using semi-structured question guides, respondents were queried on their views of the intervention, positive and negative, and perceived impacts of the intervention. During analysis, after learning that the intervention had failed to increase knowledge among participants, we also examined reasons for lack of improvement in medical knowledge. All analyses were performed in NVivo using a thematic approach. A total of 70 CBPAs engaged in one of 8 FGDs or an IDI. One-half were men; average age among all respondents was 40 years. Most (81%) practiced in rural settings and most (51%) focused on general medicine. The mean length of work experience was 3 years. All respondents made positive comments about the intervention; convenience, relevance, and quick feedback (quiz format) were praised. Downsides encompassed lack of depth of information, weak interaction, technology challenges, and challenging/irrelevant messages. Respondents described perceived impacts encompassing increased motivation, knowledge, collegial discussions, Internet use to search for more information, and clinical skills. Overall, they expressed a desire for the intervention to continue and recommended expansion to other medical professionals. Overreliance on the text messages, lack of effective self-study, and technical/language-based barriers may be potential explanations for intervention failure. As a form of mCME, daily text messages were well-received by community-level health care providers in Vietnam. This mCME approach appears very promising in low-resource environments or where traditional forms of CME are impractical. Future models might consider enhancements to foster linkages to relevant medical materials, improve interaction with medical experts, and tailor medical content to the daily activities of medical staff. © Sabin et al.

The management of HIV in pregnancy: A 10-year experience.

PubMed

Raffe, Sonia F; Savage, Charlotte; Perry, Louisa A; Patel, Amie; Keith, Tricia; Howell, Richard; Bradley, Robert; Bomont, Rob; Fidler, Katy; Gilleece, Yvonne

2017-03-01

The package of care to reduce HIV mother to child transmission (MTCT) has evolved significantly since trials of ante and intrapartum antiretroviral therapy (ART) in 1994. In the UK MTCT rate has fallen from 25.6% in the 1990s to 0.46%. We review the management of HIV in pregnancy in Brighton in the context of evolving guidelines. HIV, obstetric and neonatal notes of all HIV positive women, pregnant between 2003 and 2014, were reviewed. 97 pregnancies in 75 women were identified, resulting in 79 live births. Antenatal HIV diagnosis was made in 22 (28%). The proportion of pregnancies in those with known HIV at conception increased over the time period. At conception 58 (60%) were on ART, 33 (57%) of who continued on their original regimen. 34 (35%) initiated ART following conception: 14 known to be HIV positive, 20 diagnosed during pregnancy. Two did not start ART (1 due to miscarriage, 1 as diagnosed post-delivery) and in three cases ART history was unavailable due to transfer to alternative centres. ART was initiated on average at 22 weeks gestation (range 6-34). 4(5%) received Zidovudine (AZT) monotherapy, all before 2006. Choice of combination ART (cART) varied with time reflecting changing guidelines. Prior to 2008 an AZT containing regimen was used in 83% versus 8% after. Planned mode of delivery was documented in 73: 30(41%) planned a normal vaginal delivery (NVD), 43(59%) a caesarean section (CS). The viral load (VL) was <50copies/mL in 58(76%) at 36 weeks and 64(84%) at delivery. 90% with a detectable VL at 36 weeks delivered via CS. 100% received neonatal post-exposure prophylaxis (PEP): 68(88%) AZT monotherapy, 9(12%) cART. 84% initiated PEP within four hours. 90% completed 28days. 8(10%) babies experienced side effects. In the 10-year review period, one infant (1.3%) was diagnosed HIV positive. Both mother and infant received care in accordance with guidelines, including neonatal PEP within 4hours. Care of the HIV positive pregnant woman in Brighton has been successful with overall transmission consistent with that seen nationally. Despite effective preventative strategies MTCT remains a risk and women should be counselled accordingly. Copyright © 2017 Elsevier B.V. All rights reserved.

The Clinical Research Associate Retention Study: A Report From the Children's Oncology Group.

PubMed

Owens Pickle, Emily E; Borgerson, Dawn; Espirito-Santo, Anelise; Wigginton, Sabrina; Devine, Susan; Stork, Sue

Pediatric medicine often struggles to receive adequate research funding for its small, yet vulnerable population of patients. Remarkable discovery in pediatric oncology is credited in large part to the collaborative structure of its research community. The Children's Oncology Group conducts studies supported by the National Cancer Institute. The clinical research associate (CRA) discipline comprises professionals who support administrative duties, regulatory duties, subject management, and data collection at individual research sites. The purpose of this study was to identify factors associated with CRA retention, as the group continues to have high turnover and position vacancy. A cross-sectional survey design was used to characterize the most frequently cited reasons CRAs gave when considering leaving or staying within their position. Results suggest that low salary, unmanageable workload, lack of career advancement and professional development, and lack of research commitment from the medical team were associated with intent to leave CRA positions. The most frequently cited reasons for staying at their job were the meaningfulness and interest in the work, a supportive principal investigator, and enjoyment working with colleagues. CRAs reported serious but eminently solvable issues that can be addressed using practical and low-cost solutions to improve job satisfaction and retention.

Status of women microbiologists.

PubMed

Kashket, E R; Robbins, M L; Leive, L; Huang, A S

1974-02-08

The general picture that emerges from this study is that the woman microbiologist, upon entering the professional job market, faces (i) slower advancement; (ii) restricted extramural recognition; and (iii) fewer positions of a supervisory or administrative nature, when compared to men. Most striking is the salary differential, which increases with increasing educational level, with increasing rank, and with increasing seniority. From the beginning of her professional training, the woman microbiologist feels handicapped by lack of encouragement and proper role models. She generally receives little advice regarding her professional future and rarely feels pushed to take the most challenging position. Should she be married, she feels that her mobility is severely restricted. Even though the subjective nature of these feelings may be interpreted as projections of failure, subtle inducements for women to stay at lower levels may well exist, in addition to more objective measurements, such as lower salary levels and slower professional advancement. Despite these handicaps, professional women continue to work. As a group, they work for the same reasons that men do, they work as long and as hard as men do, and they remain at their positions as long as men do. Women and men rate themselves equally as to job performance, degree of independence, and publication rate. On the basis of this study, it should not be surprising that women professionals are less visible than men and that only a small proportion of women become what is considered successful by the usual external criteria. If women were to receive continued encouragement, scientific contact, and professional recognition at each stage of their professional lives, they would undoubtedly become more visible. The lack of encouragement and selfconfidence leading to isolation, which then leads to lack of recognition, is a vicious circle that must be broken for the woman professional. This can be done most easily for the beginning student. For older women, there must be increased placement in positions of responsibility and visibility. Protective practices that discourage women from entering arenas of competition can only be viewed as discrimination on the basis of sex, since women professionals are rarely given the choice between being protected and being independent. Unexpectedly, this study illustrates the lower status of another group of individuals who are considered deviants from the expected roles of the established society-single men with doctorates, who were found in the positions predominately filled by women. In conclusion, this study of a select group of scientists probably has general applicability to all women professionals in their roles vis-à-vis men. Examination and documentation of discriminatory practices based on sex points to the areas in which women must direct their demands for equality.